US20110093287A1 - Methods for personal emergency intervention - Google Patents

Abstract

There are provided methods and systems for personal emergency Intervention, comprising determining that an event regarding a patient has occurred, and thereupon enabling a tracking mode in a device controlled by the patient; monitoring one or more conditions to determine whether the tracking mode should be disabled, and until the tracking mode is disabled, the device: obtains a data pairing, the data pairing comprising a location of the patient and a time related to the location of the patient, and stores the data pairing within a memory in the device; and formatting a report for transmission to a medical data server, the report comprising at least a patient identifier for the patient and the data pairing. This method can be practiced automatically to allow a device controlled by a patient or other subject to be monitored without requiring the patient to manually enter information. Methods and systems also provide for networked implementations of personal emergency tracking in a defined locality and relay of emergency assistance through audial communications with the patient.

Description

CROSS-REFERENCE TO RELATED APPLICATION
• This application claims priority to U.S. Provisional Patent Application Ser. No. 60/862,743, filed Oct. 24, 2006; and claims priority to and is a continuation of: U.S. Patent Publication No. 20080097908 filed as U.S. Utility patent application Ser. No. 11/876,689 on Oct. 22, 2007; U.S. Patent Publication No. 20080097909 filed as U.S. Utility patent application Ser. No. 11/876,695 on Oct. 22, 2007; U.S. Patent Publication No. 20080097551 filed as U.S. Utility patent application Ser. No. 11/876,708 on Oct. 22, 2007; U.S. Patent Publication No. 20080103554 filed as U.S. Utility patent application Ser. No. 11/876,711 on Oct. 22, 2007; U.S. Patent Publication No. 20080103370 filed as U.S. Utility patent application Ser. No. 11/876,713 on Oct. 22, 2007; U.S. Patent Publication No. 20080097910 filed as U.S. Utility patent application Ser. No. 11/876,719 on Oct. 22, 2007; U.S. Patent Publication No. 20080215360 filed as U.S. Utility patent application Ser. No. 11/876,725 on Oct. 22, 2007; U.S. Patent Publication No. 20080097911 filed as U.S. Utility patent application Ser. No. 11/876,744 on Oct. 22, 2007; U.S. Patent Publication No. 20080097552 filed as U.S. Utility patent application Ser. No. 11/876,732 on Oct. 22, 2007; U.S. Patent Publication No. 20080097917 filed as U.S. Utility patent application Ser. No. 11/877,525 on Oct. 23, 2007; U.S. Patent Publication No. 20080103555 filed as U.S. Utility patent application Ser. No. 11/877,541 on Oct. 23, 2007; U.S. Patent Publication No. 20080218376 filed as U.S. Utility patent application Ser. No. 11/877,550 on Oct. 23, 2007; U.S. Patent Publication No. 20080224852 filed as U.S. Utility patent application Ser. No. 11/877,582 on Oct. 23, 2007; U.S. Patent Publication No. 20080097550 filed as U.S. Utility patent application Ser. No. 11/877,930 on Oct. 24, 2007; U.S. Patent Publication No. 20080183502 filed as U.S. Utility patent application Ser. No. 11/877,946 on Oct. 24, 2007; U.S. Patent Publication No. 20090234672 filed as U.S. Utility patent application Ser. No. 11/877,966 on Oct. 24, 2007; U.S. Patent Publication No. 20080097793 filed as U.S. Utility patent application Ser. No. 11/877,994 on Oct. 24, 2007; and U.S. Patent Publication No. 20090112769 filed as U.S. Utility patent application Ser. No. 11/923,013 on Oct. 24, 2007; the disclosures of which are incorporated by reference in their entirety for all purposes.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
• Not applicable.
NOTICE OF INCLUDED COPYRIGHTED MATERIAL
• A portion of the disclosure of this patent document contains material which is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever. All trademarks and service marks identified herein are owned by the applicant.
DESCRIPTION OF THE INVENTION
• 1. Field of the Invention
• The present invention relates to systems and methods for remote patient monitoring, and more particularly, to systems and methods for providing mobile personal emergency response and tracking.
• 2. Background of the Invention
• Historically, patient medical care was often provided for in the patient's home or some other environment apart from a clinical setting. Physicians, midwives, or other healthcare providers would make house calls, observe patient symptoms, formulate diagnoses, and provide treatment. As the state of the art of health care evolved over time, the number of house calls made by healthcare professionals diminished. In large part, health care providers conducted fewer and fewer house calls because it became impractical to bring bulky medical diagnosis and test equipment to the patient. Likewise, it was not cost effective or intellectually feasible for patients to purchase and operate the complicated and expensive medical machines in a home setting. Therefore, the health care model changed dramatically, emphasizing patient visits to health care facilities where an assortment of state-of-the-art test equipment would be available to assist doctors in more accurately assessing and treating patients. This meant that patients were now expected to come to the doctor, rather than the other way around.
• Innovations in electronics in the last twenty years have made available a large number of more affordable and patient-operable medical devices that obviated, at least in part, the need for the patient to go to a facility each time a medical test or device checkup was required. Size and expense were not the only factors making this possible; since the new devices provided sophisticated processing in smaller form factors, the technical complexity required to operate the devices were reduced to a level that would not overwhelm a layperson's knowledge. Unfortunately, although portable medical devices such as blood glucose meters now allow patients to perform tests outside the context of medical facilities, patients still need to meet with health care providers to discuss the results obtained.
• Some medical devices include ports to allow the communication of data to and from the medical device through a cable or other wired connection. Medical devices that communicate through such wired connections allow healthcare providers to monitor the operation of the medical device, as well as to optionally monitor a patient's biological and biometric information, the patient's behavior, and other information pertinent to the treatment of the patient. However, the manner in which medical devices communicate data varies depending on the type and manufacturer of the device, and therefore, proprietary equipment has been designed to communicate with medical devices only using a specific type of wired connection based on the type of medical device being used.
• Medical devices can communicate through a wide range of wired connections. In the context of this application, “wired connection” generally refers to any physical connection that a medical device can communicate through. For example, “wired connections” can also refer to a waveguide, such as an optical fiber. Other wired connections that can be used by various medical devices include various sizes of tip and sleeve (TS), tip, ring, and sleeve (TRS), and tip, ring, ring, and sleeve (TRRS) connections. Such connections are also commonly referred to as “RCA plugs,” “phone plugs,” and “stereo jacks” and commonly include plug diameters of 2.5 mm and 3.5 mm when used with medical devices. Other wired connections, such as serial peripheral interface bus (SPI) connections, universal serial bus (USB) connections, RS-232 serial connections, Firewire (IEEE 1394) and Ethernet connections may also be used. A wired connection can also include any soldered electrical connection, trace on a circuit board, or other physical connection. Each of these connections vary not only in the physical structure of the connection, but also in the communication protocols used to transfer data. It would thus be desirable to have the capability to communicate with a variety of medical devices regardless of the specific wired connection they use.
• To make patient monitoring more convenient, Remote Patient Monitoring (RPM) was developed. Remote Patient Monitoring (RPM) generally refers to monitoring one or more conditions of a patient without requiring the patient to visit a hospital, doctor's office, or other healthcare facility. RPM can increase the efficiency and effectiveness of providing care to patients while reducing costs. RPM can be particularly useful when a patient has a long-term or chronic disease that would otherwise require frequent visits to a healthcare facility and/or where a patient's treatment regimen should be modified based on changed patient conditions that are monitored by one or more medical devices, such as a pacemaker or glucose meter. For example, Type-I Diabetes patients (a lifelong condition) use glucose meters to monitor their blood sugar level to assist in determining when to take insulin—it would be desirable if such information could be quickly, easily, and effectively relayed to a heath care provider for review and analysis.
• Conventional RPM generally involves the use of a specific monitoring device installed in a patient's home. The device collects data concerning the patient's condition and relays the data to a healthcare provider. Some conventional systems require a patient to manually enter the data. For example, a diabetes patient using a conventional system for RPM may be required to sample their blood sugar level using a glucose meter, take note of the reading, and then manually enter the level in the conventional system. There are drawbacks with these conventional devices. Because of their complexity and proprietary interfaces, many are very expensive, which reduces the cost-savings benefit of RPM. Additionally, they often require a land-line connection (such as phone or VPN) to transmit data and/or are physically bulky/heavy and therefore difficult to transport. Furthermore, conventional systems are often unable to provide data to healthcare providers quickly where data must be manually entered by a patient, which can reduce the level of benefit the patient receives from RPM. What is needed, then, is a system to allow health care providers to freely access patient-related health data, enabling the provider to conduct a virtual house call. What is also needed is a portable device and system that interoperates with a variety of medical devices utilizing a broad range of wired connections to receive medical data, and provides for management and transport of that data to a healthcare provider.
SUMMARY OF THE INVENTION
• Methods and systems according to the present invention may operate in conjunction with any wired connection, including those described above, and may operate in conjunction with multiple wired connections. In exemplary embodiments, methods and systems according to the present invention may be configured to receive medical device data transmitted in any format and from any medical device. One method according to the present invention includes receiving data through a wired connection from a medical device, transmitting the data to an intermediary device (such as a properly equipped mobile telephone or personal digital assistant), and formatting a message including the received data for transmission to a medical data server. The intermediary device includes a software program configured to receive the data and process it into a format compatible with the medical data server. In another aspect, a method according to the present invention includes receiving data through a wired connection from a medical device, transmitting the data to an intermediary device (such as a properly equipped mobile telephone or personal digital assistant), formatting a message including the received data for transmission to a medical data server, and receiving a command from the medical data server.
• Another method according to aspects of the present invention includes receiving data through a wired connection from a medical device, transmitting the data to an intermediary device, formatting a message including the received data for transmission to a medical data server, and transmitting the formatted message from the intermediary device to the medical data server. Once at the medical data server the information can be reviewed by a healthcare professional at a location remote to the patient. This method may be practiced automatically, either continuously or at set intervals, or may be initiated by someone utilizing the system (such as the patient or health care provider). The method preferably functions without the need for the patient to manually enter information into a device. This method optionally allows for multiple different medical devices used by a single patient to be monitored, even if each of the devices communicate through different wired connections and/or use different communication protocols.
• A method according to another aspect of the present invention includes receiving data through a wired connection from a medical device by a first device, storing the data by the first device, transmitting the data to a second device by the first device, and transmitting the data from the second device to a medical data server. The data can be stored for any desired length of time, and/or until a particular event occurs. For example, the data can be stored until it is verified that the second device and/or the medical data server have received the data, allowing the data to be retransmitted if necessary. In various embodiments, commands from a medical data server of the present invention can be used for the authentication, configuration, and control of the medical device, intermediary device or another device operating in conjunction with the present invention, as well as to achieve other purposes.
• A method according to another aspect of the present invention includes receiving data through a wired connection from a medical device, transmitting the data to an intermediary device, formatting a message including the received data for transmission to a medical data server, receiving a command from the medical data server, and encrypting one or more of the received data, a portion of the received data, and a digest of the received data. The encryption can be implemented using combinations of public and private keys, and allows sensitive medical data for a patient to be securely transmitted to the intermediary device and/or medical data server without being viewed by unintended recipients.
• One method according to the present invention includes activating a first device in response to an event, receiving data through a wired connection from a medical device by the first device, transmitting the data to a second device (such as a properly equipped mobile telephone or personal digital assistant) by the first device, and transmitting the data from the second device to a medical data server. Once at the medical data server the information can be reviewed by a healthcare professional at a location remote to the patient. This method may be practiced automatically, either continuously or at set intervals, or may be initiated by someone utilizing the system (such as the patient or health care provider). The method preferably functions without the need for the patient to manually enter information into a device. This method allows the first device to be activated only as necessary to communicate with the medical device in order to conserve battery life.
• One method according to the present invention includes receiving data through a wired connection from a medical device by a mobile computing device, where the wired connection includes an adapter that communicates with the mobile computing device using a first communication format and the medical device using a second communication format. The method further includes formatting a message including the received data for transmission to a medical data server by the mobile computing device. Once at the medical data server the information can be reviewed by a healthcare professional at a location remote to the patient. This method may be practiced automatically, either continuously or at set intervals, or may be initiated by someone utilizing the system (such as the patient or health care provider). The method preferably functions without the need for the patient to manually enter information into a device. This method optionally allows for multiple different medical devices used by a single patient to be monitored, even if each of the devices communicate through different wired connections and/or use different communication protocols. The mobile computing device can be a properly-equipped cellular telephone, PDA, or other a small, portable device that is easy for a patient to transport.
• A method according to another aspect of the present invention includes receiving data through a wired connection from a medical device by a mobile computing device, where the wired connection includes an adapter that communicates with the mobile computing device using a first communication format and the medical device using a second communication format. The method further includes formatting a message including the received data for transmission to a medical data server by the mobile computing device and encrypting one or more of the received data, a portion of the received data, and a digest of the received data. The encryption can be implemented using combinations of public and private keys, and allows sensitive medical data for a patient to be securely transmitted to the intermediary device and/or medical data server without being viewed by unintended recipients.
• A system according to one aspect of the present invention comprises a processor, a plurality of device interfaces, a data relay transceiver, and a memory coupled to the processor and storing instructions. Those of skill in the relevant arts understand that the data relay transceivers referenced herein may comprise a receiver, a transmitter, or both a receiver and transmitter, and may receive and/or transmit electrical signals, radio frequency signals, modulated light signals, sonic signals, or other signals propagated through a suitable medium. The processor executes the instructions in the memory to receive data from one or more medical devices through a wired connection coupled to at least one of the device interfaces (which gathers data concerning the patient's condition), and transmits the data to an intermediary device using the data relay transceiver. This system can be implemented in a small, portable unit that is easy for a patient to transport. For example, the unit could be the size of a cell phone or contained within a cell phone, or could be a small accessory device that is connected to the medical device, such as in a container in which the medical device is also situated. In various embodiments, the user interface of a system of the present invention may include a microphone and speaker to allow the communication of audible information between the system and a user.
• In another embodiment, a system according to another aspect of the present invention comprises a processor, a device interface configured to receive data from one or more different medical devices, a data relay transceiver, and a memory coupled to the processor and storing instructions. The processor executes the instructions in the memory to receive data from the one or more medical devices through a wired connection using the device interface and transmits the data to an intermediary device using the data relay transceiver.
• The system can communicate with multiple medical devices, regardless of the type of wired connection or communications protocol utilized by each of the medical devices, and can retransmit (and optionally reformat) data from the medical device(s) to any desired recipient using any suitable frequency(ies) and communication protocol(s). While certain embodiments operate with radio frequency protocols such as BlueTooth and WiFi, other embodiments may utilize non-rf communications protocols such as modulated infrared light (e.g. IrDA). Once at the medical data server the information can be reviewed by a healthcare professional at a location remote to the patient.
• A system according to another aspect of the present invention comprises a processor, a plurality of device interfaces, a data relay transceiver, and a memory coupled to the processor and storing instructions. The processor executes the instructions in the memory to receive data from one or more medical devices through a wired connection coupled to at least one of the device interfaces, transmits the data to an intermediary device using the data relay transceiver, and encrypts the data. The data can be encrypted using a combination of public and private keys, and allows sensitive medical data for a patient to be securely transmitted to the intermediary device and/or medical data server without being viewed by unintended recipients.
• A system according to one aspect of the present invention comprises a processor, a device interface, a data relay transceiver, and a memory coupled to the processor and storing instructions. Those of skill in the relevant arts understand that the data relay transceiver referenced herein may comprise a receiver, a transmitter, or both a receiver and transmitter, and may receive and/or transmit electrical signals, radio frequency signals, modulated light signals, sonic signals, or other signals propagated through a suitable medium. The processor executes the instructions in the memory to receive data from a medical device through a wired connection using the device interface (which gathers data concerning the patient's condition), where the data is received through an adapter coupled to the device interface and that communicates with the medical data interchange device using a first communication format and with the medical device using a second communication format. The processor further executes the instructions in the memory to transmit the data to an intermediary device using the data relay transceiver. This system can be implemented in a small, portable unit that is easy for a patient to transport. For example, the unit could be the size of a cell phone or contained within a cell phone, or could be a small accessory device that is connected to the medical device, such as in a container in which the medical device is also situated. As with the method described above, the system can optionally communicate with multiple medical devices, regardless of the type of wired connection or communications protocol utilized by each of the medical devices, and can retransmit (and optionally reformat) data from the medical device(s) to any desired recipient using any suitable frequency(ies) and communication protocol(s). The adapter can be removably coupled to the medical data interchange device to allow different adapters configured to communicate with different medical devices to be used with a single medical data interchange device.
• A system according to another aspect of the present invention comprises a processor, a device interface, a data relay transceiver, and a memory coupled to the processor and storing instructions. The processor executes the instructions in the memory to receive data from a medical device through a wired connection using the device interface where the data is received through an adapter coupled to the device interface and that communicates with the medical data interchange device using a first communication format and with the medical device using a second communication format. The processor further executes the instructions in the memory to encrypt the data and to transmit the data to an intermediary device using the data relay transceiver. The encryption can be implemented using combinations of public and private keys, and allows sensitive medical data for a patient to be securely transmitted to the intermediary device and/or medical data server without being viewed by unintended recipients.
• Embodiments of the present invention may be used to monitor any appropriate medical device from essentially any location from which a communications signal can be sent and received. This enables patients to enjoy an active lifestyle by not being tied to medical device monitoring equipment that is difficult or impossible to transport or having to routinely visit health care facilities. The present invention can be used to monitor any amount and type of data from any medical device.
• The present invention can also be used for a variety of other monitoring purposes. For example, the present invention can be used to monitor a blood alcohol monitor, alcohol breathalyzer, or alcohol ignition interlock device to help insure a driver does not operate a motor vehicle under the influence of alcohol or other substance. The present invention can also be used in conjunction with a Global Positioning System (GPS) or other geolocation device to monitor the position of a patient. The present invention may also be used in a wide variety of military applications, such as remotely monitoring devices tracking the health status of soldiers on a battlefield in real-time in order to quickly dispatch aid to wounded soldiers. The present invention may be used to remotely monitor a chemical, biological agent, or radiation sensor carried by a soldier to detect an attack by unconventional weaponry.
• Embodiments of the medical device of the present invention may transmit on any frequency using any format and protocol. For example, various medical devices transmit data in the Wireless Medical Telemetry Service (WMTS) frequency bands. There are three WMTS frequency bands, including frequencies from 608 MHz to 614 MHz, 1395 MHz to 1400 MHz, and 1427 MHz to 1432 MHz. In another example, the medical device may transmit using the Medical Implant Communications Service (MICS) frequency band, including frequencies from 402 MHz to 405 MHz. In yet another example a medical device may transmit data in the 32 KHz to 175 KHz range.
• In an alternate embodiment, there is provided a method and system for personal emergency Intervention, comprising determining that an event regarding a patient has occurred, and thereupon enabling a tracking mode in a device controlled by the patient; monitoring one or more conditions to determine whether the tracking mode should be disabled, and until the tracking mode is disabled, the device: obtains a data pairing, the data pairing comprising a location of the patient and a time related to the location of the patient, and stores the data pairing within a memory in the device; and formatting a report for transmission to a medical data server, the report comprising at least a patient identifier for the patient and the data pairing. The method further includes, until the tracking mode is disabled, determining whether a measurement for an updated data pairing should be taken, and whereupon the determination is made that the measurement for the updated data pairing should be taken, the device: obtains the updated data pairing comprising an updated location of the patient and a time related to the updated location of the patient; and stores the updated data pairing in the memory in the device.
• In various embodiments, the event may comprise any desired condition, in various embodiments, the event comprises the device controlled by the patient passing a predetermined geographical position, or when the device controlled by the patient passing a predetermined geographical position is detected when an RFID (radio frequency identification) tag in the device is sensed. Further, the event may comprise the patient not being within a predetermined proximity of a predetermined geographical location for a predetermined period of time, or determining that the patient has entered a request to enable the tracking mode through a user interface in the device, or determining that the patient has entered a request to enable the tracking mode by speaking a command to enable the tracking mode, or in another embodiment, the event comprises determining that the patient has experienced an increased risk to the patient's safety.
• Determining that the patient has experienced the increased risk to the patient's safety, in various embodiments, may comprise at least one of: determining that the patient is engaging in exercise; determining that the patient is using a restroom facility; determining that the patient is leaving a predetermined area; determining that the patient is entering a predetermined area; determining that the patient is located in a hazardous public situation; determining that the patient is experiencing a predetermined perceived medical condition; determining that the patient is experiencing a medical emergency; determining that the patient is experiencing a failed connection to a medical telemetry device; receiving a notification by a healthcare provider that the patient's safety is compromised; and receiving a notification by a law enforcement officer that the patient's safety is compromised. Upon any desired criterion, the device controlled by the patient may receive a command that instructs the device to enable the tracking mode.
• Both the foregoing summary and the following detailed description are exemplary and explanatory only and are not restrictive of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
• A more complete understanding of the present invention may be derived by referring to the detailed description and claims when considered in connection with the following illustrative figures.
• FIG. 1 is a flow diagram depicting an exemplary process for medical data interchange according to various aspects of the present invention.
• FIG. 2A is a block diagram depicting an exemplary system for medical data interchange according to various aspects of the present invention.
• FIG. 2B is a block diagram depicting another exemplary system for medical data interchange according to various aspects of the present invention.
• FIG. 2C is a block diagram depicting yet another exemplary system for medical data interchange according to various aspects of the present invention.
• FIGS. 3A and 3B depict top and rear views, respectively, of an external casing for a medical data interchange device according to various aspects of the present invention.
• FIGS. 3C and 3D depict perspective views of another embodiment of an external casing for a medical data interchange device according to various aspects of the present invention.
• FIG. 3E depicts a perspective view of yet another embodiment of an external casing for a medical data interchange device according to various aspects of the present invention.
• FIG. 4 depicts the interior of an exemplary container for holding a medical device and medical data interchange device according to various aspects of the present invention.
• FIGS. 5A and 5B are a circuit diagrams depicting elements of an exemplary medical data interchange device according to various aspects of the present invention.
• FIG. 6 is a circuit diagram illustrating elements of an exemplary embodiment of a smart cable with ID and wakeup capability.
• FIG. 7 is a circuit diagram illustrating elements of an alternate exemplary embodiment of a smart cable with ID capability.
• FIG. 8 is a block diagram depicting a container including light and motion sensors for activating a medical data interchange device in accordance with various aspects of the present invention.
• FIG. 9 is a flow diagram showing an exemplary process for authenticating access to a system component of the present invention.
DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS
• An exemplary method according to an aspect of the present invention is depicted inFIG. 1. In this method, an identifier is requested from a medical device (105), and data from the medical device is received (110) and validated (115) through a wired connection. An intermediary device such as a mobile phone or personal digital assistant is authenticated (120) and activated (125). The data is transmitted by the medical device to the intermediary device (130) and the transmission to the intermediary device is confirmed (135) and validated (140). The data is stored (145) in the intermediate device. A message is formatted (150) and transmitted to a medical data server (155). Optionally, a command can be received from the medical data server (160) and optionally relayed from the intermediary device. Any combination and/or subset of the elements of the method depicted inFIG. 1 may be practiced in any suitable order and in conjunction with any system, device, and/or process. The method shown inFIG. 1 can be implemented in any suitable manner, such as through software operating on one or more computer systems. Exemplary systems for performing elements of the method shown inFIG. 1 are discussed later in this description.
Request Medical Device ID
• In the exemplary process according to aspects of the present invention depicted inFIG. 1, an identifier is requested from a medical device providing the data to be monitored (105). Any suitable identifier may be provided, such as the serial number of the medical device and/or a numeric, alphabetic, alphanumeric, or symbolic identifier. The medical device identifier can be used to determine whether the correct medical device is being monitored. The medical device identifier can also be used to determine the manufacturer, model, type, characteristics, or other information pertinent to the medical device and/or the patient(s) it monitors. The medical device identifier may be received passively, such as from a medical device that automatically includes its identifier as part of its telemetry broadcast. Alternatively, the medical device can be polled to request the medical device identifier. The medical device identifier need not be requested from the medical device each time the medical device is being monitored. For example, the medical device identifier may be stored in a storage medium for future reference.
• Receive Data from a Medical Device Through a Wired Connection
• In the exemplary method shown inFIG. 1, data is received through a wired connection from the medical device (110). As stated previously, a “wired connection” in the context of this application refers generally to any physical connection that allows communication between two devices. Wired connections thus include, without limitation: tip and sleeve (TS), tip, ring, and sleeve (TRS), and tip, ring, ring, and sleeve (TRRS) connections; serial peripheral interface bus (SPI) connections; universal serial bus (USB) connections; RS-232 serial connections, Ethernet connections, optical fiber connections, and Firewire connections. Data from a medical device may be received using any number and combinations of such connections, as well as any other type of connection. Additionally, medical device may communicate data through a wired connection using any suitable format and communications protocol. Alternatively, a plurality of medical devices automatically transmitting data on the same frequency, in the same format, and potentially at the same time (such as in the case of multiple devices of the same type and/or from the same manufacturer) can be received in accordance with the present invention by, for example, using a separate wireless receiver keyed to a unique identifier associated with each medical device.
• Systems implementing the method depicted inFIG. 1 are preferably small, light, and portable, allowing patients monitored by medical devices to lead active lifestyles without being forced to remain close to a non-portable system receiving the data from the medical device. Data can be received from any medical device, such as a blood glucose meter, a pacemaker, a blood pressure monitor, an insulin pump, a pulse oximeter, a holter monitor, an electrocardiograph, an electroencephalograph, a blood alcohol monitor, an alcohol breathalyzer, an alcohol ignition interlock, a respiration monitor, an accelerometer, a skin galvanometer, a thermometer, a patient geolocation device, a scale, an intravenous flow regulator, patient height measuring device, a biochip assay device, a sphygmomanometer, a hazardous chemical agent monitor; an ionizing radiation sensor; a monitor for biological agents, a loop recorder, a spirometer, an event monitor, a prothrombin time (PT) monitor, an international normalized ratio (INR) monitor, a tremor sensor, a defibrillator, or any other medical device.
• A medical device that includes a combination of different medical devices (such as those listed previously) may be monitored in accordance with the present invention. The medical device can be partially or completely implanted in a patient, such as in the case of a pacemaker. Data from the medical device can be received through any number of other relay devices, such as routers, hubs, bridges, switches, and modems. Where the medical device is completely implanted in the patient, such relay devices can receive data from the medical device wirelessly and retransmit the data through a wired connection. The medical device may also be located externally to a patient. The medical device may be connected to a patient (for example, through one or more electrodes), or operate independent of any coupling to a patient, such as a scale. The medical device may also operate in conjunction with a temporary interfacing with a patient, such as the case of the cuff of a blood pressure monitor encompassing the arm of a patient to take a reading.
• The medical device data can be received by any person, system, device, or other suitable recipient. The exemplary method inFIG. 1 may be practiced manually by a human being, automatically by a device, or a combination of the two. Exemplary devices for performing the method illustrated inFIG. 1 are depicted inFIGS. 2A,2B, and2C, and are discussed in detail below.
• Data can be received directly from a medical device. For example, some medical devices such as glucose meters have ports that allow data to be communicated through a cable. As mentioned previously, a medical device can also provide data using another device, system, or other entity. In one embodiment of the present invention, for example, a medical device provides data through a serial port (a wired connection) to a computing device. The computing device is in turn connected to an Ethernet router or hub. The data can thus be received through an Ethernet connection from the router or hub. In another exemplary embodiment of the present invention, a human patient retrieves data from the medical device and then provides the data through a keypad, microphone, or other suitable input device.
• The medical device data can be received from a plurality of different medical devices, where each medical device may perform any combination of functions. For example, data from a glucose meter, blood pressure monitor, and combination scale/height measuring device each transmitting data in different formats and through different wired connections may each be received in accordance with the present invention. In the case where a plurality of medical devices transmits data in response to a request for data, each device in the plurality of devices can be sent such a request separately. Alternatively, a plurality of medical devices automatically transmitting data in the same format, and potentially at the same time (such as in the case of multiple devices of the same type and/or from the same manufacturer) can be received in accordance with the present invention by, for example, using separate wired connections. When data has been received from a plurality of medical devices, in one embodiment, a list of the medical devices may be displayed on a user interface, and optionally, the user may be prompted to select one, all, or none of the plurality medical devices, whose data is desired to be transmitted to the medical data server. The data for the selected set of medical devices is then relayed as described with alternate embodiments as described herein. Any other suitable method for receiving data from a plurality of medical devices may also be used in conjunction with the present invention.
• Any type of data may be received from a medical device. For example, the data may include information regarding a patient, such as the patient's biological and biometric information, the patient's behaviors, results of analysis of physical patient parameters, and information regarding the patient's environment. For example, a medical device such as a glucose meter could provide data regarding a patient's current (or last measured) blood glucose level, the date and time the patient last used the glucose meter, and the current temperature or other environmental factors that might affect a glucose test. Other possible environmental parameters that may be included in the data received from a medical device include a battery charge level, a temperature, a barometric pressure, a code relating to an accessory for the medical device, a data validity measurement, an elapsed time since a previous reading by the medical device, a test result parameter, a signal-to-noise parameter, and a quality of service (QoS), and combinations thereof. Data received from a medical device may also include any other suitable information, such as diagnostic information regarding the medical device.
• The medical device data may provide data relating to a single patient or multiple patients. In the case where a single medical device provides data regarding multiple patients, the data can be identified with an individual patient either in the data received by medical device (such as by using a patient identifier) or through processing in accordance with the present invention.
• The medical device can provide the data in any format. Different medical devices from different manufacturers often use different formats for providing data. For example, data from a glucose meter may be provided in a series of fixed-length data records followed by a terminator indicator (such as a null or other predefined character) and/or a checksum for validating the data. Any type of data may be provided. In the case of a glucose meter, the data may include one or more readings of a patient's blood glucose level and the date and time each reading was taken. The medical device identifier discussed previously may be used to determine a specific data format used by a medical device. Alternatively, a data format may be specified by a user or selected by analyzing the format of the data received and comparing it to a set of known medical device data formats.
Validate Data
• In the exemplary process shown inFIG. 1, the data from the medical device is validated (115). The data from the medical device can be validated in any suitable manner to achieve any result. For example, the data from the medical device may be validated to ensure it was transmitted properly and completely. The medical device data may also be validated to ensure it was provided from a specific medical device or particular type of medical device. The data may also be validated to ensure that fields in the data correspond to predetermined values and/or are within certain thresholds or tolerances. Any number, code, value or identifier can be used in conjunction with validating the medical device data. For example, the data can be validated by analyzing a medical device serial number, a medical device identifier, a patient identifier, one or more parity bits, a cyclic redundancy checking code, an error correction code, and/or any other suitable feature.
Authenticate/Authorize Intermediary Device
• In the exemplary method depicted inFIG. 1, an intermediary device receiving the data is authenticated (120). In the context of the present invention, the intermediary device includes any type of system or device capable of receiving the medical device data in any manner. Such intermediate devices may include, for example, personal computers, laptops, personal digital assistants, routers, hubs, bridges, switches, modems, and mobile computing devices. The intermediary device may process the data in any manner, and can transmit some or all of the data to another recipient, such as a medical data server. For example, but not by way of limitation, the intermediary device may include a personal computer or a mobile computing device, such as a laptop computer, a mobile wireless telephone, or a personal digital assistant (PDA). In an exemplary embodiment of the present invention, the intermediate device further includes software for receiving the medical device data, formatting a message based on the data, and transmitting the formatted message to a medical data server. Such software can operate on any suitable mobile computing device and with any computer operating system. The intermediary device may also include any number of other systems and devices suitable for receiving data from the medical device, processing the data, and/or transmitting the data to a medical data server. Further discussion regarding exemplary embodiments of intermediary devices is presented later in this description.
• The intermediary device can receive the data directly from the medical device, or from one or more other devices. In one exemplary embodiment of the present invention, the intermediary device comprises a mobile computing device and is configured to receive data from one or more medical devices directly through one or more wired connections. In another exemplary embodiment of the present invention, the medical device transmits the data to a first device through a wired connection, which in turn transmits the medical device data to the intermediary device (wirelessly or through a wired connection).
• The intermediary device may be authenticated to achieve any result. For example, transmission may be restricted only to authenticated devices operating as part of the present invention. Alternatively, For example, the intermediary device may be authenticated to restrict transmission of the data from the medical device to intermediary devices operating as part of the present invention. Authentication can also prevent sensitive medical data from being broadcast and viewed by unintended recipients. Authentication can also prevent sensitive medical data from being broadcast and/or viewed by unintended recipients. The intermediary device may also be authenticated to verify the intermediary device is able to receive, process, and/or transmit the medical device data to a medical data server. During authentication, the authenticated device or devices may also be remotely commanded, and such commands may include steps that configure devices to interoperate with components of the present invention. For example, but not by way of limitation, such steps may include the downloading of software applications, applets, embedded operating code, and/or data.
• The intermediary device can be authenticated in any manner. For example, an intermediary device can be authorized to receive data from one or more medical devices using an authorization code. The authorization code can be any number, code, value or identifier to allow the intermediary device to be identified as a valid recipient of the data from the medical device. In one exemplary embodiment of the present invention, an intermediary device stores an authorization code and broadcasts the authorization code in response to a request for authorization. Unless the authorization code matches a code stored by the transmitter of the medical device data (such as the medical device itself or another transmission device), the medical device data is not transmitted to the intermediary device. Transmission of the medical device data to the intermediary device need not necessarily be predicated upon successful authentication of the intermediary device, however. For example, where the medical data is related to a medical emergency, the medical data could be transmitted to any suitable intermediary device within range, whether or not any intermediary device is actually able to be authenticated or authorized to receive the data.
• In another exemplary embodiment of the present invention, an intermediary device receiving the medical device data using a wireless network protocol (such as Bluetooth) is authenticated based on whether the intermediary device advertises one or more services. In this context, advertised services reflect functions, utilities, and processes the intermediary device is capable of performing. The intermediary device broadcasts indicators of this functionality, thus “advertising” them to other systems and devices. In the present exemplary embodiment of the invention, unless the intermediary device advertises a service that is identifiable with the operation of the present invention (i.e. a process capable of broadcasting the medical device data to a medical data server, for example), the intermediary device is not authenticated and thus the medical device data is not transmitted to the intermediary device.
Activate Intermediary Device
• In the exemplary process depicted inFIG. 1, the intermediary device can be activated (125) prior to transmitting the medical device data to the intermediary device. Many devices, particularly mobile computing devices running on batteries, employ power-saving features to conserve battery life when not in use. In the case where an intermediary device is in a power-saving or standby mode, it may be necessary to activate the intermediary device before it can receive the medical device data. The intermediary device can be activated in any suitable manner. For example, a signal configured to activate the device may be transmitted to prepare the intermediary device to receive the medical device data.
Transmit Data to Intermediary Device
• The medical device data is transmitted to the intermediary device (130) in the exemplary process depicted inFIG. 1. The data can be transmitted in any suitable manner. In one exemplary embodiment of the present invention, the medical device data is transmitted to the intermediary device using a wired connection, such as an RS-232 serial cable, USB connector, Firewire connector, or other suitable wired connection. The medical device data can also be transmitted to the intermediary device wirelessly using a wireless transmitter. Any suitable method of wireless communication can be used to transmit the medical device data, such as a Bluetooth connection, infrared radiation, Zigbee protocol, Wibree protocol, IEEE 802.15 protocol, IEEE 802.11 protocol, IEEE 802.16 protocol, and/or ultra-wideband (UWB) protocol. If desired, the medical device data could be transmitted to the intermediary device using both a wired and wireless connection, such as to provide a redundant means of communication, for example.
• Any amount of medical device data can be transmitted to the intermediary device in any manner. For example, data from the medical device can be transmitted to the intermediary device in real-time as it is measured, or medical device data can be stored (such as in a memory storage device) for a period of time before being transmitted to the intermediary device. In some cases, for example, it may be more efficient to transmit blocks of medical device data at once rather than initiating communication with an intermediary device each time data is available from the medical device. In other cases, the intermediary device may be out of range or otherwise unavailable to receive the medical device data. The medical device data can also be stored for any desired length of time, and/or until a particular event occurs. For example, the medical device data could be stored until it is verified that the intermediary device and/or the medical data server have received the data, allowing the data to be retransmitted if necessary. Data can also be deleted when a data record exceeds a predetermined storage time, and/or the oldest data record is deleted first after a predetermined storage size limit has been reached.
• The medical device data can be transmitted to the intermediary device in any format. For example, the data from the medical device can be transmitted to the intermediary device exactly as it is transmitted from the medical device. This would be the case in embodiments of the present invention where the medical device itself is transmitting the data directly to the intermediary device. Alternatively, in embodiments of the present invention where the data is being received from the medical device and then retransmitted to the intermediary device, the medical device data can be reformatted, modified, combined with other data, or processed in any other suitable manner before being transmitted to the intermediary device. For example, the medical device data can be encrypted prior to transmission to the intermediary device, and this encryption may occur at any stage, for instance in the medical device itself or at a stage after being transmitted by the medical device. In cases where the medical device data is being combined with other data and transmitted to the intermediary device, all of the data may be encrypted or simply the medical device data itself. In an alternate embodiment, a digest of the medical data may be encrypted, to digitally “sign” the data contents to verify its authenticity. For example, but not by way of limitation, this digest may be produced by providing the received medical data to a hashing algorithm such as the MD5 or SHA-1 Secure Hashing Algorithm as specified in National Institute of Standards and Technology Federal Information Processing Standard Publication Number 180-1.
• Asymmetric encryption algorithms and techniques are well known in the art. See, for example, RSA & Public Key Cryptography, by Richard A. Mollin, CRC Press, 2002, and U.S. Pat. No. 4,405,829, issued Sep. 20, 1983, the disclosures of which are fully incorporated by reference herein for all purposes. In an illustrative example, if two parties (for example, “Alice” and “Bob”) wish to communicate securely using public key cryptography, each party begins by generating a unique key pair, where one of the keys is a private key that is kept in confidence by that party, and the other key is a public key that may be publicly distributed, published only to a message recipient, or made available through a public key infrastructure. The key generation step need be done by a party only once, provided that the party's private key does not become compromised or known by another party. If Alice wants to send a message confidentially to Bob, she may use Bob's public key to encrypt the message, and once sent, only Bob can decrypt and view the message using Bob's private key. But if Alice also wanted Bob to have assurance that the message was in fact coming from her, she could further encrypt the message with her private key before sending, then when Bob's private key and Alice's public key are used to decrypt the message, Bob knows for certain that he was the intended recipient and that Alice was the one who originated the message, and Alice knows that only Bob will be able to decrypt and read her message.
• Asymmetric cryptography may be utilized to enhance security of certain implementations of the present invention. In an alternate embodiment, data transmitted by amedical device250 is encrypted with a private key of the medical device user (or optionally with the private key of a health care provider that is operating the medical device), or with a public key of the intended recipient system such as themedical data server270, or with both keys. The private and/or public keys may be delivered to the medicaldata interchange device200 through a wired or wireless connection, allowing the medicaldata interchange device200 to be configured for secure operation. In one embodiment, the system ormedical data server270 may request that the public key of the medical device be forwarded to enable decryption of any medical information encoded with the user's private key. In this manner, the data may be authenticated as coming from the actual patient that is desired to be monitored, and optionally, the patient may also be assured that only the intended recipient system ormedical device server270 is capable of decrypting and gaining access to the patient's medical device data.
• In an alternate embodiment, encrypted or unencrypted data can be transmitted through an encrypted transmission protocol, such as the wireless encryption protocols (WEP, WPA and WPA2) associated with the IEEE 802.11 wireless protocols or a Bluetooth encryption protocol associated with IEEE 802.15. Any number of other encryption methods can be used to encrypt the medical device data in conjunction with the present invention. The intermediary device may decrypt the medical device data, to allow processing of the data for example. Alternatively, to protect the data from unauthorized viewing, an intermediary device could simply retransmit the encrypted data to the medical data server.
Confirm Transmission of Data to Intermediary Device
• The transmission of the medical device data can be confirmed (135) to verify the transmission was successful. The transmission can be confirmed in any suitable manner. For example, the intermediary device can transmit an acknowledgement once the transmission is received, otherwise the transmission can be rebroadcast.
Validate Data Transmitted to Intermediary Device
• In the exemplary process shown inFIG. 1, the data transmitted to the intermediary device is validated (115). The data from the medical device can be validated in any suitable manner to achieve any result. For example, the data from the medical device may be validated to ensure it was transmitted properly and completely. The medical device data may also be validated to ensure it was provided from a specific medical device or particular type of medical device. The data may also be validated to ensure that fields in the data correspond to predetermined values and/or are within certain thresholds or tolerances. Any number, code, value or identifier can be used in conjunction with validating the medical device data. For example, the data can be validated by analyzing a medical device serial number, a medical device identifier, a patient identifier, one or more parity bits, a cyclic redundancy checking code, an error correction code, and/or any other suitable feature.
Store Data
• The intermediary device may store the medical device data (145). The intermediary device may store the data in any suitable manner, such as by using a memory storage device. Any portion or amount of medical device data (or other forms of information) received or generated by the intermediary device may be stored for any length of time. The data may be stored for a predefined period of time and/or until an event occurs. For example, in one embodiment of the present invention the data is stored by the intermediary device until the data has been transmitted to the medical data server. In another embodiment, data is stored by the intermediary device until a predetermined data transmission record size has been reached, so as to reduce communication charges that may accrue during transmission. In yet another embodiment, the intermediary device stores the data until an acknowledgment from the medical data server is received, where the acknowledgment indicates that the stored data has been received by the medical data server. The medical data may be stored in any desired file format, as well as in an encrypted or decrypted state.
Format Message for Transmission to Medical Data Server
• In the exemplary method according to an aspect of the present invention depicted inFIG. 1, a message is formatted for transmission to the medical data server. The message can originate from any entity operating in conjunction with the present invention. For example, the message may be created by the intermediary device, a device transmitting the medical device data to the intermediary device, or the medical device itself. The message can include some or all of the medical device data, as well as any other information useful to the medical data server. Multiple messages can be formatted to include any desired amount of medical device data. For example, in the case of data from a glucose meter, multiple messages may be formatted to each include a single glucose reading, or a single message could be formatted to include the last ten glucose readings taken by the meter. The message can include any other desired data from any suitable source. For example, real-time data from a medical device may be included in a message along with previously-transmitted data from the stored by the intermediary device creating the message. The message (in whole or in part) may be encrypted to protect the contents of the message from unintended viewers and/or the privacy of the patient being monitored.
• The message provides the medical device information to the medical data server in a format the medical data server can recognize and utilize. The message can thus be formatted to only include portions of the medical device data needed by the server and/or additional information about a patient, the medical device, and/or the treatment regimen. The message can be of any desired format. For example, the message can be included in a file having a tokenized format such as standard ASCII text format, or any other suitable standardized file format, such as an MS Word document, MS Excel file, Adobe PDF file, or binary picture file (JPEG, bitmap, etc.). The data within such a file can be ordered in any manner and have any suitable delimiters, notations, or other features. For example, a list of multiple glucose level readings in a text file message could be provided chronologically by when the readings were taken, with comma or tab delimiters to denote the start and end of each reading. The message may also have a unique and/or propriety format.
• The format of the message can also be based on the method by which the message is transmitted to the medical data server. For example, where the message is transmitted to the medical data server using a wireless mobile telephone such as a cellular phone, the message can be formatted as an SMS text message. Similarly, the message may be formatted as an XML record, email, and/or facsimile. The message can include multiple formats and/or multiple messages may be formatted having different formats for transmission in a variety of methods or to a variety of recipient medical data servers.
Transmit Formatted Message to Medical Data Server
• The message is transmitted to a medical data server (160) to allow the medical device data to be analyzed and processed. The message can be transmitted to a single medical data server, or to a plurality of medical data servers. The medical data server can be any suitable recipient of the medical device data. For example, the medical data server can be a computer system or other device as well as a human recipient (such as a doctor, nurse, or other healthcare provider). The message may be transmitted to the medical data server by any entity operating in conjunction with the present invention, and need not be the same entity that received the medical data or formatted the message. For example, the message may be transmitted to the medical data server by the intermediary device, any device transmitting or receiving the medical device data, or the medical device itself.
• The message can be transmitted to the medical data server in any suitable manner. For example, the message can be transmitted to the medical data server through a wired connection, such as a telephone line, fiber optic cable, and/or coaxial cable. The message may also be transmitted wirelessly using any suitable wireless system, such as a wireless mobile telephony network, General Packet Radio Service (GPRS) network, wireless Local Area Network (WLAN), Global System for Mobile Communications (GSM) network, Enhanced Data rates for GSM Evolution (EDGE) network, Personal Communication Service (PCS) network, Advanced Mobile Phone System (AMPS) network, Code Division Multiple Access (CDMA) network, Wideband CDMA (W-CDMA) network, Time Division-Synchronous CDMA (TD-SCDMA) network, Universal Mobile Telecommunications System (UMTS) network, Time Division Multiple Access (TDMA) network, and/or a satellite communication network. The message may be transmitted using any suitable combination of multiple wired and wireless communication methods. The transmission method selected to transmit the message to the medical data server can be chosen according to any desired criteria. For example, one or more transmission methods can be selected from a plurality of possible transmission methods to send the message based on each method's cost, time required to transmit, reliability, security, or any other suitable factor. Based on such criteria, the message may be stored until there is a suitable opportunity to transmit the message. For example, the message may be stored until an evening or weekend rate is available on a communications network.
• Receive a Command from Medical Data Server
• In addition to receiving the medical device data, the medical data server can transmit a command (160). The command can be received by the intermediary device, the medical device, and/or or any other suitable recipient. Any number of commands of any type may be transmitted by the medical data server. The command can be transmitted using the same variety of wired and wireless methods discussed previously for the transmittal of the formatted message. The command need not be transmitted using the same communication method with which the formatted messages are transmitted to the medical data server.
• In one embodiment of the present invention, for example, the medical data server issues a command to reconfigure a software application operating on the intermediary device. In another embodiment, the medical data server issues one or more commands to control the functionality of the medical device. In yet another embodiment, the medical data server issues one or more commands to request that a public encryption key corresponding to the patient using a medical device be forwarded to the medical data server, or that a device associated with the present invention receive a public encryption key corresponding to an intended recipient such as a particular health care service provider or other known destination such as the medical data server. In another embodiment, the medical data server issues one or more commands to cause the medical device to perform a warm reset, a cold restart, or to reset a password.
• The commands need not be sent directly to a device they are intended to control. For example, a command could be transmitted to an intermediary device, which in turn retransmits it (unmodified) to the medical device to be controlled. Alternatively, the intermediary device could receive a command from the medical server, analyze the command, and then transmit an appropriately formatted command tailored to the specific medical device to be controlled. In this manner, the medical data server need not be able to generate a command for each and every specific device it wishes to control, rather, it can send a command appropriate to a class of devices (i.e. glucose meters) and the intermediary device will appropriately translate the command to control the medical device. The commands from the medical data server can initiate/run diagnostic programs, download data, request the patient's public encryption key, download the intended recipient's public encryption key, and perform any other suitable function on the intermediary device, medical device, or other devices operating in conjunction with systems and methods of the present invention.
• In one embodiment, a user of a medical device may interact with the medical data server, and as a result of such interaction, cause a command to be created by the medical data server and transmitted to the medical device. Such a user may comprise, for example, the patient associated with the medical device or a health care provider that is caring for the patient. In various embodiments, the user may interact with a system that includes the medical data server through a computer interface (e.g. a web browser), a portable digital assistant (PDA), a mobile communication device (such as a cell phone), an emergency medical beacon, a medical data interchange device, an interactive voice response (IVR) function associated with the system, or other suitable interface. In one scenario, for example, the user calls the IVR function through a cellular network or PSTN connection, and in response to guided voice prompts, the user either gives vocal input, button-press inputs such as by DTMF tones, or a combination of methods. Based on the user's inputs to the system, whether by IVR or other means, the medical data server may respond by generating a command that is ultimately transmitted to the medical device or an intermediary device. In one implementation, the medical data server could generate and transmit a command that instructs the medical device to transmit data to the medical data server either directly or through an intermediate device. Such data may represent, for example, medical or historical information regarding a patient or the user of the medical device; medical device diagnostic information; or environmental parameters such as a battery charge level, a temperature, a barometric pressure, a code relating to an accessory for the medical device, a data validity measurement, an elapsed time since a previous reading by the medical device, a test result parameter, a signal-to-noise parameter, or a quality of service (QoS) parameter. In one implementation, in response to user input or input associated with analysis of data uploaded to the medical data server, the medical data server causes a command to be transmitted to the medical device that instructs the device to take action that results in the administration of a prescribed dose of medication to the patient, or a prescribed shock to the patient's heart.
• A command from a medical data server can be in any appropriate format and may include any suitable information. For example, a command may include data received from onemedical device250 to be delivered to anothermedical device250 through the medicaldata interchange device200. In this manner, a variety of medical devices can share data whether or not they are in communication with the medicaldata interchange device200.
• A command can also originate from anintermediary device260. For example, a command to program or reconfigure one or more software programs on the medicaldata interchange device200 depicted inFIGS. 2A,2B, and2C can be provided by anintermediary device260 to the medicaldata interchange device200 through thedata relay transceiver230. A command, as discussed above, may include multiple instructions, applets, or data elements to be processed, such as sections of executable code or interpretable scripts. Additionally, a user can program or configure a software program on any device operating in conjunction with the present invention through a suitable user interface, such as theuser interface290 of medicaldata interchange device200.
• In any system where commands can be sent remotely, security is always a concern, especially when a wireless implementation may provide an entry vector for an interloper to gain access to components, observe confidential patient data, and control health-sensitive components such as pacemakers and insulin pumps. In any digital data network, it is also possible that commands intended for one recipient may be misrouted to a patient or health care provider that was not the intended recipient of the command. Embodiments of the present invention provide for enhanced security in a remote command system while still allowing flexibility and minimal obtrusiveness.
• In one embodiment, a command received by any of the components inFIG. 2A,2B, or2C may be authenticated before the command is either acted upon by the destination component, or forwarded to another component in the system. Authentication may be directed to determining (1) whether the command came from a trusted or authorized source and (2) that the recipient is actually the intended recipient of the command. In one implementation, source command authentication is achieved by determining whether the origin of the command is a trusted component or server, and one way to accomplish this determination is analyzing whether a command is properly digitally signed by the originator or some other authentication information is provided that assures the recipient component that the message or command is authentic and the recipient component is actually the intended recipient. In an alternate implementation, destination command authentication is accommodated by examining the contents of the message or an authorization code to determine the intended recipient, or alternatively decrypting the command or a portion of the command to verify the intended recipient.
• In one embodiment, when commands are created by a command originator, the originator provides for a means to verify the authenticity and/or validity of the command by at least one of the following methods: (1) encrypting the command with a private key of the command originator; (2) generating a digest of the command (through a method such as a hashing algorithm discussed above) and optionally encrypting the hashed digest with the command originator's private key, or (3) utilizing a symmetric encryption scheme providing an authentication code (such as a cryptographically hashed password) that is compared to previously stored values. Then, when a system component receives the command along with any encrypted or cleartext certification data, the component may determine the command is valid by (1) attempting to decrypt an encrypted command message with the alleged originator's public key, (2) attempting to decrypt an encrypted digest with the alleged originator's public key, and comparing the result to a hashed value of the command, or (3) comparing a cryptographically hashed password for the alleged originator to known pre-stored values, and if a match is found, authorization is granted. As an additional step, if the command were optionally encrypted using the intended patient/provider's public key, then only the recipient is capable of decrypting the command, ensuring that only the truly intended patient's health-care devices were being issued commands, and not an unintended third party. For example, in one embodiment, authenticating the command comprises decrypting at least part of the command using at least one of: a public key associated with the medical data server; a private key associated with a user of the medical device; and a private key associated with the medical device.
Authenticate User Access to Medical Data Server
• In another embodiment, in regards to the methods described in regards toFIG. 1, it is desirable to ensure that a party attempting to interface with a system such as a medical data server is actually the party believed to be authorized to do so. Turning toFIG. 9, an embodiment is provided that illustrates a method to authenticate user access to the medical data server. A medicaldata system component901 such as a medical data server (FIG. 2,270) generates910 a request to authenticate access, either on its own accord or as a result of a message received by an alleged patient who is enrolled in the medical service provided by the medical data server. Themedical data system901 then sends a request to authenticate access to auser component902 of the present invention associated with the client, user, or health care provider, and in one implementation, such component may include the medicaldata interchange device200. Theuser component902 then receives920 the request to authenticate access, and generates930 an authentication token.
• In various embodiments, authentication tokens may comprise either simple or complex text strings or data values indicating an account number or other patient identifier that can be matched against an internal patient database by the medical data server. Alternatively, authentication tokens may comprise encoded passwords or other indicia that assert that the entity for whom authentication is requested is genuine. Generation of an authentication token may be accomplished using alternative methods such as entry of a patient identifier, PIN, or password by a patient or healthcare provider after being prompted to do so. Alternatively, a biometric measurement of the patient or healthcare provider could be obtained and the measurement rendered into a digital representation. Once generated, for security purposes the authorization token may be secured940 by encrypting the token, digesting and encrypting the digest of the token, or cryptographically hashing the token before transmission to the requesting entity such as themedical data system901 or server. As discussed above in regards to the abovementioned command authentication, in one embodiment, when authentication tokens are created, the originating component of the token may create a certification of validity through at least one of the following methods: (1) encrypting the token with a private key associated with the token originator; (2) encrypting the token with a public key associated with the token requester or destination; (3) generating a digest of the token (through a method such as a hashing algorithm discussed above) and optionally encrypting the hashed digest with the token originator's private key, or (4) providing an authentication code as at least part of the token (such as a cryptographically hashed password) that may be is compared to previously stored values. Then, when a medicaldata system component901 receives the token along with any encrypted or cleartext certification data, the component may determine the access is valid by (1) attempting to decrypt an encrypted token with the alleged originator's public key; (2) attempting to decrypt an encrypted token with the alleged originator's public key; (3) attempting to decrypt an encrypted digest with the alleged originator's public key, and comparing the result to a hashed value of the token, pin, code, or password, or (4) comparing a cryptographically hashed password for the alleged originator to known pre-stored values, and if a match is found, authorization is granted.
• The medicaldata system component901 then receives960 and analyzes970 the validity of the authentication token as described above. If examination of the authentication token provides that the token is authentic, such as by comparing the analyzed token data to known, pre-stored values such as the patient or the patient's health care provider's pre-stored hashed password or other identity datum, then access is successful and the process terminates. After analyzing the authentication token or a message containing or associated with the token, the medical data system may determine that access is either permitted or denied, and may communicate980 this status to the originator of theauthentication token902 who then receives notice of thefailure990. At that point, the system may repeat theprocess900, allowing the token originator to attempt access again.
Exemplary Systems
• Exemplary systems for use in conjunction with the present invention are depicted inFIGS. 2A,2B, and2C. These systems may be used in conjunction with the method described inFIG. 1, as well as with any subset or combination of the elements thereof. The systems shown inFIGS. 2A,2B, and2C may also be used in conjunction with any other suitable embodiments of systems and methods for medical device monitoring according to an aspect of the present invention.
• The exemplary system depicted inFIG. 2A is a medicaldata interchange device200 that includes aprocessor210 coupled to amemory220. Adata relay transceiver230 wirelessly communicates with one or moreintermediary devices260 viaantenna232, which in turn communicates with one or moremedical device servers270 through either a wired or wireless protocol. Anexternal adapter module240 communicates with one or moremedical devices250. Theadapter module240 also communicates with adevice interface242, as can any number of external devices, such as acomputer system280. Thedevice interface242 may include any number of wired or wireless connections such as a universal serial bus (USB) connection, serial connection, parallel connection, Firewire connection (such as IEEE 1394), Ethernet connection, or any other suitable connection. Those of skill in the relevant arts also recognize thatcomputer system280 may also comprise external storage media such as a FLASH drive or a portable hard drive. The exemplary system shown inFIG. 2B includes amodular adapter240 removably attached to the medicaldata interchange device200. In one implementation of this embodiment, thedevice interface242 is integrated with theadapter module240.
• The medicaldata interchange device200 may include any suitable power connection for powering the interchange device and/or for recharging an energy storage device such as a battery (not shown). The components of the medicaldata interchange device200 may receive electrical power from any other type of power supply.
• Thedevice interface242 may establish unidirectional or bidirectional communications with one or more of themedical devices250 through theadapter240. Theadapter240 may be located internally or externally to thedevice interface242 and/or medicaldata interchange device200. InFIG. 2A, for example, thedevice interface242 connects to anadapter240 that is external to themedical interchange device200, whileFIG. 2B depicts thedevice interface242 being integrated with theadapter240.
• FIG. 2C depicts an exemplary embodiment of the present invention wherein the medicaldata interchange device200 is integrated with amedical device250. The medicaldata interchange device200 can be integrated with themedical device250 using any number of suitable wired connections (i.e.—soldered connections and/or traces on a printed circuit board) to allow the medicaldata interchange device200 to communicate with components in themedical device250. As with the medicaldata interchange devices200 depicted inFIGS. 2A and 2B, the medicaldata interchange device200 depicted inFIG. 2C can communicate with any number ofintermediary devices260 and/ormedical data servers270.
• The functionality of the medicaldata interchange device200 can be implemented in any suitable manner, such as through theprocessor210 executing software instructions stored in thememory220. Functionality may also be implemented through various hardware components storing machine-readable instructions, such as application-specific integrated circuits (ASICs), field-programmable gate arrays (FPGAs) and/or complex programmable logic devices (CPLDs). Systems for medical data interchange according to an aspect of the present invention may operate in conjunction with any desired combination of software and/or hardware components.
MedicalData Interchange Device200
• Referring toFIGS. 3A and 3B, the medicaldata interchange device200 depicted inFIGS. 2A and 2B is shown enclosed within a within acase300. A case holding a system for medical data interchange according to aspects of the present invention may be of any size, shape and configuration. The system (and case enclosing it) is preferably small enough to be easily portable by a patient or person being monitored. For example, theexemplary case300 depicted inFIGS. 3A and 3B is 3 inches long, 1 inch wide, and 0.5 inches deep. The top and bottom of thecase300 are 0.05 inches thick, while the sides of thecase300 are 0.075 inches thick. The case may be manufactured from any number of materials, such as plastic, metal, wood, composites, and/or any other suitable material. Thecase300 shown inFIGS. 3A and 3B, for example, is manufactured from hard plastic.
• Thecase300 includes apower connection320 for powering theinterchange device200 and/or for recharging an energy storage device such as a battery. Thecase300 also includes aninterface module310 with four separate ports to accommodate different wired connections to theadapter240, including a serial port interface (SPI)port330, aninfrared input340, a mini-jack port350 (i.e.—a 3.5 mm TRS connector), and a super mini-jack port360 (i.e.—a 2.5 mm TRS connector). Theinterface module310 may include any number and type of wired connection ports.
• Theinterface module310 may include any suitable portion of the medicaldata interchange device200. In one embodiment, referring toFIG. 2B, theinterface module310 is anadapter module240 that includes thedevice interface242. The plurality of wired connection ports (330,340,350, and360) are coupled to theadapter240, which in turn communicates data to the rest of the medicaldata interchange device200 through thedevice interface242. In this embodiment, theinterface module310 is removably attached to thecase300 to allowdifferent modules310 to be interchangeably connected to thecase300 to communicate with differentmedical devices250.
• In another exemplary embodiment, referring again toFIG. 2A, theinterface module310 contains thedevice interface242 that couples to anexternal adapter240. In this embodiment, theadapter240 includes one or more connections to one or moremedical devices250. The connections to themedical devices250 can be through a common wiredconnection252, such as a PCI bus, ISA bus, PCI-E bus, SPI, USB, or other common connection. The connections to themedical devices250 may also be made through individual wired connections to eachmedical device254. Theadapter240 can communicate with any number ofmedical devices250 through any combination of common wiredconnections252 and individualwired connections254.
• In the exemplary embodiment depicted inFIG. 2A, theadapter240 also connects to thedevice interface242, through one or morewired connections256. Thewired connection256 between theadapter240 and thedevice interface242 can be a single shared wired connection that communicates data to and from everymedical device250 connected to theadapter240. Theadapter240 can also communicate with thedevice interface242 through a plurality ofwired connections256, wherein eachwired connection256 is dedicated to communicating with a separatemedical device250. Theadapter240 can also communicate with thedevice interface242 through any combination of dedicated or shared connections.
• Theadapter module310 may be removably attached to the rest of thecase300 to allow different modules with different types of wired connection ports to be interchangeably used, as depicted inFIG. 2B. Theadapter module310 may include any of the elements of the medicaldata interchange device200, as well as any other desired systems and devices.
• In another exemplary embodiment of the present invention, referring now toFIGS. 3C and 3D, acase370 includes aremovable adapter module380 that includes amedical device connector385 for communicating with a medical device through a wired connection. Theadapter module380 connects to thecase370 usingplug387. Theplug387 attaches to a corresponding port on the case370 (not shown) to hold theadapter module380 in place and allow the communication of data through theadapter module380. Theconnector385 and plug387 can use any desired wired connection, and need not use the same type of wired connection. In one embodiment, for example, referring toFIG. 3E, acase395 includes a 2.5 mm or 3.5 mmstereo plug connector397 connected to a USB jack on the side of the case395 (not shown). In this embodiment, theadapter module380 is implemented in acomponent398 that electrically couples thestereo plug connector397 and USB jack. Thecomponent398 includes circuitry (such as that depicted inFIGS. 6 and 7) to convert and/or redirect the signals from thestereo plug397 to the USB jack and vice versa.
• Theadapter module380 connects to thecase370 usingplug387. Theplug387 attaches to a corresponding port on the case370 (not shown) to hold theadapter module380 in place and allow the communication of data through theadapter module380. Theconnector385 and plug387 can use any desired wired connection, and need not use the same type of wired connection. In the present embodiment, for example, theconnector385 is a 2.5 mm or 3.5 mm stereo jack whileplug387 is a USB plug.
• The case can include any other suitable features. For example, the case may include a screen, lights, LEDs, keys, and speaker and microphone grilles to support features of a user interface included in a system for medical data interchange. The exemplary systems for medical data interchange shown inFIGS. 2A,2B,3A,3B,3C,3D, and3E are all configured to fit in a container along with the medical device it communicates with to allow a user to easily transport the medical device and the data interchange device together. In the exemplary system for medical data interchange depicted inFIG. 2C, the medicaldata interchange device200 is integrated within the case or packaging of themedical device250 itself.
• Other embodiments of systems for medical data interchange according to aspects of the present invention can be configured to be in small enough to be coupled with or integrated into amedical device250 or anintermediary device260. For example, amedical device250 may be manufactured to include a medicaldata interchange device200 within the packaging or housing of themedical device250. Similarly, a medicaldata interchange device200 can be integrated as part of anintermediary device260 such as a cellular phone, PDA, or other mobile computing device. Theintermediary device260 could thus be configured to both receive data from amedical device250 through a wired connection, as well as transmit messages regarding themedical device250 and/or patient to amedical data server270.
• Alternatively, a medicaldata interchange device200 can be configured to be physically attached to amedical device250 orintermediary device260. For example, where anintermediary device260 such as a mobile wireless telephone or PDA is used in conjunction with embodiments of the present invention, one exemplary embodiment of a medicaldata interchange device200 and itscase300 is configured to match the size and shape of the of theintermediary device260 and attach to the back of theintermediary device260 using metal or plastic clips that wrap around the face and/or sides of theintermediary device260. When attached, the medicaldata interchange device200 conforms to the size and shape of the outline of theintermediary device260, and is preferably shaped to conform to the dimensions of the back of theintermediary device260 to avoid unnecessarily impacting the original size of theintermediary device260. In this embodiment, the case of the medicaldata interchange device200 may also include other desirable features, such as a belt clip to allow the data interchange device/intermediary device combination to be worn by a user.
• Turning toFIG. 4, in another exemplary embodiment of the present invention, the medicaldata interchange device200 is contained in a flexible,protective container400 that opens to allow amedical device250 to be likewise contained therein. Thecontainer400 could also be configured to hold an intermediary device260 (such as a cellular phone, PDA, or other mobile computing device) to allow a medicaldata interchange device200 to be used with a variety ofintermediary devices260, which may (in some cases) provide a more cost effective approach to integrate the medicaldata interchange device200 with anintermediary device260 ormedical device250. The medicaldata interchange device200 can also be integrated within theprotective container400 itself, with thecontainer400 acting as the case for thedata interchange device200.
• Alternatively, as depicted inFIG. 4, the medicaldata interchange device200 may simply be contained within apouch410 or other structure within thecontainer400. Theexemplary container400 depicted inFIG. 4 also includes aholder420 for themedical device250 formed from clear plastic to allow a user to read adisplay422 and/or operatekeys424 on themedical device250. Theprotective container400 can also be sized to comfortably fit and protect any other desired item, such as a day planner, wallet, notepad, and/or writing utensil or PDA stylus. Theprotective container400 can be made from any combination of desired materials, such as leather, plastic, nylon, cordura, or other flexible material. Theprotective container400 can be sealed in any manner, such as by using snaps, hook-and-loop closures, buttons, and/or a zipper. Theexemplary container400 depicted inFIG. 4, for example, is sealed using azipper430. Thecontainer400 can be waterproof, heat resistant, and/or include padding to protect the medical data interchange device and other contents from the shock of a fall. Thecontainer400 may include any number of pockets, pouches, or other sub-containers inside or outside the case to hold accessories associated with themedical device250,intermediary device260, or other item(s) stored within thecontainer400.
• The exemplaryprotective container400 depicted inFIG. 4 is configured to hold a medical device250 (specifically, a glucose meter) and a medicaldata interchange device200 according to an aspect of the present invention. In this exemplary embodiment, theprotective container400 is closed using azipper430 that runs along the exterior of the sides of thecontainer400. A user unzips the two halves of thecontainer400 and opens thecontainer400 to display the glucose meter contained in theholder420 attached to the interior of one half of thecontainer400, while the medicaldata interchange device200 is contained in apouch410 attached to the interior of the other half of thecontainer400. Thepouch410 is formed from a nylon mesh material to allow a user to see and/or interact with user interface features of the medicaldata interchange device200. Thepouch410 is sealed with azipper412. Thecontainer400 includes a flexibleelastic strap440 to hold a container of blood sugar metering strips442. Thecontainer400 may include any number of other pouches or containers on the interior or exterior of the container for storing batteries and/or power cables for the glucose meter and/or medical data interchange device, and other items of use to the patient carrying the container, such as bottles of insulin and needles for use by the patient depending on the outcome of a reading by the glucose meter.
Processor210
• Theprocessor210 retrieves and executes instructions stored in thememory220 to control the operation of the medicaldata interchange device200. Any number and type of processor(s) such as an integrated circuit microprocessor, microcontroller, and/or digital signal processor (DSP), can be used in conjunction with the present invention. Referring now toFIG. 5A, an exemplary medicaldata interchange device200 according to an aspect of the present invention is implemented using amicrocontroller501. In the exemplary system depicted inFIG. 5A, themicrocontroller501 includes a Universal Asynchronous Receiver/Transmitter (UART) and Universal Serial Bus (USB). Themicrocontroller520 depicted inFIG. 5B also includes these features, along with a digital signal processor (DSP) for communication with acellular RF Transceiver530 as will be discussed in more detail below. Themicrocontrollers501,520 depicted inFIGS. 5A and 5B, respectively can include any other suitable components and features, such as comparators (504), analog-to-digital converters (ADCs) (517), and/or digital-to-analog converters (DACs) (512), though these components have been shown outside themicrocontrollers501,520 for clarity.
Memory220
• The exemplary systems depicted inFIGS. 2A and 2B include amemory220. Thememory220 stores instructions, medical device data, messages transmitted to or received from themedical data server270, and any other suitable information. Amemory220 operating in conjunction with the present invention may include any combination of different memory storage devices, such as hard drives, random access memory (RAM), read only memory (ROM), FLASH memory, or any other type of volatile and/or nonvolatile memory.
• In the exemplary embodiments depicted inFIGS. 5A and 5B, themicrocontroller501 and520 each include an on-chip memory. In addition, themicrocontroller501,520 is coupled to aflash memory510. Theflash memory510 may be of any size to achieve any desired purpose. In this exemplary embodiment, the size offlash memory510 is selected to adequately store pre-recorded voice recordings to be played through thespeaker515, discussed below. Any number of memory storage devices of any size and configuration may also be used in conjunction with the present invention.
Power Source
• Any number, combination, and type of suitable power sources can be utilized in accordance with aspects of the present invention. The exemplary systems depicted inFIGS. 5A and 5B are powered by a pair of replaceable alkaline AAA 1.5volt batteries505. The positive lead of the series-coupledbattery pair505 is connected toADC517 to enable themicrocontroller501,520 to monitor the voltage level of thebatteries505. Any number of other suitable batteries may also be used according to any desired criteria. For example, a rechargeable battery or batteries integrated with the data interchange device may be selected to reduce the overall size of the medicaldata interchange device200 and/or provide for the convenience of a user who would not need to replace batteries. Such rechargeable batteries can be charged through theUSB connector502, as well as through a dedicated power connector. Any battery of any suitable type and size may be used. Replaceable batteries may be selected to reduce the price of the medical data interchange device. The power supply circuitry shown inFIGS. 5A and 5B is exemplary only, and may be implemented by using other conventional power supply approaches. The medicaldata interchange device200 and other systems for medical data interchange according to various aspects of the present invention can utilize any appropriate power supply devices, components, circuits, and systems.
• In the exemplary circuits shown inFIGS. 5A and 5B, voltage from thebatteries505 is supplied to two DC toDC converters506,507 which supply an appropriate voltage level to the various components of the medicaldata interchange device200.DC converter506 steps up the voltage to 5 volts, whileDC converter507 steps up the voltage to 3.3 volts. Any number of voltage converters or similar components may be used as desired to supply appropriate voltage levels to components of the medicaldata interchange device200.
Data Relay Transceiver230
• Thedata relay transceiver230 communicates with one or moreintermediary devices260,medical data servers270, or other suitable systems. Any suitable communications device, component, system, and method may be used in conjunction with the present invention. In the exemplary circuits shown inFIGS. 5A and 5B, thedata relay transceiver230 comprises aBluetooth transceiver509 that is in bidirectional communication withmicrocontroller501,520 throughmultiplexer508. Themultiplexer508 allows themicrocontroller501,520 to alternately communicate with theUSB port502 and theBluetooth transceiver509 through a single UART on themicrocontroller501,520.
• The medicaldata interchange device200 may include, or operate in conjunction with, any number ofdata relay transceivers230. InFIG. 5B, for example the exemplary medicaldata interchange device200 further includes a cellular radio frequency (RF)transceiver530 in communication withmicrocontroller520. In this exemplary embodiment, themicrocontroller520 is a cellular baseband processor that includes a digital signal processor (DSP) which communicates data through a cellular RF power amplifier andfront end540 connected to acellular antenna545. Data is transmitted by themicrocontroller520 on the CELL TX INTRF line and received by the microcontroller on the CELL RX INTRF line. Additionally, themicrocontroller520 can control various features of theRF transceiver530 via the CELL CONTROL line. The RF power amplifier andfront end540 performs the necessary functions to transmit and receive cellular signals, such as power amplification, power detection, filtering, and input/output matching.
• The medicaldata interchange device200 depicted inFIG. 5B may be configured to communicate using any number and type of cellular protocols, such as General Packet Radio Service (GPRS), Global System for Mobile Communications (GSM), Enhanced Data rates for GSM Evolution (EDGE), Personal Communication Service (PCS), Advanced Mobile Phone System (AMPS), Code Division Multiple Access (CDMA), Wideband CDMA (W-CDMA), Time Division-Synchronous CDMA (TD-SCDMA), Universal Mobile Telecommunications System (UMTS), and/or Time Division Multiple Access (TDMA). A medicaldata interchange device200 operating in conjunction with the present invention may alternatively (or additionally) includedata relay transceiver230 components to communicate using any other method of wired or wireless communication.
• As discussed previously, the medicaldata interchange device200 can transmit any data to any entity operating in conjunction with the present invention. For example, the medicaldata interchange devices200 depicted inFIGS. 5A and 5B may transmit medical data to one or moreintermediary devices260, as well as to one or moremedical data servers270.
Adapter Module240
• Referring again toFIG. 2A, the exemplary medicaldata interchange device200 includes anadapter module240 for communicating with one or moremedical devices250 as well as other suitable systems. Theadapter module240 can be configured to communicate with any suitable class, type, and/or manufacturer ofmedical device250. Theadapter module240 depicted inFIG. 2A is an external component that communicates with adevice interface242 in the medicaldata interchange device200. In the exemplary circuits depicted inFIGS. 5A and 5B, theUSB port502 is configured to interface with a standard USB connection, as well as with the adapter interfaces601 and701 (shown onFIGS. 6 and 7, respectively) which utilize USB connectors, but not the USB communications protocol. Instead, the adapters depicted inFIGS. 6 and 7 implement a customized protocol tailored to communicating withmedical devices250 through ring/tip connectors605 and705. Themicrocontroller501,520 is configured to detect and utilize the same communications protocol as anadapter module240 connected toport502.
• In accordance with various aspects of the present invention, theadapter module240 can also be modular and removably attached to the body of thedata interchange device200, integrated as part of thedata interchange device200, or a combination of the two. In the exemplary embodiment of the present invention depicted inFIG. 2B, anadapter module240 is removably attached to the body of the medicaldata interchange device200 and includes thedevice interface242 to allow differentmedical devices250 to interoperate with thedata interchange device200. As newmedical devices250 and/or new wired connections are utilized, amodular adapter module240 configured to communicate with the new device or new frequency can be added to the existing system.
• Software running on or operating in conjunction with theadapter module240 can be configured/updated through thedevice interface242,auxiliary communication system244, theuser interface290, or in response to a communication from anintermediary device260 ormedical data server270 received through thedata relay transceiver230. This allows the functionality of the medicaldata interchange device200 to be dynamically updated and avoids the expense of having to create custom hardware implementations for every type of medical device to be monitored.
• FIG. 6 depicts a circuit diagram of anadapter module240 that interfaces with thedata interchange device200 through aUSB connector601. As stated previously, theadapter240 adjusts the voltage levels of Tx and Rx in order to communicate with amedical device250 connected toTRS connector605. Anadapter240 operating in conjunction with the present invention may use any combination of wired connections and communication protocols.
• Theadapter module240 depicted inFIG. 6 is configured to interface with amedical device250 that sends a wakeup signal. In operation, a signal received from themedical device250 on the Rx line is provided to theUSB connector601 through abuffer602 that provides isolation between themedical device250 and the circuitry of the medicaldata interchange device200 depicted inFIGS. 5A and 5B. The Rx signal is also provided to switch607 which places a voltage on the AID pin of theUSB connector601. Referring back toFIGS. 5A and 5B, the voltage from the AID pin onconnector601 is provided to thecomparator504 through the ID pin on theUSB port502. Thecomparator504 then activates themicrocontroller501,520 in response. The level of voltage provided on the AID pin can also be used to identify the type of meter and/or adapter connected to the medicaldata interchange device200 to themicrocontroller501,520.
• Referring again toFIG. 6, the Tx lead from theUSB connector601 is driven logically high when the UART on themicrocontroller501 is idle. The Tx signal from theUSB connector601 is inverted byinverter603. When the UART on the microcontroller is idle, theinverter603 drives the signal low, turningtransistor604 off and allowing the Tx signal to the tip ofconnector605 to float at the voltage level from themedical device250. Alternatively, when the UART on themicrocontroller501 is active, the Tx signal from theUSB connector601 is logically low and theinverter603 inverts the low signal high to activatetransistor604 and allow the Tx signal fromconnector601 to drive the Tx line on theTRS connector605 to themedical device250.
• FIG. 7 depicts a circuit diagram for anotheradapter240 according to various aspects of the present invention. In this exemplary embodiment,USB connector701 interfaces withUSB port502 shown inFIGS. 5A and 5B.Inverter702 inverts the logic level of the Tx signal provided by themicrocontroller501 through theUSB connector701 to correspond to the voltage levels used by amedical device250 connected toTRS connector705. The Rx signal from amedical device250 connected to theTRS connector705 is provided to an N-channel JFET704. In this exemplary circuit, when the Rx signal from themedical device250 is marking (a −5.5 volt signal indicative of a logical “1”) theJFET704 is turned off, causing a 5-volt signal to be provided throughbuffer703 and to the Rx lead of the UART on themicrocontroller501. Alternatively, when the Rx signal from themedical device250 is spacing (a 6-volt signal indicative of a logical “0”) theJFET704 is turned on, causing ground to be provided throughbuffer703 and to the Rx lead of the UART on themicrocontroller501,520. The present invention can be configured to operate in conjunction with any other combination of voltages between themicrocontroller501,520 and theTRS connector705.
Device Interface242
• Thedevice interface242 communicates with one or moremedical devices250. Thedevice interface242 can also communicate with any other system, device or entity. Thedevice interface242 may include any number and combination of hardware and/or software components. Thedevice interface242 can communicate with medical devices through anadapter240, as shown inFIG. 2A. In this exemplary embodiment, thedevice interface242 connects to anexternal adapter240 configured to couple with one or moremedical devices250. In this way,adapters240 that allow connections to different medical devices can be used interchangeably with the same medicaldata interchange device200. In another exemplary embodiment, referring toFIG. 2B, thedevice interface242 is integrated with theadapter240.
• Any number ofadapter modules240 may be used in conjunction with the present invention, for example to communicate with multiplemedical devices250 using different wired connections and/or communication protocols. The present invention may be used in conjunction with any wired connection and communication protocol to communicate with one or more medical devices. For example, the medicaldata interchange device200 may be configured to communicate with one or more medical devices using, without limitation: tip and sleeve (TS), tip, ring, and sleeve (TRS), and tip, ring, ring, and sleeve (TRRS) connections; serial peripheral interface bus (SPI) connections; universal serial bus (USB) connections; RS-232 serial connections, Ethernet connections, optical fiber connections, and Firewire connections.
• In the exemplary embodiments depicted inFIGS. 2A and 2B, thedevice interface242 and/oradapter240 can be configured (e.g. through a software program residing inmemory220 and executed by processor210) to detect and switch to different communication protocols and/or different wired connections to one or moremedical devices250 or other devices (such as the computer system280), thus providing interoperability between types and manufacturers of a wide variety of devices. Theauxiliary communication system244 depicted inFIG. 2B may similarly be configured.
• The medicaldata interchange device200 can be configured to automatically request data from one or moremedical devices250 at predetermined times using thedevice interface242. Any appropriate date or time setting may be used. Thedata interchange device200,medical device250, or any other device operating in conjunction with the present invention can be configured to automatically request and/or transmit data in any suitable manner. For example, the medicaldata interchange devices200 depicted inFIGS. 2A and 2B can be configured through thedevice interface242, theuser interface290, and/or from a command issued transmitted by anintermediary device260 through thedata relay transceiver230. Additionally the medical data interchange device depicted inFIG. 2B can be configured through theauxiliary communication system244. In the case of a command received through thedata relay transceiver230, the command can be generated by any suitable entity, such as from amedical data server260 or a user of the intermediary device.
• The automatic requesting/transmission of data by a device operating in conjunction with the present invention may be subject to any suitable conditions or rules that dictate whether the data is in fact requested/transmitted. For example, a medicaldata interchange device200 programmed to request data from amedical device250 at a set time may first check to verify that the medical device is within range, that thetranslator200 has sufficient battery reserves to send the request and receive the data, whether thetranslator200 has sufficient space in thememory220 to store the data, and/or whether any other suitable condition is met.
Auxiliary Communication System244
• The medicaldata interchange device200 depicted inFIG. 2B includes anauxiliary communication system244 for communicating with additional systems and devices. For example, theauxiliary communication system244 may be used to communicate with an externalpersonal computer system280 to upload software to thedata interchange device200, store data, provide or update encryption keys, perform diagnostics, and other appropriate purposes. Theauxiliary communication system244 can be a separate device, system, and/or component, or may be integrated with another component, such as thedevice interface242. For example, in one embodiment of the present invention, thedevice interface242 includes a USB port for communicating with any device capable of communicating through a USB connection. This allows the medicaldata interchange device200 to communicate instructions, software upgrades, medical data, and other information with computing devices, memory storage devices (such as portable USB memory drives), as well as medical devices. Thesame device interface242 can thus be used to receive medical data from amedical device250 as well as to download reports that include the medical data. In one embodiment, medical data received by the medicaldata interchange device200 may be formatted by theprocessor210 into a ubiquitous data format such as Portable Document Format (PDF), and subsequently transferred to an external device such as acomputer system280 through theauxiliary communication system244.
• The medicaldata interchange device200 or other system operating in conjunction with the present invention can include any suitable circuit, component, device, and system for communicating with any other device. Theauxiliary communication system244 can be used to transfer data to and from the medicaldata interchange device200, as well as for anexternal computer system280 to configure or program software and hardware in thedata interchange device200. In one embodiment of the present invention, for example, a useroperating computer system280 connected to medicaldata interchange device200 through the Internet can configure settings for thedevice interface242,adapter240, data relaytransceiver230, anduser interface290. Thecomputer system280 can also download data received by thedata interchange device200 from one or moremedical devices250. Additionally, thecomputer system280 may communicate with themedical devices250 real-time through themedical device transceiver240, such as to monitor or control one or moremedical devices250 in real-time.
User Interface290
• Themedical device250, medicaldata interchange device200,intermediary device260, or other device operating in conjunction with the present invention may include a user interface. Referring toFIGS. 2A and 2B, anexemplary user interface290 of a medicaldata interchange device200 in accordance with aspects of the present invention includes aninput device292 and anoutput device294. Theinput device292 receives commands, data, and other suitable input from a user. Theoutput device294 provides the user with data, alerts, and other suitable information from the medicaldata interchange device200.
• Any number of input devices may be included in a user interface for one or more devices in the present invention. In one embodiment of the present invention, for example, theuser interface290 includes a touch pad, a touch screen, or an alphanumeric keypad to allow a user to enter instructions and data into the medicaldata interchange device200. One or more buttons on the keypad or touch screen can be programmed or configured to perform specific functions, such as to request data from one or more medical devices. Theuser interface290 can also include one or more multifunction switches, keys, or buttons that each allows a user to perform multiple functions.
• The user interface may also include a microphone to allow the user to provide such information to the medicaldata interchange device200 verbally. In this exemplary embodiment, the medicaldata interchange device200 also includes speech recognition software to process verbal input through theuser interface290. The ability of the medical data interchange device to recognize speech from a patient can be particularly useful for users/patients who have vision problems, arthritis, or other impairments that would inhibit them from using a keypad or other input device. A microphone can be used in conjunction with audible (e.g. through sound waves perceivable by the human ear) data provided through a speaker, as discussed below, to allow a user to interact with any device operating in conjunction with the present invention in a completely auditory manner. In one nonlimiting example, audible input could also be sensed and analyzed by the medicaldata interchange device200 that a patient has uttered a command, such as the command to turn on. Bidirectional audible communication, in addition to aiding impaired patients, allows users to operate devices in the present invention in a hands-free manner which can increase the speed, ease, and efficiency in which a device (such as the medical data interchange device200) can be utilized.
• Devices operating in conjunction with the present invention may include any number of suitable output devices. Referring to the exemplary medical data interchange device circuits depicted inFIGS. 5A and 5B, auser interface290 including two lights511 (LED1 and LED2) may be used to indicate the status of the medicaldata interchange device200 to the user, as well as other pertinent information. For example, a flashing LED can be used to indicate when data from a medical device is in the process of being transferred, while a solid LED can indicate the transfer of data is complete. The medicaldata interchange devices200 depicted inFIGS. 5A and 5B also provide auditory output throughspeaker515. Themicrocontroller501,520 retrieves audio samples, such as recorded speech, from theEEPROM510 and provides output toDAC512, which converts the digital signal from themicrocontroller501,520 to an analog signal that can be output on thespeaker515. The analog signal is provided to anaudio amplifier514 that amplifies the signal. The gain of theamplifier514 is set by the ratio ofresistors516 and513.
• Any other suitable user interface features may similarly be included in devices and systems operating in accordance with the present invention. In another exemplary embodiment, for example, theoutput device294 includes a display screen to visually display information as well as a speaker (e.g. speaker515 shown inFIGS. 5A and 5B) to provide auditory output. Theoutput device294 can include multiple transducers such as audio speakers or piezoelectric elements, amplifiers, and other appropriate devices and systems to provide the auditory output. The medicaldata interchange device200 may be configured to provide words, phrases, tones, recorded music, or any other type of auditory output to a user.
• Any type of information may be communicated through theuser interface290, such as the biological, biometric, or behavioral information for one or more patients. The user interface can provide/receive any other suitable information, such as environmental information and/or diagnostic data for a medical device, a battery charge level, a temperature, a barometric pressure, a code relating to an accessory for the medical device, a biometric access measurement, a data validity measurement, an elapsed time since a previous reading by the medical device, a test result parameter, a signal-to-noise parameter, and a quality of service (QoS), and combinations thereof.
• Information provided or received by theuser interface290 may be in any appropriate format. For example, a user interface that communicates information to a user in an auditory format may first provide a data header followed by a data value to identify the data to the user. Similarly, anoutput device294 providing information to a user visually may provide a series of measurements in the form of a spreadsheet with headers indicating the source of the measurements. Theoutput device294 can also provide information in any number of desired languages, regardless of whether the information is provided audibly or visually.
• Various features of the user interface can be implemented in hardware, software, or a combination of the two. In the medicaldata interchange devices200 depicted inFIGS. 2A and 2B, for example, theuser interface290 includes voice interface software stored in thememory220, including tables of recorded words and phrases. When executed by theprocessor210, the voice interface software plays the appropriate recorded words and phrases (such as enunciating the medical data) through a speaker such as one included in theoutput device294 to provide information to the user. The voice interface software, like any software operating on the medicaldata interchange device200, can be downloaded and configured through theauxiliary communication system244 ordevice interface242. As discussed previously, any software program on any device operating in accordance with the present invention can be programmed or configured through any other suitable interface. In the medicaldata interchange device200, for example, the voice interface software could also be downloaded and configured through thedata relay transceiver230 in response from a command from amedical data server270 and/orintermediary device260, as well as from input from the user through theuser interface290. Accordingly, the voice interface software can be configured to include words and phrases in any number of different languages, and can be updated with new words and phrases as desired, such as to accommodate a newmedical device250 operating with the medicaldata interchange device200. Non-verbal sounds, such as melodies and tones, can also be stored and used by theuser interface294 to provide alerts, indicators, and other information to the user.
• The user interface can also provide/receive information to a user in a machine-readable format. In one exemplary embodiment of the present invention, for example, theuser interface290 of a medicaldata interchange device200 includes a fixed or retractable USB port to communicate with a thumb drive, memory stick, portable hard drive, an external computer system, or other USB-compatible device. This allows doctors and other healthcare providers to directly access the medicaldata interchange device200 directly, without having to retrieve the data from a medical data server. In this exemplary embodiment, the medicaldata interchange device200 can be configured to send, receive, and process machine-readable data can in any standard format (such as a MS Word document, Adobe PDF file, ASCII text file, JPEG, or other standard format) as well as any proprietary format. Machine-readable data to or from the user interface may also be encrypted to protect the data from unintended recipients and/or improper use. In an alternate embodiment, a user must enter a passcode to enable use of the USB port, and optionally, after a period of time of non-use, the USB port is automatically disabled. Any other user interface feature may be utilized to allow a human or non-human user to interact with one or more devices operating in conjunction with the present invention.
Power Saving Features
• A medical data interchange device, intermediary device, medical device, or other system operating in accordance with aspects of the present invention may include any other suitable features, components, and/or systems. For example, thedata interchange device200 or other device may be configured to preserve the life of its battery by shutting off or going into a low-power mode when it, and/or the medical device it monitors, experiences a predetermined period of non-use, or a change in a measured parameter such as indication that a case holding thetranslator200 has been actuated to a closed position. Such devices can also be configured to become active in response to any suitable event, such as receiving a signal from a device (such as a sensor).
• In one non-limiting embodiment of the present invention, referring now toFIG. 8, a medicaldata interchange device200 communicates with amotion sensor810 and alight sensor820 to determine when acontainer830 holding thedata interchange device200 and themedical device250 it monitors is open or closed. In this exemplary embodiment, thedata interchange device200 can preserve the life of its battery by shutting off or going into a low-power mode when thecontainer830 is closed and, therefore, themedical device250 held in thecontainer830, is not in use. Any type of motion sensor can be used in accordance with the present invention, such as an accelerometer, tilt switch, or other device that generates a signal in response to movement. Similarly, any type of light sensor may be used in conjunction with the present invention. The light sensor can be used to detect the amount of light entering acontainer830 holding the medical device, medical data interchange device, or other device to activate the device when the sensed amount of light exceeds a predetermined threshold, or if an increase in the amount of incident light exceeds a predetermined threshold. In an alternate embodiment, a microphone may receive audible signals that are analyzed by the medicaldata interchange device200 to indicate a command has been uttered that indicates that the medicaldata interchange device200 should be shut down or activated from a quiescent or low-power state.
• A sensor may be integrated into the medicaldata interchange device200, or operate externally to thedata interchange device200, communicating with thedata interchange device200 wirelessly or through a wired connection. For example, in the exemplary embodiment depicted inFIG. 8, themotion sensor810 andlight sensor820 are integrated into the interior of thecontainer830 and communicate with a medicaldata interchange device200 contained within to indicate when thecontainer830 is actuated from a closed position to an open position.
Security Measures
• Systems and devices operating in accordance with aspects of the present invention may implement one or more security measures to protect data, restrict access, or provide any other desired security feature. For example, any device operating in conjunction with the present invention may encrypt transmitted data and/or protect data stored within the device itself. Such security measures may be implemented using hardware, software, or a combination thereof. Any method of data encryption or protection may be utilized in conjunction with the present invention, such as public/private keyed encryption systems, data scrambling methods, hardware and software firewalls, tamper-resistant or tamper-responsive memory storage devices or any other method or technique for protecting data. Similarly, passwords, biometrics, access cards or other hardware, or any other system, device, and/or method may be employed to restrict access to any device operating in conjunction with the present invention.
• The particular implementations shown and described above are illustrative of the invention and its best mode and are not intended to otherwise limit the scope of the present invention in any way. Indeed, for the sake of brevity, conventional data storage, data transmission, and other functional aspects of the systems may not be described in detail. Methods illustrated in the various figures may include more, fewer, or other steps. Additionally, steps may be performed in any suitable order without departing from the scope of the invention. Furthermore, the connecting lines shown in the various figures are intended to represent exemplary functional relationships and/or physical couplings between the various elements. Many alternative or additional functional relationships or physical connections may be present in a practical system.
• Changes and modifications may be made to the disclosed embodiments without departing from the scope of the present invention. These and other changes or modifications are intended to be included within the scope of the present invention, as expressed in the following claims.

Claims (76)

1. A method, comprising:

determining that an event regarding a patient has occurred, and thereupon enabling a tracking mode in a device controlled by the patient;

monitoring one or more conditions to determine whether the tracking mode should be disabled, and until the tracking mode is disabled, the device:

obtains a data pairing, the data pairing comprising a location of the patient and a time related to the location of the patient, and

stores the data pairing within a memory in the device; and

formatting a report for transmission to a medical data server, the report comprising at least a patient identifier for the patient and the data pairing.

2. The method ofclaim 1 further comprising:

until the tracking mode is disabled, determining whether a measurement for an updated data pairing should be taken, and whereupon the determination is made that the measurement for the updated data pairing should be taken, the device:

obtains the updated data pairing comprising an updated location of the patient and a time related to the updated location of the patient; and

stores the updated data pairing in the memory in the device.

3. The method ofclaim 2 wherein the report includes the data pairing and one or more updated data pairings.

4. The method ofclaim 1 wherein the event comprises the device controlled by the patient passing a predetermined geographical position.

5. The method ofclaim 4 wherein the device controlled by the patient passing a predetermined geographical position is detected when an RFID (radio frequency identification) tag in the device is sensed.

6. The method ofclaim 4 wherein the device controlled by the patient passing a predetermined geographical position is detected when a signal emitted by the device is sensed.

7. The method ofclaim 4 wherein the device controlled by the patient passing a predetermined geographical position is detected when a signal emitted by a fixed beacon is sensed.

8. The method ofclaim 4 wherein the device controlled by the patient passing a predetermined geographical position is detected when proximity to a second device is sensed.

9. The method ofclaim 1 wherein the event comprises the patient not being within a predetermined proximity of a predetermined geographical location for a predetermined period of time.

10. The method ofclaim 1 wherein the event comprises determining that the patient has entered a request to enable the tracking mode through a user interface in the device.

11. The method ofclaim 1 wherein the event comprises determining that the patient has entered a request to enable the tracking mode by speaking a command to enable the tracking mode.

12. The method ofclaim 1 wherein the event comprises determining that the patient has experienced an increased risk to the patient's safety.

13. The method ofclaim 12 wherein determining that the patient has experienced the increased risk to the patient's safety further comprises at least one of:

determining that the patient is engaging in exercise;

determining that the patient is using a restroom facility;

determining that the patient is leaving a predetermined area;

determining that the patient is entering a predetermined area;

determining that the patient is located in a hazardous public situation;

determining that the patient is experiencing a predetermined perceived medical condition;

determining that the patient is experiencing a medical emergency;

determining that the patient is experiencing a failed connection to a medical telemetry device;

receiving a notification by a healthcare provider that the patient's safety is compromised; and

receiving a notification by a law enforcement officer that the patient's safety is compromised.

14. The method ofclaim 1 wherein the event comprises receiving, by the device controlled by the patient, a command that instructs the device to enable the tracking mode.

15. The method ofclaim 1 wherein the event comprises the device controlled by the patient detecting that a signal strength of a received RF signal has decreased below a previously determined level.

16. The method ofclaim 1 wherein the event comprises the device controlled by the patient detects a loss of communication with a medical service provider.

17. The method ofclaim 1 wherein the event comprises the device controlled by the patient detects that the device has been removed from a predetermined geographical area.

18. The method ofclaim 17 wherein the predetermined geographical area comprises a residence for the patient.

19. The method ofclaim 17 wherein the predetermined geographical area comprises a room for the patient within a facility for providing medical treatment.

20. The method ofclaim 1 wherein the event comprises the device controlled by the patient detects that the device has entered a predetermined geographical area.

21. The method ofclaim 20 wherein the predetermined geographical area comprises a hazardous area.

22. The method ofclaim 20 wherein the predetermined geographical area comprises a pathway for moving vehicles.

23. The method ofclaim 1 wherein the event comprises the device controlled by the patient detects an environmental parameter.

24. The method ofclaim 23 wherein the device controlled by the patient detects the environmental parameter through one or more of a sensor and a user interface in the device.

25. The method ofclaim 23 wherein the environmental parameter comprises one or more of a battery charge level, a temperature, a barometric pressure, a code relating to an accessory for the device, a data validity measurement, an elapsed time since a previous reading by the device, a test result parameter, a signal-to-noise parameter and a quality of service (QoS) parameter.

26. The method ofclaim 24 wherein the sensor comprises an accelerometer and detecting the environmental parameter comprises sensing a change in an output signal from the accelerometer.

27. The method ofclaim 24 wherein the sensor comprises a tilt switch and detecting the environmental parameter comprises sensing a change in an output signal from the tilt switch.

28. The method ofclaim 1 wherein the event comprises the device controlled by the patient detecting acceleration exceeding a predefined threshold followed by detecting one or more of a predefined attitude for the device, a predefined change in attitude for the device and acceleration less than a predefined threshold for a predefined period of time.

29. The method ofclaim 1 further comprising the device prompting the patient for a response.

30. The method ofclaim 29 wherein the prompting comprises one or more of the device vibrating, displaying a message, illuminating an indicator and announcing a message to the patient seeking the response.

31. The method ofclaim 29 wherein if the response is not received by the device within a predefined time or the response is received within the predefined time but otherwise constitutes a response indicting a predefined unfavorable condition for the patient, the device summons assistance for the patient.

32. The method ofclaim 31 wherein the summons for assistance comprises one or more of sending a communication seeking such assistance to the medical data server or a healthcare provider.

33. The method ofclaim 2 wherein the determination of whether a measurement for an updated data pairing should be taken is performed automatically, manually, continuously, regularly, irregularly, randomly or in any combination of the foregoing.

34. The method ofclaim 1 wherein the event comprises the device controlled by the patient detects that the patient is moving after a predetermined time of day.

35. The method ofclaim 1 wherein the event comprises the device controlled by the patient detects that the patient is moving before a predetermined time of day.

36. The method ofclaim 1 wherein the event comprises the device controlled by the patient detecting an abnormal medical condition for the patient.

37. The method ofclaim 36 wherein the abnormal medical condition for the patient is detected by a sensor.

38. The method ofclaim 36 wherein the abnormal medical condition for the patient is detected by a remote service that has detected the abnormal medical condition for the patient by analysis of data regarding the patient.

39. The method ofclaim 1 further comprising receiving a command instructing the device to halt the tracking mode.

40. The method ofclaim 39 wherein the command to instruct the device to halt the tracking mode is issued from one or more of the medical data server, a healthcare provider or the patient through a user interface in the device.

41. The method ofclaim 39 further comprising sending a communication confirming receipt of the command instructing the device to halt the tracking mode.

42. The method ofclaim 1 further comprising passing a home gateway instructing the device to halt the tracking mode.

43. The method ofclaim 42 wherein the home gateway comprises one or more of an RFID (radio frequency identification) tag, a low power localized signal transmitter and a Wi-Fi hotspot for a home or other predefined location.

44. The method ofclaim 1 further comprising the device arriving within a geofenced boundary instructing the device to halt the tracking mode.

45. The method ofclaim 1 further comprising the device arriving at a predetermined location instructing the device to halt the tracking mode.

46. The method ofclaim 1 further comprising the device senses that the patient pushes a button instructing the device to halt the tracking mode.

47. The method ofclaim 1 further comprising the device senses that the patient issues a verbal command that is recognized by a voice recognition system in the device to disable the tracking mode.

48. The method ofclaim 1 further comprising the device receives a command deactivating the tracking mode based on a predetermined condition.

49. The method ofclaim 48 further comprising sending a communication confirming receipt of the command instructing the device to halt the tracking mode.

50. The method ofclaim 1 further comprising the device senses that a signal strength of a received RF signal has risen above a predetermined threshold instructing the device to halt the tracking mode.

51. The method ofclaim 1 further comprising the device detects re-establishment of communication with a medical service provider instructing the device to halt the tracking mode.

52. The method ofclaim 1 wherein the device controlled by the patient comprises a global positioning service (GPS) sensor for obtaining the data pairing.

53. The method ofclaim 1 wherein the device controlled by the patient comprises a location-based service (LBS) sensor for obtaining the data pairing.

54. The method ofclaim 1 wherein the memory in the device controlled by the patient comprises a nonvolatile memory.

55. The method ofclaim 54 wherein the memory comprises a FLASH memory device.

56. The method ofclaim 1 further comprising transmitting the report to at least one of a healthcare provider and the medical data server.

57. The method ofclaim 56 wherein transmitting the report further comprises transmitting the patient identifier and the data pairing to the medical data server accessible by the healthcare provider.

58. The method ofclaim 56 wherein transmitting the report further comprises transmitting the patient identifier and the data pairing to an intermediary device.

59. The method ofclaim 58 wherein the intermediary device comprises a wireless hub.

60. The method ofclaim 58 wherein the intermediary device comprises a docking station.

61. The method ofclaim 56 wherein transmitting the report further comprises transmitting data through at least one of a cellular telephony protocol, a local wireless data transmission protocol, and a wired digital communication protocol.

62. The method ofclaim 61 wherein the cellular telephony protocol comprises one or more of a General Packet Radio Service (GPRS) network, a wireless Local Area Network (WLAN), a Global System for Mobile Communications (GSM) network, an Enhanced Data rates for GSM Evolution (EDGE) network, a Personal Communication Service (PCS) network, an Advanced Mobile Phone System (AMPS) network, a Code Division Multiple Access (CDMA) network, a Wideband CDMA (W-CDMA) network, a Time Division-Synchronous CDMA (TD-SCDMA) network, a Universal Mobile Telecommunications System (UMTS) network, a Time Division Multiple Access (TDMA) network, and/or a satellite communication network.

63. The method ofclaim 61 wherein the local wireless data transmission protocol comprises one or more of a Zigbee protocol, a Wibree protocol, an IEEE 802.11 protocol, an IEEE 802.15 protocol, an IEEE 802.16 protocol, an Ultra-Wideband (UWB) protocol, an Infrared Data Association (IrDA) protocol, a Bluetooth protocol.

64. The method ofclaim 1 wherein the report is transmitted to the medical data server once the data pairing is stored in memory.

65. The method ofclaim 2 wherein upon termination of the tracking mode, at least one of the data pairing and one or more of a plurality of the updated data pairings are included in the report which is transmitted to at least one of a healthcare provider and the medical data server.

66. The method ofclaim 65 wherein the report is transmitted following termination of the tracking mode and within a predefined time window.

67. The method ofclaim 65 wherein the predefined time window includes a time of day where lower cost of transmission is available.

68. The method ofclaim 1 further comprising receiving, by the device controlled by the patient, a command indicating that certain information stored in the memory should be uploaded from the device.

69. The method ofclaim 1 further comprising analyzing at least one of the data pairing and one or more of a plurality of the updated data pairings to determine whether a predetermined safety threshold has been exceeded for the patient.

70. The method ofclaim 1 further comprising analyzing at least one of the data pairing and one or more of a plurality of the updated data pairings to determine a mobility profile for the patient.

71. The method ofclaim 1 further comprising analyzing at least one of the data pairing and one or more of a plurality of the updated data pairings to determine an exercise profile for the patient.

72. The method ofclaim 1 further comprising analyzing at least one of the data pairing and one or more of a plurality of the updated data pairings to determine a trend of patient movement over time.

73. The method ofclaim 72 wherein the trend of patient movement over time indicates whether the patient has entered a bathroom more or less than a predefined number of times in a predefined period of time.

74. The method ofclaim 72 wherein the trend of patient movement over time indicates whether the patient has remained stationary for more or less than a predetermined period of time.

75. The method ofclaim 72 wherein the trend of patient movement over time indicates whether the patient has remained in a predefined area for more or less than a predetermined period of time.

76. The method ofclaim 72 wherein the trend of patient movement over time indicates whether the patient has failed to reach a predetermined appointment location within a predetermined time period.

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