World wide patient location and data telemetry system for implantable medical devices

• US RE42,934 E1
• Filed: 09/29/2006
• Issued: 11/15/2011
• Est. Priority Date: 06/23/1995
• Status: Expired due to Term

• Current Assignee: Remote Biomedical Tech, LLC
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Thompson, David L.
• Primary Examiner(s): Getzow; Scott M
• Application Number:
  US11/541,521
• Time in Patent Office: 1,873 Days
• Field of Search: 607 9- 32, 607/59, 607/60, 128/903, 128/904
• US Class Current: 607/30
• CPC Class Codes: A61B 2505/07 Home care
• CPC Class Codes: A61B 2560/0295 adapted for recording user messages or annotations
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/1112 Global tracking of patients, e.g. by using GPS
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G06F 19/3418 Telemedicine, e.g. remote diagnosis, remote control of instruments or remote monitoring of patient carried devices

Abstract

A system for communicating with a medical device implanted in an ambulatory patient and for locating the patient in order to selectively monitor device function, alter device operating parameters and modes and provide emergency assistance to and communications with a patient. The implanted device includes a telemetry transceiver for communicating data and operating instructions between the implanted device and an external patient communications control device that is either worn by or located in proximity to the patient within the implanted device tranceiving range. The control device preferably includes a communication link with a remote medical support network, a global positioning satellite receiver for receiving positioning data identifying the global position of the control device, and a patient activated link for permitting patient initiated personal communication with the medical support network. A system controller in the control device controls data and voice communications for selectively transmitting patient initiated personal communications and global positioning data to the medical support network, for initiating telemetry out of data and operating commands from the implanted device and transmission of the same to the medical support network, and for receiving and initiating re-programming of the implanted device operating modes and parameters in response to instructions received from the medical support network. The communications link between the medical support network and the patient communications control device may comprise a world wide satellite network, hard-wired telephone network, a cellular telephone network or other personal communications system. Methods and apparatae are also described that enhance the ability of the medical system to find patients and to get reports on patient and medical device status, and even update medical device programming using such facilities, and others described in detail within.

Claims

1. A patient monitoring system comprising:

a transceiver unit to be located in immediate proximity to a patient'"'"'s body for communicating with a device implanted in the patient'"'"'s body and with a telephone system outside the patient'"'"'s body,

the transceiver unit comprising,

a GPS location system for receiving satellite transmitted information from a set of earth orbiting satellites,

an IMD receiving telemetry circuit means for receiving telemetry from said implanted device,

a memory circuit for storing data relating to data received from said implanted device and from said earth orbital satellite,

telecommunications module for communication through wireless telephonic channels to said telephone system,

real time clock circuit producing an output signal for a real time clock,

transmission initiation processor for generating an automatic transmission over said telecommunications module through said wireless telephonic channels containing information related through said implantable device to said transceiver unit, said automatic transmission to occur at a set of periodically occurring fixed times, and

real time clock circuit update processor for interpreting received satellite transmitted information and providing an update for the real time clock circuit based on said satellite transmitted information so that said transmission initiation processor can operate within an extremely accurately clocked time slice.

2. A patient monitoring and emergency location system comprising;

a patient monitoring system as set forth in claim 1 and further comprising;

circuit means for producing a representation of said received satellite information relating the location of said transceiver unit for presentation to said telecommunications module so that said telecommunications module can transmit said representation of said location information to location receiving means in an emergency response system connected to said telephone system.

3. A patient monitoring and emergency location system as set forth in claim 2 said transceiver unit further comprising;

DGPS receiver means for receiving DGPS signals from a base station, and wherein said circuit means for producing a representation of said received location information for presentation to said telecommunications module is configured to also provide DGPS information to said telecommunications module.

4. A patient monitoring and emergency location system as set forth in claim 2 said transceiver unit further comprising;

dead reckoning circuit means for determining the relative location of said transceiver unit over time to any location at a fixed time during which an acceptable fixed location of said transceiver unit is known, and wherein said circuit means for producing a representation of said received location information for presentation to said telecommunications module is configured to also provide a representation of said dead reckoning information to said telecommunications module.

5. A patient monitoring and emergency location system as set forth in claim 2, said transceiver unit further comprising;

a distance traveled interpretive processor for receiving an output from said dead reckoning circuit and determining a distance traveled therefrom,

a trigger circuit for triggering the initiation of transmission to said telephone system by said telecommunications module when the distance traveled interpretive processor determines a distance traveled is greater than a predetermined trigger distance value.

6. A patient monitoring and emergency location system as set forth in claim 2 further comprising a processor adapted for transmitting emergency information from said transceiver unit to an emergency E911 system.

14. A method as set forth in claim 3 and further comprising:

sending coded data regarding nature of the emergency to said emergency system.

7. Emergency response system for receiving location information from a transceiver unit in proximity to a patient with an implantable medical device in communication with said transceiver unit, said emergency response system comprising;

at least one mobile unit operational on an emergency basis for receiving location information from said transceiver unit and having a GPS system and a computer system therein, such that said mobile unit GPS system produces data related to a present location of said mobile unit and makes said data related to said present location of said mobile unit available to said computer system and said mobile unit computer system comprises processor means for processing said received location information from said transceiver unit and said data related to the present location of said mobile unit to produce an indication of the relative position of said transceiver unit to said mobile unit, and

a base station for receiving through a telephone system a current location representation from said transceiver unit along with status information related to an implantable device implanted within a patient associated with said transceiver unit.

8. Method for operation of a transceiver unit for wearing on a person having location means and means for communicating with an implant and with a telephone network comprising:

providing a telemetric communications pathway between an implanted medical device(IMD) and a patient word device(PWD) to facilitate the transfer from the IMD to the PWD of data relating to any of the following information types;

a. Ser. No. or other unique ID data, b. Patient Condition, c. Device status data, d. Device Sensor data, and/or e. coordinating data,

providing a telemetric communications pathway between an IMD and a PWD to facilitate the transfer from the PWD to the IMD of data relating to any of the following information types;

a. Commands and /or b. Coordinating data,

providing a telemetric communications pathway between a node on a telephone network and said PWD and between a satellite GPS system and said PWD so as to facilitate the transfer of any of the following information types from said node and/or said satellite GPS system to said PWD;

a. Command data and/or coordinating data, and

providing a telemetric communications pathway between a node on a telephone network and said PWD so as to facilitate the transfer of any of the following information types from said PWD to said node;

PWD device data including any data received by the PWD from the IMD and/or any sensor data that may be developed and stored by the PWD and/or PWD status data and/or Dynamic Relative Reference data from a dead reckoning system associated with said PWD, and GPS and DGPS which may be stored by the PWD.

9. A method as set forth in claim 8 and further comprising

determining when said tranceiving unit has traveled a predetermined distance and

upon said determination of having traveled said predetermined distance, initiating a telephonic contact to a node on said telephone network.

10. A method as set forth in claim 8 and further comprising:

awaiting a determination of an emergency condition having occurred,

then initiating a telephonic contact to at least one node on said telephone network when as emergency condition has arisen.

11. A method as set forth in claim 10 and further comprising:

sending coded data regarding-the nature of the emergency to said at least one node.

12. A method as set forth in claim 10 and further comprising:

sending location data regarding the location of the PWD to said at least one node.

13. A method as set forth in claim 8 and further comprising:

awaiting a determination of an emergency condition having occurred,

then initiating a telephonic contact to an emergency system including a system of the two systems, standard emergency system and/or to an E-911 system, on said telephone network when as emergency condition has arisen.

15. A method as set forth in claim 13 and further comprising:

sending location data regarding the location of the PWD to said emergency system.

16. A method as set forth in claim 8 and further comprising

providing a real time clock system and a clock updating system for correcting the value of real time clock information based on satellite signals to said transceiver unit,

automatically using the corrected real time clock values to trigger an automatic turn on a communication between said PWD and a node in a narrow time slice, and

reporting to said node by said PWD some or all data facilitated for transfer on that communications pathway.

17. A method as set forth in claim 16 further comprising,

receiving command data from said node by said PWD during an additional narrow time slice.

18. A method as set forth in claim 17 further comprising,

transmitting a representation of said command data to said IMD from said PWD.

19. A method as set forth in claim 18 further comprising;

receiving said representation of said command data in said IMD,

programming the IMD based on said representation of said command data.

20. A method of monitoring a patient having a transceiver associated therewith and an implanted medical device in communication with said transceiver comprising;

monitoring GPS and DGPS location data by said transceiver,

interpreting said location data by said transceiver and

if said location data interpreted by said transceiver indicates the patient transceiver is outside a predetermined area,

initiating a telephone call by said transceiver to a telephone node on a telephone network, indicating the present location of said transceiver.

21. A method of monitoring a patient having a transceiver associated therewith and an implanted medical device in communication with said transceiver comprising;

receiving a command via a medical support network communicatively coupled to said transceiver;

monitoring said implanted medical device in accordance with said command, including monitoring the implanted medical device for an alarm condition associated with either a lack of signal over a predetermined period of time or for an alarm signal generated by said implanted medical device;

and

if either said alarm signal is received or if said lack of signal exists over said predetermined period of time,

automatically initiating an emergency telephone call by said transceiver to a node on a telephone network indicating an said alarm condition to said node.

27. The method of claim 21, further including programming said implanted medical device in accordance with said command.

28. The method of claim 27, wherein programming said implanted medical device includes altering an operating mode of said implanted medical device.

29. The method of claim 28, wherein altering an operating mode includes altering a pacing mode of said implanted medical device.

30. The method of claim 27, wherein programming said implanted medical device includes altering a parameter of said implanted medical device.

31. The method of claim 21, wherein said command is an encoded command.

32. The method of claim 21, further including:

generating, via said implanted medical device, patient data; and

transmitting said patient data to said medical support network in accordance with said command.

33. The method of claim 32, wherein transmitting said patient data is performed periodically in accordance with said command.

34. The method of claim 21, further including configuring said transceiver in accordance with said command, wherein said command specifies whether said transceiver is to initiate said emergency telephone call in response to said alarm condition.

35. The method of claim 21, further including specifying said predetermined period of time within said command.

36. The method of claim 21, further including specifying said alarm signal within said command.

37. The method of claim 21, wherein monitoring said implanted medical device further comprises the step of displaying information to the patient.

38. The method of claim 37, wherein monitoring said implanted medical device further comprises receiving information from the patient via a patient activator.

39. The method of claim 21, wherein monitoring said implanted medical device further comprises monitoring said implanted medical device via a monitor worn by the patient.

40. The method of claim 39, wherein monitoring said implanted medical device further comprises monitoring said implanted medical device via the monitor worn by the patient in one of a wrist-worn, belt worn or pocket carried monitor device.

41. The method of claim 21, wherein monitoring said implanted medical device further comprises monitoring said implanted medical device via a monitor positioned within communication range of the implanted medical device.

42. The method of claim 41, wherein monitoring said implanted medical device further comprises monitoring said implanted medical device via the monitor positioned within communication range of the implanted medical device near where the patient sleeps.

43. The method of claim 21, further comprising transmitting patient data to a medical network.

44. The method of claim 21, further comprising transmitting stored ECG histograms of patient data to a medical network.

45. The method of claim 44, further comprising transmitting marker channel information to the medical network.

46. The method of claim 21, further comprising transmitting real-time ECG data of the patient to a medical network.

47. The method of claim 21, further comprising transmitting measured physical parameters of the patient to a medical network.

48. The method of claim 21, wherein automatically initiating an emergency telephone call by said transceiver comprises initiating the emergency telephone call over a hard-wired phone line coupled to a telephone network.

49. The method of claim 21, wherein automatically initiating an emergency telephone call by said transceiver comprises the step of initiating the emergency telephone call over a cellular telephone network.

50. The method of claim 21, wherein automatically initiating an emergency telephone call by said transceiver comprises the step of initiating the emergency telephone call over a cordless telephone network.

51. The method of claim 21, further comprising sending an email message to a medical network.

52. The method of claim 21, further comprising recharging a battery within a monitoring device that monitors the implanted medical device.

53. The method of claim 21, further comprising monitoring the implanted medical device responsive to a command initiated by a patient.

54. The method of claim 21, wherein the command causes at least one of a clock or timer to be at least one of adjusted or reprogrammed.

22. A method of operating an emergency patient location system comprising,

providing said system with patients having implanted medical devices and transceiver units for monitoring communications from said implanted medical devices,

providing said transceiver units with means to receive GPS data and to store said GPS data,

providing said transceiver units with telecommunications equipment,

awaiting the development of emergency conditions to be reported by said transceiver units to said system across telephonic communications pathways,

dispatching emergency mobile units having receiver means tuned to receive signals from said transceiver unit reporting said emergency condition,

reporting from said transceiver unit location information,

receiving said location information in said emergency mobile unit and

employing said location information by said emergency mobile unit to locate the patient having the reported emergency.

23. Method as set forth in claim 22 further comprising continuously transmitting a signal by said transceiver unit after reporting said emergency condition and wherein said employing step includes triangulation on a signal transmitted by said transceiver unit after said transceiver unit initially reports said emergency condition.

24. Method as set forth in claim 22 wherein said location information transmitted by said transceiver unit includes DGPS information.

25. Method as set forth in claim 22 wherein said location information transmitted by said transceiver unit includes dead reckoning information.

26. A system for communicating with a medical clinic implanted in an ambulatory patient and for locating the patient to selectively monitor the functions of the medical clinic and provide assistance to and communications with the patient, the system comprising:

an implanted device telemetry transceiver within the implanted medical clinic for communicating data and operating instructions to and from the medical device, the implanted medical device telemetry transceiver having a transceiving range extending outside the patient'"'"'s body, a distance sufficient to receive and transmit such telemetered communication;

a communications network interface means coupled to a system controller and a communications means for selectively enabling to transmit positioning data to a medical support network and for selectively receiving commands from the medical support network wherein an implantable wireless interface including a real time clock and a system for updating said real time clock based on accurate time clock information in signals received from a global positioning system is integrated therewith;

dead reckoning circuit means for determining the relative location of said transceiver over time to any location at a fixed time during which an acceptable fixed location of said transceiver is known, and wherein a circuit means for producing a representation of received location information for presentation to a telecommunications module is configured to also provide a representation of said dead reckoning information to said telecommunications module; and

a distance traveled interpretive processor for receiving an output from said dead reckoning circuit and determining a distance traveled therefrom;

a trigger circuit for triggering the initiation of transmission to a telephone system by said telecommunications module including said communications means when the distance traveled interpretive processor determines a distance traveled is greater than a predetermined trigger distance value.

55. A method of monitoring a patient having a transceiver associated therewith and an implanted medical device in communication with the transceiver comprising:

receiving a command via a medical support network communicatively coupled to the transceiver;

monitoring the implanted medical device in accordance with the command, including monitoring the implanted medical device for an alarm condition associated with either a lack of signal over a predetermined period of time or an alarm signal generated by the implanted medical device; and

if either the alarm signal is received or if the lack of signal exists over the predetermined period of time,

automatically initiating an emergency telephone call by the transceiver to a node on a telephone network indicating the alarm condition to the node and transmitting patient data to a medical network.

56. The method of claim 55, wherein transmitting patient data to the medical network includes transmitting stored ECG histograms of patient data to the medical network.

57. The method of claim 55, wherein transmitting patient data to the medical network includes transmitting marker channel information to the medical network.

58. The method of claim 55, wherein transmitting patient data to the medical network includes transmitting real-time ECG data of the patient to the medical network.

59. The method of claim 55, wherein transmitting patient data to the medical network includes transmitting measured physical parameters of the patient to the medical network.

60. The method of claim 55, wherein automatically initiating the emergency telephone call by the transceiver comprises initiating the emergency telephone call over a hard-wired phone line coupled to the telephone network.

61. The method of claim 55, wherein automatically initiating the emergency telephone call by the transceiver comprises initiating the emergency telephone call over a cellular telephone network.

62. The method of claim 55, wherein transmitting the patient data is performed periodically in accordance with the command.

63. A method of monitoring a patient having a transceiver associated therewith and an implanted medical device in communication with the transceiver comprising:

receiving a command via a medical support network communicatively coupled to the transceiver;

monitoring said implanted medical device in accordance with the command or responsive to a patient activated command, including monitoring the implanted medical device for an alarm condition associated with either a lack of signal over a predetermined period of time or an alarm signal generated by the implanted medical device; and

if either the alarm signal is received or if said lack of signal exists over the predetermined period of time,

automatically initiating an emergency telephone call by said transceiver to a node on a telephone network indicating the alarm condition to said node and transmitting patient data to a medical network.

64. The method of claim 63, wherein transmitting patient data to the medical network includes transmitting stored ECG histograms of patient data to the medical network.

65. The method of claim 63, wherein transmitting patient data to the medical network includes transmitting marker channel information to the medical network.

66. The method of claim 63, wherein transmitting patient data to the medical network includes transmitting real-time ECG data of the patient to the medical network.

67. The method of claim 63, wherein transmitting patient data to the medical network includes transmitting measured physical parameters of the patient to the medical network.

68. The method of claim 63, wherein automatically initiating the emergency telephone call by the transceiver comprises initiating the emergency telephone call over a hard-wired phone line in coupled to the telephone network.

69. The method of claim 63, wherein automatically initiating the emergency telephone call by the transceiver comprises initiating the emergency telephone call over a cellular telephone network.

70. The method of claim 63, wherein transmitting the patient data is performed periodically in accordance with the command.