Remote monitoring system for ambulatory COPD patients

• US 20030083556A1
• Filed: 03/07/2002
• Published: 05/01/2003
• Est. Priority Date: 04/16/1999
• Status: Active Grant

• Current Assignee: MEDTRONIC CARE MANAGEMENT SERVICES, LLC (Medtronic Plc)
• Original Assignee: Cardiocom LLC (Medtronic Plc)
• Inventors: Cosentino, Louis C., Cosentino, Daniel L.
• Granted Patent: US 7,945,451 B2
• Time in Patent Office: Days
• US Class Current: 600/300
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/20 for measuring urological functions restricted to the evaluation of the urinary system A61B5/4375 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: G01G 19/4146 for controlling caloric intake, e.g. diet control
• CPC Class Codes: G01G 19/44 for weighing persons
• CPC Class Codes: G01G 23/3735 using a digital network
• CPC Class Codes: G01G 23/3742 using a mobile telephone network
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

The monitoring device incorporates a memory device that is programmed with a set of question hierearchies. Each question hierarchy corresponds to a symptom and is composed of a set of questions. The question hierarchies may contain a logical structure so that certain questions will not be asked, depending upon a patient'"'"'s answer to a preceeding question. A question hiearchy is invoked by a symptom identifier transmitted to the monitoring device by a remote computer. The remote computer may transmit a plurality of symptom identifiers to the monitoring device to cause the monitoring device to ask questions related to a plurality of symptoms. The set of symptoms inquired about may vary based upon the chronic disease afflicting the patient.

Claims

1. A health care device for monitoring a health condition of an ambulatory patient, the device comprising:

a display for presenting questions to the patient;

an input device permitting the patient to enter answers to the questions;

a microprocessor operably coupled to the display and the input device;

a read-only memory device operably coupled to the microprocessor, the read-only memory device storing a plurality of question hierarchies, each hierarchy of questions corresponding to each of a plurality of symptoms;

a communication device operably coupled to the microprocessor;

wherein the microprocessor is programmed to

receive a symptom identifier via the communication device;

based upon the symptom identifier, ask a first question from the hierarchy of questions corresponding to the symptom identified by the symptom identifier;

receive an answer to the first question via the input device; and

based upon the answer to the first question, make a decision regarding whether to ask a subsequent question from the hierarchy.

2. The monitoring device of claim 1, wherein each question within the hierarchy of questions is answerable via a response selected from a set consisting of “

yes” and

“

no.”

3. The health care device of claim 1, wherein an answer to the subsequent question in the hierarchy determines whether the symptom is more severe than indicated by the answer to the first question in the hierarchy.

4. The health care device of claim 1, wherein one of the questions within the hierarchy asks whether a physiological parameter of the patient exceeds a threshold.

5. The health care device of claim 4, wherein the threshold is received via the communication device.

6. The health care device of claim 1, wherein one of the questions within the hierarchy asks whether the patient is adhering to a pre-established health care regimen.

7. The health care device of claim 6, wherein the microprocessor is programmed to praise the patient, in response to the patient indicating that the pre-established health care regimen is being adhered to.

8. The health care device of claim 1, wherein the subsequent question within the hierarchy asks about the symptom with more specificity than the first question.

9. The health care device of claim 1, wherein the microprocessor is programmed to permit one or more questions within the hierarchy to be asked, regardless of any answer to any other question within the hierarchy.

10. The health care device of claim 1, wherein the microprocessor is programmed to permit questions within the hierarchy to be asked in a designated sequence.

11. The health care device of claim 1, wherein the hierarchy further includes a reminder to the patient to perform a particular act, the reminder requiring no answer from the patient.

12. The health care device of claim 1, wherein memory device stores each question hierarchy in a plurality of languages.

13. The health care device of claim 1, wherein:

the read-only memory device stores each question hierarchy in a digital audio format;

the monitoring device further comprises an audio output unit operably coupled to the microprocessor; and

the microprocessor is further programmed to direct each question from the hierarchy to the audio output unit, so that the question is vocalized to the patient.

14. The health care device of claim 1, wherein the input device comprises:

a first button to indicate an answer in the affirmative; and

a second button to indicate an answer in the negative.

15. The health care device of claim 1, further comprising:

a physiological parameter measuring device operably coupled to the microprocessor;

wherein the physiological parameter measuring device measures a physiological parameter of the patient and transfers the measured parameter to the microprocessor.

16. The health care device of claim 15, wherein the physiological parameter measuring device is a scale.

17. A health care system for monitoring a health condition of an ambulatory patient, the system comprising:

the health care device of claim 1;

and

a central computer system in communication with the health care device;

wherein the central computer system is programmed to

transmit the symptom identifier to the health care device, thereby causing the health care device to ask one or more questions within the hierarchies corresponding to the symptom identified by the symptom identifier.

18. The health care system of claim 17, wherein the central computer system is programmed to:

present a menu of health conditions;

permit a user to select a health condition from the menu of health conditions;

based upon the selected health condition, transmit one or more symptom identifiers to the health care device, thereby causing the health care device to ask one or more questions within one or more hierarchies corresponding to the one or more symptoms identified by the one or more symptom identifiers.

19. The health care system of claim 17, wherein the central computer system is programmed to:

assign a point value to each question within each hierarchy, wherein the point value may be earned if the question to which it is assigned is answered in accordance with a pre-defined answer;

determine a total point value, which is a sum of the point values assigned to each question asked to the patient by the health care device;

determine an earned point value, which is a sum of all points earned by the patient'"'"'s answers to the questions;

determine a ratio between the earned point value and the total point value; and

notify a health care provider if the ratio exceeds a threshold.

20. The health care system of claim 17, wherein the central computer system is programmed to:

assign a point value to each question within each hierarchy, wherein the point value may be earned if the question to which it is assigned is answered in accordance with a pre-defined answer;

assign a threshold value to each hierarchy of questions;

determine a number of points earned in each category, based upon the patient'"'"'s answers; and

notify a health care provider, if more than a pre-defined number of points are earned within more than a pre-defined number of question hierarchies.

21. A method for monitoring a health condition of an ambulatory patient, the method comprising:

receiving a symptom identifier;

retrieving, from a read-only memory device, a question from a hierarchy of questions, the hierarchy corresponding to a symptom identified by the symptom identifier;

asking the question to the patient;

receiving an answer to the question from the patient;

making a decision regarding whether to ask a subsequent question from the hierarchy, based upon the answer to the question;

wherein the device stores a plurality of question hierarchies, each hierarchy of questions corresponding to each of a plurality symptoms.

22. The method of claim 21, wherein each question within the hierarchy of questions is answerable via a response selected from a set consisting of “

yes” and

“

no.”

23. The method of claim 21, wherein an answer to the subsequent question in the hierarchy determines whether the symptom is more severe than indicated by the answer to the first question in the hierarchy.

24. The method of claim 21, wherein one of the questions within the hierarchy asks whether a physiological parameter of the patient exceeds a threshold.

25. The method of claim 24, further comprising receiving the threshold from a central computer system located at a health care facility.

26. The method of claim 21, further comprising asking whether the patient is adhering to a pre-established health care regimen.

27. The method of claim 26, further comprising praising the patient, in response to the patient indicating that the pre-established health care regiment is being adhered to.

28. The method of claim 21, wherein the subsequent question within the hierarchy asks about the symptom with more specificity than the first question.

29. The method of claim 21, further comprising asking at least one question within the hierarchy, regardless of any answer to any other question within the hierarchy.

30. The method of claim 21, further comprising ordering the hierarchy of questions according to a commanded sequence.

31. The method of claim 21, further comprising reminding the patient to perform a particular act.

32. The method of claim 21, wherein asking the question to the patient comprises vocalizing the question to the patient.

33. The method of claim 21, further comprising measuring a physiological paramater of the patient.

34. The health care device of claim 33, wherein measuring a physiological parameter comprises weighing the patient.

35. A method for monitoring a health condition of an ambulatory patient, the method comprising:

transmitting a symptom identifier to a health care device containing a read-only memory, the read-only memory storing a plurality of question hierarchies, each hierarchy of questions corresponding to each of a plurality of symptoms, whereby the transmission causes the health care device to ask to the patient one or more questions from a hierarchy corresponding to the symptom identified by the symptom identifier.

36. The method of claim 35, further comprising:

displaying a menu of health conditions;

prompting a user to select a health condition from the menu of health conditions;

based upon the selected health condition, transmitting one or more symptom identifiers to the health care device.

37. A method of analyzing a set of answers to questions drawn from a plurality of question hierarchies, each hierarchy corresponding to a symptom, the method comprising:

assigning a point value to each question within each hierarchy, wherein the point value may be earned if the question to which it is assigned is answered in accordance with a predefined answer;

determining a total point value, which is a sum of the point values assigned to each question that was asked;

determining an earned point value, which is a sum of all points earned;

determining a ratio between the earned point value and the total point value; and

notifying a health care provider if the ratio exceeds a threshold.

38. A method of analyzing a set of answers to questions drawn from a plurality of question hierarchies, each hierarchy corresponding to a symptom, the method comprising:

assigning a point value to each question within each hierarchy, wherein the point value may be earned if the question to which it is assigned is answered in accordance with a predefined answer;

assigning a threshold value to each hierarchy of questions;

determining a number of points earned in each question hierarchy, based upon the answers;

notifying a health care provider, if more than a pre-defined number of points are earned within more than a pre-defined number of question hierarchies.

39. A health care system for monitoring a health condition of an ambulatory patient, the system comprising:

a health care device comprising

a display for presenting questions to the patient;

an input device permitting the patient to enter answers to the questions;

a microprocessor operably coupled to the display and the input device;

a read-only memory device operably coupled to the microprocessor, the read-only memory device storing a plurality of question hierarchies, each hierarchy of questions corresponding to each of a plurality of symptoms;

a communication device operably coupled to the microprocessor;

wherein the microprocessor is programmed to

receive a symptom identifier via the communication device;

based upon the symptom identifier, ask a first question from the hierarchy of questions corresponding to the symptom identified by the symptom identifier;

receive an answer to the first question via the input device; and

based upon the answer to the first question, make a decision regarding whether to ask a subsequent question from the hierarchy; and

a central computer system in communication with the microprocessor of the health care device;

wherein the central computer system is programmed to

transmit the symptom identifier to the microprocessor, thereby causing the microprocessor to ask one or more questions within the hierarchies corresponding to the symptom identified by the symptom identifier;

assign a point value to each question within each hierarchy;

based upon the assigned point values, determine whether the patient is in need of care.