Real time ambulatory patient monitor

• US 5,544,661 A
• Filed: 01/13/1994
• Issued: 08/13/1996
• Est. Priority Date: 01/13/1994
• Status: Expired due to Fees

• Current Assignee: Charles L. Davis
• Original Assignee: Charles L. Davis
• Inventors: Davis, Charles L., Long, Paul V.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Getzow, Scott M.
• Application Number:
  US08/180,867
• Time in Patent Office: 943 Days
• Field of Search: 128/903, 128/904, 128/905, 128/700, 128/696, 128/672, 128/674
• US Class Current: 600/513
• 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 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• 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 5/7465 Arrangements for interactive communication between patient and care services, e.g. by using a telephone network telemetry of measured physiological signal A61B5/0002
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• 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: Y10S 128/904 Telephone telemetry

Abstract

A patient monitoring system which includes a portable device and a central station. The portable device includes an ECG and a photo-plethysmograph connected to the patient; arrhythmia analysis apparatus; an expert system for determining if a pre-established critical parameter set has been exceeded; and a wireless wide area communication device for automatically contacting the central station via a public cellular phone network when the critical parameter set has been exceeded. When the central station is contacted, the patient'"'"'s ECG waveforms, measurements, and trends, are sent to the central monitoring station and a two way voice channel between the patient and the central station is automatically opened. The central station includes a computerized facility which has a station from which a clinician can observe the real time data being sent from the patient, the patients historical records and from which the clinician can talk to the patient and activate therapeutic devices attached to the patient such as an external defibrillator, a pacer or an automatic drug infusion device.

Claims

1. A device adapted to be worn by a patient for transmitting data to a central monitoring station, said device comprising:

measurement means for measuring physiological parameters of the patient and for generating data representative of the measured parameters,

analysis means for analyzing said data and for comparing the analyzed data to preset parameters and for generating an alarm signal when said data exceeds said preset parameters,

wireless communication means connecting said device to said central monitoring station,

means for initiating contact with said central monitoring station via said wireless communication means when said alarm signal is generated,

so that said central station is notified without intervention by said patient when said alarm signal is generated;

the device including said measurement, analysis, communications and contact initiating means being packaged in a modular unit sized to be worn externally on a patient'"'"'s arm and the unit including means for mounting the unit on the patient'"'"'s arm;

the measurement means including at least one external sensor affixable to a sensing location on the patient'"'"'s skin to detect at least one physiological parameter at a location spaced from the unit;

the wireless communication means including a speaker-microphone connected to the unit and adapted for mounting adjacent the patient'"'"'s head for bidirectional voice communications with the central monitoring station;

said voice communications being enabled by said means for initiating contact with said central monitoring station; and

the wireless communication means including means for multiplexed transmission and reception of both data and voice communications via a common channel.

2. The device recited in claim 1 wherein said measurement means includes an electrocardiogram.

3. The device recited in claim 1 wherein said measurement means includes a plethysmograph transducer.

4. The device recited in claim 1 wherein said measurement means includes an ECG and a plethysmograph transducer.

5. The device recited in claim 1 wherein said analysis means includes a digital signal processor.

6. The device recited in claim 1 wherein said wireless communication means comprises a cellular phone means.

7. The device recited in claim 6 wherein said cellular phone means includes means for simultaneously transmitting data and voice communication.

8. The device recited in claim 1 including means for controlling a therapeutic device which can be activated by a command received over said wireless wide area communication means.

9. A system for monitoring a patient including:

a central station and a portable monitoring unit,

said central station including stored patient history data and first communicating means for communicating via a wide area public network,

said portable monitoring unit being adapted to be attached to an arm of a patient and including;

a second communicating means for communicating via a wide area public network,

monitoring means for monitoring physiological parameters of said patient, means for storing preset parameter limits for said physiological parameters,

means for activating said second communicating means to automatically contact said first communicating means when the limits of said physiological parameters are reached and communicating the physiological parameters to the central station,

a microphone for the patient to input voice communications to the central monitoring station;

means for multiplexing data representative of the monitored physiological parameters and of voice communications input via the microphone for contemporaneous transmission to the central monitoring station;

a speaker for the patient to listen to voice transmissions from the central monitoring station; and

means for receiving and demultiplexing control or parameter data and voice communications from the central monitoring station for outputting the voice communications to the speaker.

10. A system according to claim 9 in which the first and second communicating means each include bidirectional cellular telephone receiving and transmitting apparatus and means for compressing and decompressing data representing the physiologic parameters and voice communications.

11. The system recited in claim 9 wherein said second communication means includes a cellular phone means.

12. A system for monitoring a patient including:

a central station and a portable monitoring unit,

said central station including stored patient history data and first communicating means for communicating via a wide area public network,

said portable monitoring unit being adapted to be attached to an arm of a patient and including;

a second communicating means for communicating via wide area public network,

monitoring means for monitoring physiological parameters of said patient, means for storing preset parameter limits for said physiological parameters,

means for activating said second communicating means to automatically contact said first communicating means when the limits of said physiological parameters are reached and communicating the physiological parameters to the central station,

the first and second communicating means each including bidirectional cellular telephone receiving and transmitting apparatus and means for compressing and decompressing data representing the physiologic parameters.