Integrated patient care

• US 8,585,604 B2
• Filed: 10/29/2010
• Issued: 11/19/2013
• Est. Priority Date: 10/29/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Bennett, Tommy D., Cho, Yong Kyun, Biallas, Randolph M.
• Primary Examiner(s): Natnithithadha, Navin
• Assistant Examiner(s): BERHANU, ETSUB D
• Application Number:
  US12/915,992
• Publication Number:
  US 20120108984A1
• Time in Patent Office: 1,117 Days
• Field of Search: 600/300, 600/301, 600/485, 705/2
• US Class Current: 600/485
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4878 Evaluating oedema
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 20/13 delivered from dispensers
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A therapy regimen, e.g., a contingent medication prescription, may be created and automatically distributed to a patient via an integrated patient care system. A clinician may create therapy instructions by at least associating patient conditions with one or more therapy regimens, e.g., medication prescriptions. In some examples, the integrated patient care system may present historical condition data to the clinician to aid the clinician with creating and/or updating the therapy instructions specific to the patient. A therapy module of the integrated patient care system may use the therapy instructions to automatically select a therapy regimen from the therapy instructions based on a patient condition detected based on a sensed physiological parameter. The physiological parameter of the patient may be sensed by an implanted or external sensor. In some examples, the therapy regimen can be presented to the patient according to a predetermined schedule or in response to the detected condition.

Claims

1. A system comprising:

a pressure sensor configured to sense pulmonary artery pressure indicative of heart failure;

a first instruction module to determine a first condition indication of the sensed pulmonary artery pressure;

a second instruction module to determine a second condition of the sensed pulmonary artery pressure, the first condition being a pressure range and the second condition being pressure change;

a clinician module configured to receive input that defines one or more therapy instructions specific to a patient and to determine whether to use one or both of the first condition and the second condition to select a therapy regimen from a plurality of stored therapy regimens; and

a patient display configured to present the selected therapy regimen to the patient.

2. The system of claim 1, wherein the therapy instructions associate each therapy regimen of the plurality of stored therapy regimens with at least one of the conditions, and the processor is configured to select the therapy regimen from the plurality of stored therapy regimens based on detection of the associated condition.

3. The system of claim 2, wherein each therapy regimen of the plurality of stored therapy regimens comprise a contingent medication prescription that is only presented to the patient based on the one or more conditions.

4. The system of claim 1, further comprising:

a patient module comprising a patient telemetry module configured to receive the selected therapy regimen from the clinician module; and

a patient interface including the patient display and configured to receive input from the patient.

5. The system of claim 4, wherein the patient interface is configured to receive feedback from the patient related to the selected therapy regimen and a perceived condition of the patient, wherein the feedback comprises at least one answer to at least one question of a questionnaire presented by the patient interface, and the patient telemetry module is configured to transmit the feedback to the clinician module for presentation to the clinician.

6. The system of claim 1, wherein the one or more therapy instructions comprise a condition identifier, and wherein the condition identifier comprises at least one of a pressure range check instruction and a pressure change detection instruction, or a patient pressure status instruction.

7. The system of claim 1, wherein the first condition further comprises at least one of a normal pressure state, a low pressure state, a very low pressure state, a high pressure state, or a very high pressure state.

8. The system of claim 1, wherein the plurality of stored therapy regimens comprises at least one of a medication type, a medication dosage, and a delivery time.

9. The system of claim 1, further comprising a pill dispenser configured to receive the selected therapy regimen from the clinician module and dispense a medication according to the therapy regimen.

10. The system of claim 1, wherein the clinician module comprises a clinician interface, wherein the clinician module is configured to graphically present historical physiological parameter data of the patient via the clinician interface, graphically overlay parameters that define at least one of the first condition and the second condition over the historical physiological parameter data, and receive input from the clinician that updates the parameters that define the at least one of the first condition and the second condition based on the historical physiological parameter data.

11. The system of claim 1, further comprising a treatment module that comprises a memory, wherein the treatment module is configured to receive the one or more therapy instructions from the clinician module via a network, store the one or more therapy instructions in the memory, and receive the sensed pulmonary artery pressure from the sensor via the network.

12. A method comprising:

receiving input from a clinician at a clinician module, wherein the input defines one or more therapy instructions specific to a patient;

sensing pulmonary artery pressure indicative of heart failure with a pressure sensor;

determining a first condition indication of the sensed pulmonary artery pressure with a first instruction module;

determining a second condition indication of the sensed pulmonary artery pressure with a second instruction module, the first condition being a pressure range and the second condition being pressure change;

determining whether to use one or both of the first condition and the second condition to select a therapy regimen from a plurality of stored therapy regimens; and

presenting the selected therapy regimen to the patient via a patient display.

13. The method of claim 12, wherein the therapy instructions associate each therapy regimen of the plurality of stored therapy regimens with at least one of the conditions, and wherein selecting the therapy regimen comprises automatically selecting the at least one therapy regimen based on detection of the one or more associated conditions.

14. The method of claim 13, wherein each therapy regimen of the plurality of stored therapy regimens comprises a contingent medication prescription that is only presented to the patient upon detection of the associated condition.

15. The method of claim 13, further comprising:

receiving the selected therapy regimen with a patient telemetry module of a patient module; and

receiving input from the patient in response to the presented therapy regimen via a patient interface that includes the patient display.

16. The method of claim 15, further comprising:

receiving feedback from the patient via the patient interface related to the selected therapy regimen and a perceived condition of the patient, wherein the feedback comprises at least one answer to at least one question of a questionnaire presented by the patient interface; and

transmitting the feedback to the clinician module for presentation to the clinician via the patient telemetry module.

17. The method of claim 12, wherein the first condition further comprises at least one of a normal pressure state, a low pressure state, a very low pressure state, a high pressure state, or a very high pressure state.

18. The method of claim 12, wherein each of the plurality of stored therapy regimens comprises at least one of a medication type, a medication dosage, and a delivery time.

19. The method of claim 12, further comprising:

graphically presenting historical physiological parameter data via a clinician interface of the clinician module;

graphically overlaying parameters that define at least one of the first condition and the second condition over the historical physiological parameter data; and

receiving input from the clinician that updates the parameters that define the at least one of the first condition and the second condition based on the historical physiological parameter data.

20. The method of claim 12, further comprising:

receiving the one or more therapy instructions at a therapy module from the clinician module via a network;

storing the one or more therapy instructions in a memory of the therapy module; and

receiving the physiological parameter from the sensor at the treatment module via the network.

21. A system comprising:

means for receiving input from a clinician that defines one or more therapy instructions specific to a patient;

means for sensing pulmonary artery pressure of the patient;

means for determining a first condition indication of the sensed pulmonary artery pressure;

means for determining a second condition of the sensed pulmonary artery pressure, the first condition being a pressure range and the second condition being pressure change;

means for determining whether to use one or both of the first condition and the second condition to select a therapy regimen from a plurality of stored therapy regimens; and

means for presenting the selected therapy regimen to the patient.