Methods and systems for semi-automatic adjustment of medical monitoring and treatment
First Claim
1. A system configured for currently providing for medical therapy in fully-automatic, semiautomatic, and user-initiated manners including:
- an implantable medical device configured to provide therapy, the implantable medical device comprising;
a memory coupled to the processor containing therapy program operations that have been programmably defined with an automatic parameter value which indicates the operation is to be implemented in an automatic, semiautomatic, or user-initiated fashion;
a processor configured for calculating a patient state value and implementing therapy program operations according to both the automatic parameter value and the patient state value, the processor being further configured to adjust its operation in relation to a patient alert rule based on the characteristics of the alert event and then contingently adjusting the alerting and operating of the device if an external patient programmer does not provide a signal indicative of a patient response within a predetermined interval; and
an external patient programmer for allowing a patient to input a patient response and for communication with the implanted medical device; and
an alerting module configured for providing alert signals when selected events occur for which alerting has been defined.
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Abstract
Systems and methods are described for adjusting the operation of implantable stimulation devices used to provide medical monitoring and treatment. Several hierarchical algorithms are described which operate according to conditionally obtaining a patient response to an alert signal. In one such strategy semi-automatic therapy adjustment occurs by automatically issuing patient alert messages when selected operations are to occur, and using a patient'"'"'s response to the alert message that is provided within a selected time limit in order to contingently adjust therapy. Methods are also described for resolving conflicts which may occur when time information and sensed data information each indicate different patient states are occurring. Although treatment of neural and cardiac disorders is emphasized, the techniques can be applied to the monitoring and treatment of any medical disorder with an implanted device.
43 Citations
25 Claims
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1. A system configured for currently providing for medical therapy in fully-automatic, semiautomatic, and user-initiated manners including:
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an implantable medical device configured to provide therapy, the implantable medical device comprising; a memory coupled to the processor containing therapy program operations that have been programmably defined with an automatic parameter value which indicates the operation is to be implemented in an automatic, semiautomatic, or user-initiated fashion; a processor configured for calculating a patient state value and implementing therapy program operations according to both the automatic parameter value and the patient state value, the processor being further configured to adjust its operation in relation to a patient alert rule based on the characteristics of the alert event and then contingently adjusting the alerting and operating of the device if an external patient programmer does not provide a signal indicative of a patient response within a predetermined interval; and an external patient programmer for allowing a patient to input a patient response and for communication with the implanted medical device; and an alerting module configured for providing alert signals when selected events occur for which alerting has been defined.
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2. A medical monitoring and alerting system including:
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a sensor adapted to detect a medically relevant signal from a patient; an implanted device having a signal processor coupled to the sensor for conditioning an analog electrical signal corresponding to the medically relevant signal, thereby producing a conditioned digital signal; an alert module configured to provide an alert signal related to an alert event type; a programmable memory for storing a plurality of responsive operations associated with different alert types; an external patient programmer for presenting alert signals to a patient, communicating with other components of the system and for obtaining patient input; at least a first processor coupled to the signal processor, the alert module, the external patient programmer, and the programmable memory, the at least first processor configured to; (i) detect the occurrence of an alert event by analyzing the digital signal; (ii) determine a type of the alert event based upon a characteristic of the alert event; (iii) determine if the type of alert event is one of;
(a) a semiautomatic event defined in a semi-automatic event set, or (b) an automatic event defined in an automatic event set as a function of the alert event type; and
,(iv) operate in the case where the alert event is defined as an automatic event so as to automatically perform an operation associated with the alert event, and operate in the case where the alert event is defined as a semi-automatic alert event by sending an alert request to the alert module, thereby causing the alert module to generate and present to a patient an alert signal based upon a characteristic of the alert event, and then operating as a function of the alert event characteristic in response to patient input provided within a selected interval or to the lack thereof; the at least first processor being further configured to adjust its operation in relation to a patient alert rule that contingently adjusts the alerting and operating of the device if the external patient programmer does not provide a signal indicative of a patient response; wherein the sensor, the signal processor, the alert module, the programmable memory, the external patient programmer and the at least first processor are disposed so that the medical alert system is designed to alert at least the patient whereby the patient can be ambulatory and the system only defines a patient alert rule in relation to an alert provided to the patient. - View Dependent Claims (3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A medical monitoring and alert system which is configured to concurrently provide for therapy including:
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a sensing subsystem including a sensor to sense a medically relevant signal from a patient; an external patient programmer for obtaining patient input, and allowing the patient to communicate with an implanted device; a programmable memory for storing a plurality of responsive operations corresponding to a plurality of treatment events, said treatment events being defined as one of;
an automatic event defined in an automatic event set;
a semi-automatic event defined in a semi-automatic event set; and
, a user-initiated event defined in a user-initiated event set;at least a first processor configured to automatically accomplish at least one operation defined for the automatic event set upon detection of an automatic event signal;
semi-automatically accomplish at least one operation defined for the semiautomatic event set upon detection of a semi-automatic event signal, said detection causing the alert module to provide an alert signal according to a patient alert rule related to the characteristic of the event, and then operating responsively to patient input provided within a selected interval or to the lack thereof as a function of the event characteristic; and
, accomplish at least one operation defined for the user-initiated event set upon the user providing input defined for the user-initiated event;the at least first processor being further configured to adjust its operation in relation to a patient alert rule that contingently adjusts the alerting and operating of the device if the external patient programmer does not provide a signal indicative of a patient response within a predetermined interval; an alert module configured to provide alert signals for selected events; wherein the alert module, the programmable memory, the external patient programmer, implanted device, and the at least first processor operate to alert at least the patient wherein the alert system only defines a patient alert rule in relation to an alert provided to the patient. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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Specification