This invention relates to network based medical systems, methods and program products. More particularly, the invention relates to network based patient monitoring, diagnosis and treatment via remote specialists viewing associated patient medical devices via real-time streaming video and interactive audio among specialists, medical device technicians, patients and others at a site servicing the patient.
With an expanding world population and a limited supply of medical specialists to service patients using complex medical devices, e.g., X-Ray, MRI, etc., there is a need to (i) expand the availability of such specialists to patients, particularly patients at remote locations, and (ii) provide real-time test results of such medical devices for patients under treatment by the specialist.
The present invention provides real-time image streaming accompanied by audio for patients at different locations to a specialist at another location, the specialist having the ability (i) to observe test results of complex medical devices servicing the patient; (ii) instruct a technician operating the medical device in performing the tests, and (iii) counsel the patient with regard to treating the medical condition.
A Medical Video Call Distributor (MVCD) comprises a central switch, typically a computer including memory linked to remote video stations servicing patients via a communications network, typically the Internet. Each video station is linked to a medical device associated with a patient. The medical device transmits patient test data and video showing patient results from the operation of the medical device by a technician. A video camera provides video of the medical device, video station, technician and patient. A local computer executes software for processing the patient test data and video as streaming video, and is coupled to the central switch as part of a field one-way transmitting video station (FVS). A specialist registers with a management system incorporated into the central switch. The management system includes a database containing programming for performing a registrar function; a billing function and an Automatic Call Distributor (ACD). The specialist is registered in an ACD queue for subsequent selection by a technician associated with a medical device servicing the patient. The specialist is linked to the central switch via a specialist video station (SVS).
The operation of the MVCD begins when a technician sends a request to the central switch for a specialist registered in the management system and listed in the ACD.
After selection of the registered specialist by the technician, two way audio and one-way video connections are established between the SVS and the FVS via the Internet using Session Initiated Protocols (SIP) and Session Description Protocols (SDP). The FVS starts streaming patient test data from the medical device and video to the SVS using the local video processing software. The (specialist video station) converts the streaming video into a format suitable for a video processing system and records the video in local storage. The specialist analyzes the stored or real-time video using pause, rewind, slow, etc. The specialist can view output of more than one medical device at a session and can provide voice instructions to the technician(s) to change medical device parameter, as necessary, to complete diagnosis and treatment of the patient. The specialist discusses the diagnosis and treatment with patient via the two way audio system. The session ends and the SVS and FVS are disconnected from the central switch.
A medical video call distributor system 100, as shown in
The FVS 106 is further described in
Various communications protocol may be employed between each station 106 and the central switch 102 including Session Initiated Protocol (SIP), Transaction Control Protocol (TCP), User Datagram Protocol (UDP, Media Gateway Control Protocol (MGCP), H.323 or other digital packet communications systems. The present description, however, will be in terms of SIP (RFC 3261); Session Description Protocol (SDP) (RFC2327, RFC4796, RFC3407, RFC4566), and Real-time Transport Protocol (RTP) (RFC 1889, 3550).
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The ACD function services requests from a FVS to identify a specialist for providing medical services to a patient. The ACD is connected to the database 302 via the connection 305, and will be described hereinafter in
The Registrar function 306 is connected to the database via connection 307 and involves software for (1) receiving, recording, listing specialists and their credentials, and (2) describing SVS communication protocol in terms of device name; device authorization name, device password, etc. The specialist credentials include, but are not limited to, medical skills, experience, acceptable insurance, fees and other practice information for input to the ACD. The Registrar function will be further described hereinafter in
The Billing function 308 is connected to the database via connection 309 and involves software for receiving, recording, and listing of medical services provided to patients. The billing function includes, but is not limited to, automating the matching of delivered patient medical services to specialist fees for such services; submitting claims to the patient insurance provider, and billing the patient for fees not covered by the insurance company. The billing function will be further described hereinafter in
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A service request for a specialist is submitted to the ACD by the Field Video Station 106 in an operation 412. Typically, the service request is submitted by a technician in behalf of a patient. An operation 414 provides the technician 116 with listings 414 of specialist 134 from which to choose a specialist. A test 416 is performed to identify available specialists in the lists 414. In the event a preferred specialist is available, the specialist is contacted by the technician to initiate specialty services. The specialist is removed from the queues 410 as unavailable in an operation 418. Should a specialist not be available for the request, an operation 420 stores the request until a matching specialist is available in the queue list 414, whereupon the program continues at the operation 418. An operation 422 returns the specialist to the queue(s) when the services are completed. The specialist, upon request, may be removed from the queues in an operation 422, whereupon the program ends.
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Billing Function:
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The patient information module 467 collects and stores information in a database, (e.g., the database 302) related to the patient receiving services from the technician; the specialist, and a medical center. The collected patient information includes, but is not limited to, (1) a description of the patient's name, Social Security number, address, telephone number, etc.; (2) insurance information applicable to the patient's medical services; (3) time and duration of the services provided, and (4) the type of service provided.
The technician information module 469 collects and stores information in a database. The information includes, but is not limited to, (1) a description of the technician providing services to the patient; (2) the technician's name, Social Security number, address, telephone number, etc.; (3) the time and duration of the services provided by the technician, and (4) the type of services provided by the technician.
The specialist information module 471 collects and stores information in a database. The information includes, but is not limited to, (1) the specialist's name, Social Security number, address, telephone number, etc.; (2) the time the specialist logged into the ACD system; (3) the time and duration of the services provided and (4) the type of specialist services provided.
An interface module 473 provides data access to an outside authorized medical billing service to prepare and submit invoices for services rendered to the patient. The invoices are in behalf of the technician; specialist, medical center and others for payment of services provided to the patient. The invoices also serve as a basis for reimbursement by the insurance company, to the extent the insurance policy provides coverage of the patient.
During the performance of services, the patient/technician and the specialist interact via the FVS 106 and the SVS 108, the specialist viewing the patient/technician, medical device and interacting with the patient/technician via the streaming video and the two-way audio connection connections 120 and 122. The specialist is able to view the medical device test results on his station 108; diagnose the patient's medical condition; instruct nursing personnel at the station in the treatment of the patient and instruct the technician to modify the operation of the medical device, if needed, all the while the specialist is remotely located from the patient, technician, nursing personnel and the medical device servicing the patient.
The operation of
An operation 502 involves the technician preparing a request for services from a remote specialist, the request including the type of specialist, insurance status and other information for acceptance by the remote specialist.
An operation 504 sends the request for the specialist to the automatic call distributor (ACD).
An operation 506 involves the ACD prompting the technician for additional details, confirmation and provides a wait time for response, if necessary.
An operation 508 involves the technician confirming the request information for the ACD.
An operation 510 involves the ACD accessing listings of specialist in queues stored in a management system 300 (See
An operation 512 involves the next available specialist receiving and connecting to the technician for receiving information regarding the patient's status.
An operation 514 involves the technician performing diagnostic procedure on the patient under the specialist supervision.
An operation 516 terminates the connection between the specialist and technician after completion of the diagnostic procedures.
An operation 602 transmits FVS streaming video in the form of electrical, ultrasound, optical or like signal from the medical device for delivery to the local computer 114 using commercially available software and hardware to initiate streaming video transmission to the specialist via a FVS/SVS connection.
An operation 604 determines whether or not the specialist is ready to receive streaming video and if not, the process in an operation 605 waits for the specialist to indicate ready to receive video transmission.
An operation 606 involves the FVS/SVS negotiating network parameters, including IP address, ports to use.
An operation 608 involves the FVS/SVS negotiating security settings including encryption, keys, etc.
An operation 610 is conducted by the FVS to request the video and audio parameters including resolution and frame rate from the SVS.
An operation 612 converts the streaming video signal from the medical device to H.264/MPEG-4 AVC or other video transmission format.
An operation 614 transmits the streaming video and audio signal to the SVS.
An operation 616 involves the SVS receiving the transmission image from the FVS.
An operation 618 is converting the image to the format that SVS can display on the screen and/or store on a storage device, e.g., a hard drive.
An operation 620 involves the SVS displaying the received video on the specialist monitor.
An operation 622 allows the specialist to enter changes in video parameters, e.g., resolution, frame rate, etc.
An operation 624 sends the requested changes to the operation 610. Changes and parameters accepted by the operation 610 are passed to the operation 620 via the intervening operations 612, 614, 616 and 618.
An operation 626 ends the process session, after the changes have been installed and the test finished.
Summarizing, applicant has disclosed a Medical Video Call Distributor 100 enabling a remote specialist at a Specialist Video Station (SVS) to diagnose and treat patients at different Field Video Station (FVS), one at a time, via a network including a central switch. The specialist is able to view and alter medical equipment operated by an operator, typically a technician servicing the patient via one way streaming video and two way streaming audio. An automatic call distributor included in the central switch identifies specialists, including qualifications, for selection by the technician to treat a patient. The network parameters for the SVS and the FVS can be automatically negotiated via software. Likewise, the video parameters can be automatically adjusted for video codec, resolution, frame rate, frame geometry. The service provides the specialist the ability to change video parameters while viewing the streaming video on a monitor serviced by a camera at the station viewing the patient, medical device, and operator.
While the invention has been described in a preferred embodiment, various changes can be made therein by those skilled in the art without departing from the spirit and scope of the disclosed invention.