System and method for dynamically adjusting patient therapy

• US 8,340,792 B2
• Filed: 11/16/2010
• Issued: 12/25/2012
• Est. Priority Date: 08/25/2004
• Status: Active Grant

• Current Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Original Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Inventors: Condurso, Joseph, Yamaga, Cynthia, Butterfield, Robert, Morling, Simon, Pait, Clifton, West, Patricia, Vanderveen, Timothy, Crass, Richard
• Primary Examiner(s): HARTMAN JR, RONALD D
• Application Number:
  US12/947,773
• Publication Number:
  US 20110066260A1
• Time in Patent Office: 770 Days
• Field of Search: 702/188, 700/2, 700/17, 700/79, 700/83, 700/839, 340/3.1
• US Class Current: 700/79
• 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 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• 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: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3576 with non implanted data transmission devices, e.g. using external transmitter or receiver
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 5/172 electrical or electronic A61M5/16804, A61M5/16831 take precedence
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• 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: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 70/00 ICT specially adapted for the handling or processing of medical references
• CPC Class Codes: G16H 70/40 : relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: G16H 70/60 : relating to pathologies

Abstract

A system and method of managing therapy provided to patients in an institution. The system monitors all aspects of the medication delivery to a patient, as well as other information related to the patient, such as values of vital signs, laboratory results and patient factors such as history, diagnosis, allergies and the like. The system includes one or more databases of information, including institutionally developed rules, guidelines and protocol representing the best medical practices of the institution. The system provides alerts and/or recommendations based on the application of the rules to the information being monitored, and alerts care givers accordingly, providing for dynamic adjustment of the patient'"'"'s therapy. The system also monitors the status of the alerts, and if no action is taken in a selected period of time, may escalate the priority of the alert and/or halt the delivery of medication to the patient until the alert is resolved.

Claims

1. A system for managing therapy provided to a patient, comprising:

a two-way communication system;

a database coupled to the communication system, the database comprising;

a pharmacokinetic (PK) model configured to predict a concentration of at least one medication within at least a portion of the patient'"'"'s body tissue; and

one or more limits for the concentration of the medication within the patient'"'"'s body tissue;

a medication delivery device comprising;

a memory configured to store programs;

a communication means coupled to the communication system; and

a processor coupled to the memory and the communication means, the processor configured to retrieve the programs from the memory and operate the medication delivery device according to the programs to deliver medication to the patient at an adjustable rate, the processor further configured to accept input of delivery parameters; and

a server coupled to the communication system and configured to;

receive the delivery parameters from the medication delivery device;

retrieve the PK model and limits from the database;

utilize the PK model with the delivery parameters to predict the concentration of the medication within the body tissue of the patient if the medication is administered according to the retrieved delivery parameters;

compare the predicted concentration to the concentration limits; and

provide an alert if the predicted concentration is outside any of the concentration limits.

2. The system of claim 1, wherein the server is further configured to:

accept one or more laboratory test results; and

modify one or more of the concentration limits based on laboratory test results.

3. The system of claim 1, wherein the server is further configured to:

accept patient-specific information comprises at least one of the group of an age, a weight, a gender, a diagnosis, a blood pressure, a result of a blood test, and a result of a urine test; and

utilize the PK model with the patient-specific information.

4. The system of claim 1, wherein:

the database further comprises;

a pharmacodynamic (PD) model configured to predict a physiological response based on the concentration of the medication in the patient'"'"'s body tissues; and

one or more limits for the physiological response; and

the server is further configured to;

accept a measurement of the physiological response;

utilize the PD model to predict the physiological response based on the medication concentration predicted by the PK model;

compare the predicted physiological response to the measured physiological response; and

provide an alert if the difference between the measured physiological response and the predicted physiological response exceeds any of the physiological response limits.