Patient monitoring for sub-acute patients based on activity state and posture

• US 10,456,089 B2
• Filed: 12/13/2013
• Issued: 10/29/2019
• Est. Priority Date: 12/14/2012
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Gourmelon, Lena, Greiner, Harald, De Waele, Stijn, Gegner, Guenther, Van Den Heuvel, Teun, Meier, Wilhelm, Cao, Hanqing, Emmrich, Thomas Gerhard, Aarts, Vincent Alexander Rudolf, Zimmermann, Steffen
• Primary Examiner(s): Wehrheim, Lindsey G
• Assistant Examiner(s): Sahand, Sana
• Application Number:
  US14/648,717
• Publication Number:
  US 20150305689A1
• Time in Patent Office: 2,146 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 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/4842 Monitoring progression or stage of a disease
• 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 5/7282 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 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• 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 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

A method, and corresponding system (300), for monitoring patients based on activity state and posture. Activity state and/or posture of a patient are measured. Further, one or more vital signs of the patient are measured according to a schedule. Based on the measured activity state and/or posture of the patient and the measured one or more vital signs, the schedule is adjusted and/or patient deterioration is monitored for.

Claims

1. A medical system comprising:

at least one sensor configured to measure at least one of an activity state and a posture of a patient;

at least one vital sign sensor separate from the at least one sensor and configured to measure one or more vital signs of the patient according to a schedule wherein the one or more vital signs comprise one or more of pulse, oxygen saturation (SpO2), respiration, temperature, and carbon dioxide;

at least one processor programmed to;

adjust the schedule when the measured one or more vital signs is outside of a vital sign threshold;

control the at least one vital sign sensor to measure the at least one vital sign according to the adjusted schedule including delaying a scheduled measurement until the activity state indicates a resting state that is below the position threshold;

generate a patient deterioration alert when (i) the measured at least one of activity state and posture of the patient and (ii) the measured one or more vital signs are each outside of respective alarm thresholds; and

output the patient deterioration alert to an audio device.

2. The medical system according to claim 1, wherein the schedule includes a measurement frequency for each of the one or more vital signs, and wherein the at least one processor is further programmed to:

determine a patient deterioration score for each of the one or more vital signs from corresponding vital sign measurements;

adjust the measurement frequency for each of the one or more vital signs based on changes in the corresponding patient deterioration score; and

control the at least one vital sign sensor to measure the at least one vital sign with the adjusted frequency.

3. The medical system according to claim 2, wherein the at least one processor is further programmed to:

determine a cumulative deterioration patient score from the one or more patient deterioration scores of the one or more vital signs; and

at least one of;

adjust the measurement frequency for each of the one or more vital signs based on the cumulative deterioration patient score; and

adjust an individual scoring scheme of the patient deterioration scores including adjusting the vital sign thresholds and a list of measured vital signs.

4. The medical system according to claim 1, wherein the at least one processor is further programmed to:

determine a patient deterioration score from the vital sign measurements;

determine changes in the patient deterioration score,

in response to a change in the patient deterioration score, re-measure one or more vital signs to confirm the change;

in response to confirmation of the change and based on the change, adjust the schedule;

control the at least one vital sign sensor to monitor the one or more vital signs according to the adjusted schedule.

5. The medical system according to claim 4, wherein the at least one processor is further programmed to:

control the at least one vital sign sensor to measure the one or more vital signs;

receive the one or more measured vital signs from the at least one vital sign sensor; and

delay re-measuring of the one or more vital signs until the at least one of the activity state and the posture matches at least one of a predetermined activity state and posture.

6. The medical system according to claim 4, wherein the at least one processor is further programmed to:

in response to confirmation of the change and based on the change, generate a notification.

7. The medical system according to claim 1, wherein the at least one processor is further programmed to:

receive the one or more measured vital signs from the at least one vital sign sensor; and

instruct the patient to take a predetermined at least one of an activity state and a posture before measuring one or more vital signs.

8. The medical system according to claim 1, wherein the at least one processor is further programmed to:

control the at least one vital sign sensor to measure the one or more vital signs;

receive the one or more measured vital signs from the at least one vital sign sensor; and

discard vital sign measurements made when at least one of the corresponding activity state and the posture does not match a corresponding one of a predetermined activity state and a predetermined posture.

9. The medical system according to claim 1, wherein the at least one processor is further programmed to:

receive the one or more measured vital signs from the at least one vital sign sensor; and

display a vital sign measurement and the corresponding at least one of activity state and posture, the corresponding at least one activity state and posture displayed adjacent the vital sign measurement.

10. The medical system according to claim 1, wherein the at least one processor is further programmed to:

calculate a posture trend;

compare the posture trend to an expected posture trend; and

display an indication of at least one of, based on the posture trend;

that the posture trend is as expected;

that the posture trend is not as expected; and

that action should be taken, such as turning the patient.

11. A medical method comprising:

with a first sensor, measuring at least one of an activity state and a posture of a patient;

with a second, separate sensor, measuring one or more vital signs of the patient according to a schedule;

with at least one electronic processor, controlling the first and second sensors to continue the measuring operations when (i) the measured at least one of activity state and posture of the patient is inside of a position threshold and (ii) the measured one or more vital signs is inside of a vital sign threshold;

with at least one electronic processor, adjusting the schedule when the measured one or more vital signs is outside of a vital sign threshold;

with the at least one processor, controlling the second sensor to measure the one or more vital signs according to the adjusted schedule;

with the at least one processor, generating a patient deterioration alert when (i) the measured at least one of activity state and posture of the patient and (ii) the measured one or more vital signs are both outside of an alarm threshold; and

with the at least one processor, outputting the patient deterioration alert to an audio device.

12. The medical method according to claim 11, wherein the schedule includes a measurement frequency for each of the one or more vital signs, and wherein said medical method further includes:

determining a patient deterioration score for each of the one or more vital signs from corresponding vital sign measurements; and

adjusting the measurement frequency for each of the one or more vital signs based on changes in the corresponding patient deterioration score.

13. The medical method according to claim 11, further including:

determining a patient deterioration score from the vital sign measurements;

determining changes in the patient deterioration score,

in response to a change in the patient deterioration score, controlling the second sensor to re-measure the one or more vital signs to confirm the change; and

in response to confirmation of the change and based on the change, adjusting the schedule.

14. The medical method according to claim 13, further including:

controlling the second sensor to delay re-measurement of the one or more vital signs until at least one of the activity state and posture matches a corresponding predetermined activity state and a posture.

15. The medical method according to claim 13, further including:

in response to confirmation of the change and based on the change, generating a notification.

16. The medical method according to claim 11, further including:

controlling an output device to delay an output of an indication requesting a clinician to instruct the patient to take a predetermined activity state or posture before measuring one or more vital signs.

17. The medical method according to claim 11,

wherein when a corresponding at least one of an activity state and a posture does not match at least one of a predetermined activity state and posture, at least one of:

discarding vital sign measurements made;

delaying a scheduled measurement until the at least one of the activity state and the posture matches at least one of a predetermined activity state and a posture;

adjusting the schedule; and

generating the patient deterioration alert.