System and method for determining a reference baseline of regularly retrieved patient information for automated remote patient care

• US 6,887,201 B2
• Filed: 08/22/2003
• Issued: 05/03/2005
• Est. Priority Date: 07/26/1999
• Status: Expired due to Term

• Current Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Original Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Inventors: Bardy, Gust H.
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US10/646,244
• Publication Number:
  US 20040039264A1
• Time in Patent Office: 620 Days
• Field of Search: 600300-301, 600/310, 600/322, 600/481, 600508-509, 607/9, 607/32, 607/60, 128903-904
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing
• 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: 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: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 70/00 ICT specially adapted for the handling or processing of medical references

Abstract

A system for determining a reference baseline of regularly retrieved patient information for automated remote patient care is presented. A medical device having a sensor for monitoring at least one physiological measure of an individual patient regularly records and stores measures sets relating to patient information during an initial time period. A database collects one or more patient care records by organizing one or more patient care records and storing the collected measures set into such a patient care record for the individual patient. A server receives the collected device measures set from the medical device, processes the collected device measures set into a set of reference measures representative of at least one of measured or derived patient information, and stores the reference measures set into the patient care record as data in a reference baseline indicating an initial patient status.

Claims

1. A system for determining a reference baseline of regularly retrieved patient information for automated remote patient care, comprising:

a medical device having a sensor for monitoring at least one physiological measure of an individual patient and regularly recording and storing measures sets comprising individual measures which each relate to patient information during an initial time period and for monitoring the individual patient while the individual patient is performing a prescribed set of timed physical stressors during the initial time period;

a database collecting one or more patient care records, comprising organizing one or more patient care records, and storing the collected measures set into such a patient care record for the individual patient; and

a server receiving the collected device measures set from the medical device, and processing the collected device measures set into a set of reference measures, each reference measure being representative of at least one of measured or derived patient information, and storing the reference measures set into the patient care record as data in a reference baseline indicating an initial patient status.

2. A system according to claim 1, further comprising:

the server repeatedly receiving one or more collected measures sets which are each recorded by a sensor which monitors at least one physiological measure of the individual patient, each such sensor monitoring a site within the individual patient unique from the site monitored by any other such sensor, and analyzing one or more of the site specific collected measures sets in the patient care record for each site within the individual patient relative to one or more other site specific collected measures sets stored in the database to determine a patient status indicator; and

the database storing each collected measures set organized by specific site into the patient care record for the individual patient within the database.

3. A system according to claim 2, wherein the one or more site specific collected measures sets and the one or more other site specific collected measures sets both store measures collected from the same relative site.

4. A system according to claim 2, wherein the one or more site specific collected measures sets and the one or more other site specific collected measures sets both store measures collected from a different site.

5. A system according to claim 1, further comprising:

a remote client recording a set of quality of life measures during the initial time period;

the server receiving the quality of life measures set from the remote client, and assimilating the collected quality of life measures set into the reference baseline data stored in the patient care record; and

the database storing the collected quality of life measures set into the patient care record for the individual patient.

6. A system according to claim 1, further comprising:

a programmer reprogramming at least one of pacing interventions and pacing modes of the medical device during the initial time period; and

the medical device monitoring the individual patient subsequent to the reprogramming during the initial time period.

7. A system according to claim 1, further comprising:

a feedback recorder recording feedback from the individual patient during the initial time period;

the server receiving the recorded feedback from the remote client, and assimilating the recorded feedback into the reference baseline data stored in the patient care record; and

the database storing the recorded feedback into the patient care record for the individual patient.

8. A system according to claim 7, wherein the feedback recorder comprises at least one of an audio recorder, a digital camera, or a video camera.

9. A system according to claim 1, further comprising:

a set of acceptance parameters stored within the database with each acceptance parameter corresponding to the same type of patient information to which at least one of the reference measures relates;

the server further comprising;

an evaluation module analyzing the reference measures set for each patient care record against the acceptance parameters set; and

an acceptance module identifying each patient care record storing a reference measures set having at least one reference measure substantially non-conforming to the corresponding acceptance parameter.

10. A system according to claim 1, the server further comprising:

an analysis module analyzing one or more collected device measures sets in the patient care record for the individual patient relative to the reference measures sets in the reference baseline to determine a patient status indicator.

11. A system according to claim 1, the server further comprising:

the analysis module analyzing one or more of the collected device measures sets in the patient care record for the individual patient relative to one or more other collected device measures sets stored in the database to further determine the patient status indicator.

12. A system according to claim 1, wherein each of the set of reference measures is selected from the group comprising patient activity score, posture, atrial electrical activity, ventricular electrical activity, cardiovascular pressures, cardiac output, oxygenation, pulmonary measures, body temperature, PR interval, QRS measures, QT interval, ST-T wave measures, potassium [K+] level, sodium [Na+] level, glucose level, blood urea nitrogen and creatinine, acidity (pH) level, hematocrit, hormonal levels, cardiac injury chemical tests, myocardial blood flow, central nervous system injury chemical tests, central nervous system (CNS) blood flow, and time of day and combinations and derivatives thereof.

13. A method for determining a reference baseline of regularly retrieved patient information for automated remote patient care, comprising:

regularly recording and storing measures sets comprising individual measures which each relate to patient information by a medical device having a sensor for monitoring at least one physiological measure of an individual patient during an initial time period for monitoring the individual patient using the medical device while the individual patient is performing a prescribed set of timed physical stressors during the initial time period;

receiving the collected device measures set from the medical device;

collecting one or more patient care records into a database, comprising;

organizing one or more patient care records;

storing the collected measures set into such a patient care record for the individual patient; and

processing the collected device measures set into a set of reference measures, each reference measure being representative of at least one of measured or derived patient information, and storing the reference measures set into the patient care record as data in a reference baseline indicating an initial patient status.

14. A method according to claim 13, further comprising:

repeatedly receiving one or more collected measures sets which are each recorded by a sensor which monitors at least one physiological measure of the individual patient, each such sensor monitoring a site within the individual patient unique from the site monitored by any other such sensor;

storing each collected measures set organized by specific site into the patient care record for the individual patient within the database; and

analyzing one or more of the site specific collected measures sets in the patient care record for each site within the individual patient relative to one or more other site specific collected measures sets stored in the database to determine a patient status indicator.

15. A method according to claim 14, wherein the one or more site specific collected measures sets and the one or more other site specific collected measures sets both store measures collected from the same relative site.

16. A method according to claim 14, wherein the one or more site specific collected measures sets and the one or more other site specific collected measures sets both store measures collected from a different site.

17. A method according to claim 13, further comprising:

receiving a set of quality of life measures recorded by the individual patient during the initial time period;

storing the collected quality of life measures set into the patient care record for the individual patient within the database; and

assimilating the collected quality of life measures set into the reference baseline data stored in the patient care record.

18. A method according to claim 13, further comprising:

reprogramming at least one of pacing interventions and pacing modes of the medical device during the initial time period; and

monitoring the individual patient using the medical device subsequent to the reprogramming during the initial time period.

19. A method according to claim 13, further comprising:

receiving feedback recorded by the individual patient during the initial time period;

storing the recorded feedback into the patient care record for the individual patient within the database; and

assimilating the recorded feedback into the reference baseline data stored in the patient care record.

20. A method according to claim 13, further comprising:

defining a set of acceptance parameters with each acceptance parameter corresponding to the same type of patient information to which at least one of the reference measures relates;

analyzing the reference measures set for each patient care record against the acceptance parameters set; and

identifying each patient care record storing a reference measures set having at least one reference measure substantially non-conforming to the corresponding acceptance parameter.

21. A method according to claim 13, further comprising:

analyzing one or more collected device measures sets in the patient care record for the individual patient relative to the reference measures sets in the reference baseline to determine a patient status indicator.

22. A method according to claim 21, further comprising:

analyzing one or more of the collected device measures sets in the patient care record for the individual patient relative to one or more other collected device measures sets stored in the database to further determine the patient status indicator.

23. A method according to claim 13, wherein each of the set of reference measures is selected from the group comprising patient activity score, posture, atrial electrical activity, ventricular electrical activity, cardiovascular pressures, cardiac output, oxygenation, pulmonary measures, body temperature, PR interval, QRS measures, QT interval, ST-T wave measures, potassium [K+] level, sodium [Na+] level, glucose level, blood urea nitrogen and creatinine, acidity (pH) level, hematocrit, hormonal levels, cardiac injury chemical tests, myocardial blood flow, central nervous system injury chemical tests, central nervous system (CNS) blood flow, and time of day and combinations and derivatives thereof.

24. A computer-readable storage medium holding code for determining a reference baseline of regularly retrieved patient information for automated remote patient care, comprising:

code for regularly recording and storing measures sets comprising individual measures which each relate to patient information by a medical device having a sensor for monitoring at least one physiological measure of an individual patient during an initial time period and for monitoring the individual patient using the medical device while the individual patient is performing a prescribed set of timed physical stressors during the initial time period;

code for receiving the collected device measures set from the medical device;

code for collecting one or more patient care records into a database, comprising organizing one or more patient care records, and storing the collected measures set into such a patient care record for the individual patient; and

code for processing the collected device measures set into a set of reference measures, each reference measure being representative of at least one of measured or derived patient information, and storing the reference measures set into the patient care record as data in a reference baseline indicating an initial patient status.

25. A storage medium according to claim 24, further comprising:

code for repeatedly receiving one or more collected measures sets which are each recorded by a sensor which monitors at least one physiological measure of the individual patient, each such sensor monitoring a site within the individual patient unique from the site monitored by any other such sensor;

code for storing each collected measures set organized by specific site into the patient care record for the individual patient within the database; and

code for analyzing one or more of the site specific collected measures sets in the patient care record for each site within the individual patient relative to one or more other site specific collected measures sets stored in the database to determine a patient status indicator.

26. A storage medium according to claim 24, further comprising:

code for receiving a set of quality of life measures recorded by the individual patient during the initial time period;

code for storing the collected quality of life measures set into the patient care record for the individual patient within the database; and

code for assimilating the collected quality of life measures set into the reference baseline data stored in the patient care record.

27. A storage medium according to claim 24, further comprising:

code for reprogramming at least one of pacing interventions and pacing modes of the medical device during the initial time period; and

code for monitoring the individual patient using the medical device subsequent to the reprogramming during the initial time period.

28. A storage medium according to claim 24, further comprising:

code for receiving feedback recorded by the individual patient during the initial time period;

code for storing the recorded feedback into the patient care record for the individual patient within the database; and

code for assimilating the recorded feedback into the reference baseline data stored in the patient care record.

29. A storage medium according to claim 24, further comprising:

code for defining a set of acceptance parameters with each acceptance parameter corresponding to the same type of patient information to which at least one of the reference measures relates;

code for analyzing the reference measures set for each patient care record against the acceptance parameters set; and

code for identifying each patient care record storing a reference measures set having at least one reference measure substantially non-conforming to the corresponding acceptance parameter.

30. A storage medium according to claim 24, further comprising:

code for analyzing one or more collected device measures sets in the patient care record for the individual patient relative to the reference measures sets in the reference baseline to determine a patient status indicator.

31. A storage medium according to claim 30, further comprising:

code for analyzing one or more of the collected device measures sets in the patient care record for the individual patient relative to one or more other collected device measures sets stored in the database to further determine the patient status indicator.