System and method for patient monitoring using a reference baseline for use in automated patient care

• US 6,960,167 B2
• Filed: 08/13/2001
• Issued: 11/01/2005
• Est. Priority Date: 07/26/1999
• Status: Expired due to Fees

• Current Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Original Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Inventors: Bardy, Gust H.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Assistant Examiner(s): Oropeza, Frances P.
• Application Number:
  US09/929,243
• Publication Number:
  US 20020026104A1
• Time in Patent Office: 1,541 Days
• Field of Search: 600/300, 600/301, 600/509, 600/513
• US Class Current: 600/300
• 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 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing
• 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 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics

Abstract

A system and method for patient monitoring using a reference baseline for use in automated patient. One or more reference physiological measures relating to individual patient information recorded during an initial observation period are processed into a reference baseline. One or more updated physiological measures recorded subsequent to the initial observation period are periodically received. The updated physiological measures are compared to the reference physiological measures in the reference baseline to generate a patient status indicator identifying any such substantially non-conforming updated physiological measure.

Claims

1. A system for patient monitoring using a reference baseline for use in automated patient care, comprising:

a processing module processing one or more reference physiological measures relating to individual patient information recorded during an initial observation period by an implantable medical device into a reference baseline;

an analysis module periodically receiving one or more updated physiological measures regularly recorded by the implantable medical device subsequent to the initial observation period;

a database module storing the reference physiological measures and one or more reference quality of life measures recorded by the individual patient during the initial observation period into a patient care record for the individual patient, and storing the updated physiological measures and one or more updated quality of life measures recorded by the individual patient subsequent to the initial observation period into the patient care record;

a comparison module comparing the updated physiological measures to the reference physiological measures in the reference baseline to generate a patient status indicator identifying any such substantially non-conforming updated physiological measure; and

a quality of life comparison submodule comparing the updated quality of life measures to the reference quality of life measures in the patient care record to generate the patient status indicator identifying any such substantially non-conforming updated quality of life measure.

2. A system according to claim 1, further comprising:

a revision submodule analyzing the updated physiological measures relative to one or more further updated physiological measures to determine a revised patient status indicator.

3. A system according to claim 1, further comprising:

a feedback module providing automated feedback based on the patient status indicator to the individual patient.

4. A system according to claim 1, further comprising:

a feedback module comparing the updated measures to the reference measures in the patient care record to generate the patient status indicator identifying any such substantially non-conforming updated measures.

5. A system according to claim 1, further comprising:

a reevaluation submodule processing one or more reference physiological measures relating to individual patient information recorded subsequent to the initial observation period into a revised reference baseline.

6. A system according to claim 1, further comprising:

a monitoring submodule monitoring the individual patient while the individual patient is performing a prescribed set of timed physical stressors during the initial observation period.

7. A system according to claim 6, wherein the prescribed set of activities are representative of substantially normal activity, further comprising:

an activity submodule determining relative abnormal activity response based on any updated physiological measure identified as being substantially non-conforming to the corresponding reference physiological measure.

8. A system according to claim 6, wherein the prescribed set of activities are representative of substantially normal exercise, further comprising:

an activity submodule determining relative abnormal exercise response based on any updated physiological measure identified as being substantially non-conforming to the corresponding reference physiological measure.

9. A method for patient monitoring using a reference baseline for use in automated patient care, comprising:

processing one or more reference physiological measures relating to individual patient information recorded during an initial observation period by an implantable medical device into a reference baseline;

periodically receiving one or more updated physiological measures regularly recorded by the implantable medical device subsequent to the initial observation period;

storing the reference physiological measures and one or more reference quality of life measures recorded by the individual patient during the initial observation period into a patient care record for the individual patient;

storing the updated physiological measures and one or more updated quality of life measures recorded by the individual patient subsequent to the initial observation period into the patient care record;

comparing the updated physiological measures to the reference physiological measures in the reference baseline to generate a patient status indicator identifying any such substantially non-conforming updated physiological measure; and

comparing the updated quality of life measures to the reference quality of life measures in the patient care record to generate the patient status indicator identifying any such substantially non-conforming updated quality of life measure.

10. A method according to claim 9, further comprising:

analyzing the updated physiological measures relative to one or more further updated physiological measures to determine a revised patient status indicator.

11. A method according to claim 9, further comprising:

providing automated feedback based on the patient status indicator to the individual patient.

12. A method according to claim 9, further comprising:

comparing the updated measures to the reference measures in the patient care record to generate the patient status indicator identifying any such substantially non-conforming updated measures.

13. A method according to claim 9, further comprising:

processing one or more reference physiological measures relating to individual patient information recorded subsequent to the initial observation period into a revised reference baseline.

14. A method according to claim 9, further comprising:

monitoring the individual patient while the individual patient is performing a prescribed set of timed physical stressors during the initial observation period.

15. A method according to claim 14, wherein the prescribed set of activities are representative of substantially normal activity, further comprising:

determining relative abnormal activity response based on any updated physiological measure identified as being substantially non-conforming to the corresponding reference physiological measure.

16. A method according to claim 14, wherein the prescribed set of activities are representative of substantially normal exercise, further comprising:

determining relative abnormal exercise response based on any updated physiological measure identified as being substantially non-conforming to the corresponding reference physiological measure.

17. A computer-readable storage medium for a device holding code for performing the method according to claim 9, 10, 11, 12, 13, 14, 15, or 16.

18. A system for managing a reference baseline of patient information for use in automated patient care, comprising:

a processing module processing one or more reference physiological measures regularly recorded by an implantable medical device during an initial observation period, each reference physiological measure being representative of at least one of measured or derived data;

a database module periodically receiving one or more updated physiological measures recorded by the implantable medical device subsequent to the initial observation period, each updated physiological measure being representative of at least one of measured or derived data;

a database storing the reference physiological measures into a reference baseline in a patient care record, storing the updated physiological measures into individual measures sets in the patient care record, storing one or more reference quality of life measures recorded during the initial observation period into the patient care record, and storing one or more updated quality of life measures recorded subsequent to the initial observation period into the patient care record;

a comparison module comparing the updated physiological measures in each individual measures set to the reference physiological measures in the reference baseline and identifying any such updated physiological measure substantially non-conforming to the corresponding reference physiological measure as part of a patient status indicator; and

a quality of life comparison submodule comparing the updated quality of life measures to the reference quality of life measures in the patient care record and identifying any such updated quality of life measure substantially non-conforming to the corresponding reference quality of life measures as part of the patient status indicator.

19. A system according to claim 18, further comprising:

an analysis module analyzing the updated physiological measures in each individual measures set in the patient care record to the updated physiological measures in another individual measures set to determine a revised patient status indicator.

20. A system according to claim 18, further comprising:

a feedback database submodule storing reference measures recorded by the individual patient during the initial observation period as reference measures into the patient care record and storing updated measures recorded by the individual patient subsequent to the initial observation period into the patient care record; and

a feedback comparison submodule comparing the updated measures to the reference measures in the patient care record and identifying any such updated measures substantially non-conforming to the corresponding reference measures as part of the patient status indicator.

21. A system according to claim 18, further comprising:

a reevaluation submodule processing one or more revised reference physiological measures recorded subsequent to the initial observation period; and

the database storing the revised reference physiological measures into a revised reference baseline in the patient care record.

22. A method for managing a reference baseline of patient information for use in automated patient care, comprising:

processing one or more reference physiological measures regularly recorded by an implantable medical device during an initial observation period, each reference physiological measure being representative of at least one of measured or derived data;

storing the reference physiological measures into a reference baseline in a patient care record;

periodically receiving one or more updated physiological measures recorded by the implantable medical device subsequent to the initial observation period, each updated physiological measure being representative of at least one of measured or derived data;

storing the updated physiological measures into individual measures sets in the patient care record;

storing one or more reference quality of life measures recorded during the initial observation period into the patient care record for the individual patient;

storing one or more updated quality of life measures recorded subsequent to the initial observation period into the patient care record;

comparing the updated physiological measures in each individual measures set to the reference physiological measures in the reference baseline and identifying any such updated physiological measure substantially non-conforming to the corresponding reference physiological measure as part of a patient status indicator; and

comparing the updated quality of life measures to the reference quality of life measures in the patient care record and identifying any such updated quality of life measure substantially non-conforming to the corresponding reference quality of life measures as part of the patient status indicator.

23. A method according to claim 22, further comprising:

analyzing the updated physiological measures in each individual measures set in the patient care record to the updated physiological measures in another individual measures set to determine a revised patient status indicator.

24. A method according to claim 22, further comprising:

storing reference measures recorded by the individual patient during the initial observation period as reference measures into the patient care record;

storing updated measures recorded by the individual patient subsequent to the initial observation period into the patient care record; and

comparing the updated measures to the reference measures in the patient care record and identifying any such updated measures substantially non-conforming to the corresponding reference measures as part of the patient status indicator.

25. A method according to claim 22, further comprising:

processing one or more revised reference physiological measures recorded subsequent to the initial observation period; and

storing the revised reference physiological measures into a revised reference baseline in the patient care record.

26. A computer-readable storage medium for a device holding code for performing the method according to claim 22, 23, 24, or 25.