Charting logic decision support in electronic patient charting
Techniques for charting a medical event are disclosed. In one embodiment, the techniques may be realized as a system for charting a medical event, comprising a processor communicably coupled to a database and to a patient charting system. The processor may be configured to during the medical event: receive charting data from the patient charting system; query the database with the charting data to obtain additional data that is associated with at least some of the charting data; and send the additional data to the patient charting system to populate a patient chart during the medical event.
1. An emergency medical services (EMS) charting and treatment system comprising:
a clinical device comprising a defibrillator and a patient monitor, the clinical device configured to monitor and provide treatment for a medical condition of a patient;
at least one processor configured to execute a web-based smartphone EMS charting application to generate an electronic chart for an EMS encounter between one or more caregivers and the patient; and
at least one memory comprising the web-based smartphone EMS charting application and the electronic chart;
wherein the at least one processor is configured to:
display, via an interactive user interface, a portion of the electronic chart for the EMS encounter, the displayed portion of the electronic chart comprising a plurality of displayed fields and a plurality of selectable tabs, each selectable tab representing a corresponding set of fields;
receive first charting information from the one or more caregivers as voice data captured by a voice recognition interface, the first charting information comprising a name of a destination healthcare facility for the patient;
identify at least one first displayed field of the electronic chart based on the voice data;
populate the at least one first displayed field of the electronic chart stored locally in the at least one memory with the first charting information;
transmit, via a networked connection, to a remote database, a query for second charting information that is stored in the remote database and that is based on the first charting information;
receive the second charting information, wherein the second charting information comprises address information for the destination healthcare facility for the patient, and wherein the second charting information further comprises additional patient-specific information;
automatically populate at least one second displayed field of the electronic chart with at least a portion of the second charting information;
receive, via the interactive user interface, user input assigning a value to an encounter disposition field of the electronic chart;
in response to receiving the user input, assign a default value to a third field of the electronic chart and disabling a particular one of the selectable tabs, wherein the particular selectable tab that is disabled represents a particular set of fields that are disabled based on the user input;
display, via the interactive user interface, an update of the displayed portion of the electronic chart, wherein the update of the displayed portion of the electronic chart includes the first charting information and a first portion of the additional patient-specific information, but does not include a second portion of the additional patient-specific information;
receive third charting information comprising identification information for the clinical device;
receive fourth charting information comprising at least one of a patient age, a patient gender, a patient weight, a patient treatment history, a patient medical condition, or a patient medication;
while the clinical device is being used to provide treatment for the patient, transmit at least a portion of the fourth charting information to the clinical device based on the third charting information, wherein the portion of the fourth charting information transmitted to the clinical device (a) is required by the clinical device to provide treatment for the patient, and (b) modifies operation of the clinical device to operate at treatment parameters based on the fourth charting information;
receive a request for the electronic chart from the destination healthcare facility; and
provide the electronic chart to the destination healthcare facility via a secure communications link.
2. The system of claim 1 , wherein the interactive user interface is configured to prompt the one or more caregivers to provide the first charting information according to a template.
3. The system of claim 2 , wherein the at least one processor is configured to customize the template based on previously received charting information.
4. The system of claim 1 , wherein the interactive user interface is configured to prompt the one or more caregivers to provide fifth third charting information based on at least one of the first or the second charting information.
5. The system of claim 1 , wherein the at least one processor is configured to automatically disable one or more of the displayed fields based on the first charting information.
6. The system of claim 1 , further comprising a mobile computing device that comprises a third party interface system, wherein the at least one processor is configured to:
provide at least a portion of at least one of the first or the second charting information to a third party user via the third party interface system; and
receive input from the third party user,
wherein the third party user comprises a healthcare provider.
7. The system of claim 1 , wherein the at least one processor is configured to receive the first charting information during an examination of the patient by the one or more caregivers.
8. The system of claim 1 , further comprising a mobile computing device that is configured to scan patient data and provide the scanned patient data to the at least one processor.
9. The system of claim 8 , wherein the scanned patient data comprises driver's license information.
10. The system of claim 1 , wherein the at least one processor is configured to:
identify a database source of fifth charting information based on at least one of the first or the second charting information; and
retrieve the fifth charting information from the database source.
11. The system of claim 10 , wherein the fifth charting information comprises patient medications.
12. The system of claim 11 , wherein the at least one of the first or the second charting information comprises a patient address and the database source comprises a pharmacy proximate to the patient address.
13. The system of claim 10 , wherein the fifth-charting information comprises patient medical history information.
14. The system of claim 10 , wherein the at least one processor is configured to communicate with the database source according to a health data exchange standard.
15. The system of claim 14 , wherein the database source is part of a different organization than an organization with which the EMS charting and treatment system is associated.
16. The system of claim 1 , wherein the at least one processor is configured to validate the first and the second charting information.
17. The system of claim 16 , wherein the at least one processor is configured to validate the first and the second charting information based on a medical protocol.
18. The system of claim 1 , wherein the at least one processor is configured to generate alerts at the interactive user interface based on one or more of (a) a rate of change of the additional patient-specific information, (b) the additional patient-specific information being outside of a predetermined range, or (c) the additional patient-specific information exceeding a predetermined rate of change since a previous data input.
19. The system of claim 1 , further comprising a mobile computing device that is configured to communicate bidirectionally with the clinical device to send the portion of the fourth charting information to the clinical device and receive fifth charting information from the clinical device.
20. The system of claim 19 , wherein the clinical device is configured to provide one or more of electrical shock therapy, respiration therapy, or drug therapy.
21. The system of claim 1 , wherein the web-based smartphone EMS charting application is a web browser.
22. The system of claim 1 , wherein the at least one processor is configured to adapt the interactive user interface based on a form factor of a mobile computing device on which the web-based smartphone EMS charting application is executing.
23. The system of claim 1 , wherein the interactive user interface comprises a touchscreen interface.
24. The system of claim 1 , wherein the additional patient-specific information comprises at least one of a patient name or a patient allergy.
25. The system of claim 1 , wherein the additional patient-specific information includes a location of the patient.