Decision support tool for use with a medical monitor-defibrillator

• US 10,303,852 B2
• Filed: 03/15/2013
• Issued: 05/28/2019
• Est. Priority Date: 07/02/2012
• Status: Active Grant

• Current Assignee: Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Physio-Control Incorporated (Stryker Corporation)
• Inventors: Peterson, Ken, Smith, Mitchell A, Edwards, Denny Craig, Barcelos, Nathaniel Paul, Wootten, James, Young, Clayton, Merry, Randy L., Lewis, Dana S, Daynes, John C, Juhasz, Paul R, Okey, David, Witters, Steven, Turner, Ira M
• Primary Examiner(s): Chang, Li-Wu
• Application Number:
  US13/836,769
• Publication Number:
  US 20140272860A1
• Time in Patent Office: 2,265 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 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61N 1/3993 User interfaces for automatic external defibrillators
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Work flows are modeled as a graph of interdependent tasks to be performed. The tasks to be performed are set by a task file module configured to enable interactions between tasks and including modules for event viewing, protocol assistance, smart messaging, smart indices, reference material lookup. A decision support manager module is configured to construct data and model profiles for storage in a data and model profile bank, events for storage in a decision support events bank, and protocols for storage in a decision support protocol bank. Configuration files are provided to specify a configuration for execution of one of the tasks. Data entered through a user interface or from a network via a wireless or wired communication module may define task files in the task files module, configuration files in the configuration files module, as well as data, events, and protocols to be used for a defibrillation procedure. A decision support manager module is configured to construct a dependency graph of tasks as specified in at least one of the configuration files and to execute the dependency graph.

Claims

1. For use in a medical device for providing decision support to a caregiver:

a defibrillation processor configured to control an administration of an electrical charge as part of a defibrillation administration; and

a decision support module configured to provide decision support to the caregiver during operation of the medical device, the decision support module comprising;

a task file module configured to manage one or more task files, the task files defining a workflow of one or more interdependent tasks to be performed and defining and enabling interactions between the interdependent tasks;

a configuration file module configured to manage one or more configuration files, the configuration files specifying a configuration for execution of the one or more interdependent tasks by providing configurations for data and data flows for a task defined by the task files of the task file module;

a bank configured to provide one or more of;

data, model profiles, events, and protocols to the decision support module, the bank fed with medical data from the medical device;

a decision support manager module configured to construct a dependency graph modeling the workflow of interdependent tasks defined by the task files of the task file module using configurations for each interdependent task provided by the configuration file module; and

a dashboard generator configured to provide a visual, audio, or audio-visual display, based on the dependency graph constructed by the decision support manager module, the visual, audio, or audio-visual display configured to provide enhanced coaching to the caregiver to cause the caregiver to perform at least one of a treatment or monitoring, at least one of the treatment including administration of a treatment via the defibrillation processor.

2. The decision support module of claim 1 wherein the medical device is configured to be operated to deliver a defibrillator pulse.

3. The decision support module of claim 1 wherein the task file module includes one or more modules selected from the group consisting of:

an event viewer module;

a protocol

assistant module;

a smart

messaging

module;

a smart

indices module;

and

a reference material lookup module.

4. The decision support module of claim 1 further comprising an event viewer module configured to generate a series of time stamped events for tracking events that happened with a patient.

5. The decision support module of claim 1 further comprising a dashboard generator module and an event viewer module;

wherein the dashboard generator module is configured to generate a non-indexed view of a major vital sign as it varies over time; and

wherein the event viewer module is configured to provide an event marker at a point in time along the non-indexed view of the major vital sign, the event marker providing a record of one or more predetermined events associated with the major vital sign at that point in time.

6. The decision support module of claim 5 wherein the one or more predetermined events provided in the record of the event marker is taken from the group of predetermined events consisting of an indexed view of the major vital sign, a view of the major vital sign over a specific period of time, a specific event, details of a specific event, a time stamped event, a listing of time stamped events, a view of one or more different vital signs at that point in time, and a combination of one or more predetermined events thereof.

7. The decision support module of claim 5 wherein the record of the event marker is configurable by a user with one or more new events.

8. The decision support module of claim 7 further comprising a predetermined hierarchy of manually programmable events, the hierarchy of manually programmable events providing the one or more new events selectable by the user configuring the record of the event marker.

9. The decision support module of claim 5 wherein the record of the event marker is provided with a link back to the event marker, the link back enabling a user to return to the major vital sign as it varies over time.

10. The decision support module of claim 5 wherein the major vital sign is one of a group consisting of heart beat, SpO₂, CO₂, temperature, an oxygen saturation in the blood of a patient;

a chest compression of a patient;

an image of the internal structure of a patient;

an oxygen saturation in the blood in the brain of a patient;

the acidity or alkalinity of fluids in a patient; and

other patient parameter.

11. The decision support module of claim 1 further comprising an event viewer module configured to associate an event marker to an event, the event marker providing a record of one or more predetermined events associated with the event.

12. The decision support module of claim 1 further comprising an event viewer module configured to generate a series of time stamped events for tracking a condition of a patient.

13. The decision support module of claim 12 wherein the series of time stamped events is contained in a record.

14. The decision support module of claim 1 further comprising a protocol assistant module configured to generate a protocol of one or more activities.

15. The decision support module of claim 1 further comprising a dashboard generator configured to generate a display of one or more activities and a checklist of tasks for a care path.

16. The decision support module of claim 14 wherein the protocol assistant module is further configured to generate a time stamp for each activity of the protocol when completed.

17. The decision support module of claim 14 wherein the one or more of the activities is associated with an event that is automatically generated at the time the activity of the protocol is completed.

18. The decision support module of claim 14 wherein the one or more activities of the protocol are displayed in a primary work area of a display, and wherein information that was displayed in the primary work area of the display is moved to a background of the display.

19. The decision support module of claim 14 wherein the one or more activities of the protocol are displayed in a primary work area of a display unless clinically critical information is displayed in the primary work area of the display at the time the protocol is to be displayed.

20. The decision support module of claim 14 wherein the protocol assistant module is configured to access a Sparkline non-indexed view of a major vital sign as it varies over time and to access an event marker at a point in time along the non-indexed view of the major vital sign generated by an event viewer module and to access a record of one or more predetermined events associated with the major vital sign at that point in time provided by the event marker.

21. The decision support module of claim 14 wherein the protocol assistant module is further configured to automatically appear on a display when one or more pre- determined events occur.

22. The decision support module of claim 14 wherein the protocol assistant module is manually selectable using a protocol key.

23. The decision support module of claim 14 further comprising a user defined hierarchy of one or more protocols selectable by the user to configure the protocol generated by the decision support module.

24. The decision support module of claim 14 further comprising a system defined hierarchy of one or more protocols selectable by a user to configure the protocol generated by the decision support module.

25. The decision support module of claim 1 further comprising a smart messaging module configured to generate a set of one or more predefined messages to inform a user of an action.

26. The decision support module of claim 25 wherein the action informed by the one or more predefined messages is taken from a group of actions consisting of a reminder, a reminder to take a medication, and a suggestion to contact one or more persons.

27. The decision support module of claim 25 wherein the set of predefined messages appears as a pop-up on a display.

28. The decision support module of claim 27 wherein the pop-up is displayed in a general work area of the display.

29. The decision support module of claim 28 wherein the general work area is a bottom waveform region.

30. The decision support module of claim 25, wherein the smart messaging module is further configured to receive, from a user, an acknowledgement or cancellation of one or more of the predefined messages and wherein a record is made of the acknowledgement or cancellation.

31. The decision support module of claim 30 wherein the acknowledgement is associated with an event that is automatically generated at the time of the acknowledgement.

32. The decision support module of claim 25 wherein the smart messaging module is further configured to generate the set of one or more predefined messages on the occurrence of an initiating event or a time based Boolean Equation using a combination of vital sign data and events.

33. The decision support module of claim 25 wherein the predefined message is configured to generate an output response that is selected from a group consisting of no output response, an output response tied to a standard set of events, and an output response based on a user predefined hierarchy of manually enterable events.

34. The decision support module of claim 1 further comprising a smart indices module configured to generate a predefined indice value associated with an overall patient condition.

35. The decision support module of claim 34 wherein the smart indices module is further configured to generate the predefined indice value by a predefined indices algorithm.

36. The decision support module of claim 34 wherein the indice value appears as a vital sign information on a display.

37. The decision support module of claim 34 wherein the indice value will appear throughout a patient episode.

38. The decision support module of claim 34 wherein the indice value can be programmed to appear at the beginning of a patient episode, manually selectable via a indices menu, or automatically displayed by initiating an event.

39. The decision support module of claim 1 further comprising a reference material lookup module configured to display either a user defined set of text or graphical information in a predetermined content format.

40. The decision support module of claim 39 wherein the predetermined content format is selected from a group of formats consisting of .pdf, .doc, and html5.

41. The decision support module of claim 39 wherein the user defined set of text or graphical information is accessed manually via a user defined hierarchical menu of reference material.

42. The decision support module of claim 39 wherein the user defined set of text or graphical information is generated when the reference material is associated with a protocol task of a smart message.

43. The decision support module of claim 39 wherein preprogrammed information is displayed in a general work area of a display.

44. The decision support module of claim 43 wherein the general work area is in a bottom region of the display.

45. The decision support module of claim 43 further configured to provide a menu to enable a user to scroll through the preprogrammed information.

46. A system for providing decision support to a caregiver comprising:

a medical device comprising;

a treatment module configured to at least one of administer a treatment, control administration of a treatment or assist an administration of a treatment, the treatment including delivery of a defibrillation pulse;

a decision support module comprising;

a task file configured to define a workflow of one or more interdependent tasks to be performed and to define and enable interactions between the interdependent task;

a configuration file configured to specify a configuration for execution of the one or more interdependent tasks by providing configurations for data and data flows for a task defined by the task files of a task file module;

a data and model profile bank configured to store one or more of data and one or more model profiles for the task file;

a decision support event bank configured to store one or more events for the task file;

a decision support protocol bank configured to store one or more priorities for the task file; and

a decision support manager module configured to construct a dependency graph of tasks as specified in the configuration file, the dependency graph providing enhanced coaching to the caregiver to cause the caregiver to perform at least one of a treatment or monitoring, the treatment including at least one of treatment via the treatment module or treatment assisted by the treatment module; and

an external utility in communication with the medical device configured to exchange data between the medical device and the external utility for one or more of configuring the task file, configuring the configuration file, feeding data and model profile to the data and model profile bank, feeding decision support events to the decision support event bank, and feeding decision support protocols to the decision protocol bank.

47. The system of claim 46 wherein the medical device comprises a defibrillator operable to deliver the defibrillation pulse.

48. The system of claim 47 wherein the defibrillator includes a module selected from the group consisting of:

an event viewer module;

a protocol assistant module;

a smart messaging module;

a smart indices module; and

a reference material lookup module.

49. The system of claim 47, wherein the system is configured to communicate the dependency graph using a display of the defibrillator.

50. The system of claim 47 wherein the system is configured to communicate the dependency graph in audio format over a loud speaker of the defibrillator.

51. The system of claim 46 further comprising:

a user interface for entering data into the medical device for one or more of;

configuring the task file, configuring the configuration file, feeding data and model profile to the data and model profile bank, feeding decision support events to the decision support event bank, and feeding decision support protocols to the decision protocol bank.

52. The system of claim 46 wherein the external utility is selected from a group consisting of a medical monitor, a commercial tablet, a personal computer, and a smartphone.