System and methods for documenting medical findings of physical examination

Abstract

An electronic system and method for efficiently recording medical examination results, including what went wrong and body surface or internal parts. The present invention also provides a method of registering various problems on corresponding parts of the body. The present invention also provides an effective prescription method corresponding to the examination result including the problem and the body surface or internal body part. The present invention can improve the efficiency of physical examination and make it an important part of the doctor's actual workflow. This, in turn, makes the present invention a central point for a vast array of useful electronic tools and information. For example, in a computerized system and method for recording one or more test results, wherein the results include body parts and test result types, the method includes the steps of: displaying a body part selection view for the user, the user Select a body part, then the system displays a tool to select possible test result types, then the system also displays a selection tool to display the body part in more detail, where the user selects a test result type, which causes the system to save a Including the user's selected parts and the results of the question, and the user chooses to display a more detailed body part map here, so that the system displays a more detailed body part map. The method may also include result types, which may be selected from a result type, and which further includes a tool to select from a different set of displayed result types. Additionally, each set of result types may correspond to a set of result types related to a system of the body. The system may include a tool for selecting one or more suitable body part selection procedures, and it may also include a tool for recording instructions for the selected body part. Such means for recording said description may be selected from a group consisting of: selecting a pre-generated description text; recording a description; recording a graphic description; recording a voice description and recording a photo description.

Description

[0001] related application [0002] The present invention claims the priority right of U.S. patent application No.60 / _, _, filed on November 22, 2000, and its title is: "system and method for recording medical examination results" (SYSTEMAND METHODS FOR DOCUMENTING MEDICAL FINDINGS OF APHYSICAL EXAMINATION ), which is hereby incorporated by reference into this application in its entirety. technical field [0003] The invention relates to the field of health care, in particular to an electronic system, which helps medical personnel to record the examination results when performing physical examination on patients, and the system can be used as a collection point of electronic health care information systems. Background technique [0004] In order to improve the efficiency of medical personnel and reduce the rising cost of health care, various efforts are made to utilize computers or electronic medical records (EMR) systems to facilitate various health care services. Such sys...

AI Technical Summary

Problems solved by technology

However, current electronic medical record systems have difficulty processing such annotations effectively because such annotations cannot (a) be incorporated into an efficient system to derive findings and (b) the tools for entering such annotations are difficult to use, It is to offline transcribe text from free-entered character recognition text or recorded speech

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