Patent Application
20120178063
There is significant attention being paid to the areas of patient education, training and compliance. The practice of medicine is compromised by the ability and willingness of patients to follow the instructions of medical professionals or those who lead programs in health and wellness. The purpose of this invention is to provide a simple tool to motivate users to follow instructions from a health care professional or program leader and to provide information and reassurance for the user. An additional purpose of this invention is to increase efficiencies in the health care system by reducing the burden on health care professionals to respond to commonly asked questions and increase patient self-sufficiency overall. This tool can take many forms and can address a wide range of medical/health/wellness situations.
When a patient is diagnosed with a condition (e.g. diabetes), s/he is prescribed a new medication (e.g. warfarin or insulin), started on a new device (e.g. insulin pump or nebulizer), undergoes a procedure (such as a surgical or diagnostic procedure) or starts a new program (e.g. for weight loss or exercise), s/he goes through several stages of learning and accepting, a sort of a journey. Initially, there is stress and often pain (e.g. following a surgical procedure). Patients need to be reassured that what they are experiencing is normal and need to know what to do to take care of them selves. As stress and pain lessen, focus shifts to resuming personal function such as eating and basic mobility. As such function returns, the focus further shifts to broader social activities—returning to work, exercising, etc. The Journey is shown in
This staged approach is used in some of the preferred embodiments for this invention. In this example, described in the prior application, a physical or virtual card is created with individual audio messages that are somewhat sequential in nature. There is an additional message to provide information about what to look for if something goes wrong. Market research was conducted with patients who used prototype Medivoce VoiceCards following laparoscopic hernia and gall bladder procedures, or when newly prescribed warfarin. Both patients and healthcare providers demonstrated a high level of satisfaction with the VoiceCards. Patients appreciated the easy access to information at the touch of a button. They liked being able to repeatedly play certain messages without feeling embarrassed that they needed to call the doctor's office for yet another question. Health care professionals appreciated a reduced need to respond to patient calls focused on commonly asked questions. See
Increased patient satisfaction is important for several reasons. Satisfaction is an important component of adherence, and it is well understood that lack of adherence is a significant cost to our health care system.1,2,3,4 Patients who do not take their medications as prescribed are more likely to have need of further medical attention. Many physicians use word of mouth to grow their practices and patient satisfaction is important to the business of the practice of medicine. Some clinics and hospitals are now incorporating patient satisfaction scores in reviews of physicians to motivate doctors to pay more attention to patient satisfaction.
The VoiceCard need not follow the Journey concept. In an alternate embodiment, it may be advantageous to highlight multiple aspects. For example, for a patient undergoing orthopedic surgery, it may be important to work in parallel on inflammation, mobility and strength. Each section of the card may provide information about why each aspect is critical for a full recovery while also providing useful tips for improvement.
There are many situations in which a simple motivational and educational tool can be of great value. Certain applications were previously described such as before and after medical procedures and upon starting new medications. But there are many potential additional applications. Within the medical arena, patients (or family members or other care givers) would benefit from spoken, reassuring, motivating instructions to familiarize themselves with new medical devices such as insulin pumps, nebulizers and glucose monitoring devices. Often, after days or weeks of use, the procedures become routine, but initially fear and anxiety are frequently prevalent. There are discharge instructions printed for everyone leaving a hospital or surgicenter—and a VoiceCard recording that focuses in on the most important elements of follow-on care would be quite useful. People dealing with constant pain might also be comforted and reassured if they could easily be reminded of measures they can take to alleviate pain—or just to feel as if they can take some control. A key aspect of the series of instructions in the VoiceCard is to motivate the user to take more and more control over his/her own care/situation. In situations where the pain will subside over time (such as following joint replacement or other surgery) the VoiceCard could help set expectations for healing and recovery. There could be reminders for how to deal with pain and motivating elements to help patients move from iv morphine to oral morphine to drugs with which the patient could be sent home from the hospital. Encouraging comments about the role of physical therapy in reducing pain and the need for pain meds could also be included.
Caregivers need special instruction to ensure their own health while caring for family members who have become infirm or frail. Helping stroke patients, those dealing with joint issues, or patients undergoing rehabilitation to move safely in such a way as to not injure ones self is critically important but not frequently taught. VoiceCards that instruct on proper lifting of frail family members without hurting either party would save the cost and burden of the many injuries that result from improper techniques. Instructions for rehabilitation exercises, to match print outs or instructions provided by physical therapists, could increase patient confidence and comfort in exercising in between physical therapy visits. There are important motivational aspects to assure early success with programs such as weight loss or exercise initiation, and early success is key to continuance.
1 Osterberg L, Blaschke T. Adherence to medication. New Engl J Med 2005; 353:487-497.
2 Jencks S F, Williams M V, Coleman E A. Rehospitalizations among patients in the Medicare Fee-for-Service Program. New Engl J Med 2009; 360:1418-1428.
3 Zolnierek K B H, DiMatteo M R. Physician communication and patient adherence to treatment: a meta-analysis. Med Care 2009; 47:826-834.
4 Roter D L, Hall J A. Communication and adherence: moving from prediction to Understanding. Med Care 2009; 47:823-825.
The HWA (health/wellness appliance), in its simplest embodiment, can be an inexpensive, disposable VoiceCard or digital version thereof. The VoiceCard provides users with visual and audible information that helps them to adapt to a new disease state or condition, learn to live with a complex medication regime, recover from surgery or injury or participate in wellness programs.
HWA may be configured to provide several different series of messages and graphics based on either user action or user status. The HWA, in this embodiment, is updateable and dynamic.
The HWA can be a device that will support a user or users over a long period of time, through various conditions and programs relating to their health and wellbeing. Such as device can be an invaluable aid to proactively managing health while helping to reduce the burden of support on the medical community.
The functionality of providing information and motivation relating to a medical scenario can be combined in a greeting card. In addition to the typical well wishes, including an area for a personal message, the card could include the multi-button VoiceCard to add utility for the patient and increase the value of the sentimental gesture. This functionality can be delivered electronically as well, combining both a personal, get-well message and information to assist with healing and recovery.
FIG. 1—Illustration of the Journey patients follow when diagnosed with a new condition or when recovering from a procedure. The messages provided via VoiceCard or other HWA can be tailored to reflect what is of most concern to the user at different stages of this journey.
FIG. 2—Sample graphics for a VoiceCard designed to assist patients recovering from arthroscopic hernia surgery.
FIG. 3—Schematic of a contactless charging system for a HWA, in which the appliance would simply be placed onto the contact surface.
FIG. 4—Simulated illustrations of linear and block bar codes. The relative size of the blocks shown is larger than actual so as to make the illustration more readable. Practically, the spacing and size of the dots in the blocks matrix are much smaller than in the illustration. These are examples of optical means for loading information into the HWA.
FIG. 5—VoiceCard combined with a greeting card. This can be a physical card or a digital version with buttons to press to play the various messages relating to the patient's condition.
The HWA (health/wellness appliance), in its simplest embodiment, can be an inexpensive, disposable VoiceCard or digital version thereof.
The functionality of providing information and motivation relating to a medical scenario can be combined in a greeting card. For example, an individual might purchase a get-well card for someone undergoing surgery. In addition to the typical well wishes, including an area for a personal message, the card could include the multi-button VoiceCard to add utility for the patient and increase the value of the sentimental gesture. This functionality can be delivered electronically as well, combining both a personal, get-well message and information to assist with healing and recovery. See
HWA may be configured to provide several different series of messages based on either user action or user status. The HWA, in this embodiment, is updateable and dynamic. For example, the appliance may be updated based on changes in the patient's status. A second or third or later set of messages may be triggered by one of several options: (1) the patient can push a specific series of buttons to tell the card to load the next set of messages, e.g. more advanced exercises for a patient who has passed certain recovery milestones, some of which may be assessed b the card (ie grip strength) (2) the health care provider can send a message (wired or wireless) to communicate that the patient is ready for the next set of messages, or (3) the card may include a means for sensing the user and configuring the messages specifically for the user who is in proximity via fingerprint, voice or face recognition or communication from an RFID signal.
In a further embodiment, the graphics and audio/video portions of the HWA can be updated with the mechanisms described above. In these cases, there is an active means for displaying graphics, either a screen or electronic paper that can change configuration based on user or external inputs. In this way, the graphics in addition to the audio/video message can be tailored to the user and the status of the user for enhanced personalization, one of the important features of motivation. In a simpler version, there can be layers of graphics that peel off, revealing the next set of instructions when the buttons are updated by one of variety of methods. Low tack adhesive, such as the type used in Post-It® Notes, might be useful for removal graphic layers of this type.
In another embodiment, the HWA can sense when a layer of graphics is removed, which can trigger the automatic loading of the next set of audio instructions. There can be a simple reflective photo sensor and underlying electronics to detect the removal of a layer or a membrane or tear strip that is ruptured when the top layer of graphics is removed, triggering an update to the messages for each button. While tear strips have been used for purposes such as activating the battery circuit in electronic devices, the use of such an approach to signal a change in state in a device is unique.
If a user does not have his/her HWA with him/her, the most updated message can be provided telephonically. The user can dial a phone number and input an authentication code to access the personal information that has been stored on the HWA. On the surface, this invention may appear to have similarities to ordinary enquiries that use a dial in number with some user identification and password to unlock information such as an individual's bank balance.
What differentiates this invention is that:
This user authentication may involve entering an account number and PIN after dialing in or combining the phone number of the user, as received at a processing site, along with a recognized voice password or response to a question to allow the user to access his/her information without the need to press keys or remember long voicemail-like trees of information.
In another version, the information on the buttons can be provided via voice mail message(s), triggered either by user action or by the physician. The messages can remain available for the user to listen to as needed. In an alternate embodiment, the text could be provided via email or text message, although this option eliminates the use of voice that is a key benefit of this invention. Alternately, an email or emails can be sent that include the mp3 files for the audio messages.
For versions of this invention that can be updated, there is a need to recharge the batteries. By a simple means of providing energy for a long time, the HWA can have a life measured in years, not weeks. It is sensible to keep the onboard battery capacity small to keep the device streamlined and portable.
The need to power and operate portable appliances is a long-standing issue. There are limitations to how long the battery will last in normal use. If the battery is a primary cell (not rechargeable), the device has a fixed lifetime; once the battery is discharged the product will cease to function. If the product uses a secondary cell (can be recharged), how the battery is actually recharged affects the product design. Electrical contacts are sensitive to the mechanical design of the charging contacts and to corrosion and oxide build-up due to the environment.
Magnetic coupling has been used in products such as electric toothbrushes to couple energy for recharging batteries from a base unit charger to a portable electric toothbrush. Typically these charging systems are comprised of a sleeve or prong that the primary of a line frequency power transformer couples to a secondary winding of the transformer that is in the portable device. Their charging is inefficient due to the gaps in between the primary and secondary windings. The charging system requires a mating physical contact that limits the location of the portable appliance to a specific orientation relative to the charging base.
Newer technology high frequency devices have been introduced in the market as of 2009 which create a high frequency RF field on a charging mat that allows a portable appliance such as a cell phone or music player to be charged. These systems require the charged appliance has a special charging coupling device built into it or that the charged appliance has a charge-coupling device attached to it. In use the appliance to be charged is simply placed in a random orientation onto the mat and is charged by the coupling of the high frequency RF field to it.
This invention contemplates the first ever use of a non-contact charging system for a portable HWA. The solution of providing a charging contact or connector is the obvious one. The Medivoce HWA is intended to be used by untrained users who may not have the dexterity to place the HWA precisely into a charging cradle, thus the non-contact system is cleared preferred.
Prior art contactless systems have required precise alignment of the charged appliance and the charging device partially due to the need to minimize the size of the charging interface. Recent charge mat technology has required the use of high frequency RF energy so that the small size of the charged device is not a detriment to capturing enough radiated energy.
Medivoce's charging system is unique in its use of the inherent large form factor of the HWA to allow inexpensive printed circuit traces to capture sufficient energy to charge its battery, without the need for precise alignment or the need for flux concentrating discrete components. The large size of the anticipated HWA allows (but does not require) the use of lower frequencies, down to line frequencies, to be used. If lower frequencies are used, the elimination of the need to change the power line frequency to a higher frequency eliminates the extra cost of any frequency conversion circuitry. The use of lower frequencies with the inherent longer electrical wavelength makes the Medivoce HWA less sensitive to distance issues based upon wavelength. The use of a non-contact based charging system also provides an advantage for the Medivoce appliance as it allows it to be sealed and water resistant. See
In another embodiment, the performance of the user is measured and the measurement is used to provide an evaluation of user progress and/or to allow the user to have a different experience once the user has achieved a goal. For example, the speed at which the user can press the buttons in a sequence, the speed at which the user can react to a command and press a button, the ability of the user to manipulate the card by moving it in a translational or rotational manner and the force that the user can apply in pressing the buttons can all be measured and used to determine the messages or information that will be displayed and available.
Current video game products such as the Nintendo WII® and the Microsoft Xbox® make use of force sensitive push button assemblies. Depending on the force applied by the user to the button a variable analog or digital signal is produced. Nintendo and Radica have produced and shown game controllers that make use of MEMS [Micro Electronics Mechanical Systems] accelerometers to produce varying outputs depending on the orientation of the controller. Cell phones such as the Apple iPhone® and the Samsung Momentum® have accelerometers that sense the orientation of the product as it is held by the user. Due to the mass production of MEMS accelerometers, the price is currently less than $1.50 and will soon be below $0.50. The cost of force sensing resistors has also declined as the vendors who produce these products have cut the prices to well under $0.25 per button.
No one has applied this technology to the field of portable health/wellness appliances such as the VoiceCard. Taking this proven technology and using it in a new way and new field establishes this embodiment of this invention. This enhanced input has many applications. The following listing is not all-inclusive but serves to illustrate some of the things that this new embodiment allows.
Another embodiment of this invention that a single HWA may be shared among a number of users. If the HWA can be shared within a family or other grouping, a higher price can be justified, and more features and broader performance can be included in the HWA at a marketable and economic price.
The technological building blocks from other fields can be used in an inventive manner to deliver this performance. In this embodiment the RFID technology from the bridge & highway toll field, the fingerprint sensing technology from the computer and access security field, the use of password technology from the banking industry, and the voice recognition technology from the toy industry are examples of technology that can allow a simple HWA to be shared in a secure manner among group members.
Specific, but not limiting, examples of how these technologies might be used follow:
In the Internet field a number of companies provide a service to the consumer while the making their money by selling ads that the consumer sees when going to their websites. An example of such a service is the Google search service. All that they provide is free to the user. The user must endure advertising pitches while accessing Google content. This embodiment contemplates combining a HWA with advertising in a number of ways:
The advantage to the consumer is that this business model allows for the support of the distribution of HWAs to users with a subsidy that the advertisers are willing to pay because their message is being delivered in a very focused manner to a select group of users. This would be an extremely efficient means to get a messages to patients and should be attractive to businesses that advertise directly to patients/users.
The simple form factor, its ability to have graphics, portability, audio capability, a simple user interface independent of the need for a computer and a limited number of buttons enable the HWA to provide simple and interesting testing regimes for the user. For example, users such as those with memory loss can be provided with comforting words, a message and then a memory challenge test. The message can be a generic one, or if the HWA has the ability to be programmed by the health care professional in the office or in a connected or wireless fashion, the message can be personalized to the condition of the user.
In this embodiment the user could be presented with a memory challenge. It could take a number of forms:
Ideally, the content presented would change over time to remain interesting. Such functionality could be used to stimulate patients with memory loss. Means for tracking results or communicating results or trends in performance could be added and the content could be responsive to the performance on prior interactions.
In this embodiment of the HWA there are provisions made so that people other than the manufacturer and seller of the HWA, such as the Medivoce Corporation, can input graphics, programs or audio information into the HWA.
Systems have been set up for the delivery of music files to consumers by companies such as Microsoft with their Zune® product, for the delivery of applications to smart phones. In much the same way, multiple applications including voice, programs or graphics could be delivered to HWAs. What is contemplated is to bring this closed or open garden approach to providing user content to the HWA.
The preferred embodiment is a closed garden approach where Medivoce, another company, or a standards body must approve the content that the user or the health care provider can download to the HWA.
Many of the users of an HWA may be vision or hearing impaired. The provision for support for vision or hearing impaired users is a novel and inventive aspect of this invention. As highlighted in the prior provisional application, the HWA is particularly well suited to users with literacy issues as the majority of the information is provided orally.
It is an intention of this invention to provide appropriate messages to the user. In this embodiment of the invention particular means to improve the interface for blind or hearing-impaired individuals are contemplated. For example, for blind users it is contemplated that the HWA could be constructed so that the keys and printed text on the HWA incorporate Braille bump identification.
The audio output of the HWA being played by the integral speaker may not be optimal for those who would prefer to use an electromagnetically linked hearing aid. For those who need a hearing assistance device an embodiment of the invention could incorporate a speaker or separate transducer aimed at allowing the use of a magnetic coupling that would transduce the magnetic field into an electrical signal that might be amplified by the common hearing aid being used by the wearer. By proper speaker selection this compatibility with hearing aid pick up can be provided at a low cost. Alternatively, a separate coil can be incorporated in the HWA to optimize the ability to work with an electromagnetically coupled hearing aid pickup device.
In another embodiment of this invention a Bluetooth® transceiver is added to the product assembly. The addition of Bluetooth transceiver allows the HWA to send its audio messages directly to a Bluetooth headset and or Bluetooth linked hearing aid that the user may be wearing. The integration of a Bluetooth link into an HWA is novel and not obvious. This embodiment of the invention allows a person who is wearing a Bluetooth enabled headset to hear information from his/her HWA without the need for any wires or speakers built into the HWA. Prior art links using Bluetooth have been focused on the provision of two way telephony or one way music links. The use of this technology with a HWA is novel and provides a clean way for a user to listen to an HWA in privacy, even in a public place.
In addition to the previously disclosed embodiments, this invention contemplates the input of programming and data to the HWA via optical means. An advantage of an optical link is that it allows the HWA to be manufactured in a sealed watertight casing without the need for openings for wires or connectors. Especially in the case of an HWA which is shared in a group or family setting or is used with users who might have wet hands or be likely to spill liquids on the HWA, a sealed HWA provides a practical and desirable ability to protect the internal parts of the HWA from damage.
The VoiceCard and other HWAs can easily be configured to provide the content in the primary language of the user—graphics, audio, etc. Based on market research done, it is clear that there is an advantage to providing a dual language version, which can easily be accomplished through these devices. There can be two languages presented on the two sides of the VoiceCard, for example.
Research has shown that many minority populations in the US do not trust that the information they receive in translation, especially in Spanish, is the same as that provided in English. With a dual-language HWA it will be easy to confirm that the same content is provided in both languages, increasing the level of trust with the health care professionals and providers of the HWAs. In addition, there is often a range of language abilities within a family. The parents might speak mainly one language and the children may speak both the native language and English or perhaps mostly English. Providing a dual language device enables all generations to hear the same information in the language of preference, increasing the utility of the HWA for the users.
There may be circumstances in which it is advantageous to repurpose the VoiceCard or other form of HWA. If there are more buttons on the device than are needed at the moment, it may be useful to include a “dummy” message in case the user pushes the extra button. The message could be something like “Your VoiceCard is working properly. Please listen to the other messages for information provided by your healthcare professional” or “This VoiceCard has been provided by your doctor to help you with your recovery. Proceed to button 2.”
The object of this invention is communicate and motivate in order to improve adherence with medical/health and wellness-related instructions and increase patient satisfaction. Lack of adherence is closely correlated with poor outcomes, from not completing full courses of antibiotics and having recurrent infections to not following post-surgical instructions resulting in seriously delayed recovery times. A further object of this invention is to reduce poor outcomes and thus decrease the cost of delivering health care.
Another object of the invention is to provide a tool for Health Care Providers to augment the instructions they currently provide to people. This will reduce the number of inquiries made by patients who are not sure what they should do after they leave the medical office which will reduce the burden on already understaffed practices while improving the quality of care.
Another object of the invention is to provide and enhanced greeting card in which friends and family can provide useful medical information to a patient in conjunction with wishes for recovery and health.
Another object of the invention is to provide users, singly or in groups, with an appliance that can accept various forms of inputs to update and personalize health or wellness information. Such an appliance can become an important ally in the continuum of care through different conditions, disease states and phases of life.
This invention is intended to encourage, educate and, perhaps, amuse the patient while improving both the quality of care and the cost of delivering care.
This Application claims priority to U.S. Provisional Application No. 61/363360, filed Jul. 12, 2010, entitled “Health/Wellness Appliance”, which is incorporated by reference herein. U.S. application Ser. No. 12/951,059, “Electronic Medical Voice Instruction System”, filed Nov. 21, 2010, is incorporated by reference.
| Number | Date | Country | |
|---|---|---|---|
| 61363360 | Jul 2010 | US |
