Patient Treatment and Monitoring Systems and Methods with Cause Inferencing

• US 20130211206A1
• Filed: 02/15/2012
• Published: 08/15/2013
• Est. Priority Date: 11/05/2009
• Status: Active Grant

• Current Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Original Assignee: Jose Diaz-Buxo
• Inventors: Sands, Jeffrey J., Schlaeper, Christian, Crnkovich, Martin, Diaz-Buxo, Jos
• Granted Patent: US 10,799,117 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 2505/07 Home care
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/1468 using chemical or electrochemical methods, e.g. by polarographic means A61B5/1486 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61M 1/14 Dialysis systems; Artificial kidneys; Blood oxygenators semi-permeable membranes characterised by the material, manufacturing processes therefor B01D71/00 ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
• CPC Class Codes: A61M 1/1605 Physical characteristics of the dialysate fluid
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3317 Electromagnetic, inductive or dielectric measuring means
• CPC Class Codes: A61M 2205/3324 PH measuring means
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3368 Temperature
• CPC Class Codes: A61M 2205/3379 Masses, volumes, levels of fluids in reservoirs, flow rates
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3561 : local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/502 : User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2230/06 : Heartbeat rate only
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/50 : Temperature
• CPC Class Codes: G16H 15/00 : ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/13 : delivered from dispensers
• CPC Class Codes: G16H 20/40 : relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/40 : for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/63 : for local operation

Abstract

The invention provides a health care delivery system comprising a plurality of health care delivery devices (e.g., via the Internet, etc.), which can disposed in treatment centers ranging from patient homes to commercial health care facilities such as hospitals, dialysis centers and so forth. Reporting functionality can, instead of or in addition to identifying (and reporting on) discrepancies in the raw and/or analyzed data from the delivery devices, infer (and report) on possible causes of those discrepancies and, in some aspects of the invention, remedy those causes, thereby, providing automated operations support for the treatment centers.

Claims

1. A health care delivery system comprising:

A. a health care delivery device including

i. medical treatment apparatus,

ii. an input device that accept patient responses to one or more queries,

iii. sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health device and the medical treatment apparatus,

B. functionality that transmits one or more of the patient responses, physiometric characteristics and operating conditions a remote digital data processor,

C. the remote digital data processor

(i) correlating one or more of the patient responses, physiometric characteristics, and operating conditions received from the health care delivery device with any of (a) one another, (b) prior information received from the health care delivery device and/or from the patient'"'"'s records, (c) one or more standards, and

(ii) any of generating a report and signaling an alert on determining that the patient is not doing as expected.

2. The health care delivery system of claim 36, wherein the remote digital data processor (i) correlates any of patient responses, physiometric characteristics, and operating conditions received from a plurality of health care delivery device with any of (a) one another, (b) prior information received from the health care delivery devices and/or from patient records, (c) one or more standards, and (ii) any of generates a report and signals an alert on determining that a treatment facility is not doing as expected.

3. A health care delivery system comprising:

A. a plurality of health care delivery devices, each comprising (i) medical treatment apparatus, and (ii) including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health care delivery device and the medical treatment apparatus,

B. functionality that transmits the physiometric characteristics and operating conditions from the plurality of health care delivery devices to a remote digital data processor,

C. the digital data processor

(i) inferring causes of hypotension evidenced in information received from one or more of the plurality of said health care delivery devices,

(ii) any of generating a report indicative of that cause, signaling an alert indicative of that cause, and transmitting to a said health care delivery device a control signal for correction of that cause.

4. The health care delivery system of claim 3, in which the digital data processor (i) infers from patterns of hypotension reflected in data from the health care delivery device that patients under care by one or more of said health care delivery devices may require “

dry weight”

adjustment, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects such adjustment directly.

5. The health care delivery system of claim 4, in which the digital data processor makes such an inference in response to one or more instances of hypotension during a treatment session evidenced in information received from one or more of the plurality of said delivery devices.

6. The health care delivery system of claim 5, in which the digital data processor makes such an inference in response to a selected plurality of instances of hypotension during a selected number of treatment session evidenced in information received from one or more of the plurality of said delivery devices.

7. The health care delivery system of claim 5, in which the digital data processor makes such an inference by cross-correlating hypotension alerts signaled and/or blood pressure readings taken by one or more said delivery devices with treatment, administrative and/or other information from said delivery device and/or treatment centers in which they are disposed.

8. The health care delivery system of claim 3, in which the digital data processor (i) infers from patterns of hypotension reflected in treatment information from said delivery device and/or from treatment, administrative and/or other information from those delivery devices and/or treatment centers in which they are disposed that sensors of one or more devices may be signaling false hypotension alerts and/or providing incorrect blood pressure readings, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects correction of faulty such delivery device.

9. A health care delivery system comprising:

A. a plurality of health care delivery devices, each comprising (i) medical treatment apparatus, and (ii) including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health care delivery device and the medical treatment apparatus,

B. functionality that transmits the physiometric characteristics and operating conditions from the plurality of health care delivery devices to a remote digital data processor,

C. a digital data processor (i) infers from patterns of hypotension reflected in data from the health care delivery device, as well, optionally, as from supplemental infusate supplies, sensors and/or monitoring logic of said apparatus that patients under care by one or more of said health care delivery devices may require medication adjustment, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects such adjustment directly.

10. The health care delivery system of claim 9, in which the digital data processor makes such an inference by cross-correlating alerts signaled and sensor readings taken by one or more said delivery devices with treatment, administrative and/or other information from said delivery device and/or treatment centers in which they are disposed.

11. The health care delivery system of claim 9, in which the digital data processor (i) infers from patterns of hypotension reflected in treatment information from said apparatus and/or from treatment, administrative and/or other information from those delivery devices and/or treatment centers in which they are disposed that sensors of one or more devices may be triggering false alerts and/or providing incorrect readings, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects correction of faulty such delivery device.

12. A health care delivery system comprising:

A. a plurality of health care delivery devices, each comprising (i) medical treatment apparatus, and (ii) including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health care delivery device and the medical treatment apparatus,

B. functionality that transmits the physiometric characteristics and operating conditions from the plurality of health care delivery devices to a remote digital data processor,

C. a digital data processor (i) infers from patterns of hypotension reflected in data from the health care delivery device, as well, optionally, as from information from other sensors and/or monitoring logic of said apparatus that one or more of said apparatus may require filtration rate adjustment, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects such adjustment directly.

13. The health care delivery system of claim 12, in which the digital data processor makes such an inference by cross-correlating alerts signaled and sensor readings taken by one or more said delivery devices with treatment, administrative and/or other information from said delivery device and/or treatment centers in which they are disposed.

14. The health care delivery system of claim 12, in which the digital data processor (i) infers from patterns of hypotension reflected in treatment information from said apparatus and/or from treatment, administrative and/or other information from those delivery devices and/or treatment centers in which they are disposed that sensors of one or more devices may be triggering false alerts and/or providing incorrect readings, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects correction of faulty such delivery device.

15. A health care delivery system comprising:

A. a plurality of health care delivery devices, each comprising (i) medical treatment apparatus, and (ii) including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health care delivery device and the medical treatment apparatus,

B. functionality that transmits the physiometric characteristics and operating conditions from the plurality of health care delivery devices to a remote digital data processor,

C. a digital data processor (i) infers from patterns of hypotension reflected in data from the health care delivery device, as well, optionally, as from information from other sensors and/or monitoring logic of said apparatus that one or more of said patients under care by said apparatus may require incoming/fresh dialysate temperature adjustment, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects such adjustment directly.

16. The health care delivery system of claim 15, in which the digital data processor makes such an inference by cross-correlating alerts signaled and sensor readings taken by one or more said delivery devices with treatment, administrative and/or other information from said delivery device and/or treatment centers in which they are disposed.

17. The health care delivery system of claim 15, in which the digital data processor (i) infers from patterns of hypotension reflected in treatment information from said apparatus and/or from treatment, administrative and/or other information from those delivery devices and/or treatment centers in which they are disposed that sensors of one or more devices may be triggering false alerts and/or providing incorrect readings, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects correction of faulty such delivery device.

18. A health care delivery system comprising:

A. a plurality of health care delivery devices, each comprising (i) medical treatment apparatus, and (ii) including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health care delivery device and the medical treatment apparatus,

B. functionality that transmits the physiometric characteristics and operating conditions from the plurality of health care delivery devices to a remote digital data processor,

C. a digital data processor (i) infers from patterns of arterial and/or venous pressure alarms reflected in data from the health care delivery device, as well, optionally, as from information from other sensors and/or monitoring logic of said apparatus that one or more of said patients under care by said apparatus may require hemocoagulant medication adjustment and/or vascular access evaluation, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects such adjustment directly.

19. The health care delivery system of claim 18, in which the digital data processor makes such an inference by cross-correlating alerts signaled and sensor readings taken by one or more said delivery devices with treatment, administrative and/or other information from said delivery device and/or treatment centers in which they are disposed.

20. The health care delivery system of claim 18, in which the digital data processor (i) infers from patterns of hypotension reflected in treatment information from said apparatus and/or from treatment, administrative and/or other information from those delivery devices and/or treatment centers in which they are disposed that sensors of one or more devices may be triggering false alerts and/or providing incorrect readings, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects correction of faulty such delivery device.

21. A health care delivery system comprising:

A. a plurality of health care delivery devices, each comprising (i) medical treatment apparatus, and (ii) including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health care delivery device and the medical treatment apparatus,

B. functionality that transmits the physiometric characteristics and operating conditions from the plurality of health care delivery devices to a remote digital data processor,

C. a digital data processor (i) infers from patterns of conductivity, temperature and/or flow alarms reflected in data from the health care delivery device, as well, optionally, as from conductivity, temperature and/or flow-related information from other sensors and/or monitoring logic of said apparatus that one or more of said apparatus may require supply correction, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects such adjustment directly.

22. The health care delivery system of claim 21, in which the digital data processor makes such an inference by cross-correlating alerts signaled and sensor readings taken by one or more said delivery devices with treatment, administrative and/or other information from said delivery device and/or treatment centers in which they are disposed.

23. The health care delivery system of claim 21, in which the digital data processor (i) infers from patterns of hypotension reflected in treatment information from said apparatus and/or from treatment, administrative and/or other information from those delivery devices and/or treatment centers in which they are disposed that sensors of one or more devices may be triggering false alerts and/or providing incorrect readings, and (ii) generates reports and/or immediate alerts directing health care providers of the need for possible adjustments and/or effects correction of faulty such delivery device.

24. A method of health care delivery system comprising:

A. delivering medical treatment to a plurality of patients via one or more medical treatment apparatus, each including sensors that sense (a) physiometric characteristics of the patient in connection with treatment by the medical treatment apparatus, and (b) operating conditions of any of the health device and the medical treatment apparatus,

B. transmitting the physiometric characteristics and operating conditions from the plurality of health care delivery devices to digital data processor,

C. with the digital data processor,

(i) inferring causes of hypotension evidenced in information received from one or more of the plurality of said delivery devices,

(ii) any of generating a report indicative of that cause, signaling an alert indicative of that cause, and transmitting to a said health care delivery device a control signal for correction of that cause.