Method and system for detection of deviations in controlled environment

FIELD: method and system for controlling activity in controlled environment.

SUBSTANCE: method and system for controlling activity in controlled environment of public health care center allow, in real time scale, to form practically full and precise electronic report about servicing of patient and in real time scale provide access to information about estimation of servicing of patient, including detection of deviations from servicing procedure, realized in accordance to patient servicing schedule, and concerning actions related to servicing of patient. Schedule is renewed automatically or on basis of user data input, when on basis of accumulated information system takes decision, that event from schedule occurred or change in servicing of patient is necessary. When deviations from patient servicing schedule are detected, personnel is notified, and, on basis of character of deviations, patient servicing schedules are altered.

EFFECT: higher control quality.

2 cl, 3 dwg

This invention generally relates to a method and system designed to control activities in a controlled environment, and relates, in particular, the method and system of data collection activities in a controlled environment and processing of the collected activity data to provide real-time access to information about controlled activities and on implementation of the schedule of events, where this state is defined based on the assessment of controlled activities from the point of view of the criteria for the schedule of events.

In the hospital important is the ability to control the actions related to operational processes, such as planning pass flow of patients through the diagnostic or treatment rooms, as well as events related to the treatment of patients. With precise and complete control of such activities can be undertaken, to ensure that the appropriate steps for treatment and care are carried out properly and within the specified timeframe. In addition, the movement of patients and staff, interaction between patients and staff, as well as steps for treatment and care taken in relation to the patient, can better be managed and monitored.

If the current control activity will be performed manually, e.g. by the ode of information in the terminal with keyboard, the desired level of control will most likely not be achieved. When the health worker enters the information manually, he may not remember or do not enter the actual time when the event occurred. If the entry action for the treatment of the patient is not accurate, then the selected action may not be performed in proper sequence relative to other events of the treatment process, which prevents the comparison and evaluation of the events of the treatment process in a rapidly changing environment of health care.

When rendering emergency care at the hospital of the control activities performed in the treatment of associated with or provided by a person who has clinical expertise and knowledgeable in matters of operational management and business, i.e. specialist with combined clinical and operational functions. This operating personnel with combined functions includes, for example, specialist-a nurse who has special training in health care, is a clinical specialist in the application of practical skills, based on symptoms, and is responsible to the senior hospital management for the achievement of high-quality and effective from the point of view of the cost of the treatment of patients with large population, patients usually have such diagnoses as Insa is before, the blockage of the heart, respiratory failure, myocardial infarction, and pneumonia. Other members of staff with a combined clinical and operational functions may include managing Directors of departments, schedules, statements, hospitalists, specialists, intensive care and senior health workers. If the actions performed by personnel with combined functions or associated, controlled accurately and completely, the information collected regarding treatment, can be used as this staff and others to establish quality criteria and goals in relation to clinical and financial prospects, future growth and meet the needs of patients.

In addition, when the control treatment, provided the patient can be better assessed the progress of treatment associated with the maintenance schedule of the patient, which is usually followed by practical guidelines for clinical care. The maintenance schedule of the patient essentially asks for the patient's schedule of events, which is determined on the basis of guidelines on health services developed by various professional associations and associations of staff and hospitals. Guidelines are usually based on the best available data by preventing the idenau, diagnosis, prognostication, treatment, and prevention of harm, such as negative side effects, and profitability. One form of maintenance schedule of the patient, known as the course of clinical care, helps clinicians when making decisions by setting practical issues and determine solutions and probable outcomes. Schedule of events for course maintenance may decide, for example, specific health problems or diagnosis and to require the collection of the following clinical information: the patient's name and time of admission; assessment of the patient's condition, such as diagnosis, time, and guidance of the operator; studies that must be performed and which have been fulfilled and the appropriate time; the results of research and their dates; dates and descriptions of planned and executed by the operating personnel procedures; re-evaluation or assessment of the patient, indexed in accordance with the specified diagnosis time and the serving entity; and time of discharge or transfer. It was found that taking into account clinical opinion of the operator, as well as estimates and expectations of the patient when providing patient treatment in accordance with the schedule leads to improved and cost-effective results.

Another advantage of the full-time and full control activities, associated with treatment and operational processes, is that the risk of claims relating to treatment, and the cost can be reduced. Since is constant and irrefutable record of events that occurred, doubt that the events really happened, can no longer occur and this issue could not be raised.

In addition, accurate and complete control of treatment and prompt action can help meet regulatory requirements, and in some circumstances required for this. Existing and developing standards require hospitals efforts to improve, for example, clinical indicators. These information criteria of quality are used in the process of accreditation of hospitals and provide standardization of the performance of different hospitals, thereby allowing an assessment of the indicators within hospitals and between hospitals. Clinical criteria which must be monitored for regulatory purposes include criteria that (i) are designed to assess the processes or outcomes of care related to the provision of clinical services; (ii) allow comparison within the organization and between organizations used for continuous improvement of results of treatment of patie is tov; (iii) allow you to pay attention to the appropriateness of clinical decision-making and implementation, and (iv) relate to the important functions of the health of the patient, for example the use of medication, infection control, assessment, etc.

In addition, accurate and complete monitoring activities associated with the sequence of events of treatment and operational process that occur in connection with the medical care of the patient, can make more efficient allocation of resources, personnel and equipment.

Therefore, there is an urgent need to incorporate a comprehensive system for monitoring one or more of the following features or functions: the collection of accurate, complete and irrefutable data characterizing controlled actions regarding treatment and operational processes; determining the progress of the maintenance schedule of the patient; the notice of the operator about the danger, when the course of treatment the patient does not meet the schedule, in other words, deviates from the maintenance schedule of the patient; regulatory requirements; reduction in the risk of litigation; creating accessible real-time Protocol events that occurred, including the location of the operator and the patient, indicating the time the Yeni; tracking and modeling resource usage, monitoring the work of the staff and reducing staff the documentation.

Although the systems that rely on logistics for collecting and processing data about any activity, exist in sectors such as warehousing and wholesale trade, there is no comprehensive system for monitoring tasks facing the people, and to interact with the controlled patients in a controlled environment specifically designed for the needs of institutions is a medical emergency.

In addition, modern technology control activities in health care facilities is not quite satisfactory, because it does not provide accurate and complete collection of information about medical care in real time on the basis of which can be performed with the evaluation of medical service in real time. Modern technology also does not work in real time or identification of action for treatment, which would provide real-time detection of deviations from schedule of treatment of the patient based on the control treatment action in real time. In U.S. patent No. 5991730 included in this description by reference, describes, for example, the equipment for the following is to be placed behind the patient, which tracks the location of the patient, detecting the movement of patient among cells to store, located in a medical facility. Information collected and depending on location, is a low-level information, which does not allow to evaluate the service in real time and to perform real-time operations and maintenance, based on this evaluation. This information generally cannot be used to generate timely alerts about the need to treat the action as the evaluation of the events from the point of view of their compliance with the maintenance schedule of the patient is not performed in real time.

Similarly, although there are many known technologies that provide control information associated with the maintenance schedules of the patient, and documentation, such technologies do not include the ability to evaluate the information collected in real time in connection with treatment guidelines that would improve patient care, including the reasons or tips for action in real time. For example, in U.S. patent No. 6230142 included in this description by reference, describes a system that allows the maintenance person to record and analyze data ku the sa treatment, to do a chronological comparison, such as identifying trends in data, and to provide for tracking and documenting the results of medical care after the actual implementation. In addition, U.S. patent No. 5953704 and No. 5583758 included in this description by reference, describes systems that staff uses offline in order to perform a comparison between the proposed and actual ways of medical care and their results. In U.S. patent No. 5740800 included in this description by reference, describes an information system for managing treatment, which on the basis of input by the servicing entity data helps in choosing the correct assignment of patients served. In U.S. patent No. 5946659 included in this description by reference, describes a system that provides simultaneous input from multiple users about the deviation from the course of treatment, and in U.S. patent No. 5785530 included in this description by reference, describes a system used for three-dimensional visualization courses of treatment. The above-mentioned patents, offering the processing of data on the clinical service, do not contain the ability to use the information collected to assess the progress of treatment in comparison with the criteria of the schedule of the patient in real the m-time and to perform or request certain therapeutic actions in real time on the basis of this evaluation.

In U.S. patent No. 5960085 describes a system that allows the patient or serving his face access to confidential patient information when it detects the computer system of electronic identification cards. This system, improving access to protected data, also does not use the information collected for the evaluation of medical services in real time and does not provide treatment action in real time, based on these estimates.

One of the systems management health care facility currently marketed by the firm Versus Technology, Inc. The system uses infrared/radio frequency technology to provide real-time continuous information about the location of people and equipment when they move around the facility. Every person or piece of equipment are transmitting tag with a unique ID. Data is collected in passive mode, to provide information about the condition of the premises, the equipment used for this patient, and the presence and frequency of communication between patient and staff. Moving patients is facilitated by directing them to available places research and analysis. Instantly received information about the start and duration of the procedures allows the institution is to planirovati them in advance. Time spent on patient service person is registered as a given procedure. This data is used for reports, in particular, conform to the standards of the joint Commission on accreditation of healthcare facilities (JCAHO). Some of the reports contain "tracking Log", which describes in detail the movement of a person or piece of equipment at the facility, including identification of each premises at which they fall, the time of arrival and the service and the total time spent in each room. The report "Time spent together" shows how much time different people or equipment held together in a certain location for a certain period of time. These data can be used for billing or auditor. Although the mechanism of formation of reports on the time spent together, not stated, apparently, revealed the presence of two people/devices in the same room during the total time interval, and is not registered with the direct signal rapprochement between these two objects, see http://www.versustech.com.

The interaction between two objects, such as man and piece of equipment within health care facilities is also involved Axcess Inc. Using the technique of marking radio-frequency IU the kami, the system provides a means of tracking and locating assets within their institutions on request, the status of the equipment and inventory, location of personnel and the protection of assets from unauthorized removal from the chamber or institution. The latter is achieved by the supply of label for each piece of equipment. When the equipment is approaching the exit door or other restricted area, the label is identified and can be sent to the appropriate alarm signal. Label staff can be linked through the software with certain funds or some type of equipment, with a given dependency to allow free movement of the equipment only when it is accompanied by a duly authorised person. The system is programmed to cancel an alarm signal when the identified location of the subject equipment and authorized persons are the same. <http://www.axsi.com/whitepapers/wp_health.shtml>.

U.S. patent No. 6154139 relates to a method and system for locating objects within a controlled environment, such as health care institution. Staff (e.g., patients and staff) is supplied by sending a label that is passed as an infrared identifying signal (spread is audica within line of sight), and radio frequency identification signal (extending beyond line of sight). The infrared signal is effective to locate with any degree of accuracy. However, because it requires line of sight, it cannot be used to locate personnel in such areas, where the infrared receivers are not posted. In this case, the wireless signal can reach the radio frequency receiver within a certain distance, even through walls. So, if the patient presses the emergency call button from the bathroom, RF receiver transmits this signal to the Central processor that can determine the location of the patient through the last received IR signal (for example, from the corridor outside the bathroom).

U.S. patent No. 6211790 concerns a system for comparing parent-child-based dual-band infrared/radio transmitter attached to the bracelet worn by the mother, and in the leg and/or wrist bracelet, worn on the child. In the mapping mode infrared signals, infrared receivers located in different areas of the hospital to accurately and automatically determine their approximate location that the mother and child combined correctly. In the mode of detecting the presence of radio the frequency signals from the tag of the child are detected radio frequency receivers, distributed in the maternity ward of the hospital or even throughout the hospital. Mode security RF receivers located near exits from the maternity Department and/or hospital, detect RF signals from the foot bracelet and a signal for announcing the alarm.

In the above patents, there is a common idea of creating a system for tracking the movement and location of staff and to determine the joint presence of two people based on what they found in the same place during overlapping periods of time. This information is used for billing and for control of past events. However, these systems have only limited use as they do not provide real-time updates of the status of the maintenance schedule of the patient or deviations from expected events, which would be based on the schedule of the patient. In addition, according to these patents alarms can be filed under the incorrect Association or, on the contrary, the separation of two people or a person and an object. Although these alarm systems are useful for security purposes, they do not address issues of patient care in real time, which are interactive and dynamic.

The fit is accordance with this invention offers a method and system monitoring activities in a controlled environment. This system collects activity data, preferably in real time, and automatically processes the collected data in real time to evaluate and update the status of the schedule of events that includes an assessment of whether they were implemented schedule events based on predefined criteria, schedules, and providing access to information about the status of the schedule, which includes the identification of the detected deviations from the schedule of events, as well as information about controlled activities in real-time and archive search. In the preferred form of the invention, the controlled environment is a health care facility; controlled activities include events treatment and operational management, such as physiological measurements, location of patients and staff, information about close location to each other of the patient, operator and medical equipment, and the confirmation of the transactions or interactions between the service provider entity and a specific patient; and the schedule is the schedule of events for the care of a patient, such as the course of clinical care, including events treatment and operative management process that maintains a person chooses for the patient, and C is the previously defined criteria, used to detect deviations from the planned schedule of events.

In the preferred form of the invention, the system includes a controller associated with the sensor via a wireless, wired or a combination wired and wireless network, identification label, the apparatus for monitoring physiological parameters, as well as mobile or stationary interfaces, each of which is located within a controlled environment. Each label is either an active device such as an infrared or radio frequency transceiver automatically transmits signals encoded identification data, or a passive device such as a radio frequency defendant or read in the infrared range of the bar code, which, when receiving the request signal, respectively, from radio frequency or infrared source, reflect back signals encoded identification data, or is a combined active and passive device. Labels can be placed directly on the patients, support persons or in their vicinity and can be fastened in a stationary or mobile diagnostic or dispensing medication the equipment. The output control apparatus associated with the medical diagnostic or shortly after the first equipment or with existing data networks, to which the medical equipment has already been connected. In addition, the control apparatus includes a transmitter that with time coding passes in the controller signals the activity data representing a physiological condition, such as the main indicators of the condition of the body, which are measured medical or diagnostic equipment, as well as the identity operator, operating medical equipment, and identification data of the monitored patient. The interfaces in the preferred case contain graphic display, manual or voice input information, and transmitting the device, preferably at a constant wired or optical data line, receives from the controller control signals and transmits to the controller a signal containing activity data and other data, such as commands to change the maintenance schedule for a patient entered manually by the operating personnel. Sensors are transceivers signals that detect infrared and/or radio frequency signals encoded identification data and transmit to the controller, also preferably at a constant wire line, digital signals activity data representing the detected signals ID manually is kationnyh data. Preferably, the sensors are arranged in predetermined key locations throughout a controlled environment to ensure complete and accurate control. In the preferred form of the invention, the collected activity data represent the interaction of infrared or radio frequency signals between the sensor and the identification tag of the patient or the operator or between identification label patient identification label of the operator.

The controller is a microprocessor that executes predefined or user-editable program stored in its internal memory, collects activity data transmitted from the controlled environment, and also processes and stores data about the activity. In the preferred case, the controller processes the collected data in accordance with the schedule of events for the care of a patient to decide whether it was an event specified in the schedule, and accordingly updates the schedule, preferably after receiving confirmation from the operator. In the preferred form of the invention, the serving entity, such as a doctor, communicates with the controller through an interface to select the type and degree of control actions undertaken against the AI a specific patient. Based on the collected activity data, the controller generates and stores in its storage device indexed by time report about the location of patients and staff, about the close location of the patient and the operator, patient and equipment, and maintenance persons and equipment, as well as events medical services performed or occurring in relation to the patient. Next, the controller makes information regarding controlled conditions and the schedule of events for the patient based on the collected activity data available in real time.

In the preferred form of the invention, the controller decides whether it was an event from the schedule, defining the information collected was serving a person near the patient during a specified time interval.

In another preferred form of the invention, the schedule contains the duration and criteria of interaction with which the controller compares the collected information to decide whether it was an event from the schedule. The controller concludes that the event from the schedule occurred, if the information about the approximate location for the operator indicates that the service person was found on odashima in the same area, as a patient in a predetermined time interval that the data of physiological measurements associated with the patient, were also collected specific service person during this time interval, and measurement data representing the main indicators of the condition of the body, are within predetermined acceptable levels. It should be clear that "zone" can be defined appropriately as a specific room or even area within the premises, such as a small area around the bed of the patient.

In the preferred form of the invention, the controller continuously evaluates criteria schedules to determine that indicates whether the collected information about the deviation of service provided to the patient, from the requirements of the schedule of the event service. If the deviation is detected, the controller causes the interface to generate an audible or optical alarm signal to force the staff to perform additional operations and maintenance, which would eliminate or offset the deviation. In another form of the invention, if a predetermined deviation, the controller changes the schedule of the patient with the requirement of confirmation from the operator or without it.

Other objectives and advantages of this is subramania will be apparent from the following detailed description of preferred forms of its implementation, with the attached drawings, on which:

Figure 1 shows a block diagram of a system for collecting activity data in a controlled environment and to process the collected data in accordance with one form of embodiment of the invention.

Figure 2 shows the block diagram of the system controller shown in figure 1, in accordance with one form of embodiment of the invention.

Figure 3 shows the block diagram of the algorithm for processing the activity data collected is shown in figure 1 the system in relation to the schedule of the patient, in accordance with one form of embodiment of the invention.

Figure 1 shows the block diagram of the system 10 control activities in a controlled environment health facilities, in accordance with the preferred form of the present invention. The system 10 is automated, universal and electronic base system (platform) control for health care facilities, which is a combined wired and wireless network and uses the technique of locating and positioning with the use of infrared and radio frequency radiation, as well as technical knowledge about the physiological measurements to obtain, preferably with data collection in real time with the ability to search for information, evaluation information on the status and dormancy is the result of the medical care of a patient in real time, as well as recording locations of the operator, the patient and medical equipment and events treatment and operational process performed or occurring in a controlled environment. Although the invention is described in detail in connection with the control activities in the health facility, it should be clear that the activity in other environments, such as industrial or commercial environment, also can be controlled in accordance with this invention, to obtain the accessible real-time information regarding the activities and performance of this activity related to the schedule of events specific to these environments.

As shown in figure 1, the system 10 includes a controller 12 connected wired or wireless data transmission from the sensors 14; wearable wireless identification tag 16 of the operator; wearable wireless identification tag 18 of the patient; a wireless mobile transmitter 19 speech data; medical equipment 20 diagnostic and control interface 21. Components of the system 10, excluding or including the controller 12, are within a controlled environment, ensuring the collection system 10, preferably passively, automatically and in real-time, activity data characterizing the event of treatment and operational process, PR is outgoing or performed in a controlled environment.

Labels 16 and 18 represent blocks of active infrared transceivers, which are automatically emit infrared signals identification data encoded in digital form, with a given amplitude, which identify the source signal. Alternatively, the label 16 and 18 are RF or combined RF/IR transceiver blocks that automatically emit infrared or infrared and radio frequency identification data signals, respectively, see U.S. patent No. 6154139 and application WO 01/33748 included in this description by reference. In another form of the invention, the label includes scanned in the infrared range of the bar code or radio frequency defendant, who at the request accordingly infrared or radio frequency source, such as another label or one of the sensors 14, reflects back a signal identification data, preferably in the direction of the source of the request.

The transmitter 19 is a conventional voice-activated device, speech recognition, which detects and processes the speech signals to generate the corresponding speech data. The transmitter 19 also includes a radio frequency or infrared transmission unit for generating and transmitting encoded in the a or the form of a radio frequency or infrared signals of the speech data, based on verbal information.

Each sensor 14 includes a transceiver for transmitting radio frequency or infrared requesting signals and for receiving infrared or radio frequency identification data signals and may signal the speech data. In addition, each sensor 14 includes a block of digital signal processing components and electrical or optical signals, intended for generation and transmission in the controller 12 of the encoded digital signal activity data based on the detected signals by electrical or fiber-optic data lines, or of combined electrical and optical line 13. The signal activity data are encoded to indicate the time of transmission by the sensor 14, and the detected location and identification data of the operator, patient or transmitter 19 speech data, which is the source of activity data. The sensors 14 are positioned in key locations or zones 15A, 15C, 15C, 15D, etc. controlled environment of the hospital, such as walkways, entrances to the chamber and/or the outputs of the wards, treatment rooms, special rooms, beds, patients, etc. to ensure accurate and complete real-time tracking of the location and movement of patients and serving the living staff as well as medical and diagnostic equipment.

In the preferred form of the invention, the sensor 14 transmits the radio frequency signals or infrared range, in order to interrogate the passive tag and processes the reflected signals of the query, which form the coded signals of the identification data to generate activity data representing the location and identification data of the requested label. In another form of the invention, the echo request contains encrypted data that identifies the label that is the source of the request signal, and the sensor includes these identification data source activity data transmitted to the controller.

In another preferred form of the invention, described in detail below with reference to figure 3, the system 10 uses the information about the approximate location of the patient and the operator in relation to each other, resulting from the interaction of signals between the sensors and labels in accordance with known methods, to assess whether performed some actions that are specified for the care of a patient. For example, in the system supplied to the market Versus Technologies, Inc., the close location of the operator and the patient is determined by comparing data about the place is agodini and time to find them overlap, indicating location close during this time of overlap.

Medical control apparatus 20 contains a block of collecting physiological data, such as a conventional digital signal processing and storage device. The unit is connected to the data output port of the medical equipment (not shown) or to an existing permanent wired data network that is attached to the data port of the medical equipment. The unit detects the existing identification data that identifies the patient, the servicing entity and equipment, as well as physiological output, such as digital data representing the level of blood oxygen saturation at the output of the pulse oxigenate. Then the unit converts the detected data into digital signals activity data with time coding, which include physiological data and identify service person, medical equipment and patient corresponding to these physiological data. In addition, the control apparatus 20 includes a transmitter, which transmits digital signals to the activity data to the controller 12 essentially in real time on line 13, which passes between the apparatus 20 and the controller 12.

The interface 21 predpochtitelney a graphical display based on a microprocessor, such as a flat screen monitor that includes an input device such as a keyboard or keypad. The interface contains 21 unit radio frequency transceiver that transmits to the controller 12 encoded in digital form RF signals activity data based on the data, which introduces a whole person in relation to the event service, such as data indicating the handling of the person appointed to patient treatment at a certain time. In addition, the interface 21 receives radio frequency signals transmitted by the controller 12 and the feed command interface 21, for example, to display text data or to get attached or built-signal device or the light source of sound or light signal, respectively. In the preferred form of the invention, the interface 21 transmits control signals on the basis of input by the servicing entity data, to modify the schedule of the event service, which performs the system 10 in order to serve the patient. In the preferred form of the invention, the interface 21 is a pocket computer or input device on the basis of the keypad and contains an infrared bar code reader, the reader denigration identification or device for reading smart cards. In another preferred form of the invention, the interface 21 is connected to a wired local area network to which are connected all components of the system 10, except for the identification labels staff and patients.

The system may also allow the control apparatus 20 to communicate with other information systems of the hospital, such as information system laboratory, in which data is entered, for example, manually or with a barcode, using the known commercial technology interaction, such as XML (extensible markup language) and HL7 (national standard for the exchange of health data in electronic Health Level 7). The control apparatus 20 must be programmed to control the selected data transmitted by such systems, and to transmit copies of such data to the controller 12.

In the preferred form of the invention, the system 10 is fully wireless network covering all hospital institution, and control of physiological measurements of the patient continuously, regardless of its location, and also controls the location of patients and staff on the basis of the identification data signals generated by the interaction of radio frequency or infrared signals between what atikom and mark or between the label of the patient and the label of the operator.

As shown in figure 2, the controller 12 contains modules that execute programs to perform the functions of control activities in a controlled environment health facilities in accordance with this invention. It should be clear that each of the modules in the controller 12, which is described below as performing data processing operations, is a software module or, alternatively, a hardware module or a combined module hardware/software. In addition, each of the controller modules 12, respectively, contains a memory storage device such as random access memory, for storing data and commands for performing data processing operations in accordance with the invention. Alternatively, a command to perform data processing operations may be stored in hardware in one or more modules in the controller 12.

In accordance with the preferred form of the invention, the system 10 collects, preferably passively, automatically and in real-time activity data relating to the location and proximity of the patient and the operator, as well as events and measurements that are performed or occur that are associated with events schedule patient care, including the events of the course of clinical care, and creates from the data collected about the activities essentially complete and continuously updated report about the maintenance of the patient, which is available in real time.

As shown in figure 2, the controller 12 includes a processor module 22 connected to the module 24 controls the measuring module 26, the tracking module 28 schedule of the patient and the module 30 selection/display of information.

Module 24 control contains a receiver unit for receiving coded digital signals of activity data that is transferred via electrical or optical signals transmitted via the respective conductive lines of the data passing between the controller 12 and signal sources, such as the control apparatus 20 and the sensors 14. Further, the receiver unit may receive radio frequency and infrared signals activity data transmitted from a controlled environment. Module 24 retrieves data about the activity of carrying their signals and then transmits the data on activity in the processor 22. The processor 22 based on the information identifying the source and location of encoded together with the activity data, selectively directs the activity data associated with the labels of the patient or operator, respectively, the module 27 tracking patient or module 29 tracking services the surrounding face in the measuring module 26. The modules 27 and 29, respectively processes the received activity data, to create an indexed time record of the location of the patient and the operator in the controlled environment of the hospital, and stores these indexed records in their respective storage devices. In the preferred form of the invention, the modules 27 and 29 define the location of the patient and the operator, based on the identification information of the sensors, which are sources of signaling activity data, or using triangulation or other methods of determining location of an object as seen from different sides.

In addition, the CPU 22 detects the activity data source to which the apparatus 20 and the transmitter 19, and directs such activity data in the measuring module 26. Module 26 processes and then stores in its storage device such activity data in the form of a Protocol, indexed by source and time, with cross-references to patient and service person when possible. As part of the data processing module 26 converts the activity data representing voice data into a form suitable for storage, retrieval and processing by other modules of the controller 12.

Arr is time again to figure 2. The module 30 includes a transceiver unit, preferably with the possibility of receiving and transmitting radio frequency, optical or electrical signals, which facilitates the exchange of data between the controller 12 and the interface 21. For example, the module 30 may send to the interface 21, the signals data management that make the interface 21 generate an acoustic alarm or display a message on the screen requesting additional information from the operator. In addition, the module 30 may receive from the interface 21 activity data and instructions regarding the details of the schedule that should be used for a particular patient.

Module 28 contains in its memory a predetermined computer programs that comprise the schedule of events for patients. Service person such as a doctor, selects or changes using the interface 21 existing schedule for a particular patient. Module 28 executes the selected program to execute, in accordance with the selected schedule patient, continuous assessment of whether, scheduled events, whether you want them to do, etc. Module 28 executes the program in the presence of selectable processor 22 indexed by time records about the location of patients and staff, located close the ogenyi patient and operator and other activity data, concerning the patient, of the modules 26, 27 and 29, if such data are available.

As shown in figure 3, in the preferred form of the invention, the system 10 performs the steps shown in the example process 50, which provides real-time assessment of the implementation schedule of events for the patient in the hospital environment, the act on medical care in real time on the basis of an assessment of the schedule in real time and documentation of activities related to schedule and hospital organizational processes in General. The system 10 essentially in real time, determines deviations from maintenance schedules patients and generates a warning signal for the correction and notify staff about the deviations. As shown in figure 2 and 3, the module 28 retrieves from the appropriate modules 27 and 29 through the processor 22 indexed by time records on the location of the patient and associated with the servicing entity and the location of the patient and the operator in close proximity to one another, as well as information about the results of the physiological measurements from the module 26. These records are obtained from representing their identification data signals generated by the labels 16 and 18, or against them; signals speech data transmitted by the transmitter 19, alarms activity data transmitted by the apparatus 20, when they are suitable for this purpose. The module 28 is continuously evaluates the recorded activity data, comparing them with events included in the selected schedule of the patient. Module 28 evaluates the recorded data based on the schedule of events and associated criteria, events, and real-time interprets the activity data in the context of the events schedule, to detect deviations from this schedule. Module 30 displays the deviation of the interface 21 for staff. Module 28 updates the status indicators or changes the schedule on the basis of the assessments, including the detected deviation. In the preferred form of the invention, if the detected deviation, the module changes the schedule only after serving the person using the interface to confirm that the change in the schedule is correct.

The process 50 is illustrated below by the example of a maintenance schedule, which is assigned to the patient arriving in the emergency room urgent care hospital with complaints of chest pain. Once the patient is hospitalized, the doctor admissions Department diagnoses of the patient to determine what schedule course maintenance should follow the patient. As shown in figure 3, at step 52, the doctor using the interface 21 of interaction the Central controller communicates with the controller 12, to select or define a schedule for the patient. Chosen for this patient schedule then identified and, if necessary, is stored in the storage module 28. The schedule includes pre-defined or user-editable events, as well as criteria evidence and solutions used to evaluate the progress of treatment and implementation schedule events. The schedule can also be edited at any time by the servicing entity through an interface 21, or by the module 28 without human intervention, as described below.

In the preferred form of the invention, the content of the schedule includes events that must occur, and their descriptions or steps that should be taken in respect of a patient or group of patients. For example, a schedule may contain a set of partially ordered events, possibly including requirements relating to time and specified criteria confirm each event. Some events may include solutions based on continuously received activity data, such as physiological data measurements, and therefore, the schedule can optionally contain criteria decision making. The status of the schedule is based on events that occurred, the decisions taken by the system 10, together with information about the de who work, related to solutions, and perhaps some other relevant data.

In step 54, the module 24 controls continuously receives signals activity data from a controlled environment, remove them from the activity data, and then transmits the extracted data to the processor 22. For example, when the doctor labeled 16 moves the received patient with the mark 18 in the area of diagnostics, designated as 15A, the sensor 14 in the zone 15A detects RF signals identification data, which is continuously or almost continuously transmit labels 16 and 18. The sensor 14 in turn generates and transmits signals to the activity data, indicates that the physician and patient, which issued the labels 16 and 18, respectively, were found near each other in the zone 15A at a certain time. Information about the approximate location continues to be generated and transmitted to the module 24, while the doctor removes the electrocardiogram, which is controlled by the control apparatus 20. The control apparatus 20 transmits data signals on the activities, which preferably include the identity of the doctor and the patient, as well as the main indicators of the condition of the body defined by the electrocardiogram and having the same data timestamp, and information about the approximate location that the sensor 14 in the zone 15A PE edit against the doctor and the patient, detected simultaneously in the zone 15A. When the doctor leaves the room 15A and fades into the distance of more than 3 m from the sensor 14, while the patient remains in the premises 15A, the sensor 14 in the premises 15A no longer detects radio frequency signals transmitted by the label 18, and therefore no longer sends activity data representing information on the approximate location.

As part of step 54, the processor 22 sends activity data, respectively, in the measuring module 26 and its modules 27 and 29. The modules 26, 27 and 29, in turn, process the activity data to create a record, indexed by time, patient, service person, location of the patient and the operator and their approximate location, if this is the case, and writes such indexed data in a storage device.

In the preferred form of the invention, where the sensors 12 passively and automatically collect information regarding the location of patients and staff and event services performed or associated with patients creates irrefutable electronic report about the service of the patient. The report cannot be questioned, because in its production are not used for human decisions or actions, such as manual recording time in Notepad or a manual BP is like in the computer. This form of control activity improves the use of resources and helps in the process of certification of health facilities.

Other modules in the controller 12, such as modules 28 or 30, preferably can get real-time access to data records stored in the module 26, which contains the modules 27 and 29.

In the preferred form of the invention, the processor 22 may perform the extraction and processing records stored in the module 26, offline, in other words, not in real time, for the preparation of reports relating to, for example, mapping patients, the ordering of the data, results management, quality assessment, view resource usage and details of the hospitalization of patients, such as tracking patients, the final Fund management and scheduling. For example, the processor 22 may use the activity data to generate questions for the automated billing, which has the following content: "Dr. Smith, pulmonologist, was placed near the patient Jones, pulmonary insufficiency, for 37 minutes today, starting at 09:32. Whether it was paid to consult a pulmonologist?".

In step 56, the processor 22 is continuously searches for and evaluation of records stored in the module 26 to determine whether registered iravani new activity data associated with an individual patient. If Yes, then the CPU 22 transmits the detected new data records in the module 28.

In the preferred form of the invention, the processor 22 effectively filters the collected records regarding a particular patient, passing the module 28 only new data records relating to staff, which was discovered near the patient, and noted as a possible staff for the patient in accordance with the schedule of events for this patient. Thus, the module 28 evaluates and treats only the activity data obtained from a controlled environment, which are relevant to the schedule selected for the individual patient. The processor 22 does not transmit module 28 activity data taken in the module 24 and stored in the module 26 that are not relevant to a particular patient and his schedule, such as the accidental presence of a pediatrician about the patient for whom the planned open heart surgery, during transfer of the patient to the operating room.

In step 58, the module 28 determines relate to whether the registered activity data transmitted by the processor 22, events, or decisions from the schedule. For example, an event may include the main indicators of the condition of the body that nurse, variety is the dominant accept patients, writes to the interface 21; care of the patient from the zone to the expectations that the system 10 passively detects and records; inspection of the patient by the nurse, which she registers by pressing the alarm on the tag 18 of the patient; examination of the patient by the physician who is logged when the sensor 14 detects a doctor in the chamber 15A of the patient, if the doctor confirms the appointment and diagnosis using the interface 21 after the withdrawal of his request; taking blood samples of the patient in the laboratory, which is registered on the basis of the detection of the location of the patient and nurses laboratory assistant, scanning the label 18 patient RFID reader connected to the interface 21; and leave the patient nurse medication prescribed by a physician, nurse registers using the interface 21, by scanning the label 16 and a label containing a bar code attached to the bottle of medicine.

If the module 28 determines that the registered data are consistent with the event specified in the schedule, the module 28 in step 60 checks this decision by comparing the activity data associated with the event, with the criteria confirm that the event actually occurred. In the preferred form of the invention, the system 10 verifies the validity of the event, using the information about the approximate location of the PAC is enta and operator, stored in the module 29. For example, a specific event can be identified, if the information about the approximate location indicates that the selected service person was found within a specified distance from the patient, for which the maintenance person must provide medical care within a specified time interval.

Information about the approximate location used in step 60, in the preferred form of the invention is based on activity data obtained using RF and/or infrared technologies to determine location, which establish the exact location of the patient and the operator. For example, in step 58, the module 28 may determine that the received information, namely information about the approximate location of the patient, the ECG machine and the doctor is associated with an event of withdrawal of an electrocardiogram. These data are compared with the criteria of the event from the schedule (for example, requiring that an electrocardiogram was taken until 4 o'clock in the afternoon on a specified day) and thus validated. However, as the joint location of the patient, physician and electrocardiograph sometimes happens accidentally, the schedule sets that need confirmation from the doctor. So on his pocket computer displays a message asking for confirmed what. After confirming the authenticity of the event finally certify, and record the condition of the patient is updated.

Alternatively, in step 58, the module 28 may determine whether the scheduled event of withdrawal of an electrocardiogram of the patient based on the information on the main indicators of body condition on the electrocardiogram, which is marked with the name of the patient and transmitted to the control apparatus 20. The schedule requires, in order to verify that the electrocardiogram was taken, we used information on the approximate location. Therefore, at step 60, the module 28 performs the search and evaluation of data close to the location relating to the patient to confirm that the event measuring electrocardiogram was for this patient. For example, the module 28 evaluates information about close location to determine whether information electrocardiogram on the main indicators of the condition of the body actually transferred at the same time, when the doctor and the patient were present in the room, which was passed this information electrocardiogram.

In an alternative form of the invention, the module 28 based on the records on the location of the patient stored in the module 26 checks the authenticity of the event of withdrawal of an electrocardiogram of the patient, setting, action is positive if the patient went into a particular diagnostic study hospital, remained there for the required period of time and then left. A record of the location of the patient is extracted, for example, from activity data generated by the sensor placed at the entrance of the diagnostic study, scanning an identifying label read with infrared bar code attached to the wrist of the patient or to a truck bed to the gurney. Module 28 then processes this information and makes a decision, without human intervention, or at least with subsequent requests to confirm the person on the interface 21, which was completed procedure associated with the given location, namely the electrocardiogram, which was designated as the next step is not yet completed before the end of the maintenance schedule.

If the module 28 in step 58 determines that the registered data requires a decision, then in step 62 it evaluates these data to decide for example whether and how it should be updated schedule or should there be filed with the alarm using the interface 21. For example, criteria for decision-making regarding the event from the schedule may require module 28 continuous assessment of information on several key indicators of the state of the patient, such as blood pressure, oxygen levels in the blood and astate heartbeat. If the main indicators of the condition of the body fall into undesirable ranges established in accordance with the criteria of the schedule, the module 28 will determine whether deviations from scheduled events and, preferably, to modify the course of the service according to the schedule, to require the immediate services of the staff.

Most often, the system and schedule are updated when interacting with the nursing person. For example, the physician, using a Central control system patients can choose the correct continuation of the maintenance schedule for the patient based on the parameters that he observes in the Central control system of the hospital. He enters the selection into the system, for example, with its interface in the form of a pocket computer. As the data is entered directly by the physician, the system knows that there is no additional confirmation is not required, and the schedule is selected and subsequently tracked the correct continuation.

When the schedule is changed, it may include additional events that should be performed in a situation of emergency services, such as the use of electric shock in the case when the electrocardiogram indicates a certain irregularity of the heart rate of the patient. Follow the consequently, the module 28 will evaluate the record of the monitored activity to determine whether there was such an event.

In the preferred form of the invention, the module 28 after adoption at step 62 solutions that require immediate service, sends control signals to the module 30 to force the interface 21 to generate audible and visual alarms to alert staff about the urgency of the situation. In the preferred form of the invention, the module 28 causes the system 10 to generate alarm signals, for example, using sound or light indicators on the interface 21, when there is a discrepancy between those events that must be executed according to the schedule, and those that actually occurred. For example, the audio alert can be generated at the interface 21 in the room nurses if the patient remains in the room for too long period and this event is identified as a deviation from the normalized time of action and the expected durations shown in the schedule. In another form of the invention, the physician interacts with the system 10 through an interface 21 to change the remaining schedule events that must be performed by the module 28.

Thus, the system 10 detects off the indicators in real time and therefore has the advantage, allow it to inform the staff using the interface on the necessity of implementation of priority actions, which improves the result of the maintenance or prevent negative consequences for the individual patient. In addition, the module 28 stores the detailed report the variances to allow a retrospective study of their causes.

In step 64, the module 28 determines does the schedule to the decision or event, certified by the module 28 based on certain recorded data was confirmed using other data. If the schedule requires the verification module 28 in step 66 transmits the control signal to the module 30 of the display, which, in turn, causes the generation of a query asking for confirmation on the interface 21. The request requires the operator to confirm, for example, decision module 28 decision that the basic health indicators of the state of the patient improved so much that the dosage and types of prescription drugs can be replaced with new. Based on the response of the operator, which may be restricted options "Yes" or "No", the module 28 in step 68 determines whether the confirmation is positive. The CPU 22 supplies the timestamp confirmation and writes it to the storage device, and is also via the module 30 notifies the other staff through their personal interfaces the purpose of the medication for the patient was changed.

If at step 68 the confirmation is positive, the module 28 in step 70 determines whether the detected event is valid. For example, if the module 28 determines that the event of the removal of the nursing person electrocardiogram occurred, based on the registered data of physiological measurements that the control apparatus 20 connected to diagnostic equipment for removal of electrocardiograms, transmits to the controller 12, the module 28 evaluates the record of the location of the operator and the patient or information about close location to confirm the event. Criteria for confirmation of events, for example, may require that the registered data proved that the maintenance person and the patient were in the same area during the time for which usually must be performed removal of the electrocardiogram.

If the event is confirmed at step 70, the module 28 in step 72 updates the record status for the schedule of events. For example, the module 28 updates the schedule record to indicate that a particular service person took the electrocardiogram in just a set time, updates the reading results of the electrocardiogram and the time when the results of the analysis of the electrocardiogram nursing person became available for the review. As soon as the module 28 updates the status of the schedule, the schedule and details on his condition become available for display on the interface 21. Further, since that time, the module 28 processes the recorded data in accordance with the requirements of the updated schedule.

Thus, the maintenance person can real-time access to the status of the schedule of events for the patient, updated on the basis of the evaluation of the events that occurred, and procedures that have been performed or should be performed. From available information, the maintenance person may determine, for example, the expected and the actual time interval for a particular episode of the maintenance tasks that must be performed and have been performed at different times during this episode of care, as well as the expected and actual results at various stages of recovery of the patient.

In another preferred form of the invention, it is possible to refer to the activity data recorded by the system in relation to models of location staff to perform multiple and rapid changes in the schedules of patients. For example, an electronic statement service may indicate that nurses spend a lot of time outside the office, such as hospital re ASKI patient, and this information is valuable for the evaluation of care processes and use of resources. Through an interface 21 serving face relatively simply gives instructions to the controller 12, in order to ensure rapid implementation of the revised schedule, to check the results of the revised schedule and iteratively continue fine-tune the schedule.

Although there have been described and illustrated a preferred form of implementation of the present invention, the specialists will be clear that within the framework of the invention can be made various changes.

1. Electronic control activities in a controlled environment, according to which, by the processor, choose a schedule that includes many events, through a variety of sensors collect data about the activities in a controlled environment, essentially in real time and via processor appreciate these activity data essentially in real time, update the record on the status of the schedule, essentially in real time based on the assessment of activity data and provide real-time access to the specified account on the status of the schedule to the specified activity data, wherein the specified data collection activity, including collection location information representing places the position of the respective first and second signal identification labels and time in which the respective first and second signal identification labels are in the locations, and the assessment of activity data, including the information about the location includes determining whether there was at least one of the events schedule.

2. The method according to claim 1, wherein when the specified evaluation additionally determine whether there is a deviation from the specified schedule of events.

3. The method according to claim 2 which further includes generating an alarm signal, essentially in real time, if the specified deviation.

4. The method according to claim 2 which further includes changing the schedule in real time without human intervention, using the criteria changes to the schedule included in this schedule, if specified deviation.

5. The method according to claim 1, wherein the activity data includes information about the approximate location relative to each other for the first and second signal identification labels, and specified assessment includes the evaluation of this information about close location to determine whether there was at least one of the events schedule.

6. The method according to p. 5, in which the specified assessment includes the use of the above information close location to discover or podtverzdeniye deviations from the schedule.

7. The method according to claim 1, wherein the controlled environment is a health care institution, and the schedule includes a course of clinical services.

8. The method according to claim 1, wherein the collecting activity data is performed in the passive mode, automatically and essentially in real time.

9. Electronic control activities in a controlled environment containing multiple signal identification labels located in a controlled environment and containing means for generating identification data signals, the set of sensors in a controlled environment and containing a detection signal identification data, means for converting the detected signals into data signals on the activities and means of transmitting data signals on activities and discovery, transformation, and transmission is performed by sensors, essentially in real time, and the processor, containing means receiving signals of activity data and means of data processing activities in accordance with the schedule, which includes many events, and processing is done in real time, and the processor includes means for providing access to records about the status of the timesheet and activity data in real time, wherein the data signals of the operation and include the location information, representing the location of the respective first and second signal identification tags and the time at which the corresponding first and second signal identification labels are in the locations, and the processor includes a means of estimating activity data, including the specified location information, to determine whether there has been at least one of the events schedule, and means updates the status record schedule based on the evaluation of activity data.

10. The system according to claim 9, in which the specified evaluation further includes detection of deviations from schedule of events.

11. The system of claim 10, in which the specified processor further includes means generating an alarm signal if the detected deviation.

12. The system of claim 10, in which the specified processor further includes means to change the schedule without human intervention and use of criteria changes to the schedule included in this schedule, if the detected deviation.

13. The system according to claim 9, in which the activity data include information on the approximate location relative to each other for the respective first and second signal identification tags, and the processor further includes means assessment of this information about approximate location on the I definition, have there been at least one of the events schedule.

14. The system of item 13, in which the use of assessment tools include the use of specified information about close location to detect or confirm the presence of deviations from the schedule.

15. The system according to claim 9, in which the controlled environment is a health care institution, and the schedule includes a course of clinical services.