Energy Management for Adherent Patient Monitor

• US 20090076343A1
• Filed: 09/12/2008
• Published: 03/19/2009
• Est. Priority Date: 09/14/2007
• Status: Abandoned Application

• Current Assignee: Medtronic Monitoring, Inc. (Medtronic Plc)
• Original Assignee: Corventis
• Inventors: Bly, Mark J., Mazar, Scott T., James, Kristofer J., Wang, Jerry S.
• Application Number:
  US12/209,274
• Publication Number:
  US 20090076343A1
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 2560/0209 adapted for power saving
• CPC Class Codes: A61B 2560/0412 Low-profile patch shaped housings
• CPC Class Codes: A61B 2562/08 Sensors provided with means for identification, e.g. barcodes or memory chips
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• 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 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/02455 provided with high/low alarm devices
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/4869 Determining body composition
• CPC Class Codes: A61B 5/6833 Adhesive patches
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61B 5/7232 : involving compression of the physiological signal, e.g. to extend the signal recording period
• 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 7/003 : Detecting lung or respiration noise
• CPC Class Codes: A61N 1/36521 : the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36535 : controlled by body position or posture
• CPC Class Codes: A61N 1/36542 : controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36592 : controlled by the heart rate variability
• CPC Class Codes: A61N 1/37282 : characterised by communication with experts in remote locations using a network
• CPC Class Codes: G06Q 2220/00 : Business processing using cryptography postage metering system using cryptography G06Q2250/05
• CPC Class Codes: G16H 10/60 : for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: H04L 9/50 : using hash chains, e.g. blockchains or hash trees

Abstract

A heart failure patient management system includes a detecting system. The detecting system includes an adherent device configured to be coupled to a patient. The adherent device includes a plurality of sensors to monitor physiological parameters of the patient to determine heart failure status. At least one ID may be coupled to the adherent device that is addressable and unique to each adherent device. A wireless communication device is coupled to the plurality of sensors and configured to transfer patient data directly or indirectly from the plurality of sensors to a remote monitoring system. The remote monitoring system is coupled to the wireless communication device. An energy management device may be coupled to the plurality of sensors

Claims

1. A system for monitoring a patient, the system comprising:

a patient detecting system for measuring the patient including,

an adherent device configured to be coupled to a patient, the adherent device comprising a plurality of sensors to measure physiological parameters of the patient to determine physiologic status of the patient,

an energy management device coupled to the plurality of sensors;

a wireless communication device coupled to the plurality of sensors; and

a remote monitoring system coupled to the wireless communication device, wherein wireless communication device is configured to transfer patient data from the plurality of sensors to the remote monitoring system.

2. The system of claim 1, further comprising an energy generation device coupled to the energy management device.

3. The system of claim 1, wherein the energy management device is part of the patient detecting system.

4. The system of claim 1, wherein the adherent device is configured to sample intermittently.

5. The system of claim 4, wherein the plurality of sensors are configured to sample no more than 30 seconds for every minute for ECG, no more than once per second for an accelerometer sensor and no more than 60 seconds for every 15 minutes for impedance.

6. The system of claim 1, wherein the plurality of sensors is configured to measure at least one of bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux or patient activity.

7. The system of claim 6, wherein the plurality of sensor is configured to measure the patient activity with at least one of a ball switch, an accelerometer, minute ventilation, heart rate, bioimpedance, noise, skin temperature, heat flux, blood pressure, muscle noise or patient posture.

8. The system of claim 1, wherein the plurality of sensors is configured to switch between different modes, the different modes comprising a first mode and a second mode, the first mode different from the second mode.

9. The system of claim 1, wherein the energy management device is configured to deactivate selected sensors to reduce redundancy and reduce power consumption.

10. The system of claim 1, wherein the energy management device is configured to use sensor cycling for energy management.

11. The system of claim 10, wherein the plurality of sensors comprises a first portion of sensors and a second portion of sensors and wherein the first portion is configured to sample at first times the second portion is configured to sample at second times.

12. The system of claim 11, wherein the first times are different from the second times, and wherein the energy management device is configured to cycle sampling between the first sensors and the second sensors.

13. The system of claim 1, wherein the plurality of sensors comprises a first core sensor and a second sensor, the first core sensor configured to continuously monitor and detect, the second sensor configured to verify a physiological status in response to the core sensor raising a flag.

14. The system of claim 1, wherein the plurality of sensors comprises a first portion and a second portion, the first portion different from the second portion, and wherein the first portion of sensor are configured for short term tracking, and the second portion of the sensors are configured for long term tracking.

15. The system of claim 1, wherein the adherent device is configured to be activated.

16. The system of claim 15, wherein the adherent device is activated by at least one of, a physiological trigger, automatic impedance, a tab pull, battery insertion, a hall or reed switch, a breakable glass capsule, a dome switch, by light activation, pressure activation, body temperature activation, a connection between electronics associated with the sensors and the adherent device, exposure to air and by a capacitive skin sensor.

17. The system of claim 1, wherein the energy management device is configured to perform at least one of modulate a clock speed to optimize energy, monitor cell voltage drop—

unload cell, monitor coulomb-meter or other battery monitor, battery end of life dropoff to transfer data, elective replacement indicator, call center notification, sensing windows by the sensors based on a monitored physiological parameter or sensing rate control.

18. The system of claim 2, wherein the energy generation device is configured to generate energy by at least one of, a thermo-electric unit, kinetics, fuel cell, through solar power, a zinc air interface, Faraday generator, internal combustion, a micro-battery and with a rechargeable device.

19. The system of claim 1, further comprising:

a processor comprising a tangible medium coupled to the plurality of sensors and to the wireless communication device, the processor configured to receive patient data from the plurality of sensors and process the patient data.

20. The system of claim 19, wherein the processor is located at the remote monitoring system.

21. The system of claim 19, wherein the processor is included in a monitoring unit, the monitoring unit comprising part of the patient detecting system.

22. The system of claim 1, further comprising:

logic resources located at the remote monitoring system to determine a physiological status of the patient and detect a physiological event of a patient.

23. The system of claim 21, further comprising:

logic resources located at the monitoring unit that determine a physiological event of a patient.

24. The system of claim 1, further comprising a processor system comprising a tangible medium and wherein the processor system has program instructions for evaluating values received from the plurality of sensors with respect to acceptable physiological ranges for each value received by the processor.

25. The system of claim 1, wherein the wireless communication device is configured to receive instructional data from the remote monitoring system.

26. The system of claim 1, wherein the wireless communication device comprises at least one of a modem, a serial interface, a LAN connection and a wireless transmitter.

27. The system of claim 1, wherein the wireless communication device includes a receiver and a transmitter for receiving data indicating the values of the physiological event detected by the plurality of sensors, and for communicating the data to the remote monitoring system.

28. The system of claim 1, wherein the wireless communication device comprises a wireless local area network for receiving data from the plurality of sensors.

29. The system of claim 1, wherein the wireless communication device includes a data storage for recording the data received from the plurality of sensors.

30. The system of claim 29, wherein the wireless communication device includes an access device for enabling access to information recorded in the data storage from the remote monitoring system.

31. The system of claim 1, wherein the wireless communication device includes a controller configured to control sending of the data supplied by the plurality of sensors.

32. The system of claim 1, further comprising:

an external device coupled to the adherent device comprising the plurality of sensors.

33. The system of claim 32, wherein the external device comprises at least one of a weight scale, a blood pressure cuff, a medical treatment device or a medicament dispenser.

34. The system of claim 1, further comprising:

a notification device coupled to the patient detecting system and the remote monitoring system, the notification device configured to provide a notification when values received from the plurality of sensors are outside acceptable physiological ranges.

35. The system of claim 34, wherein the patient measurement system is configured to measure physiological parameters at a high-rate of sampling in response to a trigger from at least one of a medical provider, the remote monitoring system or a medical treatment device and wherein the at least one of the medical provider, the remote monitoring system or the medical treatment device are configured to trigger the high-rate of sampling of the physiological parameters for alert verification.

36. The system of claim 34, wherein the notification device is configured to communicate with the at least one of the patient, a clinician, a spouse, a family member, a caregiver or a medical provider when the values received from the plurality of sensors are not within acceptable physiological ranges and configured to communicate from one device to another device, to allow for therapeutic intervention to prevent decompensation when the values received from the plurality of sensors are not within acceptable physiological ranges.

37. The system of claim 1, further comprising:

a memory management device.

38. The system of claim 37, wherein the memory management device is configured to perform at least one of data compression, prioritizing of sensing by a sensor, monitoring at least some from at least some of the sensors, sensing by the sensors in real time, noise blanking such that sensor data is not stored when noise above a selected level is determined, low-power of battery caching or decimation of old sensor data.

39. The system of claim 1, wherein the adherent device comprises a wearable patch that includes a battery.

40. The system of claim 1, wherein the physiological status of the patient comprises a heart failure status and wherein at least one of the patient detecting system or the remote monitoring system comprises a processor system configured to determine the heart failure status of the patient in response to the physiological parameters.

41. The system of claim 1, wherein the plurality of sensors comprises a combination of at least two sensors configured to detect or predict decompensation and wherein the combination comprising the at least two sensors is configure to measure at least two of an electrocardiogram signal, a hydration signal, an accelerometer signal or a respiration signal of the patient.

42. The system of claim 1, wherein the remote monitoring system includes a receiver, a transmitter and a display for displaying data representative of values of at least one physiological event detected by the plurality of sensors.

43. The system of claim 1, wherein the remote monitoring system includes a data storage mechanism having a plurality of acceptable ranges for physiological values stored therein, and a comparator for comparing the data received from the monitoring system with the acceptable ranges stored in the data storage device.

44. The system of claim 1, wherein the remote monitoring system includes a portable computer.

45. The system of claim 1, wherein the remote monitoring system comprises a portable unit having a display screen and a data entry device for communicating with the wireless communication device.

46. A device for monitoring a patient, the device comprising:

an adherent device configured to adhere to a skin of the patient, the adherent device comprising a plurality of sensors, sensor circuitry coupled to the plurality of sensors, wireless circuitry and energy management circuitry, wherein the sensor circuitry comprises electrocardiogram circuitry, bioimpedance circuitry, accelerometer circuitry, and temperature sensor circuitry, wherein the power management device is coupled to the wireless circuitry and configured to transmit data from the sensor circuitry with a duty cycle of no more than about 5%.

47. The device of claim 46 wherein the device is configured to monitor a patient health status in response to the plurality of sensors.

48. The device of claim 47 wherein the patient comprises a heart failure patient and the adherent device is configured to continuously monitor the heart failure status with the wireless circuitry duty cycle of no more than about 5%.

49. The device of claim 46 wherein a majority of the sensor circuitry comprises a duty cycle of no more than about 5%.

50. The device of claim 49 wherein the electrocardiogram comprises a duty cycle of no more than about 40%, the bioimpedance circuitry comprises a duty cycle of no more than about 10%, the accelerometer circuitry comprises a duty cycle of no more than about 1%, and the temperature sensor circuitry comprises a duty cycle of no more than about 1%.

51. The device of claim 46 wherein the power management device comprises a timer coupled to the sensor circuitry to determine the duty cycle of each sensor.

52. The device of claim 51 further comprising a processor comprising a tangible medium coupled to the sensor circuitry and configured with the timer to sample data from the sensor circuitry and wherein the adherent device is configured to support the processor, the plurality of sensors, the sensor circuitry, the wireless circuitry and the energy management circuitry with the skin of the patient.

53. The device of claim 52 wherein the processor is configured to determine heart rate in response to the electrocardiogram circuitry.

54. The device of claim 53 wherein the processor is configured to determine respiration in response to the bioimpedance circuitry.

55. The device of claim 53 further comprising a processor system, the processor system comprising the processor and a second processor at a remote location, the second processor wirelessly coupled to the processor supported with adherent device, and wherein the processor system is configured to detect decompensation of a heart failure patient in response to output from the plurality of sensors.

56. The device of claim 55 wherein the second processor at the remote location is configured to combine the output from the plurality of sensors to detect the decompensation of the heart failure patient.

57. The device of claim 56 wherein the second processor at the remote location is configured to determine a respiration rate of the patient at the remote location in response to the bioimpedance circuitry.

58. The device of claim 52 comprising at least one battery configured to power the electrocardiogram circuitry, the bioimpedance circuitry and the accelerometer circuitry and the temperature sensor circuitry for at least about one week when the adherent device is adhered to the skin of the patient.

59. The device of claim 58 wherein the adherent device is configured to consume no more than about 1500 mA Hours per day when the adherent device is adhered to the patient for an extended period of at least about one week.

60. A method for monitoring a patient, the method comprising:

adhering an adherent device to a skin of the patient, the adherent device comprising a plurality of sensors;

measuring patient data with sensor circuitry coupled to the plurality of sensors, wherein the sensor circuitry comprises at least one of electrocardiogram circuitry, bioimpedance circuitry, accelerometer circuitry, or temperature sensor circuitry; and

transmitting the patient data with wireless transmission circuitry supported the skin of the patient to a remote monitoring system and wherein the wireless transmission circuitry transmits the patient data intermittently with a duty cycle of no more than about 5%.