SYSTEM AND METHOD FOR AUTOMATIC CAPTURE AND ARCHIVE OF CLINICALLY MEANINGFUL VITALS

• US 20110316704A1
• Filed: 01/12/2010
• Published: 12/29/2011
• Est. Priority Date: 02/17/2009
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Nielsen, Larry, Raber, Gregory H., Gross, Brian D., Saeed, Mohammed, Zong, Wei
• Granted Patent: US 8,878,677 B2
• Time in Patent Office: Days
• US Class Current: 340/573.1
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02116 of pulse wave amplitude A61B5/02225 takes precedence
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Medical vital signs (110) are captured, recorded, processed, and a signal quality assessment (160) is computed based on signal waveform components such as slope, amplitude, time to rise, time at peak, and degree to which signal peaks (420) and valleys (430). The signal assessment (160) may be used as a basis for rating the quality (130) of the underlying vital signal, to increase the quality of the signal by removing noisy segments and physiologically impossible peaks (424) and valleys (434), to detect a parameter value (120), to label a waveform (140), or to prompt an alarm (550) to indicate the signal has reached a critical level and issue a warning to the user of the vital data. The signal and the assessment are stored in an indexed, searchable data storage memory (590) from which the signals may be retrieved and displayed (300).

Claims

1. A signal quality assessment and control system for capturing and archiving monitored physiological data, the system comprising:

a parameter value detection processing unit which receives physiological parameter signals and generates physiologically meaningful and reliable parameter data;

a signal quality assessment processing unit which receives the physiological signals, accesses quality of the physiological signals, and generates signal quality indices indicative of the assessed quality of the physiological signals; and

a waveform labeling unit which associates the signal quality indices with the physiological data.

2. The systems according to claim 1, wherein the signal quality assessment processing unit includes:

a waveform feature extraction unit which extracts episodes from the parameter signals.

3. The system according to claim 2, wherein the signal quality assessment processing unit includes:

a waveform feature analysis unit, which compares each episode with preselected characteristics.

4. The system according to claim 3, wherein the waveform feature analysis unit determines whether each episode meets preselected criteria and further including at least one of:

a memory which stores the physiological parameter data of the episodes which meet the preselected criteria; and

a display which displays the physiological parameter data of the episodes which meet the preselected criteria.

5. The system according to claim 3 wherein the waveform feature analysis unit determines a signal quality index (SQI) and further including at least one of:

a display which concurrently displays the physiological parameter data of each episode and its signal quality index;

a memory which stores the physiological parameters data of each episode in association with its signal quality index; and

a tolerance which allows capturing data at a desired rate.

6. The system according to claim 3, wherein the preselected characteristics include signal amplitude and rate of signal amplitude change.

7. The system according to claim 3, wherein the physiological parameter signals include an EKG signal and each episode corresponding to a heartbeat.

8. A patient monitoring station comprising:

a plurality of the signal quality and assessment systems according to claim 1;

an information control processor which receives the physiological parameter data and the signal quality signals from the systems and as least one of archives in a memory or displays on a display physiological parameter and signal quality information, or triggers an alarm.

9. The system according to claim 8, wherein the information control processor contains a data-capture control (DCC) which determines if the SQI value is good and if the SQI value is good, then the DCC stores the vital value at that point in time, else the DCC stores the most recent vital to represent that point in time.

10. The system according to claim 9, wherein the information control processor leaves the SQI value as bad and vital value as questionable when there are no good SQI values for an established period of time.

11. The system according to claim 8, wherein the information control processor (ICP) contains at least one of:

a system-level alarm manager which generates an alarm based on at least one of alarm defined criteria and on alarm criteria based on the cross correlation between different vital signs;

a clinical decision support (CDS) engine/clinical advisory which includes at least one of a clinical alert and advisory about the patient'"'"'s state is generated from vital sign values received from the DCC; and

an event-evidence review which controls at least one of captured vital sign values, SQI values, trends, and corresponding SQI labeled waveforms displayed using arbitrary scales.

12. A signal quality assessment and control method for capturing and archiving monitored physiological data, the method comprising:

generating physiologically meaningful and reliable parameter data from received physiological parameter signals;

assessing a quality of the physiological parameter signals and generating signal quality indices indicative of the assessed quality of the physiological parameter signal; and

associating each signal quality index with corresponding physiological parameter data.

13. The method according to claim 12, further including extracting episodes from the parameter signals.

14. The method according to claim 13, further including comparing each episode with preselected characteristics.

15. The method according to claim 14, further including:

determining whether each episode meets preselected criteria;

storing the physiological parameter data of the episodes which meet the preselected criteria; and

displaying the physiological parameter data of the episodes which meet the preselected criteria.

16. The method according to claim 14, wherein the preselected characteristics include a signal amplitude and a rate of signal change.

17. The method according to claim 14, wherein the physiological parameter signals include a blood pressure signal and each episode corresponds to an interval between blood pressure measurements.

18. The method according to claim 14, further including:

assessing a quality of physiological parameter signals corresponding to a plurality of physiological parameters of a patient; and

displaying the physiological parameter signals and the corresponding signal quality index for each of the physiological parameter signals on a common display.

19. The method according to claim 14, further including:

generating an alarm based on a defined alarm criteria based on a cross-correlation between the physiological parameter signals.

20. The method according to claim 14, further including:

reducing hardware computer memory storage resources to save and store the physiologically meaningful parameter data through removal of meaningless or unreliable data.