US20020044059A1 - Patient point of care computer system - Google Patents

Abstract

A patient monitoring system comprises a computer, an input device coupled to the computer and configured to input patient information, and first and second display screens coupled to the computer. The computer displays a first portion of the patient information on the first display screen and a second portion of the patient information on the second display screen.

Description

• This application claims the benefit of U.S. provisional application Serial No. 60/202,283 filed May 5, 2000 and U.S. provisional application Serial No. 60/229,136 filed Aug. 30, 2000, both disclosures being expressly incorporated by reference herein.[0001]
• The invention relates to a computer system configured to be used at the point of care by the caregiver in a hospital or other health care facility in order to care for patients. The present invention facilitates electronic data entry at the point of care, provides automatic data capture, provides a computer screen with a flow sheet sized proportion, provides access to information at the point of care.[0002]
• Providing a computer at the point of care provides access to information from a laboratory, pharmacy, radiology, or other locations away from the point of care where it is needed at the point of care. The computer system of the present invention includes both manual and automated patient data entry at the point of care create an electronic record. The present invention permits caregivers to easily input chart data directly into the computer. In addition, the computer receives information automatically from various monitors and medical devices such as vital signs monitors, IV pumps, and the like. Therefore, all data related to the patient is captured at a single location which is located at the point of care. Logon to the computer system of the present invention may be controlled by an IR or RF badge worn by the nurse or caregiver. The computer is designed to remain with the patients in the hospital room and during ambulation or transportation in the hospital. In other words, the computer follows the patient wherever the patient goes from admit to discharge.[0003]
• Providing a computer at the point of care improves communication. Lab and radiology results are presented electronically to the ordering and consulting physicians at the point of care. The computer system of the present invention facilitates patient care by virtual teams which never actually meet when caring for the patient. The computer system instantaneously captures information related to the patient as well as laboratory procedures and diagnostic procedures ordered for the patient. Information is displayed in an electronic chart or flow sheet on a display. Illustratively, two adjacent display screens are used to display the patient information. There is little delay in inputting this information to the patient's chart. Such delays often occur with conventional paper charts. Therefore, the present invention reduces the likelihood of ordering redundant lab or diagnostic work on the patient. Electronic referrals, authorizations, and consultations are fast, secure and reliable. E-mail or intranet communications are used to transmit data and automate prescriptions, lab orders, and work flow.[0004]
• A computer system provides updated access to information and communication at the point of care. Patient data is stored in a memory of the computer or in a main server coupled to the computer by a communication network. Access to all patient information is available to physicians, pharmacy, radiology, lab, cath lab, or any PC connected to the computer at the point of care through a communication network. Doctors or other caregivers at remote locations can view information related to the patient by connecting to the patient's computer or the main server through the communication network. In other words, the computer system acts as a node on the network and can access information from other nodes.[0005]
• The present invention is also able to capture costs of services and transmit the cost information for billing purposes. For instance, the computer system of the present invention uses a wireless data receiver to receive signals from a badge on the caregiver and from tags on equipment located within the hospital room. Therefore, the computer system of the present invention can determine the actual cost of providing services to the patient. The computer system also includes an input device such as, for example, a keyboard or a bar code reader to capture costs of medication or other treatment or articles used by the patient.[0006]
• The system of the present invention may be used with the COMposer® communication system available from Hill-Rom. Some details of the COMposer® system are disclosed in U.S. Pat. Nos. 5,561,412; 5,699,038; and 5,838,223 which are incorporated herein by reference.[0007]
• In an illustrated embodiment of the present invention, a patient monitoring system comprises a computer, an input device coupled to the computer and configured to input patient information, and first and second display screens coupled to the computer. The computer displays a first portion of the patient information on the first display screen and a second portion of the patient information on the second display screen.[0008]
• In an illustrated embodiment of the present invention, a system comprises a computer including a memory, and a medical device for treating a patient. The medical device includes an indicator configured to provide a signal indicating when the medical device is in use to treat the patient. The system also includes a coupler coupled to the computer for receiving the input signal from the indicator. The computer is configured to store the amount of time that the medical device is in use to treat the patient in the memory.[0009]
• In one illustrated embodiment, the computer is configured to generate a bill for use of the medical device based upon the amount of time that the medical device is used to treat the patient. The medical device illustratively includes a unique identification so that the computer generates an itemized bill indicating the particular medical device used to treat the patient.[0010]
• In another illustrated embodiment of the present invention, patient care computer system is provided for use by a caregiver wearing an identification badge which includes a wireless data transmitter that uniquely identifying each caregiver. The apparatus comprises a computer including a memory for storing patient information, a display screen coupled to the computer, an input device coupled to the computer for inputting patient information, a wireless data receiver coupled to the computer, and means for detecting when a caregiver enters a room in which the computer and patient are located. The detecting means determines whether the caregiver is authorized to use the computer system and, if so, automatically logging the caregiver in to the computer system.[0011]
• In another illustrated embodiment of the present invention, a system comprises means for monitoring at least one physiological condition of a patient on a real time basis, means for recording information related to a treatment of the patient and the time that the treatment was given to the patient, and means for determining the effectiveness of the treatment of the patient by further monitoring the physiological conditions on a real time basis after the treatment.[0012]
• In another illustrated embodiment of the present invention, a computer system assigned to a patient or to a bed, cart or other device upon which the patient rests or with which the patient is associated. The system comprises a computer, and a plurality of devices for sensing various physical conditions and characteristics of the patient. Each device has an output coupled to the computer. The system also includes a display arranged to present information related to the patient.[0013]
• In another illustrated embodiment of the present invention, a system for monitoring patient information comprises a processor, a memory coupled to the processor, a user interface coupled to the processor to permit a caregiver to input instructions into the system, a display screen coupled to the processor, a power supply coupled to the processor, and a connector module configured to couple the system to a medical device including at least one of a physiological monitor, a treatment device, and a therapy device. The medical device uses the processor, the user interface, the power supply, and the display of the system to operate the medical device, thereby reducing redundant components in the medical device.[0014]
• In another illustrated embodiment of the present invention, a patient monitoring system comprises a computer, a display screen coupled to the computer, and a plurality of physiological monitors coupled to the computer. The computer displays at least two indicators on the display screen related to at least two of a heart rate signal, a respiratory rate, fluid/electrolyte/nutrition information, temperature, neurological monitoring, and blood pressure.[0015]
• In another illustrated embodiment of the present invention, a patient assist apparatus comprises a base having a plurality of casters, a support coupled to the base, an IV pole coupled to the support, and a brake mechanism coupled to at least one of the casters and to the support. The brake mechanism is configured to brake the at least one caster when a predetermined weight is applied to the support.[0016]
• In the illustrated embodiment, the apparatus further comprises a spring configured to bias the support upwardly relative to the base and a link coupled between the support and the brake mechanism. The support moves downwardly when the predetermined weight is applied to the support, thereby moving the link to actuate the brake mechanism.[0017]
• In another illustrated embodiment of the present invention, a walker apparatus comprises a base and a support coupled to the base. The support includes a handle configured to be gripped by a patient. The walker apparatus also includes a seat having a first end portion and a spaced apart second end portion. The first end portion is pivotably coupled to the support so that the seat is movable between an upwardly pivoted seating position and a downwardly pivoted storage position. The walker apparatus further includes a seat support pivotably coupled to the second end portion of the seat. The seat support is movable from a first position aligned generally parallel with the seat and a second position aligned transverse to the seat to support the seat in the seating position.[0018]
• In the illustrated embodiment, the apparatus includes a coupler configured to attach the seat support to the seat, the coupler being configured to hold the seat support in the second position automatically when the seat is moved to its upwardly pivoted seating position.[0019]
• In another illustrated embodiment of the present invention, a patient assist apparatus comprises a walker having a handle to assist movement of a patient, a computer coupled to the walker, a display coupled to the computer, and a movable arm having a first end coupled to the walker and a second end coupled to the display.[0020]
• In another illustrated embodiment of the present invention, a patient assist apparatus comprises a base having a plurality of casters and a support coupled to the base, the support having first and second sides. The apparatus also includes a latch mechanism coupled to the first side of the support. The latch mechanism is configured to couple the support to a patient support apparatus. The apparatus further includes a handle assembly coupled to the support. The handle assembly includes first and second handles movable from a first orientation located on the first side of the support to provide support handles for a patient to a second orientation located on the second side of the support to provide push handles for use when the support is coupled to the patient support apparatus. In the illustrated embodiments, the patient support apparatus is a bed or a wheelchair.[0021]
• In another illustrated embodiment of the present invention, a patient computer system comprises a display having first and second display screens located in a room, a cart configured to move with a patient outside the room and to remain with the patient inside the room, a computer coupled to the cart, and a third display screen coupled to the cart. The computer is coupled to the third display screen and coupled to the first and second display screens when the cart is in the room.[0022]
• In the illustrated embodiment, the computer includes first and second video cards. The first video card is configured to drive the first and third display screens, and the second video card is configured to drive the second display screen.[0023]
• In another illustrated embodiment of the present invention, a display for a computer comprises a housing having an interior region, a first display screen located in a first portion of the interior region of the housing, and a second display screen located in a second portion of the interior region of the housing. The first and second display screens are coupled to the computer so that the computer displays information on both the first and second display screens. In an illustrated embodiment, the housing includes a first portion and a second portion coupled to the first portion by a waterproof seal.[0024]
• Additional features of the invention will become apparent to those skilled in the art upon consideration of the following detailed description of the illustrated embodiment exemplifying the best mode of carrying out the invention as presently perceived.[0025]
BRIEF DESCRIPTION OF THE DRAWINGS
• The detailed description particularly refers to the accompanying figures in which:[0026]
• FIG. 1 is a block diagram illustrating components of the patient point of care computer system of the present invention;[0027]
• FIGS. 2 and 3 illustrate one embodiment of the computer system of the present invention;[0028]
• FIGS. 4 and 5 illustrate another embodiment of the computer system of the present invention;[0029]
• FIGS.[0030]6-8 illustrate yet another embodiment of the computer system of the present invention;
• FIGS. 9 and 10 illustrate a further embodiment of the computer system of the present invention;[0031]
• FIG. 11 is a perspective view illustrating the computer system of the present invention in an emergency room;[0032]
• FIG. 12 is a perspective view illustrating the computer system of the present invention in a neonatal intensive care unit;[0033]
• FIG. 13 is a perspective view of a computer system module of the present invention within an examination room at a doctor's office or other location;[0034]
• FIG. 14 is a perspective view illustrating the computer system of the present invention communicating with a badge on a caregiver and tags on equipment within the room for monitoring services provided to the patient;[0035]
• FIGS.[0036]15-17 illustrate an embodiment of the present invention in which the computer system is mounted on an IV pole located within a socket on a hospital bed;
• FIG. 18 is a perspective view illustrating a computer module of the present invention installed on a cart;[0037]
• FIG. 19 is a perspective view illustrating a junction box for providing wireless data transmission of a plurality of medical devices to the computer system of the present invention;[0038]
• FIG. 20 is a perspective view illustrating a computer module of the present invention attached to a patient assist device used for patient egress;[0039]
• FIG. 21 is a perspective view illustrating the patient assist device including the computer module used as an IV pole in the hospital room;[0040]
• FIG. 22 is a side elevational view illustrating the patient assist and computer module docked to a wheelchair;[0041]
• FIG. 23 is a perspective view illustrating the patient assist device coupled to a hospital bed for transport of the patient with the computer module of the present invention;[0042]
• FIG. 24 is a perspective view illustrating the patient assist device uncoupled from the hospital bed and left in the room with the patient for a diagnostic procedure;[0043]
• FIGS.[0044]25-27 illustrate one embodiment of a workstation for use with the computer system of the present invention;
• FIGS. 28 and 29 illustrate another embodiment of a workstation;[0045]
• FIG. 30 is a perspective view illustrating yet another workstation including the computer system of the present invention;[0046]
• FIG. 31 is a perspective view of a support stand for receiving a computer module;[0047]
• FIGS. 32 and 33 illustrate another stand for receiving the computer system;[0048]
• FIG. 34 is a block diagram illustrating inputs to the electronic flow sheet or chart generated by[0049]computer12 ondisplay screens18 and20;
• FIG. 35 is a block diagram of the present invention in which medical device modules are coupled to a central station to reduce redundant systems in the medical devices;[0050]
• FIGS.[0051]36-38 illustrate a modular system shown diagrammatically in FIG. 34;
• FIGS. 39 and 40 illustrate a computer integrated with an overbed table for use by a patient in the hospital room;[0052]
• FIG. 41 illustrates another embodiment of a display apparatus configured to be coupled to the computer of the present invention including a first stationary display and a second removable display which is smaller than the first stationary display;[0053]
• FIG. 42 is a perspective view of another embodiment of the present invention illustrating a module configured to be coupled directly to the patient, to the patient support, or to the patient assist device for receiving signals from physiological monitors and using telemetry to transmit these monitor signals to the computer or to a server located at a remote location;[0054]
• FIG. 43 is another embodiment of the present invention illustrating a computer module and a third display located in a separate housing from the first and second displays located in the hospital room, the computer module and the third display being mounted to the patient support apparatus;[0055]
• FIG. 44 is an illustrative display screen of one embodiment of the present invention;[0056]
• FIGS. 45 and 46 illustrate another embodiment of a movable work station including a movable cart for supporting a computer system of the present invention;[0057]
• FIGS. 47A, 47B, and[0058]48 are illustrated examples of the types of display information and data entry capabilities of the computer system of the present invention;
• FIG. 49 is a perspective view of another embodiment of a patient assist cart having a computer mounted thereon;[0059]
• FIG. 50 is a perspective view of the patient assist cart of FIG. 49 with the computer removed;[0060]
• FIG. 51 is a perspective view of the computer of FIG. 49 removed from the patient assist cart;[0061]
• FIG. 52 is a side elevational view of the computer of FIG. 51;[0062]
• FIG. 53 is a perspective view of another embodiment of the present invention illustrating the computer display screen mounted on a movable support arm on the patient assist cart, a seat in an upwardly pivoted patient support position, and push handles in a first position;[0063]
• FIG. 54 is a perspective view of the patient assist cart of FIG. 53 illustrating the patient support seat in a downwardly pivoted storage position and illustrating push handles moved to a second position for pushing a bed or other device coupled to the patient assist cart;[0064]
• FIGS. 55 and 56 are perspective views illustrating components of a computer coupled to the cart of FIGS. 53 and 54;[0065]
• FIG. 57 is a perspective view of the patient assist cart of FIGS. 53 and 54 with additional equipment loaded on the cart;[0066]
• FIG. 58 is a perspective view of the cart of FIG. 55 illustrating movement of display screen and an input device on a movable arm;[0067]
• FIGS. 59 and 60 illustrate operation of a seat of the patient assist cart;[0068]
• FIGS. 61 and 62 illustrate a latching mechanism and movable push handles of the patient assist cart;[0069]
• FIGS. 63 and 64 illustrate a mechanism for securing and unsecuring the push handles relative to a support post of the patient assist cart;[0070]
• FIG. 65 illustrates a castor breaking apparatus of the present invention;[0071]
• FIGS.[0072]66-68 illustrate a support arm for the display screen of the computer;
• FIG. 69 illustrates the patient assist cart coupled to a hospital bed;[0073]
• FIGS.[0074]70-72 illustrate operation of a latching mechanism for coupling the bed or another device to the patient assist cart;
• FIG. 73 illustrates the patient assist cart coupled to a wheelchair.[0075]
• FIGS.[0076]74-76 illustrate details of a sealed housing configured to receive first and second display screens;
• FIGS. 77 and 78 illustrate a support arm for coupling a dual screen display housing to a wall, cart or other device;[0077]
• FIGS.[0078]79A-C illustrates another embodiment of a primary support arm of the present invention.
• FIGS.[0079]80-82 illustrate various orientations fo the dual screen display in a hospital room;
• FIG. 83 illustrates details of video cards in a computer coupled to first, second and third display screens;[0080]
• FIG. 84 is a block diagram illustrating one embodiment of electronic circuitry for coupling a computer on a patient assist apparatus or workstation to a dual monitor display mounted in a room;[0081]
• FIG. 85 is a block diagram illustrating another embodiment of the electronic circuitry for coupling the computer on the patient assist apparatus or workstation to the dual monitor display mounted in the room; and[0082]
• FIG. 86 is a block diagram illustrating a further embodiment of electronic circuitry for coupling the computer on the patient assist apparatus or workstation to the dual monitor display mounted in the room.[0083]
DETAILED DESCRIPTION OF THE DRAWINGS
• Referring now to the drawings, FIG. 1 illustrates a block diagram of a patient point of[0084]care computer system10 of the present invention.Computer system10 is designed to provide improved access to data at the point of care.Centralized computer system10 organizes numerous monitors, treatment devices, and therapy devices and facilitates record keeping by providing a real time electronic chart for the patient. Thecomputer system10 of the present invention also improves communications between various caregivers who are members of a care team for the particular patient. Thecomputer system10 automates processes for ordering tests and communicating between various caregivers working with a patient.
• [0085]Computer system10 includes acomputer12 which is designed to stay with the patient during an entire stay at a hospital or other medical facility.Computer12 is coupled to amemory14 for storing and retrieving data.Computer12 is also coupled to adisplay16 which illustratively includes first andsecond displays18 and20 as discussed below in detail.Computer12 is further coupled to at least oneinput device22. Theinput device22 includes a pen or stylus based input, a keyboard, a mouse, a joystick, a voice recognition input, a touch screen, or other suitable input device. Theinput device22 permits a caregiver or other individuals to input patient information or other desired information into thecomputer12.
• [0086]Computer12 is also coupled to acommunication network24.Communication network24permits computer12 to transmit and receive information from a remote location. Information related to the patient stored inmemory14 ofcomputer12 can be accessed by a doctor at a remote location. In addition, e-mail messages or other order messages can be transmitted over thecommunication network24 to other locations both inside and outside the hospital. Therefore, a caregiver can schedule tests or request certain medications or procedures using theinput device22 ofcomputer12. These orders or prescriptions are then automatically transmitted over thecommunication network24 to the proper location. In addition, information such as test results can be sent over the communication network tocomputer12 so that the caregiver can access all information related to the patient at the point of care.
• As discussed below, the[0087]computer12 may be coupled tomonitors26,treatment devices28, andtherapy devices30 through a physiological monitoring module orcoupler32. Illustratively,coupler32 may be an RS-232 part or other suitable connector.Computer12 processes signals from themonitors26,treatment devices28, andtherapy devices30 on a real time basis. This information is used to provide an electronic chart of patient conditions ondisplay screens18 and20. Themonitors26,treatment devices28, andtherapy devices30 include, but are not limited to, heart rate monitors, temperature sensors, blood pressure monitors (invasive and noninvasive), EKG monitors, blood oxygen sensors, capnographs, ventilators, IV pumps, scales, chest drainage monitors, and the like.
• [0088]Computer12 is also coupled to abar code reader34.Bar code reader34 is either a standard bar code reader or a 2D bar code reader. Thebar code reader34 permits a caregiver to scan a bar code to indicate the type of drugs given to the patient in order to capture costs and the time that the drugs are administered.Bar code reader34 may be used on any other item given to the patient or on equipment in the room. An RFID receiver/reader35 is also coupled to thecomputer12 in another embodiment to read transmitted RFID signals.
• [0089]Computer12 is also coupled to awireless data receiver36.Data receiver36 is illustratively an IR or RF receiver. It is understood, however, that the wireless data receiver could be any type of receiver.Receiver36 is configured to receive transmission signals fromwireless transmitters38.Transmitters38 are typically included in badges worn by personnel or on tags on equipment. As discussed below, thewireless data receiver36 monitors the time and type of equipment and personnel within the vicinity of the point of care.Computer12 is also coupled to awireless data transmitter40.Transmitter40 is configured to transmit signals to a receiving station within the hospital such as, for example, whencomputer12 is disconnected from thecommunication network24 during transport of a patient from one location to another.
• [0090]Computer12 is also coupled to acamera42. Video signals fromcamera42 can be transmitted bycomputer12 to a remote location using thecommunication network24 or thewireless data transmitter40. An Internet protocol such as video over IP may be used if desired. Therefore, a doctor at a remote location can view an image of the patient. The video signal fromcamera42 may also be taped using conventional magnetic tape storage devices.
• In an illustrated embodiment,[0091]computer12 is also connected to thephone44. Therefore, the caregiver or patient can use thephone44 to place telephone calls in a conventional manner or using an Internet protocol such as voice over IP. In addition, messages or warnings can be transmitted by thecomputer12 overphone44. For instance, if a caregiver receives an e-mail message oncomputer12, the message can also be transmitted to the caregiver via phone so that the caregiver can be paged or delivered a message by voice mail. Voice mail message or instructions received on the phone line can also be converted to e-mail message and transmitted to another location viacommunication network24 ortransmitter40 or stored oncomputer12 for access by a caregiver atcomputer12.
• The[0092]computer system10 provides access to information at the point of care from the lab, pharmacy, radiology, and other locations that may be inside or outside of the hospital but that generate information relevant to the care of the patient. An electronic record is stored in memory of aserver15 coupled tocomputer12 by communication network or wireless connection for access by thecomputer12 at the point of care. However, it is within the scope of the invention as presently perceived to instead or additionally store the electronic record inmemory14 ofcomputer12 for access at the point of care. Patient information data is integrated on to a chart which is displayed on thelarge display16 including both display screens18 and20. Thecomputer system12 integrates data manually input into the computer usinginput devices22 with real time data available frommonitors26,treatment devices28,therapy devices30,bar code reader34, andwireless data receiver36. As discussed below, thecomputer12 remains with the patient during transport and at the other locations in the hospital such as, for example, for diagnostics, the operating room, and the like.
• FIGS.[0093]2-10 illustrate various embodiments of components ofcomputer system10 of the present invention. FIGS. 2 and 3 illustratedisplay16 which includes afirst display screen18 and a second,removable display screen20.Display screen20 is on aremovable module50 which is removable from asupport52, having asupport plate54 and ahandle56 coupled to thesupport plate54. It is understood that a single larger, elongated display may be used instead ofseparate display screens18 and20. However, for cost reasons or other reasons, twodisplays18 and20 are used to provide the largeroverall display16. It is also understood that more than two display screens may be coupled to support52 if needed as discussed below.
• In the illustrated embodiment,[0094]display screen18 is fixed to thesupport52.Bar code reader34 is storable within arecess58 ofsupport52.Bar code reader34 is removed in the direction of arrow60 for scanning items such as drugs or equipment supplied to the patient.Input device62 is also coupled to thesupport52.Plate54 illustratively includes aconnector64 which automatically provides connection betweenmodule50 and the rest of the system when the module is loaded ontosupport52 in the direction ofarrow66. It is understood that various connecting cords may also be used to couplemodule50 to the other components ofcomputer system10. Theconnector32 is configured to couple signals frommonitors26,treatment devices28, andtherapy devices30, to an inlet port onmodule50 whenconnector32 is installed in the direction ofarrow68 of FIG. 2.Wireless data transmitter36 may also be coupled tomodule52 by installing thetransmitter40 in the direction ofarrow70.
• The[0095]computer system10 uses both display screens18 and20 to provide a flow sheet dimension in order to display the flow sheet for the patient in electronic form so that the paper chart does not have to be manually updated. As discussed below in detail, real time data frommonitors26,treatment devices28, andtherapy devices30, are used to continuously update the flow sheet with real time data. The caregiver can input information into thecomputer12 using an input device such as the stylus orpen72 shown in FIG. 3. Illustratively, display screens18 and20 include touch screen technology so that information can be input by simply touching portions of the screen. In addition, aninput pad section74 permits the caregiver to write with thepen72 to input information.Computer12 includes handwriting recognition software such as, for example, CalliGrapher 5.3 for Windows software available from ParaGraph, so thatcomputer12 recognizes the characters written oninput pad74.
• FIGS. 4 and 5 illustrate another embodiment of the present invention. Those numbers referenced by numbers from FIGS.[0096]1-3 perform the same or similar function. In FIG. 4,base support52 includes ahousing76 formed to include anaperture78 for receiving thepen72 in the direction ofarrow80.
• A[0097]physiological monitoring module82 is coupled tohousing76.Module82 includes a plurality ofsockets84 configured to receiveconnectors86 coupled to themonitors26,treatment devices28, ortherapy devices30, as illustrated byarrows88. FIG. 5 illustrates the caregiver inputting information using thepen72. Ahandle51 is coupled tomodule50 to permit easy removal of themodule50 from the remainder ofsupport52. Anarm assembly53 is configured to couple thecomputer system10 to a suitable support structure in the room, on the bed, or on a separate cart or stand, as discussed below in detail.
• Another embodiment of the present invention is illustrated in FIGS.[0098]6-8. This embodiment shows a modularphysiological monitoring interface90 configured to be coupled tomodule50.Physiological monitoring interface90 includes aseparate housing92 having alocking mechanism94 configured to secure theinterface90 to asupport plate96 which is pivotably coupled to asupport arm98.Physiological monitoring interface90 further includes theconnector98 formed to include a plurality ofsockets100 for receiving connectors coupled to themonitors26,treatment devices28, andtherapy devices30. The wirelessdata transmitter card102 is also coupled to theinterface housing92.Physiological monitoring interface90 may include its own processor and memory for receiving the inputs from thevarious monitors26,treatment devices28, andtherapy devices30. In another embodiment,interface90 provides a physical connection between themonitors26,treatment devices28, andtherapy devices30, withmain computer12 located inmodule50, but does not include any processor of its own.
• FIGS. 6 and 7[0099]show module50 which includesdisplay screen20 coupled tophysiological monitoring interface90. Alock104 is provided to securemodule50 to theinterface90. In the illustrated embodiment,module50 includes aconnector106 configured to mate with a connector oninterface90 to provide electrical connection between thecomputer12 withinmodule50 and theinterface90. In another embodiment, a separate cord may be used to provide the electrical connection betweenmodule50 andinterface90. In addition, when physiological monitoring is not needed,module50 can be coupled directly tobase plate96.Module50 andinterface90 can be removed frombase plate96 as a unit as shown in FIG. 7. Therefore, thecomputer12 along with monitoring capabilities may be coupled to the bed or a cart adjacent the bed as discussed below for transport with the patient to various locations within the hospital. If it is desired only to transportmodule50 including thecomputer12 without the physiological monitoring capability,module50 is removed frominterface90 and coupled to the bed or cart for transport with the patient to the remote location.
• FIGS. 9 and 10 illustrate yet another embodiment of the present invention in which the[0100]phone44 andvideo camera42 are illustrated. Thecaregiver110 shown in FIG. 10 is able to see avideo image112 ondisplay16 throughvideo camera42 mounted on acomputer housing114 in a patient's room shown in FIG. 9. Thecaregiver110 may also access chart information related to the patient at the remote location. FIGS. 9 and 10 illustrate thephone44 coupled to thehousing114 byline116. The patient can see the video image of thecaregiver110location118 in FIG. 9. FIGS. 9 and 10 also illustratebuttons120 for dialing thephone44.
• As discussed above, the[0101]computer system10 of the present invention is designed to have flexibility in order to follow a patient throughout the stay in the hospital. Thecomputer system10 is capable of being located within the room to collect data at the point of care. Thecomputer10 may also be moved out of the room to enter data, such as in a hallway. Therefore, the electronic chart or flow sheet generated by the computer and all associated data follows the patient throughout the stay at the hospital.
• FIG. 11 illustrates the[0102]computer system10 in an emergency room of the hospital. Thepatient122 is located on astretcher124 containing apatient support surface126 carried on abase128, which is movable on casters130.Computer system10 is mounted on arail132 ofhead wall134 by mountingbracket136. Illustratively,bracket136 may slide alongrail132 in the directions of double-headedarrow138.Computer system10 is also pivotable on anarm140 coupled tobracket136 to adjust the position of thedisplay116 for viewing bycaregivers142,144. Physiological monitors such as heart rate monitors146 and148 are coupled to aninlet connector32 ofcomputer system10 bylines150.Computer system12 records output from the sensors on a real time basis and displays the outputs ondisplay screen18 or20.Screens18 and20 are reversed in the embodiment shown in FIG. 11.Computer12 also stores the data from the monitors for charting purposes. Data fromtreatment devices28, such asIV pump152 is also stored bycomputer12.Caregivers142 and144 can input information intocomputer12 via any of theinput devices22.
• FIG. 12 illustrates the[0103]computer system10 in a neonatal intensive care unit (NICU). In FIG. 12, thecomputer system10 is located near anincubator160 which provides a thermal support device for aninfant162.Computer12 monitors vital signs of theinfant162.Computer12 is also illustratively coupled to the controller of theincubator160 to monitor the conditions within theincubator160. Any treatments given to the infant can also be entered intocomputer system12 manually usinginput devices22,bar code reader34, or awireless data receiver36. In the FIG. 12 embodiment,computer system10 is mounted to ahead wall164 bybracket166.Arm168 is pivotable relative tobracket166. If it is necessary to transfer the infant to another location,removable module50 ofcomputer system10 is removed and attached to theincubator160 for transport.Module50 includescomputer12 anddisplay20, as well asconnector32 formonitors26,treatment devices28, andtherapy devices30. Therefore,computer12 continues to capture real time data related to theinfant162 during transport.Wireless data transmitter40 is used to communicate with base units within the hospital during transport.
• FIG. 13 illustrates the[0104]computer module50 coupled to the wall in an examination room bybracket170 and arm172. The examination room may be in the hospital, a doctor's office, or other health care facility. In FIG. 13, apatient174 is seated on an examination table176. Examination table176 illustratively includes ascale178, having an output coupled tocomputer module50 so that the weight of the patient is automatically recorded bycomputer12. It is understood that theentire computer system12 including thedual display16 discussed above may be used within the examination room. However, for cost reduction purposes, a single display onmodule50 may be adequate for the examination room. The temperature thermometer180 andblood pressure cuff182 are also coupled to theconnector32 coupled tomodule50 by lines184. Therefore,computer12 automatically captures the patient's temperature and blood pressure reading. Thecaregiver186 inputs additional information usinginput device22 which is illustratively a touch screen or pen based system. Patient symptoms may also be entered so that a doctor entering the room later can access complete information regarding thepatient174. This patient chart information is coupled to acommunication network24 so that the information can be transmitted to a remote location, such as a hospital, if information related to the patient is needed at a later time.
• Another embodiment of the present invention is illustrated in FIG. 14. In this embodiment, the[0105]wireless data receiver36 is used to receive data frombadges190 oncaregivers192.Tags194 are also located on the medical equipment within the room. Thebadges190 andtags194 transmit signals such as infrared signals or RF signals which are received byreceiver36. The signals frombadges190 andtags194 include identification information to identify theparticular caregiver192 or the particular type of equipment located in the room.Computer system12 monitors the time thatparticular caregivers192 and equipment are located within the room. The signals fromtags194 can include status information (such as in use or at rest). By knowing the location of equipment and the status of the equipment at all times, the computer can determine the amount of time that equipment is in use for each patient. Therefore, the hospital can determine the real cost of providing care to apatient196. In addition,computer12 can generate an itemized bill indicating the time and duration that equipment is used in treating the patient and the time spent by thecaregiver12 within the room. This cost information can be either maintained for internal purposes or transmitted to a billing station for charging each patient for the exact amount of equipment and caregiver time used.
• In the illustrated embodiment,[0106]computer system10 identifies thecaregiver192 based upon signals transmitted frombadge190 toreceiver36. Upon recognizing an authorizedcaregiver192 entering the room,computer12 automatically logs the user onto thesystem10. Any email or phone messages can be given tocaregiver192 via thedisplay16.Caregiver192 can also be alerted when results of tests ordered by thecaregiver192 are available.
• FIG. 15 illustrates another embodiment of the present invention in which the[0107]computer system10 is coupled to abed200 by acoupling mechanism202 which includes apin204 configured to be located within anIV socket206 ofbed200.Pin204 extends away fromhub208.Hub208 includes abracket210 which is pivotally coupled toarm212. The opposite end ofarm212 is pivotally coupled tobracket214 ofcomputer system10. AnIV pole216 supports IVbags218 and pumps220. By coupling thecomputer system10 tobed200,computer system10 is transportable with thebed200 during transport as shown in FIG. 17. Therefore,computer12 continues to capture data from themonitors26,treatment devices28, and anytherapy devices30 on a real time basis during transport of the patient within thehospital10.Wireless transmitter40 andreceiver36permit computer12 to remain in contact with the base station in the hospital during transport.
• FIG. 18 illustrates another embodiment of the present invention in which the[0108]removable module50 has been removed fromsupport52 and coupled to acart220.Cart220 includes abase222, a support224 for holding aventilator226, andpivotable IV poles228 and230. Illustratively,cart220 is a Careporter cart available from Hill-Rom, Inc. as disclosed in U.S. Pat. No. 5,966,760 and in U.S. application Ser. No. 09/105,255 which are incorporated herein by reference.Cart220 includes apivotable support arm230 for receivingmodule50.Module50 includesdisplay20,connector32,wireless data transmitter40, along withcomputer12,memory14, andinput device22.
• FIG. 19 illustrates a[0109]junction box240 having a wireless transmitter such as anRF transmitter242. Thejunction box240 includes a plurality ofinlet connectors244 configured to be coupled to physiological monitors, IV pumps, orother devices246 that do not have individual transmitters. For example,junction box240 may be used in a critical care unit with all thedevices246 coupled toinlet connectors244. Therefore, the hospital does not have to undergo the expense of placing a transmitter on eachdevice246.Transmitter242 transmits data from thedevices246 to thewireless data receiver36 ofcomputer system10 located on the bed or a cart adjacent the bed.
• [0110]Junction box240 includes aninternal memory248 for storing a selected amount of data from thedevices246.Power cord250 forjunction box240 is designed to be plugged into a suitable power outlet.
• [0111]Junction box240 also includes awireless receiver252 for receiving data from thewireless data transmitter40 ofcomputer system10.Junction box240 also illustratively includes aprocessor240 which is programmed to recognizedevices246 coupled to thejunction box240.Junction box240 communicates withcomputer12,transmitter242 andreceiver252.Processor254 determines whether thecomputer system10 is within range for transmission of data by determining whether signals from thecomputer system10 are detected byreceiver252. If thecomputer10 is within range for receiving data transmission from thejunction box240, data fromdevices240 is transmitted bytransmitter242 fromdata receiver36 wherecomputer12 stores the data inmemory14. Ifcomputer system10 is not within range to receive data,processor54 stores data from thedevices246 inmemory248 ofjunction box240. When processor again determines thatcomputer system10 is within transmission range, processor transmits the stored data fromdevices246 to thewireless data receiver36 ofcomputer system10. Therefore, information for charting purposes is supplied tocomputer system10 without requiring transmitters on each of thedevices246.
• FIGS.[0112]20-24 illustrate various uses for apatient assist apparatus260.Patient assist apparatus260 includes a base262 havingcasters264. A support portion266 is coupled tobase264. Air oroxygen tanks268 are coupled to support portion266.IV poles270 are also coupled to patient assist260. Ahandle272 is coupled to an upper end of support266. Acomputer support274 is also coupled to the upper end of support266.Computer support274 is configured to receivecomputer module50 which is illustratively removed from thetotal computer system10 as discussed above.Module50 includes asingle display20, acomputer12,memory14,wireless data receiver36,wireless data transmitter40, andcoupler32 for connecting thecomputer12 tomonitors26,treatment devices28, andtherapy devices30. Therefore, vital signs of thepatient276 as well as outputs from various devices such as IV pumps278 are captured real time bycomputer12.Display20 also displays the patient's vital signs. Patient data is transmitted via thewireless data transmitter40 to acommunication network24 or stored in local memory. In FIG. 20, the patient assist260 is used as a walker-type device to assist with patient egress after medical procedures such as surgery. Thepatient assist260 helps thepatient276 maintain his balance and keeps thecomputer12 at the point of care.
• FIG. 21 illustrates the patient assist[0113]260 andcomputer module50 for use as an IV pole within the room.Caregiver280 inputs information related to thepatient276 usingpen72 as discussed above. FIG. 22 illustrates the patient assist260 coupled to a wheelchair282.Caregiver280 uses handle272 to push the wheelchair282. A coupling mechanism is used to secure the patient assist260 to the wheelchair282. Again,computer module50 is able to monitor and record data frommonitors26,treatment devices28 andtherapy devices30 during transport of the patient. In addition, all the patient's information and chart are available ondisplay20 during transport. FIG. 23 illustratesremovable module50 fromsupport52 within the room as illustrated byarrow284.Module50 is then loaded on to patient assist260 as illustrated byarrow286 for transport of the patient on thebed290.Caregiver280 is able to view the patient's chart and vital signs during transport ondisplay20. Patient assist260 is coupled tobed290 by a suitable latching mechanism. FIG. 24 illustrates that the patient assist260 may be uncoupled frombed290 at the testing facility such as theCT scanner292.Patient276 is removed frombed290 and placed on table294. Patient assist260 is uncoupled frombed290 and left beside thepatient272 when thebed290 is removed from the room. Therefore,computer12 located withinmodule50 continues to capture patient data and data from the monitors and treatment devices while thepatient270 is at the testing facility. All previous test results and chart information are available to the caregiver at the test facility. In addition, the chart remains complete on a real time basis. In certain instances, test results can be automatically transmitted tocomputer12. In other instances, test results are obtained later and transmitter to thecomputer12 via thecommunication network24. Since all test results and lab results are available at the point of care, the present invention reduces the likelihood of duplicate testing on thepatient272.
• In the embodiment of FIGS.[0114]20-24, data related to the patient is transmitted by wireless data transmitter to a central nurse station or to the main server for transmission to any location. Therefore, patient's vital signs or other information can be displayed or monitored at the central station.
• When in the room, the[0115]computer system10 is also used as a tool to educate the patient. Information related to the patient's particular diagnosis or condition is provided to the patient so that the patient understands the care plan for treating the patient's condition.Computer12 is also used to assist compliance with a doctor's instructions after release. For instance, informative information can be provided ondisplay16 with instructions for the patient after release.Display16 can also be used as a TV set when the caregiver is not in the room.
• FIGS.[0116]25-27 illustrate aworkstation300 located in a hospital room adjacent thebed302. It is understood that theworkstation300 can be used in the hallway or at another location outside the hospital room.Computer system10 is shown on an opposite side of thebed302 fromworkstation300. It is understood thatworkstation300 may also be on the same side of the bed ascomputer system10. Illustratively,workstation300 includes anupper cabinet304, a light306, akeyboard308, and asupport310.Computer system10 is movable from thesupport arm312 to support310 onworkstation300. Data is entered intocomputer system10 usingpen72 or other input device including thekeyboard308.Computer system10 continues to monitor and record data frommonitors26,treatment devices28 andtherapy devices30 when onworkstation300. Anadditional cabinet312 is located belowkeyboard308. It is understood thatcabinet312 may be formed integrally with the rest ofworkstation300 or may be a separate piece as shown in FIG. 26 which is movable in the direction ofarrow314. As shown in FIG. 27, a curtain316 is illustratively providedadjacent workstation300 to permit thecaregiver318 to enter information into thecomputer system10 in privacy.Keyboard308 is retractable into acentral storage section320 as illustrated in FIG. 26. FIGS. 29 and 30 illustrate another embodiment of aworkstation322 as shown in FIGS. 28 and 29.Workstation322 includes a centralopen region324, anupper storage cabinet326, and ashelf328.Computer system10 mounted on asupport arm330 and is pivotable from a position locatedadjacent bed332 at the patient's point of care to a position shown, for example, in FIG. 29 in which thecomputer10 is pivoted withinspace324 for access by a caregiver atworkstation322. Aseparate keyboard332 is provided onworkstation322 for inputting additional information into thecomputer system10. A movable cabinet334 is located beneath theshelf328. It is understood that theentire workstation322 may be on a mobile cart so that theworkstation322 is movable as a unit within the room.
• FIGS.[0117]30-33 illustrate additional carts for supporting thecomputer system10. In FIG. 30,cart340 includes abase342 and acentral portion344 coupled to thebase342. Thecentral portion344 includesdrawers346. Astand348 is located ontop surface350 for supporting thecomputer system10. A screen orpartition352 is coupled tocentral portion344 and extends 180° or more aroundtop surface350 for privacy.Caregiver354 can rotate thestand340 as illustrated by double headedarrow356 away from thepatient358 as desired for privacy when inputting information into thecomputer system10.
• Another[0118]cart360 is illustrated in FIG. 31.Cart360 includes a base362 having casters364. Acentral pedestal366 includestelescoping portions368 and370. Awire storage tray372 is coupled totelescoping section368.Controls374 and376 are provided for raising and loweringtelescoping sections368 and370.Work surface378 includeshandles380 and382. Eithermodule50 ofcomputer system10 or theentire computer system10 is configured to be coupled to asupport382.Pullout keyboard384 is located underwork surface378.Surface378 may include an input device such asdevice74 in FIG. 2 which permits the caregiver to write out information to be input into thecomputer12 which is recognized by handwriting recognition software.
• Yet another[0119]cart390 is illustrated in FIGS. 32 and 33.Cart390 includes acentral portion392 havingdrawers394.Legs396 andcasters398 are coupled tocentral portion392. Stand390 includes an angledtop work surface400 and akeyboard402 which can be moved to an extended position in the direction ofarrow404 in FIG. 33 for access by acaregiver406.Computer10 is coupled to atelescoping support arm408 by apivot connection410.Arm408 can extend and retract in the direction of double-headedarrow412 in FIG. 33 to raise and lower the height ofcomputer10.Computer10 is also pivotable aboutaxis412 as illustrated by double-headedarrow414 in FIG. 33.
• FIG. 34 illustrates a summary of the real time electronic charting feature of the present invention. As discussed above,[0120]dual displays18 and20 permit replication of a chart approximately the size of a conventional flow sheet used to keep patient records in the hospital. Thedual displays18 and20 also permit viewing of two separate software application simultaneously. It is understood that a single display may be used. However, dual displays are used for cost saving purposes in order to provide the chart information. In other words, a portion of the chart data is displayed on thefirst display screen18 and another portion of the patient data chart is displayed on thesecond display screen20.Computer12 inputs information in a real time basis on the chart frommonitors26,treatment devices28 andtherapy devices30. In other words, thecomputer12 monitors these devices to provide real time information which normally is kept on patient's charts or flow sheets. For example,computer12 automatically charts information related to temperature, respirations, rhythm, heart rate, blood pressure, blood oxygen levels, or any other vital sign which is desirable to monitor. Thecomputer12 graphs this information on a continuous, real time basis on the chart.
• [0121]Computer12 also monitors the bed status as illustrated atblock420.Bed status420 includes information related to the location of various bed deck sections or other information related to the mechanical features of the bed.Computer12 also monitors bed based therapy devices as illustrated atblock422. These therapy devices include, for example, thermal treatment devices, percussion, vibration, or rotation therapy provided for the patient.Computer12 monitors the actual time and duration that such therapies are performed.Computer12 indicates these therapies on the chart so that the results of these therapies can be monitored for effectiveness by viewing the time that the therapy is performed and then determining whether the patient's condition improves based on the therapy.Computer12 also monitors medications administered using thebar code reader34, RFID reader, or other input device as indicated byblock424. Again, by charting these medications on a real time basis, the caregiver can determine the effectiveness of medications by monitoring the other vital signs in relation to the time that medications are administered. Test results are also monitored bycomputer12 as illustrated atblock426. These test results are charted, if appropriate, to assist with analysis of the effectiveness of the various treatments. As discussed above the charting from the monitors continues regardless of whether or not the patient is in the room. The modular interface card is provided for connecting the monitors, treatment devices, and therapy devices to thecomputer system10. An open system permits devices from various manufacturers to be coupled to thesystem10. Therefore, vital signs are archived and automatically downloaded to the flow chart regardless of whether or not the patient is in the room. This provides a more complete chart when compared to conventional paper charts.
• [0122]Computer12 may also be coupled to a smart mattress such as disclosed in PCT Application No. PCT/US99/25311 which is incorporated herein by reference. The smart mattress generates output signals related to a patient's weight, heart rate, respirations, temperature, EKG, ECG, SaO₂, and the like which are monitored and charted by thecomputer12.
• Another embodiment of the present invention is illustrated in FIG. 35. The embodiment of FIG. 35 provides a fully integrated[0123]care delivery system500. Thesystem500 provides open architecture which allows medical equipment manufacturers to produce module products to function with thesystem500. These medical device manufacturers access common hardware and redundant systems so that the modular devices are smaller and lighter. The smaller and lighter modular devices facilitate ergonomic benefit and their placement within the environment. Theentire system500 also has cost advantages by reducing these redundant systems.System500 includes a central station having a central processing unit (CPU)504, apower supply506, abattery backup508, adisplay510, and agraphical user interface512.User interface512 may include any type of input device discussed above. Medical device modules514 configured to be coupled to a plurality ofinput connectors516 ofstation502. Illustratively, the medical devices of modules514 are vital sign monitors, IV pumps, ventilators, defibulators, compression boots, and other medical devices that may be used to provide or monitor the care of a patient. Modules514 illustratively do not include a CPU, a power supply, a display, or a user interface. When modules514 are connected toconnector516, modules514 include asuitable connector518 so that modules514 use theCPU504,power supply506,battery backup508,display510, anduser interface512 of thecentral station502.
• [0124]Central station502 provides an open architecture to allow all medical equipment manufacturers to produce modules514 to function with thesystem500.System500 includes other components (not shown) such as the connection to thecommunication network24, thebar code reader34,wireless data receiver36,wireless data transmitter40,camera42, andphone44 as discussed above with reference to FIG. 1.CPU504 also accessesmemory518. Modules514 are less expensive since redundant systems are not used. Only the actual treatment portions of the devices are required in the modules514. Control of the modules514 is provided using thegraphic user interface512 ofstation502. Information regarding operation of the module514 is displayed ondisplay510 instead of on a separate display on the module514. Power is supplied to the module514 via thepower supply506 if thestation502 is connected to a wall outlet or via abackup battery508 if thestation502 is disconnected from the wall outlet such as, for example, during transport. Once the modules514 are connected, thesystem500 operates as discussed above to capture data for charting patient information throughout the patient's entire stay at the hospital.
• FIGS.[0125]36-38 illustrate an embodiment of the invention shown in FIG. 35. This embodiment, acart520 includes a base522 supported bycasters524 and a central portion526 for housing aventilator528 anddefibulator530. A handle532 is provided for pushing thecart520. Afirst support arm534 is coupled tohub536. Amodule receiving section540 includes a plurality ofmodule receiving cavities542 for receivingmodules544.Computer system500 is coupled to asecond arm546 attached tohub536.Display510 includes dual screens. Medical device module such asmodules544, as well asventilator528 anddefibulator530 are similar to modules514 illustrated in FIG. 35. In other words, these modules use theCPU504,power supply506,backup battery508,display510, anduser interface512 of thecomputer system500. FIG. 36 illustrates thecart520 being pushed towardbed548 in the direction of arrow550. Alarge display552 is coupled to a walladjacent bed548.Display552 is also coupled tocomputer system500 via the communication network or a wireless transmitter to display information related to the patient on thedisplay screen552. Whencaregiver554 is not in the room, another image such as a picture or TV image may be provided ondisplay screen552. FIG. 37 illustrates thecart520 at a location adjacent the head end ofbed548 for providing access tocomputer500 at the point of care near the head end of thepatient556. FIG. 38 illustrates thecart520 docked to thebed548 during transport. FIG. 38 also illustrates one of themodules544 removed frommodule receiving cavity542. In addition, FIG. 38 illustrates howventilator528 is connected to cart520.
• FIGS. 39 and 40 illustrate another embodiment of the present invention. In FIG. 39, a computer[0126]600 is integrated with an overbed table602. Table602 includes a base604 supported bycasters606. Table602 further includes aside support608 havingstorage portions610 and a top cavity612. Aconnector614 is coupled to acomputer support616. Illustratively,support614 is rotatable aboutaxis618 as shown byarrows620. Computer system600 includes a personal computer including adisplay622. A phone624 is integrated with the computer600. It is understood that the phone could be separate from the computer600. FIG. 40 illustrates the overbed table positioned over ahospital bed626 so that the computer600 is accessible to patient628. Therefore, the patient628 has access to e-mail, the Internet, a care plan, or other items such as computer games. The patient526 can conduct business or send e-mails to the doctor to ask questions.
• Another embodiment of the present invention is illustrated in FIG. 41. In the FIG. 41 embodiment, a[0127]display apparatus630 is used in place ofdisplay apparatus16 shown in FIG. 1.Display apparatus630 includes first and second display screens632 and634 coupled to a base orsupport636. Illustratively,display634 is removable frombase636 as a separate module along withcomputer12. Aconnector638 illustratively includes male and female portions for connecting thecomputer12 to thefirst display632 when thecomputer12 andsecond display634 are coupled to thebase636.First display632 includes aheight dimension640 and awidth dimension642.Second display634 includes aheight dimension644 and awidth dimension646. As illustrated in FIG. 41, the height andwidth dimensions640 and642 offirst display632 are larger than the height andwidth dimensions644 and646 ofsecond display634. Therefore, theremovable display634 is smaller than thestationary display632. Atop edge648 offirst display632 is illustratively aligned with a top edge650 ofsecond display634 onsupport636. In the illustrated embodiment, chart information or other patient information is provided on bothdisplays632 and634. Illustratively, the charting data is only provided in a top portion ofdisplay632 as illustrated bydimension652.Dimension652 is the same height asheight dimension644 ofsecond display634. A lower portion offirst display632 illustrated bydimension654 is illustratively used for providing menu items or icons.Section654 ofscreen632 may also be used as a pen or stylus based input section which provides handwriting recognition as discussed above. It is understood that additional display screens may be coupled tobase636, if desired.
• When it is desired to transport the patient or permit the patient to move about in the hospital, the[0128]computer12 anddisplay634 are removed frombase636 and coupled to the bed, patient assist, stand or other device as discussed above so that thecomputer12 anddisplay634 remain with the patient at the point of care as the patient moves throughout the hospital. The other components ofcomputer system10 permit real time monitoring and data entry as discussed above.
• FIG. 42 illustrates another embodiment of a physiological monitor signal junction box and transmitter of the present invention. In the illustrated embodiment, monitoring module[0129]660 includes a housing662 which is coupled to thepatient664 bystrap666. It is understood that the housing662 may be coupled to other portions of thepatient664 by any suitable structure. In addition, the module660 may be coupled to thepatient support device668 such as a bed or stretcher. A module660 may be also be coupled to a patient assist device, stand, or workstation as discussed above. Various physiological monitors such as heart rate monitors, temperature sensors, blood pressure cuffs, blood oxygen monitors, EKG monitors, and the like are coupled to the monitor byconnector lines670. Module660 transmits signals from the physiological monitors viaantenna672 or other suitable wireless transmitter to thecomputer12 or to aserver15 which receives the transmitted signals using a wireless receiver.
• Illustratively, module[0130]660 is similar toelements32 in FIGS. 2 and 82 in FIG. 4. Module660 may include a separate battery that can be recharged when coupled to acomputer module50 or a wall outlet.
• Yet another embodiment of the present invention is illustrated in FIG. 43. In this embodiment a[0131]computer module680 is configured to be coupled to thepatient support apparatus668 to apatient assist260 or other device as discussed above. Numerous coupling mechanisms described herein may be used to connect thecomputer module680 to the bed orpatient support668, to the patient assist260, or to one of the carts or workstations. In the FIG. 43 embodiment,computer module680 includes thecomputer12 and the components shown in FIG. 1 except fordisplay16.Computer module680 includes athird display682 in addition todisplay screens18 and20. In this embodiment, display screens18 and20 remain mounted to awall684 in a room by a mountingarm686 or other support structure as shown in FIG. 43. Patient information and inputs are received ondisplay screens18 and20 as discussed above. When in the room,computer12 withinmodule680 is coupled to displayscreens18 and20 via a physical wired connection or via a wireless connection so that patient information is displayed onscreens18 and20. However, when transported out of the room,display screen682 is used.
• [0132]Module680 includesinput connectors688 coupled tophysiological monitors26,treatment devices28, andtherapy devices30 by connectinglines690 as discussed above. Awireless data transmitter40 is provided to transmit signals from themonitors26,treatment devices28, andtherapy devices30 to themain server15 whencomputer12 is disconnected from thecommunication network24. Therefore,computer12 uses thelarger display16 which either includes an elongated single display, or side-by-side display screens18 and20 when thecomputer module680 is in the room. It is understood that thelarger displays16 may be located in different rooms throughout the hospital so that thecomputer module680 can use the displays within each room for displaying patient information. Therefore, thelarge display16 does not need to be transported with the patient through the hospital.
• While the illustrated embodiments provide a computer at the point of care, including a computer which is designed to stay with the patient, another embodiment of the present invention includes a central computer, server or other processor configured to communicate through a wired or wireless connection to modules attached to the patient, a patient support such as a bed, table, stretcher, incubator, or the like. In other words, while[0133]computer12 stays with each patient wherever he or she goes in the illustrated embodiments, it is understood that a single central computer or server in a room such as a neo-natal center may be used for many patients or infants with separate input devices and displays associated with each patient or infant.
• Another embodiment of the present invention is illustrated in FIG. 44. FIG. 44 is illustrative display screen for displaying information related to patient vital signs such as heart rate, respiratory rate, fluid/electrolytes/nutrition, temperature, and neurological monitoring. Various sections of the star shown in FIG. 44 can be adjusted in color, size, or other manners to provide a visual indication to the caregiver of alarms or warnings in connection with one of the monitored vital signs. In addition to the visual indicator, displays of actual values of each of the measured parameters may be displayed on the display screen. As discussed above, these monitored items can be stored in the memory of the computer or transmitted to a main server at a remote location. The signals are then charted on a time basis. Treatments are also either manually or automatically recorded on a time basis so that a caregiver can assess the effectiveness of various treatments, request additional treatments or lab work, or intervene to take corrective actions. Showing that a particular treatment or therapy was effective to improve a patient condition or to prevent a subsequent condition from occurring may improve the ability to charge and collect for the treatment or be reimbursed for the treatments or therapies performed on the patient.[0134]
• The present invention comprises one or more of the following features or combinations thereof.[0135]
• 1. A computer system or a component thereof assigned to a patient or to a bed or other device upon which the patient rests or with which the patient is associated, the system comprising a computer, a plurality of devices for sensing various physical conditions and characteristics of the patient, each device having an output coupled to the computer, and a display arranged to present the condition and status of the patient.[0136]
• 2. Such a system comprising a plurality of input devices for inputting data and instructions concerning the patient.[0137]
• 3. Such a system configured to store and retrieve data concerning the patient and the sensing devices and to display such data over a period of time to show relationships on a time basis.[0138]
• 4. Such a system comprising a memory in which the patient's history is stored for retrieval and display.[0139]
• 5. Such a system in which the sensing devices include heart rate sensors, respiratory rate sensors, neurological monitoring sensors, temperature sensors and the like.[0140]
• 6. Such a system comprising means for inputting fluid, electrolyte and nutrition data into the memory on a time basis.[0141]
• 7. Such a system comprising a communication network providing for remote monitoring of patient data and remote inputting of data and instructions.[0142]
• 8. Such a system further comprising a video imaging input to the computer to provide images of the patient.[0143]
• 9. Such a system further comprising ultrasound image input to the computer.[0144]
• 10. Such a system further comprising an x-ray image input to the computer.[0145]
• 11. Such a system in which the patient status and condition is stored and used for a time-based presentation on the display.[0146]
• FIGS. 45 and 46 illustrate a portable or[0147]movable workstation710 having a base712, a topvertical support member714, a bottomvertical support member715, and anupper support716 coupled to topvertical support714. A plurality ofstorage containers718 are also coupled to the topvertical support714 belowupper support716.Upper support716 includes abase frame720 coupled to topvertical support714. Akeyboard722 is movably and coupled tobase frame720 bytracks724 so thatkeyboard722 is movable from a retracted position shown in FIG. 45 to an extended position shown in FIG. 46. Arelease mechanism726 forkeyboard722 is illustrated in FIG. 45.
• A[0148]top surface728 is movably coupled tobase frame720 bytracks730.Top surface728 is movable from a retracted position shown in FIG. 45 to an extended position relative tobase frame720 as shown in FIG. 46. Therefore, after thework station710 is rolled into a room, the caregiver can extend thekeyboard722 andtop surface728 to provide a workstation for entering or reviewing patient data. The height of centervertical support714,715 is adjustable so that the caregiver can input data on thekeyboard722 in either a standing position as shown in FIG. 45 or seated position as shown in FIG. 46.
• The[0149]patient computer system732 is illustratively coupled totop surface728. As discussed above,computer system732 includes first andsecond displays734 and736 for displaying flow sheets or other information relating to the patient. Physiological monitors such as, for example, blood pressure cuffs and temperature probes are integrated into thecomputer system732. The monitors may also be separate devices.
• FIGS. 47A, 47B and[0150]48 illustrate details of illustrative types of information displayed ondisplay734 and736. Illustratively, information in FIG. 47A is displayed onscreen734 and information in FIG. 47B is displayed onscreen736.Region740 of FIG. 47B facilitates data entry of a head-to-toe physical assessment of the patient by selecting various regions on the patient icon. The caregiver may display or input different types of information related to the patient using the icon and entry keys. The “roll-in”workstation710 moved with the patient to provide a dedicated computer at the point of care of the patient.
• Another embodiment of the present invention is illustrated in FIGS.[0151]49-54. Thepatient assist cart740 includesbase742 housing side supports744 and746 andelongated plates748 and750 coupled to the side supports744 and746, respectively.752 are coupled to one end ofplates748 and750.Casters752 includes self contained foot actuated locks. Locking754 are coupled to the opposite end ofplates748 and750. As described belowcasters754 include a central brake mechanism.
• The[0152]plates748 and750 extend past ends of side supports744 and746, respectively, to provide flexible leaf springs for coupling to thecasters752 and754. In other words, theplates748 and750 may flex slightly during movement of thecart740 over uneven surfaces. Thepatient assist cart740 includes extendingsupport tubes756 and758 coupled to acentral portion745 ofbase742. Patient assistcart740 further includescastor brakes mechanisms760, afoldable seat762, andmovable handles764 as discussed in detail below. Atank support bracket766 is mounted tocentral portion745 ofbase742 for supporting an oxygen orair tank768. A plurality ofIV poles770 are coupled to supporttubes756 and758. Acomputer772 including a plurality of vital signs monitor input ports is coupled to a central mountingportion774 ofcart740. Illustratively, the mountingportion774 extends betweensupport tubes756 and758.Computer772 is rotatable oncart740 about anaxis776.
• FIG. 50 illustrates a[0153]central aperture778 formed in mountingportion774. In the illustrated embodiments,batteries780 are located inside side supports744 and746 to provide power to devices on thecart740. Anisolation transformer782 and abattery charger784 are also located within compartments in the base742 as shown in FIG. 50.Cart740 may be coupled to a wall outlet in a room when available by a plug (not shown).Batteries780 are coupled to anelectrical connector786 aligned withaperture778 to couple thecomputer772 electrically to the patient assistcart740.Computer772 includes amale connector788 configured to mate withfemale connector786 oncart740. Illustratively,power connector788 provides24 VDC power supply to thecomputer772. Atransceiver790 is coupled tocomputer772. Illustratively, thetransceiver790 sends and receives an IR or RF signal to communicate with devices or a network as discussed above. Aconnector792 is provided for powering a dual display discussed above.Computer772 includes adisplay screen794. In addition,computer772 includes a plurality ofinput connectors796 for coupling monitors such as temperature monitors, blood pressure monitors, SPO2 monitors, ECG monitors, or other monitors to thecomputer772 as discussed above. Physiological monitors or other devices are coupled tocomputer772 as discussed above or by wires or by a wireless connection to thecomputer772 or to an interface connector so that the patient's vital signs are other characteristics continue to be monitored on real time basis when the patient is away from the hospital bed or patient room.
• Patient assist[0154]apparatus740 preserves floor space in the hospital room, is located at an ergonomic position and manages all the devices in one location. Thecomputer772 follows the patient to permit automatic data capture and the ability to access or enter patient data regardless of the patient location. Patient assist740 provides a patient egress device, a transport device, and an in-room assist device. In another embodiment of the present invention a commode (not shown) is coupled tobase742. This eliminates the need for a separate bedside commode within the room.
• FIGS. 53 and 54 illustrate the patient assist[0155]cart740 with another embodiment ofcomputer800 coupled to the support posts756 and758. In this embodiment, thedisplay screen802 is mounted to a firstmovable arm804.Movable arm804 is coupled to apivotable arm806 which is coupled to supporttube758. The embodiment of FIGS. 53 and 54 provides greater visibility for a patient using the patient assistcart740 as a walker or for a caregiver when using the patient assistcart740 to push a hospital bed as shown in FIG. 69 below.
• The[0156]computer800 is illustrated in more detail in FIGS. 55 and 56. Thecomputer800 includes ahousing808 havingend portions810 and812 configured to be coupled to supporttubes756 and758, respectively. In embodiment, thecomputer800 is not easily removable fromcart740.Computer800 includes a plurality ofinputs814 for vital signs monitors as discussed above. Illustratively, the vitals monitor is available from Nasiff Associates, Inc. located in Brewerton, N.Y. It is understood that other types of suitable monitoring modules may be used withcomputer800. A plurality ofRS 232ports816 are configured to receiveconnectors818.Computer800 also includes aUSB ports820 and a printer/mouse port822.Computer800 further includes a plurality ofAC power receptacles824, aspeaker826, ahard drive828, and power converters830 as shown in FIG. 56. In addition,computer800 may include at least one PCMCIA card slot, a radio LAN device, and wireless Internet device.Computer800 is coupled todisplay screen802 includes ahousing832 mounted to arm804 as discussed below.
• FIGS. 57 and 58 illustrate another embodiment of the present invention in which a[0157]display834 andinput device836 are coupled to thesupport arm804 and tocomputer800. In addition, FIGS. 57 and 58 show IV pumps838 andIV bags840 coupled toIV poles770. Achest drainage apparatus842 is also coupled to supporttube758.
• FIG. 58 illustrates the[0158]arm804 in a downwardly pivoted position and thedisplay834 pivoted relative to thearm804 to facilitate use in the lower position.Arm804 is rotatably coupled toarm806 ofcart740 bypivot connection844 so that thearm804 rotates aboutaxis846.Arm806 also rotatable about an axis extending throughsupport tube758. Therefore, thedisplay834 andinput device836 are positionable in a plurality of different orientations to facilitate use of theinput device836 and thedisplay screen834.
• Further details of the[0159]seat762 for supporting a patient are illustrated in FIGS. 59 and 60. The seat is movable from an upwardly pivoted support position shown in FIG. 53 to a downwardly pivoted storage position shown in FIG. 54. As shown in FIGS. 59 and 60, a mountingmember850 includesapertures852 and854 configured to receivesupport tubes758 and756 ofcart740 as shown, for example, in FIG. 49. Mountingmember850 is pivotably coupled to aplanar seat856 bypivot connections858. Therefore, theseat858 pivots relative to the mountingmember850 between the upwardly pivoted position shown in FIG. 53 to the downwardly pivoted position shown in FIG. 54. Aseat support860 is coupled toseat856 by spaced apartcouplers862.End portions864 ofsupport860 extend into thecouplers862 so thatsupport860 is pivotable aboutaxis866 relative toseat856. Couplers include notchedsections868 configured to receiveopposite side portions870support860 to hold thesupport860 in the position shown in FIG. 60.Couplers862 include aramp surface872 to facilitate movement of thesupport860 from the position shown in FIG. 60 to the position shown in FIGS. 54 and 59.Side portions870 move outwardly as shown in FIG. 59 as the support is pivoted in the direction ofarrow882.Support860 is shaped to provide spaced apart supportlegs874 and876 which are configured to engageplates748 and750 as shown in FIG. 53 to support theseat856.
• When it is desired to use the[0160]seat762, an operator pivots theseat856 upwardly about mountingmember850 in the direction ofarrow878 in FIG. 54. As theseat856 is lifted,support860 pivots downwardly aboutaxis866 in the direction ofarrow880 in FIG. 59 until theside portions870enter notches868 formed incouplers862 to hold thesupport860 in the position shown in FIG. 60. Therefore, thesupport860 automatically pivots downwardly and is maintained in the support position bycouplers860 when theseat856 is pivoted upwardly.
• When it is desired to move the[0161]seat862 to a storage position, the user first pivots thesupport860 aboutaxis866 in the direction ofarrow882 shown in FIGS. 53 and 60.Support860 pivots to be generally co-planar withseat856 as shown in FIG. 54.Seat856 holds thesupport860 in the position shown in FIG. 54 for storage.
• FIGS. 53 and 54 also illustrate the[0162]handle assembly764. When in the orientation shown in FIG. 53, a patient may use thehandles884 and886 for support or like a walker. Acenter bar887 extends betweenhandles884 and886.Handle assembly764 is coupled to cart740 bycoupling mechanisms890 best shown in FIGS. 61, 63 and64.Handles884 and886 are pivotable by anaxis891 in the direction ofarrow888 in FIG. 53 to lie on an opposite side ofsupport tubes56 and58 as shown in FIG. 54. In the FIG. 54 orientation, thehandles884 and886 are usable by a caregiver to push a bed, wheelchair or other device attached to the patient assistcart740.
• As shown in FIGS. 61 and 62, the[0163]center rod887 includes a cylindrical body portion having aflat sections892 adjacent opposite ends.End couplers894 are coupled to bar887. Eachcoupler894 includes anaperture896 configured to receive an end of ahandle884,886. Astop898 is located on eachcoupler894. As best shown in FIGS. 63 and 64, mountingmechanisms890 include anaperture900 formed to receivesupport tubes756 or758. When thehandles884 and886 are pivoted upwardly as shown in FIG. 63, theflat sections892 oncenter bar887 are aligned with an opening902 formed incoupling mechanism890. ABelville washer904 and afriction member906 are located within the opening902. An inner surface offriction member906 illustratively has a cylindrical shape to engage an outersurface support tube756 or758. When theflat section892 is aligned with opening902 as shown in FIG. 63, the mountingmechanisms890 can slide up and down onsupport tubes756 and758 in the direction of double headedarrows908 in FIG. 53. FIG. 54 shows thehandle assembly764 moved downwardly.Handles884 and896 provide arm rests for theseat856 in this orientation.
• When the[0164]handles884 and886 are pivoted downwardly in the direction ofarrow910 in FIG. 64,center bar887 rotates in the direction of arrow912 which causes an outer cylindrical portion ofbar887 to engage Belville washer, thereby compressing the Belville washer and moving thefriction member906 into engagement with an outer surface oftubes756 and758. Therefore, thehandle assembly764 is held in position onsupport tubes756 and758.
• When the patient assist[0165]cart740 is used to push a hospital bed or wheelchair, thehandles884 and886 are rotated beyond the support tubes to the position shown in FIG. 54. The cylindrical surface ofcenter bar887 also compresses theBelville washer904 and moves thefriction member906 againstposts756,758 when in the FIG. 54 orientation. Ashuttle lock916 on each mountingmechanism890 is pressed inwardly to move theshuttle member916 into alignment withstops898 oncouplers894 to lock the handles in the position shown in FIG. 54.Shuttle member916 is moved in an opposite direction when it is desired to pivot the handles back to the position shown in FIG. 53.
• FIG. 65 illustrates a[0166]caster braking mechanism760 of one embodiment of the present invention.Support tubes756 and758 are each illustratively mounted over aninner tube920.Support tubes756 and758 are biased upwardly in the direction ofarrow922 by aspring924. Acoupler926 is coupled to eachsupport tube756,758.Coupler926 includes spaced apartarms928 and930.Casters754 are rotatably coupled toplates748 and750 for rotation aboutaxis932.Casters754 include astem934 having arotatable brake actuator936 configured to actuate aninternal brake938 when theactuator936 is rotated about itslongitudinal axis940. Illustrative,casters754 are model number 2944 casters available from Tente, although any suitable caster may be used. An arm942 has a first end pivotably coupled tocoupler926 by apin944 extending betweenarms928 and930. On opposite end of arm942 includes anelongated slot946 located overactuator936. Illustratively, the slot is sized so that opposite side walls engage opposite sides of hex shapedactuator936. When user usespatient assist cart740 as a walker and pushes down onhandles884 and886 with enough force,support tubes756 and758 are forced downwardly in the direction ofarrow948 by the patient's weight. Similarly, when the user sits onseat762, the user's weight movessupport tubes756 and758 downwardly in the direction ofarrow948.Couplers926 also move downwardly causing arm942 to pivot aboutaxis940, thereby rotatingactuator936 and braking thecastor754.
• In another embodiment of the present invention, the[0167]support tubes756 and758 are mounted directly over a tube on the casters and spring biased upwardly. Therefore, application of weight to the support tubes cause a brake coupled to the support tubes to engage the casters.
• FIGS.[0168]66-68 illustrate details of the mountingarm804 shown in FIGS. 53, 54,57, and58.Arm804 includes ahead950 having aflat surface952 configured to be secured to thedisplay screen802,834.Head950 includesouter walls954 and956 and acentral portion958 definingslots960 and962. Abase964 is pivotably coupled to the patient assistcart740 byconnector966.Base964 includes first and second spaced apartside walls968 and970 and acentral portion972 defining first andsecond slots974 and976. Abottom linkage978 includes spaced apartarms980 and982 coupled together by aplate984 as best shown in FIG. 68.Arm980 is coupled betweenside wall954 andside wall968 as shown in FIG. 66.Arm982 is coupled betweenside wall956 andside wall970 by suitable fasteners.Arms986 and988 are also pivotably coupled betweenhead950 andbase964.Arm986 has a first end located in slot960 and a second end located inslot974.Arm988 has a first end located inslot962 and a second end located inslot976. Acoupler990 is secured to plate984 bysuitable fasteners992 as shown in FIG. 67. Agas assist spring994 includes afirst end996 pivotably coupled tocoupler990 and asecond end998 pivotably coupled between thetop arms986 and988 bypin1000. Acover1002 is located over the arm components.Base966 includes atop plate1004. As shown in FIG. 67,base964 is secured toplate1004 byfasteners1006. As thearm804 is pivoted from a generally vertical position as shown in FIG. 57 to a generally horizontal position shown in FIG. 58, the mountingsurface952 rotates so thatdisplay802,834 is visible when the arm is either inarm804 is in the vertical position and in the horizontal position.
• As shown in FIGS. 54 and 61, the patient assist[0169]cart740 includes a pair of latchingmechanisms1010 which are illustratively formed integrally with the mountingmechanisms890 forhandles884 and886. It is understood that thelatch mechanisms1010 may be separately formed. Eachlatching mechanism1010 includes a support having first and secondupper arms1012 and1014 and first and second spaced apartlower arms1016 and1018. Afirst latch portion1020 pivotably coupled betweenarms1012 and1014 bypin1022. Asecond latch portion1024 is pivotably coupled betweenarms1016 and1018 bypin1026.
• [0170]Latches1010 are configured to secure the patient assistcart740 to ahospital bed1030 as best shown in FIG. 69.Bed1030 illustratively includes abase1032 and aframe1034 coupled to thebase1032. Illustratively, the frame includes a head frame member1036. A pair of spaced apart brackets1038 mounted to head frame member1036. Brackets include across pin1040 shown in FIGS.70-72 which is configured to enter thelatch1010. Initially, the upper andlower latch portions1020 and1024 are located in the orientation shown in FIG. 70.Upper latch1020 includes anarm1044 andbottom latch1024 includesarms1046 and1048. Initially,latch members1020 and1024 are biased to the position shown in FIG. 70 by aspring1050 as the patient assist cart moves toward the bed in the direction ofarrow1052, thepin1040 engagesarm1044 ofupper latch portion1020 to pivotupper latch portion1020 in the direction ofarrow1054. A distal end ofarm1044 moves along the curved surface1056 extending betweenarms1046 and1048 ofbottom latch portion1024. This causesbottom latch portion1024 to pivot in the direction of arrow1058 until the end ofarm1044 moves to the position of FIG. 72 to secure the locking pin within the latch mechanism and hold thelatch portions1020 and1024 in the locked position. An operator releases the latch mechanism by manually rotating theupper latch portions1020 in the direction ofarrow1060 in FIG. 72. This permitsspring1050 to move thelatch portions1020 and1024 back to the position shown in FIG. 70. Therefore, the patient assistcart740 can be removed from the bed.
• FIG. 73 illustrates a[0171]wheelchair1062 coupled to the patient assistcart740.Front wheels1064 ofwheelchair1062 are illustratively supported off the ground and latched to thebase742 bylatch members1066. Therefore, a caregiver can push thewheelchair1062 and the patient assistcart740 in a normalmanner using handles1068 ofwheelchair1062. Thepatient assist cart740 can also be coupled to arear surface1070 ofwheelchair1062 using locking pins similar to those discussed above. In this embodiment, handles884 and886 are pivoted to the position shown in FIG. 54 and used to push thewheelchair1062 and patient assistcart740.
• FIGS.[0172]74-76 illustrate another embodiment of adual screen display1100 of the present invention.Display1100 includes ahousing1102 having afirst housing portion1104 coupled to asecond housing portion1106 to define an interior region therebetween. First andsecond display screens1108 and1110 are located within the interior region ofhousing1102. As shown in FIG. 75,first housing portion1104 includes anouter flange1112 configured to engage anedge1114 ofsecond housing portion1106. Illustratively, a gasket or other seal is provided to provide a waterproof seal for the housing for holding the first andsecond display screens1108 and1110. As shown in FIG. 75,power supplies1116 and electric components1118 for converting electrical signals fordisplay screens1108 and1110 are located onfirst housing portion1104.Second housing portion1106 includes a mountingregion1120 configured to be coupled to thehead950 ofarm assembly804.
• Details of the[0173]display1100 coupled toarm804 are shown in FIG. 77 and78. Illustratively,arm804 is coupled to aprimary arm1122 by acoupler1124.Base964 ofarm804 is pivotably coupled tocoupler1124 aboutaxis1126.Coupler1124 is pivotably coupled toprimary arm1122 aboutaxis1128. On opposite end ofprimary arm1122 is pivotably coupled to anothercoupler1130 aboutpivot axis1132.Coupler1130 is pivotably coupled to a mountingbracket1134 about apivot axis1136. Thearms1122 and804 can therefore be moved to a plurality of different orientations in a room to facilitate viewing and data entry into the computer as discussed above. Aprotective frame1138 is coupled todisplay1104 to protect the display. Thearms804 and1122 also move thedisplay1100 to an ergonomic position for entering data as shown in FIG. 81.
• Another embodiment of a primary arm is illustrated in FIGS.[0174]79A-79C.Primary arm1140 is coupled tosecondary arm804 to support a cantilevered load such asdisplay1100 as indicated atlocation1142.Primary arm1140 supports the bearing load atlocation1144.Arm1140 includes threeseparate linkage arms1146,1148 and1150 which are grounded atlocations1152,1154 and1156, respectively. Arigid coupler1158 is pivotably coupled to eacharm1146,1148,1150 byconnections1160,1162 and1164, respectively, that form a triangular pattern. FIG. 79A illustrates the primary arm at a +70 degree angle. FIG. 79B illustrates the configuration ofprimary arm1140 at a zero degree angle, and FIG. 79C illustrates the position ofprimary arm1140 at a −70 degree angle.Primary arm1140 is illustratively two four bar linkages which are out of phase by 90 degrees to achieve maximum stability. As shown in FIG. 79B, anextension spring1166 is coupled to one of thelinkage arms1146,1148, or1150.Extension spring1166 is similar to the spring shown in U.S. Pat. No. 5,826,846, which is incorporated herein by reference.
• When[0175]primary arm1140 is at its uppermost angle (i.e. +70 degrees), little or no balance force is required to maintain the angular position ofdisplay1100. At thisposition extension spring1166 is in its natural unextended position and does not provide any counterbalance force toprimary arm1140. Asprimary arm1140 rotates the amount of balance force necessary to holddisplay1100 in a neutral position increases linearly with the angle of rotation. As the rotation occurs,spring1166 extends and supplies a counterbalance force that also increases asspring1166 extends. Thus, the necessary balance force required bydisplay1100 is offset by the extension force supplied byspring1166.
• FIGS.[0176]80-82 illustrate the patient assistcart740 and thedual display1100 located in ahospital room1200. Apatient1202 is located on abed1204. Thepatient assist cart740 is located adjacent a head end ofbed1204. Therefore,computer800 onpatient assist cart740 continues to collect patient information while the patient is inroom1200.Computer800 is configured to drive thedual display1100 when the patient assist is in theroom1200. Acable1206 extends fromcomputer800 to thedisplay1100. Ahead wall1210 which is coupled towall1212. A light1214 is coupled towall1212 abovehead wall1210. In FIG. 80, thedual display1100 andarms804 and1122 discussed above are moved to a configuration to position thedual display1100 in aregion1216 located between the light1214 and thehead wall1210.Display1100 is very close towall1212 so thatdisplay1100 is out of the way. In FIG. 80,arm1122 extends generally parallel towall1212 andarm804 extends upwardly fromarm1122.
• FIG. 81 shows the[0177]arms804 and1122 moved downwardly to permit acaregiver1218 to enter data into the computer using thedisplay1100 as discussed above. The height and angle ofdisplay1100 facilitate use bycaregiver1218 for data entry and viewing. Thearm804 is configured to pivot thedisplay1100 and align thedisplay1100 at an ergonomic angle of about 5 degrees to about 60 degrees relative to the ground for data entry and viewing. Preferably the angle is about 20 degrees to about 40 degrees. FIG. 82 illustrates thearms804 and822 moved to an elevated position so that the monitor may be viewed at a position above the head ofcaregiver1218. In FIG. 82, thedisplay1100 is out of reach of children. Thearms1122 and804 permit thedisplay1100 to be located at the plurality of different orientations.
• FIG. 83 illustrates additional details of the[0178]computer800 which drivesdisplay screens1108 and1110 ondisplay1100 and also drivesdisplay screen802 onpatient assist cart740.Computer800 illustratively includes twovideo cards1230 and1232. Thefirst video card1230 drives both thedisplay screen802 onpatient assist cart740 and thefirst display screen1108 ondisplay1100. Thesecond video cart1232 drives thesecond display screen1110 ondisplay1100. In other words, the images ondisplay screen802 anddisplay screen1108 are the same. This reduces the cost ofcomputer800.
• FIG. 84 is a block diagram illustrating one embodiment of electronic circuitry for coupling the[0179]computer800 located on apatient assist cart740 or work station to a dualmonitor display screen1100 coupled to anarm804,1122 in the room. Thecomputer800 on the patient assistcart740 includes a firewire link to thedual screen display1100.Main computer800 illustratively includes a mux-demux for video, touch screen, TCI/IP communications over the firewire connection. Theremote display1100 has mux-demux with a microcontroller for firewire protocol handling. It is understood that other types of transmission line systems may be used to couplecomputer800 todisplay1100. For instance, a Low Voltage Differential Signaling (LVDS) interface may be used to couplecomputer800 todual display screen1100.
• FIG. 85 is a block diagram illustrating an alternative embodiment of electronic circuitry for[0180]coupling computer800 located on the patient assistcart740 to the dualmonitor display screen1100. The FIG. 85 embodiment,computer800 includes mux-demux for sending PCI bus signals over the fire wire connection.Display1100 has mux-demux with a microcontroller to convert PCI bus signals back to parallel form. LVDS is also an alternative to the firewire in this configuration. FIG.86 illustrates yet another embodiment of the electronic circuitry for coupling thecomputer800 on the patient assistcart740 to the dualmonitor display screen1110 on thesupport arm804,1122 within thehospital room1200.
• Although the invention has been described in detail with reference to certain illustrated embodiments, variations exist within the scope and spirit of the invention as described and as defined in the following claims.[0181]

Claims (101)

1. A patient monitoring system comprising:

a computer;

an input device coupled to the computer and configured to input patient information; and

first and second display screens coupled to the computer, the computer displaying a first portion of the patient information on the first display screen and a second portion of the patient information on the second display screen.

2. The apparatus ofclaim 1, wherein the patient information is displayed on a patient chart including patient vital signs taken at predetermined times over a predetermined period of time.

3. The apparatus ofclaim 1, wherein the input device includes at least one of a physiological monitor, a wireless data receiver, and a manual input device.

4. The apparatus ofclaim 3, wherein the physiological monitor includes at least one of a heart rate monitor, a temperature sensor, a blood pressure monitor, a blood oxygen level monitor, a scale, an EKG monitor.

5. The apparatus ofclaim 3, wherein the manual input device is one of a pen based input device, a keyboard, a mouse, a bar code reader, or a voice recognition input device.

6. The apparatus ofclaim 1, wherein the input device includes a physiological monitor coupled to the computer to provide a real time data input to the computer for storing and displaying patient information.

7. The apparatus ofclaim 1, wherein the first and second displays are coupled to a base.

8. The apparatus ofclaim 7, wherein the second display, the input device, and the computer are removable from the base as a separate module for transport with the patient.

9. The apparatus ofclaim 1, further comprising a third display coupled to the computer, the patient information being displayed on each of the first, second, and third display screens.

10. The apparatus ofclaim 8, wherein the third display, the input device, and the computer are separate from the first and second displays for transport with the patient.

11. The apparatus ofclaim 1, wherein the first display screen is larger than the second display screen.

12. The apparatus ofclaim 11, wherein the first and second displays are coupled to a base so that a top edge of the first and second displays are aligned with each other.

13. The apparatus ofclaim 12, wherein a portion of the larger first display screen adjacent a bottom edge of the first display screen provides a region for at least one of a menu display area, a pen-based input device, and a touch screen input device.

14. The apparatus ofclaim 12, wherein the smaller second display, the input device, and the computer are removable from the first larger display screen as a separate module for transport with the patient.

15. The apparatus ofclaim 1, wherein the computer is coupled to a communication network to transmit patient information to a remote location and to receive patient information from the remote location.

16. A system comprising:

a computer including a memory;

a medical device for treating a patient, the medical device including an indicator configured to provide a signal indicating when the medical device is in use to treat the patient; and

a coupler coupled to the computer for receiving the input signal from the indicator, the computer being configured to store the amount of time that the medical device is in use to treat the patient in the memory.

17. The apparatus ofclaim 16, wherein the computer is configured to generate a bill for use of the medical device based upon the amount of time that the medical device is used to treat the patient.

18. The apparatus ofclaim 17, wherein the medical device includes a unique identification so that the computer generates an itemized bill indicating the particular medical device used to treat the patient.

19. The apparatus ofclaim 16, wherein the indicator includes a wireless data transmitter and the coupler is a wireless data receiver.

20. The apparatus ofclaim 19, wherein the coupler is also configured to receive a signal from a wireless data transmitter badge worn by a caregiver when the caregiver enters a room in which the computer and the patient are located.

21. The apparatus ofclaim 20, wherein the computer records the amount of time that the caregiver is in the patient's room.

22. The apparatus ofclaim 21, wherein the computer is configured to generate a bill for caregiver time based upon the amount of time that the caregiver was in the patient's room.

23. The apparatus ofclaim 20, wherein the computer is configured to recognize a particular caregiver located in the room and automatically log the caregiver on to the computer.

24. A patient care computer system for use by a caregiver wearing an identification badge which includes a wireless data transmitter that uniquely identifying each caregiver, the apparatus comprising:

a computer including a memory for storing patient information;

a display screen coupled to the computer;

an input device coupled to the computer for inputting patient information;

a wireless data receiver coupled to the computer; and

means for detecting when a caregiver enters a room in which the computer and patient are located, the detecting means determining whether the caregiver is authorized to use the computer system and, if so, automatically logging the caregiver in to the computer system.

25. The apparatus ofclaim 24, wherein the computer automatically provides an indication of any messages for the particular caregiver logged in to the system on the display screen.

26. The apparatus ofclaim 25, wherein the computer is coupled to a communication network for receiving information and messages from a remote location and for transmitting information and messages to the remote location.

27. The apparatus ofclaim 25, wherein the messages include both voice mail messages and e-mail messages.

28. The apparatus ofclaim 24, wherein the input device includes at least one of a physiological monitor and a manual input device.

29. The apparatus ofclaim 24, wherein the computer system determines the amount of time that the particular caregiver is located in the room and stores the time in the memory.

30. The apparatus ofclaim 29, wherein the computer system generates a bill for caregiver time based upon the actual amount of time that the caregiver is in the room treating the patient.

31. The apparatus ofclaim 24, wherein the computer system is configured to log on all authorized caregivers within the room so that all the caregivers can access the system.

32. The apparatus ofclaim 24, further comprising a medical device for treating the patient, the medical device including an indicator configured to provide a signal indicating when the medical device is in use to treat the patient, the wireless data receiver being configured to receive a signal from the indicator so that the computer stores the amount of time that the medical device is in use to treat the patient in the memory of the computer.

33. The apparatus ofclaim 32, wherein the computer is configured to generate a bill for use of the medical device based upon the amount of time that the medical device is used to treat the patient.

34. A system comprising:

means for monitoring at least one physiological condition of a patient on a real time basis;

means for recording information related to a treatment of the patient and the time that the treatment was given to the patient; and

means for determining the effectiveness of the treatment of the patient by further monitoring the physiological conditions on a real time basis after the treatment.

35. The apparatus ofclaim 34, wherein the treatment includes at least one of a drug treatment, an IV treatment, and a therapy device treatment.

36. The apparatus ofclaim 34, wherein the patient is located on a patient support surface and the treatment includes a therapy performed by the patient support surface including at least one of rotational therapy, percussion therapy, vibration therapy and thermal treatment therapy.

37. The apparatus ofclaim 34, wherein the treatment is a therapy device performing therapy on the patient, the system including a computer for monitoring the amount of time that the therapy is performed.

38. The apparatus ofclaim 34, wherein the system includes a computer and a display screen coupled to the computer, the computer displaying the physiological conditions of the patient on a real time basis and also displaying the times that the treatments occur on the display screen so that a caregiver can monitor the effectiveness of the treatments.

39. A computer system assigned to a patient or to a bed, cart or other device upon which the patient rests or with which the patient is associated, the system comprising a computer, a plurality of devices for sensing various physical conditions and characteristics of the patient, each device having an output coupled to the computer, and a display arranged to present information related to the patient.

40. The system ofclaim 39, wherein the system comprises a plurality of input devices for inputting data and instructions concerning the patient.

41. The system ofclaim 39, wherein the system is configured to store and retrieve data concerning the patient and the sensing devices and to display such data over a period of time to show relationships on a time basis.

42. The system ofclaim 39, wherein the system comprises a memory in which the patient's history is stored for retrieval and display.

43. The system ofclaim 39, wherein the system comprises sensing devices including at least one of heart rate sensors, respiratory rate sensors, neurological monitoring sensors, and temperature sensors.

44. The system ofclaim 39, wherein the system comprises means for inputting fluid, electrolyte and nutrition data into the memory on a time basis.

45. The system ofclaim 39, wherein the system comprises a communication network providing for remote monitoring of patient data and remote inputting of data and instructions.

46. The system ofclaim 39, wherein the system further comprises a video imaging input to the computer to provide images of the patient.

47. The system ofclaim 39, wherein the system further comprises ultrasound image input to the computer.

48. The system ofclaim 39, wherein the system further comprises an x-ray image input to the computer.

49. The system ofclaim 39 in which the patient status and condition is stored and used for a time-based presentation on the display.

50. A system for monitoring patient information, the computer system comprising:

a processor;

a memory coupled to the processor;

a user interface coupled to the processor to permit a caregiver to input instructions into the system;

a display screen coupled to the processor;

a power supply coupled to the processor; and

a connector module configured to couple the system to a medical device including at least one of a physiological monitor, a treatment device, and a therapy device, the medical device using the processor, the user interface, the power supply, and the display of the system to operate the medical device, thereby reducing redundant components in the medical device.

51. The apparatus ofclaim 50, wherein the medical device includes at least one of a vital signs monitor, an IV pump, a ventilator, a defibrilator, a compression boot and the like.

52. The apparatus ofclaim 50, wherein the user interface includes a voice recognition input device.

53. The apparatus ofclaim 50, wherein the user interface is a graphical user interface.

54. The apparatus ofclaim 50, wherein a plurality of medical devices are coupled to the computer system, the computer monitoring output signals from the medical devices on a real time basis to provide a time-based presentation of patient information on the display screen.

55. A patient monitoring system comprising:

a computer;

a display screen coupled to the computer; and

a plurality of physiological monitors coupled to the computer, the computer displaying at least two indicators on the display screen related to at least two of a heart rate signal, a respiratory rate, fluid/electrolyte/nutrition information, temperature, neurological monitoring, and blood pressure.

56. The system ofclaim 55, wherein at least three indicators are displayed.

57. The system ofclaim 55, wherein at least four indicators are displayed.

58. The system ofclaim 55, wherein at least five indicators are displayed.

59. A patient assist apparatus comprising:

a base having a plurality of casters;

a support coupled to the base;

an IV pole coupled to the support; and

a brake mechanism coupled to at least one of the casters and to the support, brake mechanism being configured to brake the at least one caster when a predetermined weight is applied to the support.

60. The apparatus ofclaim 59, further comprising a seat coupled to the support, the brake mechanism being configured to brake the at least one caster when the predetermined weight is applied to the seat.

61. The apparatus of59, further comprising a handle assembly coupled to the support, the brake mechanism being configured to apply the brake to the at least one caster when the predetermined weight is applied to the handle assembly, and a coupling mechanism configured to secure the handle assembly to the support, the coupling mechanism being adjustable to permit a height of the handle assembly on the support to be adjusted.

62. The apparatus of59, further comprising a spring configured to bias the support upwardly relative to the base and a link coupled between the support and the brake mechanism, the support moving downwardly when the predetermined weight is applied to the support, thereby moving the link to actuate the brake mechanism.

63. A walker apparatus comprising:

a base;

a support coupled to the base, the support including a handle configured to be gripped by a patient;

a seat having a first end portion and a spaced apart second end portion, the first end portion being pivotably coupled to the support so that the seat is movable between an upwardly pivoted seating position and a downwardly pivoted storage position; and

a seat support pivotably coupled to the second end portion of the seat, the seat support being movable from a first position aligned generally parallel with the seat and a second position aligned transverse to the seat to support the seat in the seating position.

64. The apparatus ofclaim 63, further comprising a coupler configured to attach the seat support to the seat, the coupler being configured to hold the seat support in the second position automatically when the seat is moved to its upwardly pivoted seating position.

65. The apparatus ofclaim 63, wherein the base includes a plurality of casters.

66. The apparatus ofclaim 63, wherein the seat support is formed to include first and second spaced apart legs configured to engage the base to support the seat in the seating position.

67. The apparatus ofclaim 63, wherein the seat support is formed from a continuous elongated piece of material configured to define the seat support.

68. The apparatus ofclaim 63, wherein the seat is aligned generally perpendicular to the support when the seat is in its upwardly pivoted seating position and the seat is aligned generally parallel to the support when the seat is in the downwardly pivoted storage position.

69. A patient assist apparatus comprising:

a walker having a handle to assist movement of a patient;

a computer coupled to the walker;

a display coupled to the computer; and

a movable arm having a first end coupled to the walker and a second end coupled to the display.

70. The apparatus ofclaim 69, wherein the walker includes a base having a plurality of casters and a support coupled to the base, the handle being coupled to the support.

71. The apparatus ofclaim 69, further comprising a plurality of IV poles coupled to the support.

72. The apparatus ofclaim 69, further comprising a battery coupled to the walker and the computer.

73. The apparatus ofclaim 72, further comprising a battery charger coupled to the walker and the battery.

74. The apparatus ofclaim 69, further comprising an isolation transformer coupled to the walker.

75. The apparatus ofclaim 69, further comprising an input device coupled to the computer and configured to input patient information.

76. The apparatus ofclaim 75, wherein the display includes first and second display screens coupled to the computer, the computer displaying a first portion of the patient information on the first display screen and a second portion of the patient information on the second display screen.

77. The apparatus ofclaim 69, wherein the input device includes at least one of a physiological monitor, a wireless data receiver, and a manual input device.

78. The apparatus ofclaim 77, wherein the physiological monitor includes at least one of a heart rate monitor, a temperature sensor, a blood pressure monitor, a blood oxygen level monitor, a scale, an EKG monitor.

79. The apparatus ofclaim 77, wherein the manual input device is one of a pen based input device, a keyboard, a mouse, a bar code reader, or a voice recognition input device.

80. The apparatus ofclaim 75, wherein the input device includes a physiological monitor coupled to the computer to provide a real time data input to the computer.

81. A patient assist apparatus comprising:

a base having a plurality of casters;

a support coupled to the base, the support having first and second sides;

a latch mechanism coupled to the first side of the support, the latch mechanism being configured to couple the support to a patient support apparatus; and

a handle assembly coupled to the support, the handle assembly including first and second handles movable from a first orientation located on the first side of the support to provide support handles for a patient to a second orientation located on the second side of the support to provide push handles for use when the support is coupled to the patient support apparatus.

82. The apparatus ofclaim 81, further comprising a locking mechanism configured to secure the first and second handles in the second orientation.

83. The apparatus ofclaim 81, wherein the patient support apparatus is a bed.

84. The apparatus ofclaim 81, wherein the patient support apparatus is a wheelchair.

85. The apparatus ofclaim 81, further comprising a computer coupled to the support, the computer including a physiological monitoring module configured to receive data from the patient.

86. The apparatus ofclaim 85, further comprising a display screen coupled to the computer and a movable arm having a first end coupled to the support and a second end coupled to the display screen.

87. The apparatus ofclaim 81, further comprising a coupling mechanism configured to secure the handle assembly to the support, the coupling mechanism being adjustable to permit a height of the handle assembly on the support to be adjusted.

88. A patient computer system comprising:

a display having first and second display screens located in a room;

a cart configured to move with a patient outside the room and to remain with the patient inside the room;

a computer coupled to the cart; and

a third display screen coupled to the cart, the computer being coupled to the third display screen and being coupled to the first and second display screens when the cart is in the room.

89. The apparatus ofclaim 88, wherein the computer includes first and second video cards, the first video card being configured to drive the first and third display screens, the second video card being configured to drive the second display screen.

90. The apparatus ofclaim 88, further comprising an input device coupled to the computer and configured to input patient information.

91. The apparatus ofclaim 90, wherein the computer displays a first portion of the patient information on the first display screen and a second portion of the patient information on the second display screen.

92. The apparatus ofclaim 90, wherein the input device includes at least one of a physiological monitor, a wireless data receiver, and a manual input device.

93. The apparatus ofclaim 92, wherein the physiological monitor includes at least one of a heart rate monitor, a temperature sensor, a blood pressure monitor, a blood oxygen level monitor, a scale, an EKG monitor.

94. The apparatus ofclaim 92, wherein the manual input device is one of a pen based input device, a keyboard, a mouse, a bar code reader, or a voice recognition input device.

95. The apparatus ofclaim 90, wherein the input device includes a physiological monitor coupled to the computer to provide a real time data input to the computer.

96. A display for a computer, the display comprising:

a housing having an interior region;

a first display screen located in a first portion of the interior region of the housing; and

a second display screen located in a second portion of the interior region of the housing, the first and second display screens being coupled to the computer so that the computer displays information on both the first and second display screens.

97. The apparatus ofclaim 96, wherein the housing includes a first portion and a second portion coupled to the first portion by a waterproof seal.

98. The apparatus ofclaim 96, wherein the information displayed on the patient chart including patient vital signs taking a predetermined times over a predetermined time period.

99. The apparatus ofclaim 96, further comprising a microphone located in the interior region of the housing.

100. The apparatus ofclaim 96, further comprising a video camera located in the interior region of the housing.

101. The apparatus ofclaim 96, wherein the first display screen and the second display screen each provide a touch screen input device.

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