CN1531408A - Correlation of sensor signals with subjective information in patient monitoring - Google Patents

Correlation of sensor signals with subjective information in patient monitoring Download PDF

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Publication number
CN1531408A
CN1531408A CNA028109651A CN02810965A CN1531408A CN 1531408 A CN1531408 A CN 1531408A CN A028109651 A CNA028109651 A CN A028109651A CN 02810965 A CN02810965 A CN 02810965A CN 1531408 A CN1531408 A CN 1531408A
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record
patient
subjective information
sensor
subjective
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W・R・马拉布尔
W·R·马拉布尔
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Cardionet LLC
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Cardionet LLC
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    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/30ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Primary Health Care (AREA)
  • Public Health (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

Health information for a patient is organized and correlated by recording a subjective-information input from the patient as a recorded patient subjectiveinformation record, monitoring and recording the condition of the patient with a sensor as a recorded patient sensor record, and automatically associating the recorded patient subjective record and the recorded patient sensor record. The association may be accomplished through the use of respective subjective-information time markers and sensor time markers to produce a subjective/sensor record.

Description

Sensor signal and subjective information is related in the patient monitoring
The present invention relates to patient's supervision, especially sensor information and the subjective information that relates to supervision is related.
Background technology
Patient's daily record (patient diaries) is to analyze the healthy patient who comes under observation, especially do not lie in bed or the important tool of the medical conditions of the patient under hospital continues to observe not.The objective physiological health evidence of sensor record, and in interested incident, to the thing of patient's WKG working and patient's sensation and the daily record record of stating the subjectivity of being done, offer the doctor and help to explain sensor record and carry out diagnostic information.Sensor record and daily record record can make the doctor understand together, and whether particular physiological condition is that the activity by patient causes, is still caused by other reason.In interested incident, sensor record also can be associated with patient's sensation (sensations).
Subjective patient's daily record can written (written form) form or the reservation of magnetic recording form.Under every kind of situation, problem often results from the making of daily record record.In some cases, patient recognizes any necessity of making the daily record record clear-headedly, therefore, does not make the daily record record.When patient recognizes a physiological problem clear-headedly, and do the daily record record, after interested incident, in time made the daily record record.When incident took place, patient often was concerned about these incidents, because incident itself can be or be considered to life-critical, as the situation of heart problem, to such an extent as to written record goes on record when can not take place with incident.The some time after incident, perhaps patient forgets and does the daily record record.Keep a record if patient remembers in the some time afterwards really, perhaps patient has made a mistake the instruction time of sensation, causes misregistration, or is recalling the result or writing down sensation sequential (timing) and make a mistake.In the time afterwards, patient can not recall most important sensation, to such an extent as to write down incorrect and/or incoherent information, and make most important information not obtain record.
Therefore, the patient day aims at understanding and diagnoses the patient aspect that is monitored that important information is provided, but necessary record usually takes place to lose or mistake in some respects.This just needs improved method, with patient's daily record of the maintenance patient that monitored, and sensor record.The present invention satisfies this requirement, and relevant advantage further is provided.
Summary of the invention
The invention provides the patient's that monitors subjective record, sensor record is finished simultaneously in this subjective record and the incident of being interested in.For example, subjective record can comprise an audio recording or clerking.This subjective record comprises patient's daily record, perhaps also comprises other subjective information, is automatically to take place related with objective sensor record.Patient removes the responsibility of need making independent written or log from, the doctor have one completely, accurate sensor record and the subjective record that is associated.Since majority can be more by speech rather than express their sensation in writing form, the subjective record that is input to audio form is compared with independent written daily record record, content more comprehensively.In addition, the sound (sounds of straining) that audio recording and daily record can obtain to change voice (inflections), twist, or the like content, and can not accomplish this point in writing form.
According to the present invention, a kind of tissue and the method that patient's health and fitness information is associated comprise the following steps: to write down the patient subjective record of patient's subjectivity input as record, with the patient sensor record as record, it is related that the patient's subjective record that makes record automatically and the patient sensor of record write down generation with sensor monitoring and record patient status.In one embodiment, use a subjective record time identification marker (subjective record time marker) to write down subjective record, use a sensor time marker (sensor time marker) to write down sensor record, subjective record utilizes their time identification markers separately to be associated with sensor record.After automatically associated steps taking place, subjectivity/sensor record is exported with form written or that computer is compatible typically.
Subjective record preferably includes the audio frequency input that derives from patient with the form of oral daily record record.Can become the part of subjective record equally for the patient's sound that can not talk, painful sound, next door people's sound, care-giver's sound or the like other audio-frequency information.But patient's audio recording numeral of record or analogue audio frequency record form, the patient sensor record of record is digital sensor record or analog sensor record.Subjective record also can comprise or comprise alternatively the written input that derives from patient.Under every kind of situation, patient's input spontaneously or is prompted to carry out, for example, by pick off to monitoring and the step of record patient responds." subjective record " refers to, the information of input is not the objective measurement that derives from pick off.
Utilize any exercisable instrument can carry out this method.Preferably, provide a supervision instrument that comprises remote monitoring unit and to the power supply of remote monitoring unit energize.Remote monitoring unit comprises, is associated with patient and monitors at least one pick off of patient status, and each pick off produces pick off output.Subjective input equipment is an operability, to receive subjective input, as audio frequency or written information, and provides subjective information output.The recording equipment record is exported from the pick off output of pick off with from the subjective information of subjective input equipment.Transceiver and microprocessor communication.Recording equipment receives by the subjective information time identification marker and the output of record subjective information, and receives and the output of record pick off by the sensor time marker.Subjective information time identification marker and sensor time marker are used in the subjective information output of record, automatically, side by side with the pick off output of record take place related, the subjectivity/sensor record that is associated with formation.
Monitor that instrument also comprises, can activate control, be reception audio frequency or subjective information in writing form, and activate subjective input equipment by a subjective input equipment of patient's operation.Monitoring that instrument can comprise, control by the receptor operated from a distance or by the subjective input equipment activation of remote monitoring unit local operation, is to receive subjective information, and it activates subjective input equipment.In a kind of method in back, subjective input equipment is independent of patient and is activated, and when subjective input equipment was an audio receiver, it was useful especially.Patient can spontaneously make the daily record record, or is prompted so that log information to be provided.Under the latter event, by patient selection, patient can be prompted to make oral or written record, perhaps, but a series of problems of inquiring about disease people, may be to get to the most useful characteristic symptom of medical personnel or the information of action, or also be useful to patient.These promptings and problem can be provided by medical personnel, and anticipated import is in the program of system.
This method records the daily record in the incident of interest, and simultaneously from patient and third-party out of Memory.It will be guaranteed that patient can not forget and make the daily record record, guarantee the direct association in time between sensor record and the subjective record, and obtain these information when patient's activity and sensation take place, rather than in the inaccurate information that obtains with patient's memory thereafter.If patient made record when incident took place unautogenously, can encourage patient to make by prompting.From more at large describing that the embodiment that proposes is subsequently carried out, in conjunction with the accompanying drawings as can be seen, other characteristics of the present invention and advantage are significantly, have illustrated principle of the present invention with the form of example.But scope of invention is not limited to the embodiment of this proposition.
The accompanying drawing simple declaration
Fig. 1 is a block flow chart of realizing the inventive method;
Fig. 2 is the rough schematic of preferred apparatus of combining with employed method among Fig. 1; With
Fig. 3 is as the pick off output of time function and the graphic extension of audio frequency output.
The specific embodiment
Fig. 1 describes tissue and makes a method for optimizing of the method that patient's health and fitness information is associated.Numeral 20 expressions provide a supervision instrument.This supervision instrument can be any operable type.Monitor that instrument is to be suitable for preferably monitoring that not being to be limited in hospital receives the ambulant patient who observes continuously.In controllable hospital environment, this method is exercisable and useful, but this method has bigger advantage when being applied to ambulant patient.
Fig. 2 illustrates a preferred instrument 40 that monitors, monitors normally No. 5959529 described type of patent of the U.S. of instrument 40, and the content of this patent disclosure is incorporated by reference this literary composition at this, but revises.Monitor that instrument 40 comprises 42, one remote monitoring unit related with the ambulatory patient that is monitored 44 of a central location, the power supply 46 relevant with patient also provides power supply to remote monitoring unit 44.(in Fig. 2, do not mark the connection of 44 single building blocks, to avoid making chart unclear from power supply 46 to remote monitoring unit.) power supply 46 form of battery typically, but it can be the power supply by patient's operation, as a thermoelectric device, or by the power supply of environmental operations, as a photovoltaic devices.Central location 42 normally be in one fixed or movably, away from remote monitoring unit 44 position far away, and can monitor a plurality of different remote monitoring unit of carrying by many patients.
Remote monitoring unit 44 comprises at least one pick off 48 related with patient, that monitor patient.Each pick off 48 produces a sensor signal 50, and this signal 50 typically is provided for sensor controller 50, and it is regulated sensor signal 50 and produces pick off output 54, and it is as the sensor information that is input to system.Pick off output 54 can be numeral or analog in form.Digitized is wherein carried out by A/D converter traditional in the sensor controller 52.Pick off 48 can be any operable type.Example can comprise a heart monitor sensor, a blood pressure monitor sensor, a body temperature monitoring sensor, a brain wave sensor, a blood glucose sensor, a blood oxygen content level sensor and a motion sensor.These pick offs 48 and sensor controller separately 52 are well known in the art.
In all implantable patient body of all or part of remote monitoring unit 44 and pick off 48, or be present in the external of patient.
But remote monitoring unit 44 also comprises a subjective input equipment of any action type.There is two types subjective input equipment to have special significance, discussed at this.A preferred subjective input equipment is exercisable audio receiver 56, in order to receiving the audio frequency input from surrounding, and provides the subjective information output 60 as the subjective information that is input to system by mike 58.Subjective information output 60 can be numeral or analog form.It can be undressed audio signal, or the processing of the commercial speech recognition software that has now had of process.In this configuration, remote monitoring unit 44 receives the audio frequency input from surrounding.Audio receiver 56 can comprise an optional audio emitter, and mike 58 can comprise an optional microphone, like this, if needed, can set up two-way communication between remote monitoring unit 44 and the patient.
The audio interface receiver activates control 62 and activates audio interface receiver 56, makes it to receive the audio signal (and can send an audio signal by optional microphone) from mike 58.The audio interface receiver activates control 62 and can be operated with one of form of button, equipment or sound control by patient selection.The audio interface receiver activates control 62 can also following alternate mode or additionally operated by following manner, operate by himself internal logic as remote monitoring unit 44, or the transceiver 64 of central location 42 by remote monitoring unit 44 carry out operated from a distance, and it connects in remote monitoring unit 44 and the central location 42 similarly transceivers.Transceiver 64 is a radio frequency transceiver preferably, connect as cell phone, but transceiver 64 also telephone connects, directly connects, infrared ray connects, microwave connects, or the like.
Second type of subjective input equipment is a written information receptor 56a, works and a written receptor activation control 62a with keyboard or other written information input equipment 58a.Situation with audio frequency accepter 56 is the same, and written information receptor 56a also can have fan-out capability, can operate by the display of patient visual.The front can be applicable to here the discussion of equipment 56,58 and 62, revises the back applicable to written I/O, with the I/O of alternate audio.Output 60 generally is subjective information output.
The characteristics of audio frequency and written subjective input equipment are used interchangeably, to be fit to effectively operation and to communicate by letter.For example, even the situation of written information receptor can be an audio form to patient's output, like this, audio prompt and problem can be given patient by phonetic representation, make patient carry out written input.Here audio frequency and written input is called as " subjective information " together, because they comprise non-pick off (non-sensor), and from patient and may be from next door people's non-quantitation information (non-quantitative), people from next door can be patient observer such as layman and/or healthcare givers at the scene at one's side.Another example is can carry out subjective input by written selecting type menu prompt patient, and actual patient's subjectivity input to be written or oral form.
Remote monitoring unit 44 comprises a time reference source 66, and this time reference source 66 provides a sensor time marker 68 to pick off output 54, provides a subjective information time identification marker 70 to subjective information output 60.Sensor time marker 68 links to each other with pick off output 54, and subjective information time identification marker 70 links to each other with subjective information output 60.Time identification marker 68 and 70 is the time absolute value that provides of the clock in time reference source 66 preferably.Time identification marker 68 and 70 needs not to be the absolute time marker, but to each other known relationship must be arranged.Yet, link to each other with the external world with significant subjective information for making pick off, preferably the absolute value of the time of Shi Yonging.
Remote monitoring unit 44 also comprises an exercisable recording equipment 72, export 60 (as the subjective information inputs) with record from the time marker pickup output 54 (as the sensor information input) of pick off 50 with from the time mark subjective information of audio receiver 56 and/or written receptor 56a.Recording equipment 72 can be the autonomous device that is built under the microprocessor/central processing unit controls of remote monitoring unit 44.If pick off output 54 and subjective information output 60 are digital, microprocessor/CPU and relevant memorizer thereof are alternately finished writing function.In general, recording equipment 72 is expressed as has a first module 74 and second unit 76, first module 74 receives and mark sensor output writing time 54, the second unit 76 receive and labelling subjective information output writing time 60, but 74 and 76 two unit can be realized in an individual equipment.
In the description in front, time reference source 66 is expressed pick off output 54 and subjective information output 60 was made marks before arriving recording equipment 72.Equally, recording equipment 72 uses independent time identification marker or single time identification marker, comes pick off output 54 and subjective information output 60 are made marks.What need the labelling time is that pick off output 54 can be in recording equipment 72 or in other local instantaneous linking to each other with subjective information output 60.If same time scale is used in pick off output 54 and subjective information output 60, just need not service time marker, pick off output 54 exports 60 with subjective information still can be related and relevant.But usually preferred service time marker, like this, pick off output 54 and subjective information output 60 can be associated with other incident outside the remote monitoring unit 44.
Get back to the discussion among Fig. 1, numeral 22 expressions, the supervision instrument 40 among Fig. 2 is operated to receive and record subjective information output 60, and numeral 24 expressions receive and record pick off output 54 numeral 26 expressions.Fig. 3 illustrates the typical consequence of the incident of pick off output 54 and subjective information output 60, although this method is not limited to this consequence of incident.Pick off output 54 is normal in very first time section 80 at first.In the time 82, pick off output 54 departs from normal pick off output with certain form, and the pick off output that exceeds threshold value that medical personnel decide identifies this skew usually.Audio receiver 56 or written receptor 56a were activated in the time 84.As mentioned above, receive and write down subjective information output 60.Subjective information output 60 typically comprises the word picture that patient is done simultaneously to incident viewpoint and sensation, and it can comprise that also sound in the environment and the third party's comment wait other audio-frequency information.Sensor time marker 86 and subjective information time identification marker 88 are applied to pick off output 54 and subjective information output 60 respectively in previously described mode, and they can instantaneous association after a while.
The times 84 of subjective information output 60 beginnings can early than, simultaneously or be later than times 82 of unusual pick off output 54 beginnings.For example, but patient's operating audio receptor activates control 62, represent a unusual sensation, or pick off export 54 depart from begin 82 normally in or before, the activity of writing down special health.Patient times 82 of unusual pick off output 54 beginnings and before also may feel not have abnormal conditions.In this case, optionally point out patient's (numeral 28 of Fig. 1) beginning daily record record, after the time 82, or after unusual pick off output 54 beginnings, carry out oral prompting 90.Be equipped with when mike 58 under the optional condition of microphone, prompting typically is done, and audio receiver 56 also can be used as emitter.In this case, can point out patient's operating audio receptor to activate control 62, or remotely activate audio receiver automatically by remote monitoring unit 44 this locality or central location 42 and activate control 62.Remote monitoring unit 44 and/or central location 42 comprise that typically detecting sensor exports 54 unusual logic processors, can activate audio receiver then and activate control 62 (need not patient's operation), and the prompting patient carries out oral daily record record.If any, prompting 90 is preferably begun in this locality by the logic of remote monitoring unit 44 self, with the time delay of avoiding establishing a communications link with central location 42.
Numeral 30 expressions, in case time marker pickup output 54 and time mark subjective information output 60 are recorded in the recording equipment 72, they are instantaneous related with 88 by time identification marker 86 separately, form a subjectivity/sensor record.(in other words, output 54 is related with 88 by the time identification marker separately 86 that exists with 60, " instantaneous " speech represents that not only association is the short time, as " temporarily ") associated steps 30 can finish in remote monitoring unit 44, numeral 32 expressions, send the subjectivity/sensor record that merges by transceiver 64 to central location 42, numeral 32 expressions.The record of pick off output 54 separately and the record of subjective information output 60 also can send to central location 42 by transceiver 64 separately, and associated steps 30 is carried out at central location 42.Like this, as described, step 30 can be before step 32 or following closely.
The association, analysis and the logic execution function that monitor instrument 40 can any exercisable form be distributed between central location 42 and the remote monitoring unit 44.These functions can be finished by remote monitoring unit 44, and central location 42 is mainly as the terminal of transceiver like this, and perhaps these functions can be finished by central location 42, so that remote monitoring unit 44 is mainly as the terminal of transceiver.More typically be, between central location 42 and remote monitoring unit 44, to distribute these functions with the function that best system is provided and the mode of economic combination.
Numeral 34 expressions, related subjectivity/sensor record are 43 optional output from central location 42 to outut device.Outut device 43 can be the local device of central location 42, as video display units or printer and/or audio output apparatus, or the memory device of central location 42.It can be a long-range connection, connects as the telephone to patient's doctor.The execution of output step 34 can be almost synchronous with the generation of incident, or after the communication by transceiver 64 is set up, have only the delay of short time with incident, the personnel of inspection record are communicated by letter with patient by transceiver 64, incident is responded, patient is helped.Patient knows and can get help that oneself is isolated, and it is steady with psychology that it is had a sense of security.When diagnosing more completely afterwards, also can use pick off and audio recording.Synchronous response is fit to urgent situation, makes the diagnosable patient of healthcare givers, and the response of delay is applicable to the after-action review of customary situation, non-emergent unusual or emergency.Under typical situation, print or show that on screen pick off output 54, subjective information exports 60 printablely or show on screen, or export as audio signal, like this, the people of analysis subjectivity/sensor record is easy to hear sound and sound is related with pick off output.
Thereby this method provides patient's the subjective information output and the direct correlation of pick off output.Related information is highly effective, and it is very useful especially under the ambulant situation of patient emergency being responded and providing aspect the diagnosis.As previously mentioned, it can be applicable to the situation of supervision instrument 40 discussed above.It also can be applicable to the surveillance scenarios of other type and monitors instrument, for example, ECG monitor/recorder that Holter monitors, incident monitors, the event loop recorder monitors (Event LoopRecorder monitoring), ECG pressure testing system, implantable (implantable), implantable cardiac pacemaker, external cardiac pacemaker, pacemaker and sleep asphyxia monitor.
Though for illustrative purposes, describe a certain embodiments of the present invention here in detail, under the premise without departing from the spirit and scope of the present invention, can make multiple changes and improvements.Therefore, except appended claim, scope of the present invention is not restricted.

Claims (20)

1. a tissue, and the method for related patient's health and fitness information, it may further comprise the steps:
A supervision instrument is provided, comprises:
A remote monitoring unit, this remote monitoring unit comprises:
At least one and patient's situation is related and monitor the pick off of patient status, and each pick off produces pick off output,
Subjective information output is imported and provided to an exercisable subjective information receptor to receive subjective information,
An exercisable recording equipment, with record at least from the output of the pick off of a pick off and from the subjective information output of subjective information receptor and
The transceiver of communicating by letter with recording equipment and
The connected power supply of energy is provided to remote monitoring unit;
Use the subjective information time identification marker to receive and write down the recording equipment of subjective information output;
Use the sensor time marker to receive and write down the recording equipment of pick off output;
Utilize subjective information time identification marker and sensor time marker, automatically, instantaneously that the pick off output of the subjective information output of record and record is related to form the subjectivity/sensor record of association.
2. the method for claim 1, subjective information input wherein is the audio frequency input.
3. the method for claim 1, subjective information input wherein is written input.
4. the method for claim 1, supervision instrument wherein further comprises:
Can activate control by the subjective information receptor of patient's operation, it activates the subjective information receptor to receive subjective information.
5. the method for claim 1, supervision instrument wherein further comprises:
Activate control by the remote-operated subjective information receptor of transceiver, activate the subjective information receptor for receiving subjective information.
6. the method for claim 1, supervision instrument wherein further comprises:
The exercisable subjective information receptor of remote monitoring unit activates control, activates the subjective information receptor for receiving subjective information.
7. the method for claim 1, the step of reception wherein and the output of record subjective information produces digital subjective information record, receives and step that the record pick off is exported, produces digital sensor record.
8. the method for claim 1, the step of reception wherein and the output of record subjective information produces analog subjective information record, receives and step that the record pick off is exported, produces analog sensor record.
9. the method for claim 1, transceiver wherein is a radio frequency transceiver
10. the method for claim 1 after the automatic instantaneous associated steps, also comprises another step:
Output subjectivity/sensor record.
11. the method for claim 1, recording equipment wherein comprises exercisable individual unit, with output of record pick off and subjective information output.
12. the method for claim 1, supervision instrument wherein further comprises:
An exercisable central location is communicated by letter with recording equipment by transceiver.
13. a tissue, and the method for related patient's health and fitness information, it may further comprise the steps:
Use subjective information time identification marker record to import as patient's subjective information record from patient's subjectivity;
Use sensor monitoring and record patient's situation, as patient sensor record by sensor time marker record; With
By subjective information time identification marker and the patient's subjective information record of sensor time marker auto-associating record and the patient sensor record of record separately, to produce subjectivity/sensor record.
14. method as claimed in claim 13, subjective information input wherein is the audio frequency input.
15. method as claimed in claim 13, subjective information input wherein is written input.
16. method as claimed in claim 13, wherein Ji Lu patient's subjective record is a digital subjective record, and the patient sensor of record record is a digital sensor record.
17. method as claimed in claim 13 after the auto-associating step, also comprises another step:
Output subjectivity/sensor record.
18. method as claimed in claim 13, the step of the subjective input of record may further comprise the steps
The prompting patient carries out the subjectivity input.
19. method as claimed in claim 13, the step that wherein writes down subjective information may further comprise the steps:
The prompting patient carries out the subjectivity input, uses the supervision of pick off and the step of record patient with response.
20. a tissue, and the method for related patient's health and fitness information, it may further comprise the steps:
Record is from patient's subjective information record of patient's subjectivity input conduct record;
Use the patient sensor record of sensor monitoring and record patient's situation as record; And
Automatically write down the patient's subjective information record of record and the patient sensor of record related.
CNA028109651A 2001-04-23 2002-04-22 Correlation of sensor signals with subjective information in patient monitoring Pending CN1531408A (en)

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