Advanced patient management with environmental data

• US 10,092,186 B2
• Filed: 10/24/2016
• Issued: 10/09/2018
• Est. Priority Date: 03/06/2002
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Hatlestad, John D., Stahmann, Jeffrey E., Zhu, Qingsheng
• Primary Examiner(s): GETZOW, SCOTT M
• Application Number:
  US15/332,609
• Publication Number:
  US 20170035297A1
• Time in Patent Office: 715 Days
• CPC Class Codes: A61B 2560/0247 for compensation or correction of the measured physiological value
• CPC Class Codes: A61B 2560/0252 using ambient temperature
• CPC Class Codes: A61B 2560/0257 using atmospheric pressure
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Systems, devices and methods for using environmental data to manage health care are disclosed. One aspect is an advanced patient management system. In various embodiments, the system includes at least one implantable medical device (IMD) to acquire at least one IMD parameter indicative of patient wellness, means to acquire at least one environmental parameter from at least one external source, and means to correlate the at least one parameter indicative of patient wellness and the at least one environmental parameter to assist with patient health care decisions. Other aspects and embodiments are provided herein.

Claims

1. A system for monitoring a heart failure patient, the system comprising:

a first sensor configured to acquire a first physiological or physical parameter and one or more second sensors configured to acquire one or more second physiological or physical parameters different than the first physiological or physical parameter;

at least one medical device configured to acquire an environmental parameter that is capable of affecting at least one of the first or the one or more second physiological or physical parameters; and

wherein the at least one medical device is configured to adjust the first or one or more second physiological or physical parameters based on the environmental parameter, and to determine a heart failure (HF) status indication using the adjusted first or one or more second physiological or physical parameters.

2. The system of claim 1, further comprising a display for displaying one or more of the first and one or more second physiological or physical parameters and the environmental parameter, wherein the at least one medical device is configured to adjust the displayed physiological or physical parameters based on the environmental parameter.

3. The system of claim 1, wherein the at least one medical device includes an implantable medical device (IMD) and an external device communicatively coupled to the IMD, the external device configured to acquire an environmental parameter, and the IMD or the external device configured to determine the HF status indication using the first and one or more second physiological or physical parameters and the environmental parameter.

4. The system of claim 1, wherein the at least one medical device is configured to:

determine a correlation between the environmental parameter and the first or one or more second physiological or physical parameters;

determine a change in the first or one or more second physiological or physical parameters to be attributable to a change in the environmental parameter based on the determined correlation; and

determine the HF status indication using the determined change attributably;

to the change in the environmental parameter.

5. The system of claim 4, further comprising a therapy circuit configured to deliver a heart failure therapy in response to a detected worsening HF status indication,

wherein the at least one medical device are configured to cooperate to program the heart failure therapy based on the determination that the change in the first or one or more second physiological or physical parameters is attributable to the change in the environmental parameter.

6. The system of claim 1, wherein the first sensor includes a heart sound sensor configured to acquire the first physiological or physical parameter including a heart sound parameter indicative of cardiac systolic or diastolic function.

7. The system of claim 1, wherein the second sensor includes one of the sensors selected from the group consisting of:

a heart rate sensor;

a respiration sensor to acquire a respiration parameter including a respiration rate, respiratory tidal volume, or a respiratory rhythm; and

an impedance sensor to acquire the second physiological or physical parameter including an impedance parameter indicative of edema.

8. The system of claim 1, wherein the at least one medical device is configured to:

generate a composite parameter by combining (1) the change in first physiological or physical parameter and (2) the change in one or more second physiological or physical parameters; and

determine the HF status indication using at least the composite parameter.

9. The system of claim 8, further comprising a third sensor configured to detect a third physiological or physical parameter indicative of patient chronic risk for developing worsening HF, wherein the at least one medical device are configured to generate the composite parameter further using the third physiological or physical parameters.

10. The system of claim 9, wherein the third physiological or physical parameter includes a parameter selected from the group consisting of:

a heart sound parameter, a physical activity, and a respiration rate.

11. The system of claim 1, wherein the environmental parameter includes at least one environmental parameter selected from the group consisting of:

altitude, temperature, air quality, pollen counts, humidity, and environmental pressure.

12. The system of claim 11, wherein the at least one medical device includes an input circuit configured to acquire the environmental parameter from an external sensor or from a database that stores environmental parameter values.

13. A method for monitoring a heart failure patient, the method comprising:

sensing a first physiological or physical parameter via a first sensor and sensing one or more second physiological or physical parameters different than the first physiological or physical parameter via one or more second sensors;

acquire an environmental parameter via at least one medical device, the environmental parameter capable of affecting at least one of the first or the one or more second physiological or physical parameters;

adjusting the first or one or more second physiological or physical parameters based on the environmental parameter; and

determining a heart failure (HF) status indication using the adjusted first or one or more second physiological or physical parameters.

14. The method of claim 13, further comprising:

displaying, on a display, one or more of the first and one or more second physiological or physical parameters and the environmental parameter; and

adjusting the displayed physiological or physical parameters, via the at least one medical device;

based on the environmental parameter.

15. The method of claim 13, comprising:

determining a correlation between the environmental parameter and the first or one or more second physiological or physical parameters; and

determining a change in the first or one or more second physiological or physical parameters to be attributable to a change in the environmental parameter based on the determined correlation.

16. The method of claim 15, further comprising:

programming a heart failure therapy based on the determination that the change in the first or one or more second physiological or physical parameters is attributable to the change in the environmental parameter; and

delivering the programmed heart failure therapy in response to a detected worsening HF status indication.

17. The method of claim 13, wherein:

the first physiological or physical parameter includes a heart sound parameter indicative of cardiac systolic or diastolic function; and

the second physiological or physical parameter is selected from the group consisting of;

a heart rate, a respiration parameter including a respiration rate, respiratory tidal volume, or a respiratory rhythm, and an impedance parameter indicative of edema.

18. The method of claim 13, wherein determining the HF status indication includes:

computing a composite parameter using (1) the change in first physiological or physical parameter and (2) the change in one or more second physiological or physical parameters; and

detecting the HF status indication based on the composite parameter.

19. The system of claim 18, wherein computing the composite parameter further includes using a third physiological or physical parameter indicative of patient chronic risk for worsening heart failure, the third physiological or physical parameter including a parameter selected from the group consisting of:

a heart sound parameter, a physical activity, and a respiration rate.

20. The system of claim 13, wherein the environmental parameter includes at least one environmental parameter selected from the group consisting of:

altitude, temperature, air quality, pollen counts, humidity, and environmental pressure.