Method and apparatus for controlling an implantable medical device

• US 20110172740A1
• Filed: 01/14/2010
• Published: 07/14/2011
• Est. Priority Date: 01/13/2009
• Status: Active Grant

• Current Assignee: Jeffrey A. Matos
• Original Assignee: Jeffrey A. Matos
• Inventors: Matos, Jeffrey A.
• Granted Patent: US 9,545,520 B2
• Time in Patent Office: Days
• US Class Current: 607/60
• CPC Class Codes: A61N 1/362 Heart stimulators heart defibrillators A61N1/39
• CPC Class Codes: A61N 1/37258 Alerting the patient
• CPC Class Codes: A61N 1/37264 Changing the program; Upgrading firmware
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: H04B 17/309 Measuring or estimating channel quality parameters
• CPC Class Codes: H04L 1/0003 by switching between different modulation schemes
• CPC Class Codes: H04L 1/0013 Rate matching, e.g. puncturing or repetition of code symbols
• CPC Class Codes: H04L 1/0015 characterised by the adaptation strategy
• CPC Class Codes: H04L 1/0026 Transmission of channel quality indication
• CPC Class Codes: H04W 24/02 Arrangements for optimising operational condition
• CPC Class Codes: H04W 4/023 using mutual or relative location information between multiple location based services [LBS] targets or of distance thresholds

Abstract

A system and methods of maintaining communication with a medical device for exchange of information, instructions, and programs, in a highly reliable manner. Apparatus and methods for accomplishing this task include:

• • 1) The inclusion of a locating device in the system, in close proximity to an implanted device, but which does not drain the implanted device battery. The locating device may be implanted or external to the body.
  • 2) The use of motion detection and global positioning system devices to locate elements within a communicating system for the medical device;
  • 3) The assessment of received signal quality by elements of the system;
  • 4) The use of a notification system for a device user who is moving out of range of communications; and
  • 5) Documenting the absolute and functional integrity of instructions received by the medical device.

Claims

1. A medical treatment system having an implantable medical device, which allows a person using the device to be easily located, to facilitate communication between the device and a remote location, said system comprising:

(1) electronic medical apparatus adapted to be implanted in a human, a so-called implantable medical device (IMD) comprising, in combination;

(a) a first transmitting/receiving (T/R) device for at least one of

(i) transmitting information to, and

(ii) receiving at least one control signal from, at least one remote location;

(b) a medical treatment device, coupled to said first T/R device, for treating said patient in response to control signals applied thereto;

(2) a first locator device, adapted to be located in the vicinity of said human, comprising a wireless first locator transmitting device, operative to transmit first locator signals;

(3) a second locator device, comprising;

(a) a second locator receiving device, operative to receive said first locator signals;

(b) a communication quality assessment device, coupled to said second locator receiving device, for assessing the quality of the received locator signals, and for producing a communication quality signal in dependence upon the assessed quality of said first locator signals; and

(c) a second locator transmitting device, coupled to said communication quality assessment device, for transmitting said communication quality signal;

(4) a communication device, comprising

(a) a second T/R device, for communicating with;

(i) the second locator transmitting device, for receiving said communication quality signal, and

(ii) said first T/R device;

(b) a second T/R controlling device, coupled to said second T/R device, for controlling the mode of communication of said second T/R device;

wherein;

(a) said communication quality assessment device determines information concerning the location of said first locator based on at least one of;

(i) the detection of said first locator signal by said second locator,

(ii) the absence of a detected first locator signal by said second locator, and

(iii) the intensity of said detected first locator signal;

(b) said second locator transmits the information concerning the location of said first locator to said communication device; and

(c) said second T/R controlling device is operative to control a mode of communication between said second T/R device and said first T/R device, in dependence upon said location information;

thereby to improve communication with the IMD.

2. The medical treatment system defined in claim 1, wherein said first locator device and said IMD are mechanically linked, such that both are adapted to be implanted in said human in whom both said devices continue to be mechanically linked.

3. The medical treatment system defined in claim 1, wherein said IMD and said first locator device are adapted to be implanted in said human, but are not mechanically linked.

4. The medical treatment system defined in claim 3, wherein said first locator device is adapted to be implanted subcutaneously in said human and said IMD is adapted to be implanted at a deeper level than the subcutaneous layer.

5. The medical treatment system defined in claim 1, wherein said IMD is adapted to be implanted in said human and said first locator device is adapted to be located outside of said human, touching the outer surface of the skin of said human.

6. The medical treatment system defined in claim 1, wherein said IMD is adapted to be implanted in said human and said first locator device is adapted to be located outside of said human, and is physically linked to an article worn by said human.

7. The medical treatment system defined in claim 6, wherein said article of clothing includes at least one of:

a belt, a watch and jewelry.

8. The medical treatment system defined in claim 1, wherein said second T/R controlling device is operative to control a mode of communication selected from the group consisting of:

(i) a power output for said second T/R device;

(ii) a signal sensitivity for said second T/R device;

(iii) at least one transmission frequency for said second T/R device;

(iv) an output signal modulation type for said second T/R device;

(v) a selection of at least one of a connection via (a) a radiofrequency link, (b) Internet, (c) a hard wire connection, for said second T/R device;

(vi) a rate of information transfer by said second T/R device

(vii) a method of signal encoding by said second T/R device;

(viii) a message repetition frequency, for said second T/R device; and

(ix) a selection of at least one other communication device with which said second T/R device communicates.

9. The medical treatment system defined in claim 1, further comprising

(4) alarm apparatus, situated in proximity to at least one of (i) said person, and (ii) another person, comprising:

(a) a notification device for producing at least one output from the group consisting of a sound, a light and a vibration; and

(b) a receiving device, coupled to said notification device, for receiving at least one of (i) a first locator signal, and (ii) said communication quality signal;

wherein

said receiving device causes said notification device to produce said at least one output;

(i) in the absence of a received first locator signal,

(ii) upon receipt of a low quality first locator signal,

(iii) upon receipt of a communication quality signal indicating an unacceptable quality communication between said first and said second locator device;

thereby to notify at least one of (i) said person and (ii) said other person that the location of said first locator device requires attention.

10. The medical treatment system defined in claim 1, wherein said second locator device further comprises a notification device, coupled to said communication quality assessment device, for producing at least one output from the group consisting of:

a sound, a light and a vibration; and

wherein at least one of;

(i) the absence of a received first locator signal;

(ii) the receipt of an unacceptable quality first locator signal;

causes the production of said at least one output by said notification device;

thereby to notify at least one of (i) said person and (ii) said other person that the location of said first locator device requires attention.

11. The medical treatment system defined in claim 1, wherein the IMD includes at least one sensor, coupled to said first T/R device for sensing a medical condition of said person and producing a sensor output signal in response to said medical condition, wherein said first T/R device transmits a representation of said sensor output signal.

12. The medical treatment system defined in claim 11, wherein said sensor is further coupled to said medical treatment device and wherein said medical treatment device automatically applies an appropriate treatment to said patient in response thereto.

13. The medical treatment system defined in claim 1, wherein said communication device is located at said remote location and further comprises:

(c) a first input device, coupled to said second T/R device, responsive to a technical expert, for producing at least one real time remote control signal for controlling said EMD unit.

14. The medical treatment system defined in claim 1, further comprising a remote station (RS) at said remote location including:

(a) a first input device, responsive to a medical expert, for producing at least one real time remote control signal for controlling said EMD unit; and

(b) a third transmitting/receiving (T/R) device, coupled to said input device, for electronic communication with at least one of (i) the first T/R device of said remotely located IMD, and (ii) the second T/R device of said communication device.

15. The medical treatment system defined in claim 14, wherein:

(a) said second T/R device is operative to re-transmit said received communication quality signal to said third T/R device; and

(b) said remote station further comprises a third T/R controlling device, coupled to said third T/R device, for controlling the mode of communication between said third T/R device and at least one of said first T/R device and said second T/R device;

thereby to permit said third T/R device to improve its communications.

16. The medical treatment system defined in claim 14, wherein said technical expert is operative to notify at least one of:

(a) said person;

(b) another person in the vicinity of said person;

of a received communication quality signal indicating an unacceptable quality communication between said first and said second locator device.

17. The medical treatment system defined in claim 16 further comprising:

(4) alarm apparatus, situated in proximity to at least one of (i) said person, and (ii) another person, comprising;

(a) a notification device for producing at least one of a sound, a light and a vibration; and

(b) a receiving device, coupled to said notification device;

wherein

said technical expert sends an alarm signal to said first input device, for transmission by said third T/R device to said alarm apparatus;

thereby to notify at least one of (i) said person, and (ii) another person, of said unacceptable quality communication.

18. The medical treatment system defined in claim 1, wherein:

(a) said second T/R device is operative to re-transmit said received communication quality signal to said first T/R device; and

(b) said IMD further comprises a first T/R controlling device, coupled to said first T/R device, for controlling the mode of communication between said first T/R device and said second T/R device;

thereby to cause said first T/R device to improve its communications with said second T/R device.

19. The medical treatment system defined in claim 17, wherein:

(a) said second T/R device is operative to re-transmit said received communication quality signal to said first T/R device; and

(b) said IMD further comprises a first T/R controlling device, coupled to said first T/R device, for controlling the mode of communication between said first T/R device and at least one of said second T/R device and said third T/R device;

thereby to permit said first T/R device to improve its communications with at least one of said second T/R device and said third T/R device.

20. The medical treatment system defined in claim 1, wherein:

(a) said second locator device further comprises an additional transmitting device, for transmitting a first assessment signal,

(b) said first locator device further comprises a first locator receiving device, coupled to said first locator transmitting device, for receiving said first assessment signal, and

(c) said first locator transmitting device is further operative to transmit a second assessment signal;

(d) said communication quality assessment device is operative to assess the quality the received second assessment signal, and for producing said communication quality signal in dependence upon the assessed quality of said second assessment signal;

wherein

(i) said second locator device transmits said first assessment signal to said first locator device;

(ii) upon receipt of said first assessment signal, said first locator device transmits a second assessment signal to said second locator device; and

(iii) said communication quality assessment device assesses said second assessment signal;

thereby to assess the quality of communication between the two locator devices.

21. A medical treatment system having an implantable medical device, which allows a person using the device to be easily located, to facilitate communication between the device and a remote location, said system comprising:

(1) electronic medical apparatus adapted to be implanted in a human, a so-called implantable medical device (IMD) comprising, in combination;

(a) a first transmitting/receiving (T/R) device for at least one of

(i) transmitting information to, and

(ii) receiving at least one control signal from, at least one remote location;

(b) a medical treatment device, coupled to said first T/R device, for treating said patient in response to control signals applied thereto;

(2) a first locator device, adapted to be in the vicinity of said human, comprising;

(a) a first locator receiving device;

(b) an energy storage device, coupled to said first locator receiving device, for storing energy contained in incoming electrical signals;

(c) a first locator transmitting device, coupled to said energy storage device and to said first locator receiving device, operative to transmit first locator signals;

(3) a second locator device, comprising;

(a) a second locator transmitting device, operative to transmit second locator signals, for receipt by said first locator receiving device;

(b) a second locator receiving device, operative to receive said first locator signals;

(c) a communication quality assessment device, coupled to said second locator receiving device, for assessing the quality of said received first locator signals, and for producing a communication quality signal in dependence upon the assessed quality of said first locator signals; and

(d) a second locator quality signal transmitting device, coupled to said communication quality assessment device, for transmitting said communication quality signal;

(4) a communication device, comprising

(a) a second T/R device, for communicating with;

(i) the second locator transmitting device, for receiving said communication quality signal, and

(ii) said first T/R device;

(b) a second T/R controlling device, coupled to said second T/R device, for controlling the mode of communication of said second T/R device;

wherein;

(a) said transmitted second locator signals, received by said first locator receiver, supply energy for powering said first locator device;

(b) said communication quality assessment device determines information concerning the location of said first locator based on at least one of;

(i) the detection of said first locator signal by said second locator,

(ii) the absence of a detected first locator signal by said second locator, and

(iii) the intensity of said detected first locator signal;

(c) said second locator transmits the information concerning the location of said first locator to said communication device; and

(d) said second T/R controlling device is operative to control a mode of communication between said second T/R device and said first T/R device, in dependence upon said location information;

thereby to improve communication with the IMD.

22. The medical treatment system defined in claim 21, wherein said first locator device and said IMD are mechanically linked, such that both are adapted to be implanted in said human in whom both said devices continue to be mechanically linked.

23. The medical treatment system defined in claim 21, wherein said IMD and said first locator device are adapted to be implanted in said human, but are not mechanically linked.

24. The medical treatment system defined in claim 23, wherein said first locator device is adapted to be implanted subcutaneously in said human and said IMD is adapted to be implanted at a deeper level than the subcutaneous layer.

25. The medical treatment system defined in claim 21, wherein said IMD is adapted to be implanted in said human and said first locator device is adapted to be located outside of said human, touching the outer surface of the skin of said human.

26. The medical treatment system defined in claim 21, wherein said IMD is adapted to be implanted in said human and said first locator device is adapted to be located outside of said human, and is physically linked to an article worn by said human.

27. The medical treatment system defined in claim 26, wherein said article of clothing includes at least one of:

a belt, a watch and jewelry.

28. The medical treatment system defined in claim 21, wherein said second T/R controlling device is operative to control a mode of communication selected from the group consisting of:

(i) a power output for said second T/R device;

(ii) a signal sensitivity for said second T/R device;

(iii) at least one transmission frequency for said second T/R device;

(iv) an output signal modulation type for said second T/R device;

(v) a selection of at least one of a connection via (a) a radiofrequency link, (b) Internet, (c) a hard wire connection, for said second T/R device;

(vi) a rate of information transfer by said second T/R device

(vii) a method of signal encoding by said second T/R device;

(viii) a message repetition frequency, for said second T/R device; and

(ix) a selection of at least one other communication device with which said second T/R device communicates.

29. The medical treatment system defined in claim 21, further comprising:

(4) alarm apparatus, situated in proximity to at least one of (i) said person, and (ii) another person, comprising;

(a) a notification device for producing at least one output from the group consisting of a sound, a light and a vibration; and

(b) a receiving device, coupled to said notification device, for receiving at least one of (i) a first locator signal, and (ii) said communication quality signal;

wherein

said receiving device causes said notification device to produce said at least one output;

(i) in the absence of a received first locator signal,

(ii) upon receipt of a low quality first locator signal,

(iii) upon receipt of a communication quality signal indicating an unacceptable quality communication between said first and said second locator device;

thereby to notify at least one of (i) said person and (ii) said other person that the location of said first locator device requires attention.

30. The medical treatment system defined in claim 21, wherein said second locator device further comprises a notification device, coupled to said communication quality assessment device, for producing at least one output from the group consisting of:

a sound, a light and a vibration; and

wherein at least one of;

(i) the absence of a received first locator signal;

(ii) the receipt of an unacceptable quality first locator signal;

causes the production of said at least one output by said notification device;

thereby to notify at least one of (i) said person and (ii) said other person that the location of said first locator device requires attention.

31. The medical treatment system defined in claim 21, wherein the IMD includes at least one sensor, coupled to said first T/R device for sensing a medical condition of said person and producing a sensor output signal in response to said medical condition, wherein said first T/R device transmits a representation of said sensor output signal.

32. The medical treatment system defined in claim 31, wherein said sensor is further coupled to said medical treatment device and wherein said medical treatment device automatically applies an appropriate treatment to said patient in response thereto.

33. The medical treatment system defined in claim 21, wherein said communication system is located at said remote location and further comprises:

(c) a first input device, coupled to said second T/R device, responsive to a technical expert, for producing at least one real time remote control signal for controlling said EMD unit.

34. The medical treatment system defined in claim 21, further comprising a remote station (RS) at said remote location including:

(a) a first input device, responsive to a medical expert, for producing at least one real time remote control signal for controlling said EMD unit;

(b) a third transmitting/receiving (T/R) device, coupled to said input device, for electronic communication with at least one of (i) the first T/R device of said remotely located IMD, and (ii) the second T/R device of said communication device.

35. The medical treatment system defined in claim 34, wherein:

(a) said second T/R device is operative to re-transmit said received communication quality signal to said third T/R device; and

(b) said remote station further comprises a third T/R controlling device, coupled to said third T/R device, for controlling the mode of communication between said third T/R device and at least one of said first T/R device and said second T/R device;

thereby to permit said third T/R device to improve its communications.

36. The medical treatment system defined in claim 34, wherein said technical expert is operative to notify at least one of:

(a) said person;

(b) another person in the vicinity of said person;

of a received communication quality signal indicating an unacceptable quality communication between said first and said second locator device.

37. The medical treatment system defined in claim 36 further comprising:

(4) alarm apparatus, situated in proximity to at least one of (i) said person, and (ii) another person, comprising;

(a) a notification device for producing at least one of a sound, a light and a vibration; and

(b) a receiving device, coupled to said notification device;

wherein

said technical expert sends an alarm signal to said first input device, for transmission by said third T/R device to said alarm apparatus;

thereby to notify at least one of (i) said person, and (ii) another person, of said unacceptable quality communication.

38. The medical treatment system defined in claim 21, wherein:

(a) said second T/R device is operative to re-transmit said received communication quality signal to said first T/R device; and

(b) said IMD further comprises a first T/R controlling device, coupled to said first T/R device, for controlling the mode of communication between said first T/R device and said second T/R device;

thereby to permit said first T/R device to improve its communications with said second T/R device.

39. The medical treatment system defined in claim 37, wherein:

(a) said second T/R device is operative to re-transmit said received communication quality signal to said first T/R device; and

(b) said IMD further comprises a first T/R controlling device, coupled to said first T/R device, for controlling the mode of communication between said first T/R device and at least one of said second T/R device and said third T/R device;

thereby to permit said first T/R device to improve its communications with at least one of said second T/R device and said third T/R device.

40. The medical treatment system defined in claim 21, wherein:

(a) said first locator device further comprises a first locator communication quality assessment device, coupled to said first locator receiving device and to said first locator transmitting device, for assessing the quality of the received second locator signals and for producing a first locator communication quality signal in dependence upon the assessed quality of said second locator signals;

(b) said first locator transmitting device is operative to transmit said first locator communication quality signal to said second locator device;

(c) said second locator device further comprises a second locator transmitting device controller, coupled to said second locator receiving device, for receipt of said first locator communication quality signal, and coupled to at least one of;

(I) said second locator transmitting device, for controlling at least one of;

(i) the power output of said second locator transmitting device;

(ii) the transmitter frequency of said second locator transmitting device;

(iii) the repetition rate of said second locator transmitting device; and

(iv) the direction of transmission of said second locator transmitting device; and

(II) said second locator quality signal transmitting device, to control a mode of communication selected from the group consisting of;

(i) a power output for said second locator transmitting device;

(ii) at least one transmission frequency for said second locator transmitting device;

(iii) an output signal modulation type for said second locator transmitting device;

(iv) a selection of at least one of a connection via (a) a radiofrequency link, (b) Internet, (c) a hard wire connection, for said second locator transmitting device;

(v) a rate of information transfer by said second locator transmitting device;

(vi) a method of signal encoding by said second locator transmitting device;

(vii) a message repetition frequency, for said second locator transmitting device; and

(viii) a selection of at least one other communication device with which said second locator transmitting device communicates.

thereby to improve communication between said second locator device and at least one of said first locator device and another device.

41. The medical treatment system defined in claim 21, wherein:

(a) said first locator device further comprises a first locator communication quality assessment device coupled to said first locator receiving device and to said first locator transmitting device for assessing the quality of the received second locator signals, and for producing a first locator communication quality signal, in dependence upon the assessed quality of said second locator signals;

(b) said first locator transmitting device is operative to transmit said first locator communication quality signal to said second locator device;

(c) said second locator receiving device is further coupled to said second locator transmitting device, to re-transmit said first locator communication quality signal;

(d) said second T/R device is operative to receive said re-transmitted first locator communication quality signal; and

(e) said second T/R controlling device is operative to control a mode of communication between said second T/R device and said first T/R device, in dependence upon said first locator communication quality signal;

thereby to improve communication to said IMD.

42. The medical treatment system defined in claim 41, wherein:

(a) said second T/R device is operative to re-transmit said received first locator communication quality signal;

(b) said first T/R device is operative to receive said re-transmitted first locator communication quality signal;

(c) said IMD further comprises a first T/R controlling device, coupled to said first T/R device, for controlling the mode of communication between said first T/R device and said second T/R device;

thereby to cause said first T/R device to improve communication with said second T/R device.

43. The medical treatment system defined in claim 41, further comprising a remote station (RS) at said remote location comprising:

(a) a first input device, responsive to a technical expert, for producing at least one real time remote control signal for controlling said IMD;

(b) a third transmitting/receiving (T/R) device, coupled to said input device, for electronic communication with at least one of (i) the first T/R device of said remotely located IMD, and (ii) the second T/R device of said communication device;

(c) a third T/R controlling device, coupled to said third T/R device, for controlling the mode of communication between said third T/R device and at least one of said first T/R device and said second T/R device; and

(d) said second T/R device is operative to re-transmit said received first locator communication quality signal;

wherein;

(i) said third T/R device receives said re-transmitted first locator communication quality signal; and

(ii) said third T/R controlling device controls the mode of communication of said third T/R device based on said first locator communication quality signal;

thereby to cause said third T/R device to improve its communications.

44. A medical treatment system having a medical device which allows a person using the device access to a medical expert that can communicate with the medical device from a remote site, said system comprising, in combination:

(A) an electronic medical device (EMD) unit comprising, in combination;

(1) a first wireless transmitting/receiving (T/R) device for transmitting information to, and for receiving at least one control signal from, a plurality of remote locations;

(2) a medical treatment device, coupled to said first T/R device, for treating said person in response to control signals applied thereto;

(B) a remote station (RS) unit at said remote location including;

(1) a first input device, responsive to a medical expert, for producing at least one real time remote control signal for controlling said EMD;

(2) a second transmitting/receiving (T/R) device, coupled to said input device, for electronic communication with the first T/R device of said remotely located EMD; and

(C) at least one communication relay unit, x said communication relay unit(s) numbered from “

1”

to “

x”

, each yth communication relay unit including a (y+2)th communication relay transmitting/receiving (T/R) device for communicating with at least two of (i) the EMD, (ii) the RS, (iii) one of said communication relay units, and (iv) at least one other communication relay unit, wherein

(1) x is an integer which is at least the integer 1

(2) y is an integer ranging from the integer 1 to the integer x; and

wherein at least one of said units is a first unit further comprising;

(a) a first global positioning system, for determining a location of said first unit;

(b) a first communication quality assessment device, coupled to said first global positioning system, for assessing the expected quality of communication signals to be received by the T/R device associated with at least one of (i) said first unit and (ii) at least one other of said units, and for producing a first communication quality signal in dependence upon the respective expected quality of said communication signals; and

(b) a first mode selection device coupled to said respective, associated T/R device and said first communication quality assessment device for selecting the mode of communication with at least one other one of said units, in response to receipt of said communication quality signal from said communication quality assessment device;

thereby to select a mode of communication in dependence upon the current location of said unit and to improve the communication of said EMD unit and said RS unit;

45. The medical treatment system defined in claim 44, wherein said EMD unit includes at least one sensor, coupled to said first T/R device for sensing a medical condition of said person and producing a sensor output signal in response to said medical condition, wherein said first T/R device transmits a representation of said sensor output signal to at least one of (i) at least one of said x communication relay units, and (ii) said RS unit.

46. The medical treatment system defined in claim 45, wherein said sensor is further coupled to said medical treatment device and wherein said medical treatment device is operative to automatically apply an appropriate treatment to said patient in response thereto.

47. The medical treatment system defined in claim 44, wherein the EMD unit is adapted to be implanted in said person.

48. The medical treatment system defined in claim 44, wherein, upon the detection of a location, a respective mode selection device of said at least one first unit is operative to control at least one of:

(i) the selection of at least one other unit with which said at least one first unit communicates;

(ii) a power output for said T/R device of said first unit;

(iii) a signal sensitivity for said T/R device of said first unit;

(iv) at least one transmission frequency for said T/R device of said first unit;

(v) an output signal modulation type for said T/R device of said first unit;

(vi) a selection of at least one of a connection via (a) a radiofrequency link, (b) Internet, (c) a hard wire connection, for said T/R device of said first unit;

(vii) a rate of information transfer;

(viii) a method of signal encoding; and

(ix) a message repetition frequency.

49. The medical treatment system defined in claim 44, wherein:

(a) the respective communication quality assessment device includes a memory for storing a location of at least one stationary communication unit selected from the group consisting of (i) a stationary remote station, and (ii) at least one stationary communication relay unit; and

(b) said global positioning system is operative to repeatedly determine the spatial relationship between said at least one first unit and at least one of (i) said stationary remote station and (ii) said at least one stationary communication relay unit.

50. The medical treatment system defined in claim 44, wherein:

(1) the global positioning system of said at least one first unit is coupled to the respective T/R device of said at least one first unit, for transmission of respective labeled coordinate information including;

(a) information which identifies said respective first unit; and

(b) location information relating to said respective first unit;

(2) an at least one other second unit includes;

(a) a respective second communication quality assessment device, coupled to the respective T/R device of said second unit, for receipt of said labeled coordinate information from said at least one first unit, and for producing a respective second communication quality signal in dependence upon said labeled coordinate information; and

(b) a second mode selection device coupled to said respective T/R device of said second unit and to said second communication quality assessment device, for selecting the mode of communication between at least one pair of units, each said pair comprising (i) said second unit and (ii) a first unit, in response to receipt of said respective second communication quality signal from said second communication quality assessment device;

whereby said second communication quality assessment device is responsive to said location information from said at least one first unit, to determine if said at least one pair of units is in an acceptable location for communication.

51. The medical treatment system defined in claim 50, wherein

(a) said at least one second unit further comprises a second global positioning system, coupled to said second communication quality assessment device, for determining a location of said second unit;

(b) said at least one second communication assessment device is operative to utilize location information from each pair of units wherein one member of the pair is selected from said at least one first unit and the other member of the pair is selected from said at least one second unit, to determine at least one of;

(i) a change in the position of each of the two members of each pair of two units;

(ii) the presence of a motionless state of a pair, in which neither member of such pair of said units is moving, and

(iii) the presence of a state in which at least one member of a pair of said units is moving.

52. The medical treatment system defined in claim 51, wherein

(a) at least one of said second units is a local control unit;

(b) at least two of said first units transmit respective labeled coordinate information to said at least one local control unit;

(c) the communication quality assessment device of said local control unit is operative to analyze all received location information and to determine optimization information comprising at least one of (i) an optimal route for communications among said second unit and said at least two first units, and (ii) optimal communication parameters for said second unit and said at least two first units;

(d) the communication quality assessment device of said local control unit is further coupled to the T/R device of said local control unit, to cause said T/R device to transmit said optimization information, for each first which transmitted said respective labeled coordinate information; and

(e) the T/R device of each of said first units is coupled to the respective communication quality assessment device of said first units;

wherein

(i) each of said first units transmits respective labeled coordinate information to said local control unit;

(ii) the communication quality assessment device of said local control unit determines respective optimization information for said first units;

(iii) said optimization information is transmitted to said first units, and supplied to said respective mode selection device of said first units;

thereby to improve communication among said local control unit and said at least two first units.

53. The medical treatment system defined in claim 51, comprising one second unit and a plurality of first units, wherein,

(a) each of a plurality of first units transmits respective labeled coordinate information to said one second unit;

(b) the communication quality assessment device of said second unit is operative to analyze all received location information and determine optimization information comprising at least one of (i) a route for improved communication among said second unit and said plurality of first units, and (ii) parameters for improved communication among said second unit and said plurality of first units;

(c) the communication quality assessment device of said second unit is further coupled to the T/R device of said second unit, to cause said device to transmit said optimization information; and

(d) the T/R device of each of said plurality of first units is coupled to the respective communication quality assessment device of each of said first unit;

wherein

(i) each of said plurality of first units transmits respective labeled coordinate information to said second unit;

(ii) the communication quality assessment device of said second unit determines said optimization information for said second unit and said plurality of first units;

(iii) said optimization information is transmitted to said first units, and passed to each said respective mode selection device;

whereby said second unit is a master control unit;

thereby to optimize communications between said EMD unit and said RS unit.

54. The medical treatment system defined in claim 53, wherein:

(a) the communication quality assessment device of said master control unit includes a memory for storing a location of all stationary units; and

(b) said communication quality assessment device of said master control unit is operative to determine the spatial relationship between each said stationary unit, and each other unit.

55. The medical treatment device system defined in claim 52, wherein said communication parameters include at least one of:

(i) a choice of power output for at least one T/R device;

(ii) a choice of signal sensitivity for at least one T/R unit;

(iii) a choice of at transmission frequency for at least one T/R unit;

(iv) a choice of output signal modulation type for at least one T/R unit;

(v) a choice of the rate of information transfer;

(vi) a choice of the method of signal encoding; and

(vii) a choice of message repetition frequency.

56. The medical treatment device system defined in claim 53, wherein said communication parameters include at least one of:

(i) a choice of power output for at least one T/R device;

(ii) a choice of signal sensitivity for at least one T/R unit;

(iii) a choice of at transmission frequency for at least one T/R unit;

(iv) a choice of output signal modulation type for at least one T/R unit;

(v) a choice of the rate of information transfer;

(vi) a choice of the method of signal encoding; and

(vii) a choice of message repetition frequency.

57. The medical treatment system defined in claim 51, wherein:

(a) the T/R device of at least one additional unit is operative to (i) receive said labeled coordinate information from said at least one first unit, and (ii) re-transmit said information;

(b) the T/R device of said at least one second unit is operative to receive said re-transmitted labeled coordinate information; and

(c) the mode selection device of said at least one second unit is operative to select the mode of communication between;

(1) said at least one second unit and

(2) at least one of;

(i) said at least one first unit, which initially transmitted said coordinate information,

(ii) said at least one additional, which re-transmitted said coordinate information, and

(iii) yet one other unit;

thereby

to allow position information of a unit to be propagated among the medical treatment system units, to optimize communications within the medical treatment system.

58. The medical treatment system defined in claim 52, wherein:

(a) the T/R device of at least one more unit is operative to (i) receive said optimization information from said at least one second unit, and (ii) re-transmit said optimization information;

(b) the T/R device of said at least one first unit is operative to receive said re-transmitted optimization information; and

(c) the selection device of said at least one first unit is operative to select the mode of communication between

(1) said at least one first unit and

(2) at least one of;

(i) said at least one second unit, which initially transmitted said optimization information,

(ii) said at least one more unit, which re-transmitted said optimization information, and

(iii) yet one other unit;

thereby

to allow communication optimization information to be propagated among the medical treatment system units, to optimize communications within the medical treatment system.

59. The medical treatment system defined in claim 44, wherein at least one of said at least one first units further comprises a respective velocity determination device, coupled to said respective first global positioning system and to said respective first communication quality assessment device, for determining at least one of (i) the average speed of said respective first unit, over an interval of time, and (ii) the net direction of motion of said respective first unit, over said interval of time;

wherein, said respective velocity determination device calculates at least one of said respective average speed, and (ii) said respective net direction by comparing (i) a respective position of said respective first unit at a first instant in time, with a respective position of said respective first unit at a second instant in time.

60. The medical treatment system defined in claim 59, wherein

(1) the velocity determining device of said at least one first unit is coupled to the respective T/R device of said at least one first unit, for transmission of respective labeled velocity information including:

(a) information which identifies said respective first unit;

(b) a respective time of said first instant and of said second instant; and

(c) velocity information relating to said respective first unit, including at least one of;

 

(i) said average speed during said interval of time; and

 

(ii) said net direction of motion;

(2) an at least one other second unit includes;

(a) a respective second communication quality assessment device, coupled to the respective T/R device of said second unit, for receipt of said labeled velocity information from said at least one first unit, and for producing a respective second communication quality signal in dependence upon said labeled velocity information; and

(b) a second mode selection device coupled to said respective T/R device of said second unit and to said second communication quality assessment device, for selecting the mode of communication between at least one pair of units, each said pair comprising;

(i) said second unit and (ii) a first unit, in response to receipt of said respective second communication quality signal from said second communication quality assessment device;

whereby said second communication quality assessment device is responsive to said velocity information from said at least one first unit, to determine if said at least one pair of units will be in an acceptable location for communication, at a future instant in time.

61. The medical treatment system defined in claim 60, wherein

(a) said at least one second unit further comprises a second velocity determining device, coupled to said second communication quality assessment device, for determining at least one of (i) an average speed and (ii) a net direction of said second unit;

(b) said at least one second communication assessment device is operative to utilize velocity information from each pair of units wherein one member of the pair is selected from said at least one first unit and the other member of the pair is selected from said at least one second unit, to determine at least one of;

(i) a change in the at least one of the average speed and the net direction of each of the two members of each pair of two units;

(ii) the relative average speed and the relative net direction of each pair of the two members; and

(iii) the presence of a motionless state of a pair, in which neither member of such pair of said units is moving.

62. The medical treatment system defined in claim 44, wherein at least one of said at least one first units further comprises a respective velocity determination device which is operative to determine at least one of (i) the magnitude of an acceleration of said respective first unit, over an interval of time, and (ii) the net direction of acceleration of said respective first unit, over said interval of time;

wherein, said respective velocity determination device calculates at least one of (i) the magnitude of said respective acceleration, and (ii) said respective net direction of said acceleration by comparing a respective average speed and net direction of motion of said respective first unit at a first instant in time, with a respective average speed and net direction of motion of said respective first unit at a second instant in time.

63. The medical treatment system defined in claim 62 further comprising a device for determining when the value of said magnitude of said respective acceleration exceeds a threshold, to determine a likelihood of at least one of (i) a collapse of said person, and (ii) a collision of a moving vehicle containing said person.

64. A medical treatment system having a medical device which allows a person using the device access to a medical expert that can communicate with the medical device from a remote site, said system comprising, in combination:

(1) an electronic medical device (EMD) unit comprising, in combination;

(a) a first wireless transmitting/receiving (T/R) device for transmitting information to, and for receiving at least one control signal from, a plurality of remote locations;

(b) a medical treatment device, coupled to said first T/R device, for treating said person in response to control signals applied thereto;

(2) a remote station (RS) unit at said remote location including;

(a) a first input device, responsive to a medical expert, for producing at least one real time remote control signal for controlling said EMD unit;

(b) a second transmitting/receiving (T/R) device, coupled to said input device, for electronic communication with the first T/R device of said remotely located EMD unit; and

(3) at least one communication relay unit, x said unit(s) numbered from “

1”

to “

x”

, each yth unit including;

(a) a (y+2)th communication relay transmitting/receiving (T/R) device for communicating with at least two of (i) the EMD unit, (ii) the RS unit, (iii) one of said communication relay units, and (iv) at least one other communication relay unit;

(b) a yth communication quality assessment device for assessing at least one of the expected and the actual quality of communications signals to be received by said (y+2)th communication relay T/R device from at least one of (i) said EMD unit, (ii) said RS unit, and (iii) said at least one other communication relay unit, and for producing a yth communication quality signal in dependence upon the respective assessed quality of the communication signals; and

(c) a yth mode selection device coupled to each of said respective (y+2)th T/R device and said respective communication quality assessment device for selecting the mode of communication with at least one of (i) said EMD unit, (ii) said RS unit, and (iii) said at least one other communication relay unit, in response to receipt of said respective communications quality signal from said respective communication quality assessment device;

wherein

(1) x is an integer which is at least the integer 1, and

(2) y is an integer ranging from the integer 1 to the integer x;

whereby

communication between said EMD and said RS may be improved.

65. The medical treatment system defined in claim 64, wherein said RS further comprises:

(a) an RS communication quality assessment device for assessing at least one of the expected and the actual quality of communications signals to be received by said second T/R device from at least one of (i) said EMD unit, and (ii) said at least one communication relay unit, and for producing a RS communication quality signal in dependence upon the respective assessed quality of the communication signals; and

(b) an RS mode selection device coupled to said second T/R device and said RS communication quality assessment device for selecting the mode of communication with at least one of (i) said EMD unit, and (ii) said at least one other communication relay unit, in response to receipt of said RS communications quality signal from said RS communication quality assessment device;

whereby communication between the RS and at least one other unit may be improved.

66. The medical treatment system defined in claim 64, wherein said EMD further comprises:

(a) an EMD communication quality assessment device for assessing at least one of the expected and the actual quality of communications signals to be received by said first T/R device from at least one of (i) said RS unit, and (ii) said at least one communication relay unit, and for producing an EMD communication quality signal in dependence upon the respective assessed quality of the communication signals; and

(b) an EMD mode selection device coupled to said first T/R device and said EMD communication quality assessment device for selecting the mode of communication with at least one of (i) said RS unit, and (ii) said at least one other communication relay unit, in response to receipt of said EMD communications quality signal from said EMD communication quality assessment device;

whereby communication between the EMD and at least one other unit may be improved.

67. The medical treatment system defined in claim 64, wherein said communication quality assessment device is coupled to said (y+2)th T/R device and measures the quality of communication signals actually received by the (y+2)th T/R device.

68. The medical treatment system defined in claim 65, wherein said RS communication quality assessment device is coupled to said second T/R device and measures the quality of communication signals actually received by the second T/R device.

69. The medical treatment system defined in claim 66, wherein said EMD communication quality assessment device is coupled to said first T/R device and measures the quality of communication signals actually received by the first T/R device.

70. The medical treatment system defined in claim 64, wherein said yth communication quality assessment device assesses the expected quality of communication signals to be received by the (y+2)th T/R device, based upon at least one external factor.

71. The medical treatment system defined in claim 65, wherein said RS communication quality assessment device assesses the expected quality of communication signals to be received by the second T/R device, based upon at least one external factor.

72. The medical treatment system defined in claim 66, wherein said EMD communication quality assessment device assesses the expected quality of communication signals to be received by the first T/R device, based upon at least one external factor.

73. The medical treatment system defined in claim 70, wherein said at least one external factor is selected from the group consisting of:

(a) a previous assessment of expected quality, (b) a distance to another communication relay unit, (c) a state of motion of said communication relay unit, (d) atmospheric conditions, (e) a time of the day, and (f) a day of the year.

74. The medical treatment system defined in claim 71, wherein said at least one external factor is selected from the group consisting of:

(a) a previous assessment of expected quality, (b) a distance to at least one of;

(i) at least one communication relay unit, and (ii) said EMD unit, (c) a state of motion of said RS unit, (d) atmospheric conditions, (e) a time of the day, and (f) a day of the year.

75. The medical treatment system defined in claim 72, wherein said at least one external factor is selected from the group consisting of:

(a) a previous assessment of expected quality, (b) a distance to at least one of;

(i) at least one communication relay unit, and (ii) said RS unit, (c) a state of motion of said EMD unit, (d) atmospheric conditions, (e) a time of the day, and (f) a day of the year.

76. The medical treatment system defined in claim 64, wherein the EMD unit includes at least one sensor, coupled to said first T/R device for sensing a medical condition of said person and producing a sensor output signal in response to said medical condition, wherein said first T/R device transmits a representation of said sensor output signal to at least one of said x communication relay units.

77. The medical treatment system defined in claim 76, wherein said sensor is further coupled to said medical treatment device and wherein said medical treatment device automatically applies an appropriate treatment to said patient in response thereto.

78. The medical treatment system defined in claim 64, wherein the EMD unit is adapted to be implanted in said patient.

79. The medical treatment system defined in claim 67, wherein:

(a) at least one of

(i) a test communication relay unit, including a respective test communication relay transmitting/receiving (T/R) device for communicating with at least two of (i) the EMD unit, (ii) the RS unit, (iii) one of said communication relay units, and (iv) at least one other communication relay unit,

(ii) said RS unit, and

(iii) said EMD unit,

includes a device for generating a test signal which identifies the respective unit which has transmitted said test signal, said device coupled to the respective T/R device of said at least one unit;

(c) the signal quality assessment device of at least one other communication relay unit is operative to produce a test signal quality signal, indicating the quality of the test signal received by said at least one other communication relay unit; and

(d) the selection device of said at least one other communication relay unit is operative to select the mode of communication between (1) said at least one other communication relay unit and (2) at least one of;

(i) the unit which transmitted said test signal,

(ii) at least one other unit,

in response to receipt of the respective test signal quality signal from said respective signal quality assessment device;

thereby to improve the quality of the communications between the unit which transmitted said test signal and the communications relay unit which received said test signal to render acceptable communications within the medical treatment system.

80. The medical treatment system defined in claim 68, wherein:

(a) at least one of

(i) a test communication relay unit, including a respective test communication relay transmitting/receiving (T/R) device for communicating with at least two of (i) the EMD unit, (ii) the RS unit, (iii) one of said communication relay units, and (iv) at least one other communication relay unit, and

(ii) said EMD unit

includes a device for generating a test signal which identifies the respective unit which has transmitted said test signal, said device coupled to the respective T/R device of said at least one unit;

(b) said RS further comprises

(i) a signal quality assessment device operative to produce a RS test signal quality signal, indicating the quality of the test signal received by said RS unit, coupled to said second T/R; and

(ii) a selection device, coupled to said RS signal quality assessment device and said second T/R device, operative to select the mode of communication between (1) said RS unit and (2) at least one of;

(i) the unit which transmitted said test signal,

(ii) at least one other unit,

in response to receipt of said RS test signal quality signal from said RS signal quality assessment device;

thereby to improve the quality of the communications between the unit which transmitted said test signal and said RS unit to render acceptable communications within the medical treatment system.

81. The medical treatment system defined in claim 69, wherein:

(a) at least one of

(i) a test communication relay unit, including a respective test communication relay transmitting/receiving (T/R) device for communicating with at least two of (i) the EMD unit, (ii) the RS unit, (iii) one of said communication relay units, and (iv) at least one other communication relay unit, and

(ii) said RS unit,

includes a device for generating a test signal which identifies the respective unit which has transmitted said test signal, said device coupled to the respective T/R device of said at least one unit;

(b) said EMD further comprises

(i) a signal quality assessment device operative to produce an EMD test signal quality signal, indicating the quality of the test signal received by said EMD unit, coupled to said second T/R; and

(ii) a selection device, coupled to said EMD signal quality assessment device and said first T/R device, operative to select the mode of communication between (1) said EMD unit and (2) at least one of;

(i) the unit which transmitted said test signal,

(ii) at least one other unit,

in response to receipt of said EMD test signal quality signal from said EMD signal quality assessment device;

thereby to improve the quality of the communications between the unit which transmitted said test signal and said EMD unit to render acceptable communications within the medical treatment system.

82. The medical treatment system defined in claim 67, wherein:

(a) at least one of said at least one communication relay unit, a test communication relay unit, includes a device for generating a test signal which identifies the respective unit which has transmitted said test signal, said device coupled to the respective T/R device of said at least one communication relay unit;

(b) the signal quality assessment device of at least one other communication relay unit is operative to produce a test quality signal, representing the quality of the test signal received by said at least one other communication relay unit; and

(c) the mode selection device of said at least one other communication relay unit is operative to;

(A) select the mode of communication between (1) said at least one other communication relay unit and (2) at least one of;

(i) the unit which transmitted said test signal, and

(ii) at least one other unit; and

(B) cause said T/R device of said at least one other communication relay unit to transmit a mode selection command to said respective test communication relay unit;

(d) the mode selection device of said respective test communication relay unit is further coupled to said respective test communication relay T/R device, to receive said mode selection command, and in response thereto, to select the mode of communication between

(1) said respective test communication relay unit and (2) at least one of;

(i) said respective other communication relay unit and

(ii) at least one other unit;

thereby to cause said respective other communication relay unit to control the mode of communication of at least another communication relay unit.

83. The medical treatment system defined in claim 64, wherein at least one communication relay unit includes at least one motion detecting device, coupled to said respective communication quality assessment device;

thereby to determine if a communication relay unit is in an acceptable location or state of motion.

84. The medical treatment system defined in claim 83, wherein said at least one motion detecting device is selected from the group consisting of (i) an accelerometer-based motion detector, (ii) a piezoelectric crystal-based motion detector, and (iii) a global positioning system-based motion detector.

85. The medical treatment system defined in claim 83, wherein, upon the detection of a non-acceptable location or state of motion, a respective mode selection device of said at least one communication relay unit is operative to control at least one of:

(i) the selection of at least one other communication relay unit with which said at least one communication relay unit communicates;

(ii) a power output for said respective (y+2)th T/R unit;

(iii) a signal sensitivity for said respective (y+2)th T/R unit;

(iv) at least one transmission frequency for said respective (y+2)th T/R unit;

(v) an output signal modulation type for said respective (y+2)th T/R unit;

(vi) a selection of at least one of a connection via (a) a radiofrequency link, (b) Internet, (c) a hard wire connection, for said respective (y+2)th T/R unit;

(vii) a rate of information transfer;

(viii) a method of signal encoding; and

(ix) a message repetition frequency.

86. The medical treatment system defined in claim 64, wherein:

(1) at least one first communication relay unit includes at least one motion detecting device selected from the group consisting of;

(i) an accelerometer-based motion detector,

(ii) a piezoelectric crystal-based motion detector, and

(iii) a global positioning system-based motion detector, coupled to the respective (y+2)th T/R device of said at least one first relay unit, for transmission of labeled coordinate information including;

(a) information which identifies said at least one other relay unit; and

(b) at least one of location and motion information relating to said at least one other relay unit;

(2) at least one second relay unit communication quality assessment device is coupled to said respective (y+2)th T/R device, for receipt of said labeled coordinate information from said at least one first communication relay unit; and

(3) said at least one second relay unit communication quality assessment device is responsive to at least one of said location and motion information from said at least one first relay unit, to determine if a communications relay unit may be in a sub-optimal location or state of motion.

87. The medical treatment system defined in claim 83, wherein

(1) at least one other communication relay includes at least one motion detecting device selected from the group:

(i) an accelerometer-based motion detector,

(ii) a piezoelectric crystal-based motion detector, and

(iii) a global positioning system-based motion detector,

coupled to the respective (y+2)th T/R device of said at least one other relay unit, for transmission of labeled coordinate information including;

(a) information which identifies said at least one other relay unit; and

(b) at least one of location and motion information concerning said at least one other relay unit, and

(2) said at least one communication relay unit communication quality assessment device is coupled to said respective (y+2)th T/R device, for receipt of said labeled coordinate information from said at least one other relay unit;

(3) said at least one communication relay unit communications assessment device is responsive to at least one of said location and motion information from each pair of relay units to determine at least one of;

(a) the presence of a motionless state of a pair, in which neither member of a pair of said relay units is moving, and

(b) the presence of a state in which at least one member of a pair of said two relay units is moving;

wherein one member of the pair is selected from said at least one relay unit and the other member of the pair is selected from said at least one other relay unit.

88. The medical treatment system defined in claim 87, wherein,

(a) at least one of said at least one communication relay units is a local control unit;

(b) at least two of said other relay unit transmits respective labeled coordinate information to said at least one local control unit;

(c) the communications assessment device of said local control unit is operative to analyze all received motion and location information and determine optimization information comprising at least one of (i) an optimal route for communications among said local control unit and said at least two other communication relay units, and (ii) optimal communication parameters for said local control unit and said at least two other communication relay units,

(d) the communications assessment device of said local control unit is further coupled to the T/R device of said local control unit, to cause said respective T/R device to transmit said optimization information, for each other communications relay unit which transmitted said respective labeled coordinate information; and

(e) the T/R device of each of said other communication relay units is coupled to the respective communications assessment device of said other communication relays;

wherein

(iv) each of said other communication relay units transmits respective labeled coordinate information to said local control unit;

(v) the communication quality assessment device of said local control unit determines respective optimization information for said other communication relay units;

(vi) said optimization information is transmitted to said other communication relay units, and supplied to said respective mode selection device of said other communication relay units;

thereby to improve communications among said local control unit and said at least two other communication relay units.

89. The medical treatment system defined in claim 87, wherein,

(a) each of a plurality of said other communication relay units transmit respective labeled coordinate information to a single one of said communication relay units;

(b) the communication quality assessment device of said single communication relay unit is operative to analyze all received motion and location information and determine optimization information comprising at least one of (i) a route for improved communications among said single communications relay unit and said plurality of other communication relay units, and (ii) parameters for improved communication among said single communications relay unit and said plurality of other communication relay units;

(c) the communication quality assessment device of said single communication relay unit is further coupled to the respective T/R device of said single communication relay unit, to cause said respective T/R device to transmit said optimization information; and

(d) the T/R device of each of said plurality of other communication relays is coupled to the respective communications assessment device of each of said other communication relays;

wherein

(iv) each of said plurality of other communication relay units transmits respective labeled coordinate information to said single communication relay unit;

(v) the communication quality assessment device of said single communication relay unit determines said optimization information for said single communication relay unit and said plurality of other communication relay units;

(vi) said optimization information is transmitted to said plurality of other communication relay units, and passed to each said respective mode selection device;

whereby said single communication relay unit is a master control unit;

thereby to optimize communications between said EMD unit and said RS unit.

90. The medical treatment system defined in claim 89, wherein:

(a) the communication quality assessment device of said master control unit includes a memory for storing a location of all stationary communication relay units;

(b) said motion detecting device of said master control unit and each of said other communication relay units is a global positioning system; and

(c) said communication quality assessment device of said master control unit is operative to determine a spatial relationship between each said stationary unit, and each other unit.

91. The medical treatment device system defined in claim 88, wherein said communication parameters include at least one of:

(i) a choice of power output for at least one (y+2)th T/R device;

(ii) a choice of signal sensitivity for at least one (y+2)th T/R unit;

(iii) a choice of at transmission frequency for at least one (y+2)th T/R unit;

(iv) a choice of output signal modulation type for at least one (y+2)th T/R unit;

(v) a choice of the rate of information transfer;

(vi) a choice of the method of signal encoding; and

(vii) a choice of message repetition frequency.

92. The medical treatment device system defined in claim 89, wherein said communication parameters include at least one of:

(i) a choice of power output for at least one (y+2)th T/R device;

(ii) a choice of signal sensitivity for at least one (y+2)th T/R unit;

(iii) a choice of at transmission frequency for at least one (y+2)th T/R unit;

(iv) a choice of output signal modulation type for at least one (y+2)th T/R unit;

(v) a choice of the rate of information transfer;

(vi) a choice of the method of signal encoding; and

(vii) a choice of message repetition frequency.

93. The medical treatment system defined in claim 87, wherein:

(a) the T/R device of at least one additional communication relay device is operative to (i) receive said labeled coordinate information from said at least one other relay unit, and (ii) re-transmit said information;

(b) the T/R device of said at least one communication relay unit is operative to receive said re-transmitted labeled coordinate information; and

(c) the selection device of said at least one communication relay unit is operative to select the mode of communication between;

(1) said at least one communication relay unit and

(2) at least one of;

(i) said at least one other communication relay unit, which initially transmitted said coordinate information,

(ii) said at least one additional communication relay unit, which re-transmitted said coordinate information,

(iii) yet one other communication relay unit,

(iv) said RS unit, and

(v) said EMD unit;

thereby

to allow at least one of position and motion information of a communicating unit to be propagated among the medical treatment system units, to optimize communications within the medical treatment system.

94. The medical treatment system defined in claim 88, wherein:

(a) the T/R device of at least one more communication relay device is operative to (i) receive said optimization information from said at least one relay unit, and (ii) re-transmit said optimization information;

(b) the T/R device of said at least one other communication relay unit is operative to receive said re-transmitted optimization information; and

(c) the selection device of said at least one other communication relay unit is operative to select the mode of communication between

(1) said at least one other communication relay unit and

(2) at least one of;

(i) said at least one communication relay unit, which initially transmitted said optimization information,

(ii) said at least one more communication relay unit, which re-transmitted said optimization information,

(iii) yet one other communication relay unit,

(iv) said RS unit, and

(v) said EMD unit;

thereby

to allow communication optimization information to be propagated among the medical treatment system units, to optimize communications within the medical treatment system.

95. The medical treatment system defined in claim 90, wherein said determination of an optimal route of communications includes the determination of a communications path between said EMD unit and said RS unit, via z said communication relay units,

wherein at least one of:

(a) the largest value of all of the distances between each of ½

(z+2)(z+1) possible pairs of communicating units which are included in said route is minimized;

(b) the largest value of each of ½

(z+2)(z+1) first mathematical functions of at least one of (i) the distance between a pair of communicating units and (ii) the maximum communication range of one member of the pair, and (iii) the maximum range of the other member of the pair, (iv) the maximum sensitivity of one member of the pair and (v) the maximum sensitivity of the other member of the pair, is minimized;

(c) the smallest value of each of a ½

(z+2)(z+1) second mathematical functions of at least one of (i) the distance between a pair of communicating units and (ii) the maximum communication range of one member of the pair, and (iii) the maximum range of the other member of the pair, (iv) the maximum sensitivity of one member of the pair and (v) the maximum sensitivity of the other member of the pair, is maximized.

thereby to select a route wherein the weakest link is the most robust possible.

96. The medical treatment system defined in claim 90, wherein said determination of an optimal route of communications entails the determination of a communications path between said EMD unit and said RS unit, via z said communication relay units,

wherein at least one of:

(a) the largest value of a third function of all of the distances between each of ½

(z+2)(z+1) possible pairs of communicating units which are included in said route is minimized;

(b) the smallest value of a third function of all of the distances between each of ½

(z+2)(z+1) possible pairs of communicating units which are included in said route is maximized.

thereby to select a maximally robust route.

97. The medical treatment system defined in claim 67, wherein

(1) at least one other communication relay unit includes a signal quality assessment device, coupled to the respective T/R device of said other communication relay unit, operative to produce an incoming quality signal, representing the quality of the communication signals received by said respective T/R device;

(2) said signal quality assessment device of said at least one other communication relay unit is further coupled to the said T/R device of said at least one other relay unit, for transmission of labeled signal quality information, representing said respective incoming quality signal, including;

(a) the identity of said at least one other relay unit; and

(b) signal quality information concerning the signals received by the respective T/R device of said at least one other relay unit, and

(3) said at least one communication relay unit communication quality assessment device is coupled to said respective T/R device, for (i) receipt of said labeled signal quality information from said at least one other relay unit, and (ii) assessment of the quality of signals received by said one communication relay unit;

(4) said at least one communication relay unit communications assessment device is responsive to at least one of (i) said received labeled signal quality information, and (ii) said assessment of the quality of signals received by said one communications relay unit to produce said respective communication quality signal;

whereby

the mode selection device of said at least one communication relay unit improves the communication between said at least one communication relay unit and each other communication relay unit from which it receives said labeled signal quality information.

98. The medical treatment system defined in claim 97, wherein,

(a) at least one of said at least one communication relay units is a local control unit;

(b) at least two of said other communication relay units transmit respective labeled signal quality information to said at least one local control unit;

(c) the communication quality assessment device of said local control unit is operative to analyze all received signal quality information and determine optimization information comprising at least one of (i) an optimal route for communications among said local control unit and said at least two other communication relay units, and (ii) optimal communication parameters for said local control unit and said at least two other communication relay units,

(d) the communication quality assessment device of said local control unit is further coupled to the T/R device of said local control unit, to cause said respective T/R device to transmit said optimization information, for each other communications relay unit which transmitted said respective labeled signal quality information; and

(e) the T/R device of each of said other communication relay units is coupled to the respective communication quality assessment device of said other communication relays;

wherein

(i) each of said other communication relay units transmits respective labeled signal quality information to said local control unit;

(ii) the communication quality assessment device of said local control unit determines respective optimization information for said other communication relay units;

(iii) said optimization information is transmitted to said other communication relay units, and supplied to said respective mode selection device of said other communication relay units;

thereby to improve communications among said local control unit and said at least two other communication relay units.

99. The medical treatment system defined in claim 97, wherein,

(a) each of a plurality of said other communication relay units transmit respective labeled signal quality information to a single one of said communication relay units;

(b) the communication quality assessment device of said single communication relay unit is operative to analyze all received signal quality information and determine optimization information comprising at least one of (i) a route for improved communications among said single communications relay unit and said plurality of other communication relay units, and (ii) parameters for improved communication among said single communications relay unit and said plurality of other communication relay units;

(c) the communication quality assessment device of said single communication relay unit is further coupled to the respective T/R device of said single communication relay unit, to cause said respective T/R device to transmit said optimization information; and

(d) the T/R device of each of said plurality of other communication relays is coupled to the respective communications assessment device of each of said other communication relays;

wherein

(i) each of said plurality of other communication relay units transmits respective labeled signal quality information to said single communication relay unit;

(ii) the communication quality assessment device of said single communication relay unit determines said optimization information for said single communication relay unit and said plurality of other communication relay units;

(iii) said optimization information is transmitted to said plurality of other communication relay units, and passed to each said respective mode selection device;

whereby said single communication relay unit is a master control unit;

thereby to optimize communications between said EMD unit and said RS unit.

100. The medical treatment system defined in claim 99, wherein:

(a) the communication quality assessment device of said master control unit includes a memory for storing a location of each stationary communication relay units; and

(b) said communication quality assessment device of said master control unit is operative to determine the spatial relationship between each said stationary unit, and each other unit.

101. The medical treatment device system defined in claim 98, wherein said communication parameters include at least one of:

(i) a choice of power output for at least one (y+2)th T/R device;

(ii) a choice of signal sensitivity for at least one (y+2)th T/R unit;

(iii) a choice of at transmission frequency for at least one (y+2)th T/R unit;

(iv) a choice of output signal modulation type for at least one (y+2)th T/R unit;

(v) a choice of the rate of information transfer;

(vi) a choice of the method of signal encoding; and

(vii) a choice of message repetition frequency.

102. The medical treatment device system defined in claim 99, wherein said communication parameters include at least one of:

(i) a choice of power output for at least one (y+2)th T/R device;

(ii) a choice of signal sensitivity for at least one (y+2)th T/R unit;

(iii) a choice of at transmission frequency for at least one (y+2)th T/R unit;

(iv) a choice of output signal modulation type for at least one (y+2)th T/R unit;

(v) a choice of the rate of information transfer;

(vi) a choice of the method of signal encoding; and

(vii) a choice of message repetition frequency.

103. The medical treatment system defined in claim 97, wherein:

(a) the T/R device of at least one additional communication relay device is operative to (i) receive said labeled signal quality information from said at least one other relay unit, and (ii) re-transmit said information;

(b) the T/R device of said at least one communication relay unit is operative to receive said re-transmitted labeled signal quality information; and

(c) the selection device of said at least one communication relay unit is operative to select the mode of communication between;

(1) said at least one communication relay unit and

(2) at least one of;

(i) said at least one other communication relay unit, which initially transmitted said signal quality information,

(ii) said at least one additional communication relay unit, which re-transmitted said signal quality information,

(iii) yet one other communication relay unit,

(iv) said RS unit, and

(v) said EMD unit;

thereby

to allow said signal quality information of a communicating unit to be propagated among the medical treatment system units, to optimize communications within the medical treatment system.

104. The medical treatment system defined in claim 98, wherein:

(a) the T/R device of at least one more communication relay device is operative to (i) receive said optimization information from said at least one relay unit, and (ii) re-transmit said optimization information;

(b) the T/R device of said at least one other communication relay unit is operative to receive said re-transmitted optimization information; and

(c) the selection device of said at least one other communication relay unit is operative to select the mode of communication between

(1) said at least one other communication relay unit and

(2) at least one of;

(i) said at least one communication relay unit, which initially transmitted said optimization information,

(ii) said at least one more communication relay unit, which re-transmitted said optimization information,

(iii) yet one other communication relay unit,

(iv) said RS unit, and

(v) said EMD unit;

thereby

to allow communication optimization information to be propagated among the medical treatment system units, to optimize communications within the medical treatment system.

105. A medical treatment and testing apparatus, for medical treatment of a person, which allows a remote station to perform testing on the apparatus from a remote location, said apparatus comprising, in combination:

(A) an electronic medical device comprising, in combination;

(1) first transmitting and receiving device (T/R) device;

for transmitting information to, and for receiving at least one control signal from and a remote station;

(2) at least one sensor for producing a sensor signal representing a physiologic state of a person;

(3) a first processor, having an input and an output, for receiving said sensor signals, for making a decision related to medical therapy for said person, responsive to said sensor signals, and for producing a first therapy signal output representing said decision;

(4) a medical treatment device, for applying medical treatment to said person;

(5) an input switching device, having;

(a) a plurality of inputs, including;

(i) one input coupled to said first T/R device, for receipt of test signals, and

(ii) at least one other input coupled to said at least one sensor, for receipt of sensor signals;

(b) an output, coupled to said first processor input;

said input switching device being responsive to a first control signal received from said first T/R device for selecting the input to be outputted;

(6) an output switching device, having;

(a) an input, coupled to said first processor output for receipt of said first processor therapy signal;

(b) a plurality of outputs, including;

(i) one output coupled to said medical treatment device; and

(ii) one output coupled to said first T/R device, for transmission of test results; and

said output switching device being responsive to a second control signal received from said first T/R device for selecting the output of said output switching device;

(B) a remote station unit at said remote location, including;

(1) a first input device, responsive to a technical expert, for producing at least one remote control signal for controlling and testing said medical device;

(2) a second transmitting/receiving (T/R) device, coupled to said input device, for electronic communication with the first T/R device of said remotely located EMD unit; and

(3) a first output device, coupled to said second T/R device, for receipt of said first therapy signal;

wherein

(I) In a first operating state,

said input switching device;

couples said sensor signal to said first processor input, and

uncouples said first T/R device from said first processor input; and

said output switching device;

couples said first processor output to said medical treatment device; and

uncouples said first processor output from said first T/R device; and

(II) In a second operating state,

said input switching device;

uncouples said sensor signal from said first processor input, and

couples said first T/R device to said first processor input; and

said output switching device;

uncouples said first processor output from said medical treatment device; and

couples said first processor output to said first T/R device; and

(III) said technical expert determines the choice of operating state by inputting control signals to said second T/R device which are transmitted to said first T/R device, and then passed to the input of each of said input switching device and said output switching device, for respective control thereof;

(IV) said technical expert (a) applies test signals to said first input device, which are passed sequentially by said second T/R, said first T/R and said input switching device to said first processor input; and

(b) receives the first processor output, which is passed sequentially by said output switching device, said first T/R device, and said second T/R device, for evaluation;

whereby, in said first operating state, said medical treatment device is operative to provide treatment based on said sensor signals; and

in said second operating state, said technical expert evaluates the response of said first processor to a test signal,

thereby to determine whether said first processor is functioning properly.

106. The medical treatment and testing apparatus defined in claim 105, wherein:

(a) said remote station further comprises a display device, coupled to said second T/R device, for displaying output information from said first processor, received by said second T/R device; and

(b) said technical expert is a human;

thereby to allow a human technical expert to determine if said first processor is functioning properly in said second operating state.

107. The medical treatment and testing apparatus defined in claim 105, wherein said technical expert is a logic device operative to initiate said testing and to determine if said first processor is functioning properly in said second operating state.

108. The medical treatment and testing apparatus defined in claim 105, wherein:

(a) said electronic medical device further comprises a test signal generating device for generating at least one test signal, with an output coupled to another one of said plurality of inputs of said input switching device; and

(b) in a third operating state;

said input switching device;

uncouples said sensor signal from said first processor input,

uncouples said first T/R device to said first processor input, and

couples said test signal generating device to said first processor input; and

said output switching device;

uncouples said first processor output from said medical treatment device; and

couples said first processor output to said first T/R device;

whereby

said technical expert selects said third operating state to determine if said first processor is functioning properly in said third operating state.

109. The medical treatment and testing apparatus defined in claim 108, wherein:

(a) said test signal generating device is further coupled to said first T/R device; and

(b) said technical expert controls said test signal generating device by inputting said at least one test signal generating device control signal into said first input device;

thereby to activate said test signal generating device only during said third operating state.

110. The medical treatment and testing apparatus defined in claim 108, wherein said test signal generating device is further coupled to said first T/R device to cause the transmission by said first T/R device of said at least one test signal;

thereby to cause said at least one test signal to be received by said second T/R device for evaluation by said technical expert to determine if said first processor is functioning properly.

111. The medical treatment and testing apparatus defined in claim 105, wherein, in a fourth operating state:

said input switching device;

couples said sensor signal to said first processor input, and

uncouples said first T/R device from said first processor input; and

said output switching device;

couples said first processor output to said medical treatment device and to said first T/R device;

whereby said technical expert may evaluate the response of said first processor to said sensor signals.

112. The medical treatment and testing apparatus defined in claim 105, wherein said electronic medical device is adapted to be implanted in a living being.

113. The medical treatment and testing apparatus defined in claim 105, wherein said electronic medical device is adapted to be attached outside the body of a living being.

114. The medical treatment and testing apparatus defined in claim 105, wherein

(a) said first processor is further coupled to said first T/R device;

and

(b) said technical expert includes means for providing an instruction to said first input device for transmission to said first T/R device, said instruction comprising at least one of a command, a complete program, a part of a program, a complete operating system, and a part of an operating system for said first processor;

thereby to allow said technical expert to provide said instructions to said first processor.

115. The medical treatment and testing apparatus defined in claim 114, wherein:

(a) said electronic medical device is operative to transmit a received instruction back to said remote station; and

(b) said remote station further comprises a computer device, coupled to each of said first input device and to said second T/R device, for

(i) storing;

(I) an instruction transmitted by said remote station, and

(II) said received instruction;

(ii) comparing the transmitted instruction with said received instruction; and

(iii) generating at least one comparison signal which indicates whether said transmitted instruction and said received instruction are the same;

thereby to convey information to said technical expert indicating whether said transmitted instruction was properly received by said electronic medical device.

116. The medical treatment and testing apparatus defined in claim 105, further comprising a second processor, coupled to each of:

(a) said at least one sensor;

(b) said first processor; and

(c) said medical treatment device;

said second processor having an input and an output, for receiving said sensor signals, for making a decision related to medical therapy for said person, responsive to said sensor signals, and for producing a second therapy signal output representing said decision;

wherein;

(i) said first processor is operative to signal said second processor of the operating state;

(ii) in said second operating state, said second processor is operative to make a therapy decision for said person, in response to said sensor signals, and for producing a second therapy signal output representing said decision;

(iii) said medical treatment device is operative to apply medical treatment to said person in response to said second therapy signal from said second processor;

whereby said electronic medical device utilizes said second processor to perform the decision-related functions of said first processor, while said first processor is undergoing evaluation testing, thereby to provide uninterrupted therapy to said person.

117. The medical treatment and testing apparatus defined in claim 116, wherein said second processor is operative to provide information to said first processor relating to at least one of the sensor signals and the respective second processor decision which occur during the duration of the second operating state.

118. The medical treatment and testing apparatus defined in claim 116, wherein

(a) said first processor is further coupled to said first T/R device;

(b) said second processor is coupled to said first processor;

and wherein

(i) said technical expert includes means for providing a first instruction to said first input device for transmission to said first T/R device, said instruction comprising at least one of a command, a complete program, a part of a program, a complete operating system, and a part of an operating system for said first processor; and

(ii) said technical expert includes means for providing a second instruction to said first input device for transmission to said first T/R device, said instruction comprising at least one of a command, a complete program, and a part of a program, for said first processor, causing said first processor to provide a copy of said first instruction to said second processor;

thereby to provide said first instruction to both said first and said second processors.

119. The medical treatment and testing apparatus in claim 116, wherein said second processor is coupled to each of:

(a) said input switching device; and

(b) said output switching device;

and wherein, in said second operating state, said second processor is operative to cause said input switching device and said output switching device to return said electronic medical device to said first operating state;

thereby to return to said first operating state in the event of a physiological state which requires therapy by said first processor.

120. The medical treatment and testing apparatus in claim 119, wherein said first processor produces an availability signal consisting of at least one of (a) a first processor available signal, and (b) a first processor unavailable signal, and provides said availability signal to said second processor, and wherein said second processor does not cause a transition from said second operating state to said first operating state when said first processor is unavailable.

121. The medical treatment and testing apparatus defined in claim 105, further comprising:

(C) at least one communication relay unit, x said unit(s) numbered from “

1”

to “

x”

, each yth unit including a (y+2)th communication relay transmitting/receiving (T/R) device for communicating with at least two of (i) said electronic medical device, (ii) said remote station, (iii) one of said communication relay units, and (iv) at least one other communication relay unit,

wherein

(1) x is an integer which is at least the integer 1, and

(2) y is an integer ranging from the integer 1 to the integer x;

whereby communication between said electronic medical device and said remote station may be improved.

122. The medical treatment and testing apparatus defined in claim 121, wherein

(a) said remote station further comprises a remote station computer, coupled to each of said first input device and to said second T/R device, for

(i) the storage of a first instruction transmitted by said remote station;

(ii) the storage of a second instruction received by said remote station;

(iii) the comparison of said transmitted instruction with said received instruction; and

(iv) the generation of at least one comparison signal which indicates any difference between said first instruction and said second instruction; and

(b) at least one communication relay unit further comprises a respective communication relay unit memory device, coupled to the respective T/R device of said relay unit, for storage of a received first instruction, and re-transmission as a second instruction;

wherein;

(1) said technical expert is operative to provide a first instruction, comprising at least one of a command, a complete program, a part of a program, a complete operating system, and a part of an operating system for said first processor;

(2) said first instruction is received by the respective communication relay T/R unit, and stored in said respective communication relay unit computer as a stored first instruction;

(3) said stored first instruction is retransmitted by said respective communication relay T/R unit as a second instruction;

(4) said second instruction is received by said remote station and stored in said remote station computer;

(5) said remote station computer generates at least one comparison signal which indicates any difference between said first instruction and said second instruction;

thereby to inform said technical expert whether said transmitted first instruction was properly received by said communication relay unit.

123. The medical treatment and testing apparatus defined in claim 121, wherein at least one of said communication relay units further comprises:

(a) a communication quality assessment device for assessing at least one of the expected and the actual quality of communications signals to be received by said respective communication relay T/R device from at least one of (i) said electronic medical device, (ii) said remote station, and (iii) said at least one other communication relay unit, and for producing a respective communication quality signal in dependence upon the respective assessed quality of the communication signals; and

(b) a mode selection device, coupled to each of said respective T/R device and said respective communication quality assessment device of said at least one communication relay unit, for selecting the mode of communication with at least one of (i) said electronic medical device, (ii) said remote station, and (iii) said at least one other communication relay unit, in response to receipt of said respective communication quality signal from said respective communication quality assessment device;

whereby

communication between said electronic medical device and said remote station may be improved.