Patient care delivery system

• US 20010051765A1
• Filed: 06/28/2001
• Published: 12/13/2001
• Est. Priority Date: 03/31/1999
• Status: Abandoned Application

• Current Assignee: James Jorasch, Jason Krantz, Jay S. Walker, Magdalena Mik
• Original Assignee: James Jorasch, Jason Krantz, Jay S. Walker, Magdalena Mik
• Inventors: Jorasch, James A., Walker, Jay S., Mik, Magdalena, Krantz, Jason
• Application Number:
  US09/893,495
• Publication Number:
  US 20010051765A1
• Time in Patent Office: Days
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/02411 of foetuses
• CPC Class Codes: A61B 5/1112 Global tracking of patients, e.g. by using GPS
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: Y10S 128/904 Telephone telemetry

Abstract

A method and apparatus for analyzing data from remote monitoring equipment, such as patient telemetry devices, and determining (i) whether an anomalous event has occurred, (ii) if an anomalous event has occurred, whether a physician should be contacted, and (iii) if a physician should be contacted, selecting the physician to contact. Further, the system operates in parallel, in that a plurality of experts (e.g. physicians) may be contacted in response to a single or multiple anomalous events, thus ensuring an efficient response to an anomalous event.

Claims

1. A method comprising:

receiving from a remote monitoring device an indication of a physiological anomaly associated with a patient;

selecting at least one remote expert from a plurality of potential remote experts to provide an opinion regarding the anomaly;

determining at least one compensation amount to be provided to at the least one of the at least one selected remote experts in exchange for the opinion; and

causing a communication with the at least one selected remote expert to be initiated, wherein the communication comprises a request for the opinion in exchange for the compensation amount.

2. The method of

claim 1

, wherein the remote monitoring device is a portable device.

3. The method of

claim 1

, wherein the step of selecting comprises:

selecting, based on the received indication, at least one remote expert from a plurality of remote experts to provide an opinion regarding the anomaly.

4. The method of

claim 1

, further comprising:

receiving the opinion from the at least one selected remote expert after the step of causing the communication; and

providing a diagnosis to the patient based on the opinion.

5. The method of

claim 1

, wherein the step of selecting comprises:

determining at least one of at least one patient preference and at least one patient parameter associated with the patient;

determining at least one expert criterion associated with each of the plurality of potential experts; and

selecting at least one expert from the plurality of experts based on a comparison of;

the at least one of the at least one patient preference and the at least one patient parameter to;

the at least one expert criterion.

6. The method of

claim 1

, wherein the step of selecting comprises:

determining an area of medicine associated with the anomaly; and

selecting at least one expert from the plurality of potential experts that practices in the area of medicine.

7. The method of

claim 1

, wherein the step of determining at least one compensation amount comprises:

selecting at least one compensation amount based on a minimum compensation amount previously agreed to by the at least one expert.

8. The method of

claim 1

, wherein the step of determining at least one compensation amount comprises:

determining at least one compensation amount based on at least one of

(i) a current time of day;

(ii) information associated with the patient;

(iii) information associated with the at least one expert;

(iv) an area of medicine associated with the anomaly;

(v) an area of medicine associated with the at least one expert;

(vi) at least one compensation amount previously offered to at least one expert from the plurality of potential experts;

(vii) at least one compensation amount previously accepted by at least one expert from the plurality of potential experts;

(viii) whether the expert has previously provided an opinion regarding the patient; and

(ix) a number of experts selected.

9. The method of

claim 1

, further comprising:

determining that none of the selected experts has responded affirmatively to the transmitted request;

determining an increased compensation amount for at least one of the selected experts; and

causing a communication to be initiated with the at least one expert wherein an indication of the increased compensation amount is transmitted.

10. The method of

claim 1

, further comprising:

receiving a response indicating a willingness to provide an opinion in exchange for the compensation amount from at least one of the selected experts; and

causing data indicating the anomaly to be provided to the at least one expert who responded.

11. The method of

claim 10

wherein the step of causing data indicating the anomaly to be provided comprises:

transmitting data indicative of the anomaly to the at least one expert who responded.

12. The method of

claim 10

wherein the step of causing data indicating the anomaly to be provided comprises:

providing, to the at least one expert who responded, access to the data indicating the anomaly via at least one of an internet and an intranet site.

13. The method of

claim 10

further comprising:

causing to be provided, to the at least one expert who responded, additional information associated with the patient.

14. The method of

claim 13

wherein the additional information comprises the patient'"'"'s medical history.

15. The method of

claim 1

, wherein the expert is at least one of a physician, a nurse, and a medical technician.

16. The method of

claim 1

, wherein the communication includes an indication of the compensation amount.

17. The method of

claim 1

, further comprising:

establishing a direct communication link between the at least one selected expert and the patient.

18. A method comprising:

receiving, from a remote monitoring device, an indication that a patient is in need of a medical diagnosis;

selecting a plurality of remote experts to provide the diagnosis;

transmitting physiological data associated with the patient to the plurality of remote experts;

receiving at least one opinion from the plurality of experts; and

determining an aggregate diagnosis based on the at least one opinion.

19. The method of

claim 18

, further comprising:

determining a compensation amount to be provided to each of the plurality of experts; and

causing the compensation amount to be provided to each of the plurality of experts in exchange for the at least one opinion.

20. The method of

claim 19

, wherein the step of determining a compensation amount is determined before the step of transmitting and further comprising:

transmitting to each of the plurality of experts an indication of the compensation amount as part of a request to provide an opinion; and

receiving a response to the request from each of the plurality of experts.

21. The method of

claim 20

further comprising:

determining the number of responses that are an acceptance of the offer.

22. The method of

claim 21

further comprising:

transmitting the request to additional experts if the number of responses that are an acceptance is below a minimum number.

23. The method of

claim 22

further comprising:

determining at least one increased compensation amount; and

transmitting a request for the opinion in exchange for the increased compensation amount to at least one of the experts whose response was not an acceptance if the number of responses that are an acceptance is below a minimum number.

24. The method of

claim 18

, further comprising:

determining a first compensation amount for a first expert that is included in the plurality of experts; and

determining a second compensation amount for a second expert that is included in the plurality of experts.

25. The method of

claim 24

wherein the first compensation amount is not the second compensation amount.

26. The method of

claim 18

, wherein the step of determining an aggregate diagnosis comprises:

receiving an opinion from each one of the plurality of experts;

categorizing each of the opinions into a possible diagnosis; and

selecting, as the aggregate diagnosis, the possible diagnosis that the most opinions are categorized into.

27. The method of

claim 18

, wherein at least one of the plurality of experts is in a location different from the location of at least another of the plurality of experts.

28. The method of

claim 18

wherein each of the plurality of experts provides an individual opinion regarding the patient.

29. The method of

claim 28

wherein at least one of the plurality of experts is unaware that another of the plurality of experts is also providing an opinion regarding the patient.

30. The method of

claim 18

wherein the plurality of experts communicate with one another before providing an opinion regarding the patient.

31. The method of

claim 30

wherein the plurality of experts, after communicating with one another, provide a single opinion regarding the patient.

32. The method of

claim 31

wherein the step of determining an aggregate diagnosis comprises:

utilizing the single opinion is used as the aggregate diagnosis.

33. The method of

claim 18

, further comprising:

transmitting the aggregate diagnosis to the patient.

34. A method, comprising:

establishing an agreement with an expert, wherein the agreement specifies a periodic compensation amount that the expert will receive in exchange for providing a minimum number of diagnoses during a time period;

transmitting, during the time period, a plurality of requests to the expert, wherein each request comprises a request for a diagnosis of a physiological anomaly associated with a patient;

receiving, from the expert, a response to each of the requests;

receiving, for each response that is an acceptance of the request, the diagnosis for the patient of the request; and

causing the compensation amount to be provided to the expert if, at the end of the time period, it is determined that the expert has provided the minimum amount of diagnoses during the time period.

35. The method of

claim 34

, further comprising:

selecting the exert from a plurality of remote experts based on a received anomaly and the agreement.

36. The method of

claim 34

, further comprising:

causing a reduced compensation amount to be provided to the expert if, at the end of the time period, it is determined that the expert has not provided the minimum amount of diagnoses during the time period.

37. The method of

claim 34

, further comprising:

causing the compensation amount to be withheld from the expert if, at the end of the time period, it is determined that the expert has not provided the minimum amount of diagnoses during the time period.

38. The method of

claim 34

, further comprising:

incrementing a stored number of diagnoses provided by the expert during the time period when the diagnosis is received.

39. The method of

claim 38

, further comprising:

determining that the diagnosis provided is associated with at least one factor that indicates a complication in providing the diagnosis; and

incrementing the stored amount of diagnoses by an additional amount based on the at least one factor.

40. The method of

claim 39

, wherein the at least one factor that indicates a complication in providing the diagnosis comprises at least one of:

(i) a greater than average complexity in the anomaly,

(ii) a greater than average amount of time required to provide the diagnosis,

(iii) an indication that the expert communicated directly with the patient, and

(iv) an indication that the patient'"'"'s life was saved due to the diagnosis.

41. The method of

claim 40

, further comprising:

providing to the expert, at least once during the time period, an indication of a current number of diagnoses provided.

43. The method of

claim 41

, wherein the step of receiving a diagnosis comprises:

receiving a diagnosis based on the anomaly, wherein the diagnosis includes at least one instruction regarding an action to be taken in accordance with the diagnosis.

42. A method, comprising:

establishing an agreement with an entity, wherein the entity agrees to continuously monitor physiological parameters through at least one telemetry device in exchange for compensation;

wearing the at least one telemetry device;

receiving an indication from the entity that an anomaly has occurred in at least one of the physiological parameters; and

receiving a diagnosis based on the anomaly.

44. The method of

claim 42

, wherein the action to be taken comprises:

an action to be taken by the entity.

45. The method of

claim 42

, wherein the at least one instruction comprises:

an instruction to take a medication.

46. An apparatus comprising:

a storage device; and

a processor connected to the storage device,

the storage device storing a program for controlling the processor; and

the processor operative with the program to;

receive from a remote monitoring device an indication of a physiological anomaly associated with a patient;

select at least one remote expert from a plurality of potential remote experts to provide an opinion regarding the anomaly;

determine at least one compensation amount to be provided to at the least one of the at least one selected remote experts in exchange for the opinion; and

cause a communication with the at least one selected remote expert to be initiated, wherein the communication comprises a request for the opinion in exchange for the compensation amount.

47. A computer readable medium encoded with processing instructions for implementing a method, the method comprising the steps of:

receiving from a remote monitoring device an indication of a physiological anomaly associated with a patient;

selecting at least one remote expert from a plurality of potential remote experts to provide an opinion regarding the anomaly;

determining at least one compensation amount to be provided to at the least one of the at least one selected remote experts in exchange for the opinion; and

causing a communication with the at least one selected remote expert to be initiated, wherein the communication comprises a request for the opinion in exchange for the compensation amount.

48. An apparatus comprising:

a storage device; and

a processor connected to the storage device,

the storage device storing a program for controlling the processor; and

the processor operative with the program to;

receive, from a remote monitoring device, an indication that a patient is in need of a medical diagnosis;

select a plurality of remote experts to provide the diagnosis;

transmit physiological data associated with the patient to the plurality of remote experts;

receive at least one opinion from the plurality of experts; and

determine an aggregate diagnosis based on the at least one opinion.

49. A computer readable medium encoded with processing instructions for implementing a method, the method comprising the steps of:

receiving, from a remote monitoring device, an indication that a patient is in need of a medical diagnosis;

selecting a plurality of remote experts to provide the diagnosis;

transmitting physiological data associated with the patient to the plurality of remote experts;

receiving at least one opinion from the plurality of experts; and

determining an aggregate diagnosis based on the at least one opinion.

50. An apparatus comprising:

a storage device; and

a processor connected to the storage device,

the storage device storing a program for controlling the processor; and

the processor operative with the program to;

establish an agreement with an expert, wherein the agreement specifies a periodic compensation amount that the expert will receive in exchange for providing a minimum number of diagnoses during a time period;

transmit, during the time period, a plurality of requests to the expert, wherein each request comprises a request for a diagnosis of a physiological anomaly associated with a patient;

receive, from the expert, a response to each of the requests;

receive, for each response that is an acceptance of the request, the diagnosis for the patient of the request; and

cause the compensation amount to be provided to the expert if, at the end of the time period, it is determined that the expert has provided the minimum amount of diagnoses during the time period.

51. A computer readable medium encoded with processing instructions for implementing a method, the method comprising the steps of:

;

establishing an agreement with an expert, wherein the agreement specifies a periodic compensation amount that the expert will receive in exchange for providing a minimum number of diagnoses during a time period;

transmitting, during the time period, a plurality of requests to the expert, wherein each request comprises a request for a diagnosis of a physiological anomaly associated with a patient;

receiving, from the expert, a response to each of the requests;

receiving, for each response that is an acceptance of the request, the diagnosis for the patient of the request; and

causing the compensation amount to be provided to the expert if, at the end of the time period, it is determined that the expert has provided the minimum amount of diagnoses during the time period.