CA2208594C

CA2208594C - User monitoring system

Info

Publication number: CA2208594C
Application number: CA 2208594
Authority: CA
Inventors: David M. Kutzik; Anthony P. Glascock; Douglas L. Chute; Thomas T. Hewett; Barbara G. Hornum
Original assignee: Behavioral Informatics Inc
Current assignee: Care Innovations LLC
Priority date: 1994-12-23
Filing date: 1995-12-21
Publication date: 2000-12-05
Anticipated expiration: 2015-12-21
Also published as: CA2208594A1

Abstract

A system (100) is provided for monitoring a user in a user living area. The system includes a system controller (110) and an activity detection subsystem (112, 116, 120, 124, 128). The activity detection subsystem (112, 116, 120, 124, 128) monitors a daily living activity of the user and provides information representative of the daily living activity to the system controller (110). The system controller (110) includes a control circuit which generates a control signal in response to the daily activity information obtained by the activity detection subsystem (112, 116, 120, 124, 128).
Control information from the system controller (110) is applied by way of a control information communication channel both to the activity detection subsystem (112, 116, 120, 124, 128) and to a remote monitoring site (148). The activity detection subsystem (112, 116, 120, 124, 128) may be a system for determining the movement of the user around the home, medication compliance by the user, problems with usage of stoves or other potentially dangerous appliances, and selected auxiliary appliances.

Description

W 096120449 rCTnUS95/16752 USER MONITORING SYSTEM

Field of the Invention The present invention relates to a system for providing in-home monitoring and intervention to assist individuals, particularly functionally impaired persons, in maintaining independent living.

Back~ nd of the Invention Several known user monitoring systems have an immediate ~esponse feature. In one prior art system if a user falls down and is unable to get up the user may push a button on a small radio frequency transmitter. This radio ~requency transmitter may ~e worn by the user.~ ~or example, it may be worn on a necklace or on a key chain for convenience and to assure that it is available when it is needed. Pushing the button activates a deYice at the residence of the user which places a telephone call to a user remote monitorin~ site. Personnel at the remote monitoring site may listen and talk through a paging telephone in order to communicate with the user.
O Additionally, personnel at the user monitoring site may dispatch an ambulance or other assistance for the user.

W09612~9 PCT~S95/16752 There is a large number of devices designed to ~nh~nce medication compliance and to monitor the extent of non-compliance. Devices availa~le in the prior ar~
include timers, medicament containers and com~inations of tLmers and containers. Also available in the prior art are multiple compartment timed containers which only open at timed intervals and beep until the compartment is opened and closed. Devices availa~le to researchers include specialized containers and bottle caps which record the date and time of opening of the cont~iner.
This information is pro~ided in a machine transferable form which may be applied to a computer for analysis of scheduling and dosing compliance.
In addition, a ~ariety of spec;~li7-ed dispensers using stripped, bubble wrapped medicaments is available. These dispensers are a~ailable from pharmacists and are adapted to provide t~e correct pills at ~h~ ed times and use-a less eYr~n~ive method for loading doses than other prior art self-lo~;n~ timed dispensers. One prior art system in particular uses a host computer system to CO11LLO1 a dispensing sche~ e in addition to a local timer-memory system.- Another system uses color coded indicia to aid in identification of medic2tion ~y users.

Various home health monitoring systems are also known in the prior art. These systems fall into a broad category of de~ices which offer in-home electronic monitoring of health conditions ranging from fetal heart beat to blood pressure and blood sugar. Some of these health monitoring systems transmit a log to a central unit if a monitored parameter is outside a predetermined range. Other systems monitor predetermined health related parameters in the environment of the user.
The present invention comprises a user monitoring s~stem for monitoring and intervening in selected activities of daily li~ing for users requiring differing le~els of monitoring or supervision. The user monitoring system monitors and pro~ides interventions ; relat~ng to four principal e~ent domains. These event domains are (1) movement around the home, (2)'medicztion compl;~n~P ~y the user, (3~ pro~lems with usage of stoves or other potentially dangerous app~ ces, and (4) selected a~Y;li~ry appliance ~o~lLL~l. Each of these event domains ~uL~,ponds to a detection subsystem of the user monitoring system. Each detection subsystem is ~ P~ to the user monitoring system by means of radio frequency signals transmitted from su~system sensors and recei~ed ~y a system controller device within the user W 096120449 P~-lr~5~/16752 monitoring system. In addition to using informatio~
obta;ne~ by monitoring the selected activities of daily living to make decisions locally, the user monitoring system pro~l~ces, stores and transfers data concerning all monitored event domains and intervention activity to a remote case management system for further analysis 2nd ~ntervention. The remote czse management monitoring system may use a knowledge base and an in f erence generator in order to make decisions regarding various types and degrees of intervention. The user monitoring system may ~rovide reminders for the user to take their medications. Local and remote ~p~oy~amming of event parameters determining interventions and data recording are provided. The user monitoring system may execute ~u,.L~o}~ed shutdown of the stove and other app~ oes as well as call the semote monitoring site in the event of possible emergencies. Data for monthly case monitoring L~G~S which may include event logs of problem ~C~UL L ences may be pro~ided to permit cross-sec~i~n~l and long-term trend analysis of difficulties. These may serve as a basis ~or case management decisions determining additional contacts and interventions.

O 96~0449 PCTrUS95/167S2 ~ummarY of the In~ention A system is provided for monitoring a user in a user living area. The system includes a system controller and an activity detection su~system. The acti~ity detection subsystem monitors a daily living activity of the user and provides information representative of the daily living activity to the system controller. The system controller includes a eo~ vl circuit which generates a control signal in response to the daily living activity information o~tained by the acti~ity detection subsystem. Control information from the system controller is applied by way of a control information communication channel both to the activity detection su~system and to a remote monitoring site.

Brief Des~riPtion of the Drawina~
The foregoing summary, as well as the following detailed description of preferred ~ho~iments of the invention, will be better understood when read in conjunction with the appended drawings. For the ~u~ose of illustrating the in~ention, there is shown in the drawin~s embodiments which are presently preferred. I~
should be understood, however, that the invention is not W096/2~9 PCT~S95/16752 limited to the precise arrangements and instrumentalities shown. In the drawings:
Fig. l is a block diagram representation of the user monitoring system of the present invention;
Fig. 2 is a more detailed block diagram representation of the system controller device of ~ig. l;
Fig. 3 is a block diagram representation of the movement activity detection subsystem of the user monitoring system of Fig. l;
0 Figs. 4A,B are side and top plan views of the medication self-management detection subsystem of the user monitoring system of Fig. l;
Fig. ~ is a more detailed block diagram ~e~re~entation of the medication self-management detection subsystem of Figs. 4A,B;
Fig. 6 is a block diagram representation of the gas stove safety detection subsystem of the user monitoring system of Fig. l;
Fig. 7 is a block diagram representation of the O electric stove safety detection subsystem of the user monitoring system of Fig. l;
Fig. 8 is a more detailed schematic representation of the current drain monitor of the electric stove safety detection subsystem of ~ig. 7:

W O 96~0449 P~ 9S/~6752 Fig. 9 is a schematic representation of the water overflow detection subsystem of the user monit~ring system of ~ig. l;
Fig. 10 is a block diagram representation of the auxiliary appliance detection subsystem of the user monitoring system of Fig. l; and ~ igs. llA-llM are flow charts representing opera~ions performed wi~h respect to the ~arious subsystems of the system of claim 1.

Detaile~ DescriPtion of Preferred ~mbo~imentQ
Referring to the drawings, wherein the same reference numerals are used to designate the same elements throu~hout, there is shown in Fig . 1 a ~lock diagram representation of a user monitoring system 100 in accordance with a preferred embod;ment of the present invention. The monitoring system may be used to monitor and assist elderly persons, functionally impaired persons or the like on a temporary short-term basis or on a long-term basis. T~e user monitoring system loo includes a microprocessor h:~C~ system ~u.-LYoller de~ice 110 linked to ~arious sensors which are pro~ided within a number of activity detection subsystems 112-128. Activity detection subsystems 112-123 are adapted to monitor W096~2~9 PCT~S95116752 various activities of daily living of the user of the monitoring system 100. Also included are the in-home telephone 132 which is located within the user living area being monitored and an outside telephone line 144.
Any number of daily living activity detection subsystems may be provided within the user monitoring system 100 of the present invention. The detection subsystems provided in one embodiment may include a movement detection subsystem 112, a medication self-management detection su~system 116, and a stove safety detection ~hLay~e~ 120. However, it will be understood that using differing types of monitors, any other activities of daily living may be sensed and detected within user monitoring system 100. Additionally, the ; user monitoring system 100 may be coupled to a computer h:~e~ case monitoring system 148 by way of a tel~rhc!nP
line 144. Formal and informal care gi~ers may be provided with information to determine whether short and long term intervention is required using the data transmitted to the case monitoring system 148. It will be understood that in addition to telephone line 144 or interactive television, any method of transmitting messages to system 148 may be used. ~or example, W096~9 PCT~S95/16752 _ g _ messages may be transmitted by an add-on fiber optic cable box or a portable transmitter.
The user monitoring system loO integrates sensor data from different àcti~ity domains to make a i num~er of determinations at predetermined times on a twenty-four hour basis. One acti~ity domain determination within the user monitoring system 100 includes movement of the person being monitored. ln this movement domain determinations are made by the mo~ement detection su~system 112 whether the user is up and around. The~detection information which results from this determination by movement detection subsystem 112 is transmitted to the system co~.L.oller device 110.
Another acti~ity domain determination within the user monitoring system 100 is a determination of medication self-management. In this acti~ity domain determinations are made whether the user is following a predetermined medication regimen. This determination is made by the medication self-management dete~tion subsystem 116 of the user monitoring system 100. The detection information which results of this determination by medication self-management system 116 is also transmitted to the system controller device 110.

W096l2~9 PCT~S9~/16752 Stove usage is another activity domain which is monitored by the user monitoring system 100. In this activity domain determinations are made as to whether a stove has been left on inappropriately. Detection information in accordance w~th this determination is transmitted to the system controller device 110. This determination may be made by differing embodiments of the sto~e safety detection subsystem 120 depending on whether the stove being monitored by detection subsystem 120 is a g2s stove or an electric stove.
In-the preferred embodiment of the user monitoring system 100 it is also possible to monitor and ~G~LL~l other designated appliances usin~ one or more a~ ry systems subsystems 128. These auxiliary systems may include, for example, other poten~ially harmful appli~r~s such as irons or electric space heaters. System ~u..LLoller de~ice 110 also receives detection information representati~e of the determination of the detection subsystems 116, 128.
Referring to ~ig. 2, there is shown a more detailed block diagram representation of the system controller de~ice 110 of the user monitoring system 100.
The system controller device 110 includes a computer 208 and a radio frequency multichannel receiver 212. The o96n~9 PCT~Sgsn6752 computer 208 may be any type of computer capable of n;~ C~+ or any similar functionally equi~alent object code. The various ch~n~els of the radio frequency receiver 212 are provided within system controller de~ice 110 for recei~ing radio frequency signals transmitted from the various detection subsystems 112-128 by way of detection system antennas provided within the ~arious detection subsystems 112-128. It will be understood that.
a sufficient number of information ch~nn~ls reouired to accommodate the number of detectors should be provided within system 100. These c-v~ ication channels may be provided, for example, by a number of radio frequency rh~n~elC within sadio frequency receiver 212.
The various rh~nnels of the radio frequency recei~er 212 thus serve as detection information ~ el~
for recei~ing detection information within the monitoring system 100. However, it will be understood that any information ~h~nnDl or information ~Qn~;t or means for applying information may be used to apply information from detection subsyst~c 112-128 to system controller 110. The system ~o..L~oller device 110 is also pro~ided with an AC power line transmitter 202 for applying control signals t~ the ~arious detection subsystems 112-128 and to the remote monitoring site 148. Additiona W O 96/20449 PC~rrUS9S/16752 a system controller modem 204, and a telephone interfacing circuit 202 are present wit~in the system ~o~,L~oller 110.
In the preferred embo~iment of the user monitoring system 100 the system controller device 110 may also be provided with a ~oice data storage device 210. The ~oice data storage device 210 may be used within the user monitoring system 100 to store ~arious audio reminder and inquiry messages which may be provided o to the user being monitored at predetermined times.
The power supply of the system oonL~uller device 110 of the user monitoring system 100 may include a w~ll regulated ~attery with a battery h~r~tr to ~ er.t loss of valuable user data stored in the user monitoring system 100. ~he radio frequency multi~h~nn~l recei~er 212 of the system cG.~LLoller device 110 is a conventio multirh~n~l radio frequency device ha~ing a~o~.iate anti-interference t~chnology for ~le~..Ling interference between the various subsystem rh:~nn~ls and interference from external sources. The anti-interference t~r~nology may be, for example, broad spectrum modulation.
In the preferred embodiment of the system controller device 110 the radi~ frequency recei~er 212 may be a pulsed radio frequency device- T~e power line W096~49 PCT~S9~/16752 tr~nC~itter 202 of the system controller device 110 is a conventional system for turning controlled appl;~nc~ on and off. In the preferred embodiment of the user monitoring system 100, t~is co,lL~ol may be accomplished by sending pulsed radio frequency signals through the AC
lines of the living areas of the user as understood by those skilled in the art. The use of different pulsed si~A-c~ ~ecoA~hle by different detection subsystems,~is effective to pro~ide any required number of control O information rh~n~ls for applying control signals to detection subsystems 112-128 by system controller 110.
However, it will be understood that the tr~cmi~cion of cGl.L~ol information from the system contr~ller device 110 to the various detection subsystems 112-128 may be performed by any suitable information ch~n~els.
The ~G"L,oller modem 204 of the system controller device 110 may be a conventional modem capable of pro~iding known incoming and outgoing modem protocols.
The outgoing protocols of the cG~ oller modem 204 may be used for data transfer from the system ~.,L~oller device 110 to the case monitoring site 148 or to other locations by way of telephone line 144. The incom;ng protocols of the system controller modem 2~4 may be used for reprogramming various monitoring and intervention W096~9 PCT~S951167S2 parameters of the user monitoring system 100.
Reprogr2mming may be performed either by the remote case monitoring site 148 through the-controller modem 204 or directly to the system controller device 110.
Additionally, the incoming protocols may be used for any type of communication with the user monitoring system 100 .
The local telephone interface circuit 206 of the system controller device 110 provides several functions within the user monitoring system 100. It transmits i~coming calls received ~y the user monitoring system 100 by way of the telephone line 144 to the in-home telephone 132. The telep~one interface de~ice 206 also ~n~cts ringing voltage as well as synthesized ~oice messages from the voice data storage de~ice 210 to the in-house telephone 132 on command-to provide messages to the user by way of the in-home telephone 132. It also makes several determinations regarding the state of the in-house telephone 132. For example, determinations when the in-home telephone 132 is off-hook, when the in-home telephone 132 is not off-hook, and whether the num~er one has been pressed on the in-home telephone 132 may be made by the local telephone interface circuit 206.

W 096no449 PCTAUS95/167S2 The user monitoring system 100 operates in a home mode and in an away mode. The away mode of the user monitoring system 100 may be selected by pressing a dedicated away switch (not shown) located in a convenient location in the home of the user. Additionally, the away mode of user monitoring system 100 may be remotely set from the case management monitoring host site 148. The home mode of the user monitoring system 100 may ~e passive~y set, for example, by the opening of a door when the user returns home.
In-t~e preferred embodiment of the system ~u~.L~oller device 110, a reprosr~m~able microprocessor receives detection information, makes dete~ tions as set forth herein, and provides ~o,lL~ol information ; accordingly. However, it will be understood by those s~illed in the art that any type of ~o~,L~ol circuitry capable of performing the operations set forth herein may be used within the user monitoring system 100.
Referring to Fig. 3, there is shown a block diagram representation of a preferred emlbodiment of the movement activity detection subsystem 112 of the user monitoring system 100. Within the user monitoring system 100, movement sensed by the movement activity detection WOg6/2~9 PCT~S95116752 subsystem 112 is assumed to indicate that the user being monitored is up and around.
It will be understood by those skilled in the art that the configuration of the movement detection subsystem 112 may vary according to the differing living arezs being monitored by user monitoring system 100.
However, in general the movement detection su~system 112 includes at least one and preferably several motion sensors such as motion sensor 304 positioned at spaced O locations within the home of the user or a conventional reed switch ~oor opening such as sensor detector 308.
The motion sensor 304 and the reed switch 308 are provided for determining whether there is movement or activity within the living area being monitored by the user monitoring system 100.
In the most basic ~hodiment of the detection subsystem 112, only a single motion sensor 304 may be provided. In this case the single motion sensor 304 is preferably placed between t~e bed of the user and the ) ba~hroom. In a case where only a single reed switch is provided within the mo~ement detection subsystem 112, it is preferably placed on the door of the bathroom. Such basic configurations of the movement detection subsystem 116 are effective to determine whether the user being PCT~S95116752 W096~9 monitored has gotten out of bed or has gone to the bathroom after a predetermined time.
When an activity is sensed by the motion sensor 304 or the door opening sensor 308, a motion transmitter 306 of the motion detection subsystem 112 transmits a -radio freguency signal by way of the motion antenna 302.
This motion signal representing an activity of daily living by the user-is received by the system controller device llO of the user monitoring system lO0. It is therefore activity of daily living information which indicates that the detected user movement has occurred within the.home being monitored by the user monitoring system lO0.
Similarly, a conventional reed switch (not shown) or other type of switch within the door opening sensor 308 is provided with a radio frequency door opening transmitter 312. The d~or opening transmitter 312 transmits a door opening signal indicating.the opening of a door or cabinet to which the sensor 308 is ~o applied. The door opening signal is transmitted by ~ detection subsystem 112 is a radio frequency signal representative of this activity. It is transmitted to the system controller device llO by way of the motion detection antenna 310.

W096/2~9 PCT~S95/167S2 If the dwelling being monitored is larye or complex a more elaborate configuration of movement and acti~ity sensors 304, 308 may be required within the movement detection subsystem 112 of the user monitoring system 100. However, in the preferred embodiment of the user monitoring system loO at least movement from the bed and movement into and out of the bathroom should be monitored by the movement detection subsystem 112.
Inappropriate periods of user inactivity as indicated by 0 sensors 304, 308 or other sensor disposed in these locations may indicate a medical emergency. It will be understood that a plurality of motion sensors or switches such as reed switches may be placed in locations within the living area being monitored and that there are no theoretical li~itations in the number of such de~ices which ~ay be used with the mo~ement detection system 112.
When the movement detection subsystem 112 operates in the home mode the user ~onitoring system 100 is in a twenty-four hour cycle. This twenty-four hour O cycle includes ~nformation with reçpect to the usua~
waking time of the user being monitored. Using the motion sensors 304, 308 of the motion detection subsystem 112 the user monitoring system 100 determines if ~he user remains in bed a specified length of time beyond the W096~9 PCT~S95/167S2 usual waking time or has not g~ne from the bed to the bathroom for a predetermined tLme period. If the user monitoring system 100 determines an abnormal lack of user acti~ity such as this it may enter a wake up monitor ~h~e~, In the wake up monitor phase of the user monitoring system 100 the system co1.L,oller device 110 may place a telephone call to the user by way of the telephone 132 in order to determine whether the user is ha~ing a problem. If the telephone call placed by the system controller device 110 is answered, the user is Led by the system ~o~,L~uller device 110 to depress a predeterr;ned key on the in-home telephone 132. For e~a~yle, the user may be prompted to press the telephone !~ key ;nrl; c~ting the n~her one. If the user complies with the prompt from the system co.,L,oller de~ice 110 the wake up monitor phase of the user monitoring system 100 is complete. If there is no answer to the cal} p~aced ~y the system ~o.,L,oller de~ice 110 and the user monitoring 0 system 100 is not in away mode, or if the user answers the telepho~e but does not depress the requested key, the user monitoring system 100 contacts the case monitoring site 148 with an immediate status report indicating a potential problem with the user.

W 096/20449 PCTrUS95/16752 Assuming all is well, the acti~ity movement detection subsystem 112 of the user monitoring system lOo merely monitors all system status changes within system 100. This includes monitoring and storing information from the motion detectors 304, 308 representing movement and the opening and closing of doors, the usage of medication, the usage of the stove and appli Anoes ~ and any other au~iliary devices which may be monitored by the user monitoring system lOo.
Each status change detected by the user monitoring system 100 is assumed to indicate acti~ity of the user being monitored. In the event of the detection of a period of inacti~ity in ~c~ss of a predetermined amount of time during the usual waking hours of the user, the user monitoring system 100 ~eLuL~,s to the wake up monitor phase and places a telephone call to the user as pre~iously described. The period of inacti~ity required for the user monitoring system 100 to L~L~" to the wake up monitor phase is adjustable dep ~ upon the habits of a particular user but may, for example, be two and one-half hours.
When the user monitoring system 100 is in the away mode it does not record or le~L~ any acti~ities.
It merely waits for active or passi~e resetting of the W 096/20449 P~l/u~S/16752 ' - 21 -home mode as pre~iously described. Acti,ve resetting of the home mode of the user monitoring system 100 occurs when the user activates a dedicated home/away switc~
which may be mounted at ~ny convenient location. Passive resetting of the mode of the user monitoring system 100 may occur when the user returns and changes the status of any detection subsystem 112-128.
Referring to ~igs. 4A,B, and 5, there are shown a side view, a top plan view, and a schematic 0 representation of a preferred embodiment of the medication self-management detection subsystem 116 of the user monitoring system 100 of the present invention. The medication self-management detection subsystem 116 comprises a medication holder 404 which is a specialized portable holder or caddy for holding at least one medication cont~in~r 402 in a coLL~ contAin~r ope,ning 404.
In t_e preferred ~hodiment of the medication detection subsystem 116 a plurality of the medication O cont~in~rs 402 may be installed within their corre~on~ing cont~in~r openings 4~6 in the portab~e medication holder 404 when the user being monitored is not removing medication from them. The medication containers 402 and the container openings 406 within the Wo 96/20449 PCrluSs5/l67s2 medication holder 404 may be color coded. In this method the colors of a selected medication container 402 and its cont~; n~r opening 406 match each other. Likewise, each container opening 406 of the medication holder 404 may be S provided with a match;r~ colored light 408. The colored lights 408 assist the user in returning a removed medication container 402 to its correct container opening 406.
~hen a. medication container 402 is disposed 0 within a cont~iner opening 406 of the medication holder 404 the medication container 402 closes a conventional ~ normally open switch 416. When the medication container 402 is remo~ed from the opening 406 of the medication holder 404 it releases the normally open switch 416 .5 causing it to open. When a switch 416 within the medication holder 404 is opened or closed in this manner by a medication cont~ r 402 a radio frequency medication transmitter 424 is acti~rated. In this manner the medication self-management detection system 116 O rc~ cates this acti~rity of daily li~ring infomlation with the system col.LLoller de~rice 110.
The radio frequency signal pro~rided by the medication transmitter 424 when it is activated by a switch 416 is pulse code modulated by pulse coder 420.

W O 96~0449 1~1lU~9S/167S2 The modulating of the pulse c~der 420 is performed in a series of differing manners according to which switch 416 within the medication container 404 is opened. The selected pulse coded signal from the medication S transmitter 424 is received, decoded, and stored by the system controller de~rice 110 of the user monitoring system 100.
~hile the medication container 402 is removed from the medication holder 404 its matching colored light 0 408 is acti~tated. This causes the color code of the m~jc~tion container 402 removed from the medication holder 404 to be displayed as previously described. When the medication cont~inPr 402 is replaced in its opening 406 of the me~ic~tion hc~lder 404 and the transmitter 424 is activated to transm;t a correspo~in~ pulse code moA~ ted signal, the colored light 4~8 turns off ana the transmission from the medication transmitter 424 to the system ~G..L~oller device 110 terminates. Tl~e termination of the tr~n~mission by the medication transmitter 424 o in~ic~tes to the system ~,Gl~LLoller de~rice 110 that t~e medication cont~in~r 402 has been LeL.lL~Ied to its opening 406 in the medication holder 404.
It will be understood by those skilled in the art that any number of medication openings 406 may be W096~49 PCT~S95116752 provided within a container holder 404 of the medication self-management detection subsystem 116, However, it is believed from current research that the daily medication management needs of a majority of users of the user monitoring system lO0 may be met by eight medication openings 406 and eight corresponding medication contA;~ers 402 although only three are shown in order to simplify the drawings. It will also be understood that the openings 406 of the container holder 404 and the medication cont~; n~rS 402 may be provided with keying features so that only the correct medication container 402 may be placed into an opening 406 of the medication holder 404.
While the a~ove describes many of the features of a preferred embodiment of the medication self-management detection system 116, it should be noted that various arrangements of medication holders and dispensers may be used. For example, the medications within a medication holder 404 may be organized according to the ~0 time of day they are taken. In this type of organization medications which are taken at the same time may be loaded together into a single compaLL~ent within the medication holder 404. A plurality of these compartments may be provided within the medication self-management Wos6/2o449 PCT~S95/16752 - 2s -detection system 116. The opening and closing of these compa~L~ents may ~e monitored by the medication self-management detection system 116 in substantially the same ~nne~ as previously described with-respect to monitoring the removal of the medication containers 402 from the openings of the medication holder 404.
As previously described the pulsed tr~c~ ions from the medication transmitter 424 to the system controller device 110 may carry a plurality of .0 differing codes corresponding to the plurality of differing medication containers 402. ~ach pulse code corresponds to an individual medication cont~; n~r 402 and indicates when its corresponding medication container 402 is currently removed from the medication holder 404.
.5 The system ~o,.LLoller device 110 of the user monitoring system 100 is programmed to record the times of removal and replacement of each medication cont~i~Pr 402 within medicine holder 404 according to these transmissions. It is also ~ G~lammed to dete~ine 0 ~he~ ed on-time removals of each of the medication cont~in~rs 404 from the medicine holder 404. Compliance data representative of these determinations according to transmissions from the medication self-management W096~49 PCT~S95/167S2 detection system 116 may be transferred to the case monitoring site 148 for intervention decisions.
The system controller device 110 of the user monitoring system 100 may be progrA~-~ to det~r~;ne when S usex compliance does not conform to a scheduled regimen.
After a selected time period, for example,-one-half hour, without user compliance, voice data from the voice data storage device 224 may be applied by the controller device 110 to the in-home telephone 132 to remind the user to take medications. The system controller device 110 may also provide general and specific reminders and inquiries to the user concerning medications after the user returns from being away. These rPm~ s and inquiries may be made with respect to all medications or ~5 with respect to specific medications. The system controller device 110 may also provide specific time scheduled reminders to take medication.
Referring to ~igs. 6, 7, there are shown two ~mhodiments of the stove safety detection subsystem 120, 0 the stove safety detection subsystem 600 and an electric stove safety detection su~system 700. The stove safety detection systems 600, 700 of Figs. 6, 7 are preferred alternate em~odiments which are adapted for monitoring WO 96120449 PCT/US9~i/16752 and controlling gas stoves and electric stoves, respectively.
The stove safety detection subsystems 600, 700 of the user monitoring system 100 each include an appropriate stove-in-use sensor for det~r~i n; ~g when a monitored stove is turned on. Each stove safety detection subsystem 600, 700 also includes an appropriate shut-off receiver unit for receiving a radio frequency tr~nC~iccion from the system controller de~ice 110 by way O of the AC lines to turn the monitored stove off and protect the user. The stove-in-use sensors of the stove safety detection subsystems 600, 700 continuously provide information to the system ~o~.Lloller device 110 of the user monitoring system 100 regarding whether the .~ monitored stove is currently on.
The stove-in-use sensor 604 of the gas stove safety detection subsystem 600 is a gas flow monitor 604.
The gas flow monitor 604 is disposed in the gas line 602 w~ich supplies gas to the gas stove 610 in order to O monitor the gas supplied by the gas line 602 to the gas stove 610. Gas flow information from the g2s flow monitor 604 is pulse coded by a pulse coder 612. The coded signal from the pulse coder 612 is transmitted t~

W096/2~49 PCT~S95/167S2 the system ~o--LLoller device 110 by a gas stove transmitter 620 by way of the gas stove antenna 616.
The system ~nLl~ller device 110 ~ay determine that the gas stove 610 must be shut off in accordance with the coded information from the gas flow monitor 604.
If this determination is made by the system controller device, it applies a ~..L~ol signal to the gas stove safety detection subsystem 600 by way of the AC line 630.
The co.lLlol signal to the gas stove detection system 600 LO from the system c~nLloller device 110 is generated and transmitted by way of the AC power line transmitter 216 as previously described. This control signal is received by the c~lL~ller recei~er 628 of the gas stove safety detection subsystem 600. The ~u,.L~oller recei~er 628 .5 instruc~s a gas shut off valve 608 by way of a step down circuit 608 to terminate gas flow through gas line 602 to the gas stove 610 in response to the ~IILLol signal.
~his turns off t~e gas stove 610.
When the user monitoring system 100 monitors an O electric stove 710, an electrical cNrrent draw monitoring device 704 is provided for use along with the electric stove safety detection system 700. The electrical current monitoring device 704 is applied to the AC power line 706 which supplies p~wer to the electrical s~ove Wos6~9 PCT~S95/16752 710. By monitoring the AC power line 706 detector subsystem 700 is able to indicate the on/off status of the burners of the electric stove 710. On/off status information is coded by the pulse coder 712 and transmitted by an electric stove transmitter 720 by way of antenna 716 to the system controller device 110.
The system col,L~oller device 110 may determine that the electric stove 710 must be shut off in accordance with the coded information from the ~LL~
draw monitor 704 as previously described with respect to the gas stove safety detection system 600. If electric stove 710 is to be shut off, the system controller device 110 applies a c~-Lrol signal to the electric stove safety detection subsystem 700 by way of the AC line 730. This signal is received by a controller receiver 728 of the electric stove safety detection subsystem 700. The ~..L~oller receiver 728 instructs the electrical trip relay 708 to interrupt electricity through the elecLLical power supply line 702 to electrical stove 710. T~is o turns electric stove 710 off.
When the stove safety detection subsystems 600, 700 provide information indicating that a stove is on, shut down predet~rm;~ed control algori~hms are followed in order to determine whether the stove 610, 710 should W096/2~9 PCT~S9S/16752 be turned off. These predetermi~e~ control algorithms are executed within the system co~.Lloller device 110 of the user monitoring system 100. In the preferred P~bodiment of the user monitoring system 100 the algorithms operate upon coded information transmitted from the stove safety detection management subsystems 600, 700 and the movement detection subsystem 112 in the following manner although the other algorithms may be used if desired:
If (no movement detected for 30 minutes) or (away-mode status) and stove-on status), then (call with stove reminder).
If (no answer to call), then initiate shut down and record event. If (call is L5 answered and 1 is pressed), override shut down.
If (stove on status) and (smoke detector tripped), then initiate shut down and record event.
If (stove is on for ~X] minutes), ~0 then alert remote site host with automated telephone ~Pss~ge: "Your stove is on, do you want it on? If yes, press l; otherwise, it will be turned off." Answering the telephone nd pressing 1 override the shut-down sequence.

W096~9 PCT~S95/16752 Additionally, management su~systems 600, 700 may include smoke detector sensor devices 632, 732 coupled to radio frequency transmitters 620, 720. The smoke detection sensor devices 632, 732 may be st~n~rd S optical smoke detector modified to include a subsystem switrhing circuit (not shown) which is effective to provide a smoke detect co~lL~ol signal when smoke is detected by the sensor devices 632, 732. The radio frequency transmitters 620, 720 of the smoke detection O subsystem is coupled to the subsystem switching circuit of the smoke detection sensor devices 632, 732 in a manner well understood by those skilled in the art.
When the sensor devices 632, 732 detect smoke within the home of the user they sound a fire alarm in a .
,,ve,,Lional manner. Additionally, the detection of smoke by the sensor devices 632, 732 activates su~system switc~;n~ circuit which activates the respective smoke detector tran-cmitter 620, 72C. In ~e~onse the ~moke . detection transmitters 620, 720 pro~ide a pulsed radio O frequency c~rlLlol signal by way of the antenna 616. This co"Llol signal col,ve~ information to the system controller device 110 of the user monitoring system 100.
The information transmitted ~y the subsystems 600, 700 in this mznner indicates to the system controller device llo W096/20~9 PCT~S95/16752 that ~ok~ was detected by a sensor de~ice 632, 732. It may also indicate which particular sensor device i5 triggered if more than one sensor device 632, 732 is used within a subsystem 600, 700.
Referring to Fig. 8, there is shown a more detailed schematic representation of the current draw monitor 704 of the electric stove detection subsystem 700. The current drain monitor 704 may include a passive clamp coil 730 disposed around the electrical supply line 0 706 w~ich applies electrical energy to the electric stove 710. Electromagnetic fields arising from the current applied to the stove 710 by way of the electrical supply line 706 thus induce ~uLL~lL in the passi~e clamp coil 730. The current in~llre~ in the passi~e clamp coil 730 may be rectified by a bridge rectifier 734, amplified by an amplifier 73~, and applied to a diode switch 742. The diode switch 742 may then co..LLol the gate of silicon ~o.,LL~l regulator 746 to apply energy to the pulse coder 712.
O It will be understood that any method may be used for sensing the ele~LLv~agnetic fields arising from the current applied to the stove by way of the electrical supply line which induces current in the passive clam~
coil 730, provided the current induced in the passi~e W096~9 PCT~SsS/l67s2 clamp coil is used to toggle an electronic switch of suitable design to control a pulsed radio frequency signal indicating to the system C~llt~ oller the on/off state of the stove 710. Additionally, it will be understood by those skilled in the art that pulse code 710 may be controlled ~y any other means for determining the state of stove 710.
Referring to Fig. 9, there is shown a preferred em~odiment of the water overflow detection subsystem 124 0 of the user monitoring system lO0. The water overflow detection subsystem 124 may be installed on plumbing fixtures such as sinks and bathtubs within the home of the user being monitored by the user monitoring system 100. Within the water overflow detection subsystem 124 a water level sensing device 1004 and a remote ~u--L~ol~ed shut-off device 1030 are provided in communication with the system co.lL.oller device llO of the user monitoring system lO0.
In the principles of its operation, the water overflow detection subsystem 124 is s;~ to the gas stove safety subsystem 600 previously described. The water level sensing device 1004 or water level monitor 1004 sends information to the system controller device 110 by means of a pulsed radio frequency water level W096l2~49 PCT~S95/16752 ~ - 34 -transmitter 1002. The system controller device 11~ is pr~grammed to initizte shut off of water within overflow detection subsystem 124 by means of a radio frequency remote control signal. The radio frequency remote collt~ol signal is transmitted through the home of the user ~y way of the AC lines.
The oG~t-~ol signal from the system co.,t-Icller device 110 is received by the controller receiver 1044, stepped down by step down circuit 1040. The stepped down O signal is used to co.,Llol resetable electrically controlled water valves 1034, 1038. The electrically ~G..L~olled ~alve 1034 may control water flow from an inlet pipe 1026 to a tub supply pipe 1028. The electronically ~or.L,olled val~e 1038 may c~ .ol water flow from an inlet pipe 1026 to a sink inlet pipe 1032.
The water level sensing device 1004 includes two water level detectors ~006, 1012, and a siren module 1018 ha~ing a conventional timer. A siren tr~n~Anc~r such as a piezoele~LLic crystal is also pro~ided. A
O three-state pulsed radio frequency trans~itter ~002 may be pro~ided within ~he water overflow detection subsystem 124.
When water is sensed at a warning level by the level detecto~ 1006 the system controller device 110 of W096/20449 PCT~S95116752 the user monitoring system 100 is informed that water is approaching ~he warning level mark, When this is detected the user monitoring system 100 calls the user on the in-home telephone 132 in order to pro~ide a r2minder.
~hen the level detector 1012 determines that the water level has approached the high water mark, the siren 1024 sounds. Additionally, the received radio frequency pulse data informs the system controller device 110 of the user monitoring system 100 to turn the water off. This event L0 is logged within the system controller de~ice 110. The water overflow detection subsystem 124 may be p~yLammed to permit resetting of the valves 1034, 1038 in response to commands from within user monitoring system 100 or from the case monitoring site 148.
.5 Referring to Fig. 10, there is shown a block diag,ram ~e~l~sentation of the a~ ry appliance detection subsystem 128 of the user monitoring system 100. The a~Yili~ry appli~nce detection subsystem 128 provides additional rh~nTI~15 to the user monitoring O system 100 for monitoring and co.. LI~lling further appl;~nc~s 1116 or de~ices 1116~
The on/off state of the further device 1116 is monitored and transmitted to the system controller device 110 of the user monitoring system 100 by means of a -WO 96t20449 PCIIUS95116752 current draw detector 1108. The current draw detector 1108 monitors current applied to the device 1116 by way of the AC power supply line 1114. The cnrrent draw detector 1108 is coupled to a radio frequency auxiliary transmitter 1112 which transmits a two state signal representing on and of f . This information may be used by the system cGI.t~oller de~ice 110 both for status change data and for generatinq a daily activi~y data log. The cnrrent draw sensor 1108 of the auxiliary detection .o subsystem 128 should be sufficiently sensitive to distinguish between trickle draw and operational power when auxiliary de~ice 1116 is a solid state de~ice such as a television or a clock radio.
In addition to the monitoring of the use of~a a~ ry device 1116, automatic remote ~G,-L-ol of the de~ice 1116 may be accomplished. The system conl roller de~ice 110 of the user monitoring system 100 may be pLoyL~mmed to cu.,L~ol a ~G..L,olled outlet or 2 ~l~e~Lacle adapter which applies energy to the AC line 1114. This LLO1 may be exercised at predetermined times of the day or upon certain en~ironmental G~ L~.Ices. ~or example, when the user monitoring system 100 is in the away mode this feature may ~e used to automatically turn the auxiliary appliance 1116 off. More than one -W 096~ W49 PCTrUS95tl6752 auxiliary subsystem 128 may be provided within the user monitoring system 100.
Furthermore, monitoring system lOo may be provided with an auxiliary detection system which is not monitored by a current draw monitor 1108 or controller receiver 1104. ~or example, the multirh~nnel receiver 212 of system ~o.lL~oller 110 may be used to monitor smoke detection subsystem 900 shown in ~ig. 9.
It will be understood that many differing L0 combinations of auxiliary detection s~bsystems may be provided within the user monitoring system 100 of the present invention. It will also be understood that these combinations may ~e used in combination with automated dialing systems at other locations. Automated ~iAl ;~g L~ syst~mC which may call t~e dwellings of ~arious users, for example, one or more times a day have been developed.
This provides the user with an opportunity to return a predetermined signal if there are no problems and a different predetermined signal or no signal if there ~0 are problems.
These ser~ices may give users up to six automated contacts per day. Por example, an automated dialing system for providing medication compliance reminders, suitable for use with the user monitoring W096l2~49 PCT~S95/167S2 system 100, has been field te~ted. In this 2utomated reminder system users were called daily and reminded to follow their medication regimen.
Referring to ~igs. llA-llN, there are shown S flow chart representations of the operations of the ~arious subsystems of the user monitor system 100.
Fig. llA is a flow chart representation of a method for determining which of the various subsystems has initiated an event for processing by the controller 110. Fig. llB
L0 is a flow chart representation of a method for determining whether the user has arisen by a designated wake up time. This method may be performed in response, for example, to a signal from the motion sensor 304.
Fig. llC is a representation of a method for deter~ n;~g whether the user is complying with the medication sçh~ e as indicated by the subsystem 116.
Fig. llD is a representation of methods for det~r - i ni n~ whether a stove has been left on according to the subsystem 600 and whether the smoke detector 732 has 0 been acti~ated. Fig. llE is a flow chart representation of a method for t~ning off the stove 610, 710. Fig. llF
is a flow chart representation of a method for controlling water flow according to the subsystem 124. A

WO 96/20449 ~-1/U~5S/16752 pseudocode representation of a method for controlling water flow is set forth in Table I.

Is there a flow If yes Is there a change of state If yes send event to main controller If no recycle to flow monitor If no Is there a change of state If yes send event to main controller If no recycle to flow monitor Is there water overflow If yes Send event to main controller If no Is there water warning If yes send event to main controller If no recycle to water overflow 2~ Table I

Fig. llG is a flow chart ~e~re~entation of a method for alerting a user that an appliance has been left on, for example, in accordance with the bridge rectifier 734. Fig. llH shows a method for calling a designated party when an alert has been determined.
Fig. llI shows a method for recording the detection of ~ movement, for example,-in response to a signal from the motion sensor 304.

W096~49 PCT~Sgsll67s2 Fig. llJ is a flow chart representation of a method for re~;ng switches within the user monitoring system 100. A pseudocode representation of a method for re~;ng switches is set forth in Table II.

Is t~e switch open If yes Is there a state change If yes send event to controller turn off light If no recycle to open test If no Is there a state change If yes send event to main controller turn on light If no recycle to open test Table II

Fig. llR is a flow chart representation of an algorithm for determining either current flow or gas flow. Fig. llL is a flow chart representation of zn algorithm for detecting water o~erflow. Fig. llM is a flow chart ~e~esentation of an algorit~ for co~.Llolling an auxillary appliance. A pseudocode representation of this method is set forth in Table III.

Wos6~9 PCT~S95116752 Is the automatic timer set If yes Is there current draw If yes Is turn off timer eYree~e~
If yes turn off appliance send event to controller If no recycle to AT set If no Is turn on time e~eA~
If yes turn on appliance send event to controller If no recycle to AT set If no Is there ~u~ L draw If yes Is there a state change If yes send event to main controller If no re~ycle to AT set If no Is there a state change If yes send event to main ~o..Lloller If no recycle to AT set Table III

As pre~iously described, using the microprocessor based system controller de~ice llO and a system of sensors the user monitoring system lO0 can determine, for example, whether users are up and about in their homes and whether they are ha~ing dif ficulty 4D managing theiT medications. It can also be determ;ne~

W096/20449 PCT~S95/16752 whether the user has accidentally left a stove on or has failed to get out of bed a predeter~;ne~ number of hours after a usual waking time. If the user monitoring system lO0 detects any of these or other problems it can then call the user on the in-home telephone 132 to provide a remin~er about the medications, stove, or other detected problems.
Using this data from the user monitoring system lO0, the remote case monitoring system 148 may provide on-line case monitoring of each user by receiving st~n~rd information and information designated as priority information and analyzing the received information. In order to do this, the remote case monitoring system 148 converts incoming data on each user into various summary reports which track the activities of the client. This makes it possible to distribute specialized gerontological every day li~ing summary reports to users, family members, case managers, physicians and others. It also makes it possible to collect and act upon the designated priority information which may indicate ~mme~;~te pr~blems for the user. ~or example when a user appears not to have gotten out of bed a problem may be indicated.

W096/2W49 PCT~S95/167S2 Additionally, the collection of this kind of data by the remote case monitoring system 148 may provide an ayyL~yGte data base for identifying which users require personal interventions and which do not. In order to perform these functions the remote case monitoring system 148 serves as a central hub for the collection, analysis and ~h~n~e of information which has direct case management import. It should be understood that in different embodiments of the inventive concept different degrees of autonomy of the local system controller llO in relation to the remote system 148 are possible. In one embodiment a local system con~oller 110 may be programmed to perform many functions performed by the remote case monitoring system 148 in another embodiment.
For example the ~;Pl ;ng and s~n~;ng of voice messages to a list of relatives and providers may be performed either by the local system ~u,.Lroller llO or the remote case monitoring system 148. However, it will be understood that the primary function of the local system co..L,oller llO is to provide lower level case management of local observations and decisions and the primary function of the remote case monitoring system 148 is to provide higher level case management to enable long W 096~0449 ~1r~g5/16752 term interpretation of the data obtained from the user monitor system 100 and intervention in view of the long-term interpretation.
Thus in the preferred emho~iment of the present S invention, the user monitoring system 100 or the remote case management system 148 may use its electronic records to enable the production of sche~ ed periodic user activity reports based upon information gathered by the ~arious subsystems of the user monitoring system 100.
These periodic le~GLLs may include collections, compilations and arrangements of information on any or all of the monitored activities within the user's living area. These electronic records may be used in combination with any other information to produce any lS type of periodic activity ~OL Ls desired on the user being monitored. These user acti~ity reports may be used by a professional case manager or a designated family m~mher to determine if the user is experiencing problems with specific activities of daily li~ing. Thus these problems may be dealt with before they become a threat to the continl~e~ well being of the user and the ability of the user to live independently.
Furthermore, in addition to pro~iding remote case monitoring and in-home reminders, the user W096/2~9 PCT~S95/16752 monitoring system 100 may be programmed to take corrective actions when certain problems are detected.
For example, if the user being monitored has not gotten out of bed by a predetermined time the user monitoring system 100 may call the user on the telephone 132. If there is no answer to the telephone call the user monitoring system 100 may be programmed to automatically transmit this information to the remote case monitoring site 148.
A social worker, health professional or designated family member at the remote case monitoring site 148 may respond to the transmitted information according to a predetermined protocol. In addition to transmitting the information to the remote case 1~ monitoring site 148 the user monitoring system 100 may provide control signals within the home of the user. For example, if the user monitoring system 100 of the present invention determines that a stove ~as been left on, the user monitoring system 100 itself can turn off the stove.
The remote case monitoring system 148, in association with the user monitoring system 100, may serve the functions of a case management site. In an example of the case management 5ite function of the remote case monitoring system 148 the case management W09612~9 PCT~S9S116752 site may monitor approximately fifty distributed clients, each using a distributed user electronic monitoring system lO0. The fifty clients thus ha~e the system controller llO and various subsystem sensors installed in their dwellings in ways appropriate for thè specific configuration of their living areas. For example, the various subsystem sensors must be adapted for dif~erent floor plans and furniture arrangements.
The remote case monitoring system 148 may receive information from the distributed user monitoring syst~C lO0 on an immediate basis or at predetermined time intervals. For example, the remote case monitoring system 148 may receive information hourly, daily or weekly basis. If one of the clients does not get out of ~ed within a predetPrmi n~ time duration and does not answer the telephone, the local system cul,L.oller llO of the user monitoring system lO0 at that client's house may call the case management site. At the case management site, this event may be blouyhL to the ;mmediate attention of the human case monitor, for ex2mple, by means of a cu~uLer screen. The remote case manager may examine individual case and data records for the client being monitored to learn the predetermined response for the monitored person when the repDrted event occurs.

W09612~49 PCT~S95/16752 Likely interventions required of personnel at the case management site may include calling a local case manager, a hospital social worker or a local next of kin.
Other actions the remote case monitor may execute include calling the user, remotely downloading the last twenty-four or forty-eight hours worth of event summary information from the local user monitoring system l00 and remotely initiating a diagnostic sequence on the local user monitoring system l00.
The protocol of proc~du~es for intervention by the remote case monitor 148 may differ from one remote case monitoring system 148 to another and from one user to another. It is anticipated in the preferred ~ho~;~ent of the invention that various intervention decisions such as who to call when predetermined events occur and what messages to deli~er may be carried out by a machine intelligence expert system (not shown) at the remote case monitoring system 148 or by a person or a combination of both~ The local user monitoring system l00 may also be ~LoyL~mmed to carry out such decisions as who to call when appropriate. For example, the user monitoring system l00 may have a contact list of people to contact in ~arious emergencies.

? . CA 02208594 1997-06-23 W O 96/20449 PCTrUS95/16752 In addition to receiving and interpreting data indicating the need for intervention in event of emergencies, the remote case monitoring system 148 routinely receives downloaded data from individual user monitoring systems 100 at predetermined intervals. ~his data is interpreted on t~e individual and ayyL~yate level by means of trend analysis software which detects larger than statistically normal deviations from event pattern measurements. The remote case monitoring system 148 may use this analysis to produce periodic summary reports of events relating to everyday living tasks in the home en~ironment of the user. More specifically these reports may be used to detect certain event classes, to weight them in terms of their relative importance and to compare them with baselines of task performance. The events weighed with respect to their importance may include getting out of bed, managing medication, the proper ~O~1LLO1 of a stove, the proper ~Gl.Ltol of water flow, and the proper ~c~nL~ul of celected electrical appl;~n~eC.
Based upon the reports of these events, gerontological li~ing summary reports may be prepared in machine form and paper form at the remote case management system 148 for distribution to predesignated parties involved in the case management of the user of the user monitoring system W096r2~49 PCT~S95/167S2 lOO. These parties may include the users themselves, relatives of the user, case manager social workers, physicians and other appropriate formal and informal - providers.
Two additional functions of the remote case monitoring system 148 may be provided. These functions are: (l) the remote programming and reprogramming of the user monitoring system lOO, and (2) the generation of ayy~eydte and individual level data on relatively large numbers of users. This data may serve both as an empirically grounded knowledge base driving the decision protocols for both humans and machines as well as research data for further development of the user monitoring system lOO.
In order for these functions to ~e performed data must be transmitted between the user monitoring system lOO and the remote case monitoring system 148.
Information trans~itted to the system ~ol1L~uller llO of the local user monitoring system lOO from the remote case monitoring system 148 may include three different types of commands: queries, diagnostics and settings. The query co~r~n~c request the downloading of specific information from the memory of the user monitoring system lOO to the remote case monitoring system 148. The W096/2W49 PCT~S951167S2 requested information forms the basis of the gerontological everyday living events report along with specific information nec~ss~ry for case monitoring by the remote system 148. For example the status of different subsystems of the user monitoring system loO might be made available to the remote system 148 when the motion subsystem 112 indicates that the user has not gotten up in the morning.
The diagnostic commands to the local user monitoring system 100 test the different subsystems of the system 100 by suppressing the ability of the system 100 to either call out interventions or change settings on any of the remotely controlled devices while at the same time initiating a sequence of event codes which indicate the presence of various kinds of problems as if they were indicated by the different subsystems.
The setting commands from the remote case management system 148 to the user monitoring system 100 reset the parameters on the timers within the user monitoring system 100 as well as other variable values for the decisions made in the decision trees described hereinbelow. These parameters may include, but are not limited to, the time of waking up, the times for taking W096/2~9 PCT~S95/167S2 different medications and the length of time which should elapse prior to turning off the stove.
Transfer information transmitted in the opposite direction, from the system eo"t,oller 110 of the user monitor system 100 to the remote case monitoring system 148, includes two types: (1) priority specific data transfer and (2) st~d~rd data transfer. Priority specific data transfer is initiated by the local system controller 110 by means of dialing the remote case monitoring system 148 by way of the telephone line 144 or by means of another data link (not shown) and indicating the presence of a problem which the remote case monitoring system 148 must detect, record and act upon.
Situations in which the local system controller 110 dials out to inform the remote case monitoring system 148 that the user did not get out of bed or that the stove was left on, are potential emergencies and are therefore examples of priority specific data transfer.
St~n~rd data transfer includes the downlo~in~ of event log information for each subsystem. This information is used to produce trend analysis reports which show the frequency of oc~u~lence of different events over a predetermined time period such as six mont~s. ~hus the trend analysis report might show that over the course of W09612~9 PCT~S95116752 six months the user became increasingly noncompliant with medications and/or increasingly likely to leave the stove on inappropriately. ~sing a known trend analysis - t~chn;gue, software-driven reports can detect increasing frequencies of problems of every day activities.
The trend analysis report may be a monthly paper or machine report which provides several indicators of performance on different areas of everyday living monitored by the user monitoring system 100. These areas may include waking and sleeping, medication management, stove management, water flow management and the operation of additional appliances. The raw data for this Le~O' L
is based on the event log data transferred from the local system controller 110 remote system using st~n~rd data 1~ transfer and priority specific modes. The raw data is used to provide a continuous baseline of the s~oeccful and not s~rcec~ful completion of the five task areas.
For example, in one month a user may use the stove fifty-five times and leave it on in violation of the ~r~y~ammed protocol two times. The monthly report line for the stove category might then show fifty-five uses and two usage errors. ~urthermore, usage errors may be classified according to level of importance by means of a weighting system. An error of, for example, Wos6~9 PCT~S95/16752 skipping one medication may be weighted as considerably less significant comrAred with an error of leaving the stove on and lea~ing the apaLL~ent for several hours.
Thus not only are errors recorded and plotted against continuous baselines over time in the trend analysis report of the system of the present invention, ~ut the report is intended to contain a ranking system to reflect the potential negative impacts of different errors.
In addition to errors, the trend analysis report can plot deviations in behavior indicating changes in plot trend. For example, the trend analysis report can plot waking and sleeping hours and the number of times a user goes to the bathroom. While none of this in itself indicates a situation requiring intervention, sudden changes in sleep habits, bathroom use, even appliance use may indicate sudden changes in health or cognitive well being reguiring a relative or a case management social worker or case management social worker or a physician to visit or interview the user.
While any num~er of combinations of interpreted data can be used in any number of speciali~ed reports, it is anticipated that most case management sites and most relatives would want to know the frequency and severity of specific errors, the e~tent and accuracy of medication W 096~0449 rCTnUS95/16752 compliance and whether a waking or sleeping pattern of a user is changing radically. The trend analysis report provides case managers and relatives with this information and enables them to better help the user by locating subtle changes in behavior patterns, monitoring various kinds of potentially dangerous errors and keeping a record of baseline functioning in relation to monitored activities.
W~ile the operation of the monitoring system 100 has been described principally with respect to the monitoring of a gerontological patient, it will be understood that system 100 may be used to monitor any type of patient, for example, infants and burn victims.
Additionally, it will be understood that, using the 1~ correct sensors, monitoring system 100 may monitor any parameters relevant to these patients, for example, ambient temperature, body temperature and blood pressure.
In general, anything which may be sensed by a sensor and converted into an electrical signal may be monitored by the monitoring system 100. Additionally, the data could be made available to a doctor prior to routine doctor' 5 appointments in addition to being used to compile reports at the remote monitoring site 148. The system could be W096/2~9 PCT~S95116752 monitored by a friend or relative rather than by professionals at a remote monitoring site.

It will be appreciated by those skilled in the art that changes could be made to the embodiment described above without departing from the broad inventive conGPrt thereof. It is understood, therefore, that this invention is not limited to the particular emho~;ments disclosed, ~ut it is intended to cover all modifications within the spirit and scope of the present invention as defined by the appended claims.

Claims

1. A system for monitoring a user in a user living area, said system including a remote monitoring site, comprising:
a system controller;
an activity detection subsystem for monitoring a daily living activity of the user independently of physiological measurements, said activity detection subsystem having at least one detector device capable of being activated in response to said occurrence of said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide to the system controller information representative or said daily living activity, said system controller having a control circuit for generating a control signal in response to said daily living activity information;
a control information communication channel for applying said control signal to said remote monitoring site;
a report generator for generating a scheduled periodic reports on daily living activities, said reports having collections of said information representative of selected daily living activities;
a generator for generating a trend analysis in accordance with said reports of said information on said daily living activities; and means for intervening in said user living area in accordance with said trend analysis.

2. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises a motion detector subsystem for detecting motion of said user.

3. The system for monitoring a user in a user living area of claim 2, further comprising a switch coupled to an object for detecting movement of said object.

4. The system for monitoring a user in a user living area of claim 3, wherein said switch comprises a reed switch connected to a door.

5. The system for monitoring a user in a user living area of claim 2, wherein said user living area comprises a bed and said motion detector subsystem is disposed within said user living area to determine whether said user is disposed in said bed.

6. The system for monitoring a user in a user living area of claim 2, wherein said system controller comprises timing means for acting cooperatively with said motion detector subsystem to determine a period of user inactivity.

7. The system for monitoring a user in a user living area of claim 6, further comprising means for determining that said period of user inactivity is longer than a predetermined time period.

8. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises a medicine compliance detection subsystem.

9. The system for monitoring a user in a user living area of claim 8, wherein said medicine compliance detector subsystem comprises:
a medication container for containing medication; and, a medication container holder for holding said medication container, said medication container holder including means for determining whether said medication container is disposed within said medication container holder.

10. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises a water use detection subsystem.

11. The system for monitoring a user in a living area claim 10, wherein said water use detection subsystem comprises a water level detector.

12. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises an auxiliary appliance detection subsystem.

13. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises a stove use subsystem.

14. The system for monitoring a user in a user living area of claim 1, wherein said system controller comprises a multi-channel radio frequency receiver.

15. The system for monitoring a user in a user living area of claim 1, wherein said user living area is provided with a power supply line and said system controller comprises a power line transmitter for applying said control signal to said activity detection subsystem by way of said power supply line.

16. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises a controller receiver for receiving said control signal from said system controller by way of said power supply line.

17. The system for monitoring a user in a user living area of claim 1, wherein said system controller comprises voice data storage for storing voice messages and providing said voice messages to said user.

18. The system for monitoring a user in a user living area of claim 1, wherein said user living area is provided with a telephone line and said system controller applies said control signal to said remote monitoring site by way of said telephone line.

19. The system for monitoring a user in a user living area of claim 1, further comprising means for intervening in said user living area in accordance with said control information and a predetermined intervention protocol.

20. The system for monitoring a user in a user living area of claim 1, further comprising means for separating said information into priority information and standard information and immediately transferring said priority information to said remote monitoring site.

21. The system for monitoring a user in a user living area of claim l, including a plurality of said user living areas each user living area of said plurality of user living areas being provided with a system controller and a control information communication channel and each providing information representative of a daily living activity within said user living areas of said plurality of user living areas comprising means for aggregating information supplied by said control information communication channels.

22. The system for monitoring a user in a user living area of claim 1, further comprising means for applying said control signal to said activity detection subsystem.

23. The system for monitoring a user in a user living area of claim 1, wherein said activity detection subsystem comprises means for providing information representative of said daily living activity independently of any attachments to said user.

24. A system having a power line and a plurality of user living areas for monitoring a user in said user living areas, said system including a remote monitoring site, comprising:
a system controller and a control information communication channel providing information representative of daily living activities within the user living areas of said plurality of user living areas, each system controller including a radio frequency receiver;
an activity detection subsystem for monitoring a daily living activity of said user independently of physiological measurements, said activity detection subsystem having at least one detector device capable of being activated in response to said occurrence of said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide to the system controller information representative of said daily living activity, said system controller having a control circuit for generating a control signal in response to said daily living activity information;
a power line transmitter for applying said control signal to said subsystem by way of said power line;
a controller receiver for receiving said control signal by way of said power line;
a control information communication channel in each user living area of said plurality of user living areas for applying said control signal to said remote monitoring site;

means fur aggregating information supplied by said control information control channels;
a motion detector disposed within said user living area to detect the motion of said user and determine whether said user is out of a bed; and a timer cooperating with said motion detector for determining a period of user inactivity.

25. The system for monitoring a user in a user living area of claim 24, further comprising means for generating reports of said daily living activities, said reports having collections of said information representative of said daily living activity.

26. The system for monitoring a user in a user living area of claim 25, further comprising means for generating scheduled periodic reports.

27. The system for monitoring a user in a user living area of claim 26, wherein said periodic reports comprise information on selected daily living activities.

28. The system for monitoring a user in a user living area of claim 25, further comprising means for generating a trend analysis in accordance with said reports of said information on said daily living activities.

29. The system for monitoring a user in a user living area of claim 28, further comprising means for detecting changes in said trends.

30. The system for monitoring a user in a user living area of claim 25, further comprising means for generating summaries of said reports of said information representative of said daily living activity.

31. The system for monitoring a user in a user living area of claim 30, further comprising means for distributing said summaries.

32. The system for monitoring a user in a user living area of claim 28, further comprising means for intervening in said user living area in accordance with said trend analysis.

33. A system having a power line and a plurality of user living areas for monitoring a user in said user living areas, said system including a remote monitoring site, comprising:
a system controller and a control information communication channel providing information representative of daily living activities within the user living areas of said plurality of user living areas, each system controller including a radio frequency receiver;
an activity detection subsystem for monitoring a daily living activity said user independently of physiological measurements, said activity detection subsystem having at least one detector device capable of being activated in response to said occurrence or said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide to the system controller information representative of said daily living activity, said system controller having a control circuit for generating a control signal in response to said daily living activity information;
a power line transmitter for applying said control signal to said subsystem by way of said power line;
a controller receiver for receiving said control signal by way of said power line;
a control information communication channel in each user living area of said plurality of user living areas for applying said control signal to said remote monitoring site; and said activity detection subsystem including a water use detection subsystem.

34. The system for monitoring a user in a user living area of claim 33, further comprising a report generator for generating reports of said daily living activities, said reports having collections of said information representative of said daily living activity.

35. The system for monitoring a user in a user living area of claim 34, further comprising means for generating scheduled periodic reports.

36. The system for monitoring a user in a user living areas of claim 35, wherein said periodic reports include information on selected daily living activities.

37. The system for monitoring a user in a user living area of claim 34, further comprising means for generating a trend analysis in accordance with said reports of said information on said daily living activities.

38. The system for monitoring a user in a user living area of claim 37, further comprising means for detecting changes in said trends.

39. The system for monitoring a user in a user living area of claim 34, further comprising means for generating summaries of said reports of said information representative of said daily living activity.

40. The system for monitoring a user in a user living area of claim 39;
further comprising means for distributing said summaries.

41. The system for monitoring a user in a user living area of claim 33, comprising means for intervening in said user living area in accordance with said control information and a predetermined intervention protocol.

42. The system for monitoring a user in a user living area of claim 33, further comprising means for separating said information into priority information and standard information and immediately transferring said priority information to said remote monitoring site.

43. The system for monitoring a user in a user living area of claim 37, further comprising means for intervening in said user living area in accordance with said trend analysis.

44. A system having a power line and a plurality of user living areas for monitoring a user in said user living areas, said system including a remote monitoring site, comprising:
a system controller and a control information communication channel providing information representative of daily living activities within the user living areas of said plurality of user living areas, each system controller including a radio frequency receiver;

an activity detection subsystem for monitoring a daily living activity of said user independently of physiological measurements, said activity detection subsystem having at least one detector device capable of being activated in response to said occurrence of said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide to the system controller information representative of said daily living activity, said system controller having a control circuit for generating a control signal in response to said daily living activity information;
a power line transmitter for applying said control signal to said subsystem by way of said power line;
a controller receiver for receiving said control signal by way of said power line;
a control informational communication channel in each user living area of said plurality of user living areas for applying said control signal to said remote monitoring site;
and said activity detection subsystem including a stove use subsystem.

45. The system for monitoring a user in a user living area of claim 44, further comprising a report generator for generating reports of said daily living activities, said reports having collections of said information representative of said daily living activity.

46. The system for monitoring a user in a user living area of claim 45, further comprising means for generating scheduled periodic reports.

47. The system for monitoring a user in a user living area of claim 46, wherein said periodic reports include information of selected daily living activities.

48. The system for monitoring a user in a user living area of claim 45, further comprising means for generating a trend analysis in accordance with said reports of said information of said daily living activities.

49. The system for monitoring a user in a user living area of claim 48, further comprising means for detecting changes in said trends.

50. The system for monitoring a user in a user living area of claim 45, further comprising means for generating summaries of said reports of said information representative of said daily living activity.

51. The system for monitoring a user in a user living area of claim 50, further comprising means for distributing said summaries.

52. The system for monitoring a user in a user living area of claim 44, comprising means for intervening in said user living area in accordance with said control information and a predetermined intervention protocol.

53. The system for monitoring a user in a user living area of claim 44, further comprising means for separating said information into priority information and standard information and immediately transferring said priority information to said remote monitoring site.

54. The system for monitoring a user in a user living area of claim 48, further comprising means for intervening in said user living area in accordance with said trend analysis.

55. A system for monitoring a user in a user living area, said system including a remote monitoring site comprising;
a system controller;
an activity detection subsystem for monitoring a daily living activity of said user independently of physiological measurements, said activity detection subsystem having at least one detector device capable of being activated in response to an occurrence of said daily living activity and capable of determining at said user living area that said daily activity has occurred to provide information to said system controller representative of said daily living activity, said system controller having a control circuit for generating a control signal in response to said information representative of said daily living activity;
a control information communication channel for applying said control signal to said remote monitoring site;

a report generator for generating a schedule periodic report on said daily living activity, said report having collections of said information representative of selected daily living activity;
and circuitry for intervening in said user living area in accordance with said scheduled periodic report.

56. The system for claim 55, wherein said activity detection subsystem comprises a detector for determining food preparation.

57. The system of claim 55, wherein said activity detection subsystem comprises a detector for determining a user bath.

58. A system of claim 55, wherein said activity detection subsystem comprises a detector for determining whether said user is out of bed.

59. The system of claim 55, wherein said activity detection subsystem comprises a medication management system for determining medication use.

60. A system for monitoring a user in a user living area, said system including a remote monitoring site, comprising:
a system controller;
an activity detection subsystem for monitoring a daily living activity of the user independently of physiological measurements, said activity detection subsystem having at least one detector device capable of being activated in response to an occurrence of said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide information to said system controller representative of said daily living activity, said system controller having a control circuit for generating a control signal in response to said information representative of said daily living activity;
a control information communication channel for applying said control signal to said remote monitoring site;

a generator for generating a trend analysis in accordance with said determined daily living activity; and circuitry for intervening in said user living area in accordance with said trend analysis.

61. A system for monitoring a user in a living area, said system including a remote monitoring site, comprising:
a programmable system controller;
a programming device disposed at the remote monitoring site for programming said programmable system controller;
an activity detection subsystem for monitoring a daily living activity of the user, said activity detection subsystem having at least one detector device capable of being activated in response to said occurrence of said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide the programmable system controller information representative of said daily activity, said programmable system controller having a control circuit for generating a control signal in response to said daily living activity information representative of said daily living activity and according to said programming;
a control information communication channel for applying said control signal to said remote monitoring site in accordance with said remotely programmed system controller; and circuitry for intervening in said user living area in accordance with said daily living activity information representative of said daily living activity.

62. A system for monitoring a user in a user living area, said system including a remote monitoring site, comprising:
a system controller;
a plurality of activity detection subsystem for monitoring a corresponding plurality of differing daily living activities of said user, said activity detection subsystem each having a least one detector device capable of being activated in response to occurrences of said daily living activities and capable of determining at said user living area that said daily living activities have occurred to provide information to said system controller information representative of said daily living activities, said system controller having a control circuit for generating control signals in response to the occurrence of the daily living activities as determined by the activity detection subsystems and providing control information in accordance with a plurality of said control signals;
a control information communication channel for applying said control signals to said remote monitoring site; and circuitry for intervening in said user living area in accordance with said control information.

63. A method for monitoring a user in a user living area, in a system including a remote monitoring site, comprising the steps of:
(a) programming from the remote monitoring site a system controller located at the user living area to perform first monitoring operations;
(b) said first monitoring operations including monitoring a daily living activity of said user by said programmed system controller using an activity detection subsystem having a least one detector device capable of being activated in response to an occurrence of said daily living activity and capable of determining at said user living area that said daily living activity has occurred to provide to the system controller information representative of said daily living activity, said system controller having a control circuit for generating a control signal in response to said information representative of said daily living activity, comprising the steps of:
(c) applying said control signal to said control remote monitoring site by way of a communication channel in accordance with said first monitoring operations;
(d) reprogramming from the remote monitoring site the system controller to perform second monitoring operations to determine at said user site that a daily living activity has occurred; and (e) applying a further control signal to said remote monitoring site by way of the communication channel in accordance with said second monitoring operations.