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Title:
AUTOMATED CLINICAL DOCUMENTATION SYSTEM AND METHOD
Document Type and Number:
WIPO Patent Application WO/2019/173356
Kind Code:
A1
Abstract:
A method, computer program product, and computing system for obtaining encounter information of a patient encounter; processing the encounter information to generate an encounter transcript; processing at least a portion of the encounter transcript to populate at least a portion of a medical record associated with the patient encounter; providing the medical record to a medical professional; and enabling the medical professional to influence the medical record. A method, computer program product, and computing system for obtaining encounter information of a patient encounter; processing the encounter information to generate an encounter transcript; and processing the encounter transcript to locate one or more procedural events within the encounter transcript.

Inventors:
JANCSARY JEREMY MARTIN (AT)
DREXEL CHRISTINA (AT)
MILANOVIC LJUBOMIR (AT)
Application Number:
PCT/US2019/020778
Publication Date:
September 12, 2019
Filing Date:
March 05, 2019
Export Citation:
Click for automatic bibliography generation   Help
Assignee:
NUANCE COMMUNICATIONS INC (US)
International Classes:
A61B5/00
Foreign References:
US20170116392A12017-04-27
US20100094656A12010-04-15
Other References:
See also references of EP 3761860A4
Attorney, Agent or Firm:
COLANDREO, Brian J. et al. (US)
Download PDF:
Claims:
What Is Claimed Is:

Automated Amendment of Records:

1. A computer- implemented method executed on a computing device, comprising:

obtaining encounter information of a patient encounter; processing the encounter information to generate an encounter transcript;

processing at least a portion of the encounter transcript to populate at leas t a portion of a medical record associated with the patient encounter;

providing the medical record to a medical professional; and enabling the medical professional to influence the medical record.

2. The computer-implemented method of claim 1 wherein obtaining encounter information of a patient encounter includes one or more of:

obtaining encounter information from the medical professional;

obtaining encounter information from a patient; and

obtaining encounter information obtaining encounter information from a third party.

3. The computer-implemented method of claim 1 wherein providing the medical record to a medical professional includes one or more of:

providing a text-based copy of the medical record to the medical professional; and

providing an audio-based copy of the medical record to the medical professional.

4. The computer-implemented method of claim 1 wherein enabling the medical professional to influence the medical record includes:

enabling the medical professional to provide verbal feedback concerning the medical record.

5. The computer-implemented method of claim 4 further comprising:

amending the medical record based, at least in part, upon the verbal feedback.

6. Hie computer-implemented method of claim 5 wherein the verbal feedback concerns including pertinent information in the medical record, and amending the medical record based, at least in part, upon the verbal feedback includes:

obtaining the pertinent information from the encounter transcript; and modifying the medical record based, at least in part, upon the pertinent information.

7. The computer-implemented method of claim 5 wherein the verbal feedback concerns removing non-pertinent information from the medical record, and amending die medical record based, at least in part, upon die verbal feedback includes:

modifying the medical record based, at least in part, upon the non- pertinent information.

Tracking Procedural Events:

8. A computer-implemented method, executed on a computing device, comprising:

obtaining encounter information of a patient encounter; processing the encounter information to generate an encounter transcript; and

processing the encounter transcript to locate one or more procedural events within the encounter transcript.

9. The computer-implemented method of claim 8 wherein obtaining encounter information of a patient encounter includes one or more of:

obtaining encounter information from the medical professional;

obtaining encounter information from a patient; and

obtaining encounter information obtaining encounter information from a third party.

10. The computer-implemented method of claim 8 further comprising:

processing at least a portion of the encounter transcript to populate at least a portion of a medical record associated with the patient encounter.

11. The computer-implemented method of claim 8 wherein processing the encounter transcript to locate one or more procedural events within die encounter transcript includes one or more of:

manually-initiating the processing of the encounter transcript to locate one or more procedural events within the encounter transcript; and

automatically-initiating the processing of the encounter transcript to locate one or more procedural events within the encounter transcript.

12. The computer-implemented method of claim 8 wherein processing the encounter transcript to locate one or more procedural events within the encounter transcript includes:

associating the one or more procedural events with one or more portions of the encounter information of the patient encounter.

13. Hie computer-implemented method of claim 8 further comprising:

confirming the identity of one or more encounter participants of the patient encounter.

14. The computer-implemented method of claim 8 wherein the one or more procedural events includes one or more of:

an informed consent event;

a personal medical history event;

a family medical history event;

a drag allergy event;

a drug side-effect event; and

a drug warning event.

Description:
Automated Clinical Documentation System and Method

Related Application(s)

[001] This application claims priority to the following U.S. Application Nos: 16/271,029 filed on 08 February 2019 and 16/270,888 filed on 08 February 2019, each of which claim the benefit of U.S. Provisional Application No. 62/638,809, filed on 05 March 2018; the entire contents of which are incorporated herein by reference.

Technical Field

[002] This disclosure relates to documentation systems and methods and, more particularly, to automated clinical documentation systems and methods.

Background

[003] As is known in the art, clinical documentation is the creation of medical records and documentation that details the medical history of medical patients. As would be expected, traditional clinical documentation includes various types of data, examples of which may include but are not limited to paper-based documents and transcripts, as well as various images and diagrams.

[004] As the world moved from paper-based content to digital content, clinical documentation also moved in that direction, where medical records and documentation were gradually transitioned from stacks of paper geographically-dispersed across multiple locations / institutions to consolidated and readily accessible digital content.

Summary of Disclosure

Automated Amendment of Records:

[005] In one implementation, a computer-implemented method is executed on a computing device and includes: obtaining encounter information of a patient encounter; processing the encounter information to generate an encounter transcript; processing at least a portion of the encounter transcript to populate at least a portion of a medical record associated with the patient encounter; providing the medical record to a medical professional; and enabling the medical professional to influence the medical record.

[006] One or more of the following features may be included. Obtaining encounter information of a patient encounter may include one or more of: obtaining encounter information from the medical professional; obtaining encounter information from a patient; and obtaining encounter information obtaining encounter information from a third party. Providing the medical record to a medical professional may include one or more of: providing a text-based copy of the medical record to the medical professional; and providing an audio-based copy of the medical record to the medical professional. Enabling the medical professional to influence the medical record may include enabling the medical professional to provide verbal feedback concerning the medical record. The medical record may be amended based, at least in part, upon the verbal feedback. The verbal feedback may concern including pertinent information in the medical record, and amending the medical record based, at least in part, upon the verbal feedback may include: obtaining the pertinent information from the encounter transcript; and modifying the medical record based, at least in part, upon the pertinent information. The verbal feedback may concern removing non-pertinent information from the medical record, and amending the medical record based, at least in part, upon the verbal feedback may include: modifying the medical record based, at least in part, upon the non-pertinent information.

[007] The details of one or more implementations are set forth in the accompanying drawings and the description below. Other features and advantages will become apparent from the description, the drawings, and the claims.

Tracking Procedural Events:

[008] In one implementation, a computer-implemented method is executed on a computing device and includes: obtaining encounter information of a patient encounter; processing the encounter information to generate an encounter transcript; and processing the encounter transcript to locate one or more procedural events within the encounter transcript.

[009] One or more of the following features may be included. Obtaining encounter information of a patient encounter may include one or more of: obtaining encounter information from the medical professional; obtaining encounter information from a patient; and obtaining encounter information obtaining encounter information from a third party. At least a portion of the encounter transcript may be processed to populate at least a portion of a medical record associated with the patient encounter. Processing the encounter transcript to locate one or more procedural events within the encounter transcript may include one or more of: manually-initiating the processing of the encounter transcript to locate one or more procedural events within the encounter transcript; and automatically-initiating the processing of the encounter transcript to locate one or more procedural events within the encounter transcript. Processing the encounter transcript to locate one or more procedural events within the encounter transcript may include associating the one or more procedural events with one or more portions of the encounter information of the patient encounter. The identity of one or more encounter participants of the patient encounter may be confirmed. The one or more procedural events may include one or more of: an informed consent event; a personal medical history event; a family medical history event; a drug allergy event; a drug side-effect event; and a drug warning event.

[0010] The details of one or more implementations are set forth in the accompanying drawings and the description below. Other features and advantages will become apparent from the description, the drawings, and the claims.

Brief Description of the Drawings

[0011] FIG. 1 is a diagrammatic view of an automated clinical documentation compute system and an automated clinical documentation process coupled to a distributed computing network;

[0012] FIG. 2 is a diagrammatic view of a modular ACD system incorporating the automated clinical documentation compute system of FIG. 1 ; [0013] FIG. 3 is a diagrammatic view of a mixed-media ACD device included within the modular ACD system of FIG. 2;

[0014] FIG. 4 is a flow chart of one implementation of the automated clinical documentation process of FIG. 1 ;

[0015] FIG. 5 is a flow chart of another implementation of the automated clinical documentation process of FIG. 1 ;

[0016] FIG. 6 is a flow chart of another implementation of the automated clinical documentation process of FIG. 1 ;

[0017] FIG. 7 is a flow chart of another implementation of the automated clinical documentation process of FIG. 1 ;

[0018] FIG. 8 is a flow chart of another implementation of the automated clinical documentation process of FIG. 1 ; and

[0019] FIG. 9 is a flow chart of another implementation of the automated clinical documentation process of FIG. 1.

[0020] Like reference symbols in the various drawings indicate like elements.

Detailed Description of the Preferred Embodiments

System Overview

[0021] Referring to FIG. 1, there is shown automated clinical documentation process 10. As will be discussed below in greater detail, automated clinical documentation process 10 may be configured to automate the collection and processing of clinical encounter information to generate / store / distribute medical records.

[0022] Automated clinical documentation process 10 may be implemented as a server-side process, a client-side process, or a hybrid server-side / client-side process. For example, automated clinical documentation process 10 may be implemented as a purely server-side process via automated clinical documentation process lOs. Alternatively, automated clinical documentation process 10 may be implemented as a purely client-side process via one or more of automated clinical documentation process lOcl, automated clinical documentation process l0c2, automated clinical documentation process l0c3, and automated clinical documentation process l0c4. Alternatively still, automated clinical documentation process 10 may be implemented as a hybrid server-side / client-side process via automated clinical documentation process lOs in combination with one or more of automated clinical documentation process lOcl, automated clinical documentation process l0c2, automated clinical documentation process l0c3, and automated clinical documentation process l0c4.

[0023] Accordingly, automated clinical documentation process 10 as used in this disclosure may include any combination of automated clinical documentation process lOs, automated clinical documentation process lOcl, automated clinical documentation process l0c2, automated clinical documentation process l0c3, and automated clinical documentation process l0c4.

[0024] Automated clinical documentation process lOs may be a server application and may reside on and may be executed by automated clinical documentation (ACD) compute system 12, which may be connected to network 14 (e.g., the Internet or a local area network). ACD compute system 12 may include various components, examples of which may include but are not limited to: a personal computer, a server computer, a series of server computers, a mini computer, a mainframe computer, one or more Network Attached Storage (NAS) systems, one or more Storage Area Network (SAN) systems, one or more Platform as a Service (PaaS) systems, one or more Infrastructure as a Service (IaaS) systems, one or more Software as a Service (SaaS) systems, a cloud- based computational system, and a cloud-based storage platform.

[0025] As is known in the art, a SAN may include one or more of a personal computer, a server computer, a series of server computers, a mini computer, a mainframe computer, a RAID device and a NAS system. The various components of ACD compute system 12 may execute one or more operating systems, examples of which may include but are not limited to: Microsoft Windows Server tm ; Redhat Linux tm , Unix, or a custom operating system, for example. [0026] The instruction sets and subroutines of automated clinical documentation process lOs, which may be stored on storage device 16 coupled to ACD compute system 12, may be executed by one or more processors (not shown) and one or more memory architectures (not shown) included within ACD compute system 12. Examples of storage device 16 may include but are not limited to: a hard disk drive; a RAID device; a random access memory (RAM); a read-only memory (ROM); and all forms of flash memory storage devices.

[0027] Network 14 may be connected to one or more secondary networks (e.g., network 18), examples of which may include but are not limited to: a local area network; a wide area network; or an intranet, for example.

[0028] Various IO requests (e.g. IO request 20) may be sent from automated clinical documentation process lOs, automated clinical documentation process lOcl, automated clinical documentation process l0c2, automated clinical documentation process l0c3 and/or automated clinical documentation process l0c4 to ACD compute system 12. Examples of IO request 20 may include but are not limited to data write requests (i.e. a request that content be written to ACD compute system 12) and data read requests (i.e. a request that content be read from ACD compute system 12).

[0029] The instruction sets and subroutines of automated clinical documentation process lOcl, automated clinical documentation process l0c2, automated clinical documentation process l0c3 and/or automated clinical documentation process l0c4, which may be stored on storage devices 20, 22, 24, 26 (respectively) coupled to ACD client electronic devices 28, 30, 32, 34 (respectively), may be executed by one or more processors (not shown) and one or more memory architectures (not shown) incorporated into ACD client electronic devices 28, 30, 32, 34 (respectively). Storage devices 20, 22, 24, 26 may include but are not limited to: hard disk drives; optical drives; RAID devices; random access memories (RAM); read-only memories (ROM), and all forms of flash memory storage devices. Examples of ACD client electronic devices 28, 30, 32, 34 may include, but are not limited to, personal computing device 28 (e.g., a smart phone, a personal digital assistant, a laptop computer, a notebook computer, and a desktop computer), audio input device 30 (e.g., a handheld microphone, a lapel microphone, an embedded microphone (such as those embedded within eyeglasses, smart phones, tablet computers and/or watches) and an audio recording device), display device 32 (e.g., a tablet computer, a computer monitor, and a smart television), machine vision input device 34 (e.g., an RGB imaging system, an infrared imaging system, an ultraviolet imaging system, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system), a hybrid device (e.g., a single device that includes the functionality of one or more of the above-references devices; not shown), an audio rendering device (e.g., a speaker system, a headphone system, or an earbud system; not shown), various medical devices (e.g., medical imaging equipment, heart monitoring machines, body weight scales, body temperature thermometers, and blood pressure machines; not shown), and a dedicated network device (not shown).

[0030] Users 36, 38, 40, 42 may access ACD compute system 12 directly through network 14 or through secondary network 18. Further, ACD compute system 12 may be connected to network 14 through secondary network 18, as illustrated with link line 44.

[0031] The various ACD client electronic devices (e.g., ACD client electronic devices 28, 30, 32, 34) may be directly or indirectly coupled to network 14 (or network 18). For example, personal computing device 28 is shown directly coupled to network 14 via a hardwired network connection. Further, machine vision input device 34 is shown directly coupled to network 18 via a hardwired network connection. Audio input device 30 is shown wirelessly coupled to network 14 via wireless communication channel 46 established between audio input device 30 and wireless access point (i.e., WAP) 48, which is shown directly coupled to network 14. WAP 48 may be, for example, an IEEE 802.lla, 802.llb, 802.llg, 802.11h, Wi-Fi, and/or Bluetooth device that is capable of establishing wireless communication channel 46 between audio input device 30 and WAP 48. Display device 32 is shown wirelessly coupled to network 14 via wireless communication channel 50 established between display device 32 and WAP 52, which is shown directly coupled to network 14.

[0032] The various ACD client electronic devices (e.g., ACD client electronic devices 28, 30, 32, 34) may each execute an operating system, examples of which may include but are not limited to Microsoft Windows tm , Apple Macintosh tm , Redhat Linux tm , or a custom operating system, wherein the combination of the various ACD client electronic devices (e.g., ACD client electronic devices 28, 30, 32, 34) and ACD compute system 12 may form modular ACD system 54.

The Automated Clinical Documentation System

[0033] Referring also to FIG. 2, there is shown a simplified exemplary embodiment of modular ACD system 54 that is configured to automate clinical documentation. Modular ACD system 54 may include: machine vision system 100 configured to obtain machine vision encounter information 102 concerning a patient encounter; audio recording system 104 configured to obtain audio encounter information 106 concerning the patient encounter; and a compute system (e.g., ACD compute system 12) configured to receive machine vision encounter information 102 and audio encounter information 106 from machine vision system 100 and audio recording system 104 (respectively). Modular ACD system 54 may also include: display rendering system 108 configured to render visual information 110; and audio rendering system 112 configured to render audio information 114, wherein ACD compute system 12 may be configured to provide visual information 110 and audio information 114 to display rendering system 108 and audio rendering system 112 (respectively).

[0034] Example of machine vision system 100 may include but are not limited to: one or more ACD client electronic devices (e.g., ACD client electronic device 34, examples of which may include but are not limited to an RGB imaging system, an infrared imaging system, a ultraviolet imaging system, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system). Examples of audio recording system 104 may include but are not limited to: one or more ACD client electronic devices (e.g., ACD client electronic device 30, examples of which may include but are not limited to a handheld microphone (e.g., one example of a body worn microphone), a lapel microphone (e.g., another example of a body worn microphone), an embedded microphone, such as those embedded within eyeglasses, smart phones, tablet computers and/or watches (e.g., another example of a body worn microphone), and an audio recording device). Examples of display rendering system 108 may include but are not limited to: one or more ACD client electronic devices (e.g., ACD client electronic device 32, examples of which may include but are not limited to a tablet computer, a computer monitor, and a smart television). Examples of audio rendering system 112 may include but are not limited to: one or more ACD client electronic devices (e.g., audio rendering device 116, examples of which may include but are not limited to a speaker system, a headphone system, and an earbud system).

[0035] ACD compute system 12 may be configured to access one or more datasources 118 (e.g., plurality of individual datasources 120, 122, 124, 126, 128), examples of which may include but are not limited to one or more of a user profile datasource, a voice print datasource, a voice characteristics datasource (e.g., for adapting the automated speech recognition models), a face print datasource, a humanoid shape datasource, an utterance identifier datasource, a wearable token identifier datasource, an interaction identifier datasource, a medical conditions symptoms datasource, a prescriptions compatibility datasource, a medical insurance coverage datasource, and a home healthcare datasource. While in this particular example, five different examples of datasources 118 are shown, this is for illustrative purposes only and is not intended to be a limitation of this disclosure, as other configurations are possible and are considered to be within the scope of this disclosure.

[0036] As will be discussed below in greater detail, modular ACD system 54 may be configured to monitor a monitored space (e.g., monitored space 130) in a clinical environment, wherein examples of this clinical environment may include but are not limited to: a doctor’s office, a medical facility, a medical practice, a medical lab, an urgent care facility, a medical clinic, an emergency room, an operating room, a hospital, a long term care facility, a rehabilitation facility, a nursing home, and a hospice facility. Accordingly, an example of the above-referenced patient encounter may include but is not limited to a patient visiting one or more of the above-described clinical environments (e.g., a doctor’s office, a medical facility, a medical practice, a medical lab, an urgent care facility, a medical clinic, an emergency room, an operating room, a hospital, a long term care facility, a rehabilitation facility, a nursing home, and a hospice facility).

[0037] Machine vision system 100 may include a plurality of discrete machine vision systems when the above-described clinical environment is larger or a higher level of resolution is desired. As discussed above, examples of machine vision system 100 may include but are not limited to: one or more ACD client electronic devices (e.g., ACD client electronic device 34, examples of which may include but are not limited to an RGB imaging system, an infrared imaging system, an ultraviolet imaging system, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system). Accordingly, machine vision system 100 may include one or more of each of an RGB imaging system, an infrared imaging systems, an ultraviolet imaging systems, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system.

[0038] Audio recording system 104 may include a plurality of discrete audio recording systems when the above-described clinical environment is larger or a higher level of resolution is desired. As discussed above, examples of audio recording system 104 may include but are not limited to: one or more ACD client electronic devices (e.g., ACD client electronic device 30, examples of which may include but are not limited to a handheld microphone, a lapel microphone, an embedded microphone (such as those embedded within eyeglasses, smart phones, tablet computers and/or watches) and an audio recording device). Accordingly, audio recording system 104 may include one or more of each of a handheld microphone, a lapel microphone, an embedded microphone (such as those embedded within eyeglasses, smart phones, tablet computers and/or watches) and an audio recording device.

[0039] Display rendering system 108 may include a plurality of discrete display rendering systems when the above-described clinical environment is larger or a higher level of resolution is desired. As discussed above, examples of display rendering system 108 may include but are not limited to: one or more ACD client electronic devices (e.g., ACD client electronic device 32, examples of which may include but are not limited to a tablet computer, a computer monitor, and a smart television). Accordingly, display rendering system 108 may include one or more of each of a tablet computer, a computer monitor, and a smart television.

[0040] Audio rendering system 112 may include a plurality of discrete audio rendering systems when the above-described clinical environment is larger or a higher level of resolution is desired. As discussed above, examples of audio rendering system 112 may include but are not limited to: one or more ACD client electronic devices (e.g., audio rendering device 116, examples of which may include but are not limited to a speaker system, a headphone system, or an earbud system). Accordingly, audio rendering system 112 may include one or more of each of a speaker system, a headphone system, or an earbud system.

[0041] ACD compute system 12 may include a plurality of discrete compute systems. As discussed above, ACD compute system 12 may include various components, examples of which may include but are not limited to: a personal computer, a server computer, a series of server computers, a mini computer, a mainframe computer, one or more Network Attached Storage (NAS) systems, one or more Storage Area Network (SAN) systems, one or more Platform as a Service (PaaS) systems, one or more Infrastructure as a Service (IaaS) systems, one or more Software as a Service (SaaS) systems, a cloud-based computational system, and a cloud-based storage platform. Accordingly, ACD compute system 12 may include one or more of each of a personal computer, a server computer, a series of server computers, a mini computer, a mainframe computer, one or more Network Attached Storage (NAS) systems, one or more Storage Area Network (SAN) systems, one or more Platform as a Service (PaaS) systems, one or more Infrastructure as a Service (IaaS) systems, one or more Software as a Service (SaaS) systems, a cloud-based computational system, and a cloud-based storage platform.

Microphone Array

[0042] Referring also to FIG. 3, audio recording system 104 may include microphone array 200 having a plurality of discrete microphone assemblies. For example, audio recording system 104 may include a plurality of discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218) that may form microphone array 200. As will be discussed below in greater detail, modular ACD system 54 may be configured to form one or more audio recording beams (e.g., audio recording beams 220, 222, 224) via the discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218) included within audio recording system 104.

[0043] For example, modular ACD system 54 may be further configured to steer the one or more audio recording beams (e.g., audio recording beams 220, 222, 224) toward one or more encounter participants (e.g., encounter participants 226, 228, 230) of the above-described patient encounter. Examples of the encounter participants (e.g., encounter participants 226, 228, 230) may include but are not limited to: medical professionals (e.g., doctors, nurses, physician’s assistants, lab technicians, physical therapists, scribes (e.g., a transcriptionist) and/or staff members involved in the patient encounter), patients (e.g., people that are visiting the above-described clinical environments for the patient encounter), and third parties (e.g., friends of the patient, relatives of the patient and/or acquaintances of the patient that are involved in the patient encounter).

[0044] Accordingly, modular ACD system 54 and/or audio recording system 104 may be configured to utilize one or more of the discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218) to form an audio recording beam. For example, modular ACD system 54 and/or audio recording system 104 may be configured to utilize various audio acquisition devices to form audio recording beam 220, thus enabling the capturing of audio (e.g., speech) produced by encounter participant 226 (as audio recording beam 220 is pointed to (i.e., directed toward) encounter participant 226). Additionally, modular ACD system 54 and/or audio recording system 104 may be configured to utilize various audio acquisition devices to form audio recording beam 222, thus enabling the capturing of audio (e.g., speech) produced by encounter participant 228 (as audio recording beam 222 is pointed to (i.e., directed toward) encounter participant 228). Additionally, modular ACD system 54 and/or audio recording system 104 may be configured to utilize various audio acquisition devices to form audio recording beam 224, thus enabling the capturing of audio (e.g., speech) produced by encounter participant 230 (as audio recording beam 224 is pointed to (i.e., directed toward) encounter participant 230). Further, modular ACD system 54 and/or audio recording system 104 may be configured to utilize null steering precoding to cancel interference between speakers and/or noise.

[0045] As is known in the art, null-steering precoding is a method of spatial signal processing by which a multiple antenna transmitter may null multiuser interference signals in wireless communications, wherein null-steering precoding may mitigate the impact off background noise and unknown user interference. In particular, null-steering precoding may be a method of beamforming for narrowband signals that may compensate for delays of receiving signals from a specific source at different elements of an antenna array. In general and to improve performance of the antenna array, incoming signals may be summed and averaged, wherein certain signals may be weighted and compensation may be made for signal delays.

[0046] Machine vision system 100 and audio recording system 104 may be stand alone devices (as shown in FIG. 2). Additionally / alternatively, machine vision system 100 and audio recording system 104 may be combined into one package to form mixed- media ACD device 232. For example, mixed-media ACD device 232 may be configured to be mounted to a structure (e.g., a wall, a ceiling, a beam, a column) within the above-described clinical environments (e.g., a doctor’s office, a medical facility, a medical practice, a medical lab, an urgent care facility, a medical clinic, an emergency room, an operating room, a hospital, a long term care facility, a rehabilitation facility, a nursing home, and a hospice facility), thus allowing for easy installation of the same. Further, modular ACD system 54 may be configured to include a plurality of mixed- media ACD devices (e.g., mixed-media ACD device 232) when the above-described clinical environment is larger or a higher level of resolution is desired.

[0047] Modular ACD system 54 may be further configured to steer the one or more audio recording beams (e.g., audio recording beams 220, 222, 224) toward one or more encounter participants (e.g., encounter participants 226, 228, 230) of the patient encounter based, at least in part, upon machine vision encounter information 102. As discussed above, mixed-media ACD device 232 (and machine vision system 100 / audio recording system 104 included therein) may be configured to monitor one or more encounter participants (e.g., encounter participants 226, 228, 230) of a patient encounter.

[0048] Specifically and as will be discussed below in greater detail, machine vision system 100 (either as a stand-alone system or as a component of mixed-media ACD device 232) may be configured to detect humanoid shapes within the above-described clinical environments (e.g., a doctor’s office, a medical facility, a medical practice, a medical lab, an urgent care facility, a medical clinic, an emergency room, an operating room, a hospital, a long term care facility, a rehabilitation facility, a nursing home, and a hospice facility). And when these humanoid shapes are detected by machine vision system 100, modular ACD system 54 and/or audio recording system 104 may be configured to utilize one or more of the discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218) to form an audio recording beam (e.g., audio recording beams 220, 222, 224) that is directed toward each of the detected humanoid shapes (e.g., encounter participants 226, 228, 230).

[0049] As discussed above, ACD compute system 12 may be configured to receive machine vision encounter information 102 and audio encounter information 106 from machine vision system 100 and audio recording system 104 (respectively); and may be configured to provide visual information 110 and audio information 114 to display rendering system 108 and audio rendering system 112 (respectively). Depending upon the manner in which modular ACD system 54 (and/or mixed-media ACD device 232) is configured, ACD compute system 12 may be included within mixed-media ACD device 232 or external to mixed-media ACD device 232.

The Automated Clinical Documentation Process

[0050] As discussed above, ACD compute system 12 may execute all or a portion of automated clinical documentation process 10, wherein the instruction sets and subroutines of automated clinical documentation process 10 (which may be stored on one or more of e.g., storage devices 16, 20, 22, 24, 26) may be executed by ACD compute system 12 and/or one or more of ACD client electronic devices 28, 30, 32, 34.

[0051] As discussed above, automated clinical documentation process 10 may be configured to automate the collection and processing of clinical encounter information to generate / store / distribute medical records. Accordingly and referring also to FIG. 4, automated clinical documentation process 10 may be configured to obtain 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) of a patient encounter (e.g., a visit to a doctor’s office). Automated clinical documentation process 10 may further be configured to process 302 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to generate an encounter transcript (e.g., encounter transcript 234), wherein automated clinical documentation process 10 may then process 304 at least a portion of the encounter transcript (e.g., encounter transcript 234) to populate at least a portion of a medical record (e.g., medical record 236) associated with the patient encounter (e.g., the visit to the doctor’s office). Encounter transcript 234 and/or medical record 236 may be reviewed by a medical professional involved with the patient encounter (e.g., a visit to a doctor’s office) to determine the accuracy of the same and/or make corrections to the same.

[0052] For example, a scribe involved with (or assigned to) the patient encounter (e.g., a visit to a doctor’s office) may review encounter transcript 234 and/or medical record 236 to confirm that the same was accurate and/or make corrections to the same. In the event that corrections are made to encounter transcript 234 and/or medical record 236, automated clinical documentation process 10 may utilize these corrections for training / tuning purposes (e.g., to adjust the various profiles associated the participants of the patient encounter) to enhance the future accuracy / efficiency / performance of automated clinical documentation process 10.

[0053] Alternatively / additionally, a doctor involved with the patient encounter (e.g., a visit to a doctor’s office) may review encounter transcript 234 and/or medical record 236 to confirm that the same was accurate and/or make corrections to the same. In the event that corrections are made to encounter transcript 234 and/or medical record 236, automated clinical documentation process 10 may utilize these corrections for training / tuning purposes (e.g., to adjust the various profiles associated the participants of the patient encounter) to enhance the future accuracy / efficiency / performance of automated clinical documentation process 10.

[0054] For example, assume that a patient (e.g., encounter participant 228) visits a clinical environment (e.g., a doctor’s office) because they do not feel well. They have a headache, fever, chills, a cough, and some difficulty breathing. In this particular example, a monitored space (e.g., monitored space 130) within the clinical environment (e.g., the doctor’s office) may be outfitted with machine vision system 100 configured to obtain machine vision encounter information 102 concerning the patient encounter (e.g., encounter participant 228 visiting the doctor’s office) and audio recording system 104 configured to obtain audio encounter information 106 concerning the patient encounter (e.g., encounter participant 228 visiting the doctor’s office) via one or more audio sensors (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218).

[0055] As discussed above, machine vision system 100 may include a plurality of discrete machine vision systems if the monitored space (e.g., monitored space 130) within the clinical environment (e.g., the doctor’s office) is larger or a higher level of resolution is desired, wherein examples of machine vision system 100 may include but are not limited to: an RGB imaging system, an infrared imaging system, an ultraviolet imaging system, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system. Accordingly and in certain instances / embodiments, machine vision system 100 may include one or more of each of an RGB imaging system, an infrared imaging system, an ultraviolet imaging system, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system positioned throughout monitored space 130, wherein each of these systems may be configured to provide data (e.g., machine vision encounter information 102) to ACD compute system 12 and/or modular ACD system 54.

[0056] As also discussed above, audio recording system 104 may include a plurality of discrete audio recording systems if the monitored space (e.g., monitored space 130) within the clinical environment (e.g., the doctor’s office) is larger or a higher level of resolution is desired, wherein examples of audio recording system 104 may include but are not limited to: a handheld microphone, a lapel microphone, an embedded microphone (such as those embedded within eyeglasses, smart phones, tablet computers and/or watches) and an audio recording device. Accordingly and in certain instances / embodiments, audio recording system 104 may include one or more of each of a handheld microphone, a lapel microphone, an embedded microphone (such as those embedded within eyeglasses, smart phones, tablet computers and/or watches) and an audio recording device positioned throughout monitored space 130, wherein each of these microphones / devices may be configured to provide data (e.g., audio encounter information 106) to ACD compute system 12 and/or modular ACD system 54.

[0057] Since machine vision system 100 and audio recording system 104 may be positioned throughout monitored space 130, all of the interactions between medical professionals (e.g., encounter participant 226), patients (e.g., encounter participant 228) and third parties (e.g., encounter participant 230) that occur during the patient encounter (e.g., encounter participant 228 visiting the doctor’s office) within the monitored space (e.g., monitored space 130) of the clinical environment (e.g., the doctor’s office) may be monitored / recorded / processed. Accordingly, a patient“check-in” area within monitored space 130 may be monitored to obtain encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) during this pre- visit portion of the patient encounter (e.g., encounter participant 228 visiting the doctor’s office). Further, various rooms within monitored space 130 may be monitored to obtain encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) during these various portions of the patient encounter (e.g., while meeting with the doctor, while vital signs and statistics are obtained, and while imaging is performed). Further, a patient“check-out” area within monitored space 130 may be monitored to obtain encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) during this post visit portion of the patient encounter (e.g., encounter participant 228 visiting the doctor’s office). Additionally and via machine vision encounter information 102, visual speech recognition (via visual lip reading functionality) may be utilized by automated clinical documentation process 10 to further effectuate the gathering of audio encounter information 106.

[0058] Accordingly and when obtaining 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106), automated clinical documentation process 10 may: obtain 306 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a medical professional (e.g., encounter participant 226); obtain 308 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a patient (e.g., encounter participant 228); and/or obtain 310 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a third party (e.g., encounter participant 230). Further and when obtaining 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106), automated clinical documentation process 10 may obtain 300 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from previous (related or unrelated) patient encounters. For example, if the current patient encounter is actually the third visit that the patient is making concerning e.g., shortness of breath, the encounter information from the previous two visits (i.e., the previous two patient encounters) may be highly-related and may be obtained 300 by automated clinical documentation process 10.

[0059] When automated clinical documentation process 10 obtains 300 the encounter information, automated clinical documentation process 10 may utilize 312 a virtual assistant (e.g., virtual assistant 238) to prompt the patient (e.g., encounter participant 228) to provide at least a portion of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) during a pre- visit portion (e.g., a patient intake portion) of the patient encounter (e.g., encounter participant 228 visiting the doctor’s office).

[0060] Further and when automated clinical documentation process 10 obtains 300 encounter information, automated clinical documentation process 10 may utilize 314 a virtual assistant (e.g., virtual assistant 238) to prompt the patient (e.g., encounter participant 228) to provide at least a portion of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) during a post- visit portion (e.g., a patient follow-up portion) of the patient encounter (e.g., encounter participant 228 visiting the doctor’s office). Automated Transcript Generation

[0061] Automated clinical documentation process 10 may be configured to process die encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to generate encounter transcript 234 that may he automatically formatted and punctuated.

[0062] Accordingly and referring also to FIG. 5, automated clinical documentation process 10 may be configured to obtain 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) of a patient encounter (e.g., a visit to a doctor’s office).

[0063] Automated clinical documentation process 10 may process 350 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to: associate a first portion of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) with a first encounter participant, and associate at least a second portion of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) with at least a second encounter participant.

[0064] As discussed above, modular ACD system 54 may be configured to form one or more audio recording beams (e.g., audio recording beams 220, 222, 224) via the discrete audio acquisition devices (e.g., discrete audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218) included within audio recording system 104, wherein modular ACD system 54 may be further configured to steer the one or more audio recording beams (e.g., audio recording beams 220, 222, 224) toward one or more encounter participants (e.g., encounter participants 226, 228, 230) of the above- described patient encounter.

[0065] Accordingly and continuing with the above-stated example, modular ACD system 54 may steer audio recording beam 220 toward encounter participant 226, may steer audio recording beam 222 toward encounter participant 228, and may steer audio recording beam 224 toward encounter participant 230. Accordingly and due to the directionality of audio recording beams 220, 222, 224, audio encounter information 106 may include three components, namely audio encounter information 106A (which is obtained via audio recording beam 220), audio encounter information 106B (which is obtained via audio recording beam 222) and audio encounter information 106C (which is obtained via audio recording beam 220).

[0066] Further and as discussed above, ACD compute system 12 may be configured to access one or more datasources 118 (e.g., plurality of individual datasources 120, 122, 124, 126, 128), examples of which may include but are not limited to one or more of a user profile datasource, a voice print datasource, a voice characteristics datasource (e.g., for adapting the automated speech recognition models), a face print datasource, a humanoid shape datasource, an utterance identifier datasource, a wearable token identifier datasource, an interaction identifier datasource, a medical conditions symptoms datasource, a prescriptions compatibility datasource, a medical insurance coverage datasource, and a home healthcare datasource.

[0067] Accordingly, automated clinical documentation process 10 may process 350 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to: associate a first portion (e.g., encounter information 106A) of the encounter information (e.g., audio encounter information 106) with a first encounter participant (e.g., encounter participant 226), and associate at least a second portion (e.g., encounter information 106B, 106C) of the encounter information (e.g., audio encounter information 106) with at least a second encounter participant (e.g., encounter participants 228, 230; respectively).

[0068] Further and when processing 350 the encounter information (e.g., audio encounter information 106A, 106B, 106C), automated clinical documentation process 10 may compare each of audio encounter information 106A, 106B, 106C to the voice prints defined within the above-referenced voice print datasource so that the identity of encounter participants 226, 228, 230 (respectively) may be determined. Accordingly, if the voice print datasource includes a voice print that corresponds to one or more of the voice of encounter participant 226 (as heard within audio encounter information 106A), the voice of encounter participant 228 (as heard within audio encounter information 106B) or the voice of encounter participant 230 (as heard within audio encounter information 106C), the identity of one or more of encounter participants 226, 228, 230 may be defined. And in the event that a voice heard within one or more of audio encounter information 106A, audio encounter information 106B or audio encounter information 106C is unidentifiable, that one or more particular encounter participant may be defined as“Unknown Participant”.

[0069] Once the voices of encounter participants 226, 228, 230 are processed 350, automated clinical documentation process 10 may generate 302 an encounter transcript (e.g., encounter transcript 234) based, at least in part, upon the first portion of the encounter information (e.g., audio encounter information 106A) and the at least a second portion of the encounter information (e.g., audio encounter information 106B. 106C).

Automated Role Assignment

[0070] Automated clinical documentation process 10 may be configured to automatically define roles for the encounter participants (e.g., encounter participants 226, 228, 230) in the patient encounter (e.g., a visit to a doctor’s office).

[0071] Accordingly and referring also to FIG. 6, automated clinical documentation process 10 may be configured to obtain 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) of a patient encounter (e.g., a visit to a doctor’s office).

[0072] Automated clinical documentation process 10 may then process 400 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate a first portion of the encounter information with a first encounter participant (e.g., encounter participant 226) and assign 402 a first role to the first encounter participant (e.g., encounter participant 226).

[0073] When processing 400 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate the first portion of the encounter information with the first encounter participant (e.g., encounter participant 226), automated clinical documentation process 10 may process 404 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate a first portion of the audio encounter information (e.g., audio encounter information 106A) with the first encounter participant (e.g., encounter participant 226).

[0074] Specifically and when processing 404 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate the first portion of the audio encounter information (e.g., audio encounter information 106A) with the first encounter participant (e.g., encounter participant 226), automated clinical documentation process 10 may compare 406 one or more voice prints (defined within voice print datasource) to one or more voices defined within the first portion of the audio encounter information (e.g., audio encounter information 106A); and may compare 408 one or more utterance identifiers (defined within utterance datasource) to one or more utterances defined within the first portion of the audio encounter information (e.g., audio encounter information 106A); wherein comparisons 406, 408 may allow automated clinical documentation process 10 to assign 402 a first role to the first encounter participant (e.g., encounter participant 226). For example, if the identity of encounter participant 226 can be defined via voice prints, a role for encounter participant 226 may be assigned 402 if that identity defined is associated with a role (e.g., the identity defined for encounter participant 226 is Doctor Susan Jones). Further, if an utterance made by encounter participant 226 is“I am Doctor Susan Jones”, this utterance may allow a role for encounter participant 226 to be assigned 402.

[0075] When processing 400 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate the first portion of the encounter information with the first encounter participant (e.g., encounter participant 226), automated clinical documentation process 10 may process 410 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate a first portion of the machine vision encounter information (e.g., machine vision encounter information 102 A) with the first encounter participant (e.g., encounter participant 226).

[0076] Specifically and when processing 410 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate the first portion of the machine vision encounter information (e.g., machine vision encounter information 102A) with the first encounter participant (e.g., encounter participant 226), automated clinical documentation process 10 may compare 412 one or more face prints (defined within face print datasource) to one or more faces defined within the first portion of the machine vision encounter information (e.g., machine vision encounter information 102A); compare 414 one or more wearable token identifiers (defined within wearable token identifier datasource) to one or more wearable tokens defined within the first portion of the machine vision encounter information (e.g., machine vision encounter information 102A); and compare 416 one or more interaction identifiers (defined within interaction identifier datasource) to one or more humanoid interactions defined within the first portion of the machine vision encounter information (e.g., machine vision encounter information 102A); wherein comparisons 412, 414, 416 may allow automated clinical documentation process 10 to assign 402 a first role to the first encounter participant (e.g., encounter participant 226). For example, if the identity of encounter participant 226 can be defined via face prints, a role for encounter participant 226 may be assigned 402 if that identity defined is associated with a role (e.g., the identity defined for encounter participant 226 is Doctor Susan Jones). Further, if a wearable token worn by encounter participant 226 can be identified as a wearable token assigned to Doctor Susan Jones, a role for encounter participant 226 may be assigned 402. Additionally, if an interaction made by encounter participant 226 corresponds to the type of interaction that is made by a doctor, the existence of this interaction may allow a role for encounter participant 226 to be assigned 402.

[0077] Examples of such wearable tokens may include but are not limited to wearable devices that may be worn by the medical professionals when they are within monitored space 130 (or after they leave monitored space 130). For example, these wearable tokens may be worn by medical professionals when e.g., they are moving between monitored rooms within monitored space 130, travelling to and/or from monitored space 130, and/or outside of monitored space 130 (e.g., at home).

[0078] Additionally, automated clinical documentation process 10 may process 418 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate at least a second portion of the encounter information with at least a second encounter participant; and may assign 420 at least a second role to the at least a second encounter participant.

[0079] Specifically, automated clinical documentation process 10 may process 418 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate at least a second portion of the encounter information with at least a second encounter participant. For example, automated clinical documentation process 10 may process 418 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to associate audio encounter information 106B and machine vision encounter information 102B with encounter participant 228 and may associate audio encounter information 106C and machine vision encounter information 102C with encounter participant 230.

[0080] Further, automated clinical documentation process 10 may assign 420 at least a second role to the at least a second encounter participant. For example, automated clinical documentation process 10 may assign 420 a role to encounter participants 228, 230.

Automated Movement Tracking

[0081] Automated clinical documentation process 10 may be configured to track the movement and/or interaction of humanoid shapes within the monitored space (e.g., monitored space 130) during the patient encounter (e.g., a visit to a doctor’s office) so that e.g., the automated clinical documentation process 10 knows when encounter participants (e.g., one or more of encounter participants 226, 228, 230) enter, exit or cross paths within monitored space 130.

[0082] Accordingly and referring also to FIG. 7, automated clinical documentation process 10 may process 450 the machine vision encounter information (e.g., machine vision encounter information 102) to identify one or more humanoid shapes. As discussed above, examples of machine vision system 100 generally (and ACD client electronic device 34 specifically) may include but are not limited to one or more of an RGB imaging system, an infrared imaging system, an ultraviolet imaging system, a laser imaging system, a SONAR imaging system, a RADAR imaging system, and a thermal imaging system).

[0083] When ACD client electronic device 34 includes a visible light imaging system (e.g., an RGB imaging system), ACD client electronic device 34 may be configured to monitor various objects within monitored space 130 by recording motion video in the visible light spectrum of these various objects. When ACD client electronic device 34 includes an invisible light imaging systems (e.g., a laser imaging system, an infrared imaging system and/or an ultraviolet imaging system), ACD client electronic device 34 may be configured to monitor various objects within monitored space 130 by recording motion video in the invisible light spectrum of these various objects. When ACD client electronic device 34 includes an X-ray imaging system, ACD client electronic device 34 may be configured to monitor various objects within monitored space 130 by recording energy in the X-ray spectrum of these various objects. When ACD client electronic device 34 includes a SONAR imaging system, ACD client electronic device 34 may be configured to monitor various objects within monitored space 130 by transmitting soundwaves that may be reflected off of these various objects. When ACD client electronic device 34 includes a RADAR imaging system, ACD client electronic device 34 may be configured to monitor various objects within monitored space 130 by transmitting radio waves that may be reflected off of these various objects. When ACD client electronic device 34 includes a thermal imaging system, ACD client electronic device 34 may be configured to monitor various objects within monitored space 130 by tracking the thermal energy of these various objects.

[0084] As discussed above, ACD compute system 12 may be configured to access one or more datasources 118 (e.g., plurality of individual datasources 120, 122, 124, 126, 128), wherein examples of which may include but are not limited to one or more of a user profile datasource, a voice print datasource, a voice characteristics datasource (e.g., for adapting the automated speech recognition models), a face print datasource, a humanoid shape datasource, an utterance identifier datasource, a wearable token identifier datasource, an interaction identifier datasource, a medical conditions symptoms datasource, a prescriptions compatibility datasource, a medical insurance coverage datasource, and a home healthcare datasource.

[0085] Accordingly and when processing 450 the machine vision encounter information (e.g., machine vision encounter information 102) to identify one or more humanoid shapes, automated clinical documentation process 10 may be configured to compare the humanoid shapes defined within one or more datasources 118 to potential humanoid shapes within the machine vision encounter information (e.g., machine vision encounter information 102).

[0086] When processing 450 the machine vision encounter information (e.g., machine vision encounter information 102) to identify one or more humanoid shapes, automated clinical documentation process 10 may track 452 the movement of the one or more humanoid shapes within the monitored space (e.g., monitored space 130). For example and when tracking 452 the movement of the one or more humanoid shapes within monitored space 130, automated clinical documentation process 10 may add 454 a new humanoid shape to the one or more humanoid shapes when the new humanoid shape enters the monitored space (e.g., monitored space 130) and/or may remove 456 an existing humanoid shape from the one or more humanoid shapes when the existing humanoid shape leaves the monitored space (e.g., monitored space 130).

[0087] For example, assume that a lab technician (e.g., encounter participant 242) temporarily enters monitored space 130 to chat with encounter participant 230. Accordingly, automated clinical documentation process 10 may add 454 encounter participant 242 to the one or more humanoid shapes being tracked 452 when the new humanoid shape (i.e., encounter participant 242) enters monitored space 130. Further, assume that the lab technician (e.g., encounter participant 242) leaves monitored space 130 after chatting with encounter participant 230. Therefore, automated clinical documentation process 10 may remove 456 encounter participant 242 from the one or more humanoid shapes being tracked 452 when the humanoid shape (i.e., encounter participant 242) leaves monitored space 130.

[0088] Also and when tracking 452 the movement of the one or more humanoid shapes within monitored space 130, automated clinical documentation process 10 may monitor the trajectories of the various humanoid shapes within monitored space 130. Accordingly, assume that when leaving monitored space 130, encounter participant 242 walks in front of (or behind) encounter participant 226. As automated clinical documentation process 10 is monitoring the trajectories of (in this example) encounter participant 242 (who is e.g., moving from left to right) and encounter participant 226 (who is e.g., stationary), when encounter participant 242 passes in front of (or behind) encounter participant 226, the identities of these two humanoid shapes may not be confused by automated clinical documentation process 10.

[0089] Automated clinical documentation process 10 may be configured to obtain 300 the encounter information of the patient encounter (e.g., a visit to a doctor’s office), which may include machine vision encounter information 102 (in the manner described above) and/or audio encounter information 106.

[0090] Automated clinical documentation process 10 may steer 458 one or more audio recording beams (e.g., audio recording beams 220, 222, 224) toward the one or more humanoid shapes (e.g., encounter participants 226, 228, 230) to capture audio encounter information (e.g., audio encounter information 106), wherein audio encounter information 106 may be included within the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106).

[0091] Specifically and as discussed above, automated clinical documentation process 10 (via modular ACD system 54 and/or audio recording system 104) may utilize one or more of the discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218) to form an audio recording beam. For example, modular ACD system 54 and/or audio recording system 104 may be configured to utilize various audio acquisition devices to form audio recording beam 220, thus enabling the capturing of audio (e.g., speech) produced by encounter participant 226 (as audio recording beam 220 is pointed to (i.e., directed toward) encounter participant 226). Additionally, modular ACD system 54 and/or audio recording system 104 may be configured to utilize various audio acquisition devices to form audio recording beam 222, thus enabling the capturing of audio (e.g., speech) produced by encounter participant 228 (as audio recording beam 222 is pointed to (i.e., directed toward) encounter participant 228). Additionally, modular ACD system 54 and/or audio recording system 104 may be configured to utilize various audio acquisition devices to form audio recording beam 224, thus enabling the capturing of audio (e.g., speech) produced by encounter participant 230 (as audio recording beam 224 is pointed to (i.e., directed toward) encounter participant 230).

[0092] Once obtained, automated clinical documentation process 10 may process 302 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to generate encounter transcript 234 and may process 304 at least a portion of encounter transcript 234 to populate at least a portion of a medical record (e.g., medical record 236) associated with the patient encounter (e.g., a visit to a doctor’s office). Automated Amendment of Records:

[0093] Automated clinical documentation process 10 may be configured to allow a user (e.g., a medical professional) to amend medical record 236 based upon verbal feedback received from the user (e.g., a medical professional). Accordingly and referring also to FIG. 8, automated clinical documentation process 10 may be configured to obtain 300 encounter information of a patient encounter (e.g., a visit to a doctor’s office), wherein (and as discussed above) this encounter information may include machine vision encounter information 102 and/or audio encounter information 106.

[0094] As discussed above and when obtaining 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106), automated clinical documentation process 10 may: obtain 306 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a medical professional (e.g., encounter participant 226); obtain 308 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a patient (e.g., encounter participant 228); and/or obtain 310 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a third party (e.g., encounter participant 230).

[0095] Further and as discussed above, automated clinical documentation process 10 may be configured to process 302 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to generate an encounter transcript (e.g., encounter transcript 234). Once the encounter transcript (e.g., encounter transcript 234) is generated, automated clinical documentation process 10 may process 304 at least a portion of the encounter transcript (e.g., encounter transcript 234) to populate at least a portion of a medical record (e.g., medical record 236) associated with the patient encounter (e.g., the visit to the doctor’s office).

[0096] As discussed above, encounter transcript 234 and/or medical record 236 may be reviewed by a medical professional involved with the patient encounter (e.g., a visit to a doctor’s office) to determine the accuracy of the same and/or make corrections to the same. For example, a scribe involved with (or assigned to) the patient encounter (e.g., a visit to a doctor’s office) and/or a doctor involved with the patient encounter (e.g., a visit to a doctor’s office) may review encounter transcript 234 and/or medical record 236 to confirm that the same was accurate and/or make corrections to the same. In the event that corrections are made to encounter transcript 234 and/or medical record 236, automated clinical documentation process 10 may utilize these corrections for training / tuning purposes (e.g., to adjust the various profiles associated the participants of the patient encounter) to enhance the future accuracy / efficiency / performance of automated clinical documentation process 10.

[0097] Accordingly and to effectuate such a review of medical record 236, automated clinical documentation process 10 may provide 500 the medical record (e.g., medical record 236) to a medical professional (e.g., encounter participant 226) and may enable 502 the medical professional (e.g., encounter participant 226) to influence the medical record (e.g., medical record 236).

[0098] When providing 500 the medical record (e.g., medical record 236) to a medical professional (e.g., encounter participant 226), automated clinical documentation process 10 may: provide 504 a text-based copy of the medical record (e.g., medical record 236) to the medical professional (e.g., encounter participant 226); and/or provide 506 an audio-based copy of the medical record (e.g., medical record 236) to the medical professional (e.g., encounter participant 226).

[0099] For example, automated clinical documentation process 10 may provide 504 a text-based copy (e.g., a printed hardcopy or a computer rendered softcopy) of medical record 236 so that medical record 236 may be reviewed for accuracy by the medical professional (e.g., encounter participant 226). Additionally / alternatively, automated clinical documentation process 10 may provide 506 an audio-based copy (e.g., via an audio stream) of medical record 236 so that medical record 236 may be reviewed for accuracy by the medical professional (e.g., encounter participant 226).

[00100] When enabling 502 the medical professional (e.g., encounter participant 226) to influence the medical record (e.g., medical record 236), automated clinical documentation process 10 may enable 508 the medical professional (e.g., encounter participant 226) to provide verbal feedback (e.g., feedback 240) concerning the medical record (e.g., medical record 236). Accordingly and if reading a text-based copy of the medical record (e.g., medical record 236), automated clinical documentation process 10 may“listen” for verbal feedback 240 via e.g., audio input device 30 and/or the plurality of discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218). Additionally / alternatively and if listening to an audio-based copy of the medical record (e.g., medical record 236), automated clinical documentation process 10 may“listen” for verbal feedback 240 via e.g., audio input device 30 and/or the plurality of discrete audio acquisition devices (e.g., audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218).

[00101] Once verbal feedback 240 is received, automated clinical documentation process 10 may amend 510 the medical record (e.g., medical record 236), based, at least in part, upon verbal feedback 240. As will be discussed below in greater detail, verbal feedback 204 may concern adding pertinent information included within the encounter transcript (e.g., encounter transcript 234) into the medical record (e.g., medical record 236). Conversely, verbal feedback 204 may concern removing non-pertinent information from the medical record (e.g., medical record 236).

[00102] If verbal feedback 240 concerns including pertinent information in the medical record (e.g., medical record 236); amending 510 the medical record (e.g., medical record 236) based, at least in part, upon verbal feedback 240 may include: obtaining 512 the pertinent information from the encounter transcript (e.g., encounter transcript 234); and modifying 514 the medical record (e.g., medical record 236) based, at least in part, upon the pertinent information obtained 512. Alternatively and if verbal feedback 240 concerns removing non-pertinent information from the medical record (e.g., medical record 236); amending 510 the medical record (e.g., medical record 236) based, at least in part, upon verbal feedback 240 may include: modifying 516 the medical record (e.g., medical record 236) based, at least in part, upon the non-pertinent information.

[00103] Assume for this example that the medical professional (e.g., encounter participant 226) reviewed the medical record (e.g., medical record 236) and provided verbal feedback 240 concerning medical record 236. Verbal feedback 240 may be processed by automated clinical documentation process 10 using Natural Language Understanding (NLU) technology, such as that offered by Nuance Communications of Burlington, MA. As is known in the art, NLU is a branch of artificial intelligence (AI) that uses computer software to understand input provided by humans in the form of sentences in text or speech format, thus allowing human-computer interaction (HCI). Specifically, NLU understanding of natural human languages enables computers to understand commands without the formalized syntax of computer languages and enables computers to communicate back to humans in their own languages. The field of NLU is typically considered to be a subset of natural language processing (NLP). While both NLU and NLP understand human language, NLU may more effectively communicate with untrained individuals and may better understand the intent and meaning of that human language. NLU may even understand the meaning of human language despite common human errors (e.g., mispronunciations, transposed letters / words, etc.). NLU uses AI algorithms to reduce human speech into a structured ontology, wherein these AI algorithms may extract content concerning intent, timing, locations and sentiments. For example and when processing a request for an island camping trip on Vancouver Island on the 18th of August, NLU may break down this request into subcomponents such as: need: ferry tickets [intent] / need: camping lot reservation [intent] / Vancouver Island [location] / August 18th [date].

[00104] Verbal feedback 240 provided by the medical professional (e.g., encounter participant 226) may concern simple administrative procedures, such as e.g., making minor edits to medical record 236 and/or adding / removing / revising a few words within medical record 236. However, verbal feedback 240 may involve more complex operations.

[00105] For example, assume that during the patient encounter (e.g., encounter participant 228 visiting the doctor’s office), the medical professional (e.g., encounter participant 226) and the patient (e.g., encounter participant 228) discuss various things. Assume for illustrative purposes that one of this things discussed is that encounter participant 228 is constantly thirsty. However and upon reviewing medical record 236, the medical professional (e.g., encounter participant 226) realizes that the information and discussion concerning the constant thirst of encounter participant 228 is not included / referenced within medical record 236. Further, assume that the medical professional (e.g., encounter participant 226) believes that the information & discussion concerning the constant thirst of encounter participant 228 should have been included / referenced within medical record 236 .

[00106] Accordingly, verbal feedback 240 provided by the medical professional (e.g., encounter participant 226) may be“Please include the discussion about the constant thirst of the patient”. As discussed above, automated clinical documentation process 10 may amend 510 the medical record (e.g., medical record 236), based, at least in part, upon verbal feedback 240. Specifically and since verbal feedback 240 concerns including pertinent information (e.g., the information about the constant thirst of the patient) in the medical record (e.g., medical record 236); when amending 510 the medical record (e.g., medical record 236) based, at least in part, upon verbal feedback 240, automated clinical documentation process 10 may: obtain 512 the pertinent information (e.g., the information about the constant thirst of the patient) from the encounter transcript (e.g., encounter transcript 234); and may modify 514 the medical record (e.g., medical record 236) based, at least in part, upon the pertinent information obtained 512.

[00107] When modifying 514 the medical record (e.g., medical record 236) based, at least in part, upon the pertinent information obtained 512, automated clinical documentation process 10 may simply add the pertinent information (e.g., the information about the constant thirst of the patient) to the medical record (e.g., medical record 236). However, more substantial changes may occur to the medical record (e.g., medical record 236). For example, assume that the pertinent information (e.g., the information about the constant thirst of the patient) triggers a concern that to the patient (e.g., encounter participant 228) may be diabetic. Accordingly, automated clinical documentation process 10 may e.g., reformat the medical record (e.g., medical record 236) or may utilize a different template to generate the medical record (e.g., medical record 236).

[00108] Continuing with the above-stated example, further assume that during the patient encounter (e.g., encounter participant 228 visiting the doctor’s office), the medical professional (e.g., encounter participant 226) and the patient (e.g., encounter participant 228) discussed that encounter participant 228 has lost three pounds. And upon reviewing medical record 236, the medical professional (e.g., encounter participant 226) realizes that the information and discussion concerning this loss of three pounds of encounter participant 228 is included / referenced within medical record 236. Further, assume that the medical professional (e.g., encounter participant 226) believes that the information and discussion concerning this loss of three pounds of encounter participant 228 should not have been included / referenced within medical record 236, as the patient (e.g., encounter participant 228) is more than 100 pounds overweight. .

[00109] Accordingly, verbal feedback 240 provided by the medical professional (e.g., encounter participant 226) may be“Please remove the discussion about the loss of three pounds”. As discussed above, automated clinical documentation process 10 may amend 510 the medical record (e.g., medical record 236), based, at least in part, upon verbal feedback 240. Specifically and since verbal feedback 240 concerns removing non-pertinent information from the medical record (e.g., medical record 236); amending 510 the medical record (e.g., medical record 236) based, at least in part, upon verbal feedback 240 may include modifying 516 the medical record (e.g., medical record 236) based, at least in part, upon the non-pertinent information (e.g., the loss of three pounds).

[00110] When modifying 516 the medical record (e.g., medical record 236) based, at least in part, upon the non-pertinent information, automated clinical documentation process 10 may simply remove the non-pertinent information (e.g., the information about the loss of three pounds) from the medical record (e.g., medical record 236). However, more substantial changes may occur to the medical record (e.g., medical record 236). For example, assume that the removal of the non-pertinent information (e.g., the loss of three pounds) triggers a concern that the weight of the patient is not under control. Accordingly, automated clinical documentation process 10 may e.g., reformat the medical record (e.g., medical record 236) or may utilize a different template to generate the medical record (e.g., medical record 236).

Tracking Procedural Events:

[00111] Automated clinical documentation process 10 may be configured to allow a user (e.g., a medical professional) to examine an encounter transcript (e.g., encounter transcript 234) for the occurrence of certain procedural events. Accordingly and referring also to FIG. 9, automated clinical documentation process 10 may be configured to obtain 300 encounter information of a patient encounter (e.g., a visit to a doctor’s office), wherein (and as discussed above) this encounter information may include machine vision encounter information 102 and/or audio encounter information 106.

[00112] As discussed above and when obtaining 300 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106), automated clinical documentation process 10 may: obtain 306 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a medical professional (e.g., encounter participant 226); obtain 308 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a patient (e.g., encounter participant 228); and/or obtain 310 encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) from a third party (e.g., encounter participant 230).

[00113] Further and as discussed above, automated clinical documentation process 10 may be configured to process 302 the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) to generate an encounter transcript (e.g., encounter transcript 234). Once the encounter transcript (e.g., encounter transcript 234) is generated, automated clinical documentation process 10 may process 304 at least a portion of the encounter transcript (e.g., encounter transcript 234) to populate at least a portion of a medical record (e.g., medical record 236) associated with the patient encounter (e.g., the visit to the doctor’s office).

[00114] Automated clinical documentation process 10 may process 550 the encounter transcript (e.g., encounter transcript 234) to locate one or more procedural events within the encounter transcript (e.g., encounter transcript 234). Examples of such procedural events may include but are not limited to: an informed consent event; a personal medical history event; a family medical history event; a drug allergy event; a drug side-effect event; and a drug warning event.

• Informed Consent Event: When procedures are performed on patients, the patients may be required to give an informed consent with respect to the procedures being performed. Accordingly and in the event that e.g., a patient is receiving an injectable medication, the patient may be required to provide an informed consent to the medical professional authorizing the injection.

• Personal Medical History Event: When a patient visits a clinical environment, the medical professional may inquire about the personal medical history of the patient, as such information may be of paramount importance when determining how to examine and/or treat the patient.

• Family Medical History Event: When a patient visits a clinical environment, the medical professional may inquire about the family medical history of the patient, as such information may be of paramount importance when determining how to examine and/or treat the patient.

• Drug Allergy Event: When a patient visits a clinical environment, the medical professional may inquire about any drug allergies that the patient has or may have, as such information may be of paramount importance when determining how to treat the patient.

• Drug Side-Effect Event: When a patient visits a clinical environment, the medical professional may explain to the patient any potential side effects that the patient may experience when taking a medication that has been / will be prescribed.

• Drug Warning Event: When a patient visits a clinical environment, the medical professional may explain to the patient any potential addictive effects that are associated with a medication that has been / will be prescribed.

[00115] When processing 550 the encounter transcript (e.g., encounter transcript 234) to locate one or more procedural events within the encounter transcript (e.g., encounter transcript 234), the processing 550 of the encounter transcript (e.g., encounter transcript 234) may be manually-initiated or automatically-initiated.

[00116] For example and via automated clinical documentation process 10, a medical professional (e.g., encounter participant 226) may manually-initiate 552 the processing 550 of the encounter transcript (e.g., encounter transcript 234) to locate one or more procedural events within the encounter transcript (e.g., encounter transcript 234). Accordingly and at the request of the medical professional (e.g., encounter participant 226), automated clinical documentation process 10 may process 550 encounter transcript 234 to look for portions of encounter transcript 234 that concern one or more of an informed consent event; a personal medical history event; a family medical history event; a drug allergy event; a drug side-effect event; and a drug warning event.

[00117] Additionally / alternatively, automated clinical documentation process 10 may automatic ally-initiate 554 the processing 550 of the encounter transcript (e.g., encounter transcript 234) to locate one or more procedural events within the encounter transcript (e.g., encounter transcript 234). Accordingly and automatically, automated clinical documentation process 10 may process 550 encounter transcript 234 to look for portions of encounter transcript 234 that concern one or more of an informed consent event; a personal medical history event; a family medical history event; a drug allergy event; a drug side-effect event; and a drug warning event.

[00118] Specifically and when processing 550 the encounter transcript (e.g., encounter transcript 234) to locate one or more procedural events within the encounter transcript (e.g., encounter transcript 234), automated clinical documentation process 10 may examine encounter transcript 234 to locate portions of encounter transcript 234 (using e.g., a defined vocabulary words, a list of words / phrases, artificial intelligence and/or machine learning) that concern one or more of an informed consent event; a personal medical history event; a family medical history event; a drug allergy event; a drug side-effect event; and a drug warning event.

[00119] Once the procedural events are located within the encounter transcript (e.g., encounter transcript 234), automated clinical documentation process 10 may associate 556 the one or more procedural events (e.g., an informed consent event; a personal medical history event; a family medical history event; a drug allergy event; a drug side-effect event; and/or a drug warning event) with one or more portions of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) of the patient encounter (e.g., a visit to a doctor’s office).

[00120] For example, if processing 550 the encounter transcript (e.g., encounter transcript 234) to locate an informed consent event concerning the administration of a flu vaccine, automated clinical documentation process 10 may examine encounter transcript 234 to locate the portion(s) of encounter transcript 234 that concern the administration of the flu vaccine. Once the relevant portion(s) of the encounter transcript 234 are located, automated clinical documentation process 10 may associate 556 the procedural event(s) located within encounter transcript 234 with one or more portions of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106), wherein these one or more portions of the encounter information (e.g., machine vision encounter information 102 and/or audio encounter information 106) may be video information (from e.g., machine vision encounter information 102) and/or audio information (from e.g., audio encounter information 106) that illustrates the patient in question providing the informed consent concerning the administration of the flu vaccine.

[00121] As discussed above, ACD compute system 12 may be configured to access one or more datasources 118 (e.g., plurality of individual datasources 120, 122, 124, 126, 128), examples of which may include but are not limited to one or more of a user profile datasource, a voice print datasource, a voice characteristics datasource (e.g., for adapting the automated speech recognition models), a face print datasource, a humanoid shape datasource, an utterance identifier datasource, a wearable token identifier datasource, an interaction identifier datasource, a medical conditions symptoms datasource, a prescriptions compatibility datasource, a medical insurance coverage datasource, and a home healthcare datasource.

[00122] Further and as discussed above, when processing audio encounter information 106, automated clinical documentation process 10 may compare audio encounter information 106 to the voice prints defined within the above-referenced voice print datasource so that the identity of encounter participants may be determined. Therefore, automated clinical documentation process 10 may confirm 558 the identity of one or more encounter participants of the patient encounter (e.g., encounter participant 228 visiting the doctor’s office). For example, if the voice print datasource includes a voice print for encounter participant 228 (i.e., the patient visiting the doctor’s office), automated clinical documentation process 10 may confirm 558 the identity of encounter participant 228, thus authenticating the informed consent given by encounter participant 228 concerning the administration of the flu vaccine.

General:

[00123] As will be appreciated by one skilled in the art, the present disclosure may be embodied as a method, a system, or a computer program product. Accordingly, the present disclosure may take the form of an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.) or an embodiment combining software and hardware aspects that may all generally be referred to herein as a“circuit,”“module” or“system.” Furthermore, the present disclosure may take the form of a computer program product on a computer-usable storage medium having computer-usable program code embodied in the medium.

[00124] Any suitable computer usable or computer readable medium may be utilized. The computer-usable or computer-readable medium may be, for example but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, device, or propagation medium. More specific examples (a non-exhaustive list) of the computer-readable medium may include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a transmission media such as those supporting the Internet or an intranet, or a magnetic storage device. The computer-usable or computer-readable medium may also be paper or another suitable medium upon which the program is printed, as the program can be electronically captured, via, for instance, optical scanning of the paper or other medium, then compiled, interpreted, or otherwise processed in a suitable manner, if necessary, and then stored in a computer memory. In the context of this document, a computer- usable or computer-readable medium may be any medium that can contain, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device. The computer-usable medium may include a propagated data signal with the computer-usable program code embodied therewith, either in baseband or as part of a carrier wave. The computer usable program code may be transmitted using any appropriate medium, including but not limited to the Internet, wireline, optical fiber cable, RF, etc.

[00125] Computer program code for carrying out operations of the present disclosure may be written in an object oriented programming language such as Java, Smalltalk, C++ or the like. However, the computer program code for carrying out operations of the present disclosure may also be written in conventional procedural programming languages, such as the "C" programming language or similar programming languages. The program code may execute entirely on the user's computer, partly on the user's computer, as a stand-alone software package, partly on the user’ s computer and partly on a remote computer or entirely on the remote computer or server. In the latter scenario, the remote computer may be connected to the user’s computer through a local area network / a wide area network / the Internet (e.g., network 14).

[00126] The present disclosure is described with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems) and computer program products according to embodiments of the disclosure. It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, may be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer / special purpose computer / other programmable data processing apparatus, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.

[00127] These computer program instructions may also be stored in a computer- readable memory that may direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means which implement the function/act specified in the flowchart and/or block diagram block or blocks.

[00128] The computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide steps for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.

[00129] The flowcharts and block diagrams in the figures may illustrate the architecture, functionality, and operation of possible implementations of systems, methods and computer program products according to various embodiments of the present disclosure. In this regard, each block in the flowchart or block diagrams may represent a module, segment, or portion of code, which comprises one or more executable instructions for implementing the specified logical function(s). It should also be noted that, in some alternative implementations, the functions noted in the block may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It will also be noted that each block of the block diagrams and/or flowchart illustrations, and combinations of blocks in the block diagrams and/or flowchart illustrations, may be implemented by special purpose hardware-based systems that perform the specified functions or acts, or combinations of special purpose hardware and computer instructions. [00130] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the disclosure. As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms "comprises" and/or "comprising," when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof.

[00131] The corresponding structures, materials, acts, and equivalents of all means or step plus function elements in the claims below are intended to include any structure, material, or act for performing the function in combination with other claimed elements as specifically claimed. The description of the present disclosure has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to the disclosure in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the disclosure. The embodiment was chosen and described in order to best explain the principles of the disclosure and the practical application, and to enable others of ordinary skill in the art to understand the disclosure for various embodiments with various modifications as are suited to the particular use contemplated.

[00132] A number of implementations have been described. Having thus described the disclosure of the present application in detail and by reference to embodiments thereof, it will be apparent that modifications and variations are possible without departing from the scope of the disclosure defined in the appended claims.