Telecommunications network for remote patient monitoring

• US 7,256,708 B2
• Filed: 09/21/2004
• Issued: 08/14/2007
• Est. Priority Date: 06/23/1999
• Status: Expired due to Term

• Current Assignee: Visicu Incorporated (Koninklijke Philips N.V.)
• Original Assignee: Visicu Incorporated (Koninklijke Philips N.V.)
• Inventors: Breslow, Michael, Rosenfeld, Brian
• Primary Examiner(s): Lee; Benjamin C.
• Assistant Examiner(s): BLOUNT, ERIC
• Application Number:
  US10/946,548
• Publication Number:
  US 20060071797A1
• Time in Patent Office: 1,057 Days
• Field of Search: 340/573.1
• US Class Current: 340/870.01
• 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 5/0022 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 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G08B 21/0211 Combination with medical sensor, e.g. for measuring heart rate, temperature
• CPC Class Codes: G08B 21/0476 Cameras to detect unsafe condition, e.g. video cameras
• CPC Class Codes: G16H 10/40 for data related to laboratory analysis, e.g. patient specimen analysis
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/20 relating to practices or guidelines
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: H04L 67/12 specially adapted for proprietary or special-purpose networking environments, e.g. medical networks, sensor networks, networks in vehicles or remote metering networks

Abstract

A communications network for providing continuous patient monitoring to provide critical care services from a remote location. A plurality of patient monitoring stations with associated patient monitoring instrumentation is connected over a communications network to a command center to which data flows continuously for analysis. A standardized series of guideline algorithms for treating a variety of critical care conditions are prompted to provide critical care by caregivers who monitor the progress of individual patients at remote patient monitoring stations. A smart alert system that can be flexibly set from the command center provides for patient-specific rules to be established to alert the caregivers to potential patient problems so that intervention can occur in a timely fashion. A data storage/data warehouse function analyzes individual patient information from a plurality of command centers and provides updated algorithms and critical care support to the remote command centers.

Claims

1. A hospitalized patient care system comprising:

a telecommunication network;

monitoring stations comprising monitoring equipment adapted to monitor data elements from geographically dispersed hospitalized patients and to send the monitored data elements to a remote command center via the telecommunications network, wherein the remote command center is adapted to;

receive the monitored data elements from the geographically dispersed hospitalized patients;

access patient data elements indicative of a medical condition associated with each of the geographically dispersed hospitalized patients;

establish patient-specific rules associated with each of the geographically dispersed hospitalized patients; and

apply the patient-specific rules continuously and simultaneously using a rules engine adapted to;

select data elements from the monitored data elements and the patient data elements associated with a hospitalized patient;

apply a patient-specific rule associated with the hospitalized patient to the selected data elements;

determine in an automated fashion at the remote command center whether the patient-specific rule for the hospitalized patient has been contravened; and

in the event the patient-specific rule for the hospitalized patient has been contravened, issue an alert from the remote command center.

2. The system of claim 1, wherein the patient specific rule for the hospitalized patient comprises an algorithm.

3. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and a clinical data element of the hospitalized patient.

4. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and a medication data element of the hospitalized patient.

5. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

6. The system of claim 1, wherein the selected data elements comprise a clinical data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

7. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and another physiological data element of the hospitalized patient.

8. The system of claim 1, wherein the selected data elements comprise at least two data elements of the hospitalized patient selected from the group consisting of a physiological data element, a clinical data element of the hospitalized patient, a medication data element of the hospitalized patient, and a laboratory data element of the hospitalized patient.

9. The system of claim 1, wherein the alert comprises a patient intervention protocol and order.

10. The system of claim 1 wherein the rules engine is further adapted to:

determine whether the hospitalized patient requires monitoring by the monitoring station; and

in the event the hospitalized patient does not require monitoring by the monitoring station, issue a release protocol and order.

11. The system of claim 1, wherein monitoring equipment further comprises physiological sensors and monitored data elements comprise physiological data elements.

12. The system of claim 1, wherein monitoring equipment further comprises:

a video imaging system and wherein monitored data elements comprises video image data elements, and

a voice communication system and wherein monitored data further comprises audio data elements.

13. The system of claim 12, wherein the hospitalized patient care system further comprises an audio/video teleconferencing server, and wherein the audio/video teleconferencing server is adapted to:

bridge a local visitation terminal and a remote visitation terminal;

send audio and video signals generated by the local visitation terminal to the remote visitation terminal;

send audio and video signals generated by the remote visitation terminal to the local visitation terminal; and

provide the audio data elements and video image data elements to both the remote visitation terminal and the local visitation terminal.

14. The system of claim 1, wherein the hospitalized patient care system further comprises a patient support system adapted to:

access a decision support algorithm;

apply the decision support algorithm to selected data elements of a hospitalized patient;

apply the decision support algorithm to user input; and

provide patient care advice to the user.

15. The system of claim 14, wherein the patient care advice is a diagnosis.

16. The system of claim 14, wherein the patient care advice is a method of treatment.

17. The system of claim 14, wherein the patient care advice is a laboratory protocol.

18. The system of claim 14, wherein the patient support system is further adapted to:

access an order writing module; and

issue an order.

19. The system of claim 18, wherein the order comprises authorization to administer medication to the hospitalized patient.

20. The system of claim 18, wherein the order comprises authorization to subject the hospitalized patient to a laboratory protocol.

21. The system of claim 18, wherein the order comprises authorization to subject the hospitalized patient to a surgical procedure.

42. The system of claim 1, wherein a monitoring station is a transportable monitoring station comprising the monitoring equipment.

43. The system of claim 42, wherein the transportable monitoring station comprises a cart.

44. The system of claim 43, wherein the transportable monitoring station further comprises a video camera, a microphone, a speaker, patient monitoring devices, a printer, a network interface, and a data entry device.

45. The system of claim 42, wherein the transportable monitoring station is wearable by the patient.

46. The system of claim 1, wherein the monitoring equipment is integrated into a patient support device.

47. The system of claim 46, wherein the patient support device is selected from the group consisting of a bed, a chair, a recliner, and a wheelchair.

48. The system of claim 1, wherein the telecommunications network comprises a wireless sub-network and wherein a monitoring station is adapted to send the monitored data elements to the remote command center via the telecommunications network using the wireless subnetwork.

49. The system of claim 48, wherein the monitoring station is a transportable monitoring station comprising the monitoring equipment.

50. The system of claim 49, wherein the transportable monitoring station comprises a cart.

51. The system of claim 50, wherein the transportable monitoring station further comprises a video camera, a microphone, a speaker, patient monitoring devices, a printer, a network interface, and a data entry device.

52. The system of claim 49, the transportable monitoring station is wearable by the patient.

53. The system of claim 48, wherein the monitoring equipment is integrated into a patient support device.

54. The system of claim 53, wherein the patient support device is selected from the group consisting of a bed, a chair, a recliner, and a wheelchair.

55. The system of claim 1, wherein the hospitalized patient is located in a hospital.

56. The system of claim 1, wherein the hospitalized patient is located in a nursing home.

57. The system of claim 1, wherein the hospitalized patient is located in a mobile health care facility.

58. The system of claim 57, wherein the mobile health care facility is selected from the group consisting of a ship, a helicopter, and an ambulance.

59. The system of claim 1, wherein the hospitalized patient is located in a space-based health care facility.

60. The system of claim 1, wherein the hospitalized patient is located in a field health care facility.

61. The system of claim 1, wherein the hospitalized patient is located in a residence.

62. The system of claim 1, wherein the wherein the hospitalized patient is located in an emergency room.

63. The system of claim 1, wherein the wherein the hospitalized patient is located in an intensive care unit.

64. The system of claim 1, wherein the wherein the hospitalized patient is located in an operating room.

65. The system of claim 1, wherein the wherein the hospitalized patient is located in a step down unit.

22. A method for continuous assessment of geographically dispersed hospitalized patients:

receiving at a remote command center monitored data elements from geographically dispersed hospitalized patients via a telecommunications network;

accessing patient data elements indicative of a medical condition associated with each of the geographically dispersed hospitalized patients;

establishing patient-specific rules associated with each of the geographically dispersed hospitalized patients;

selecting data elements from the monitored data elements and the patient data elements associated with a hospitalized patient;

applying a patient-specific rule associated with the hospitalized patient to the selected data elements;

making a determination in an automated fashion at the remote command center whether the patient-specific rule for the hospitalized patient has been contravened; and

in the event the patient-specific rule for the hospitalized patient has been contravened, issuing an alert from the remote command center.

23. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with a hospitalized patient comprises selecting a physiological data element of the hospitalized patient and a clinical data element of the hospitalized patient.

24. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with a hospitalized patient comprises selecting a physiological data element and a medication data element of the hospitalized patient.

25. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with a hospitalized patient comprises selecting a physiological data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

26. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with a hospitalized patient comprises selecting a clinical data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

27. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with a hospitalized patient comprises selecting a physiological data element of the hospitalized patient and another physiological data element of the hospitalized patient.

28. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with a hospitalized patient comprises selecting at least two data elements of the hospitalized patient selected from the group consisting of a physiological data element, a clinical data element of the hospitalized patient, a medication data element of the hospitalized patient, and a laboratory data element of the hospitalized patient.

29. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein issuing an alert comprises issuing a patient intervention protocol and order.

30. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, further comprising:

making a determination whether the hospitalized patient requires monitoring; and

in the event the hospitalized patient does not require monitoring, issuing a release protocol and order.

31. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein receiving at a remote command center monitored data elements from geographically dispersed hospitalized patients comprises receiving physiological data elements.

32. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein receiving at a remote command center monitored data elements from geographically dispersed hospitalized patients comprises receiving video image data elements and audio data elements.

33. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 32, wherein the method further comprises:

bridging a local visitation terminal and a remote visitation terminal;

sending audio and video signals generated by the local visitation terminal to the remote visitation terminal;

sending audio and video signals generated by the remote visitation terminal to the local visitation terminal; and

providing the audio data elements and video image data elements to both the remote visitation terminal and the local visitation terminal.

34. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, further comprising:

accessing a decision support algorithm;

applying the decision support algorithm to selected data elements of a hospitalized patient;

applying the decision support algorithm to user input; and

providing patient care advice to the user.

35. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 34, wherein providing patient care advice to the user comprises providing the user a diagnosis.

36. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 34, wherein providing patient care advice to the user comprises providing the user a method of treatment.

37. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 34, wherein providing patient care advice to the user comprises providing the user a laboratory protocol.

38. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 34, wherein the method further comprises:

accessing an order writing module; and

issuing an order.

39. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 38, wherein issuing an order comprises issuing an authorization to administer medication to the hospitalized patient.

40. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 38, wherein issuing an order comprises issuing an authorization to subject the hospitalized patient to a laboratory protocol.

41. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 38, wherein issuing an order comprises issuing an authorization to subject the hospitalized patient to a surgical procedure.

66. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the monitored data elements are acquired using a transportable monitoring station.

67. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 66, wherein the transportable monitoring station comprises a cart.

68. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 67, wherein the transportable monitoring station further comprises a video camera, a microphone, a speaker, patient monitoring devices, a printer, a network interface, and a data entry device.

69. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 67, wherein the transportable monitoring station is wearable by the patient.

70. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the monitored data elements are acquired using monitoring equipment integrated into a patient support device.

71. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 70, wherein the patient support device is selected from the group consisting of a bed, a chair, a recliner, and a wheelchair.

72. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the telecommunications network comprises a wireless sub-network and wherein receiving at a remote command center monitored data elements from geographically dispersed hospitalized patients via a telecommunications network comprises receiving at the remote command center monitored data elements from the geographically dispersed hospitalized patients via the wireless subnetwork.

73. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 72, wherein the monitored data elements are acquired using a transportable monitoring station comprising monitoring equipment.

74. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 73, wherein the transportable monitoring station comprises a cart.

75. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 74, wherein the transportable monitoring station further comprises a video camera, a microphone, a speaker, patient monitoring devices, a printer, a network interface, and a data entry device.

76. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 73, wherein the transportable monitoring station is wearable by the patient.

77. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 72, wherein the monitored data elements are acquired using monitoring equipment integrated into a patient support device.

78. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 77, wherein the patient support device is selected from the group consisting of a bed, a chair, a recliner, a wheelchair, a stretcher and a gurney.

79. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the hospitalized patient is located in a hospital.

80. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the hospitalized patient is located in a nursing home.

81. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the hospitalized patient is located in mobile health care facility.

82. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 81, wherein the mobile health care facility is selected from the group consisting of a ship, a helicopter, and an ambulance.

83. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the hospitalized patient is located in a space-based health care facility.

84. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the hospitalized patient is located in a field health care facility.

85. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the hospitalized patient is located in a residence.

86. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the wherein the hospitalized patient is located in an emergency room.

87. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the wherein the hospitalized patient is located in an intensive care unit.

88. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the wherein the hospitalized patient is located in an operating room.

89. The method for continuous assessment of geographically dispersed hospitalized patients as in claim 22, wherein the wherein the hospitalized patient is located in a step down unit.