Enhanced Diagnostics for a Telepresence Robot

• US 20140139616A1
• Filed: 12/16/2013
• Published: 05/22/2014
• Est. Priority Date: 01/27/2012
• Status: Abandoned Application

• Current Assignee: Teladoc Health, Inc.
• Original Assignee: Touch Technologies Incorporated
• Inventors: Pinter, Marco, Wright, Timothy C., Reynolds, H. Neal
• Application Number:
  US14/108,036
• Publication Number:
  US 20140139616A1
• Time in Patent Office: Days
• US Class Current: 348/14.08
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 5/0008 Temperature signals
• CPC Class Codes: A61B 5/0013 Medical image data A61B1/00011, A61B6/56, A61B8/56 take precedence
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0075 by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy A61B5/0071 takes precedence
• CPC Class Codes: A61B 5/0077 Devices for viewing the surface of the body, e.g. camera, magnifying lens
• CPC Class Codes: A61B 5/015 By temperature mapping of body part
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• 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 5/1128 using image analysis A61B5/1127 takes precedence
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4809 Sleep detection, i.e. determining whether a subject is asleep or not
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• 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 5/741 using synthesised speech
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: B25J 11/009 Nursing, e.g. carrying sick persons, pushing wheelchairs, distributing drugs
• CPC Class Codes: B25J 9/1689 : Teleoperation
• CPC Class Codes: G05D 1/0038 : by providing the operator with simple or augmented images from one or more cameras located onboard the vehicle, e.g. tele-operation images analyzed by a computer and used for automatic navigation G05D1/0246
• CPC Class Codes: G16H 10/60 : for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: H04N 7/148 : Interfacing a video terminal to a particular transmission medium, e.g. ISDN

Abstract

A telepresence device may autonomously check patients. The telepresence device may determine the frequency of checking based on whether the patient has a risk factor. The telepresence device may include an image sensor, a thermal camera, a depth sensor, one or more systems for interacting with patients, or the like. The telepresence device may be configured to evaluate the patient'"'"'s condition using the one or more sensors. The telepresence device may measure physiological characteristics using Eulerian video magnification, may detect pallor, fluid level, or fluid color, may detect thermal asymmetry, may determine a psychological state from body position or movement, or the like. The telepresence device may determine whether the patient is experiencing a potentially harmful condition, such as sepsis or stroke, and may trigger an alarm if so. To overcome alarm fatigue, the telepresence device may annoy a care provider until the care provider responds to an alarm.

Claims

1. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of autonomously checking a patient, the method comprising:

visiting the patient with a telepresence device;

accessing a medical record of the patient;

performing, using the telepresence device, one or more diagnostic activities to evaluate the patient, wherein the one or more diagnostic activities are selected based on the medical record;

determining whether a potentially harmful condition exists with the patient based on results from the one or more diagnostic activities; and

performing an action responsive to the potentially harmful condition if it is determined that the potentially harmful condition exists.

2. The non-transitory computer-readable storage medium of claim 1, wherein the one or more diagnostic activities include receiving telemetry data from a patient monitor.

3. The non-transitory computer-readable storage medium of claim 1, wherein the one or more diagnostic activities include measuring a physiological characteristic of the patient using an image sensor.

4. The non-transitory computer-readable storage medium of claim 3, wherein measuring the physiological characteristic comprises determining a temperature of the patient from a thermographic image.

5. The non-transitory computer-readable storage medium of claim 1, wherein visiting the patient comprises automatically visiting a plurality of patients in a predetermined order, wherein the predetermined order is determined based on a risk level of each patient, and wherein higher risk patients are visited more often than lower risk patients.

6. The non-transitory computer-readable storage medium of claim 1, wherein the one or more diagnostic activities are selected by a care provider.

7. The non-transitory computer-readable storage medium of claim 1, wherein performing the action responsive to the potentially harmful condition comprises performing an action selected from the group consisting of archiving the results from the one or more diagnostic activities, alerting a local care provider, and alerting a remote care provider.

8. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of diagnosing sepsis in a patient, the method comprising:

visiting the patient with a telepresence device;

performing, using the telepresence device, one or more diagnostic activities on the patient to detect sepsis;

evaluating results from the one or more diagnostic activities; and

alerting a care provider if the results indicate sepsis is present in the patient.

9. The non-transitory computer-readable storage medium of claim 8, wherein performing one or more diagnostic activities comprises detecting at least one of changes in temperature and changes in pulse across a plurality of visits.

10. The non-transitory computer-readable storage medium of claim 9, wherein evaluating the results comprises detecting at least one of an increase in temperature of more than two percent and an increase in pulse of more than 20%.

11. The non-transitory computer-readable storage medium of claim 8, wherein performing one or more diagnostic activities includes detecting temperature asymmetry from a thermographic image.

12. The non-transitory computer-readable storage medium of claim 8, wherein the method further comprises capturing video of respiration by the patient for viewing by the care provider.

13. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of diagnosing a stroke, the method comprising:

visiting a patient using a telepresence device;

performing, using the telepresence device, one or more diagnostic tests on the patient to detect a stroke;

determining, based on the diagnostic tests, whether the patient has suffered a stroke; and

alerting a care provider if the patient has suffered a stroke.

14. The non-transitory computer-readable storage medium of claim 13, wherein the one or more diagnostic tests include an interactive test requiring the patient to correctly perform an action.

15. The non-transitory computer-readable storage medium of claim 14, wherein the action is selected from the group consisting of maintaining a limb in an elevated position for a predetermined length of time and speaking in response to a prompt.

16. The non-transitory computer-readable storage medium of claim 13, wherein the one or more diagnostic tests include detecting at least one of face symmetry and facial expression using an image sensor.

17. The non-transitory computer-readable storage medium of claim 13, wherein determining whether the patient has suffered a stroke comprises determining the results of one or more tests on the National Institute of Health Stroke Scale.

18. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of non-tactilely measuring actigraphy, the method comprising:

measuring a position of a limb of a patient using a depth sensor on a telepresence device;

determining motion of the limb based on variations in position measurements over time; and

determining a psychological state of the patient based on the motion of the limb.

19. The non-transitory computer-readable storage medium of claim 18, wherein determining the psychological state includes determining whether the patient is in a state selected from the group consisting of asleep, distressed, and agitated.

20. The non-transitory computer-readable storage medium of claim 18, wherein determining the psychological state includes determining whether the patient is asleep, and wherein the method further comprises delaying an interactive diagnostic until the patient is awake.

21. The non-transitory computer-readable storage medium of claim 18, wherein the method further comprises receiving a request from a care provider for notification when the patient is awake, and alerting the care provider if the psychological state of the patient includes being awake.

22. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of autonomously checking a plurality of patients with a telepresence device, the method comprising:

receiving indications of the plurality of patients;

receiving medical data for at least one of the plurality of patients; and

determining a frequency of checking each of the plurality of patients with the telepresence device based on the received medical data.

23. The non-transitory computer-readable storage medium of claim 22, wherein the method further comprises detecting one or more risk factors in the received medical data, and wherein determining the frequency comprises determining the frequency based on the one or more risk factors.

24. The non-transitory computer-readable storage medium of claim 23, wherein detecting one or more risk factors comprises receiving an indication of a diagnosis requiring more frequent checking.

25. The non-transitory computer-readable storage medium of claim 22, wherein the medical data includes an indication of the frequency.

26. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of overcoming alarm fatigue in a care provider, the method comprising:

detecting that a patient is experiencing an alarm condition;

locating a care provider;

navigating a telepresence device to the care provider; and

alerting the care provider that the patient experiencing the alarm condition using the telepresence device.

27. The non-transitory computer-readable storage medium of claim 26, wherein detecting that the patient is experiencing the alarm condition comprises performing one or more diagnostic activities on the patient.

28. The non-transitory computer-readable storage medium of claim 26, wherein locating the care provider comprises locating the care provider using a vision system on the telepresence device.

29. The non-transitory computer-readable storage medium of claim 26, wherein alerting the care provider comprises performing at least one action selected from the group consisting of displaying a message on a display device, playing an alert sound, and playing an audio message comprising synthesized speech.

30. A non-transitory computer-readable storage medium including computer-readable instruction code for performing a method of autonomously checking a patient, the method comprising:

visiting the patient with a telepresence device;

if the patient is coupled to a patient monitor, attempting to acquire telemetry data from the patient monitor;

measuring a patient characteristic using an image sensor on the telepresence device;

determining whether a potentially harmful condition exists with the patient based on at least one of the telemetry data and the patient characteristic; and

performing an action responsive to the potentially harmful condition if it is determined that the potentially harmful condition exists.

31. The non-transitory computer-readable storage medium of claim 30, wherein the telemetry data corresponds to the patient characteristic.

32. The non-transitory computer-readable storage medium of claim 31, wherein measuring the patient characteristic comprises measuring the patient characteristic if the telemetry data is not acquired from the patient monitor.

33. The non-transitory computer-readable storage medium of claim 30, wherein attempting to acquire the telemetry data comprises attempting to perform optical character recognition on a display of the patient monitor.

34. The non-transitory computer-readable storage medium of claim 30, wherein attempting to acquire the telemetry data comprises requesting the telemetry data via a wireless network.

35. The non-transitory computer-readable storage medium of claim 34, wherein requesting the telemetry data comprises requesting the telemetry data from a system selected from the group consisting of the patient monitor and an electronic medical record system.

36. The non-transitory computer-readable storage medium of claim 30, wherein the telemetry data corresponds to a physiological characteristic distinct from the patient characteristic.

37. The non-transitory computer-readable storage medium of claim 36, wherein the patient characteristic includes at least one characteristic selected from the group consisting of pallor, fluid level, fluid color, and thermal symmetry.