Patient in-the-loop participatory care and monitoring

• US 9,881,133 B2
• Filed: 05/17/2013
• Issued: 01/30/2018
• Est. Priority Date: 05/18/2012
• Status: Active Grant

• Current Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Original Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Inventors: Gravenstein, Nikolaus, Lampotang, Samsun, Lizdas, David, Bisht, Yashwant Singh, Schwab, Wilhelm K.
• Primary Examiner(s): Dsouza, Adolf
• Application Number:
  US14/400,525
• Publication Number:
  US 20150137988A1
• Time in Patent Office: 1,719 Days
• Field of Search: None
• 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 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/447 specially adapted for aiding the prevention of ulcer or pressure sore development, i.e. before the ulcer or sore has developed
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts
• CPC Class Codes: A61B 5/7267 involving training the classification device
• CPC Class Codes: A61B 5/7296 for compensation of signal variation due to stress unintentionally induced in the patient, e.g. due to the stress of the medical environment or examination deliberately inducing physiological or psychological stress A61B5/4884
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: F04C 2270/041 Controlled or regulated
• CPC Class Codes: G01F 15/063 using electrical means
• CPC Class Codes: G01N 33/4925 measuring blood gas content, e.g. O2, CO2 , HCO3
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Methods and systems for patient participatory care and monitoring are provided for applications including respiratory care, ECG monitoring, capnography, infusion pump alarm prevention/management, pressure sore prevention, incentive spirometry, consciousness monitoring during sedation, pain management and other care and monitoring modalities. A patient in-the-loop system includes an input interface for receiving data acquired from a monitoring, controlling or sensing device, a storage device for storing the data at a first location, and a processor for analyzing artifacts in the data and determining whether the patient provided a deliberate action with respect to the device as a response to a prompt or query. The processor can further initiate a variety of prompts and/or output queries stored in the storage device at a second location to the patient. The data derived from these patient-in-the-loop techniques are formatted to be received and interpreted by electronic medical record and electronic record keeping systems.

Claims

1. A method of patient participatory care and monitoring, comprising:

querying, instructing, or prompting a patient based on a query library to provide a response by prompting performance of an act by the patient that results in deliberate introduction of an artifact into a signal or inaction by the patient that results in no-artifact or cessation of the patient-introduced artifact;

receiving the signal from a device monitoring, controlling, or sensing a condition of the patient; and

analyzing the signal from the device based on the presence, absence of a patient-introduced artifact, or cessation of the patient-introduced artifact and on a response library to determine the patient'"'"'s response.

2. The method according to claim 1, wherein the querying, instructing or prompting of the patient is performed without active involvement from or in the absence of a healthcare worker.

3. The method according to claim 1, further comprising:

displaying the response of the patient on a monitor.

4. The method according to claim 1, wherein querying, instructing or prompting a patient to provide the response comprises:

outputting, via a speaker, at least one audio prompt, instruction or query.

5. The method according to claim 4, wherein outputting the at least one audio prompt instruction or query is performed according to a predetermined interval to periodically request a response from the patient, the response from the patient being determined by analyzing the signal from the device.

6. The method according to claim 1, wherein analyzing the signal from the device comprises analyzing artifacts in the signal indicating the condition or response of the patient being monitored, controlled or sensed.

7. The method according to claim 6, wherein analyzing the signal from the device is performed within a specified time window after the querying, instructing or prompting.

8. The method according to claim 6, wherein the device is a pulse oximeter, wherein the signal is received from a pulse oximeter probe, wherein analyzing artifacts in the signal comprises performing a peak analysis, filtering, or transform of the signal from the pulse oximeter probe to determine whether the patient had shaken or squeezed a finger on which the pulse oximeter probe is placed.

9. The method according to claim 6, wherein the device is a non-invasive blood pressure monitor, wherein the signal is received from a blood pressure cuff of the non-invasive blood pressure monitor, wherein analyzing artifacts in the signal comprises performing a peak analysis, filtering, or transform of the signal from the blood pressure cuff to determine whether the patient had squeezed or tapped the blood pressure cuff.

10. The method according to claim 1, further comprising:

in response to detecting an initial pre-alarm or an impending alarm condition from the signal from the device, querying, instructing, or prompting the patient to perform a remedial action without active involvement from or in the absence of a healthcare worker.

11. The method according to claim 1, wherein the device is an infusion pump or a pulse oximeter.

12. The method according to claim 1, further comprising:

providing data related to a patient'"'"'s response or actions to an electronic medical records system.

13. The method according to claim 1, further comprising:

performing a learning baseline to establish baseline measures indicative of no-artifact and deliberate artifact carried out by the patient; and

performing a quality control session verifying that the device is appropriate to allow reliable discrimination between response and no response.

14. The method according to claim 13, wherein analyzing the signal from the device comprises analyzing artifacts in the signal indicating the condition or response of the patient being monitored, controlled or sensed, and

wherein the baseline measures are stored in a memory and accessed during the analyzing of the artifacts in the output signal to interpret and determine the patient'"'"'s response.

15. The method according to claim 14, wherein the device is an existing device, and

wherein the method is implemented on a retrofit kit on the existing device.

16. The method according to claim 15, wherein the retrofit kit does not interfere with operation of the existing device and reads a status of the existing device via electronic communication or via a photodetector monitoring the status of the existing device.

17. A patient in-the-loop monitoring system comprising:

a memory device; and

a processor for reading data received from a pulse oximeter probe via an I/O port, storing the data at a first location in the memory device, and analyzing the data stored at the first location based on a response library to determine whether the patient deliberately manipulated artifacts in the data from the pulse oximeter probe,

wherein the data is the result of querying, instructing, or prompting the patient based on a query library to provide a response by prompting performance of an act by the patient that results in deliberate introduction of an artifact into a signal or inaction by the patient that results in no-artifact or cessation of the patient-introduced artifact.

18. The system according to claim 17, wherein the processor further outputs queries and prompts stored at a second location in the memory device to the patient via a speaker.

19. The system according to claim 17, further comprising a monitor, wherein the processor outputs an image or data for display on the monitor.

20. The system according to claim 17, wherein the processor further:

performs a learning baseline to establish baseline measures indicative of no-artifact and deliberate artifact carried out by a patient; and

performs a quality control session verifying that a device is appropriate to allow reliable discrimination between response and no response.

21. The system according to claim 20, wherein the system is implemented as a retrofit kit on a pulse oximeter having the I/O port providing data from the pulse oximeter probe.

22. The system according to claim 21, wherein the retrofit kit does not interfere with operation of the pulse oximeter and reads a status of the pulse oximeter via electronic communication or via a photodetector.

23. A non-transitory computer-readable medium having instructions stored thereon that, when executed, cause a processor to perform a method of patient participatory monitoring and care comprising:

outputting, via a speaker, at least one query or audio prompt to query, instruct, or prompt a patient based on a query library to provide a response by prompting performance of an act by the patient that results in deliberate introduction of an artifact into a signal or inaction by the patient that results in no-artifact or cessation of the patient-introduced artifact;

receiving data from the patient during a time period for providing the response;

performing a learning baseline to establish baseline measures indicative of no-artifact and deliberate artifact carried out by the patient;

performing a quality control session verifying that a device is appropriate to allow reliable discrimination between response and no response; and

analyzing artifacts in the data based on a response library to determine the patient'"'"'s response.

24. The non-transitory computer-readable medium according to claim 23, further comprising instructions for displaying the patient'"'"'s response on a monitor.

25. The non-transitory computer-readable medium according to claim 23, wherein outputting the at least one query or audio prompt is performed according to a predetermined interval to periodically request a response from the patient, the response from the patient being determined by analyzing the artifacts in the data.

26. The non-transitory computer-readable medium according to claim 23, wherein analyzing artifacts in the data comprises performing a peak analysis, filtering or transform of the data to determine whether the patient had deliberately manipulated the probe.

27. The non-transitory computer-readable medium according to claim 23, wherein the method performed by the processor further comprises:

performing a learning baseline to establish baseline measures indicative of no-artifact and deliberate artifact carried out by the patient; and

performing a quality control session verifying that a device is appropriate to allow reliable discrimination between response and no response.

28. The non-transitory computer-readable medium according to claim 27, wherein the device is an existing device, and

wherein the non-transitory computer-readable medium is implemented on a retrofit kit on the existing device.

29. The non-transitory computer-readable medium according to claim 28, wherein the retrofit kit does not interfere with operation of the existing device and reads a status of the existing device via electronic communication monitoring the status of the existing device.