Therapy programming guidance based on stored programming history

• US 7,819,909 B2
• Filed: 03/23/2006
• Issued: 10/26/2010
• Est. Priority Date: 07/20/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Lee, Michael T.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US11/388,227
• Publication Number:
  US 20060235472A1
• Time in Patent Office: 1,678 Days
• Field of Search: 607/2
• US Class Current: 607/1
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37264 Changing the program; Upgrading firmware

Abstract

A programming device used to program delivery of therapy to a patient by a medical device, such as an implantable neurostimulator or pump, maintains or accesses a programming history for the patient. The programming history may take the form of a record of programs, e.g., combinations of therapy parameters, tested during one or more prior programming sessions. The programming device may analyze, or otherwise use the programming history to provide guidance information to a user, such as a clinician, which may assist the user in more quickly identifying one or more desirable programs during a current programming session.

Claims

1. A method comprising:

controlling an implantable medical device to deliver therapy to a patient according to each of a plurality of programs with a programming device during a programming session;

recording rating information for each of the plurality of programs during the programming session within the programming device;

receiving selection of a subset of the programs during the programming session;

storing the selected subset of the programs within the implantable medical device, wherein each of the programs within the selected subset of the programs is available to be selected by the patient to control delivery of therapy by the implantable medical device outside of the programming session;

for the selected subset of the programs, storing information identifying the programs and rating information associated with the programs in a programming history for the patient within the implantable medical device; and

storing within the implantable medical device information identifying the programs and rating information associated with the programs for each of the plurality of programs as a session log separate from the programming history, wherein the session log is associated with the programming session.

2. The method of claim 1, further comprising:

recording rating information during a subsequent programming session with the programming device;

updating the programming history stored in the implantable medical device to include the rating information.

3. The method of claim 1, wherein storing rating information associated with the programs in a programming history comprises storing a subset of the rating information associated with each of the programs in the programming history within the implantable medical device.

4. The method of claim 3, wherein storing a subset of the rating information comprises storing a therapeutic range for each of the programs, wherein the therapeutic range for a program is determined during the programming session, and based on an amplitude of first effect perception and an amplitude at which side effects are not tolerated.

5. The method of claim 3, wherein storing a subset of the rating information comprises storing information identifying amplitudes at which rating information changed for each of the programs.

6. The method of claim 1, further comprising:

recording physiological sensor information during delivery of therapy according to one of the selected subset of programs within the implantable medical device; and

storing the physiological sensor information in association with the one of the selected subset of programs in the programming history within the implantable medical device.

7. The method of claim 1, wherein controlling an implantable medical device to deliver therapy comprises controlling the implantable medical device to deliver one of spinal cord stimulation or deep brain stimulation.

8. The method of claim 1, further comprising:

retrieving the programming history from the implantable medical device during a subsequent programming session;

analyzing the retrieved programming history; and

providing guidance information to a user based on the analysis to guide the selection of therapy programs during the subsequent programming session.

9. The method of claim 8,

wherein each of the programs includes a respective electrode configuration with a plurality of electrodes selected from an electrode set for delivery of stimulation,

wherein analyzing the programming history comprises associating information from the programming history with at least one individual electrode from the electrode set, and

wherein providing guidance information comprises providing information relating to the individual electrode.

10. The method of claim 8, wherein providing guidance information comprises displaying a graphical representation of the programming history that includes efficacy and side effect information for a plurality of the programs.

11. The method of claim 8, wherein providing guidance information comprises displaying a graphical representation of the programming history that includes a therapeutic range for each of a plurality of the programs.

12. The method of claim 1, wherein the session log includes information identifying the programs and rating information associated with one or more programs tested during the programming session that are not part of the selected subset of the programs.

13. The method of claim 1, further comprising:

retrieving the programming history and the session log from the implantable medical device during a subsequent programming session;

providing guidance information to a user based on the programming history and the session log to guide the selection of therapy programs during the subsequent programming session.

14. The method of claim 1, wherein the programming session is a first programming session, the plurality of programs is a first set of programs, and the session log is a first session log, and wherein the method further comprises storing information identifying a second set of programs and rating information associated with the second set of programs within the implantable medical device as a second session log separate from the programming history, wherein the second session log is associated with the second programming session.

15. The method of claim 1, wherein the selected subset of the programs includes at least two different programs.

16. The method of claim 1, wherein the programming session is a part of a plurality of programming sessions, wherein the session log is part of a plurality of session logs, and wherein each session log is associated with a respective programming session.

17. A system comprising:

an implantable medical device that delivers a therapy to a patient; and

a programming device that controls the implantable medical device to deliver the therapy to the patient according to each of a plurality of programs during a programming session, records rating information for each of the plurality of programs during the programming session, receives selection of a subset of the programs, provides the selected subset of the programs to the implantable medical device, and provides information identifying the programs and rating information associated with the programs to the implantable medical device,

wherein the implantable medical device stores the selected subset of the programs provided by the programming device,

wherein each of the programs within the selected subset of the programs is available to be selected by the patient to control delivery of therapy by the implantable medical device outside of the programming session,

wherein, for the selected subset of the programs, the implantable medical device stores the information identifying the programs and rating information associated with the programs received from the programming device as a programming history for the patient, and

wherein the implantable medical device stores the information identifying the programs and rating information associated with the programs for each of the plurality of programs as a session log separate from the programming history, wherein the session log is associated with the programming session.

18. The system of claim 17,

wherein the programming device retrieves the programming history from the implantable medical device during a subsequent programming session, records rating information during the subsequent programming session, updates the programming history to include the rating information, and provides the updated programming history to the implantable medical device, and

wherein the implantable medical device stores the updated programming history.

19. The system of claim 17, wherein the programming device provides a subset of the recorded rating information associated with each of the programs to the implantable medical device, and the implantable medical device stores the subset of the rating information in the programming history.

20. The system of claim 19, wherein the subset of the rating information comprises a therapeutic range for each of the programs, wherein the therapeutic range for a program is determined during the programming session, and based on an amplitude of first effect perception and an amplitude at which side effects are not tolerated.

21. The system of claim 19, wherein the subset of the rating information comprises information identifying amplitudes at which rating information changed for each of the programs.

22. The system of claim 17, wherein the implantable medical device records physiological sensor information during delivery of therapy according to one of the selected subset of programs within the implantable medical device, and stores the sensor information in association with the one of the selected subset of programs in the programming history.

23. The system of claim 17, wherein the implantable medical device delivers one of spinal cord stimulation or deep brain stimulation.

24. The system of claim 17, wherein the programming device retrieves the programming history from the implantable medical device during a subsequent programming session, analyzes the retrieved programming history, and provides guidance information to a user based on the analysis to guide the selection of therapy programs during the subsequent programming session.

25. The system of claim 24,

wherein each of the programs includes a respective electrode configuration with a plurality of electrodes selected from an electrode set for delivery of stimulation, and

wherein the programming device associates information from the programming history with at least one individual electrode from the electrode set, and provides information relating to the individual electrode.

26. The system of claim 24, wherein the programming device displays a graphical representation of the programming history that includes efficacy and side effect information for a plurality of the programs.

27. The system of claim 24, wherein the programming device displays a graphical representation of the programming history that includes a therapeutic range for each of a plurality of the programs.

28. A non-transitory computer-readable medium comprising instructions that cause a programmable processor to:

control an implantable medical device to deliver therapy to a patient according to each of a plurality of programs with a programming device during a programming session;

record rating information for each of the plurality of programs during the programming session within the programming device;

receive selection of a subset of the programs during the programming session;

store the selected subset of the programs within the implantable medical device, wherein each of the programs within the selected subset of the programs is available to be selected by the patient to control delivery of therapy by the implantable medical device outside of the programming session;

for the selected subset of the programs, store information identifying the programs and rating information associated with the programs in a programming history for the patient within the implantable medical device; and

store within the implantable medical device information identifying the programs and rating information associated with the programs for each of the plurality of programs as a session log separate from the programming history, wherein the session log is associated with the programming session.

29. The non-transitory computer-readable medium of claim 28, wherein the instructions that cause a programmable processor to store rating information associated with the programs in a programming history comprise instructions that cause a programmable processor to store a subset of the rating information associated with each of the programs in the programming history with the implantable medical device.

30. The non-transitory computer-readable medium of claim 29, wherein the instructions that cause a programmable processor to store a subset of the rating information comprise instructions that cause a programmable processor to store a therapeutic range for each of the programs, wherein the therapeutic range for a program is determined during the programming session, and based on an amplitude of first effect perception and an amplitude at which side effects are not tolerated.

31. The non-transitory computer-readable medium of claim 28, further comprising instructions that cause a programmable processor to:

record physiological sensor information during delivery of therapy according to one of the selected subset of programs within the implantable medical device; and

store the physiological sensor information in association with the one of the selected subset of programs in the programming history within the implantable medical device.

32. The non-transitory computer readable medium of claim 28, further comprising instructions that cause a programmable processor to:

retrieve the programming history from the implantable medical device during a subsequent programming session;

analyze the retrieved programming history; and

provide guidance information to a user based on the analysis to guide the selection of therapy programs during the subsequent programming session.