As medical device technologies continue to evolve, active implanted medical devices have gained increasing popularity in the medical field. For example, one type of implanted medical device includes neurostimulator devices, which are battery-powered or battery-less devices that are designed to deliver electrical stimulation to a patient. Through proper electrical stimulation, the neurostimulator devices can provide pain relief for patients or restore bodily functions.
Implanted medical devices (for example a neurostimulator) can be controlled using an electronic programming device such as a clinician programmer or a patient programmer. These programmers can be used by medical personnel or the patient to define the particular electrical stimulation therapy to be delivered to a target area of the patient's body, alter one or more parameters of the electrical stimulation therapy, or otherwise conduct communications with a patient. In some cases, these electronic programmers allow the creation and display of pain maps and stimulation maps as part of the pain diagnosis and communication with the patient. However, these pain/stimulation maps may be relatively large in size (i.e., contains a large amount of data). As a result, they are not suitable for storage on electronic devices with limited storage capacity. The lack of storage flexibility for existing pain/stimulation maps limits the effectiveness of using these maps and may also drive up diagnostic costs.
Therefore, although existing neurostimulation devices and methods have been generally adequate for their intended purposes, they have not been entirely satisfactory in every aspect.
One aspect of the present disclosure involves an electronic apparatus for data-reducing and transmitting a sensation map of a patient. The electronic device includes: a memory storage component configured to store programming code; and a computer processor configured to execute the programming code to perform the following tasks: providing a sensation map associated with the patient, the sensation map including a graphical depiction of a sensation experienced by the patient; generating a data file having a data size less than a data size of the sensation map, wherein the data file contains digital information allowing a reconstruction of the sensation map; establishing electronic communication with an implanted medical device located inside the patient's body; and thereafter sending the data file to the implanted medical device for storage.
Another aspect of the present disclosure involves a medical system. The medical system includes: a neurostimulator configured to deliver electrical stimulation to a patient via one or more of a plurality of contacts located on a lead; and a portable electronic programmer having an electronic processor and a touch-sensitive graphical user interface, wherein the electronic programmer is configured to: provide a sensation map associated with a patient, the sensation map including a graphical depiction of a sensation experienced by the patient; generate a data file having a data size less than a data size of the sensation map, wherein the data file contains digital information allowing a reconstruction of the sensation map; establish electronic communication with the neurostimulator; and thereafter send the data file to the neurostimulator for storage.
Yet another aspect of the present disclosure involves a method of setting stimulation parameters for neurostimulation. The method comprises: providing a sensation map associated with a patient, the sensation map including a graphical depiction of a sensation experienced by the patient; generating a data file having a data size less than a data size of the sensation map, wherein the data file contains digital information allowing a reconstruction of the sensation map; establishing electronic communication with an implanted medical device located inside the patient's body; and thereafter sending the data file to the implanted medical device for storage.
One more aspect of the present disclosure involves a programmable pulse generator for delivering a stimulation therapy to a patient. The programmable pulse generator includes: a transceiver configured to electronic data via electronic communication conducted with an external clinician programmer; a memory storage configured to store the electronic data, wherein the electronic data includes: a stimulation program containing programming instructions for operating the programmable pulse generator; and a data file having a smaller data size than the sensation map and containing digital information allowing reconstruction of the sensation map that graphically depicts, on the external clinician programmer, a sensation experienced by the patient stimulation program and the data file; and a microcontroller and stimulation circuitry configured to generate electrical pulses of the stimulation therapy based on the stimulation program.
Aspects of the present disclosure are best understood from the following detailed description when read with the accompanying figures. It is emphasized that, in accordance with the standard practice in the industry, various features are not drawn to scale. In fact, the dimensions of the various features may be arbitrarily increased or reduced for clarity of discussion. In the figures, elements having the same designation have the same or similar functions.
It is to be understood that the following disclosure provides many different embodiments, or examples, for implementing different features of the invention. Specific examples of components and arrangements are described below to simplify the present disclosure. These are, of course, merely examples and are not intended to be limiting. Various features may be arbitrarily drawn in different scales for simplicity and clarity.
The use of active implanted medical devices has become increasingly prevalent over time. Some of these implanted medical devices include neurostimulator (also referred to as a pulse generator) devices that are capable of providing pain relief by delivering electrical stimulation to a patient. In that regards, electronic programmers have been used to configure or program these neurostimulators (or other types of suitable active implanted medical devices) so that they can be operated in a certain manner. These electronic programmers include clinician programmers and patient programmers, each of which may be a handheld device. For example, a clinician programmer allows a medical professional (e.g., a doctor or a nurse) to define the particular electrical stimulation therapy to be delivered to a target area of the patient's body, while a patient programmer allows a patient to alter one or more parameters of the electrical stimulation therapy.
In recent years, these electronic programmers have achieved significant improvements, for example, improvements in size, power consumption, lifetime, and ease of use. For instance, electronic programmers have been used to generate and/or display pain maps and stimulation maps (collectively referred to as sensation maps or medical maps) for a patient. In general, a pain map graphically illustrates the location or intensity of a patient's pain, and a stimulation map graphically illustrates the location or intensity of the electrical stimulation (e.g., stimulation delivered by the neurostimulator) perceived by the patient. These pain/stimulation maps can serve as useful tools for diagnosing the patient's pain and treatment and also allow visual/non-verbal communication between a patient and a healthcare professional. In addition, a history of the maps, if collected, can provide a record of a patient's treatment progress, and the maps can also be analyzed across patient groups. In some embodiments, to protect patient privacy, the personal information of the patients are stripped before the history of the pain/stimulation maps are collected and analyzed. In other words, the history of the pain/stimulation maps may be collected and analyzed anonymously in certain embodiments.
According to the present disclosure, image data used to graphically depict the pain/stimulation maps are pixelated (e.g., broken up into a number of irreducible pieces based on features of the image). Consequently, the data files associated with the pain/stimulation maps are typically contain a vast amount of data because of the large number of pixels required to represent the maps. In fact, map data files are generally too large to store in the limited storage capacity of an implanted medical device, such as an implantable neurostimulator. Existing neurostimulators only store the parameters of the electrical pulses being delivered to the patient (for example, frequency and amount of electrical current). Since implantable neurostimulators do not have sufficient storage capacity for the vast amount of data associated with the pain/stimulation maps, these maps (or associated data files) may have to be stored on external devices like stimulation parameter programmers or in an external database or library. Thus, the shortcomings of the present device and method of storing pain/stimulation maps are as follows:
To address the issues discussed above, the present disclosure offers a method and system of compressing pain/stimulation maps down to a small enough size to facilitate their storage on an implanted medical device (e.g., implanted pulse generator), as discussed below in more detail.
Although an IPG is used here as an example, it is understood that the various aspects of the present disclosure apply to an external pulse generator (EPG) as well. An EPG is intended to be worn externally to the patient's body. The EPG connects to one end (referred to as a connection end) of one or more percutaneous, or skin-penetrating, leads. The other end (referred to as a stimulating end) of the percutaneous lead is implanted within the body and incorporates multiple electrode surfaces analogous in function and use to those of an implanted lead.
The external charger 40 of the medical device system 20 provides electrical power to the IPG 70. The electrical power may be delivered through a charging coil 90. In some embodiments, the charging coil can also be an internal component of the external charger 40. The IPG 70 may also incorporate power-storage components such as a battery or capacitor so that it may be powered independently of the external charger 40 for a period of time, for example from a day to a month, depending on the power requirements of the therapeutic electrical stimulation delivered by the IPG.
The patient programmer 50 and the clinician programmer 60 may be portable handheld devices that can be used to configure the IPG 70 so that the IPG 70 can operate in a certain way. The patient programmer 50 is used by the patient in whom the IPG 70 is implanted. The patient may adjust the parameters of the stimulation, such as by selecting a program, changing its amplitude, frequency, and other parameters, and by turning stimulation on and off. The clinician programmer 60 is used by a medical personnel to configure the other system components and to adjust stimulation parameters that the patient is not permitted to control, such as by setting up stimulation programs among which the patient may choose, selecting the active set of electrode surfaces in a given program, and by setting upper and lower limits for the patient's adjustments of amplitude, frequency, and other parameters.
In the embodiments discussed below, the clinician programmer 60 is used as an example of the electronic programmer. However, it is understood that the electronic programmer may also be the patient programmer 50 or other touch screen programming devices (such as smart-phones or tablet computers) in other embodiments.
Referring to
In some embodiments, the present disclosure offers a database that includes a plurality of predefined human body models that each correspond to a specific body type, for example a predefined body type for a 40 year old Caucasian male with a height of 6′1 and a weight of 200 pounds, or a 20 year old African American female with a height of 5′5 with a weight of 120 pounds, so on and so forth. In these embodiments, a healthcare professional or the patient can quickly select a predefined body type from this database that most closely matches his/her physical conditions/characteristics. In this manner, the healthcare professional need not spend too much time specifically customizing the human body model 110 to the patient, since a predefined human body model that is substantially similar to the patient is already available from the database. It is also understood that such database may be available to a network of healthcare professionals and may be downloaded to the electronic programmer upon verifying the necessary login credentials. The patient models may also be uploaded from an electronic programmer to the database. In some further embodiments, the clinician programmer discussed herein is configured to capture an image of the patient (for example via an integrated camera). The proportions and other bodily details of the patient may then be automatically adjusted by processing the captured patient image.
As discussed above, height is not the only variable that can be adjusted in customizing a human body model that closely matches the actual patient. Gender and weight are also among the variables that can be adjusted. As examples,
Referring now back to
The stimulation map may be created in a similar manner, except that the stimulation map corresponds with the perceived stimulation experienced by the patient. The pain map and stimulation map are drawn on a touch-sensitive screen in the illustrated embodiment. A graphics accelerator may be used to speed up the generation of these maps.
Once the virtual button 128 is engaged to trigger the display of the menu items 120-127, the menu items 120-121 may be used to indicate different levels of intensity of the pain or stimulation. For example, referring to
Similarly, the patient may also draw a region 150 to indicate a region on the body where the patient experiences stimulation while the stimulation therapy is active. The stimulation maps may be configured in a similar manner as the pain maps. In other words, the stimulation maps may be configured to portray different intensities of stimulation sensations, different regions of stimulation sensations, different types of stimulation sensations or different depths of stimulation sensations. Note that the pain region 140 and the stimulation region 150 may be displayed individually, or simultaneously, as shown in
It is understood that although pain maps are used as an example herein for illustration purposes, stimulation maps containing regions with different stimulation intensity may be generated in the same manner.
Referring back to
The menu item 123 is used to delete an existing pain map or stimulation map.
The menu item 124 is used to cycle through different maps, such as switching between pain maps and stimulation maps.
The menu item 125 is used to generate a new pain map or a new stimulation map.
The menu item 126 is used to save changes to a pain map or a stimulation map.
The menu item 127 is used to view a playback of the pain map and/or stimulation map associated with a patient. Among other things, this may be used to show progression of treatment.
Of course, these menu items 120-127 are merely examples. Some of these menu items may be removed, and other menu items may be added in alternative embodiments to carry out the generation and editing of the pain map and stimulation map.
The present disclosure also allows for predefined pain or stimulation regions. For example, referring now to
In the embodiment shown in
The correlations between stimulation parameters (e.g., milliamps, polarity, pulse width, frequency, lead position) or activity parameters (e.g., sitting, standing, sleeping, running, etc.) and perceived stimulation maps are a valuable part of map analysis, because they indicate the degree to which a parameter is related to a certain effect. Map correlations, which can be carried out between individual stimulation programs (“programs”) and effective or perceived stimulation maps, are also possible between groups of programs (“programs sets”) and an effective stimulation map. A more detailed discussion of stimulation parameters, programs and program sets is found in U.S. patent application Ser. No. 13/601,631, filed on Aug. 31, 2012, and entitled “Programming and Virtual Reality Representation of Stimulation Parameter Groups” to Norbert Kaula, et al., the content of which is hereby incorporated by reference in its entirety. Note that in some embodiments, the “program sets” may also be referred to as “programs” while the “programs” may be referred to as “sub-programs.”
The present disclosure further allows for a determination of an overlap between a pain map and a stimulation map. For example, referring now to
In various embodiments, any of the maps in Table 1 below may be compared, either one to another, or in combinations. The possibilities range from maps recorded at the initial session through the current session, and include pain maps (PAIN); stimulation program maps (STIM-Px), where x may vary up to a predetermined number (e.g. 4); and stimulation program set maps (STIM-Sx), where y is determined by the number of programs (x).
For example, if there are three stimulation programs (STIM-P1, STIM-P2, STIM-P3), then there are seven possible stimulation program sets (STIM-P1, STIM-P2, STIM-P3, STIM-P1+STIM-P2, STIM-P1+STIM-P3, STIM-P2+STIM-P3, STIM-P1+STIM-P2+STIM-P3).
Additional aspects of the generation and display of the pain/stimulation maps are discussed in provisional U.S. Patent Application No. 61/824,296, filed on May 16, 2013, entitled “Features and Functionalities of an Advanced Clinician Programmer,” which as discussed above has been incorporated by reference in its entirety.
Based on the discussions above, it can be seen that the pain/stimulation maps of the present disclosure may be data-heavy, particularly since they may contain 3D information (e.g., the maps may be generated over a 3D model). Meanwhile, implantable medical devices such as IPGs (an example of a neurostimulator) typically have limited data storage capacity. The limited data storage capacity is due at least in part to the small physical dimensions, the access speed requirements, and power consumption constraints of the implantable medical device. Therefore, the large file sizes associated with the 3D pain/stimulation maps make their storage on the IPG (associated with the patient for whom the pain/stimulation maps are generated) impractical, if not impossible. Thus, the present disclosure utilizes a compression process to reduce the data sizes of the pain/stimulation maps. The compressed pain/stimulation maps may then be sent to the IPG of the patient.
As a first step of the data compression, a technique known as Connected Component Labeling (CCL) is used to determine areas of interest on the pain/stimulation maps. In one aspect, Connected Component Labeling identifies regions of pixels that have similar or identical qualities (for example, color). These regions are also called “blobs.” Blobs can usually be described with less information than can the original pixelated images. After Connected Component Labeling is performed to the pain/stimulation maps, and the areas of interest are identified, a plurality of compression methods or techniques is executed on the pain/stimulation maps. As an example, a “contour tracing” method may be executed on the pain/stimulation map. In general, contour tracing is a method that identifies the edges or borders of a blob. Several types of contour tracing are described below for compression of medical map data, though other types exist and can be used.
In addition to contour tracing, other types of data compression methods may include, but are not limited to, Run-Length Encoding, Huffman coding, Golomb coding, Arithmetic coding, LZW coding, Symbol-based coding, and bit-plane coding, etc.
The pain/stimulation maps are compressed by each of the plurality of suitable data compression methods, and a respective compressed data file is generated accordingly for each compression method. One of these compressed data files may then be selected for storage on the IPG of the patient. For example, the compressed data file having the smallest data size may be selected for storage. This may be repeated for each of the pain/stimulation maps, thereby generating a plurality of available compressed data files suitable for storage on the IPG. Note that each compressed data file need not necessarily be associated with only one compression technique. Instead, multiple compression techniques may be associated with a single data file. For example, a pain/stimulation map for which a data file is generated may have a plurality of different segments with unique graphical characteristics. For example, the pain/stimulation map may have different types/depths of pain/stimulation that are represented by different textures. In addition, various pain/stimulation maps may be generated on different body regions that have different geometries. Due to these differences, one compression technique may be more suitable for compressing one body region or one particular pain/stimulation map, while another compression technique may be more suitable for compressing another body region or another pain/stimulation map. Consequently, a given compressed data file may be generated by the application of several different compression techniques.
A clinician programmer such as the clinician programmer 60 in
In some embodiments, the IPG may contain a partition-able memory storage, for example in accordance with the IPG disclosed in U.S. patent application Ser. No. 13/604,197, filed on Sep. 5, 2012, entitled “Method and System for Associating Patient Records with Pulse Generators,” the disclosure of which is hereby incorporated by reference in its entirety. In other words, the memory for the IPG may be divided or separated into a plurality of different mutually exclusive partitions. The data stored in one of the partitions may be inaccessible by entities that also store data in the other partition. Different types of data may be stored in these different partitions. For example, one of the memory partitions may be configured to store personal information of a patient in which the IPG is implanted. The personal information may include visual identification information of the patient. Such visual identification information may include an electronic photograph or picture of the patient, or an electronic video of the patient. The personal information of the patient may also include other types of biometric, demographic, or biographical data of the patient, such as the name, residential address, email address, employment, phone number, birthdate, age, height, weight, blood type, medication taken, symptoms, and hospital identification number of the patient, etc.
In comparison, the other memory partition may be configured to store one or more compressed data files that allow for the reconstruction of the pain/stimulation maps as discussed above, as well as treatment protocols. The treatment protocol may include one or more of the following: a date of sensation map creation, a type of implant lead (e.g., 1×12, 2×6, etc.) containing electrodes configured to deliver electrical stimulation to the patient, an activated electrode configuration (e.g., which electrodes are programmed to be an anode or a cathode) on the implant lead, a polarity programmed for each activated electrode, an amount of current programmed for each activated electrode, a pulse width programmed for each activated electrode, and a frequency programmed for each activated electrode. Each compressed data file may be associated with a respective treatment protocol. The compressed data file and the treatment protocol may be downloaded from the clinician programmer via an established electronic communications link.
In some embodiments, the clinician programmer may generate a plurality of pain/stimulation maps over a period of time, where each of the pain/stimulation maps is generated at a different point in time. For example, a first pain map and a first stimulation map may be generated on Jan. 10, 2008, a second pain map and a second stimulation map may be generated on Jan. 10, 2009, a third pain map and a third stimulation map may be generated on Jan. 10, 2010, and a fourth pain map and a fourth stimulation map may be generated on Jan. 10, 2011. The clinician programmer can compress all of these pain/stimulation maps and generate the compressed data files in the manner discussed above. Each of the compressed data files may also contain the time information (i.e., the time that the pain/stimulation map is generated). The clinician programmer then sends all the compressed data files to the IPG for storage. At a later point in time, these compressed data files may be retrieved by another clinician programmer (or another suitable device) and may be used to reconstruct their corresponding pain/stimulation maps. As such, a history of pain/stimulation maps may be stored in the IPG and may be retrieved at any time. A healthcare professional may then use this history of pain/stimulation maps and see how the patient's pain has migrated or changed over time, and how effective the stimulation therapy is at these different points in time. In some embodiments, the IPG may be configured to store a record of the compressed data files, so that even after the data files are erased, a record of their storage on the IPG may still be retrieved. Again, multiple compression mechanisms may be used to compress data across multiple files. Whichever method that offers the best results will be used. Since each file contains the information regarding which method was used to carry out the compression, decompression can be done using the same method.
In some embodiments, the memory storage capacity on the IPG may not be sufficiently big to hold even several of the compressed data files. For example, it may not be big enough to hold 4 compressed data files. In that case, the IPG and the clinician programmer may be configured to let the memory storage of the IPG to automatically store data files that will fit and discard one or more data files that will not fit. For example, data files 2, 3, 4 may be stored, but data file 1 will be discarded. In some embodiments, the user may be presented with an option so he can choose whichever data file he wishes to save to the IPG.
The embodiments of the present disclosure offer are many advantages by allowing compressed pain/stimulation maps to be stored on the IPG. It is understood, however, that not all advantages are necessarily discussed herein, other embodiments may offer different advantages, and that no advantage is required for all embodiments. Some of these advantages are associated with the fact that IPGs are implanted in the patient, and as such they are always with the patient. Thus, the compressed pain/stimulation maps are stored in a reliable place (i.e., the patient's body) and may be readily retrieved wherever the patient goes.
Various shortcomings of previous methods and the advantages offered by the embodiments disclosed herein are listed below:
Referring first to
The method 500 includes a step 510, in which a data file is generated. The data file has a data size less than a data size of the sensation map. The data file contains digital information allowing a reconstruction of the sensation map. In some embodiments, the step 510 includes the following steps: performing a Connected Component Labeling (CCL) process to the sensation map to generate a processed image of the sensation map; generating a plurality of data files by executing a plurality of data compression algorithms to the processed image of the sensation map, respectively, the data compression algorithms being selected from the group consisting of: Chain Code, Minimum Perimeter Polygon, Estimation with Primitives, Fourier descriptors, and run-length encoding; computing a respective data size for each of the data files; and selecting the data file with a smallest data size as the data file to be sent to the implanted medical device.
The method 500 includes a step 515, in which electronic communication is established with an implanted medical device located inside the patient's body. In some embodiments, the implanted medical device is an IPG. The electronic communication may be established through radios of the clinician programmer and the implanted medical device under the MICS protocol.
The method 500 includes a step 520, in which a treatment protocol is associated with the sensation map. In some embodiments, the treatment protocol includes one or more of the following information: a date of sensation map creation, a type of implant lead containing electrodes configured to deliver electrical stimulation to the patient, an activated electrode configuration on the implant lead, a polarity programmed for each activated electrode, an amount of current programmed for each activated electrode, a pulse width programmed for each activated electrode, and a frequency programmed for each activated electrode.
The method 500 includes a step 525, in which the treatment protocol is sent to the implanted medical device along with the associated data file for storage.
The method 500 includes a step 530, in which the treatment protocol is sent to a remote electronic database along with the associated data file for storage.
It is understood that additional process steps may be performed before, during, or after the steps 505-540. For example, the method 500 may include a step of generating a plurality of data files over time (i.e., a history of the pain/stimulation maps), wherein each data file corresponds to a data-reduced sensation map at a different point in time, and sending the plurality of data files to the implanted medical device for storage. For reasons of simplicity, other additional processes are not specifically discussed herein. Furthermore, the steps 505-530 need not be performed in the numerical order shown in
The CP includes a printed circuit board (“PCB”) that is populated with a plurality of electrical and electronic components that provide power, operational control, and protection to the CP. With reference to
The CP includes memory, which can be internal to the processor 600 (e.g., memory 605), external to the processor 600 (e.g., memory 610), or a combination of both. Exemplary memory include a read-only memory (“ROM”), a random access memory (“RAM”), an electrically erasable programmable read-only memory (“EEPROM”), a flash memory, a hard disk, or another suitable magnetic, optical, physical, or electronic memory device. The processor 600 executes software that is capable of being stored in the RAM (e.g., during execution), the ROM (e.g., on a generally permanent basis), or another non-transitory computer readable medium such as another memory or a disc. The CP also includes input/output (“I/O”) systems that include routines for transferring information between components within the processor 600 and other components of the CP or external to the CP.
Software included in the implementation of the CP is stored in the memory 605 of the processor 600, RAM 610, ROM 615, or external to the CP. The software includes, for example, firmware, one or more applications, program data, one or more program modules, and other executable instructions. The processor 600 is configured to retrieve from memory and execute, among other things, instructions related to the control processes and methods described below for the CP.
One memory shown in
The CP includes multiple bi-directional radio communication capabilities. Specific wireless portions included with the CP are a Medical Implant Communication Service (MICS) bi-directional radio communication portion 620, a Wi-Fi bi-directional radio communication portion 625, and a Bluetooth bi-directional radio communication portion 630. The MICS portion 620 includes a MICS communication interface, an antenna switch, and a related antenna, all of which allows wireless communication using the MICS specification. The Wi-Fi portion 625 and Bluetooth portion 630 include a Wi-Fi communication interface, a Bluetooth communication interface, an antenna switch, and a related antenna all of which allows wireless communication following the Wi-Fi Alliance standard and Bluetooth Special Interest Group standard. Of course, other wireless local area network (WLAN) standards and wireless personal area networks (WPAN) standards can be used with the CP.
The CP includes three hard buttons: a “home” button 635 for returning the CP to a home screen for the device, a “quick off” button 640 for quickly deactivating stimulation IPG, and a “reset” button 645 for rebooting the CP. The CP also includes an “ON/OFF” switch 650, which is part of the power generation and management block (discussed below).
The CP includes multiple communication portions for wired communication. Exemplary circuitry and ports for receiving a wired connector include a portion and related port for supporting universal serial bus (USB) connectivity 655, including a Type A port and a Micro-B port; a portion and related port for supporting Joint Test Action Group (JTAG) connectivity 660, and a portion and related port for supporting universal asynchronous receiver/transmitter (UART) connectivity 665. Of course, other wired communication standards and connectivity can be used with or in place of the types shown in
Another device connectable to the CP, and therefore supported by the CP, is an external display. The connection to the external display can be made via a micro High-Definition Multimedia Interface (HDMI) 670, which provides a compact audio/video interface for transmitting uncompressed digital data to the external display. The use of the HDMI connection 670 allows the CP to transmit video (and audio) communication to an external display. This may be beneficial in situations where others (e.g., the surgeon) may want to view the information being viewed by the healthcare professional. The surgeon typically has no visual access to the CP in the operating room unless an external screen is provided. The HDMI connection 670 allows the surgeon to view information from the CP, thereby allowing greater communication between the clinician and the surgeon. For a specific example, the HDMI connection 670 can broadcast a high definition television signal that allows the surgeon to view the same information that is shown on the LCD (discussed below) of the CP.
The CP includes a touch screen I/O device 675 for providing a user interface with the clinician. The touch screen display 675 can be a liquid crystal display (LCD) having a resistive, capacitive, or similar touch-screen technology. It is envisioned that multitouch capabilities can be used with the touch screen display 675 depending on the type of technology used.
The CP includes a camera 680 allowing the device to take pictures or video. The resulting image files can be used to document a procedure or an aspect of the procedure. Other devices can be coupled to the CP to provide further information, such as scanners or RFID detection. Similarly, the CP includes an audio portion 685 having an audio codec circuit, audio power amplifier, and related speaker for providing audio communication to the user, such as the clinician or the surgeon.
The CP further includes a power generation and management block 690. The power block 690 has a power source (e.g., a lithium-ion battery) and a power supply for providing multiple power voltages to the processor, LCD touch screen, and peripherals.
In one embodiment, the CP is a handheld computing tablet with touch screen capabilities. The tablet is a portable personal computer with a touch screen, which is typically the primary input device. However, an external keyboard or mouse can be attached to the CP. The tablet allows for mobile functionality not associated with even typical laptop personal computers. The hardware may include a Graphical Processing Unit (GPU) in order to speed up the user experience. An Ethernet port (not shown in
It is understood that a patient programmer may be implemented in a similar manner as the clinician programmer shown in
The IPG provides stimuli to electrodes of an implanted medical electrical lead (not illustrated herein). As shown in
The IPG also includes a power supply portion 740. The power supply portion includes a rechargeable battery 745, fuse 750, power ASIC 755, recharge coil 760, rectifier 763 and data modulation circuit 765. The rechargeable battery 745 provides a power source for the power supply portion 740. The recharge coil 760 receives a wireless signal from the PPC. The wireless signal includes an energy that is converted and conditioned to a power signal by the rectifier 763. The power signal is provided to the rechargeable battery 745 via the power ASIC 755. The power ASIC 755 manages the power for the IPG. The power ASIC 755 provides one or more voltages to the other electrical and electronic circuits of the IPG. The data modulation circuit 765 controls the charging process.
The IPG also includes a magnetic sensor 780. The magnetic sensor 780 provides a “hard” switch upon sensing a magnet for a defined period. The signal from the magnetic sensor 780 can provide an override for the IPG if a fault is occurring with the IPG and is not responding to other controllers.
The IPG is shown in
The IPG includes memory, which can be internal to the control device (such as memory 790), external to the control device (such as serial memory 795), or a combination of both. Exemplary memory include a read-only memory (“ROM”), a random access memory (“RAM”), an electrically erasable programmable read-only memory (“EEPROM”), a flash memory, a hard disk, or another suitable magnetic, optical, physical, or electronic memory device. The programmable portion 785 executes software that is capable of being stored in the RAM (e.g., during execution), the ROM (e.g., on a generally permanent basis), or another non-transitory computer readable medium such as another memory or a disc.
Software included in the implementation of the IPG is stored in the memory 790. The software includes, for example, firmware, one or more applications, program data, one or more program modules, and other executable instructions. The programmable portion 785 is configured to retrieve from memory and execute, among other things, instructions related to the control processes and methods described below for the IPG. For example, the programmable portion 285 is configured to execute instructions retrieved from the memory 790 for sweeping the electrodes in response to a signal from the CP.
Referring now to
The medical infrastructure 800 also includes a plurality of electronic programmers 820. For sake of illustration, one of these electronic programmers 820A is illustrated in more detail and discussed in detail below. Nevertheless, it is understood that each of the electronic programmers 820 may be implemented similar to the electronic programmer 820A.
In some embodiments, the electronic programmer 820A may be a clinician programmer, for example the clinician programmer discussed above with reference to
The electronic programmer 820A contains a communications component 830 that is configured to conduct electronic communications with external devices. For example, the communications device 830 may include a transceiver. The transceiver contains various electronic circuitry components configured to conduct telecommunications with one or more external devices. The electronic circuitry components allow the transceiver to conduct telecommunications in one or more of the wired or wireless telecommunications protocols, including communications protocols such as IEEE 802.11 (Wi-Fi), IEEE 802.15 (Bluetooth), GSM, CDMA, LTE, WIMAX, DLNA, HDMI, Medical Implant Communication Service (MICS), etc. In some embodiments, the transceiver includes antennas, filters, switches, various kinds of amplifiers such as low-noise amplifiers or power amplifiers, digital-to-analog (DAC) converters, analog-to-digital (ADC) converters, mixers, multiplexers and demultiplexers, oscillators, and/or phase-locked loops (PLLs). Some of these electronic circuitry components may be integrated into a single discrete device or an integrated circuit (IC) chip.
The electronic programmer 820A contains a touchscreen component 840. The touchscreen component 840 may display a touch-sensitive graphical user interface that is responsive to gesture-based user interactions. The touch-sensitive graphical user interface may detect a touch or a movement of a user's finger(s) on the touchscreen and interpret these user actions accordingly to perform appropriate tasks. The graphical user interface may also utilize a virtual keyboard to receive user input. In some embodiments, the touch-sensitive screen may be a capacitive touchscreen. In other embodiments, the touch-sensitive screen may be a resistive touchscreen.
It is understood that the electronic programmer 820A may optionally include additional user input/output components that work in conjunction with the touchscreen component 840 to carry out communications with a user. For example, these additional user input/output components may include physical and/or virtual buttons (such as power and volume buttons) on or off the touch-sensitive screen, physical and/or virtual keyboards, mouse, track balls, speakers, microphones, light-sensors, light-emitting diodes (LEDs), communications ports (such as USB or HDMI ports), joy-sticks, etc.
The electronic programmer 820A contains an imaging component 850. The imaging component 850 is configured to capture an image of a target device via a scan. For example, the imaging component 850 may be a camera in some embodiments. The camera may be integrated into the electronic programmer 820A. The camera can be used to take a picture of a medical device, or scan a visual code of the medical device, for example its barcode or Quick Response (QR) code.
The electronic programmer contains a memory storage component 860. The memory storage component 860 may include system memory, (e.g., RAM), static storage 608 (e.g., ROM), or a disk drive (e.g., magnetic or optical), or any other suitable types of computer readable storage media. For example, some common types of computer readable media may include floppy disk, flexible disk, hard disk, magnetic tape, any other magnetic medium, CD-ROM, any other optical medium, RAM, PROM, EPROM, FLASH-EPROM, any other memory chip or cartridge, or any other medium from which a computer is adapted to read. The computer readable medium may include, but is not limited to, non-volatile media and volatile media. The computer readable medium is tangible, concrete, and non-transitory. Logic (for example in the form of computer software code or computer instructions) may be encoded in such computer readable medium. In some embodiments, the memory storage component 860 (or a portion thereof) may be configured as a local database capable of storing electronic records of medical devices and/or their associated patients.
The electronic programmer contains a processor component 870. The processor component 870 may include a central processing unit (CPU), a graphics processing unit (GPU) a micro-controller, a digital signal processor (DSP), or another suitable electronic processor capable of handling and executing instructions. In various embodiments, the processor component 870 may be implemented using various digital circuit blocks (including logic gates such as AND, OR, NAND, NOR, XOR gates, etc.) along with certain software code. In some embodiments, the processor component 870 may execute one or more sequences computer instructions contained in the memory storage component 860 to perform certain tasks.
It is understood that hard-wired circuitry may be used in place of (or in combination with) software instructions to implement various aspects of the present disclosure. Where applicable, various embodiments provided by the present disclosure may be implemented using hardware, software, or combinations of hardware and software. Also, where applicable, the various hardware components and/or software components set forth herein may be combined into composite components comprising software, hardware, and/or both without departing from the spirit of the present disclosure. Where applicable, the various hardware components and/or software components set forth herein may be separated into sub-components comprising software, hardware, or both without departing from the scope of the present disclosure. In addition, where applicable, it is contemplated that software components may be implemented as hardware components and vice-versa.
It is also understood that the electronic programmer 820A is not necessarily limited to the components 830-870 discussed above, but it may further include additional components that are used to carry out the programming tasks. These additional components are not discussed herein for reasons of simplicity. It is also understood that the medical infrastructure 800 may include a plurality of electronic programmers similar to the electronic programmer 820A discussed herein, but they are not illustrated in
The medical infrastructure 800 also includes an institutional computer system 890. The institutional computer system 890 is coupled to the electronic programmer 820A. In some embodiments, the institutional computer system 890 is a computer system of a healthcare institution, for example a hospital. The institutional computer system 890 may include one or more computer servers and/or client terminals that may each include the necessary computer hardware and software for conducting electronic communications and performing programmed tasks. In various embodiments, the institutional computer system 890 may include communications devices (e.g., transceivers), user input/output devices, memory storage devices, and computer processor devices that may share similar properties with the various components 830-870 of the electronic programmer 820A discussed above. For example, the institutional computer system 890 may include computer servers that are capable of electronically communicating with the electronic programmer 820A through the MICS protocol or another suitable networking protocol.
The medical infrastructure 800 includes a database 900. In various embodiments, the database 900 is a remote database—that is, located remotely to the institutional computer system 890 and/or the electronic programmer 820A. The database 900 is electronically or communicatively (for example through the Internet) coupled to the institutional computer system 890 and/or the electronic programmer. In some embodiments, the database 900, the institutional computer system 890, and the electronic programmer 820A are parts of a cloud-based architecture. In that regard, the database 900 may include cloud-based resources such as mass storage computer servers with adequate memory resources to handle requests from a variety of clients. The institutional computer system 890 and the electronic programmer 820A (or their respective users) may both be considered clients of the database 900. In certain embodiments, the functionality between the cloud-based resources and its clients may be divided up in any appropriate manner. For example, the electronic programmer 820A may perform basic input/output interactions with a user, but a majority of the processing and caching may be performed by the cloud-based resources in the database 900. However, other divisions of responsibility are also possible in various embodiments.
According to the various aspects of the present disclosure, the sensation maps may be uploaded from the electronic programmer 820A to the database 900. The sensation maps saved in the database 900 may thereafter be downloaded by any of the other electronic programmers 820B-820N communicatively coupled to it, assuming the user of these programmers has the right login permissions. For example, a compressed sensation map is generated by the electronic programmer 820A and uploaded to the database 900. That compressed map can then be downloaded by the electronic programmer 820B, which can use the downloaded compressed sensation map to reconstruct or recreate the original uncompressed sensation map. In this manner, a less data-intensive sensation map may be derived from a data-heavy sensation map, sent to a different programmer through the database, and then be used to reconstruct the original sensation map.
The database 900 may also include a manufacturer's database in some embodiments. It may be configured to manage an electronic medical device inventory, monitor manufacturing of medical devices, control shipping of medical devices, and communicate with existing or potential buyers (such as a healthcare institution). For example, communication with the buyer may include buying and usage history of medical devices and creation of purchase orders. A message can be automatically generated when a client (for example a hospital) is projected to run out of equipment, based on the medical device usage trend analysis done by the database. According to various aspects of the present disclosure, the database 900 is able to provide these functionalities at least in part via communication with the electronic programmer 820A and in response to the data sent by the electronic programmer 820A. These functionalities of the database 900 and its communications with the electronic programmer 820A will be discussed in greater detail later.
The medical infrastructure 800 further includes a manufacturer computer system 910. The manufacturer computer system 910 is also electronically or communicatively (for example through the Internet) coupled to the database 900. Hence, the manufacturer computer system 910 may also be considered a part of the cloud architecture. The computer system 910 is a computer system of medical device manufacturer, for example a manufacturer of the medical devices 810 and/or the electronic programmer 820A.
In various embodiments, the manufacturer computer system 910 may include one or more computer servers and/or client terminals that each includes the necessary computer hardware and software for conducting electronic communications and performing programmed tasks. In various embodiments, the manufacturer computer system 910 may include communications devices (e.g., transceivers), user input/output devices, memory storage devices, and computer processor devices that may share similar properties with the various components 830-870 of the electronic programmer 820A discussed above. Since both the manufacturer computer system 910 and the electronic programmer 820A are coupled to the database 900, the manufacturer computer system 910 and the electronic programmer 820A can conduct electronic communication with each other.
According to the various aspects of the disclosure, the electronic programmer 820 can generate and then compress a data-heavy pain/stimulation map and produce a data file that can be used to reconstruct the pain/stimulation map. The data file may then be sent to the medical device 810 for storage. The data file may also be sent to the database 900 for storage. The data file may later be retrieved (from the medical device 810 or from the database 900) by the same electronic programmer 820 or another electronic programmer to reconstruct the original pain/stimulation map.
Neural tissue (not illustrated for the sake of simplicity) branch off from the spinal cord through spaces between the vertebrae. The neural tissue can be individually and selectively stimulated in accordance with various aspects of the present disclosure. For example, referring to
The electrodes 1120 deliver current drawn from the current sources in the IPG device 1100, therefore generating an electric field near the neural tissue. The electric field stimulates the neural tissue to accomplish its intended functions. For example, the neural stimulation may alleviate pain in an embodiment. In other embodiments, a stimulator may be placed in different locations throughout the body and may be programmed to address a variety of problems, including for example but without limitation; prevention or reduction of epileptic seizures, weight control or regulation of heart beats.
It is understood that the IPG device 1100, the lead 1110, and the electrodes 1120 may be implanted completely inside the body, may be positioned completely outside the body or may have only one or more components implanted within the body while other components remain outside the body. When they are implanted inside the body, the implant location may be adjusted (e.g., anywhere along the spine 1000) to deliver the intended therapeutic effects of spinal cord electrical stimulation in a desired region of the spine. Furthermore, it is understood that the IPG device 1100 may be controlled by a patient programmer or a clinician programmer 1200, the implementation of which may be similar to the clinician programmer shown in
The foregoing has outlined features of several embodiments so that those skilled in the art may better understand the detailed description that follows. Those skilled in the art should appreciate that they may readily use the present disclosure as a basis for designing or modifying other processes and structures for carrying out the same purposes and/or achieving the same advantages of the embodiments introduced herein. Those skilled in the art should also realize that such equivalent constructions do not depart from the spirit and scope of the present disclosure, and that they may make various changes, substitutions and alterations herein without departing from the spirit and scope of the present disclosure.
The present application is a utility application of provisional U.S. Patent Application No. 61/695,433, filed on Aug. 31, 2012, entitled “System and Method of Compressing Medical Maps For Pulse Generator Or Database Storage,” and a utility application of provisional U.S. Patent Application No. 61/695,407, filed on Aug. 31, 2012, entitled “Method and System of Producing 2D Representations of 3D Pain and Stimulation Maps and Implant Models on a Clinician Programmer,” and a utility application of provisional U.S. Patent Application No. 61/695,721, filed on Aug. 31, 2012, entitled “Method and System of Creating, Displaying, and Comparing Pain and Stimulation Maps,” and a utility application of provisional U.S. Patent Application No. 61/695,676, filed on Aug. 31, 2012, entitled “Method and System of Adjusting 3D Models of Patients on a Clinician Programmer,” and a utility application of provisional U.S. Patent Application No. 61/824,296, filed on May 16, 2013, entitled “Features and Functionalities of an Advanced Clinician Programmer,” and a continuation-in-part of U.S. patent application Ser. No. 13/604,197, filed on Sep. 5, 2012, entitled “Method and System for Associating Patient Records with Pulse Generators,” the disclosures of each of which are hereby incorporated by reference in their entirety.
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61824296 | May 2013 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 13604197 | Sep 2012 | US |
Child | 13973363 | US |