Apparatus To Measure The Instantaneous Patients' Acuity Value

• US 20080214904A1
• Filed: 06/13/2006
• Published: 09/04/2008
• Est. Priority Date: 06/22/2005
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Saeed, Mohammed, Nielsen, Larry, Zong, Wei, Ali, Walid S.I., Abdala, Omar, Eshelman, Larry J., Frassica, Joseph J.
• Granted Patent: US 9,167,968 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• 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 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

In a patient monitoring system (10), shorter interval physiological parameters and longer interval clinical data are collected from a monitored patient (12). A composite acuity score generator (70) generates or updates a composite acuity score indicative of wellbeing of the patient (12) based at least on the sensed physiological parameters and the longer interval data. A monitor (22, 56) displays current values of at least one of selected sensed physiological parameters, longer interval data, and the composite acuity score.

Claims

1. A patient monitoring system comprising:

at least one sensor which senses shorter interval physiological parameters of a monitored patient;

at least one database which stores longer interval data of the monitored patient;

a composite acuity score generator which generates or updates one or more composite acuity scores indicative of wellbeing of the patient based at least on the sensed physiological parameters and the longer interval data; and

a monitor for displaying at least current values of at least one of selected sensed physiological parameters values, longer interval data, and the composite acuity score.

2. The system as set forth in claim 1, further including:

a basic acuity score generator which naps values of at least the sensed physiological parameters to points which are preassigned to each sensed physiological parameter to generate basic acuity scores of the patient.

3. The system as set forth in claim 2, wherein the basic acuity score generator continually automatically updates the basic acuity scores based on the sensed physiological parameters.

4. The system as set forth in claim 1, wherein the longer interval data includes at least one of:

medication administration record;

patient'"'"'s profile data;

clinician notes and orders from physician'"'"'s and nurse'"'"'s entry journal;

laboratory data;

imaging data; and

physiological parameter variability metric indicative of a trend in the patient wellbeing change.

5. The system as set forth in claim 1, wherein the monitor includes:

a Patient Indices Interactive Display including;

a Patient Index Score Window which displays the composite acuity score of the patient, the displayed composite acuity score being indicative of an overall current condition of the patient, and

a Patient Index Trend Curve which displays the trend data in a graphic window including a map showing how the patient reached the current condition.

6. The system as set forth in claim 5, wherein the trend data is displayed in one of a linear time scaled graphic window or a logarithmic time scaled graphic window.

7. The system as set forth in claim 5, further including:

a plurality of patient indices selection boxes each of which triggering a display of a preselected Patient Index.

8. The system as set forth in claim 5, further including:

a mechanism for selecting a time which selection triggers an automatic display in vital boxes of selected physiological parameters and the longer interval data which contribute to the composite acuity score at the selected time.

9. The system as set forth in claim 8, further including:

a detailed component display which displays detailed values of the selected physiological parameters and the longer interval data for the displayed composite acuity score for the selected time.

10. The system as set forth in claim 8, further including:

trend displays which display trend data curves for the selected physiological parameters and the longer interval data which contribute to the composite acuity score.

11. The system as set forth in claim 1, further including:

an alarm generator which generates an alarm in response to the current composite acuity reaching a threshold.

12. The system as set forth in claim 11, further including:

a key deteriorating parameter extractor which determines the physiological parameters primarily responsible for the composite acuity score reaching the threshold, the key deteriorating parameters being displayed on the monitor.

13. The system as set forth in claim 11, further including:

a key deteriorating parameter extractor which causes the monitor to display the physiological parameters that are significant to medical personnel deciding a course of action for altering and enhancing the patient'"'"'s current physiological condition.

14. The system as set forth in claim 1, further including:

an alarm generator for generating one of a video and audio alarm for medical personnel, which generated alarm includes at least one of text, graphics, sound, vibration, color accents at least in response to one of the physiological parameter value exceeding a first predetermined threshold and the composite acuity score exceeding a second predetermined threshold.

15. The system as set forth in claim 1, wherein the sensed physiological parameters include at least one of an Electrocardiogram (ECG), an Electroencephalogram (EEG), an Electromyogram (EMG), an invasive blood pressure (BP), a non-invasive blood pressure (NiBP), pulse, cardiac output, respirations, blood oxygen (SpO₂), and core body temperature.

16. A monitoring method comprising:

sensing shorter interval physiological parameters of a monitored patient;

collecting longer interval data of the patient;

generating one or more composite acuity scores indicative of wellbeing of the patient based at least on the sensed physiological parameters and the longer interval data; and

displaying at least current values of at least one of selected sensed physiological parameters values, the longer interval data, and the composite acuity score.

17. The method as set forth in claim 16, further including:

generating basic acuity score values including;

preassigning points to at least each sensed physiological parameter, and

mapping values of the sensed physiological parameter to the preassigned points; and

continually automatically updating the basic acuity score based at least on the sensed physiological parameters.

18. The method as set forth in claim 16, wherein the longer interval data includes at least one of:

medication administration record;

patient'"'"'s profile data;

clinician notes and orders from physician'"'"'s and nurse'"'"'s entry journal;

laboratory data;

imaging data; and

physiological parameter variability metric indicative of a trend in the patient wellbeing change.

19. The method as set forth in claim 16, wherein the step of displaying includes:

displaying the composite acuity score of the patient, the composite acuity score being indicative of an overall current condition of the patient; and

displaying the trend data in a graphic window including a map showing how the patient reached the current condition.

20. The method as set forth in claim 19, further including:

displaying the trend data in one of a linear time scaled graphic window or a logarithmic time scaled graphic window.

21. The method as set forth in claim 19, further including:

selecting one of a plurality of patient indices; and

displaying the selected patient index.

22. The method as set forth in claim 19, further including:

selecting a time (t_L); and

displaying the physiological parameters and the longer interval data which contribute to the composite acuity score at the selected time (t_L).

23. The method as set forth in claim 22, further including:

displaying detailed values of the physiological parameters and the longer interval data for the displayed composite acuity score for the selected time (t_L).

24. The method as set forth in claim 22, wherein the step of displaying includes:

selecting physiological parameters and the longer interval data which contribute to the displayed composite acuity score; and

displaying trend data for the selected physiological parameters and the longer interval data.

25. The method as set forth in claim 16, further including:

generating an alarm in response to the composite acuity score reaching a threshold value which is indicative of a medically significant deterioration of the condition of the patient.

26. The method as set forth in claim 25, further including:

extracting key physiological parameters values conducive to the overall deteriorating condition of the patient; and

displaying the key deteriorating parameters values.

27. The method as set forth in claim 26, further including:

based on the displayed key deteriorating parameters values, determining a course of treatment.

28. The method as set forth in claim 16, further including:

generating one of a video and audio alarm for medical personnel, which alarm includes at least one of text, graphics, sound, vibration, color accents at least in response to one of the physiological parameter value exceeding a first predetermined threshold and the generated composite acuity score exceeding a second predetermined threshold.

29. The method as set forth in claim 16, wherein the sensed physiological parameters include at least one of an Electrocardiogram (ECG), and Electroencephalogram (EEG), an Electromyogram (EMG), an invasive blood pressure (BP), a non-invasive blood pressure (NiBP), pulse, cardiac output, respirations, blood oxygen (SpO₂), and core body temperature.

30. A patient monitoring system comprising:

a means for continuously or intermittently measuring a plurality of shorter interval physiological parameters and longer interval clinical data of a patient;

a means for calculating an acuity score indicative of a risk of mortality from at least the measured physiological parameters, the acuity score being recalculated as the measured physiological parameters change; and

a means for displaying at least a current acuity score.

31. A patient monitoring system comprising:

a means for continuously or intermittently measuring a plurality of shorter interval physiological parameters and longer interval clinical data of a patient;

a means for calculating an acuity score indicative of the likelihood of single or multi-organ failure from at least the measured physiological parameters, the acuity score being recalculated as the measured physiological parameters change; and

a means for displaying at least a current acuity score.

32. A patient monitoring system comprising:

a means for continuously or intermittently measuring a plurality of shorter interval physiological parameters and longer interval clinical data of a patient;

a means for calculating an acuity score indicative of the current physiological instability of the patient from at least the measured physiological parameters, the acuity score being recalculated as the measured physiological parameters change; and

a means for displaying at least a current acuity score.