System and method for determining a reference baseline record for use in automated patient care

• US 20010021801A1
• Filed: 05/18/2001
• Published: 09/13/2001
• Est. Priority Date: 07/26/1999
• Status: Active Grant

• Current Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Original Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Inventors: Bardy, Gust H.
• Granted Patent: US 6,945,934 B2
• Time in Patent Office: Days
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• 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: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 70/00 ICT specially adapted for the handling or processing of medical references

Abstract

A system and method for determining a reference baseline record for use in automated patient care. One or more physiological measures are retrieved. Each of the measures relates to individual patient information recorded during an initial observation period from a patient care record. One or more reference measures are determined from the physiological measures. Each reference measure is representative of at least one of measured and derived patient information. The reference measures are stored into the patient care record indicating a reference baseline patient status.

Claims

1. A system for determining a reference baseline record for use in automated patient care, comprising:

a database storing patient care records with each record containing one or more physiological measures relating to individual patient information recorded during an initial observation period; and

an analysis module determining one or more reference measures, each representative of at least one of measured and derived patient information, from the physiological measures retrieved from one such patient care record and storing the reference measures into the one such patient care record indicating a reference baseline patient status.

2. A system according to

claim 1

, further comprising:

a medical device having a sensor for monitoring and recording the physiological measures at least one of directly and derivatively.

3. A system according to

claim 2

, further comprising:

a reprogrammer reprogramming the performance profile of the medical device during the initial observation period; and

the database obtaining the physiological measures from the medical device subsequent to reprogramming.

4. A system according to

claim 2

, further comprising:

the medical device monitoring the individual patient while the individual patient is performing a prescribed set of timed physical stressors during the initial observation period.

5. A system according to

claim 1

, further comprising:

the database storing patient care records with each record containing physiological measures from sensors monitoring a plurality of anatomical sites within the individual patient; and

the analysis module analyzing the physiological measures from one such patient care record relative to each anatomical site.

6. A system according to

claim 1

, further comprising:

the database receiving quality of life measures recorded by the individual patient during the initial observation period; and

the analysis module combining the collected quality of life measures into patient care record indicating an expanded reference baseline patient status.

7. A system according to

claim 1

, further comprising:

the database receiving feedback recorded by the individual patient during the initial observation period; and

the analysis module combining the feedback into patient care record indicating an expanded reference baseline patient status.

8. A system according to

claim 1

, further comprising:

the analysis module analyzing one or more physiological measures from the patient care record to at least one of the reference measures and one or more other physiological measures to determine the reference baseline patient status.

9. A system according to

claim 1

, wherein each of the reference measures is selected from the group comprising patient activity score, posture, atrial electrical activity, ventricular electrical activity, cardiovascular pressures, cardiac output, oxygenation, pulmonary measures, body temperature, PR interval, QRS measures, QT interval, ST-T wave measures, potassium [K+] level, sodium [Na+] level, glucose level, blood urea nitrogen and creatinine, acidity (pH) level, hematocrit, hormonal levels, cardiac injury chemical tests, myocardial blood flow, central nervous system injury chemical tests, central nervous system (CNS) blood flow, and time of day and combinations and derivatives thereof.

10. A method for determining a reference baseline record for use in automated patient care, comprising:

retrieving one or more physiological measures relating to individual patient information recorded during an initial observation period from a patient care record;

determining one or more reference measures, each representative of at least one of measured and derived patient information, from the physiological measures; and

storing the reference measures into the patient care record indicating a reference baseline patient status.

11. A method according to

claim 10

, further comprising:

obtaining the physiological measures from a medical device having a sensor for monitoring the physiological measures at least one of directly and derivatively.

12. A method according to

claim 11

, further comprising:

reprogramming the performance profile of the medical device during the initial observation period; and

obtaining the physiological measures from the medical device subsequent to reprogramming.

13. A method according to

claim 11

, further comprising:

monitoring the individual patient while the individual patient is performing a prescribed set of timed physical stressors during the initial observation period.

14. A method according to

claim 10

, further comprising:

receiving the physiological measures from sensors monitoring a plurality of anatomical sites within the individual patient from a patient care record; and

analyzing the physiological measures relative to each anatomical site.

15. A method according to

claim 10

, further comprising:

receiving quality of life measures recorded by the individual patient during the initial observation period; and

combining the collected quality of life measures into patient care record indicating an expanded reference baseline patient status.

16. A method according to

claim 10

, further comprising:

receiving feedback recorded by the individual patient during the initial observation period; and

combining the feedback into patient care record indicating an expanded reference baseline patient status.

17. A method according to

claim 10

, further comprising:

analyzing one or more physiological measures from the patient care record to at least one of the reference measures and one or more other physiological measures to determine the reference baseline patient status.

18. A method according to

claim 10

, wherein each of the reference measures is selected from the group comprising patient activity score, posture, atrial electrical activity, ventricular electrical activity, cardiovascular pressures, cardiac output, oxygenation, pulmonary measures, body temperature, PR interval, QRS measures, QT interval, ST-T wave measures, potassium [K+] level, sodium [Na+] level, glucose level, blood urea nitrogen and creatinine, acidity (pH) level, hematocrit, hormonal levels, cardiac injury chemical tests, myocardial blood flow, central nervous system injury chemical tests, central nervous system (CNS) blood flow, and time of day and combinations and derivatives thereof.

19. A computer-readable storage medium for a device holding code for performing the method according to claims 10, 11, 14, 15, 16, and 17.

20. A system for applying a reference baseline record for use in automated patient care, comprising:

a database storing one or more reference measures in a patient care record indicating a reference baseline patient status, the reference measures each being representative of at least one of measured and derived patient information and being determined from physiological measures relating to individual patient information recorded during an initial observation period; and

an analysis module comparing the reference measures to acceptance parameters corresponding to the same type of patient information to which the reference measures relate.

21. A system according to

claim 20

, further comprising:

the analysis module identifying each patient care record storing reference measures substantially non-conforming to a corresponding acceptance parameter.

22. A system according to

claim 20

, further comprising:

the analysis module periodically recomparing the reference measures to the corresponding acceptance parameters.

23. A system according to

claim 20

, wherein each of the reference measures is selected from the group comprising a patient activity score, posture, atrial electrical activity, ventricular electrical activity, cardiovascular pressures, cardiac output, oxygenation, pulmonary measures, body temperature, PR interval, QRS measures, QT interval, ST-T wave measures, potassium [K+] level, sodium [Na+] level, glucose level, blood urea nitrogen and creatinine, acidity (pH) level, hematocrit, hormonal levels, cardiac injury chemical tests, myocardial blood flow, central nervous system injury chemical tests, central nervous system (CNS) blood flow, and time of day and combinations and derivatives thereof.

24. A method for applying a reference baseline record for use in automated patient care, comprising:

retrieving one or more reference measures from a patient care record indicating a reference baseline patient status, the reference measures each being representative of at least one of measured and derived patient information and being determined from physiological measures relating to individual patient information recorded during an initial observation period; and

comparing the reference measures to acceptance parameters corresponding to the same type of patient information to which the reference measures relate.

25. A method according to

claim 24

, further comprising:

identifying each patient care record storing reference measures substantially non-conforming to a corresponding acceptance parameter.

26. A method according to

claim 24

, further comprising:

periodically recomparing the reference measures to the corresponding acceptance parameters.

27. A method according to

claim 24

, wherein each of the reference measures is selected from the group comprising a patient activity score, posture, atrial electrical activity, ventricular electrical activity, cardiovascular pressures, cardiac output, oxygenation, pulmonary measures, body temperature, PR interval, QRS measures, QT interval, ST-T wave measures, potassium [K+] level, sodium [Na+] level, glucose level, blood urea nitrogen and creatinine, acidity (pH) level, hematocrit, hormonal levels, cardiac injury chemical tests, myocardial blood flow, central nervous system injury chemical tests, central nervous system (CNS) blood flow, and time of day and combinations and derivatives thereof.

28. A computer-readable storage medium for a device holding code for performing the method according to claims 24, 25, and 26.