Method and apparatus for monitoring development of medication induced febrile neutropenia

• US 10,314,549 B1
• Filed: 07/16/2014
• Issued: 06/11/2019
• Est. Priority Date: 07/16/2013
• Status: Active Grant

• Current Assignee: Alacrity Patient Services, Inc.
• Original Assignee: Alacrity Patient Services, Inc.
• Inventors: Berz, David
• Primary Examiner(s): Jenness, Nathan J
• Application Number:
  US14/333,341
• Time in Patent Office: 1,791 Days
• Field of Search: 600300, 600301
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/4833 Assessment of subject's compliance to treatment
• CPC Class Codes: A61B 5/6802 Sensor mounted on worn items
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Systems and methods for home monitoring and detection of febrile neutropenia in a patient are provided. The system includes a photoplethysmographic sensor for sensing photoplethysmographic signals of the patient, and one or more blood borne parameter sensors for sensing parameters in the patient'"'"'s blood. A febrile neutropenia monitoring application receives information sensed by the photoplethysmography sensor and the one or more blood borne parameter sensors and determines, based on the received information, the presence or deterioration of febrile neutropenia. The method includes the steps of: sensing photoplethysmographic signals of the patient with a photoplethysmographic sensor worn by the patient; sensing blood borne parameters in the patient'"'"'s blood with one or more blood borne parameter sensors; transmitting the sensed photoplethysmographic signals and blood borne parameters to a febrile neutropenia monitoring application; and determining, by the febrile neutropenia monitoring application, the presence or deterioration of febrile neutropenia based on the received information.

Claims

1. A system for out-patient, home monitoring and detection of chemotherapy induced febrile neutropenia in a patient, the system comprising:

a wearable pulse oximeter for sensing photoplethysmographic signals of the patient;

a wearable movement sensor for sensing movement of the patient and for correcting for motion and/or gravitational interferences in the patient'"'"'s photoplethysmographic signals resulting from said sensed movements;

a temperature sensor for sensing the patient'"'"'s body temperature;

one or more point-of-care blood borne parameter sensors for sensing parameters in the patient'"'"'s blood including neutrophil count; and

a febrile neutropenia monitoring application, hosted at least partially on a server and electronically accessible over at least one network system to a patient computer,

wherein the febrile neutropenia monitoring application is configured to determine the patient'"'"'s peripheral vascular resistance and heart rate based on information sensed by the pulse oximeter, and to receive information sensed by the pulse oximeter, the temperature sensor and the one or more blood borne parameter sensors and to determine, based on the received information, a change in the patient'"'"'s condition, and should said change approach or be out of compliance with pre-determined criteria including a single body temperature reading of >

38.3°

C. or a temperature of >

38°

C. sustained for >

1 hour with an absolute neutrophil count of <

1000 cells/microL, indicative of the possible presence or deterioration of febrile neutropenia, provide an alarm to a healthcare provider located remotely from the patient'"'"'s home upon a determination of the presence of or deterioration of febrile neutropenia in a patient.

2. The system of claim 1 further comprising a healthcare provider computer, wherein the febrile neutropenia monitoring application is further configured to provide an alarm to the healthcare provider computer upon a determination of the presence or deterioration of febrile neutropenia in the patient.

3. The system of claim 2, wherein the febrile neutropenia monitoring application is further configured to provide an alarm to the healthcare provider computer upon a determination of patient non-compliance with a patient monitoring protocol.

4. The system of claim 1 further comprising a blood pressure sensor,

wherein the febrile neutropenia monitoring application is configured to receive information sensed by the blood pressure sensor and to determine the presence or deterioration of febrile neutropenia based at least in part on the information sensed by the blood pressure sensor.

5. The system of claim 1, wherein the blood borne parameter sensors comprise a cell-based assay for sensing monocytes.

6. The system of claim 1, wherein the febrile neutropenia monitoring application is further configured to provide a communication to the patient computer, upon a determination of the presence or deterioration of febrile neutropenia in the patient, said communication prompting the patient to perform at least one of:

seeking professional medical care, and begin taking antibiotics.

7. A method for out-patient home monitoring and detection of chemotherapy induced febrile neutropenia in a patient, the method comprising:

sensing photoplethysmographic signals of the patient including vascular resistance, heart rate and blood oxygen saturation with a pulse oximeter worn by the patient;

sensing movement of the patient and correcting for motion and/or gravitational interferences of the patient'"'"'s photoplethysmographic signals resulting from said sensed movement;

sensing the patient'"'"'s body temperature with a temperature sensor;

sensing blood borne parameters in the patient'"'"'s blood, including neutrophil count, with one or more point-of-care blood borne parameter sensors;

transmitting the sensed photoplethysmographic signals and blood borne parameters to a febrile neutropenia monitoring application;

determining, based on changes in the sensed photoplethysmographic signals and blood born parameters, if said signals are approaching or out of compliance with pre-determined criteria including a single body temperature reading of >

38.3°

C. or a temperature of >

38°

C. sustained for >

1 hour with an absolute neutrophil count of <

1000 cells/microL, indicative of the presence or deterioration of febrile neutropenia; and

providing an alarm to a healthcare provider located remotely from the patient'"'"'s home upon a determination of the presence of or deterioration of febrile neutropenia in a patient.

8. The method of claim 7 further comprising:

providing, by the febrile neutropenia monitoring application, an alarm to a healthcare provider computer upon a determination of the presence or deterioration of febrile neutropenia in the patient.

9. The method of claim 7 further comprising:

providing, by the febrile neutropenia monitoring application, an alarm to a healthcare provider computer upon a determination of patient non-compliance with a patient monitoring protocol.

10. The method of claim 7 further comprising:

sensing the patient'"'"'s blood pressure, wherein the determining, by the febrile neutropenia monitoring application, is further based on changes in the blood pressure information.

11. The method of claim 7, wherein the blood borne parameter sensors comprise a cell-based assay for sensing monocytes.

12. The method of claim 7 further comprising:

providing, by the febrile neutropenia monitoring application, a communication to a patient computer, upon a determination of the presence or deterioration of febrile neutropenia in the patient, said communication prompting the patient to perform at least one of;

seeking professional medical care, and begin taking antibiotics.

13. A non-transitory computer readable medium containing instructions for home monitoring and detection of chemotherapy induced febrile neutropenia in a patient enabled at least in part on a processor of a computerized device, the instructions, which when executed by the processor, performing the steps of:

receiving photoplethysmographic signals of the patient including vascular resistance, heart rate and blood oxygen saturation from a pulse oximeter worn by the patient;

receiving correction signals for the photoplethysmographic signals based on sensed movement of the patient;

receiving patient body temperature signals from a temperature sensor;

receiving blood borne parameters including neutrophil count in the patient'"'"'s blood from one or more point-of-care blood borne parameter sensors;

determining, if said signals are approaching or out of compliance with pre-determined conditions including a single body temperature reading of >

38.3°

C. or a temperature of >

38°

C. sustained for >

1 hour with an absolute neutrophil count of <

1000 cells/microL, indicative of the presence or deterioration of febrile neutropenia based on changes in the signals received from the photoplethysmographic sensor and the one or more blood borne parameter sensors; and

providing an alarm to a healthcare provider located remotely from the patient'"'"'s home upon a determination of the presence or deterioration of febrile neutropenia in a patient.