The present application finds particular application in remote communication of healthcare information, education, and monitoring of the health status for a patient, particularly involving user-friendly installation of networking systems at a patient's location, such as a patient's residence, to facilitate connecting a user to a centralized server for service. However, it will be appreciated that the described technique(s) may also find application in other remote user systems, other health status monitoring techniques, or other communication techniques.
Home telemonitoring and information systems leverage consumer electronics and broadband technologies to implement a secure, personalized healthcare platform connecting patients and their care providers, thereby enabling new care models. For example, healthcare organizations can use such systems to manage patients with chronic diseases. Some systems can use vital sign measurement devices in the patient's home to obtain objective, quantifiable data on the patient's medical condition. Additionally, short surveys or questionnaires can be presented to the patient to obtain subjective data on the patient's medical condition and to test the patient's knowledge of healthcare issues. A variety of techniques can be employed to assist the patient in modifying his or her behavior to help treat the patient's medical condition. For example, custom video content can be presented on the patient's television in his or her home using an Internet protocol set top box connected to a broadband (e.g., cable, DSL, satellite) Internet connection.
However, conventional solutions have drawbacks. One problem is related to the costs of equipment, maintaining the broadband connection, and installing the equipment. Another problem with conventional solutions is that broadband connections to the home, although fairly common, are not readily available in some geographical areas. The high data rates available over broadband are typically only required for video transfer, not for other functions such as vital sign device data, messages, surveys, quizzes, etc. Thus, there is an unmet need in the art for systems and methods that facilitate streamlining remote patient monitoring systems to reduce patient confusion during setup and/or use, and to mitigate costs associated with providing unnecessary functionality that the patient does not need or use.
In accordance with one aspect, a system for remotely monitoring a patient includes a home-end device HED that periodically connects to a healthcare service provider server over a communication link and receives at least one decryption key. The system further includes a media player that receives a storage medium containing encrypted audio/video (A/V) content, a scheduled portion of which is unlocked by the at least one decryption key, and a power cable connection.
In accordance with another aspect, a method for providing a remote patient healthcare monitoring and education system includes instructing the patient to connect an HED to a telephone line and a power source, physically providing encrypted healthcare-related media content to a patient on a physical medium, instructing the patient to insert the media content physical medium into a media player associated with the HED, and generating a communication link between the HED and a centralized server over the telephone line. The method additionally includes providing one or more keys that unlock a scheduled portion of the media content to the HED and displaying the scheduled portion of the media content to the patient.
One advantage is that overall system cost is reduced.
Another advantage resides in simplified installation.
Another advantage resides in employing a public switching telephone network to provide service to patients that do not or cannot receive broadband service.
Another advantage resides in providing A/V content on a storage medium to mitigate an amount of bandwidth required to present the content to the patient.
Still further advantages of the subject innovation will be appreciated by those of ordinary skill in the art upon reading and understand the following detailed description.
The innovation may take form in various components and arrangements of components, and in various steps and arrangements of steps. The drawings are only for purposes of illustrating various aspects and are not to be construed as limiting the invention.
The system 10 comprises a home-end device (HED) 12 located at the patient's residence or other remote location, and that communicates bi-directionally with a server 14 at a central location, such as a healthcare provider's location. The HED 12 and the server 14 communicate, for instance, over a public switch telephone network (PSTN) communication line. The server 14 in turn is coupled to a terminal 16 that is employed by a clinician (e.g., a doctor, a nurse, or some other healthcare provider). The terminal 16 can be located at the healthcare provider location or remotely in another location. Additionally, communication between the server 14 and the terminal 16 can be wireless or wired, and can occur over an Internet/Ethernet connection or the like. The clinician (and/or the terminal 16) schedules delivery of A/V media 18 for the patient, which may comprise one or more DVDs with healthcare-related information stored thereon, and which can be stored at the healthcare provider location or some other storage facility. Once scheduled, the A/V media 18 is delivered to the patient's location (e.g., via mail or post, courier, etc.) for playing back to the patient using a media player 20 included in the HED 12. According to other embodiments, the media is provided to the patient at regularly-scheduled appointments. Additionally, the HED is operatively coupled (e.g., via wired or wireless communication links, such as Zigbee, Bluetooth, infrared, radio frequency, etc.) to one or more monitoring devices 22 that monitor a health status of the patient.
The A/V content, stored on a medium (e.g., DVD-ROM, CD, memory stick, floppy disk, or some other suitable medium), may be scheduled to be delivered at the time of installation of the HED and/or the monitoring devices, or at a later time. For instance, a clinician can order A/V content on a portable medium to be delivered to the patient's home or remote location. The system 10 provides for delivery of this content on a physical medium and by a physical delivery method (e.g., mail or post, courier, etc.). A/V content delivery over conventional communication links typically involves high bandwidth connections. Although A/V content can be delivered over any electronic communication link, using a deliverable media enables the communication link to the patient's HED to be of lower bandwidth than would otherwise be possible.
Additionally, scheduling and delivery of the A/V content can be incorporated into a healthcare plan for the patient. For instance, feedback from the patient can be obtained in a variety of ways, including verbal feedback received at an appointment with a clinician, feedback from surveys completed by the patient using the HED, etc. The feedback information can automatically trigger updates to the delivery and/or viewing schedules for the patient.
At installation, the A/V media 18 is installed in the proper location (e.g., a DVD drive or the like) for use in the HED. If media (e.g., DVDs, CDs, etc.) are later delivered to the patient, the patient receives a medium and places it in the proper location for use by the HED. The clinician can schedule replacement and/or updated audio-video content at a later time by scheduling delivery of additional or replacement A/V content, delivered in the same or similar manner After installation or delivery, the clinician can schedule a certain segment or portion of the audio-video content to be viewed by the patient. The patient receives notices on the HED that the patient has been requested to view the specified segment(s) (e.g., an LED that is illuminated to indicate that new content is available, etc.). The patient then uses the HED to start the viewing of the segment or portion of the A/V content that has been specified. The patient can also view segments of the A/V content at the patient's own initiative by using the HED to select the portion of content he desires from a menu of possible segments. In any case, the patient can be provided with a key or code that unlocks the scheduled portion of media content for viewing. The HED can notify the clinician, via the server and terminal, what A/V content the patient has viewed and when the patient viewed it, whether the clinician requested the viewing by the patient or the patient viewed the content of his own initiative. The clinician can also receive an indication that the patient has not watched the specified content within a pre-specified time period, which can be set by the clinician.
In accordance with various embodiments, The A/V media 18 comprises one or more of optical media, such as a CD-ROM or DVD, semiconductor memory (e.g., RAM, ROM), and magnetic media (e.g., disk, take, etc.). The communication link can be, for instance, a PSTN line, a cellular communication link, a 2-way pager link, and/or a broadband communication channel, such as DSL, cable, or wireless broadband. The HED 12 can include input devices such as a plurality of buttons that the patient depresses to enter information and/or select information presented to the patient, a touch panel screen for information entry, voice-activated entry etc. Additionally, the HED can include output components such as an LED or plasma screen, a CRT or LCD monitor, speakers, automated voice output, etc. In one embodiment, the HED is connected to the patient's television, which is used as an output component to present the A/V content to the patient. The media player 20 can include commercially available media players, such as a TV-DVD/CD player, a DVD/CD player with integrated display, a custom-designed player for optical, magnetic, or semiconductor media. Media player control can include optical control, such as by infrared remote control, or wired control. It will be appreciated that various embodiments can comprise numerous combinations of elements in order to facilitate reducing system cost and mitigating a dependency on broadband availability.
The central server 14 can include custom and/or off-the-shelf hardware. Customized software permits physical media delivery and tracking, patient content viewing specification, scheduling, and tracking, notice of a patient's failure to view specified content, notice to a patient of an impending content delivery, etc. The delivery scheduling method can include electronic communication, mail, phone communication, etc. The physical delivery method of the media can include mail, private delivery service, hand delivery, patient pickup (e.g., at the service provider's clinic or office), etc.
Equipment such as the HED 12, A/V media 18, monitoring devices 22, and a remote control 36 for entering and/or selecting information into the HED can be shipped or otherwise delivered to the patient (e.g., by mail or post, courier, or some other means), as prescribed or otherwise directed by the service provider or clinician. The HED includes the GUI 32 for presenting information to the patient, and an integral or external modem 34 that provides a connection to a centralized server. The modem 34 utilizes a PSTN communication protocol or the like to generate a communication link over a telephone line at the patient's location, according to some aspects. The HED additionally includes a media player 38 that receives the A/V media 18 for presentation to a patient. According to one example, the A/V media is stored on a DVD ROM disc and the media player is a DVD player. According to another example, the media is stored on a memory stick and the media player comprises USB port into which the memory stick is inserted. Yet another example includes A/V media stored on a CD, and the media player comprises a CD player that reads information from the CD for presentation to the patient. It is to be appreciated that the storage medium on which the A/V media is stored may be any suitable storage medium, and the media player may accordingly include any suitable means for reading the A/V media from the storage medium for playback the patient.
The HED additionally comprises a plurality of buttons and/or keys 40 that the patient employs to enter information into the HED. For instance, the plurality of buttons can include a number of directional arrows (e.g., up, down, left, right, etc.) that the patient uses to navigate through information presented on the GUI, as well as an “enter” key that the patient depresses to select or enter information on the GUI for entry to the HED. According to another embodiment, the HED includes a numerical keypad, similar to that of a telephone, which the patient uses to enter numerical information. Yet another embodiment relates to a touchscreen GUI for user input. Additionally, the system 30 includes the remote control 36, which has a similar or identical plurality of keys 40, and the HED receives information from the remote control via a wireless component 42. Optionally, the input buttons or keys can be located only on the remote. For instance, the wireless component can include an infrared (IR) and/or radio frequency (RF) component that receives one or more of IR and RF signals from the remote control. Additionally, the wireless component can include a Bluetooth, Zigbee, or other component and can receive information using associated communication protocols from one or more monitoring devices 22. For example, the monitoring devices 22 can include a digital scale, a blood pressure (BP) monitor, a pulse oximeter, a glucometer, a rhythm strip recorder, or any other suitable patient monitoring devices that measure a state of the patient and transmit information related thereto to the HED for transmission to the service provider and/or clinician.
In one embodiment, the HED is a flat screen monitor with a built-in DVD drive, a built-in telephone modem, and a built-in communication module if wireless patient modules are part of the system. Input buttons can then be located on the remote, a touch screen, or as virtual buttons displayed on the GUI. Alternatively, a limited number of buttons can be arranged in columns along sides of the GUI. In this manner, the HED has only two cords, a power cord 44 that terminates with a standard and easily recognizable wall plug, and a telephone cord 46 that ends with a standard plug for a telephone jack. Additionally or alternatively, the HED has a telephone jack, coupled to an internal modem 34, into which a user can insert a telephone cord, and then can insert the other end of the cord into a wall-mounted telephone jack.
According to a general example, the system 30 exhibits reduced overall system cost by replacing the set-top box, the patient's television the cable modem, cables to connect the components, AB audio/video switch, separate infrared receiver, event waiting indicator, broadband service, professional installation, etc., with a less expensive hardware configuration, capable of presenting the same (or similar) patient interface. The equipment is “plug-and-play,” meaning that professional installation is not required, and communicates with the clinical end via a standard telephone line already present in the patient's home (therefore eliminating the cable or other broadband subscription and associated monthly service charge). Video can be provided on DVD disks and video program material is periodically updated by sending new DVD disks to the patient's home. A video monitor, DVD player, and interface are part of the HED, and can be either integrated or separate off-the-shelf components. Patient control and/or input occurs by touchscreen, buttonpad, mouse, or custom tablet.
In some embodiments, the GUI and media player are an integral off-the-shelf device, such as a portable DVD player that is plugged into the HED, which provides the remaining functionality (e.g., communication link to the central server, wireless communication with the remote and/or monitoring devices, etc.)
Data transfer is executed using small packets capable of being delivered over telephone lines at reasonable and/or conventional data rates. Video need not be transferred in this manner because it is present on a DVD disc. The system 30 controls the media player to call up DVDs at the appropriate time and with the appropriate controls. For an example, a particular video segment is scheduled for the patient to view, and the patient starts the video presentation when the patient chooses. In the event that the media content is not already inserted into the media player, the HED can prompt the user to insert the media content. Automatic control of the media player can be performed using wired or wireless means, for example using the IR signals from a controlling unit to remotely control the media player. Additionally, A/V media is refreshed from time to time, such as by sending out new discs or other storage media as needed. In this manner, the system 30 leverages off-the-shelf, high volume, readily available, and competitively priced components (such as DVD players, LCD or CRT displays, etc.). Additionally or alternatively, the HED includes custom hardware, software, and/or firmware.
Accordingly, in one embodiment, the system 30 facilitates providing an interface including a display specific for patient monitoring, which does not rely on broadband or the patient's existing television. The system 30 also provides for data transfer over a telephone line instead of broadband, and video delivery via DVD installed with the system and updated by periodic mailing to the patients home. Moreover, DVD playback is controlled by the system, and the HED serves as data hub for transferring messages, surveys, quizzes, and vital sign data from the patient's home to the clinical application.
In one embodiment, the HED 12 is a self-contained unit that is user friendly, such as a digital picture frame/display or portable DVD player. Since many TVs are now a part of home entertainment systems with complex cabling, requiring highly paid professionals to modify the cabling to accommodate an additional system, complex setup issues are mitigated by providing the self-contained HED. The GUI display 32, such as an LCD or the like, is connected with (or easily cabled to) which includes the DVD ROM player 38, a computer controller (not shown) such as a processor and associated memory, the modem 34, the wireless component 42 for receiving signals from wireless physiological parameter monitors 22, and an input device such as the remote control 36, the small keypad 40, or a touchscreen. The HED has one input connection for a regular phone line and another power connection for electrical power. In one embodiment, the HED includes a picture frame and digital picture display that displays digital photographs when not in use for medical purposes and is easily switched over to its medical applications at the touch of a button.
In another embodiment, the HED includes A/V ports (e.g., typically red, yellow, and white color-coded A/V connectors) (not shown) that the patient may use to connect the HED to corresponding ports on the patient's TV should the patient so desire. In this case, the patient is provided with the option of performing a third connection by plugging the HED into the A/V jacks, which are often conveniently located on the front of more modern television sets, should the patient desire a larger display than is provided on the HED.
The patient periodically receives the DVD 18, for instance in the mail or during a doctor's visit. According to an example, a single DVD carries approximately 90 days worth of educational programming However, it will be appreciated that various DVDs have different storage capacities, and that more or fewer educational programs may be stored on a single DVD in accordance with healthcare program constraints and as a function of DVD capacity. Periodically, the system 30 dials in to the hospital or medical center to receive instructions, report physiological parameter readings, receive e-mail messages for the patient, and the like. Unlike a typical DVD player, the system controls the programming content that can be presented at any given time. For example, once a day, the system permits the viewer to watch the next scheduled video segment(s). In this example, the HED auto-connects to the server, receives decryption keys for a specified video segment, and then alerts the patient that a video is ready for viewing. The segment(s) are read from the DVD disk on a designated schedule. The programming can also include a survey which enables a patient to answer questions about the video. Based on the scoring of this survey, the medical center may send control signals to the unit such that at the next viewing, a remedial segment is played, an advanced segment is played, one of the prior video segments is played, or the like.
A well-being survey can be presented to the patient each morning or more often, during the day. This survey asks the patient general questions about how the patient is feeling. The answers to these questions are transmitted via a modem and phone line to the medical center where they will be computer reviewed using a series of rules. If the answers indicate that medical assistance should be provided, a nurse on call or other medical professional is alerted and appropriate instructions are returned promptly to the patient. The patient's HED controls the modem to hold the communication line open for a period of time after reporting these survey results. If the rules-based analysis indicates that there is a medical problem, the computer at the hospital end can instruct the patient's HED control computer to hold the connection open longer while a medical professional is consulted.
By providing an integrated HED with only power and telephone inputs, the HED can be readily carried by the patient to substantially any room in the home or other remote location. The GUI can be viewed like a TV, held like a book, or the like. The GUI can also be held as close to or as far away from the patient as the patient's eyesight may dictate. Moreover, the patient can take the HED when visiting friends or relatives down the street or across the country. For instance, the GUI portion of the HED can be folded down into a closed position against the keypad 40 (e.g., such as is common with portable DVD players, laptops and the like). In other embodiments, the GUI portion is collapsible, retractable, and/or expandable, further reducing device size and increasing portability. The HED can be made even more portable using rechargeable and cell phone technologies. Still furthermore, the HED can be equipped with a reset button (not shown) that the patient can press when plugging the HED in to a new phone line. Depressing the reset button causes the HED to connect to a registration server to alert the server to re-identify the phone number from which the HED is dialing in. The HED can then open a communication link with the service provider server as usual.
In one embodiment, the patient receives a DVD containing several educational videos and the like. For instance, the patient can receive a DVD containing approximately 90 videos of approximately 5-10 minutes in length, and can view a new video each day for approximately three months, at which time the patient receives a new DVD (e.g., via mail, post, courier, etc.). A/V media is encrypted to prevent unauthorized viewing. When the patient plugs in and logs on to the service provider network, the patient's HED receives keys that unlock scheduled content and permit the patient to view the scheduled content. For example, the patient can log into the system (e.g., by plugging in to the telephone line and optionally entering user identification information when prompted, etc.) and the keys (e.g., a decryption codec or the like) can be downloaded to the HED to permit the patient to view the content scheduled for the given day or session. According to another example, the patient can select a video or other media that the patient would like to view and can request that the video be made available. In such a case, the service provider server can transmit the decryption key(s) required for the requested video to the patient's HED to unlock the video for viewing. In this manner, proprietary content can be protected by the service provider and/or manufacturer until the user is authorized to view the content. Additionally, restricting access to the content helps the patient remain focused on the healthcare plan as provided, rather that pursuing his own objectives, which can distract the patient and detract from the goals of the healthcare plan generated by the healthcare provider.
At 66, the patient connects to the service provider's server using a communication link generated by the HED. The communication link can be automatically opened by the HED when the user connects the HED to a phone jack, and/or can be initiated upon the patient entering user ID information into the HED. At 68, one or more decryption keys are received at the HED to unlock one or more videos or surveys for patient viewing. For instance, if the patient is scheduled to view one or more videos on a given day, then upon logging on to the system, the decryption keys for the relevant portion of the content on the DVD are provided to the patient's HED. According to another example, the HED and/or the server track patient viewing activity, and the HED is provided with decryption keys for a next unviewed video in a series of videos.
At 70, the patient is permitted to view the scheduled content. According to an example, videos may be marked with a watermark or other signal that prompts the HED to record and/or transmit an indication that the video has been viewed by the patient.
Additionally, at 72, other information is entered into the HED and transmitted to the server for evaluation by a clinician. For instance, entered information can be user-entered information, such as through a remote control associated with the HED, keys or a touchscreen on the HED, etc. Additionally or alternatively, entered information can include information received from one or more patient monitoring devices (e.g., a scale, a BP monitor, a blood-glucose monitor, an oximeter, a rhythm strip recorder, or some other suitable patient status monitoring device, at 74. The HED then transmits entered information to the server, at 76. By providing the media content on a storage medium that is inserted into the HED, a need for a high-speed broadband connection is mitigated, thus permitting the HED and server to communicate using a less expensive alternative communication link, such as the PSTN communication link, to transmit smaller packets of information (e.g., monitoring device measurement information, decryption key information, etc.).
At 88, the patient is prompted to complete a survey related to the viewed content. For example, the patient can be prompted to rate the video(s) for information content, ease of understanding, relevance to the patient's present condition, etc. Additionally, the patient can be prompted to enter objective information, which can be automatically entered from monitoring devices connected to the HED and/or can comprise patient diet information and the like, as well as subjective information (e.g., how the patient feels, whether the patient has experienced specified symptoms, etc.). In response to the entered information, a clinician can update the patient's content-viewing schedule, at 90. For example, the patient may enter information that renders one or more scheduled videos less relevant than other scheduled videos, and the clinician can redesign the patient's viewing schedule with preference given to the more relevant video content. Additionally, the method facilitates reducing system complexity for the user because all information transfer between the server and the HED occurs over a PSTN connection, so the user does not need to maintain an expensive broadband service. Furthermore, the method facilitates providing service to users that cannot obtain broadband connections due to geographical or other impediments.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/IB08/50561 | 2/15/2008 | WO | 00 | 9/2/2009 |
Number | Date | Country | |
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60893739 | Mar 2007 | US |