Patient care recommendation system

• US 10,383,526 B2
• Filed: 08/05/2011
• Issued: 08/20/2019
• Est. Priority Date: 08/06/2010
• Status: Active Grant

• Current Assignee: United States Secretary of the Army, U.S. Army Medical Research And Materiel Command
• Original Assignee: The United States of America As Represented By The Secretary of Agriculture
• Inventors: Batchinsky, Andriy, Cancio, Leopoldo C., Salinas, Jose
• Primary Examiner(s): Weston, Tiffany
• Assistant Examiner(s): Tran, Tho Q
• Application Number:
  US13/204,502
• Publication Number:
  US 20150157213A1
• Time in Patent Office: 2,937 Days
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• 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 5/7228 Signal modulation applied to the input signal sent to patient or subject; demodulation to recover the physiological signal modulation H03C
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• 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: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 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: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Disclosed are systems and methods to provide a patient care recommendation. The systems and methods receive patient information and a plurality of patient physiological signals that are related to a patient. The systems and methods are then operable to produce at least one derived patient signal from at least one of the plurality of patient physiological signals. The systems and methods use the patient information, at least one of the plurality of patient physiological signals, and the at least one derived patient signal to provide at least one patient care recommendation.

Claims

1. A patient health determination system, comprising:

a respiration monitoring device that is operable to provide a plurality of patient respiratory signals related to a patient;

a heart monitoring device that is operable to provide a plurality of patient heart signals related to the patient; and

a diagnosis engine coupled to the respiration monitoring device and the heart monitoring device, wherein the diagnosis engine is programmed to;

receive the plurality of patient respiratory signals from the respiration monitoring device;

receive the plurality of patient heart signals from the heart monitoring device;

determine a degree of decoupling, where the degree of decoupling is determined based on a ratio of a length of a R-to-R interval within one inspiration cycle to a length of a R-to-R interval within one expiration cycle in an electrocardiography waveform, wherein the R-to-R interval within one inspiration cycle and the R-to-R interval within one expiration cycle are obtained from one respiratory cycle; and

provide a patient health indicator based on only the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals; and

wherein the patient health indicator provides an indication of a need for life saving intervention by medical personnel.

2. The system of claim 1, wherein each of the plurality of patient respiratory signals is received by the diagnosis engine within at most 5 microseconds of a most recently received patient respiratory signal.

3. The system of claim 1, wherein each of the plurality of patient heart signals is received by the diagnosis engine with a granularity of at most 5 microseconds.

4. The system of claim 1, wherein the degree of decoupling determined between the plurality of patient respiratory signals and the plurality of patient heart signals is relative to a coupling between the plurality of patient respiratory signals and the plurality of patient heart signals that exists in a healthy patient.

5. The system of claim 1, wherein the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals is associated with a physiological sign of instability in a database that is coupled to the diagnosis engine.

6. The system of claim 1, wherein the diagnosis engine determines the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals by performing a calculation on at least some of the plurality of patient respiratory signals and at least some of the plurality of patient heart signals.

7. The system of claim 1, further comprising:

a display coupled to the diagnosis engine and operable to display the patient health indicator.

8. A non-transitory computer-readable medium comprising computer-readable instructions to provide a patient health determination, said computer-readable instructions comprising instructions that, when executed by a processor, cause the processor to:

retrieve a plurality of patient respiratory signals from a respiration monitoring device;

retrieve a plurality of patient heart signals from a heart monitoring device;

determine a degree of decoupling, where the degree of decoupling is determined based on a ratio of a length of a R-to-R interval within one inspiration cycle to a length of a R-to-R interval within one expiration cycle in an electrocardiography waveform; and

provide a patient health indicator based only on the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals; and

wherein the patient health indicator provides an indication of a need for life saving intervention by medical personnel.

9. The non-transitory computer-readable medium of claim 8, wherein the instructions, when executed by a processor, cause the processor to:

retrieve each of the plurality of patient respiratory signals within at most 5 microseconds of a most recently retrieved patient respiratory signal.

10. The non-transitory computer-readable medium of claim 8, wherein the plurality of patient heart signals have a granularity of 5 microseconds or less.

11. The non-transitory computer-readable medium of claim 8, wherein the degree of decoupling determined between the plurality of patient respiratory signals and the plurality of patient heart signals is relative to a coupling between the plurality of patient respiratory signals and the plurality of patient heart signals that exists in a healthy patient.

12. The non-transitory computer-readable medium of claim 8, wherein the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals is associated with a physiological sign of instability in a database that is coupled to the processor.

13. The non-transitory computer-readable medium of claim 8, wherein the instructions, when executed by a processor, that cause the processor to determine the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals further include instructions that cause the processor to:

perform a calculation on at least some of the plurality of patient respiratory signals and at least some of the plurality of patient heart signals.

14. The non-transitory computer-readable medium of claim 8, wherein the instructions, when executed by a processor, cause the processor to:

provide the patient health indicator to a display.

21. The computer-readable medium of claim 8, wherein the degree of decoupling is determined to exist when a ratio of the length of the R-to-R interval within one inspiration cycle to the length of the R-to-R interval within one expiration cycle in an electrocardiography waveform is greater than or equal to 1.

15. A method to provide a patient health determination, comprising:

receiving in at least a waveform analysis engine a plurality of patient respiratory signals from a respiration monitoring device that is coupled to a patient;

receiving in at least the waveform analysis engine a plurality of patient heart signals from a heart monitoring device that is coupled to the patient;

determining a degree of decoupling with at least one of the waveform analysis engine and a diagnosis engine, where the degree of decoupling is determined based on a ratio of a length of a R-to-R interval within one inspiration cycle to a length of a R-to-R interval within one expiration cycle in an electrocardiography waveform, wherein the R-to-R interval within one inspiration cycle and the R-to-R interval within one expiration cycle are obtained from one respiratory cycle; and

providing with the diagnosis engine a patient health indicator to an indicator device, wherein the patient health indicator is based only on the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals; and

wherein the patient health indicator provides an indication of a need for life saving intervention by medical personnel.

16. The method of claim 15, further comprising:

receiving each of the plurality of patient respiratory signals within at most 5 microseconds of a most recently received patient respiratory signal; and

receiving each of the plurality of patient heart signals within at most 5 microseconds of a most recently received patient heart signal.

17. The method of claim 15, wherein the degree of decoupling determined between the plurality of patient respiratory signals and the plurality of patient heart signals is relative to a coupling between the plurality of patient respiratory signals and the plurality of patient heart signals that exists in a healthy patient.

18. The method of claim 15, wherein the degree of decoupling between the plurality of patient respiratory signals and the plurality of patient heart signals is associated with a physiological sign of instability that is retrieved from a database.

19. The method of claim 15, wherein the determining the degree of decoupling includes:

performing a calculation on at least some of the plurality of patient respiratory signals and at least some of the plurality of patient heart signals.

20. The method of claim 15, wherein the indicator device is a display device.

22. The method of claim 15, further comprising receiving patient information;

and

wherein the patient health indicator is based on the received patient information.