Patient safety processor

• US 10,032,526 B2
• Filed: 03/15/2013
• Issued: 07/24/2018
• Est. Priority Date: 05/17/2001
• Status: Expired due to Fees

• Current Assignee: Lawrence A. Lynn
• Original Assignee: Lawrence A. Lynn
• Inventors: Lynn, Lawrence A., Lynn, Eric N.
• Primary Examiner(s): Patel, Neha
• Application Number:
  US13/844,404
• Publication Number:
  US 20130268291A1
• Time in Patent Office: 1,957 Days
• Field of Search: 705 2, 705 3
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: H04N 9/87 Regeneration of colour television signals H04N9/80 takes precedence

Abstract

A processor-based system for analyzing physiologic data and medical care is provided wherein the patient data is analyzed to construct images that are representative of a patient'"'"'s condition. The processor provides a self-modulating analysis, which is responsive to the occurrence of additional data items to increase the information contained in the images. Identifications of modes of physiologic failure by the analysis of the generated images provides for earlier recognition and intervention and improved protocolization of testing and treatment.

Claims

1. A patient monitor for monitoring a plurality of patients in a hospital system to detect, in real time, the development of sepsis cascades and for identifying, in real time, the patients developing the sepsis cascade, comprising:

a plurality of local patient safety monitors at the plurality of locations, each of the plurality of local patient safety monitors configured to receive physiologic measurements from at least a pulse oximeter and a blood pressure monitor for one or more patients,

a central patient safety monitor remote from the plurality of local patient safety monitors, and including a central safety image definitions database containing and occurrence definitions; and

wherein the central patient safety monitor is configured to receive at least the physiological measurements and to receive hematology and chemistry laboratory values associated with each patient of the plurality of patients, and includes;

a time series objectification processor configured to convert the received physiologic measurements, hematology, and chemistry laboratory values into a plurality of object streams, each including parallel time series of a plurality of objects, wherein each of the plurality of objects corresponds to one or more of an event or threshold violation of the received physiologic measurements defined by a predefined event definition set;

a relational binary processor configured to receive the plurality of object streams and generate a plurality of relational binary streams, each including parallel time series of a plurality of relational binaries, wherein each of the plurality of relational binaries corresponds to a determined relationship between two or more of the plurality of objects defined by a predefined relational binary definition set; and

a failure image processor configured to receive the plurality of object streams and the plurality of relational binary streams and further configured to generate a plurality of time-sequenced digital failure images of cascade patterns based on a combination of the plurality of relational binaries and the plurality of objects based on a predefined cascade pattern definition set and to store the images of the cascade pattern in the database of the central patient safety monitor;

wherein the at least one definition of the cascade pattern defines rise events and fall events wherein the at least one definition of the cascade pattern defines a timing of the rise events and the fall events in relation to each other to define a temporal pattern of the rise events and the fall events, and wherein the at least one definition of the cascade pattern defines a sepsis cascade as being comprised of at least four of the rise events or fall events;

a search engine configured to search the database of the central patient safety monitor to identify one or more patients having the cascade pattern, wherein the cascade pattern is a pattern indicative of sepsis; and

based on identifying the one or more patients having the cascade pattern, output on a graphical display of the central patient safety monitor an indication identifying the one or more patients having the cascade pattern and a digital image of the cascade pattern for each of the one or more patients identified as having the cascade pattern.

2. The system of claim 1, wherein outputting the indication identifying the one or more patients having the cascade pattern comprises:

sending a notification to a patient safety console of the local patient safety monitor associated with the one or more patients having the physiological data correspond to the cascade pattern,

wherein the notification causes the patient safety console to display on a graphical display of the patient safety console the indication identifying the one or more patients having the cascade pattern and the digital image of the cascade pattern for the one or more patients.

3. The system of claim 1, wherein the cascade pattern is associated with one or more of sepsis, severe sepsis or septic shock.

4. The system of claim 1, wherein the central patient safety monitor is further configured to determine and output at least one characteristic of the cascade pattern, the at least one characteristic comprising one or more of a severity of the cascade pattern, a duration of the cascade pattern, a time of onset of the cascade pattern, a timing relationship of the cascade pattern to other events or another cascade pattern, a time of termination of the cascade pattern, components of the cascade pattern, a state of evolution of the cascade pattern, a length of stay associated with the cascade pattern, or treatments associated with the cascade pattern.

5. The system of claim 4, wherein the at least one characteristic of the cascade pattern is defined by one or more of a number of changes in physiologic parameters associated with the cascade pattern, a severity of the changes in the physiologic parameters associated with the cascade pattern, a number of systems affected by the cascade pattern, or a presence, number or severity of failure associated with the changes in the physiologic parameters associated with the cascade pattern.

6. The system of claim 1, wherein the central patient safety monitor is further configured to determine and output a rate of growth of the cascade pattern based on one or more of an increase in number or severity of new changes in physiologic parameters being added per unit time, an increase in a number of systems affected, or an increase in a number of changes in physiologic parameters associated with different systems.

7. The system of claim 1,

wherein the central patient safety monitor is further configured to:

electronically receive first patient data associated with a first local patient safety monitor at a first hospital included in the plurality of hospitals;

electronically receive second patient data associated with a second local patient safety monitor at a second hospital included in the plurality of hospitals; and

identify one or more hospitals of the plurality of hospitals in which the one or more patients having the cascade pattern are located.

8. The system of claim 1, comprising:

a pulse oximeter;

a blood pressure monitor; and

wherein a portion of the data associated with the plurality of patients is received from the pulse oximeter and the blood pressure monitor.

9. A patient monitor for monitoring a plurality of patients in a hospital system to detect, in real time, the development of sepsis cascades and for identifying, in real time, the patients developing the sepsis cascade, comprising:

a plurality of local patient safety monitors at the plurality of locations, each of the plurality of local patient safety monitors configured to receive physiologic measurements from at least a pulse oximeter and a blood pressure monitor for one or more patients,

a central patient safety monitor remote from the plurality of local patient safety monitors, and including a central safety image definitions database containing and occurrence definitions; and

wherein the central patient safety monitor is configured to receive at least the physiological measurements and to receive hematology and chemistry values associated with each patient of the plurality of patients, and includes;

a time series objectification processor configured to convert the received physiologic measurements, hematology, and chemistry laboratory values into a plurality of object streams, each including parallel time series of a plurality of objects, wherein each of the plurality of objects corresponds to one or more of an event or threshold violation of the received physiologic measurements defined by a predefined event definition set;

a relational binary processor configured to receive the plurality of object streams and generate a plurality of relational binary streams, each including parallel time series of a plurality of relational binaries, wherein each of the plurality of relational binaries corresponds to a determined relationship between two or more of the plurality of objects defined by a predefined relational binary definition set; and

a failure image processor configured to receive the plurality of object streams and the plurality of relational binary streams and further configured to generate a plurality of time-sequenced digital failure images of cascade patterns based on a combination of the plurality of relational binaries and the plurality of objects based on a predefined cascade pattern definition set and to store the images of the cascade pattern in the database of the central patient safety monitor;

wherein the at least one definition of the cascade pattern defines rise events and fall events wherein the at least one definition of the cascade pattern defines a timing of the rise events and fall events in relation to each other to define a temporal pattern of the rise events and the fall events, and wherein the at least one definition of the cascade pattern defines a sepsis cascade as being comprised of at least four of the rise events or fall events;

a search engine configured to search the database of the central patient safety monitor to identify one or more patients of the plurality of patients having the cascade pattern, wherein the cascade pattern is a pattern indicative of sepsis;

based on identifying the one or more patients of the plurality of patients having the cascade pattern, output a warning to a display of the central patient safety monitor indicating detection of the cascade pattern and identifying the one or more patients of the plurality of patients having physiologic data corresponding to the cascade pattern, the warning comprising a digital image of the cascade pattern;

track a growth or decline of the cascade pattern; and

based on tracking the growth or decline of the cascade pattern, output an indication indicative of the growth or decline of the cascade pattern,

wherein the cascade pattern comprises a pathophysiologically linked series of changes in physiologic parameters and laboratory data associated with a particular patient, and

wherein the growth or decline of the cascade pattern represents an increase or a decrease in a number of the pathophysiologically linked series of changes in the physiologic parameters and the laboratory data per unit time.

10. The system of claim 9, wherein the image of the cascade pattern comprises a moving picture representing the growth or decline of the cascade pattern.

11. The system of claim 9, wherein the cascade pattern is associated with one or more of severe sepsis or septic shock.

12. The system of claim 9, wherein the central patient safety monitor is further configured to determine and output, to a user interface displayed by a patient safety console, an indication of a type of cascade pattern detected.

13. The system of claim 9, wherein the central patient safety monitor is further configured to determine and output, to a user interface displayed by a patient safety console, an indication of a timing and a type of the changes in the physiologic parameters and the laboratory data associated with the cascade pattern.

14. The system of claim 9, wherein the central patient safety monitor is further configured to determine and output, to a user interface displayed by a patient safety console, an indication of a length of the cascade pattern.

15. The system of claim 9, wherein the central patient safety monitor is further configured to:

determine and output, to a user interface displayed by a patient safety console, an indication of timing of therapy in relation to the pathophysiologically linked series of changes in the physiologic parameters and the laboratory data associated with the cascade pattern.

16. The system of claim 9, comprising:

a patient safety console, and

wherein the central patient safety monitor is further configured to;

based on identifying the one or more patients of the plurality of patients having physiologic data corresponding to the cascade pattern, send a notification to the patient safety console comprising information indicating the detection of the cascade pattern and

identifying the one or more patients of the plurality of patients having physiologic data corresponding to the cascade pattern,

wherein the notification activates the patient safety console to cause the patient safety console to display the information indicating the detection of the cascade pattern and identifying the one or more patients of the plurality of patients having physiologic data corresponding to the cascade pattern.

17. The system of claim 9, comprising:

a pulse oximeter;

a blood pressure monitor; and

wherein a portion of the electronic medical records is derived from output received from the pulse oximeter and the blood pressure monitor.

18. A patient monitor for monitoring a plurality of patients in a hospital system to detect, in real time, the development of sepsis cascades and for identifying, in real time, the patients developing the sepsis cascade, comprising:

a plurality of local patient safety monitors at the plurality of locations, each of the plurality of local patient safety monitors configured to receive physiologic measurements from at least a pulse oximeter and a blood pressure monitor for one or more patients,

a central patient safety monitor remote from the plurality of local patient safety monitors, and including a central safety image definitions database containing and occurrence definitions; and

wherein the central patient safety monitor is configured to receive at least the physiological measurements and to receive hematology and chemistry laboratory values associated with each patient of the plurality of patients, and includes;

a time series objectification processor configured to convert the received physiologic measurements, hematology, and chemistry laboratory values into a plurality of object streams, each including parallel time series of a plurality of objects, wherein each of the plurality of objects corresponds to one or more of an event or threshold violation of the received physiologic measurements defined by a predefined event definition set;

a relational binary processor configured to receive the plurality of object streams and generate a plurality of relational binary streams, each including parallel time series of a plurality of relational binaries, wherein each of the plurality of relational binaries corresponds to a determined relationship between two or more of the plurality of objects defined by a predefined relational binary definition set; and

a failure image processor configured to receive the plurality of object streams and the plurality of relational binary streams and further configured to generate a plurality of time-sequenced digital failure images of cascade patterns based on a combination of the plurality of relational binaries and the plurality of objects based on a predefined cascade pattern definition set and to store the images of the cascade pattern in the database of the central patient safety monitor;

wherein the at least one definition of the cascade pattern defines rise events and fall events, wherein the at least one definition of the cascade pattern defines a timing of the rise events and fall events in relation to each other to define a temporal pattern of the rise events and the fall events, and wherein the at least one definition of the cascade pattern defines a complex sepsis cascade as being comprised of at least four of the rise or fall events,

a search engine configured to search the parallel and overlapping time series to;

identify a plurality of occurrences, each occurrence of the plurality of occurrences being comprised of a rise event or a fall event, the occurrences comprising one or more inflammatory occurrences, metabolic occurrences, volumetric occurrences, hemodynamic occurrences, therapy occurrences, hematologic occurrences, or respiratory occurrences;

identify a timing of the plurality of occurrences;

identify at least one relational pattern of occurrences along a plurality of time series, wherein the at least one relational pattern of occurrences is indicative of sepsis for a particular patient; and

identify the particular patient generating the at least one relational pattern of occurrences; and

based on identifying the particular patient generating the at least one relational pattern of occurrences, output to a graphical display of the central patient safety monitor an indication comprising information identifying the particular patient generating the at least one relational pattern of occurrences and indicating a detection of sepsis for the particular patient, the indication comprising a digital image of the at least one relational pattern of occurrences.

19. The system of claim 18, comprising:

a patient safety console, and

wherein the central patient safety monitor is further configured to;

based on identifying the particular patient generating the at least one relational pattern of occurrences, send a notification to the patient safety console,

wherein the notification causes the patient safety console to display the indication comprising the information identifying the particular patient generating the at least one relational pattern of occurrences and indicating the detection of sepsis for the particular patient.

20. The system of claim 18, comprising:

a pulse oximeter;

a blood pressure monitor; and

wherein a portion of the patient datasets is derived from output received from the pulse oximeter and the blood pressure monitor.