Cardiac rehabilitation using patient monitoring devices

• US 8,905,925 B2
• Filed: 06/10/2009
• Issued: 12/09/2014
• Est. Priority Date: 07/15/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Beck, Kenneth C., Wariar, Ramesh, Averina, Viktoria A.
• Primary Examiner(s): Thomson, William
• Assistant Examiner(s): Archer, Marie
• Application Number:
  US12/482,172
• Publication Number:
  US 20100016678A1
• Time in Patent Office: 2,008 Days
• Field of Search: 600300-301, 600363-365, 600373-374, 600377-379, 600382-384, 600386-394, 600/481, 600/485, 600500-503, 600/509, 600515-519, 600529-531, 600544-547, 600/549, 128920-925, 705 2- 3, 482 1- 9
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/222 combined with detection or measurement of physiological parameters, e.g. heart rate
• CPC Class Codes: A61B 5/4833 Assessment of subject's compliance to treatment
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A63B 2230/08 other bio-electrical signals
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• 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 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: Y10S 482/902 Employing specific graphic or video display

Abstract

Systems and methods permit remotely-monitored rehabilitation of a patient. A system can comprise a patient monitor configured to monitor a patient'"'"'s physiological data. The patient monitor can monitor using a first monitoring mode. A patient communication device can be configured to present, to the patient, an option to perform an exercise regimen, and to receive a response indicating whether the patient will perform the exercise regimen. A configuration module coupled to the patient communication device can be configured to activate a second monitoring mode when the response indicates that the patient will perform the exercise regimen. When the exercise regimen is complete, the first monitoring mode can be re-established. When the response indicates that the patient will not perform the exercise regimen, the response can be recorded as a negative response, and the option to perform the exercise regimen can be presented again.

Claims

1. A system comprising:

a patient monitor configured to monitor a patient'"'"'s physiological data using a first monitoring mode;

a patient communication device configured to;

present, to a patient, an option to perform an exercise regimen, the option including at least one response option indicating the patient will perform the exercise regimen and at least one response option indicating the patient will not perform the exercise regimen; and

receive a response to the presented option from the patient indicating whether the patient will perform the exercise regimen; and

a configuration module, coupled to the patient communication device, the configuration module configured to,

when the response to the presented option indicates that the patient will perform the exercise regimen;

activate a second monitoring mode of the patient monitor;

detect that the exercise regimen is complete; and

re-establish the first monitoring mode after the exercise regimen is complete; and

when the response to the presented option indicates that the patient will not perform the exercise regimen;

receive from the patient, a reason why the patient will not perform the exercise regimen;

record the response to the presented option as a negative response with the received reason; and

repeat presenting the option to perform the exercise regimen to the patient.

2. The system of claim 1, wherein the patient monitor is configured to monitor the patient'"'"'s physiological data repeatedly at intervals of time.

3. The system of claim 1, wherein the patient monitor includes an implantable medical device.

4. The system of claim 1, wherein the patient monitor is configured to:

receive the patient'"'"'s physiological data at a central system; and

store the patient'"'"'s physiological data at the central system.

5. The system of claim 1, wherein the configuration module is configured to detect that the exercise regimen is complete by receiving an indication from the patient that the patient has completed exercising.

6. The system of claim 1, wherein the configuration module is configured to use patient physiological data sensed in the second monitoring mode to determine that the patient has completed exercising.

7. The system of claim 1, comprising:

a clinician communication device, coupled to the patient communication device, and configured to;

present, to a clinician, the patient'"'"'s physiological data captured during the first and second monitoring modes;

receive a clinician message from the clinician, the clinician message being in response to the presentation of the patient'"'"'s physiological data; and

communicate with patient communication device to revise at least one of the exercise regimen or the second monitoring mode based on the clinician message.

8. The system of claim 7, wherein the patient communication device is configured to revise the exercise regimen by revising at least one of:

an intensity of an exercise, a frequency of an exercise, a duration of an exercise, a type of exercise, or a specified exercise.

9. The system of claim 7, wherein the patient monitor is configured to use the clinician message to revise an aspect of the second monitoring mode corresponding to at least one of:

a data to monitor, a frequency to monitor data, or a selection of devices used to monitor data.

10. The system of claim 7, wherein the clinician message is formed at least in part using the patient'"'"'s physiological data.

11. The system of claim 1, comprising

a clinician communication device, coupled to the patient communication device, and configured to:

present, to a clinician, the patient'"'"'s negative response;

receive a clinician message from the clinician, the clinician message being in response to the presentation of the patient'"'"'s physiological data; and

communicate with patient communication device to revise at least one of the exercise regimen or the second monitoring mode.

12. The system of claim 11, wherein the patient communication device is configured to revise the exercise regimen by revising at least one of:

an intensity of an exercise, a frequency of an exercise, a duration of an exercise, a type of exercise, or a specified exercise.

13. The system of claim 11, wherein the patient monitor is configured to use the clinician message to revise an aspect of the second monitoring mode corresponding to at least one of:

a data to monitor, a frequency to monitor data, or a selection of devices used to monitor.

14. The system of claim 11, wherein the clinician message is formed at least in part using the negative response.

15. The system of claim 1, wherein the option to perform the exercise regimen is presented on a day associated with the exercise regimen.

16. The system of claim 15, wherein the exercise regimen is requested by a clinician communication device.

17. The system of claim 1, wherein the exercise regimen is presented in a list of exercise regimens.

18. The system of claim 17, wherein each exercise regimen in the list of exercise regimens is associated with a priority level and the exercise regimen with the highest priority level is emphasized in the list of exercise regimens.

19. A method comprising:

monitoring a patient'"'"'s physiological data received from a patient-monitoring device, the monitoring including using a first monitoring mode;

presenting, to a patient, an option to perform an exercise regimen;

receiving a response to the presented option from the patient indicating whether the patient will perform the exercise regimen;

when the response to the presented option indicates that the patient will perform the exercise regimen;

activating a second monitoring mode of the patent-monitoring device;

detecting that the exercise regimen is complete; and

re-establishing the first monitoring mode after the exercise regimen is complete; and

when the response to the presented option indicates that the patient will not perform the exercise regimen;

receiving from the patient, a reason why the patient will not perform the exercise regimen;

recording the response to the presented option as a negative response with the received reason; and

repeatedly presenting the option to perform the exercise regimen to the patient.

20. The method of claim 19, wherein the patient-monitoring device includes an implantable medical device.

21. The method of claim 19, wherein the monitoring of the patient'"'"'s physiological data includes:

receiving the patient'"'"'s physiological data at a central system; and

storing the patient'"'"'s physiological data at the central system.

22. The method of claim 19, wherein the detecting that the exercise regimen is complete includes receiving an indication from the patient that the patient has completed exercising.

23. The method of claim 19, wherein the detecting that the exercise regimen is complete includes using patient physiological data sensed in the second monitoring mode to determine that the patient has completed exercising.

24. The method of claim 19, comprising:

presenting, to a clinician, the patient'"'"'s physiological data captured during the first and second monitoring modes;

receiving a clinician message from the clinician, the clinician message being in response to the presentation of the patient'"'"'s physiological data; and

using the clinician message to revise at least one of the exercise regimen or the second monitoring mode.

25. The method of claim 24, wherein the clinician message is formed at least in part using the patient'"'"'s physiological data.

26. The method of claim 19, comprising

presenting, to a clinician, the patient'"'"'s negative response;

receiving a clinician message from the clinician, the clinician message being in response to the presentation of the patient'"'"'s physiological data; and

using the clinician message to revise at least one of the exercise regimen or the second monitoring mode.

27. The method of claim 19, wherein presenting the option to perform an exercise regimen to the patient includes presenting a menu including a plurality of exercise regimens, each exercise regimen having a priority level, and each priority level displayed with the menu.

28. An apparatus comprising:

means for monitoring a patient'"'"'s physiological data including using a first monitoring mode;

means for presenting, to a patient, an option to perform an exercise regimen;

means for receiving a response to the presented option from the patient indicating whether the patient will perform the exercise regimen; and

when the response to the presented option indicates that the patient will perform the exercise regimen;

means for activating a second monitoring mode to monitor the patient'"'"'s physiological data;

means for detecting that the exercise regimen is complete; and

means for re-establishing the first monitoring mode after the exercise regimen is complete; and

when the response to the presented option indicates that the patient will not perform the exercise regimen;

means for receiving from the patient, a reason why the patient will not perform the exercise regimen

means for recording the response to the presented option as a negative response with the received reason; and

means for repeating the presentation of the option to perform the exercise regimen to the patient.

29. A non-transitory machine-readable medium including instructions, which when executed by a machine, cause the machine to:

monitor a patient'"'"'s physiological data received from a patient-monitoring device using a first monitoring mode;

present, to a patient, an option to perform an exercise regimen;

receive a response to the presented option from the patient indicating whether the patient will perform the exercise regimen;

when the response to the presented option indicates that the patient will perform the exercise regimen;

activate a second monitoring mode of the patient-monitoring device;

detect that the exercise regimen is complete; and

re-establish the first monitoring mode after the exercise regimen is complete; and

when the response to the presented option indicates that the patient will not perform the exercise regimen;

receive from the patient, a reason why the patient will not perform the exercise regimen

record the response to the presented option as a negative response with the received reason; and

repeatedly present the option to perform the exercise regimen to the patient.