System and method for prioritizing medical conditions

• US 8,942,794 B2
• Filed: 02/19/2014
• Issued: 01/27/2015
• Est. Priority Date: 11/16/1999
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Bardy, Gust
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US14/184,157
• Publication Number:
  US 20140171810A1
• Time in Patent Office: 342 Days
• Field of Search: 600/301, 600/513, 600515-518, 600/483, 128923-925
• US Class Current: 600/513
• 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 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• 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 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

The technology disclosed herein generally relates to a method for providing an index disorder in automated patient care. A set of device measures is stored in a database. Quantitative health care data indicators in the database are provided, where the indicators were regularly recorded by a medical device for a patient under automated patient care. Collected device measures are retrieved with a processor. An index disorder is identified through derived measure determination and statistical calculation with a processor.

Claims

1. A method for providing an index disorder for use in automated patient care, comprising:

storing a set of device measures in a database;

providing quantitative health care data indicators in the database, wherein the indicators were regularly recorded by a medical device for a patient under automated patient care;

retrieving the device measures with a server system;

deriving measures from the device measures with the server system;

performing statistical calculations for at least a portion of the measures from the measures in the group consisting of;

the set of device measures, the derived measures, and the indicators;

identifying each of a plurality of health disorders based on one or more of the derived measures, the indicators, and the device measures;

ordering the plurality of health disorders in temporal sequence with a diagnostic module; and

identifying the index disorder through the derived measures, the ordering of the plurality of health disorders, and the statistical calculations with the server system.

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

identifying, with a categorizing component, the index disorder from a plurality of index disorder candidates as having a pathophysiology substantially matching the health disorder that occurred substantially least recently.

3. A method according to claim 1, wherein identifying each of a plurality of health disorders further comprises:

identifying a first health disorder in a first time window and identifying a second health disorder within a different time window.

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

sorting, with an evaluation component, the plurality of health disorders into a symptomatic event ordering set; and

evaluating, with the evaluation component, each health disorder in the symptomatic event ordering set for matched pathophysiology.

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

prioritizing, with a comparison component, the health disorders using a predefined ordering, wherein health disorders that occurred least recently are given higher priority than health disorders that occurred most recently; and

comparing, with the comparison component, the health disorders to pathophysiological indicators for one or more index disorder candidates, wherein health disorders having higher priorities are compared before the health disorders having lower priorities.

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

tracking, with a hysteresis component, temporal changes in physiology;

applying, with the hysteresis component, a stickiness threshold to the temporal changes; and

determining whether interventive changes are appropriate based on applying the stickiness threshold to the temporal changes.

7. A method according to claim 1, further comprising:

testing, with a testing component, observed physiological changes against one or more indicator thresholds to determine a patient status indicating at least one of a change and a status quo of the index disorder;

wherein the one or more indicator thresholds corresponds to a pathophysiology indicative of at least one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation index disorders.

8. The method according to claim 1, wherein identifying each of a plurality of health disorders comprises identifying two or more of the group consisting of:

pneumonia, heart failure, and atrial fibrillation.

9. A system for identifying an index disorder, comprising:

a database configured to store a set of device measures and receive quantitative health care data indicators from a patient medical device;

a server system configured to;

retrieve the device measures, derive measures from the device measures, and perform statistical calculations for at least a portion of the measures from the measures in the group consisting of;

the device measures, the derived measures, and the indicators, wherein the server system comprises;

a comparison module configured to identify each of a plurality of health disorders based on one or more of the derived measures, the indicators, and the device measures;

a diagnostic module configured to order the plurality of health disorders in temporal sequence and identify the index disorder through the derived measures, the ordering of the plurality of health disorders, and the statistical calculations.

10. A system according to claim 9, further comprising a categorizing component configured to identify the index disorder from a plurality of index disorder candidates as having a pathophysiology substantially matching the health disorder that occurred substantially least recently.

11. A system according to claim 9, wherein the comparison module is further configured to identify a first health disorder in a first time window and identify a second health disorder within a different time window.

12. A system according to claim 9, further comprising an evaluation component configured to sort the plurality of health disorders into a symptomatic event ordering set and evaluate each health disorder in the symptomatic event ordering set for matched pathophysiology.

13. A system according to claim 9, wherein the comparison module is further configured to prioritize the health disorders using a predefined ordering, wherein health disorders that occurred least recently are given higher priority than health disorders that occurred most recently, and wherein the comparison module is further configured to compare the health disorders to pathophysiological indicators for one or more index disorder candidates, wherein health disorders having higher priorities are compared before the health disorders having lower priorities.

14. A system according to claim 9, further comprising a hysteresis component configured to track temporal changes in physiology, apply a stickiness threshold to the temporal changes, and determine whether interventive changes are appropriate based on applying the stickiness threshold to the temporal changes.

15. A system according to claim 9, further comprising a testing component configured to test observed physiological changes against one or more indicator thresholds to determine a patient status indicating at least one of a change and a status quo of the index disorder, wherein the one or more indicator thresholds corresponds to a pathophysiology indicative of at least one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation index disorders.

16. The system according to claim 9, wherein the comparison module is further configured to identify each of a plurality of health disorders comprising pneumonia, heart failure, and atrial fibrillation.