System and method for prioritizing multiple health disorders for use in automated patient care

• US 20020188213A1
• Filed: 07/31/2002
• Published: 12/12/2002
• Est. Priority Date: 11/16/1999
• Status: Active Grant

• Current Assignee: Gust H. Bardy
• Original Assignee: Gust H. Bardy
• Inventors: Bardy, Gust H.
• Granted Patent: US 6,834,203 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• 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: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• 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: Y10S 128/923 by comparison of patient data to other data

Abstract

A system and method for prioritizing multiple health disorders for use in automated patient care is described. A plurality of monitoring sets are retrieved from a database. Each of the monitoring sets include stored measures relating to patient information recorded and derived on a substantially continuous basis. A patient status change is determined by comparing at least one stored measure from each of the monitoring sets to at least one other stored measure with both stored measures relating to the same type of patient information. Each patient status change is ordered in temporal sequence from least recent to most recent. A plurality of health disorder candidates categorized by quantifiable physiological measures of pathophysiologies indicative of each respective health disorder are evaluated and the health disorder candidate with the pathophysiology most closely matching those patient status changes which occurred least recently is identified.

Claims

1. A system for prioritizing multiple health disorders for use in automated patient care, comprising:

a comparison module comparing at least one recorded physiological measure from a plurality of monitoring sets to at least one other recorded physiological measure to quantify a change in patient pathophysiological status for equivalent patient information;

an analysis module ordering each patient pathophysiological status change in temporal sequence from least recent to most recent, categorizing a plurality of health disorder candidates using quantifiable pathophysiologies indicative of each health disorder, and identifying the health disorder candidate having the pathophysiology substantially corresponding to the patient pathophysiological status changes which occurred substantially least recently.

2. A system according to claim 1, further comprising:

a diagnostic module comparing the at least one recorded physiological measure to at least one other recorded physiological measure which was previously recorded within an adjustable time window for the equivalent patient information.

3. A system according to claim 1, further comprising:

a diagnostic module identifying the health disorder candidates having pathophysiologies substantially corresponding to the patient pathophysiological status changes which occurred substantially most recently.

4. A system according to claim 1, further comprising:

a diagnostic module categorizing a plurality of previously related quantifiable pathophysiologies for one of the health disorder candidates into a symptomatic event ordering set, and evaluating each quantifiable pathophysiology in the symptomatic event ordering set responsive to a change in at least one of the quantifiable pathophysiologies.

5. A system according to claim 1, further comprising:

a diagnostic module prioritizing the patient pathophysiological status changes in accordance with a pre-determined ordering, and comparing the patient pathophysiological status changes having a higher priority which occurred least recently before the patient pathophysiological status changes having a lower priority.

6. A system according to claim 1, further comprising:

a database module retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

7. A system according to claim 6, further comprising:

a server system collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

8. A system according to claim 7, further comprising:

at least one of an implantable medical device and an external medical device recording the at least one recorded physiological measure and the at least one other recorded physiological measure.

9. A system according to claim 1, further comprising:

a diagnostic module comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

10. A system according to claim 1, further comprising:

a stored stickiness indicator for at least one recorded physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment; and

a diagnostic module timing each change in patient pathophysiological status for the equivalent patient information, and determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

11. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

12. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

13. A system according to claim 1, wherein the plurality of health disorders comprise congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation, the system further comprising:

defining an indicator threshold corresponding to a quantifiable pathophysiology of a pathophysiology indicative of one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation; and

testing each patient pathophysiological status change against an indicator threshold corresponding to the same type of patient information as the recorded physiological measures which were compared.

15. A method according to claim 14, further comprising:

comparing the at least one recorded physiological measure to at least one other recorded physiological measure which was previously recorded within an adjustable time window for the equivalent patient information.

16. A method according to claim 14, further comprising:

identifying the health disorder candidates having pathophysiologies substantially corresponding to the patient pathophysiological status changes which occurred substantially most recently.

17. A method according to claim 14, further comprising:

sorting a plurality of previously-related quantifiable pathophysiologies for one of the health disorder candidates into a symptomatic event ordering set; and

evaluating each quantifiable pathophysiology in the symptomatic event ordering set responsive to a change in at least one of the quantifiable pathophysiologies.

18. A method according to claim 14, further comprising:

prioritizing the patient pathophysiological status changes in accordance with a pre-determined ordering; and

comparing the patient pathophysiological status changes having a higher priority which occurred least recently before the patient pathophysiological status changes having a lower priority.

19. A method according to claim 14, further comprising:

retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

20. A method according to claim 19, further comprising:

collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

21. A method according to claim 20, further comprising:

recording the at least one recorded physiological measure and the at least one other recorded physiological measure with at least one of an implantable medical device and an external medical device.

22. A method according to claim 14, further comprising:

comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

23. A method according to claim 14, further comprising:

defining a stickiness indicator for at least one recorded physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

timing each change in patient pathophysiological status for the equivalent patient information; and

determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

24. A method according to claim 14, further comprising:

comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

25. A method according to claim 14, further comprising:

comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

26. A method according to claim 14, wherein the plurality of health disorders comprise congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation, the method further comprising:

defining an indicator threshold corresponding to a quantifiable pathophysiology indicative of one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation; and

testing each patient pathophysiological status change against an indicator threshold corresponding to the same type of patient information as the recorded physiological measures which were compared.

27. A computer-readable storage medium for a device holding code for performing the method according to claim 14.

29. A system according to claim 28, further comprising:

the analyzer identifying the multiple health disorder candidates having pathophysiologies substantially corresponding to the patient pathophysiological status changes which occurred substantially most recently.

30. A system according to claim 28, further comprising:

the database module retrieving a plurality of previously-related quantifiable pathophysiologies for one of the multiple health disorder candidates from the database;

a sorter sorting the retrieved quantifiable pathophysiologies into a symptomatic event ordering set;

the analyzer revising each quantifiable pathophysiology in the symptomatic event ordering set responsive to a change in at least one of the quantifiable pathophysiologies; and

the database module storing each revised quantifiable pathophysiology into the database.

31. A system according to claim 28, further comprising:

the analyzer module prioritizing the patient pathophysiological status changes in accordance with a pre-determined ordering of priorities for pathophysiologies, and comparing the patient pathophysiological status changes having a higher priority which occurred least recently before the patient pathophysiological status changes having a lower priority.

32. A system according to claim 28, further comprising:

the server system receiving a set of one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

the database module storing the quality of life measures set into the patient care record for the individual patient into the database; and

the analyzer analyzing the quality of life measures in the recorded physiological measures set relative to the other quality of life measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

33. A system according to claim 28, further comprising:

the server system receiving a set of one or more baseline recorded physiological measures relating to patient information recorded during an initial time period or derived therefrom;

the database module storing the baseline recorded physiological measures set into the patient care record for the individual patient into the database; and

the analyzer analyzing the recorded physiological measures in the recorded physiological measures set relative to the baseline recorded physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

34. A system according to claim 28, further comprising:

a comparison module retrieving the other recorded physiological measures from measures sets for at least one of an individual patient, a peer group, and a overall patient population.

35. A system according to claim 28, wherein the multiple health disorders comprise at least one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation.

37. A method according to claim 36, further comprising:

identifying the multiple health disorder candidates having pathophysiologies substantially corresponding to the patient pathophysiological status changes which occurred substantially most recently.

38. A method according to claim 36, further comprising:

retrieving a plurality of previously-related quantifiable pathophysiologies for one of the multiple health disorder candidates from the database;

sorting the retrieved quantifiable pathophysiologies into a symptomatic event ordering set;

revising each quantifiable pathophysiology in the symptomatic event ordering set responsive to a change in at least one of the quantifiable pathophysiologies; and

storing each revised quantifiable pathophysiology into the database.

39. A method according to claim 36, further comprising:

prioritizing the patient pathophysiological status changes in accordance with a pre-determined ordering of priorities for pathophysiologies; and

comparing the patient pathophysiological status changes having a higher priority which occurred least recently before the patient pathophysiological status changes having a lower priority.

40. A method according to claim 36, further comprising:

receiving a set of one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing the quality of life measures set into the patient care record for the individual patient into the database; and

analyzing the quality of life measures in the recorded physiological measures set relative to the other quality of life measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

41. A method according to claim 36, further comprising:

receiving a set of one or more baseline recorded physiological measures relating to patient information recorded during an initial time period or derived therefrom;

storing the baseline recorded physiological measures set into the patient care record for the individual patient into the database; and

analyzing the recorded physiological measures in the recorded physiological measures set relative to the baseline recorded physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of respiratory insufficiency.

42. A method according to claim 36, further comprising:

retrieving the other recorded physiological measures from measures sets for at least one of an individual patient, a peer group, and a overall patient population.

43. A method according to claim 36, wherein the multiple health disorders comprise at least one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation.

14. A method for prioritizing multiple health disorders for use in automated patient care, comprising:

comparing at least one recorded physiological measure from a plurality of monitoring sets to at least one other recorded physiological measure to quantify a change in patient pathophysiological status for equivalent patient information;

ordering each patient pathophysiological status change in temporal sequence from least recent to most recent;

categorizing a plurality of health disorder candidates using quantifiable pathophysiologies indicative of each health disorder; and

identifying the health disorder candidates having the quantifiable pathophysiologies substantially comparable to the patient pathophysiological status changes which occurred substantially least recently.

28. A system for analyzing a patient status for multiple health disorders for use in automated patient care, comprising:

a server system receiving a plurality of sets of one or more recorded physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

a database module storing each recorded physiological measures set into a patient care record for an individual patient into a database;

an analyzer comparing at least one recorded physiological measure from a plurality of the recorded physiological measures sets to at least one other recorded physiological measure to quantify a change in patient pathophysiological status for equivalent patient information, ordering each patient pathophysiological status change in temporal sequence from least recent to most recent, categorizing a plurality of multiple health disorder candidates using quantifiable pathophysiologies indicative of each multiple health disorder, and identifying the multiple health disorder candidates having the quantifiable pathophysiologies substantially comparable to the patient pathophysiological status changes which occurred substantially least recently.

36. A method for analyzing a patient status for multiple health disorders for use in automated patient care, comprising:

receiving a plurality of sets of one or more recorded physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing each recorded physiological measures set into a patient care record for an individual patient into a database;

comparing at least one recorded physiological measure from a plurality of the recorded physiological measures sets to at least one other recorded physiological measure to quantify a change in patient pathophysiological status for equivalent patient information;

ordering each patient pathophysiological status change in temporal sequence from least recent to most recent;

categorizing a plurality of multiple health disorder candidates using quantifiable pathophysiologies indicative of each multiple health disorder; and

identifying the multiple health disorder candidates having the quantifiable pathophysiologies substantially comparable to the patient pathophysiological status changes which occurred substantially least recently.

44. A computer-readable storage medium for a device holding code for performing the method according to claim 36.