DECISION SUPPORT TOOL FOR USE WITH A MEDICAL MONITOR-DEFIBRILLATOR

• US 20140272860A1
• Filed: 03/15/2013
• Published: 09/18/2014
• Est. Priority Date: 07/02/2012
• Status: Active Grant

• Current Assignee: Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Physio-Control Incorporated (Stryker Corporation)
• Inventors: Peterson, Ken, Smith, Mitchell A., Merry, Randy L., Lewis, Dana S., Daynes, John C., Juhasz, Paul R., Edwards, Denny Craig, Barcelos, Nathaniel Paul, Wootten, James, Young, Clayton, Okey, David, Witters, Steven, Turner, Ira M.
• Granted Patent: US 10,303,852 B2
• Time in Patent Office: Days
• US Class Current: 434/262
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/33 specially adapted for cooperation with other devices
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• 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: A61N 1/3993 User interfaces for automatic external defibrillators
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Work flows are modeled as a graph of interdependent tasks to be performed. The tasks to be performed are set by a task file module configured to enable interactions between tasks and including modules for event viewing, protocol assistance, smart messaging, smart indices, reference material lookup. A decision support manager module is configured to construct data and model profiles for storage in a data and model profile bank, events for storage in a decision support events bank, and protocols for storage in a decision support protocol bank. Configuration files are provided to specify a configuration for execution of one of the tasks. Data entered through a user interface or from a network via a wireless or wired communication module may define task files in the task files module, configuration files in the configuration files module, as well as data, events, and protocols to be used for a defibrillation procedure. A decision support manager module is configured to construct a dependency graph of tasks as specified in at least one of the configuration files and to execute the dependency graph.

Claims

1. For use in a, medical device for providing decision support to a caregiver:

a decision support module comprising;

a task file module configured to define a workflow of one or more interdependent tasks to be performed and to define and enable interactions between the tasks;

a configuration file module configured to specify a configuration for execution of the one or more interdependent tasks;

a bank configured for storing data, one or more model profiles, events, and/or protocols for the task file;

a decision support manager module configured to construct a dependency graph of the work flow of interdependent tasks defined by the task file module using task configurations for each task provided by the configuration files module and

a dashboard generator configured to provide an visual, audio, or audio-visual display of the dependency graphs of the dependency graph constructed by the decision support manager module.

2. The decision support module of claim 1 wherein the medical device is a defibrillator.

3. The decision support module of claim 2 wherein the task file further comprises:

an event viewer module;

a protocol assistant module;

a smart messaging module,

a smart indices module, and/or

a reference material lookup module.

4. The decision support module of claim 3 wherein the event viewer module generates a series of time stamped events for tracking what has happened with the patient.

5. The decision support module of claim 3:

wherein the dashboard generator module generates a Sparkline non-indexed view of a major vital sign as it varies over time; and

wherein the event viewer module provides an event marker at a point in time along the non-indexed view of the major vital sign, the event marker providing a record of one or more predetermined events associated with the major sign at that point in time.

6. The decision support module of claim 5 wherein the one or more predetermined events provided in the record of the event marker is taken from the group of predetermined events consisting of an indexed view of the vital sign, a view of the vital sign over a specific period of time, a specific event, details of a specific event, a time stamped event, a listing of time stamped events, a view of one or more different vital signs at that point in time, and a combination of one or more predetermined events thereof.

7. The decision support module of claim 5 wherein the record of the event marker is configurable by the user with one or more new events.

8. The decision support module of claim 7 further comprising a user defined hierarchy of manually programmable events, the hierarchy of manually programmable events providing the one or more new events selectable by the user for configuring the record of the event marker.

9. The decision support module of claim 5 wherein the record of the event marker is provided with a link back to the event marker, the back link enabling the user to return to the vital sign as it varies over time.

10. The decision support module of claim 5 wherein the major vital sign is taken from the group consisting of heart beat, SpO2, CO2, temperature, an oxygen saturation in the blood of a patient;

a chest compression of a patient;

an image of the internal structure of a patient;

an oxygen saturation in the blood in the brain of a patient;

the acidity or alkalinity of fluids in a patient;

or other patient parameter.

11. The decision support module of claim 2:

wherein the event viewer module associates an event marker to an event, the event marker providing a record of one or more predetermined events associated with the event.

12. The decision support module of claim 3 wherein the event viewer module generates a series of time stamped events for tracking what has happened with the patient.

13. The decision support module of claim 12 wherein the series of time stamped events is contained in the record.

14. The decision support module of claim 3 wherein the protocol assist module generates a pre-defined protocol of one or more activities.

15. The decision support module of claim 2 where the dashboard generator generates a display of each activity of the one or more activities and one or more of each activity is checked off by a user when the one or more of each activity is completed.

16. The decision support module of claim 14 wherein the protocol assist module generates a time stamp for the each activity of the protocol when completed.

17. The decision support module of claim 14 wherein one or more of the pre-defined activities is associated with an event that is automatically generated at the time the activity of the protocol is completed.

18. The decision support module of claim 14 wherein the one or more activities of the protocol are displayed in a primary work area of a display, and wherein information that is displayed in the primary work area of the display at the time the protocol appears on the display is moved to the background.

19. The decision support module of claim 14 wherein the one or more activities of the protocol are displayed in a primary work area of a display unless information that is displayed in the primary work area of the display at the time the protocol is to be displayed is clinically critical information.

20. The decision support module of claim 14 wherein the protocol assistant module is configured to access a Sparkline non-indexed view of a major vital sign as it varies over time and to access an event marker at a point in time along the non-indexed view of the major vital sign generated by the event viewer module and to access a record of one or more predetermined events associated with the major sign at that point in time provided by the event marker.

21. The decision support module of claim 14 wherein the protocol assistant module is selected appears automatically on a display when certain events occur.

22. The decision support module of claim 14 wherein the protocol assistant module is selected manually using a protocol key.

23. The decision support module of claim 14 further comprising a user defined hierarchy of manually programmable protocols, the hierarchy of manually programmable protocols providing one or more protocols selectable by the user for configuring the protocol generated by the decision support module.

24. The decision support module of claim 14 further comprising a system defined hierarchy of manually programmable protocols, the hierarchy of manually programmable protocols providing one or more protocols selectable by the user for configuring the protocol generated by the decision support module.

25. The decision support module of claim 3 wherein the smart messaging module generates a set of one or more predefined messages to inform the user of an action.

26. The decision support module of claim 25 wherein the action informed by the user message is taken from the group of action consisting of a reminder, a reminder to take a medication, and a suggestion to contact one or more persons.

27. The decision support module of claim 25 wherein the predefined message appears as a pop-up on a display.

28. The decision support module of claim 27 wherein the pop-up message is displayed in a general work area of a display.

29. The decision support module of claim 28 wherein the general work area is a bottom waveform region.

30. The decision support module of claim 25 wherein a user may acknowledge or cancel the message and wherein a record is made of the acknowledgement or cancellation.

31. The decision support module of claim 30 wherein the acknowledgements is associated with an event that is automatically generated at the time of the acknowledgement.

32. The decision support module of claim 25 wherein an input to the predefined message includes an initiating event or a time based Boolean Equation using a combination of vital sign data and events.

33. The decision support module of claim 25 wherein the output of a predefined message is a no output or an output tied to a standard set of events or an output based on a user predefined hierarchy of manually enterable events.

34. The decision support module of claim 3 further comprising a smart indices module configured to generate a predefined indice value associated with the overall patient condition.

35. The decision support module of claim 34 wherein the predefined indice is determined by a predefined indices algorithm.

36. The decision support module of claim 34 wherein the indice value appears as a vital sign information on a display.

37. The decision support module of claim 34 wherein once selected the indice value will appear throughout a patient episode.

38. The decision support module of claim 34 wherein the indice value can be programmed to appear at the beginning of each patient episode, manually selectable via a indices menu, or automatically displayed by initiating an event.

39. The decision support module of claim 3 further comprising a reference material lookup module configured to display a user predefined set of text and graphical information in a predetermined content format.

40. The decision support module of claim 39 wherein the predetermined content format is taking from the group of formats consisting of .pdf, .doc, and html5.

41. The decision support module of claim 39 wherein the reference material is accessed manually via a user defined hierarchical menu of reference material.

42. The decision support module of claim 39 wherein the reference material is requested manually when reference material is associated with a protocol task of a smart message.

43. The decision support module of claim 39 wherein the preprogrammed information is displayed in a general work area of a display.

44. The decision support module of claim 41 wherein the general work area is in a bottom region of the display.

45. The decision support module of claim 42 wherein a user may enter a menu to scroll up and down the preprogrammed information and close the menu when finished.

46. A system for providing decision support to a caregiver comprising:

a medical device comprising a decision support module comprising;

a task file configured to enable one or more interdependent tasks;

a configuration file configured to specify a configuration for execution of the one or more interdependent tasks;

a data and model profile bank for storing data and/or one or more model profiles for the task file;

a decision support event bank for storing one or more events for the task file;

a decision support protocol bank for storing one or more priorities for the task file; and

a decision support manager module configured to construct a dependency of tasks as specified in at least one of the configuration files and to execute the dependency graph; and

an external utility in communication with the defibrillator for exchanging data between the defibrillator and the external utility for configuring the task file, configuring the configuration file, feeding data and model profile to the data and model profile bank, feeding decision support events to the decision support event bank, and/or feeding decision support protocols to the decision protocol bank.

47. The system of claim 46 wherein the medical device is a defibrillator.

48. The system of claim 47 wherein the defibrillator wherein the task file further comprises:

an event viewer module;

a protocol assistant module;

a smart messaging module,

a smart indices module, and/or

a reference material lookup module.

49. The decision support module of claim 47 wherein the dependency graph is communicated to the caregiver by a display of the dependency graph on a display of the defibrillator.

50. The decision support module of claim 47 wherein the dependency graph is communicated to the caregiver by a projection in audio format over a loud speaker of the defibrillator.

51. The system of claim 47 wherein the defibrillator comprises:

a user interface for entering data into the defibrillator for configuring the task file, configuring the configuration file, feeding data and model profile to the data and model profile bank, feeding decision support events to the decision support event bank, and/or feeding decision support protocols to the decision protocol bank.

52. The system of claim 47 wherein the external utility is taken from the group consisting of a medical monitor, a commercial tablet, a personal computer, or a smartphone.

53. A method of providing decision support to a caregiver comprising:

selecting one or more tasks to be performed for a medical procedure;

selecting a configuration for execution of the selected tasks;

providing a data and/or model profile feed for use in performing the tasks;

providing a decision support events feed for performing the tasks;

providing a decision support protocol feed to define one or more protocol for the one or more tasks; and

constructing a dependency graph of tasks based upon the selected tasks for coaching the caregiver.

54. The method of claim 53 wherein the medical procedure is a defibrillation of a patient.

55. The method of claim 53 further comprising:

communicating the dependency graph to the caregiver for display of the dependency graph on a display.