System and method for prioritizing medical conditions

• US 8,092,382 B2
• Filed: 08/29/2006
• Issued: 01/10/2012
• Est. Priority Date: 11/16/1999
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Bardy, Gust H.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US11/512,689
• Publication Number:
  US 20060293573A1
• Time in Patent Office: 1,960 Days
• Field of Search: 600/301, 600/300, 600/513, 600515-518, 600/483, 128923-925
• US Class Current: 600/301
• 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: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• 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: Y10S 128/923 by comparison of patient data to other data

Abstract

A system for ordering and prioritizing multiple health disorders for automated remote patient care is presented. A database maintains information for an individual patient by organizing monitoring sets in a database, and measures relating to patient information previously recorded and derived on a substantially continuous basis into a monitoring set in the database. A server retrieving and processing the monitoring includes a comparison module comparing stored measures from each of the monitoring sets to other stored measures from another of the monitoring sets with both stored measures relating to the same type of patient information, and an analysis module ordering each patient status change in temporal sequence and categorizing health disorder candidates by quantifiable physiological measures, and identifying the health disorder candidate having the pathophysiology substantially corresponding to the patient status changes which occurred substantially least recently as the index disorder.

Claims

1. An analysis system for providing an index disorder for use in automated patient care, comprising:

a server comprising;

a database configured to store a set of device measures regularly recorded by a medical device for a patient under automated patient care;

a set of reference baseline measures recorded during an initial observation period; and

indicator thresholds corresponding to quantifiable physiological measures of pathophysiologies; and

a diagnostic module configured to retrieve the device measures and the reference baseline measures from the database, comprising;

a comparison module configured to iteratively process the device measures and the reference baseline measures with the indicator thresholds and configured to identify multiple near-simultaneous disorders from said iterative process, wherein each iterative loop of the iterative process comprises analyzing the device measures and the reference baseline measures for changes occurring over time; and

an analysis module configured to analyze and order the changes and the multiple-near simultaneous disorders occurring over time and to identify the index disorder based on said analysis modules analyzing and ordering.

2. An analysis system according to claim 1,

the database further configured to store processed raw and physiological measures;

the analysis module further comprising;

an ordering component configured to compare a plurality of the processed raw and physiological measures to quantify one or more changes in pathophysiology, and to order the pathophysiology changes in temporal sequence.

3. An analysis system according to claim 1,

the comparison module further comprising:

a categorizing component configured to categorize health disorder candidates by pathophysiology, and to identify the health disorder candidate having a pathophysiology substantially comparable to a change in pathophysiology that occurred either substantially least or most recently.

4. An analysis system according to claim 3,

the database further comprising a plurality of previously-related pathophysiologies for at least one health disorder candidate;

the diagnostic module further comprising an evaluation component configured to sort the plurality of previously-related pathophysiologies for at least one health disorder candidate into a symptomatic event ordering set, and to evaluate each pathophysiology in the symptomatic event ordering set in response to a change in the pathophysiology being evaluated.

5. An analysis system according to claim 1,

the database further configured to store processed raw and physiological measures;

the comparison module further configured to compare at least one of the processed raw and physiological measures to at least one other of the processed raw and physiological measures that were previously recorded.

6. An analysis system according to claim 1,

the comparison module further configured to prioritize pathophysiology changes using a predefined ordering, wherein the physiological changes have different priorities, and wherein the comparison component is further configured to compare the pathophysiology changes having higher priorities that occurred least recently before the pathophysiology changes having lower priorities.

7. An analysis system according to claim 1, the server further comprising:

a feedback module comprising a hysteresis component configured to track temporal changes in pathophysiology.

8. An analysis system according to claim 1, wherein the indicator thresholds correspond to a pathophysiology indicative of at least one of congestive heart failure, myocardial ischemia, respiratory insufficiency, and atrial fibrillation health disorders;

and

the diagnostic module configured to test pathophysiology changes against the indicator thresholds to determine whether a change in pathophysiology has occurred.