Patent Application
20150094545
The present disclosure relates generally to physiological monitoring systems, and more particularly to associating physiological measurements with an at-rest status of a patient.
At-rest physiological measurements are used by clinicians for a variety of clinical purposes, including determining fitness level, detecting cardiac disease, and monitoring stress level. Collecting at-rest physiological measurements, however, may be difficult and unreliable. Traditionally, at-rest physiological measurements are taken in a clinical setting, where a clinician may ask the patient to sit or lie down in order to facilitate an at-rest status in the patient. Given the limited time during which a clinician is available to see each patient, however, the patient may not have ample time to achieve an at-rest status such that the physiological measurements are truly taken at-rest. Additionally, such methods limit the clinician to brief snapshots of physiological measurements based on the patient's limited visits to the office, with no data gathered relating to the patient's physiological measurements during the time the patient is away from the doctor's office.
One way to collect physiological measurements is to provide a patient with a remote monitoring device. Traditional remote monitoring devices, however, may monitor and/or transmit physiological measurements constantly, with no means provided to differentiate between physiological measurements gathered when the patient is active and physiological measurements gathered when the patient is at-rest. Thus, for example, physiological measurements transmitted to a clinician from these remote devices might indicate an increased heart rate but could fail to indicate whether the increased heart rate was due to exercise or some other activity, or whether the increased heart rate was indicative of some other underlying concern. For example, the increased heart rate could be due to infection, or could be merely due to a patient's normal workout session. The clinician, however, may have no means by which to differentiate between the two possible causes or any other cause. The physiological measurements provided by the remote monitoring device may therefore be largely medically irrelevant, and may lead to misdiagnosis.
In order to remotely monitor physiological measurements of a patient, it is therefore necessary to provide a means by which it may be determined that the patient is at-rest, and a means to correlate the physiological measurements transmitted to the caregiver with these periods of patient at-rest status.
Because many physiological measurements are only clinically relevant when taken while the patient is at-rest, it may be beneficial to a clinician to receive remotely monitored physiological measurements “flagged” as having been taken during an at-rest period. In this way, the clinician may be able to identify variations in physiological measurements, for example heart rate, which cannot be attributed to normal patient activity or non-life threatening anxiety, and may therefore be attributable instead to some underlying health issue. One method of accomplishing this includes receiving activity data of a patient from one or more sensors, receiving physiological data of the patient from one or more sensors, and determining that an at-rest condition of the patient is satisfied by at least one of the received activity data and physiological data. An at-rest indicator may then be associated with one or more physiological measurements of the patient based at least in part on this determination.
By collecting both activity data and physiological data in order to determine that an at-rest condition is satisfied, a patient may be determined to be at-rest based on either the activity data or the physiological data, or alternatively, a patient may be determined to be at-rest based on both the activity data and the physiological data such that situations in which a patient is at-rest mechanically, but not at-rest physiologically, or vice versa, may be disregarded. For example, a patient who has recently run three miles and is now seated may be mechanically at-rest, but his heart rate may continue to be elevated as a result of the physical exertion for an additional five minutes after he sits down, such that any physiological measurements collected during this period of “recovery” are not related to a true at-rest status. Thus, by requiring that an at-rest condition be satisfied by both physiological data and activity data, a clinician may decipher those physiological measurements collected when the patient is truly at-rest.
Certain embodiments of the present disclosure may include some, all, or none of the above advantages. One or more other technical advantages may be readily apparent to those skilled in the art from the figures, descriptions, and claims included herein. Moreover, while specific advantages have been enumerated above, various embodiments may include all, some, or none of the enumerated advantages.
Further scope of the applicability of the described methods and apparatuses will become apparent from the following detailed description, claims, and drawings. The detailed description and specific examples are given by way of illustration only, since various changes and modifications within the spirit and scope of the description will become apparent to those skilled in the art.
A further understanding of the nature and advantages of the present invention may be realized by reference to the following drawings. In the appended figures, similar components or features may have the same reference label. Further, various components of the same type may be distinguished by following the reference label with a dash and a second label that distinguishes among the similar components. If only the first reference label is used in the specification, the description is applicable to any one of the similar components having the same first reference label irrespective of the second reference label.
In order to efficiently understand the physiological condition of a patient, clinicians monitor a plurality of physiological measurements of the patient. These measurements may include, for example, the patient's heart rate, heart rate variability, respiration rate, respiration rate variability, blood pressure, oxygen saturation levels, glucose levels, weight, perspiration, core temperature, electromyography data, electroencephalogram data, etc. These physiological measurements may only serve as accurate indicators of a patient's health, however, when monitored when the patient is at-rest. For example, increased perspiration may be a natural byproduct of vigorous exercise in a healthy patient, but may be indicative of thyroid issues, infection, or diabetes in an unhealthy patient when observed when the patient is at-rest. Presenting physiological measurements to a clinician flagged as having been taken when the patient was at-rest, therefore, may provide the clinician with valuable background information as to the medical relevance of the measurements received.
An at-rest status may be achieved by a patient being physiologically at-rest and/or mechanically at-rest. For example, a patient may be mechanically at-rest in that the patient is seated, but may not be physiologically at-rest because he has just climbed a flight of stairs to reach the chair in which he is seated, and his heart rate and respiration rate may therefore still be elevated. Thus, the combination of mechanical at-rest status and physiological at-rest status may best indicate to a clinician that physiological measurements taken during a particular period of time are taken when the patient is truly at-rest.
The present disclosure includes a method and system for determining and presenting to the clinician physiological measurements associated with flags indicating which physiological measurements were taken when the patient was mechanically and/or physiologically at-rest. The recorded physiological measurements may be collected through a physiological monitoring system. One example of a physiological monitoring system is a remote physiological monitoring system. Examples below describe such a system, though it should be understood that any type of physiological monitoring system may provide physiological data and activity data from which an at-rest status may be determined for display to a clinician.
Referring first to
The sensor units 110 are described in greater detail below. The sensor units 110 may be a body-worn device, coupled to the patient's chest or to any other suitable portion of the patient's body, such as the patient's arm, wrist, or thigh. The sensor units 110 may be coupled to the patient using an adhesive, a strap, or any other suitable means. In an alternative embodiment, the sensor units 110 may be coupled to or integral with a garment worn by a patient, such as a belt, wristband, headband, armband, or piece of clothing.
In some embodiments, the sensor units 110 are sensors configured to conduct periodic or ongoing automatic measurements of one or more physiological measurements, physiological data and/or activity data. A patient may wear or otherwise be attached to one or more sensor units 110 so that the sensor units 110 may measure, record, and/or report physiological measurements, physiological data, and/or activity data associated with the patient.
Each sensor unit 110 may be capable of sensing multiple physiological measurements, as well as sensing physiological data and activity data. Thus, the sensor units 110 may each include multiple sensors such as heart rate and ECG sensors, respiratory rate sensors, and accelerometers. For example, a first sensor in a sensor unit 110 may be an oxygen saturation monitor or a glucose level monitor operable to detect a patient's blood oxygen or sugar levels. A second sensor within a sensor unit 110 may be operable to detect a second physiological parameter. For example, the second sensor may be a heart rate monitor, an electrocardiogram (ECG) sensing module, a breathing rate sensing module, and/or any other suitable module for monitoring any suitable physiological measurement. A third sensor within a sensor unit 110 may be operable to detect the position, velocity, and/or acceleration of the sensor unit 110. Multiple sensor units 110 may be used on a single patient 105. The data collected by the sensor units 110 may be wirelessly conveyed to either the local computing devices 115, 120 or to the remote computing device 145 (via the network 125 and server 135). Data transmission may occur via, for example, frequencies appropriate for a personal area network (such as Bluetooth or IR communications) or local or wide area network frequencies such as radio frequencies specified by the IEEE 802.15.4 standard.
The sensor units 110 may include any of the sensors, detectors, and/or modules operable to detect physiological parameters illustrated and described in U.S. Patent Publication No. 2011/0257542, filed Apr. 15, 2011; U.S. Patent Publication No. 2012/0143019, filed Jun. 6, 2011; U.S. Patent Publication No. 2009/0227856, filed Dec. 19, 2008; U.S. Patent Publication No. 2009/0281394, filed Sep. 21, 2007; U.S. Patent Publication No. 2013/0144130, filed Jan. 30, 2012; U.S. Patent Application No. 61/823,596, filed Mar. 15, 2013; U.S. Patent Application No. 61/864,161, filed Aug. 9, 2013; U.S. Pat. No. 8,400,302, issued Mar. 19, 2013; and/or U.S. Pat. No. 8,079,247, issued Dec. 20, 2011, each of which is commonly owned and which is incorporated herein by reference in its entirety.
In one embodiment, one or more sensor units 110 comprises an accelerometer to measure patient activity data. The accelerometer may be a three-axis microelectromechanical system (MEMS) accelerometer, a piezoelectric accelerometer, a mechanical accelerometer, and/or any other suitable device to detect acceleration and/or static acceleration fields (e.g., the gravitational field). In addition or alternatively, the accelerometer may include a gyroscope operable to detect angular position, angular velocity, and/or angular acceleration of the sensor unit 110.
In some embodiments, one or more third-party sensors 130 may comprise sensors to detect environmental data, such as surface pressure to detect whether a patient 105 is sitting down or lying still. Additionally, one or more third-party sensors 130 may comprise video cameras for detecting whether the patient 105 is sitting down or lying still. In this way, the third-party sensors 130 may provide data relating to the activity data of the patient 105. In some embodiments, third-party sensors 130 may detect environmental data such as temperature, humidity or vibration data in order to determine patient activity data or physiological data. For example, if third-party sensor 130 detects increased humidity, this data may be indicative of increased patient respiration and body temperature. In another example, if third-party sensor 130 detects vibration data, this data may be indicative of patient movement or activity.
The local computing devices 115, 120 may enable the patient 105 and/or a local caregiver to monitor the collected physiological measurements. For example, the local computing devices 115, 120 may be operable to present data collected from sensor units 110, 130 in a human-readable format. For example, the received data may be outputted as a display on a computer or a mobile device. The local computing devices 115, 120 may include a processor that may be operable to present data received from the sensor units 110, 130 in a visual format. The local computing devices 115, 120 may also output data in an audible format using, for example, a speaker. In alternative embodiments, the received data may be output as a display or in an audible format from the one or more sensor units 110 themselves.
The local computing devices 115, 120 may be custom computing entities configured to interact with the sensor units 110. In some embodiments, the local computing devices 115, 120 and the sensor units 110 may be portions of a single sensing unit operable to sense and display physiological measurements. In another embodiment, the local computing devices 115, 120 may be general purpose computing entities such as a personal computing device, for example a desktop computer, a laptop computer, a netbook, a tablet personal computer (PC), an iPod®, an iPad®, a smart phone (e.g., an iPhone®, an Android® phone, a Blackberry®, a Windows® phone, etc.), a mobile phone, a personal digital assistant (PDA), and/or any other suitable device operable to send and receive signals, store and retrieve data, and/or execute modules.
The local computing devices 115, 120 may include memory, a processor, an output, a data input and a communication module. The processor may be a general purpose processor, a Field Programmable Gate Array (FPGA), an Application Specific Integrated Circuit (ASIC), a Digital Signal Processor (DSP), and/or the like. The processor may be configured to retrieve data from and/or write data to the memory. The memory may be, for example, a random access memory (RAM), a memory buffer, a hard drive, a database, an erasable programmable read only memory (EPROM), an electrically erasable programmable read only memory (EEPROM), a read only memory (ROM), a flash memory, a hard disk, a floppy disk, cloud storage, and/or so forth. In some embodiments, the local computing devices 115, 120 may include one or more hardware-based modules (e.g., DSP, FPGA, ASIC) and/or software-based modules (e.g., a module of computer code stored at the memory and executed at the processor, a set of processor-readable instructions that may be stored at the memory and executed at the processor) associated with executing an application, such as, for example, receiving and displaying data from sensor units 110.
The data input module of the local computing devices 115, 120 may be used to manually input physiological measurements instead of or in addition to receiving data from the sensor units 110. For example, a user of the local computing device 115, 120 may make an observation as to one or more physiological or activity conditions, or physiological measurements, of a patient and record the observation using the data input module. A user may be, for example, a nurse, a doctor, and/or any other medical healthcare professional authorized to record patient observations, the patient, and/or any other suitable person. For instance, the user may measure the patient's body temperature (e.g., using a stand-alone thermometer) and enter the measurement into the data input module. In some embodiments, the data input module may be operable to allow the user to select “body temperature” and input the observed temperature into the data input module, e.g., using a keyboard. In other embodiments, the data input module may be operable to allow the user to select whether the patient is stationary or is mechanically in motion. Automatically collected physiological data and activity data may be used to flag the manually input physiological measurements as being associated with an at-rest status.
The processor of the local computing devices 115, 120 may be operated to control operation of the output of the local computing devices 115, 120. The output may be a television, liquid crystal display (LCD) monitor, cathode ray tube (CRT) monitor, speaker, tactile output device, and/or the like. In some embodiments, the output may be an integral component of the local computing devices 115, 120. Similarly stated, the output may be directly coupled to the processor. For example, the output may be the integral display of a tablet and/or smartphone. In some embodiments, an output module may include, for example, a High Definition Multimedia Interface™ (HDMI) connector, a Video Graphics Array (VGA) connector, a Universal Serial Bus™ (USB) connector, a tip, ring, sleeve (TRS) connector, and/or any other suitable connector operable to couple the local computing devices 115, 120 to the output.
As described in additional detail herein, at least one of the sensor units 110 may be operable to transmit physiological measurements to the local computing devices 115, 120 and/or to the remote computing device 145 continuously, at scheduled intervals, when requested, and/or when certain conditions are satisfied (e.g., during an at-rest condition). In some embodiments, the rate at which physiological measurements are collected and/or transmitted may increase when the patient is determined to be at-rest.
The remote computing device 145 may be a computing entity operable to enable a remote user to monitor the output of the sensor units 110. The remote computing device 145 may be functionally and/or structurally similar to the local computing devices 115, 120 and may be operable to receive data streams from and/or send signals to at least one of the sensor units 110 via the network 125. The network 125 may be the Internet, an intranet, a personal area network, a local area network (LAN), a wide area network (WAN), a virtual network, a telecommunications network implemented as a wired network and/or wireless network, etc. The remote computing device 145 may receive and/or send signals over the network 125 via communication links 150 and server 135.
The remote computing device 145 may be used by, for example, a health care professional to monitor the output of the sensor units 110. In some embodiments, the remote computing device 145 may receive an indication of physiological measurements when the sensors detect an at-rest condition, when the healthcare provider requests the information, at scheduled intervals, and/or at the request of the healthcare provider and/or the patient 105. For example, the remote computing device 145 may be operable to receive summarized physiological measurements from the server 135 and display the summarized physiological measurements in a convenient format. The remote computing device 145 may be located, for example, at a nurses station or in a patient's room, and may be configured to display a summary of the physiological measurements collected from one or more patients. In some instances, the local computing devices 115, 120 may also be operable to receive and display physiological measurements in much the same way that the remote computing device 145 is operable.
The server 135 may be configured to communicate with the sensor units 110, the local computing devices 115, 120, third-party sensors 130, the remote computing device 145 and databases 140. The server 135 may perform additional processing on signals received from the sensor units 110, local computing devices 115, 120 or third-party sensors 130, or may simply forward the received information to the remote computing device 145 and databases 140. The databases 140 may be examples of electronic health records (“EHRs”) and/or personal health records (“PHRs”), and may be provided by various service providers. The third-party sensor 130 may be a sensor that is not attached to the patient 105 but that still provides data that may be useful in connection with the data provided by sensor units 110. In certain embodiments, the server 135 may be combined with one or more of the local computing devices 115, 120 and/or the remote computing device 145.
The server 135 may be a computing device operable to receive data streams (e.g., from the sensor units 110 and/or the local computing devices 115, 120), store and/or process data, and/or transmit data and/or data summaries (e.g., to the remote computing device 145). For example, the server 135 may receive a stream of heart rate data from a sensor unit 110, a stream of oxygen saturation data from the same or a different sensor unit 110, and a stream of acceleration data from either the same or yet another sensor unit 110. Based on corresponding physiological data and activity data received, the server 135 may be able to determine which physiological measurements were taken during an at-rest period, and may flag the physiological measurements accordingly. In some embodiments, the server 135 may “pull” the data streams, e.g., by querying the sensor units 110 and/or the local computing devices 115, 120. In some embodiments, the data streams may be “pushed” from the sensor units 110 and/or the local computing devices 115, 120 to the server 135. For example, the sensor units 110 and/or the local computing devices 115, 120 may be configured to transmit data as it is generated by or entered into that device. In some instances, the sensor units 110 and/or the local computing devices 115, 120 may periodically transmit data (e.g., as a block of data or as one or more data points).
The server 135 may include a database (e.g., in memory) containing physiological measurements received from the sensor units 110 and/or the local computing devices 115, 120. Additionally, as described in further detail herein, software (e.g., stored in memory) may be executed on a processor of the server 135. Such software (executed on the processor) may be operable to cause the server 135 to monitor, process, summarize, present, and/or send a signal associated with physiological measurements, for example indicating those physiological measurements that were taken during an at-rest period.
Although the server 135 and the remote computing device 145 are shown and described as separate computing devices, in some embodiments, the remote computing device 145 performs the functions of the server 135 such that a separate server 135 may not be necessary. In such an embodiment, the remote computing device 145 receives physiological measurement streams from the sensor units 110 and/or the local computing devices 115, 120, processes the received physiological measurements, and displays the processed physiological measurements as summarized physiological measurements, with at-rest flags indicating those physiological measurements taken during an at-rest period.
Additionally, although the remote computing device 145 and the local computing devices 115, 120 are shown and described as separate computing devices, in some embodiments, the remote computing device 145 performs the functions of the local computing devices 115, 120 such that a separate local computing device 115, 120 may not be necessary. In such an embodiment, the user (e.g., a nurse or a doctor) may manually enter the patient's physiological measurements (e.g., the patient's body temperature) directly into the remote computing device 145.
In the system 100 of
Based on the received activity data and/or physiological data, it may be determined that the patient is at-rest. This determination may be made at the one or more sensor units 110, or may be determined at any one of the local computing devices 115, 120, the remote computing device 145, and/or the server 135. Physiological measurements may be received on an ongoing basis from the one or more sensor units 110. Upon determining that the patient is at-rest, collected physiological measurements may be flagged as having been taken during an at-rest period. This “at-rest flag” may be linked to the physiological measurements transmitted to the patient or clinician to be displayed, for example, at a nurses station or in a patient's room, or alternatively on any of the local computing devices 115, 120 or the remote computing device 145. In some embodiments, the flagged physiological measurements may be displayed on the one or more sensor units 110.
As shown in
Representation 200 also illustrates a mechanical at-rest threshold 220 and a physiological at-rest threshold 230. A mechanical at-rest threshold 220 may be represented by a metabolic equivalence threshold (MET) of 1 MET, for example. Thus, a determination of whether the patient is mechanically at-rest may be made when the patient activity level 210 is below 1 MET as determined by, for example, an accelerometer in conjunction with a vector magnitude module 425 (as described in relation to
A physiological at-rest threshold 230 is also shown in representation 200. The physiological at-rest threshold 230 may vary among patients based on individual patient physiological parameters, and may also vary based on the physiological data being monitored. For example, as illustrated in representation 200, the physiological at-rest threshold 230 may represent a heart rate threshold, below which the patient may be determined to be physiologically at-rest. In alternate embodiments, the physiological at-rest threshold may represent a blood oxygen threshold or a perspiration threshold, for example, by which corresponding physiological data may be determined to indicate an at-rest status of a patient.
In one embodiment, a determination of whether a patient is at-rest may be based only on the patient activity level 210 determined by the activity data received; in other words, the patient may be determined to be mechanically at-rest. In other embodiments, a determination of whether a patient is at-rest may be based only on the patient physiological level 215 determined by the physiological data received, meaning that the patient is physiologically at-rest. In still other embodiments, a determination of at-rest status is based on both the patient activity level 210 and the patient physiological level 215. Thus, where the patient physiological level 215 is below the physiological at-rest threshold 230, and where the patient activity level 210 is also below the mechanical at-rest threshold 220, an at-rest flag 250 may be set to “true” 255. During the period in which the at-rest flag 250 is set to “true” 255, monitored physiological measurements may be associated with an at-rest indicator.
In some embodiments, for example where the patient physiological level 215 is indicated by patient heart rate, the physiological at-rest threshold 230 may be selected from any of a predetermined at-rest heart rate; a stable heart rate over a predetermined period of time, such as 30 seconds, 1 minute, 2 minutes or any other suitable period of time; or a heart rate within a range that has historically been associated with the patient being at-rest, such as 100 beats per minute (bpm), 75 bpm, 60 bpm, or any other suitable threshold.
In some embodiments, the at-rest flag 250 is only set to “true” 255 when the patient physiological level 215 and the patient activity level 210 are both below the physiological at-rest threshold 230 and the mechanical at-rest threshold 220, respectively, for a predetermined period of time. The predetermined period of time may be measured by an at-rest timer window 245-a-1, 245-a-2 of any suitable length of time to allow for patient recovery, for example 20 minutes, 10 minutes, 5 minutes, etc. Individual at-rest timer window durations may be adjusted based on individual patients' health and fitness levels. When the at-rest timer has surpassed the at-rest timer window 245-a-1, 245-a-2, the at-rest flag 250 may be set to “true” 255, and the physiological measurements collected thereafter may be associated with an at-rest indicator for the period of time during which the at-rest flag 250 remains set to “true” 255.
As shown in the example illustrated in
The components of the apparatus 305 may, individually or collectively, be implemented using one or more application-specific integrated circuits (ASICs) adapted to perform some or all of the applicable functions in hardware. Alternatively, the functions may be performed by one or more other processing units (or cores), on one or more integrated circuits. In other examples, other types of integrated circuits may be used (e.g., Structured/Platform ASICs, Field Programmable Gate Arrays (FPGAs), and other Semi-Custom ICs), which may be programmed in any manner known in the art. The functions of each unit may also be implemented, in whole or in part, with instructions embodied in a memory, formatted to be executed by one or more general or application-specific processors.
The at-rest indicator module 320 may be configured to monitor the physiological data and activity data sensed by the sensing module 310 and processed by the signal processing module 315, described in more detail below with respect to
In some examples where apparatus 305 is part of one or more of the local computing devices 115, 120 or remote computing device 145, the transceiver module 325 may be operable to receive data streams from the one or more sensor units 110, as well as to send and/or receive other signals between the sensor units 110 and either the local computing devices 115, 120 or the remote computing device 145 via the network 125 and server 135. In one embodiment, the transceiver module 325 may receive data streams from the sensor units 110 and also forward the data streams to other devices. The transceiver module 325 may include wired and/or wireless connectors. For example, in some embodiments, sensor units 110 may be portions of a wired or wireless sensor network, and may communicate with the local computing devices 115, 120 and/or remote computing device 145 using either a wired or wireless network. The transceiver module 325 may be a wireless network interface controller (“NIC”), Bluetooth® controller, IR communication controller, ZigBee 0 controller and/or the like.
In some embodiments, where apparatus 305 is part of one or more of the sensor units 110, the transceiver module 325 may send a signal to a local computing device 115, 120 and/or remote computing device 145 if the patient taps the device, as detected by the one or more sensor units 110. In some embodiments, the patient may tap the sensor unit 110 such that communication of the signal occurs directly from the apparatus 305. In other embodiments, the patient may tap the sensor unit 110, which may send a signal to apparatus 305, wherein apparatus 305 may be part of one or more of the local computing devices 115, 120 or remote computing device 145. Alternatively, the transceiver module 325 may send a signal if an acceleration-based alert signal is detected by the sensor unit 110, as illustrated and described in commonly owned U.S. Patent Application No. 61/882,268, filed Sep. 25, 2013, which is incorporated herein by reference in its entirety.
The local computing device 115, 120 and/or remote computing device 145, upon receiving a signal from the transceiver module 325, may send alerts using such methods as short message service (SMS) text messages, email, or any other suitable means. In embodiments where apparatus 305 is part of one or more of the sensor units 110, transceiver module 325 may send a signal to the local computing device 115, 120 and/or remote computing device 145. In alternative embodiments, where apparatus 305 is part of one or more of the local computing device 115, 120 or remote computing device 145, the transceiver module 325 may communicate the signal within the apparatus 305. For example, if the signal indicates that a vital sign exceeds a threshold, the monitoring station may send information to the patient, a clinician, support personnel, a family member, etc. The information may include web content, educational information, or support information, or a request to take part in an activity, such as a fitness test, questionnaire, or exercise program. The information may further request that the patient make a dietary or sleeping pattern change. In some embodiments, the local computing device 115, 120 and/or remote computing device 145 may book an appointment for the patient with a caregiver.
In some embodiments, where apparatus 305 is part of one or more of the sensor units 110, transceiver module 325 may be operable to determine when a local computing device 115, 120 and/or remote computing device 145 is available to receive a signal from the transceiver module 325. For example, the transceiver module 325 may detect when a local computing device 115, 120 and/or remote computing device 145 is within a certain distance of the apparatus 305. In such an embodiment, the transceiver module 325 may push data to the local computing device 115, 120 and/or remote computing device 145. In other embodiments, physiological data may be pulled from the transceiver module 325 by the local computing device 115, 120 and/or remote computing device 145. In other words, the transceiver module 325 may receive a signal requesting physiological measurements from the local computing device 115, 120 and/or remote computing device 145.
In some examples, where apparatus 305 is part of one or more of the local computing device 115, 120 or remote computing device 145, or alternatively where apparatus 305 is part of one or more of the sensor units 110, the signal processing module 315 may include circuitry, logic, hardware and/or software for processing the data streams received from the sensor units 110. The signal processing module 315 may include filters, analog-to-digital converters and other digital signal processing units. Data processed by the signal processing module 315 may be stored in a buffer, for example, in the storage module 330. The storage module 330 may include magnetic, optical or solid-state memory options for storing data processed by the signal processing module 315. The at-rest indicator module 320 may access the data stored in the storage module 330 and output an at-rest indicator associated with the physiological measurements.
The vector magnitude module 425 may further comprise an analog to digital converter (ADC, not shown). In one embodiment, at least one of the sensor units 110 may comprise an accelerometer. The accelerometer may be operable to send a signal associated with any one of detected position, velocity, and/or acceleration of the sensor unit 110 to the ADC, which may sample the analog signal output by the accelerometer and convert the analog signal into a digital acceleration signal. The ADC may then send the digital acceleration signal to the vector magnitude module 425, which may be operable to correlate the digital acceleration signal to an activity level of the patient. In some embodiments, the vector magnitude module 425 may calculate a metabolic equivalency (expressed in METs) of the patient's activity. In some embodiments, the vector magnitude module 425 may be customizable based on the patient's age, gender, body weight, etc. The metabolic equivalency output by the vector magnitude module 425 may be used to determine the mechanical at-rest status of the patient. For example, by convention, 1 MET is the at-rest metabolic rate of an average individual, and therefore a patient may be determined to be mechanically at-rest when the vector magnitude module 425 calculates a metabolic equivalency of 1 MET based on the digital acceleration signal received from the ADC. Although described as separate from the one or more sensor units 110, in some embodiments apparatus 305-a may be a component of one or more sensor units 110 such that the signal from the accelerometer is directed within the apparatus 305-a component of the one or more sensor units 110 to convert the analog signal to a digital acceleration signal.
The physiological data module 405 may be used to receive processed physiological data signals received from signal processing module 315-a to determine whether the physiological data is above or below the physiological at-rest threshold 230 (of
The activity data module 410 may similarly be used to receive processed activity data signals received from signal processing module 315-a to determine whether the activity data is above or below the mechanical at-rest threshold 220 (of
The at-rest module 415 may be used to determine, based on at least one of the determinations of physiological data module 405 and activity data module 410, whether the patient is physiologically at-rest, mechanically at-rest, or both. Upon determination that the patient is at-rest, the data transmission module 420 will associate an at-rest indicator with one or more physiological measurements, such that the physiological measurements transmitted to the caregiver or patient, or alternatively displayed on the one or more sensor units 110, are flagged as having been taken during periods of at-rest status.
The sensor unit 110-a, which may include one or more aspects of apparatus 305 (as described in
The memory module 510 may include random access memory (RAM) or read-only memory (ROM). The memory module 510 may store computer-readable, computer-executable software (SW) code 515 containing instructions that are configured to, when executed, cause the processor module 535 to perform various functions described herein for communicating, for example, at-rest status. Alternatively, the software code 515 may not be directly executable by the processor module 535, but may be configured to cause the sensor unit 110-a (e.g., when compiled and executed) to perform various of the functions described herein.
The processor module 535 may include an intelligent hardware device, e.g., a CPU, a microcontroller, an ASIC, etc. The processor module 535 may process information received through the transceiver module 325-b or information to be sent to the transceiver module 325-b for transmission through the antenna 530. The processor module 535 may handle, alone or in connection with the at-rest indicator module 320-b, various aspects of signal processing as well as determining and transmitting at-rest status indicators.
The transceiver module 325-b may include a modem configured to modulate packets and provide the modulated packets to the antennas 530 for transmission, and to demodulate packets received from the antennas 530. The transceiver module 325-b may, in some examples, be implemented as one or more transmitter modules and one or more separate receiver modules. The transceiver module 325-b may support at-rest status-related communications. The transceiver module 325-b may be configured to communicate bi-directionally, via the antennas 530 and communication link 150, with, for example, local computing devices 115, 120 and/or the remote computing device 145 (via network 125 and server 135 of
The at-rest indicator module 320-b may be configured to perform or control some or all of the features or functions described with reference to
The server 135-a may include a server processor module 610, a server memory module 615, a local database module 645, and/or a communications management module 625. The server 135-a may also include one or more of a network communication module 605, a remote computing device communication module 630, and/or a remote database communication module 635. Each of these components may be in communication with each other, directly or indirectly, over one or more buses 640.
The server memory module 615 may include RAM and/or ROM. The server memory module 615 may store computer-readable, computer-executable code 620 containing instructions that are configured to, when executed, cause the server processor module 610 to perform various functions described herein related to presenting at-rest indicated physiological measurements. Alternatively, the code 620 may not be directly executable by the server processor module 610 but may be configured to cause the server 135-a (e.g., when compiled and executed) to perform various of the functions described herein.
The server processor module 610 may include an intelligent hardware device, e.g., a central processing unit (CPU), a microcontroller, an ASIC, etc. The server processor module 610 may process information received through the one or more communication modules 605, 630, 635. The server processor module 610 may also process information to be sent to the one or more communication modules 605, 630, 635 for transmission. Communications received at or transmitted from the network communication module 605 may be received from or transmitted to sensor units 110, local computing devices 115, 120, or third-party sensors 130 via network 125-a, which may be an example of the network 125 described in relation to
The server 135-a may also include an at-rest indicator module 320-c, which may be an example of the at-rest indicator module 320 of apparatus 305 described in relation to
At block 705, the method 700 may include receiving activity data of a patient from one or more sensors. As discussed above, activity data may comprise acceleration data, position data, posture data, etc.
At block 710, the method 700 may include receiving physiological data of a patient from one or more sensors. The one or more sensors for receiving physiological data may be the same one or more sensors for receiving activity data, or may be separate sensors. As discussed above, physiological data may comprise heart rate, respiration rate, blood oxygen levels, etc.
At block 715, the method 700 may include determining that an at-rest condition is satisfied by at least one of the received activity data and physiological data. As described above, it may be determined that an at-rest condition is satisfied by determining whether the received activity data and/or the received physiological data falls below the mechanical at-rest threshold and/or the physiological at-rest threshold, respectively.
At block 720, the method 700 may include receiving physiological measurements of the patient. As discussed above, physiological measurements may be collected on an ongoing basis, or may be collected at discrete time intervals based, for example, on patient or caregiver request, or based on a predetermined schedule.
At block 725, the method 700 may include associating an at-rest indicator with one or more physiological measurements of the patient based at least in part on the determination that an at-rest condition is satisfied. Thus, while physiological measurements may be collected and/or transmitted on an ongoing basis, only those physiological measurements collected during an at-rest period will be associated with an at-rest indicator. The caregiver may then base diagnoses on the received physiological measurements with the accompanying background information of whether the patient was at-rest when the subject physiological measurements were observed.
In some embodiments, the operations at blocks 705, 710, 715, 720 or 725 may be performed using the at-rest indicator module 320 described with reference to
The method 800 may be used, for example, to monitor one or more of a patient's physiological measurements and to present the associated data to a healthcare professional (e.g., a nurse or doctor) with associated at-rest indicators to make clear to the caregiver which physiological measurements were collected while the patient was at-rest. In some embodiments, the patient may be monitored in a hospital, a hospice or other healthcare related facility. In other embodiments, the patient may be monitored at home and the patient's physiological measurements may be streamed to the location of the healthcare provider. The vital signs or other physiological measurements being monitored may include, but are not limited to, the patient's heart rate, heart rate variability, respiratory rate, respiratory rate variability, body temperature, blood pressure, blood oxygen saturation, EMG data, ECG data, weight, blood sugar, and/or the like.
As shown in
At step 810, the method 800 includes monitoring physiological data and activity data of a patient. For example, the local computing devices 115, 120, remote computing device 145 and/or server 135 shown and described above with reference to
At step 815, the method 800 includes determining whether an at-rest condition is satisfied. As described above with respect to
In some embodiments, the patient may be determined to be physiologically at-rest based upon reaching a predetermined physiological benchmark or benchmark range, for example a heart rate of 75-85 bpm, or may be determined to be physiologically at-rest based upon maintaining a stable physiological parameter over a predetermined period of time. Additionally, in some embodiments the patient may be determined to be mechanically at-rest when the patient activity level is below a predetermined mechanical at-rest threshold. In one embodiment, the mechanical at-rest threshold may be represented by a metabolic equivalence threshold of 1 MET as determined by, for example, an accelerometer in conjunction with a vector magnitude module 425, as described with reference to
In the instance that the at-rest condition is determined to be satisfied at step 815 on the basis of the monitored physiological data, the monitored activity data, or both, the method 800 may include operating an at-rest timer to measure patient inactivity and setting an initial at-rest flag to “true,” as shown in step 820. The at-rest timer may be operated for a predetermined period of time to determine whether the patient has had sufficient time to recover from any previous physical activity. For example, where a patient has recently run up a flight of stairs and has now come to a stop, although the patient is no longer mechanically active, the patient may require, for example, 5-10 minutes, depending on individual health and fitness levels, to physiologically recover from the exertion and to reach a physiologically at-rest state.
In some embodiments, a caregiver chooses the length of recovery for the at-rest timer. For example, the caregiver, using the local computing devices 115, 120 or remote computing device 145, may determine and enter the length of time for which it may take the individual patient to physiologically recover from exertion, based on the patient's individual health and fitness levels. In other embodiments, the length of recovery may be preselected. For example, software executing on the processor of the local computing devices 115, 120, the remote computing device 145, and/or the server 135 may preselect the recovery length. In still other embodiments, the length of recovery may be inputted into the one or more sensor units 110 directly.
The initial at-rest flag may be set to “true” at step 820 to indicate that the patient has initially satisfied the at-rest condition. This initial at-rest condition may be used in conjunction with operation of a glitch timer, as discussed in further detail below.
At step 825, the method 800 includes determining whether the at-rest timer has exceeded the predetermined at-rest threshold. As discussed above, the duration or window of the at-rest timer may be tailored to suit individual patients' health and fitness needs. For example, an elderly patient or a patient having a high body mass index may require a longer at-rest timer duration than a younger patient or a patient having a lower body mass index, the latter of which patients may require shorter periods of time to recover from exertion. As shown in
If, at step 825, it is determined that the at-rest timer has not exceeded the at-rest threshold, method 800 will return to step 810 to continue to monitor physiological data and activity data of the patient. As the at-rest timer continues to operate, the physiological data and activity data will be constantly monitored, or in some embodiments monitored at preselected intervals, to determine whether the at-rest condition continues to be satisfied, as shown in step 815. If the at-rest condition continues to be satisfied by the monitored activity data and/or physiological data, and the at-rest timer proceeds to meet or exceed the predetermined at-rest threshold at step 825, the at-rest flag will be set to “true” and physiological measurements will be associated with an at-rest indicator at step 830, after which the flagged physiological measurements can be transmitted to a computing device or caregiver, or alternatively displayed on the one or more sensor units 110.
In the alternative, if, as the at-rest timer continues to operate, and the physiological data and/or activity data monitored at some point fail to satisfy the at-rest condition at step 815, at step 835 the method 800 will include determining whether an initial at-rest flag is true. As discussed above, if the at-rest condition was initially determined to be satisfied at step 815, then the at-rest timer was operated at step 820 and the initial at-rest flag was set to “true.” Thus, the determination at step 835 is affirmative, that the initial at-rest flag is true. This scenario may result because, for example, the patient has been seated and relaxed such that he is determined to be physiologically and mechanically at-rest, but has at some point shifted to a different position, for example onto his back, or has raised his arm to scratch his head, or any number of other minor movements. This transient movement may thus temporarily cause at least the activity data, and possibly the physiological data, to spike above the mechanical at-rest threshold and/or the physiological at-rest threshold, respectively, as shown by spike 235 in
In an alternate embodiment not shown in the method 800 of
Referring again to
The above description provides examples, and is not limiting of the scope, applicability, or configuration set forth in the claims. Changes may be made in the function and arrangement of elements discussed without departing from the spirit and scope of the disclosure. Various embodiments may omit, substitute, or add various procedures or components as appropriate. For instance, the methods described may be performed in an order different from that described, and various steps may be added, omitted, or combined. Also, features described with respect to certain embodiments may be combined in other embodiments.
The detailed description set forth above in connection with the appended drawings describes exemplary embodiments and does not represent the only embodiments that may be implemented or that are within the scope of the claims. The term “exemplary” used throughout this description means “serving as an example, instance, or illustration,” and not “preferred” or “advantageous over other embodiments.” The detailed description includes specific details for the purpose of providing an understanding of the described techniques. These techniques, however, may be practiced without these specific details. In some instances, well-known structures and devices are shown in block diagram form in order to avoid obscuring the concepts of the described embodiments.
Information and signals may be represented using any of a variety of different technologies and techniques. For example, data, instructions, commands, information, signals, bits, symbols, and chips that may be referenced throughout the above description may be represented by voltages, currents, electromagnetic waves, magnetic fields or particles, optical fields or particles, or any combination thereof.
The various illustrative blocks and modules described in connection with the disclosure herein may be implemented or performed with a general-purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A general-purpose processor may be a microprocessor, but in the alternative, the processor may be any conventional processor, controller, microcontroller, or state machine. A processor may also be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, multiple microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. A processor may in some cases be in electronic communication with a memory, where the memory stores instructions that are executable by the processor.
The functions described herein may be implemented in hardware, software executed by a processor, firmware, or any combination thereof. If implemented in software executed by a processor, the functions may be stored on or transmitted over as one or more instructions or code on a computer-readable medium. Other examples and implementations are within the scope and spirit of the disclosure and appended claims. For example, due to the nature of software, functions described above may be implemented using software executed by a processor, hardware, firmware, hardwiring, or combinations of any of these. Features implementing functions may also be physically located at various positions, including being distributed such that portions of functions are implemented at different physical locations. Also, as used herein, including in the claims, “or” as used in a list of items indicates a disjunctive list such that, for example, a list of “at least one of A, B, or C” means A or B or C or AB or AC or BC or ABC (i.e., A and B and C).
A computer program product or computer-readable medium both include a computer-readable storage medium and communication medium, including any mediums that facilitate transfer of a computer program from one place to another. A storage medium may be any medium that may be accessed by a general purpose or special purpose computer. By way of example, and not limitation, a computer-readable medium may comprise RAM, ROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium that may be used to carry or store desired computer-readable program code in the form of instructions or data structures and that may be accessed by a general-purpose or special-purpose computer, or a general-purpose or special-purpose processor. Also, any connection is properly termed a computer-readable medium. For example, if the software is transmitted from a website, server, or other remote light source using a coaxial cable, fiber optic cable, twisted pair, digital subscriber line (DSL), or wireless technologies such as infrared, radio, and microwave, then the coaxial cable, fiber optic cable, twisted pair, DSL, or wireless technologies such as infrared, radio, and microwave are included in the definition of medium. Disk and disc, as used herein, include compact disc (CD), laser disc, optical disc, digital versatile disc (DVD), floppy disk and Blu-ray disc where disks usually reproduce data magnetically, while discs generally reproduce data optically with lasers. Combinations of the above are also included within the scope of computer-readable media.
The previous description of the disclosure is provided to enable a person skilled in the art to make or use the disclosure. Various modifications to the disclosure will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other variations without departing from the spirit or scope of the disclosure. Throughout this disclosure the term “example” or “exemplary” indicates an example or instance and does not imply or require any preference for the noted example. Thus, the disclosure is not to be limited to the examples and designs described herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
This application claims priority to U.S. Provisional Patent Application No. 61/885,182, filed on Oct. 1, 2013, the entirety of which is incorporated by reference herein.
| Number | Date | Country | |
|---|---|---|---|
| 61885182 | Oct 2013 | US |
