Patient monitoring and exception notification

• US 9,901,287 B2
• Filed: 12/19/2011
• Issued: 02/27/2018
• Est. Priority Date: 12/22/2010
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Shelly, Benjamin Irwin, Kane, Michael Thomas, Matthews, Gregory Delano, Ressler, Heather Dawn, Carter, Jr., Duane Howard
• Primary Examiner(s): Cheng, Jacqueline
• Assistant Examiner(s): PORTILLO, JAIRO H
• Application Number:
  US13/994,364
• Publication Number:
  US 20130267865A1
• Time in Patent Office: 2,262 Days
• Field of Search: None
• CPC Class Codes: A61B 2505/07 Home care
• CPC Class Codes: A61B 5/0004 characterised by the type of physiological signal transmitted
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0803 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• 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
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A monitoring system is used to measure various parameters of the sleep, respiration, and/or other bodily functions of a subject. One or more metrics are calculated that quantify deviation from the mean, trends, changes over time, and/or other changes in the parameters. The metrics are used to generate notifications of these changes that can be conveyed to caregivers and/or other users.

Claims

1. A method for providing dynamic-threshold-based exception notifications on behalf of a subject, the method comprising:

periodically measuring, with a medical device attached to the subject for periodically measuring the subject'"'"'s respiration, a plurality of subsequent measurements of breathing parameters of the subject during a first period and a second period, the breathing parameters including a first and a second breathing parameter, wherein the first breathing parameter is an average tidal volume of the subject and the second breathing parameter is an apnea-hypopnea index of the subject;

determining, with a processor, statistical metrics of the measured plurality of subsequent measurements, wherein the statistical metrics include;

a first statistical metric corresponding to measurements taken during the first period, wherein the first statistical metric includes trend estimation of the measurements during the first period; and

a second statistical metric subsequent to the first statistical metric corresponding to measurements taken during the second period, wherein the second statistical metric includes trend estimation of the measurements during the second period, and wherein the second period is longer than the first period;

automatically adjusting a breathing parameter threshold for the measured first breathing parameter, wherein the breathing parameter threshold is a threshold of average tidal volume, such that the breathing parameter threshold changes from a first threshold value at a first time during the first period to a second threshold value at a second time during the first period or the second period, wherein the automatically adjusting includes increasing the breathing parameter threshold in response to an increase in variability of the measured second breathing parameters in the first period and/or the second period;

verifying, with a processor, whether the statistical metrics warrant a notification on behalf of the subject to a user based on (i) the automatically-adjusted breathing parameter threshold at a given time during the first period and (ii) a comparison between the first statistical metric and the second statistical metric; and

conveying, via a user interface, the notification on behalf of the subject to the user.

2. The method of claim 1, wherein the statistical metrics include statistical variability of the parameters.

3. The method of claim 1, wherein the statistical metrics include a first standard deviation for a set of measurements measured during the first period spanning less than two weeks, and a second standard deviation for a set of measurements measured during the second period spanning more than two weeks, and wherein verifying whether the statistical metrics warrant a notification includes comparing the first standard deviation and the second standard deviation.

4. A system for providing dynamic-threshold-based exception notification on behalf of a subject, the system comprising:

a medical device attached to the subject configured to periodically measure subsequent measurements of breathing parameters of the subject during a first period and a second period, the breathing parameters including a first and second breathing parameters, wherein the first breathing parameter is an average tidal volume of the subject and the second breathing parameter is an apnea-hypopnea index of the subject;

a user interface configured to exchange information with a user, wherein the information includes notifications;

electronic storage to store measurements from the measurement device; and

a processor configured to execute computer program modules, the computer program modules comprising;

a statistical module configured to determine statistical metrics of the subsequent measurements measured by the medical device, wherein the statistical metrics include;

a first statistical metric corresponding to measurements taken during the first period, and wherein, the first statistical metric includes trend estimation of the measurements during the first period; and

a second statistical metric subsequent to the first statistical metric corresponding to measurements measured during the second period, wherein the second period is longer than the first period, and wherein the second statistical metric includes trend estimation of the measurements during the second period;

a verification module configured to

automatically adjusting a breathing parameter threshold for the measured first breathing parameter, wherein the breathing parameter threshold is a threshold of average tidal volume, such that the breathing parameter threshold changes from a first threshold value at a first time during the first period to a second threshold value at a second time during the first period or the second period, wherein the automatically adjusting includes increasing the breathing parameter threshold in response to an increase in variability of the measured second breathing parameters in the first period and/or the second period; and

verify whether the determined statistical metrics warrant a notification on behalf of the subject based on (i) the automatically-adjusted breathing parameter threshold at a given time during the first period and (ii) a comparison between the first statistical metric and the second statistical metric; and

a user interface module configured to control the user interface to convey the notification on behalf of the subject to the user.

5. The system of claim 4, wherein the statistical metrics determined by the statistical module include statistical variability of the parameters.

6. The system of claim 4, wherein the statistical metrics determined by the statistical module include a first standard deviation for a set of measurements measured during the first period spanning less than two weeks, and a second standard deviation for a set of measurements measured during the second period spanning more than two weeks, and wherein operation of the verification module is further based on a comparison between the first standard deviation and the second standard deviation.

7. A system configured to provide dynamic-threshold-based exception notification on behalf of a subject, the system comprising:

means for periodically measuring a plurality of subsequent measurements of breathing parameters of the subject during a first period and a second period, the breathing parameters including a first and second breathing parameters, wherein the first breathing parameter is an average tidal volume of the subject and the second breathing parameter is an apnea-hypopnea index of the subject;

means for determining statistical metrics of the measured plurality of subsequent measurements, wherein the statistical metrics include;

a first statistical metric corresponding to measurements taken during the first period, and wherein, the first statistical metric includes trend estimation of the measurements during the first period; and

a second statistical metric subsequent to the first statistical metric corresponding to measurements measured during the second period, wherein the second statistical metric includes trend estimation of the measurements during the second period, and wherein the second period is longer than the first period;

means for automatically adjusting a breathing parameter threshold for the measured first breathing parameter, wherein the breathing parameter threshold is a threshold of average tidal volume, such that the breathing parameter threshold changes from a first threshold value at a first time during the first period to a second threshold value at a second time during the first period or the second period, wherein the automatically adjusting includes increasing the breathing parameter threshold in response to an increase in variability of the measured second breathing parameters in the first period and/or the second period; and

means for verifying whether the statistical metrics warrant a notification on behalf of the subject to a user based on (i) the automatically-adjusted breathing parameter threshold at a given time during the first period and (ii) a comparison between the first statistical metric and the second statistical metric; and

means for conveying the notification on behalf of the subject to the user.

8. The system of claim 7, wherein the statistical metrics include statistical variability of the parameters.

9. The system of claim 7, wherein the statistical metrics include a first standard deviation for a set of measurements measured during the first period spanning less than two weeks, and a second standard deviation for a set of measurements measured during the second period spanning more than two weeks, and wherein the operation of the means for verifying the statistical metrics warrant a notification includes comparing the first standard deviation and the second standard deviation.