SYSTEM AND METHOD FOR PATIENT MONITORING

• US 20120179067A1
• Filed: 01/10/2011
• Published: 07/12/2012
• Est. Priority Date: 01/10/2011
• Status: Active Grant

• Current Assignee: Bodiguide Inc.
• Original Assignee: Bioguidance, LLC
• Inventors: Wekell, William Oren
• Granted Patent: US 8,827,930 B2
• Time in Patent Office: Days
• US Class Current: 600/587
• 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 5/0004 characterised by the type of physiological signal transmitted
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/107 Measuring physical dimensions, e.g. size of the entire body or parts thereof
• CPC Class Codes: A61B 5/1072 measuring distances on the body, e.g. measuring length, height or thickness A61B5/1076 takes precedence
• CPC Class Codes: A61B 5/1073 Measuring volume, e.g. of limbs
• CPC Class Codes: A61B 5/1075 for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer A61B8/0858 takes precedence
• CPC Class Codes: A61B 5/1077 Measuring of profiles
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61B 5/4878 Evaluating oedema
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/6828 Leg
• CPC Class Codes: A61B 5/6831 Straps, bands or harnesses
• CPC Class Codes: A61B 5/7275 : Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 5/7282 : Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/747 : in case of emergency, i.e. alerting emergency services
• CPC Class Codes: A61B 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick

Abstract

Systems and methods of monitoring a patient. Exemplary methods include receiving sensor data associated with the patient from a plurality of sensors of a patient monitoring device and determining whether the sensor data satisfies one or more trigger conditions. For each of the trigger conditions satisfied, one or more messages are sent to at least one of the patient monitoring device and an external computing device for display thereby to at least one of the patient, a caregiver, and a support person. Satisfaction of one or more of the trigger conditions may indicate the patient has edema and/or is trending toward decompensation. The sensor data may have been collected from a heart rate sensor, an oximeter, an accelerometer, and/or a sensor configured to detect a distance around a limb of a patient. In some embodiments, the trigger conditions are provided by the patient, caregiver, and/or support person.

Claims

1. A system for use with an external device and a patient monitoring device worn on a limb of a patient, at least one of the external device and the patient monitoring device comprising a display device, the external device and the patient monitoring device each being connected to the system by at least one network, the patient monitoring device being operable to collect at least one measurement of a distance around the patient'"'"'s limb and transmit the at least one measurement of the distance around the patient'"'"'s limb to the system via the at least one network, the system comprising:

one or more processors;

one or more storage devices connected to the one or more processors, each of the one or more storage devices storing at least one of data and instructions, the data comprising a threshold amount and a first model of the patient'"'"'s limb comprising a first circumference measurement associated with a selected location along the patient'"'"'s limb, the instructions being executable by the one or more processors and when executed thereby implementing a method comprising;

comparing the at least one measurement of the distance around the patient'"'"'s limb with the first model of the patient'"'"'s limb,

determining whether the distance around the patient'"'"'s limb has increased based on the comparison,

if the one or more processors determine the distance around the patient'"'"'s limb has increased, the method further comprising;

determining a second circumference measurement associated with the selected location along the patient'"'"'s limb based on the at least one measurement of the distance around the patient'"'"'s limb,

determining whether the second circumference measurement is greater than the first circumference measurement by more than the threshold amount, and

sending a first message over the at least one network to at least one of the external device and the patient monitoring device for display thereby on the display device when the one or more processors determine the second circumference measurement is greater than the first circumference measurement by more than the threshold amount.

2. The system of claim 1, wherein the method further comprises:

determining more than a threshold amount of time has elapsed since the system received the at least one measurement of the distance around the patient'"'"'s limb; and

sending a second message over the at least one network to at least one of the external device and the patient monitoring device for display thereby on the display device when the one or more processors determine more than a threshold amount of time has elapsed since the system received the at least one measurement of the distance around the patient'"'"'s limb, the second message indicating the system is not receiving measurements from the patient monitoring device.

3. The system of claim 1, for use with the patient monitoring device being operable to execute instructions received from the one or more processors, wherein the method further comprises:

instructing the patient monitoring device to collect the at least one measurement of the distance around the patient'"'"'s limb and transmit the at least one measurement of the distance around the patient'"'"'s limb to the system.

4. The system of claim 1, for use with the patient monitoring device being operable to collect an alignment measurement, and transmit the alignment measurement to the system via the at least one network, wherein the data further comprises an expected alignment value, and the method further comprises:

comparing the alignment measurement to the expected alignment value;

determining the patient monitoring device was not properly positioned on the patient'"'"'s limb when the alignment measurement differs from the expected alignment value by more than a predetermined amount; and

sending a second message over the at least one network to at least one of the external device and the patient monitoring device for display thereby on the display device when the one or more processors determine the patient monitoring device was not properly positioned on the patient'"'"'s limb.

5. The system of claim 1, for use with the patient monitoring device being operable to collect a first distance measurement of a first distance around the patient'"'"'s limb and a second distance measurement of a second distance around the patient'"'"'s limb, wherein the data further comprises a differential threshold, and the method further comprises:

determining a differential value by subtracting one of the first and second distance measurements from the other,

determining whether the differential value is greater than the differential threshold; and

if the one or more processors determine the differential value is greater than the differential threshold, sending a second message over the at least one network to at least one of the external device and the patient monitoring device for display thereby on the display device, the second message comprising at least one of an indication indicating the patient monitoring device is improperly positioned on the patient'"'"'s limb and a request requesting repositioning of the patient monitoring device on the patient'"'"'s limb.

6. The system of claim 1, for use with the patient monitoring device being operable to collect a first distance measurement of a first distance around the patient'"'"'s limb and a second distance measurement of a second distance around the patient'"'"'s limb, the second distance measurement having been collected at a predetermined distance from the first distance measurement along the patient'"'"'s limb, the patient monitoring device being further operable to transmit orientation information to the system via the at least one network, the orientation information identifying the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device, wherein the first model comprises a first minimum circumference, and the method further comprises:

determining a differential value by subtracting the first distance measurement from the second distance measurement;

determining the orientation of the patient monitoring device based on the orientation information;

identifying first and second measurement positions on the patient'"'"'s limb relative to the first minimum circumference whereat the first and second distance measurements, respectively, were collected by the patient monitoring device, the first and second measurement positions being identified based on the differential value and the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device;

determining a first model distance around the patient'"'"'s limb at a first position in the first model corresponding to the first measurement position on the patient'"'"'s limb,

wherein comparing the at least one measurement of the distance around the patient'"'"'s limb with the first model of the patient'"'"'s limb comprises comparing the first distance measurement with the first model distance, and determining whether the distance around the patient'"'"'s limb has increased based on the comparison comprises determining the distance around the patient'"'"'s limb has increased when the first distance measurement is greater than the first model distance.

7. The system of claim 6, wherein the first model has a first portion extending away from the first minimum circumference in a first direction and a second portion extending away from the first minimum circumference in a direction opposite the first direction, and identifying the measurement position based on the differential value and the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device comprises:

identifying in which of the first and second portions of the first model the first and second measurement positions are located based on whether the first distance measurement is larger than the second distance measurement, and the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device; and

identifying the first position and a second position in the identified portion of the first model, the first position being spaced apart from the second position by the predetermined distance along the patient'"'"'s limb, the first model identifying the first model distance at the first position and a second model distance at the second position, a differential value calculated by subtracting the first model distance from the second model distance being substantially identical to the differential value of the first and second distance measurements.

8. The system of claim 1, wherein the first model comprises a minimum circumference, and the first circumference measurement associated with the selected location along the patient'"'"'s limb is the minimum circumference of the first model.

9. The system of claim 8, wherein determining the second circumference measurement based on the at least one measurement of the distance around the patient'"'"'s limb comprises:

creating a second model of the patient'"'"'s limb based on the first model, the second model comprising a minimum circumference, the second circumference measurement being the minimum circumference of the second model.

10. The system of claim 9, wherein the first model comprises a first contoured line identifying a distance around the patient'"'"'s limb for each position along a portion of the patient'"'"'s limb, and

the second model comprises a second contoured line substantially identical to the first contoured line but shifted relative to the first contoured line by a difference between the second circumference measurement and the first circumference measurement.

11. The system of claim 10, wherein the first and second contoured lines each have a parabolic shape.

12. The system of claim 1, wherein the method further comprises:

receiving the threshold amount and patient instructions associated with the threshold amount from the external device over the at least one network; and

sending the patient instructions with the first message over the at least one network to the at least one of the external device and the patient monitoring device for display thereby on the display device when the one or more processors determine the second circumference measurement is greater than the first circumference measurement by more than the threshold amount.

13. The system of claim 1, wherein the method further comprises:

constructing the first model of the patient'"'"'s limb from a plurality of measurements of the distance around the patient'"'"'s limb collected at a plurality of locations along the patient'"'"'s limb.

14. The system of claim 1, wherein the first model comprises a parabola and the method further comprises performing a curve fitting operation on a plurality of measurements of the distance around the patient'"'"'s limb collected at a plurality of locations along the patient'"'"'s limb to generate the first model.

15. The system of claim 1, for use with the patient monitoring device being operable to collect a patient activity log, and transmit the patient activity log to the system via the at least one network, wherein the data further comprises an activity threshold, and the method further comprises:

determining an amount of activity based on the patient activity log;

determining whether the amount of activity is below the activity threshold; and

sending a second message over the at least one network to at least one of the external device and the patient monitoring device for display thereby on the display device when the one or more processors determine the amount of activity is below the activity threshold.

16. A system for use with an external device and a patient monitoring device worn on a limb of a patient, at least one of the external device and the patient monitoring device comprising a display device, the patient monitoring device being operable to collect at least one measurement of a distance around the patient'"'"'s limb and transmit the at least one measurement via at least one network, the system comprising:

a web server configured to generate a website displayable on the display device of at least one of the external device and the patient monitoring device, the website comprising at least one page configured to receive reference information from the at least one of the external device and the patient monitoring device, the reference information comprising a swelling threshold value; and

a computing device storing a plurality of previously received measurements of the distance around the patient'"'"'s limb, the computing device being connected to the web server and configured to;

receive the reference information from the web server,

receive the at least one measurement of the distance around the patient'"'"'s limb from the patient monitoring device over the at least one network,

determine whether the patient'"'"'s limb has swelled by more than the swelling threshold value based on the plurality of previously received measurements of the distance around the patient'"'"'s limb and the at least one measurement of the distance around the patient'"'"'s limb received from the patient monitoring device, and

instruct the web server to display a message on the website indicating the patient'"'"'s limb has swelled by more than the swelling threshold value when the computing device determines the patient'"'"'s limb has swelled by more than the swelling threshold value.

17. The system of claim 16, wherein the message comprises instructions to be executed by the patient.

18. The system of claim 17, wherein the instructions comprise a predefined treatment plan.

19. The system of claim 18, wherein the predefined treatment plan comprises an instruction to modify a dosage of at least one medication.

20. A system for use with an external device and a patient monitoring device worn on a limb of a patient, at least one of the external device and the patient monitoring device comprising a display device, the patient monitoring device being operable to occasionally collect a measurement of an amount of patient physical activity and transmit the measurements collected via at least one network, the system comprising:

a web server configured to generate a website displayable on the display device of at least one of the external device and the patient monitoring device, the website comprising at least one page configured to receive reference information from the at least one of the external device and the patient monitoring device, the reference information comprising criteria identifying when a patient'"'"'s level of physical activity is declining; and

a computing device connected to the web server and configured to;

receive the reference information from the web server,

receive the measurements of the amount of patient physical activity from the patient monitoring device over the at least one network,

determine whether the measurements of the amount of patient physical activity indicate the patient'"'"'s level of physical activity is declining based on the criteria identifying when a patient'"'"'s level of physical activity is declining; and

instruct the web server to display a message on the website indicating the patient'"'"'s level of physical activity is declining when the computing device determines the measurements of the amount of patient physical activity indicate the patient'"'"'s level of physical activity is declining.

21. The system of claim 20, wherein the message comprises instructions to be executed by the patient.

22. The system of claim 21, wherein the instructions comprise a predefined treatment plan.

23. The system of claim 22, wherein the predefined treatment plan comprises an instruction to modify a dosage of at least one medication.

24. The system of claim 20 for use with the patient monitoring device being operable to collect a heart rate of the patient, and transmit the heart rate via the at least one network, wherein the instructions of the message instruct the patient to perform a predetermined physical activity, and

the computing device is further configured to receive the heart rate of the patient from the patient monitoring device as the patient performs the predetermined physical activity.

25. The system of claim 20 for use with the patient monitoring device being operable to collect a measurement of an amount of oxygen in the patient'"'"'s blood, and transmit the measurement of the amount of oxygen via the at least one network, wherein the instructions of the message instruct the patient to perform a predetermined physical activity, and

the computing device is further configured to receive the measurement of the amount of oxygen from the patient monitoring device as the patient performs the predetermined physical activity.

26. A method of managing heart failure comprising:

(i) receiving sensor data associated with a patient from a plurality of sensors of a patient monitoring device;

(ii) determining whether the sensor data satisfies one or more trigger conditions; and

(iii) for each of the one or more trigger conditions determined to be satisfied, sending a message to at least one of the patient monitoring device and an external computing device displayable thereby to at least one of the patient, a caregiver, and a support person.

27. The method of claim 26, wherein satisfaction of at least a first trigger condition of the one or more trigger conditions indicates the patient has edema.

28. The method of claim 26, wherein satisfaction of at least a first trigger condition of the one or more trigger conditions indicates the patient is trending toward decompensation.

29. The method of claim 26, wherein the sensor data comprises data collected from at least one of a heart rate sensor, an oximeter, an accelerometer, and a sensor configured to detect a distance around a limb of the patient.

30. A method for use with a threshold amount and a first model of the patient'"'"'s limb comprising a first circumference measurement associated with a selected location along the patient'"'"'s limb, the method comprising:

obtaining at least one measurement of the distance around the patient'"'"'s limb;

comparing the at least one measurement of the distance around the patient'"'"'s limb with the first model of the patient'"'"'s limb; and

determining whether the distance around the patient'"'"'s limb has increased based on the comparison, if it is determined the distance around the patient'"'"'s limb has increased, the method further comprising;

determining a second circumference measurement associated with the selected location along the patient'"'"'s limb based on the at least one measurement of the distance around the patient'"'"'s limb,

determining whether the second circumference measurement is greater than the first circumference measurement by more than the threshold amount, and

sending a first message to at least one of the patient, a caregiver, and a support person when the second circumference measurement is greater than the first circumference measurement by more than the threshold amount.

31. The method of claim 30, further comprising:

instructing a patient monitoring device to collect and transmit the at least one measurement of the distance around the patient'"'"'s limb, wherein obtaining the at least one measurement of the distance around the patient'"'"'s limb comprises receiving the at least one measurement of the distance around the patient'"'"'s limb transmitted by the patient monitoring device.

32. The method of claim 31, further comprising:

obtaining an alignment measurement from the patient monitoring device;

comparing the alignment measurement to an expected alignment value;

determining the patient monitoring device was not properly positioned on the patient'"'"'s limb when the alignment measurement differs from the expected alignment value by more than a predetermined amount; and

sending a second message to at least one of the patient, the caregiver, and the support person when it is determined the patient monitoring device was not properly positioned on the patient'"'"'s limb.

33. The method of claim 30, wherein obtaining the at least one measurement of the distance around the patient'"'"'s limb comprises receiving the at least one measurement of the distance around the patient'"'"'s limb from a patient monitoring device,

the at least one measurement of the distance around the patient'"'"'s limb comprises a first distance measurement of a first distance around the patient'"'"'s limb and a second distance measurement of a second distance around the patient'"'"'s limb, and

the method further comprises:

determining a differential value by subtracting one of the first and second distance measurements from the other,

determining whether the differential value is greater than a differential threshold, and

if the differential value is greater than the differential threshold, sending a second message to at least one of the patient, the caregiver, and the support person, the second message comprising at least one of an indication indicating the patient monitoring device is improperly positioned on the patient'"'"'s limb and a request requesting repositioning of the patient monitoring device on the patient'"'"'s limb.

34. The method of claim 30, wherein the first model comprises a first minimum circumference,

obtaining the at least one measurement of the distance around the patient'"'"'s limb comprises receiving the at least one measurement of the distance around the patient'"'"'s limb from a patient monitoring device,

the at least one measurement of the distance around the patient'"'"'s limb comprises a first distance measurement of a first distance around the patient'"'"'s limb and a second distance measurement of a second distance around the patient'"'"'s limb, the second distance measurement having been collected at a predetermined distance from the first distance measurement along the patient'"'"'s limb, and

the method further comprises:

receiving orientation information from the patient monitoring device identifying the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device,

determining a differential value by subtracting the first distance measurement from the second distance measurement;

determining the orientation of the patient monitoring device based on the orientation information;

identifying first and second measurement positions on the patient'"'"'s limb relative to the first minimum circumference whereat the first and second distance measurements, respectively, were collected by the patient monitoring device, the first and second measurement positions being identified based on the differential value and the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device; and

determining a first model distance around the patient'"'"'s limb at a first position in the first model corresponding to the first measurement position on the patient'"'"'s limb,

wherein comparing the at least one measurement of the distance around the patient'"'"'s limb with the first model of the patient'"'"'s limb comprises comparing the first distance measurement with the first model distance, and determining whether the distance around the patient'"'"'s limb has increased based on the comparison comprises determining the distance around the patient'"'"'s limb has increased when the first distance measurement is greater than the first model distance.

35. The method of claim 34, wherein the first model has a first portion extending away from the first minimum circumference in a first direction and a second portion extending away from the first minimum circumference in a direction opposite the first direction, and identifying the measurement position based on the differential value and the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device comprises:

identifying in which of the first and second portions of the first model the first and second measurement positions are located based on whether the first distance measurement is larger than the second distance measurement, and the orientation of the patient monitoring device when the first and second distance measurements were collected by the patient monitoring device; and

identifying the first position and a second position in the identified portion of the first model, the first position being spaced apart from the second position by the predetermined distance along the patient'"'"'s limb, the first model identifying the first model distance at the first position and a second model distance at the second position, a differential value calculated by subtracting the first model distance from the second model distance being substantially identical to the differential value of the first and second distance measurements.

36. The method of claim 30 for use with the first model comprises a minimum circumference, wherein the first circumference measurement associated with the selected location along the patient'"'"'s limb is the minimum circumference of the first model, and

determining the second circumference measurement based on the at least one measurement of the distance around the patient'"'"'s limb comprises creating a second model of the patient'"'"'s limb based on the first model, the second model comprising a minimum circumference, the second circumference measurement being the minimum circumference of the second model.

37. The method of claim 36 for use with the first model comprising a first contoured line identifying a distance around the patient'"'"'s limb for each position along a portion of the patient'"'"'s limb, wherein the second model comprises a second contoured line substantially identical to the first contoured line but shifted relative to the first contoured line by a difference between the second circumference measurement and the first circumference measurement.

38. The method of claim 30, further comprising:

obtaining patient instructions associated with the threshold amount; and

sending the patient instructions with the first message to the at least one of the patient, the caregiver, and the support person when the second circumference measurement is greater than the first circumference measurement by more than the threshold amount.

39. The method of claim 30, further comprising:

obtaining a plurality of measurements of the distance around the patient'"'"'s limb collected at a plurality of locations along the patient'"'"'s limb; and

constructing the first model of the patient'"'"'s limb from the plurality of measurements of the distance around the patient'"'"'s limb.

40. The method of claim 39, wherein constructing the first model comprises performing a curve fitting operation on the plurality of measurements of the distance around the patient'"'"'s limb.

41. The method of claim 30, further comprising:

obtaining a patient activity log;

determining an amount of activity based on the patient activity log;

determining whether the amount of activity is below an activity threshold; and

sending a second message to at least one of the patient, the caregiver, and the support person when the amount of activity is below the activity threshold.

42. A method comprising:

obtaining a plurality of measurements of distances around a limb of a patient;

obtaining at least one new measurement of a distance around the limb of the patient;

displaying a user interface to at least one of the patient, a caregiver, and a support person;

receiving reference information provided to the user interface by the at least one of the patient, the caregiver, and the support person, the reference information comprising a swelling threshold value;

determining whether the patient'"'"'s limb has swelled by more than the swelling threshold value based on the plurality of measurements of distances around the patient'"'"'s limb and the at least one new measurement of the distance around the patient'"'"'s limb; and

when it is determined the patient'"'"'s limb has swelled by more than the swelling threshold value, displaying a message to at least one of the patient, the caregiver, and the support person indicating the patient'"'"'s limb has swelled by more than the swelling threshold value.

43. The method of claim 42, wherein the message comprises instructions to be executed by the patient.

44. The method of claim 43, wherein the instructions comprise a predefined treatment plan.

45. The method of claim 44, wherein the predefined treatment plan comprises an instruction to modify a dosage of at least one medication.

46. A method comprising:

obtaining a plurality of measurements of amounts of patient physical activity;

displaying a user interface to at least one of the patient, a caregiver, and a support person;

receiving reference information provided to the user interface by the at least one of the patient, the caregiver, and the support person, the reference information comprising criteria identifying when a patient'"'"'s level of physical activity is declining;

determining whether the measurements of the amounts of patient physical activity indicate the patient'"'"'s level of physical activity is declining based on the criteria identifying when a patient'"'"'s level of physical activity is declining; and

when it is determined the measurements of the amount of patient physical activity indicate the patient'"'"'s level of physical activity is declining, displaying a message to at least one of the patient, the caregiver, and the support person indicating the patient'"'"'s level of physical activity is declining.

47. The method of claim 46, wherein the message comprises instructions to be executed by the patient.

48. The method of claim 47, wherein the instructions comprise a predefined treatment plan.

49. The method of claim 48, wherein the predefined treatment plan comprises an instruction to modify a dosage of at least one medication.