SYSTEMS AND METHODS FOR STORING, ANALYZING, AND RETRIEVING MEDICAL DATA

• US 20090119330A1
• Filed: 10/10/2008
• Published: 05/07/2009
• Est. Priority Date: 10/12/2007
• Status: Active Grant

• Current Assignee: Masimo Corporation
• Original Assignee: Masimo Corporation
• Inventors: Muhsin, Bilal, Sampath, Anand
• Granted Patent: US 8,274,360 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 40/67 for remote operation

Abstract

Physiological information obtained from a medical patient can be stored in a dynamic round-robin database. Parameter descriptors may be used to identify parameter values in the records. The parameter values can be dynamically updated by changing the parameter descriptors to provide for a flexible database. In addition, the size of files used in the database can be dynamically adjusted to account for patient condition. In certain implementations, the round-robin database can be adaptive, such that an amount of data stored in the database is adapted based on patient condition and/or signal condition. Additionally, medical data obtained from a clinical network of physiological monitors can be stored in a journal database. The medical data can include device events that occurred in response to clinician interactions with one or more medical devices and device-initiated events, such as alarms and the like. The journal database can be analyzed to derive statistics, which may be used to improve clinician and/or hospital performance.

Claims

1. In a multi-patient monitoring environment having a plurality of patient monitoring devices in communication with one or more clinician monitoring stations, a method of storing physiological information obtained from a medical patient, the method comprising:

receiving identification information from a patient monitor over a network, the patient monitor comprising one or more processors operative to process physiological data obtained from one or more sensors coupled to a medical patient;

in response to receiving the identification information, retrieving first parameter descriptors corresponding to the patient monitor based at least partly on the identification information, each first parameter descriptor operative to identify a parameter measurable by the patient monitor;

creating a round-robin database (RRDB) file comprising a header, the header comprising the first parameter descriptors;

receiving the physiological data from the patient monitor, the physiological data comprising second parameter descriptors operative to identify the physiological data; and

using the first parameter descriptors in the header to map the physiological data to locations in the RRDB file based at least partly on the second parameter descriptors received from the patient monitor.

2. The method of claim 1, wherein the first and second parameter descriptors implement an extensible markup language (XML) specification.

3. The method of claim 1, wherein using the first parameter descriptors in the header to map the physiological data to locations in the RRDB file comprises storing the physiological data in records of the file.

4. The method of claim 1, wherein the records of the file do not include the second parameter descriptors.

5. The method of claim 1, further comprising dynamically adjusting a size of the RRDB file in response to determining an acuity level of the patient.

6. The method of claim 5, wherein determining the acuity level of the patient comprises analyzing a plethysmograph variability index.

7. The method of claim 5, wherein determining the acuity level of the patient comprises analyzing a data confidence indicator.

8. The method of claim 1, further comprising dynamically creating a second RRDB file in response to a determination of an acuity level of the patient.

9. The method of claim 1, further comprising, in response to receiving third parameter descriptors from the patient monitor, automatically creating a second RRDB file comprising a second header, the second header comprising the third parameter descriptors.

10. A method of journaling medical data from a plurality of medical devices, the method comprising:

receiving messages from a plurality of medical devices over a clinical network, the medical devices comprising patient monitors, each patient monitor comprising one or more processors operative to process physiological information received from one or more sensors coupled to a medical patient;

processing the messages to determine a medical event described by each of the messages, the medical event comprising one or more of the following;

a first device event occurring in response to a clinician interaction with a selected one of the medical devices, and

a second device event occurring without clinician interaction with the selected medical device;

storing information about the one or more medical events in a journal database, the journal database comprising physical computer storage;

in response to a request for a medical events report, obtaining medical statistics about the medical events stored in the journal database; and

generating a report comprising the medical statistics.

11. The method of claim 10, wherein the first device event comprises one of the following:

an alarm deactivation, changing of alarm limits, a logon or logging off of a clinician to a nurses'"'"' station system, an admittance of the patient, and a discharge of the patient.

12. The method of claim 10, wherein the second device event comprises an alarm.

13. The method of claim 10, further comprising storing one or more event counters in the journal database, the one or more event counters operative to store a count of one or more medical events.

14. The method of claim 13, wherein obtaining medical statistics about the medical events comprises accessing a selected event counter.

15. The method of claim 13, wherein generating the report comprises generating a monitoring report card.

16. The method of claim 13, wherein generating the report comprises comparing alarm response times among clinicians.

17. The method of claim 13, wherein generating the report comprises comparing alarm response times among hospitals.

18. A method of dynamically adjusting types of physiological information obtained from a medical patient, the method comprising:

obtaining first physiological data corresponding to one or more first physiological parameters of a medical patient using one or more processors operative to process physiological signals measured by one or more sensors coupled to the patient;

automatically associating the first physiological data with first parameter descriptors to generate first associated physiological data, the first parameter descriptors operative to describe the one or more first physiological parameters in the first physiological data;

providing the first associated physiological data to a round-robin database, the first parameter descriptors operative to describe the first physiological data in the round-robin database, the round-robin database comprising physical computer storage;

obtaining second physiological data corresponding to one or more second physiological parameters of the medical patient;

automatically associating the second physiological data with second parameter descriptors to generate second associated physiological data; and

providing the second associated physiological data to the round-robin database.

19. The method of claim 18, wherein the first and second parameter descriptors implement an extensible markup language (XML) specification.

20. The method of claim 18, wherein providing the first associated physiological data to a round-robin database comprises transmitting the associated physiological data to a multi-patient monitoring system over a clinical network.

21. A system for reconstructing medical events and physiological data received from a plurality of medical devices for a given period of time, the system comprising:

a server system comprising one or more physical computing devices operative to receive a request from a user to review journaled medical data and physiological data corresponding to a period of time, the physiological data being obtained from one or more patient monitors, each patient monitor comprising one or more processors operative to process physiological information received from one or more sensors coupled to a medical patient; and

the server system configured to;

retrieve the journaled medical data for the specified time period from a journal database, the journal database comprising first physical computer storage, the journaled medical data comprising one or more of;

first device events occurring in response to clinician interactions with the one or more patient monitors, and

second device events occurring without clinician interaction with the one or more patient monitors;

retrieve physiological data for the specified time period from a round-robin database, the round-robin database comprising second physical computer storage;

correlate the journaled medical data with the physiological data with respect to time; and

output the correlated journaled and physiological data for presentation to the user.

22. A system for storing physiological information obtained from a medical patient, the system comprising:

a network management module operative to;

receive identification information from a patient monitor over a network, the patient monitor comprising one or more processors operative to process physiological data obtained from one or more sensors coupled to a medical patient; and

receive the physiological data from the patient monitor, the physiological data comprising first parameter descriptors operative to identify the physiological data;

a round-robin database (RRDB) component operative to, in response to receiving the identification information from the network management module;

retrieve second parameter descriptors corresponding to the patient monitor based at least partly on the identification information each second parameter descriptor operative to identify a parameter measurable by the patient monitor;

create an RRDB file comprising a header, the header comprising the second parameter descriptors; and

use the second parameter descriptors in the header to map the physiological data to locations in the RRDB file based at least partly on the first parameter descriptors received from the patient monitor.

23. The system of claim 22, wherein the first and second parameter descriptors implement an extensible markup language (XML) specification.

24. The system of claim 22, wherein the RRDB component is further operative to use the first parameter descriptors in the header to map the physiological data to locations in the RRDB file by storing the physiological data in records of the file.

25. The system of claim 22, wherein the records of the file do not include the second parameter descriptors.

26. A method of dynamically adjusting physiological information provided to a medical database, the method comprising:

providing an adaptive round-robin database (RRDB) operative to store physiological information of a plurality of patients;

receiving a first indication of a first acuity level of a patient in communication with a patient monitor, the patient monitor comprising one or more processors operative to process physiological data obtained from one or more sensors coupled to a medical patient;

providing a first amount of physiological information to the adaptive RRDB in response to receiving the first indication;

receiving a second indication of a second acuity level of the patient, the second acuity level being greater than the first acuity level; and

in response to receiving the second indication, adapting the amount of data provided to the adaptive RRDB by providing a second amount of physiological information to the adaptive RRDB that is greater than the first amount of physiological information.

27. The method of claim 26, wherein determining the first and second acuity levels of the patient comprises analyzing a plethysmograph variability index.

28. The method of claim 26, wherein determining the first and second acuity levels of the patient comprises analyzing a data confidence indicator.

29. The method of claim 26, wherein determining the first and second acuity levels of the patient comprises analyzing an alarm history of the patient.

30. The method of claim 26, wherein providing a first amount of physiological information to the adaptive RRDB comprises creating a first RRDB file for the physiological information.

31. The method of claim 30, wherein adapting the amount of data provided to the adaptive RRDB comprises creating one or more additional RRDB files corresponding to one or more of the patient monitor, a parameter monitored by the patient monitor, and a channel of physiological data.