US20220319651A1 - Optical sensing systems and methods for detecting a physiological condition of a patient - Google Patents

Abstract

The present disclosure provides a physiological monitoring system that includes at least one physiological sensor indicative of a physiological condition of a patient, the at least one sensor worn by a patient. Sensors can include one or more optical sensors configured to measure a physiological parameter, such as total hemoglobin, Sp2, methemoglobin, carboxyhemoglobin, and the like. A monitoring system can receive measured information from the sensor and determine if the physiological condition of the user indicates an urgent medical need. When the physiological condition of the user indicates an urgent medical need, the electronic device can generate an alert.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• Any and all applications for which a foreign or domestic priority claim is identified in the Application Data Sheet as filed with the present application are hereby incorporated by reference under 37 CFR 1.57.
BACKGROUNDField
• The present disclosure relates to the field of patient monitoring devices. More specifically, the disclosure relates to portable and handheld personal health organizers that are adapted to be coupled with patient monitors that measure physiological characteristics such as blood glucose level, total hemoglobin, SpO₂, methemoglobin, carboxyhemoglobin, and the like.
Description of the Related Art
• Caregivers often employ patient monitoring systems or devices, such as pulse oximeters, capnographs, blood pressure cuffs, and the like, for convenient spot checking and even continuous monitoring of physiological characteristics of a patient. Patient monitoring systems generally include one or more sensors applied to a patient, a monitoring device, and one or more cables connecting the one or more sensors to the monitoring device.
• Portability of these monitoring systems is advantageous for a number of reasons. For example, portable devices provide the patient with mobility and provide the caregiver the option of including the monitoring device when transporting patients from one setting to another. Also, caregivers often transport patients from an ambulance to a hospital emergency room, and between surgical, intensive care, and recovery settings. As another example, portable devices can also provide the patient the capability of using the monitoring systems at home or the office.
• An example of a patient monitoring device is a glucometer, which is used in a procedure for measuring glucose concentration in the blood. Glucometers are a key element of home blood glucose monitoring by people with diabetes mellitus or prone to hypoglycemia. A glucometer typically provides a numerical readout of the patient's glucose level. Other monitor devices may measure physiological characteristics such as total hemoglobin, SpO₂, methemoglobin, carboxyhemoglobin, etc.
• For many conventional patient monitoring devices such as pulse oximeters or glucometers, separate monitoring devices may be needed to measure the oxygen and glucose level saturations. Viewing and analyzing different physiological characteristics would also require separate devices. Moreover, conventional patient monitoring devices are limited to the specialized functions provided by the individual devices, which often include limited data analysis or synchronization capabilities.
SUMMARY OF THE DISCLOSURE
• Embodiments of the present disclosure provide a portable health organizer that enables patients and healthcare personnel to manage health data, and in particular, physiological reading data from one or more health data collection devices such as a glucometer or pulse oximeter. In an embodiment, the personal health organizer is a dedicated portable device that is adapted to retrieve reading data from a health data collection device, which is a noninvasive device in an embodiment and an invasive device in another embodiment.
• In another embodiment, the personal health organizer is a software module/platform that is configured to be executed on a general purpose computing device such as a personal computer, a laptop, a mobile phone, a mobile computer, and a wristwatch computer. The general purpose computer device is directed by the personal health organizer software module/platform to collect or receive data from either an invasive or non-invasive health data collection device. Another embodiment is a personal health organizer device that includes an integrated health data collection module that is configured to receive physiological data reading from a sensor. The personal health organizer can measure various physiological reading data invasively or non-invasively through a sensor connected through a sensor port in an embodiment.
• In an embodiment, the personal health organizer provides seamless integration of the reading data with the patient's existing medical data and with a number of software applications that help a patient manages his or her health. For example, the physiological reading data, e.g., blood glucose, total hemoglobin, SpO₂, methemoglobin, carboxyhemoglobin, can be tracked over a time period so the patient is reminded to take medication and/or perform a new reading. The reminders can be customized or calculated based on prior medical history and/or personal information such as age and gender stored in the personal health organizer. As another example, the reading data can also be forwarded to healthcare providers such as physicians and pharmacies so they can provide feedback to the patient. The personal health organizer can also trigger alerts if the reading data indicate an abnormal level that requires medical attention.
• In addition to the forgoing, embodiments of the present disclosure also provide electronic medical record (EMR) integration in conjunction with support for medical record synchronization across networked locations (e.g. via a cloud computing network). Medical data (including reading data and other patient-entered data such as medication schedule and activity/food in-take logs) from the personal health organizer device are automatically synchronized with the corresponding records located at a remote entity (e.g. in a centralized EMR storage or at the healthcare providers' data storage). For example, newly obtained reading data can be synchronized with a shared, synchronized calendar so that both the physician and the patient user can adjust an appointment if the reading requires a change in the appointment schedule. As another example, prescription information can be synchronized so that reimbursements can be handled automatically when the user finishes a current prescription and purchases a new refill. In another example, the personal health organizer can initiate the prescription refill process after verifying drug interaction and consent of the user and the physician.
• In other embodiments, the personal health organizer includes an accelerometer that detects user motion and the motion can assist in the collection of and/or display of medical/reading data. For example, the accelerometer can detect a user's intent to use the device via touch/motion and automatically start the collection of data when the user places his or her finger into a sensor associated with a health collection data device. In another example, the personal health organizer can begin health data collection once the user places his or her finger into a sensor associated with a health collection data device and/or provides a gesture via a touch-screen input associated with the personal health organizer. In yet another example, the personal health organizer begins the data collection when the user places a finger into the sensor. The LEDs and photo diodes in the sensor can detect the presence of the finger and initiate data collection. The presence of a finger can be determined, for example, by determining when there is a significant reduction in detected light. Such a reduction in detected light can indicate the presence of a finger and start the data collection process.
• In other embodiments, the personal health organizer includes a number of health education and gaming modules designed to educate the user on health management and motivate the user toward a healthier lifestyle. The educational and gaming content can be customized based on the user's current reading data. For example, a tree icon indicative of the user's health can be displayed on the personal health organizer, with the health of the tree corresponding to the recent readings obtained directly by the personal health organizer through a connected sensor or through an associated health data collection device.
• For purposes of summarizing the invention, certain aspects, advantages and novel features of the invention have been described herein. Of course, it is to be understood that not necessarily all such aspects, advantages or features will be embodied in any particular embodiment of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
• A general architecture that implements the various features of the invention will now be described with reference to the drawings. The drawings and the associated descriptions are provided to illustrate embodiments of the invention and not to limit the scope of the invention. Throughout the drawings, reference numbers are re-used to indicate correspondence between referenced elements.
• FIGS. 1A and 1B illustrate an embodiment of a personal health organizer.
• FIGS. 2A and 2B illustrate another embodiment of a personal health organizer.
• FIGS. 3A and 3B illustrate yet another embodiment of a personal health organizer.
• FIG. 4 is a block diagram that illustrates the components of a personal health organizer in accordance with one embodiment.
• FIG. 5 is a block diagram that illustrates the modules of a personal health organizer in accordance with one embodiment.
• FIG. 6A is a flow diagram that illustrates various methods performed by the personal health organizer in accordance with one or more embodiments.
• FIG. 6B illustrates the transfer and synchronization of reading data and medical data in accordance with one embodiment.
• FIG. 7 illustrates a sample handheld monitor and an exemplary noninvasive optical sensor of a health data collection device in accordance with one embodiment.
• FIG. 8 is a block diagram of an example health data collection device capable of noninvasively measuring one or more blood analytes in a monitored patient, according to an embodiment of the disclosure.
DETAILED DESCRIPTION OF PREFERRED AND ALTERNATIVE EMBODIMENTS
• Embodiments of the invention will now be described with reference to the accompanying figures, wherein like numerals refer to like elements throughout. The terminology used in the description presented herein is not intended to be interpreted in any limited or restrictive manner, simply because it is being utilized in conjunction with a detailed description of certain specific embodiments of the invention. Furthermore, embodiments of the invention can include several novel features, no single one of which is solely responsible for its desirable attributes or which is essential to practicing the inventions herein described.
• Systems, methods, and computer-readable media are disclosed for obtaining and analyzing medical data from a medical device or a data server. More specifically, systems, methods, and computer readable media are disclosed for enabling a portable device to obtain and analyze medical data from a health data collection device, such as a glucometer.
• FIGS. 1A-1B, 2A-2B, and 3A-3B illustrate three primary embodiments of the personal health organizer. First,FIGS. 1A and 1B depict a dedicated portable personal health organizer device that is configured to receive data from a health data collection device such as a glucometer. In an embodiment, the personal health organizer is configured to analyze data from the collection device, manage the collected data, and use the collected data to assist the patient in managing his or her personal healthcare. For example, the collected data can be used to schedule reminders for the patient to visit his or her physician or pharmacist. Second,FIGS. 2A and 2B depict a general purpose computing device configured to execute a personal health organizer software module, with the computing device further configured to receive data from a health data collection device such as a glucometer. The general purpose computing device can be a mobile computing device with its own operating system and software, and has installed upon it the personal health organizer software module configured to perform tasks that are substantially similar to those performed by the dedicated personal health organizer depicted inFIGS. 1A and 1B. Finally,FIGS. 3A and 3B depict a device that integrates a personal health organizer software module with a health data collection device module, with the collection device module coupled with hardware to perform tasks of health data collection such as those performed by a glucometer or other patient monitoring device described above. Each of these primary embodiments will be described in further detail below.
Personal Health Organizer as a Dedicated Portable Device
• FIG. 1A shows apersonal health organizer110 as a device configured for analyzing data collected by a healthdata collection device112. As shown inFIG. 1A, thepersonal health organizer110 can be connected to the healthdata collection device112 via acommunications link114. The communications link114 can be a wired or wireless connection adapted to transfer data between the two devices. Examples of wired connections include USB, serial, and parallel and examples of wireless connections include Bluetooth®, Wi-Fi, WiMAX, Wireless USB, and ZIGBEE. In various embodiments, the healthdata collection device112 is configured to collect physiological data from a patient invasively or non-invasively. The healthdata collection device112 can be a glucometer, a pulse oximeter, monitor devices that measure total hemoglobin, SpO₂, methemoglobin, carboxyhemoglobin, and the like. Example portable non-invasive monitoring devices are disclosed in co-pending U.S. patent application Ser. No. 12/534,827, filed Aug. 3, 2009, assigned to Masimo Labs of Irvine, Calif., the Assignee of the present application, the disclosure of which is incorporated herein by reference.
• Thepersonal health organizer110 can comprise a computing system configured to perform functional tasks of various embodiments of the invention. For example, in an embodiment, thepersonal health organizer110 accesses data collected by the healthdata collection device112 or stored at amedical data server120 connected via anetwork124, which can include a LAN, WAN, or the Internet. Themedical data server120 and thepersonal health organizer110 can be connected to the network viacommunications links146 and148, respectively, and the communications links can include wired or wireless connections. Themedical data server120 can be a conventional, preexisting data system operated by an entity such as a hospital or an insurance company.
• In the embodiment depicted inFIG. 1B, the healthdata collection device112 includes afinger clip sensor116 connected to amonitor118 via a cable. Moreover, themonitor118 can advantageously includes electronic processing, signal processing, and data storage devices capable of receiving signal data from thesensor116, processing the signal data to determine one or more output measurement values indicative of one or more physiological parameters of a monitored patient, and displaying the measurement values, trends of the measurement values, combinations of measurement values, and the like. Alternatively, in an embodiment, thepersonal health organizer110 includes a sensor port that allows for a sensor such as thesensor116 to be connected directly to thepersonal health organizer110, and in that embodiment thepersonal health organizer110 includes components and devices for processing the signal data from thesensor116.
• Themonitor118 can also include other components, such as a speaker, a power button, removable storage or memory (e.g., a flash card slot), an AC or DC power port, and one or more network interfaces, such as a universal serial bus (USB) interface, an Ethernet port, or a wireless port. These interfaces and ports can be used by themonitor118 in one embodiment to communicate with thesensor116 via acommunication link104, which may include various types of communication protocols and links as described above with respect to thecommunication link114. For example, themonitor118 can include a display that can indicate a measurement for glucose, for example, in mg/dL. Other analytes and forms of display can also appear on themonitor118.
• In addition, although a single sensor with asingle monitor118 is shown, different combinations of sensors and device pairings can be implemented. For example, multiple sensors can be provided for a plurality of differing patient types or measurement sites or even patient fingers. Thesensor116 can also connect to themonitor118 wirelessly. Alternatively, thesensor116 and themonitor118 can be integrated into a single unit. A skilled artisan would appreciate that many other monitoring device configurations can be used as well.
Personal Health Organizer as a Software Module
• FIG. 2A depicts another embodiment with a personal healthorganizer software module132 executed on a generalpurpose computing device126, with thecomputing device126 coupled with the healthdata collection device112 via acommunications link128. The communications link128 can be a wired or wireless connection adapted to transfer data between the two devices. The personalhealth organizer module132 can be an executable program on an operating system of a device such as a mobile phone, a personal digital assistant, a portable music player, an electronic book reader, a netbook, a TV media center, and a laptop or desktop computer. For example, the personalhealth organizer module132 can be an application that is executed on the operating system of a mobile phone such as the iPhone manufactured by Apple, Inc., a Blackberry device manufactured by Research In Motion, Inc., the Pre manufactured by Palm, Inc, or a mobile device manufactured by HTC, Nokia, or Motorola, etc. In an embodiment, the personal healthorganizer software module132 is configured to perform tasks that are substantially similar to those performed by the dedicated personal health organizer depicted inFIG. 1A. In an embodiment, thecomputing device126 is connected to thenetwork124 via acommunications link122, which can be a wired or wireless connection. As withFIG. 1A, thecomputing device126 can be connected to themedical data server120 via thenetwork124.
• As shown inFIG. 2B, thegeneral computing device126 can be coupled with the healthdata collection device112, with themonitor118 andsensor116 as described above. In the embodiments shown inFIGS. 1A, 1B, 2A, and 2B, the communication and/or I/O interfaces of the healthdata collection device112 can be used to connect topersonal health organizer110 or126. For example, the USB interface could be used to connect themonitor118 to a USB port of thepersonal health organizer110 or126. As another example, the wireless port of the healthdata collection device112 could be used to communicate with the personal health organizer via a wireless link, such as an RF or infrared link or a Bluetooth® link. A skilled artisan will appreciate that a variety of other configurations and communication mechanisms are possible. For example, in an embodiment, generalpurpose computer device126 includes a sensor port that allows for a sensor such as thesensor116 to be connected directly to the generalpurpose computer device126, and in that embodiment the generalpurpose computer device126 includes components and devices for processing the signal data from thesensor116. In another embodiment, thesensor116 can be connected wirelessly to the generalpurpose computer device126 through one or more known wireless connection protocols such as Bluetooth®. A skilled artisan will also appreciate that connecting themonitor118 to the personal health organizer can allow the personal health organizer to collect, store, or analyze the output measurement values produced by themonitor118.
• Integrated Device with Personal Health Organizer and Health Data Collection Modules
• FIG. 3A depicts another embodiment with a personal healthorganizer software module132 executed on acomputing device130 that is integrated with a health datacollection device module134. In an embodiment, the health datacollection device module134 is configured to collect physiological data such as glucose reading and other physiological parameters. In an embodiment, the health datacollection device module134 includes components and devices for processing the signal data from thesensor116. As shown inFIG. 3B, theintegrated device130 can include a monitor display and asensor116. The monitor display can provide for display for both the personal healthorganizer software module132 and the health datacollection device module134. In an embodiment, thesensor116 can be further integrated into theintegrated device130. In another embodiment, the wire connecting thesensor116 to theintegrated device130 can be retractable or detachable so that thesensor116 can be housed within theintegrated device130 or elsewhere when thesensor116 is not in use. In the detachable embodiment, theintegrated device130 includes a sensor port that allows for thesensor116 to be connected directly to theintegrated device130 through one or more known connection/communication protocols including USB and Ethernet. Thesensor116 can also connect wirelessly to theintegrated device130.
• In one or more embodiments, thepersonal health organizer110,126 or130 can be covered by a water-proof case (e.g. a case that can withstand water pressure up to 300M in depth). In an embodiment, thesensor116 is either detached from the personal health organizer device or integrated into the personal health organizer within the water-proof case. The case can allow, for example, divers to use the personal health organizer under water.
• Although a single personal health organizer is depicted inFIGS. 1A-3B, many different personal health organizers, monitoring devices, or sensors that operate as described above can be provided. In addition, multiple distinct healthcare entities and systems can communicate with a personal health organizer and its associated monitoring device and/or sensor. This can include corporate two-way interaction of data hubs such as Google Health, Microsoft Health Vault, and hubs maintained by WellPoint or other insurers. One skilled in the art will appreciate that any number of patients or healthcare professionals can be provided access to thepersonal health organizer110,126, or130 or thedata server120.
Personal Health Organizer Components—General
• FIG. 4 illustrates in more detail components of an examplepersonal health organizer110, general computing device126 (with a personal health organizer module132) orintegrated device130 in accordance with various embodiments (hereinafter referred to as “personal health organizer”). In an embodiment, the components are divided into required components and optional components. InFIG. 4, the required components are illustrated in blocks with continuous lines while the optional components are illustrated in blocks with dotted lines.
• As illustrated inFIG. 4, various embodiments of the personal health organizer include one or more of the following components: one or more computer processor(s)202, astorage204, a display/touch panel206, and aninterface208. One or more of these components can be connected together via a system bus210. In an embodiment, thestorage204 includes (1) data storage such as a hard disk and/or removable media such as a flash drive, and/or (2) memory storage such as RAM or ROM. The processor(s)202 can process signals received from a sensor such as thesensor116 shown inFIGS. 1B, 2B, and 3B and derive physiological readings such as blood glucose level or other parameters from the signals. Thestorage204 can include instructions or data for performing one or more methods disclosed herein. In one or more embodiments, thestorage204 includes a media card reader interface that accepts a media card such as an SD card, a microSD card, a memory stick, a CF card and the like. The portable media card can be used to store patient information and enable the personal health organizer device to be shared, with the settings and data for the individual user stored in the user's media card. The personal health organizer can also include a biometric identification module (such as a vein pattern or finger print scanner)246 to distinguish one user from another or provide security for information stored.
• In an embodiment, a personal health organizer computing platform/module300 and related modules (shown inFIG. 5) are stored instorage204 and executed on theprocessor202. Additionally, the personal health organizer can access information including patient medical and reading data stored instorage204 in performing methods disclosed herein.
• Theinterface208 can include aninput234, which can in turn include wired and wireless input connections in accordance with various protocols such USB, serial, parallel, SATA, Firewire (IEEE 1394), Bluetooth®, Wi-Fi, WiMAX, Wireless USB, ZIGBEE, etc. Althoughinterface208 is shown as a simple interface, multiple interfaces could be used. For example, the interface can include one or more commonly available input/output (I/O) interfaces that provide a communication interface to various external devices, connected via a wired, wireless, or combination of wired and wireless, communication link. In addition,sensor interface224 can double as a wired interface to other connection types.
• Theinput234 can also accept input from an input device such as a keyboard, a mouse, a speech recognition device, a touch screen device and/or other data entering devices. In an embodiment, the user inputs information through the touch screen functionality integrated into the display/touch panel206. Theinput234 can be connected to the healthdata collection device112, other medical devices, other computing devices, etc. to collect medical and/or physiological reading data that is to be processed, analyzed, and/or communicated.
• In an embodiment, theinterface208 also includes anetwork interface240 that can receive information over any type of network, such as a telephony-based network (e.g., PBX or POTS), a local area network (LAN), a wide area network (WAN), a dedicated intranet, and/or the Internet. Thenetwork interface240 can include a wired interface such as an Ethernet interface or a wireless interface such as Wi-Fi or WiMAX.
• The personal health organizer can be adapted to provide output information to anoutput232, with the information output through wired and wireless connections in accordance with various protocols such USB, serial, parallel, SATA, Firewire, Bluetooth®, Wi-Fi, WiMAX, Wireless USB, ZIGBEE, etc. Information can also be output to anexternal display228 and/or aprinter230.
• As further described below, the personal health organizer can use the stored patient information to generate reports, alerts, and the like for healthcare providers. The personal health organizer can then output the medical information via theoutput232 and/or send the medical information through via thenetwork124.
• Thestorage204 can store personal data associated with patients connected to the personal health organizer, such as name, address, telephone number, driver's license number, social security number, credit card account number, checking account number, age, gender, ethnicity, etc. Sensitive or personal data may be stored in an encrypted format and/or not stored on the personal health organizer. In an embodiment, the user is provided with data storage and security options and can configure the device as desired. In an embodiment, information stored on the device can be remotely wiped, for example, if the device is lost or stolen. Thestorage204 can preferably also include records of reports generated for the healthcare providers (when a provider is the user) or patients, alerts generated for the healthcare providers or patients, patients associated with the healthcare providers, and requests made by the healthcare providers or patients. Thestorage204 can also include the healthcare provider's or patient's membership identification (“ID”) and password. The information to be stored in thestorage204 can be entered, obtained, or transmitted using the touch screen enableddisplay206, the input andoutput232 and234, and/or thenetwork interface240.
• The personal health organizer in an embodiment includes one or more of: a media decoder/encoder/player218 for playing back music and media, aphone226, a built-in video/stillcapability camera214, abarcode interface220, a magnetic compass/accelerometer216, asensor interface224, a glucose strip reader222, a biometric identification module (such as a retinal, vein pattern, or finger-print scanner)246, and anaudio component244. Themedia player218 can play back media such as music and video via a media center software displayed on thedisplay206. Thecamera214 can support a document scanner that allows user to input documents and forms from healthcare providers or insurance companies. In an embodiment, the camera is paired with an optical character recognition module so that scanned medical forms can be converted into data that can be uploaded for synchronization at a server in a network (e.g. a cloud computing network) or stored on the personal health organizer device. The scanner can also enable the user to fill out a medical form and send the completed form to a healthcare provider or an insurance company. User can also photograph or scan the bar code of prescriptions and food packaging to obtain information on drug and nutrition.
• Thesensor interface224 can be used to connect to a health data collection device and/or a sensor such as thesensor116 shown inFIGS. 1A-3B to obtain reading data from the device or sensor. The glucose strip reader222 can be used to read/scan glucose strips and obtain reading data from the strips. Thebarcode interface220 can be used for distinguishing patient records in a hospital setting.
• The personal health organizer can also include aGPS receiver component212, which can determine the location of the personal health organizer. TheGPS receiver component212 can include a digital GPS receiver that can determine the location of the personal health organizer by determining coordinates, such as latitude, longitude, altimeter, etc. using conventional methods know in the art. In the case of an emergency associated with a user of the personal health organizer, emergency services or address book contacts can be contacted and location information of the user can be given by the personal health organizer using information provided by theGPS receiver component212. In addition, the personal health organizer can be adapted to locate and discover nearby healthcare facilities and/or computing devices. For instance, the personal health organizer can determine its location as discussed above, and from knowing its location it could determine the closest hospital or pharmacy, etc. The personal health organizer can also determine what medical devices, equipment, monitors, and/or other computing devices are located near it, for example, by using the broadcast IDs of these devices (e.g. Wi-Fi SSIDs).
• In an embodiment, the magnetic compass/accelerometer component216 enables a virtual reality capability. For example, a panoramic photo can be viewed on thedisplay206 by tilting/rotating the device, where the device updates the current viewing angle of the picture using the 3D acceleration vector from the accelerometer and the direction from the magnetic compass. In an embodiment, other accelerometer-related features include an orientation aware graphic user interface (GUI) on thedisplay206, whereby the GUI adjusts according to the physical orientation of the personal health organizer device. In another embodiment, the GUI provides a hospital navigational feature that can assist a user with navigating or routing through a hospital, for example, using a virtual reality depiction of the hospital. In addition, thedisplay206 can be configured so that a “Portrait View” is used to display numbers and a “Horizontal/Landscape” view is used to view full screen trended data (e.g. readings tracked over a period of time). Both view options can be overridden in the control menu of the personal health organizer device. While in the “trend view,” in an embodiment, the user can slide the trend timeline along a horizontal axis shake of the device, which can be taken to be a user generated gesture interaction with the device. In another embodiment, the user can rapidly shake the personal health organizer device and press the power button shortly to clear the trend that is being viewed. In another embodiment, the user can control or access the scroll menu with a vertical axis shake. An icon can be displayed to show a 2D bubble level and/or a 3D bubble level to give the user feedback that the device is being used in a good orientation for use.
• In yet another embodiment, while the personal health organizer device is in an “Exercise Activity Flag Mode,” the physical movement of the user is measured and correlated with the user's pulse rate, with the pulse being measured by the personal health organizer or a sensor strapped to the exercising user, in order to rate the user's physical activity.
• In other embodiments, the accelerometer can be used so that a three-axis tilt of the device can adjust the perspective view of numerical 3D objects, and a three-axis tilt of the device can adjust the perspective view of the graph for more information. In other embodiments, a steady rapid shake of the device can be reflected in the falling apart of screen information on thedisplay206 and a prompt to notify the user that heavy vibration is detected. Rapid shaking of the device during an alarm clock notification can snooze the alarm.
• The personal health organizer can include a device history log in which a user voluntarily provides access to log data so the manufacturer of the personal health organizer device can determine usage frequencies of various features. The log can be anonymized so that personal medical data is blacked out, blocked, or not provided.
Personal Health Organizer Components—Accessibility Features
• The personal health organizer can also include software and/or hardware support (e.g. the audio component244) for providing a user interface for visually impaired users, including speech and command recognition. In an embodiment, the personal health organizer provides haptic (touch-based) feedback. The feedback can be provided in addition to the audible voice and tonal feedback of the device (e.g. having a vibration notification on each screen interaction to assist the user in navigating the screens).
• One embodiment of the personal health organizer includes an “auto-start” feature in which, after power on, the motion sensor andsensor116 detects if a finger is placed and held steady for a time period (e.g. two seconds) at thesensor116. If so, the device starts the measurement and can optionally upload the result to a server. In an embodiment, the auto-start feature can be paired with audible instructions, sent via theaudio component244, to assist the user in using the device in auto-start mode.
Modules of the Personal Health Organizer
• In one or more embodiments, the personal health organizer device includes one or more modules as shown inFIG. 5. As shown, the personal health organizer device includes a medical and/or physiological datainput software module310 that supports and/or controls the receipt of medical or physiological reading data from the healthdata collection device112, for example. In addition, asensor interface module306 can be included in the personal health organizer device to interface with various sensors. For example, in the embodiment depicted inFIGS. 3A and 3B, where the health data collection functionality is integrated into the personal health organizer device, the personal health organizer includes thesensor interface module306 to interface with the attachedsensor116.
• In an embodiment, the personal health organizer or personal health organizer module further includes a personal healthorganizer software platform300 on which one or more of the following modules can be executed. In another embodiment, the modules can be executed on an operating system on a computing device apart from the personalhealth organizer platform300. The modules include a networkcomputing support module302, a communications I/O interface module304, an electronic medicaldata integration module322, agaming module324, a medicaldata analysis module326, a medical information andeducation module328, adevice security module342, and a medicaldata display module344. These modules are further described as follows.
Medical Data Analysis Module
• The medicaldata analysis module326, by way of example, can be used to receive medical or physiological data from the healthdata collection device112 and/or thesensor116. For example, the medicaldata analysis module326 can be used to receive the measurement outputs from themonitor118 inFIGS. 1B and 2B. As another example, the medicaldata analysis module326 can be used to receive data from thesensor116 inFIG. 3B. The medicaldata analysis module326 can then analyze the data received from thesensor116 to determine reading data and/or measurement values similar to those determined by themonitor118.
• After receiving or determining the reading data, the medicaldata analysis module326 can perform analysis on the reading data. For example, the medicaldata analysis module326 can determine both pre-prandial and post-prandial peak glucose levels. This analysis can help healthcare professionals know when and how to titrate medications, especially for patients who are on an insulin sliding scale coverage. As another example, the medicaldata analysis module326 can determine the mean glucose levels (daily, weekly, or monthly, etc.). The medicaldata analysis module326 can also determine the correlation between the hemoglobin A1cand the glucose levels over a period of time, e.g., a two to three month period. This can show how well controlled the patient's blood sugar level is based on the glucose readings from the glucometer. These functions described can be performed by the medicaldata analysis module326, a sub-module, and/or a separate program on the personal health organizer.
Medical Data Analysis Module—Data Tracking
• In addition to receiving medical data, the medicaldata analysis module326 can be configured to send collected or stored medical data to interested parties using the networkcomputing support module302 and/or the communications I/O interface module304. For example, the medicaldata analysis module326 can send a digital copy of a user's entire medical record, proof of health insurance, etc. to interested parties, such as a physician office. Medical data including current and past readings, reading trends, analyses, medical records, insurance records, can be sent via email, text message, or any other communication medium/protocol to any interested party. Likewise, an interested party (e.g. doctor, insurance company) can also send the same type of data to the personal health organizer via email, text message, or any other communication medium/protocol and the attached/transmitted data can be integrated into the records kept on the personal health organizer.
• The medicaldata analysis module326 can further include one or more sub-modules or programs for tracking medical data, including reading data and/or data related patient activities and correlating the medical data with patient activities. For example, the medicaldata analysis module326 can track daily food intake that can be downloaded vianetwork124. In that embodiment, the medicaldata analysis module326 is used to receive input from a user, via theinput234 and/or the display/touch panel206, indicating food taken throughout the day. Then the medicaldata analysis module326 can store the input in thestorage204, analyze the input to determine trends, and/or generate reports based on the input. This can help the physician, dietician, or patient to improve or modify dietary strategies for glucose control. In an embodiment, trending data is displayed to the user in various graphical formats on thedisplay206 through the medicaldata display module344.
• As another example, the medicaldata analysis module326 can track the glycemic index (GI), which describes the effect of carbohydrates on glucose level, and is sometimes used for medical nutrition therapy. In another embodiment, the medicaldata analysis module326 can maintain a log of insulin injections given and/or received to show a patient's compliance with medications. The insulin injections can be input by the user into the personal health organizer via the user interface on thedisplay206 or input automatically with digital syringe. The medicaldata analysis module326 can also generate hypoglycemia or hyperglycemia alerts. For example, when the received reading data indicates that blood glucose is too low or too high, the medicaldata analysis module326 can alert the patient and prompt the patient to log any symptoms of hypoglycemia or hyperglycemia. Moreover, the medicaldata analysis module326 can have threshold reading values and/or accompanying symptom checklists configurable by a physician or a patient, so that if blood glucose values are detrimentally low or high and/or certain accompanying symptoms appear, alerts will be automatically sent to the patient's physician or emergency medical personnel. Similarly, the medicaldata analysis module326 can determine if a user has missed a reading and it can send alerts (via SMS, email, automated voice call, etc.) to a friend, family member, or a caretaker to check on the user.
• Moreover, the medicaldata analysis module326 can calculate the amount of insulin to be given based on the user's carbohydrate intake and glucose level post-prandial. This is helpful for patients who are on an insulin sliding scale coverage. Also, the medicaldata analysis module326 can perform continuous blood glucose monitoring for patients in a hospital setting or in critical care.
• The medicaldata analysis module326 can also be configured to manage activity flags, based on data input by a user. The data input can, by way of example, include: exercise time and severity of exercise, insulin (basal bolus) dosage, medication taken, food (GI index, carbohydrates/proteins) consumed, weight tracking, pulse rate tracking, or CO tracking for smokers. In addition, the tracking can include custom flags for other user-defined activities.
• In an embodiment, the medicaldata analysis module326 works with the medicaldata display module344 to provide visualization of health data tracking or trending. In an embodiment, the medicaldata display module344 displays trended data for a user in a variety of graphical formats, for example, when rotated in a horizontal position. The trended data can contain continuous or spot readings of measureable parameters or user input for activity flags, as discussed above.
• A skilled artisan would appreciate that the medicaldata analysis module326 could be associated with different types of programs or applications installed by the user that can interface with the medicaldata analysis module326. The functions described herein can also be performed by the medicaldata analysis module326 alone, one or more sub-modules, and/or one or more separate modules/programs on the personal health organizer.
Network Computing Support Module and Electronic Medical Data Integration Module
• In addition to analyzing reading data and providing the user with reminders, alerts, and other feedback to improve the user's health, the personal health organizer in an embodiment includes the electronic medical datarecord integration module322 and/or the networkcomputing support module302 to assist in medical data synchronization. For example, the electronic medical datarecord integration module322 can provide data backup and synchronization of medical results, contacts, and other user data (music, videos, etc.). The electronic medical datarecord integration module322 can also be configured to enable synchronization of emails, text messages, and voice messages. The electronic medical datarecord integration module322 and/or the networkcomputing support module302 can also be configured to synchronize patient data to centralized medical data servers such as Google Health, Microsoft Health Vault, etc.
• The electronic medical datarecord integration module322 can also enable non-patients such as physicians and family members of a primary patient user to synchronize patient data with different access privileges. For instance, an alias can be created to allow non-trusted sources to review patient data without personally identifiable information. The electronic medical datarecord integration module322 can further enable a user to prove good health practices and compliance to receive special discounted rates or rate cuts from health insurance providers. In an embodiment, the electronic medical datarecord integration module322 and/or the networkcomputing support module302 include an embedded web server that allows access to locally stored history, reading/medical data, data settings, and calendar, etc.
• The electronic medical datarecord integration module322 and the networkcomputing support module302 can be associated with a calendar program. The program can allow a user to synchronize the calendar of the personal health organizer with an online synchronized calendar such as Outlook, iCalendar, Google Calendar, Yahoo Calendar, etc. The calendar can also provide an alarm function, including a smart clock that can store or access times for scheduled tests and can determine, based on reading data, if more tests are needed (invasive or non-invasive). As another example, when a prescription is entered, the personal health organizer device in an embodiment tracks medication intake and provides reminders for taking the prescribed medication.
• In addition, the electronic medical datarecord integration module322 can be configured such that the personal health organizer can be used by multiple users. For example, each user's data can be tracked separately on the same device. As a result, for instance, one family would only have to buy one device for spot checking, and family members can login via a password or a biometric identification system as further described below. As another example, an endocrinologist office could purchase patient licenses and store the data of patients the office spot-checks, with the patient records separated by identification tags and protected via the security features described herein. A skilled artisan would appreciate that the users' medical data (including insurance information) could be stored separately on the personal health organizer or a remote system, e.g., an Electronic Medical Record (EMR) server located on a remote computing network (e.g. cloud computing network).
• In an embodiment, the medical data stored on the personal health organizer can be retrieved by an EMS or a first responder through the use of a Rad57 or similar device. A physician can also perform data retrieval using a similar device. In another embodiment, the electronic medical datarecord integration module322 can be configured to manage medical expenses and reimbursements. The electronic medical datarecord integration module322 can be used to track health items purchased by the user and synchronize the items with a medical expense account. The purchased items can also be compared by a comparison shopper module/program for best prices and alternative products. The purchase history information can also be sent to insurance companies for reimbursement of co-pay overages, for example.
• In another embodiment, the networkcomputing support module302 can be configured to provide reminders to the user if the personal health organizer is not with the user. For example, the user can call the personal health organizer via phone or send an email or text message with a particular question regarding appointment times, medication intake schedule, etc. In an embodiment, the personal health organizer or a data server with synchronized medical data records within a remote computing network (e.g. cloud computing network) provides answers to the particular questions sent.
• Since diabetic patients are likely users of the personal health organizer and diabetes can sometimes lead to vision impairment, in an embodiment the electronic medical datarecord integration module322 is configured to synchronize eye care prescription requirement dates and vision check-ups on a calendar. In an embodiment, the personal health organizer includes software for testing the user's vision on the device to determine if a new prescription is needed. The testing software can include Ishihara plates and distance charts displayed on thedisplay206, with the displayed testing materials sized according to an arm's length testing distance.
• In yet another embodiment, the electronic medical datarecord integration module322 is configured to coordinate prescription. For example, once a user's physician verbally mentions a prescription, the personal health organizer can acoustically identify the drug term and search for generic alternatives. Once the physician agrees to the drug (either the branded drug or the suggested generic alternative), the electronic medical datarecord integration module322 is configured in an embodiment to locate a closest pharmacy (using the built-in GPS and/or triangulation software based on cell tower location) with the best price and provides contact information of the pharmacy to the user. It can also provide the pharmacy information to a remote computing network (e.g. cloud computing network) for data synchronization or send it directly to the user's physician so that he or she can submit an electronic prescription.
• Various embodiments of the personal health organizer also provide for exchange of medical data and related information via email. For example, while a caregiver is taking a reading or measurement of a patient with the personal health organizer, the caregiver can ask the patient whether or how the patient would like to receive information relating to the measurement, and if the patient prefers email or text messages, the email or text message format. The caregiver can input these communication preferences and send an email or text message to the patient at the point of measurement. In one embodiment, an email of the reading or measurement is automatically sent to the patient upon the completion of measurement process. In another embodiment, the email is sent later at the direction of the caregiver user or at a time configured by the caregiver user. The email or text message could also be routed to additional supervising caregivers, medical records personnel or files, others in the health providing mechanism for a particular patient, or the like. In some embodiments, federal, state, local, caregiver facility rulemaking bodies may place requirements on the distribution and/or content of the information, including, for example, the level of permission required for certain types of data based on, for example, the content thereof. In those instances, the personal health organizer may advantageously ask the caregiver at the point of measurement to acquire the appropriate permissions, or withhold sending the email or text message until such permissions are processed, authenticated, verified, or otherwise checked and approved or the like. In other embodiments, the personal health organizer may review the available permissions and appropriate rule authorities and determine the format and content of the email or text message that is available for sending. For example, the personal health organizer may include less information, less detailed information, different groupings of medical and/or personal information based on a particular patient's permissions and/or applicable medical data disclosure rules. Other forms of electronic communications can also be used, for example, information can be posted to a website, such as a private blog. Information can also be sent through various other information posting websites such as, for example, Twitter™.
• None, some, or all of the information relating to patient interactions with the personal health organizer can be sent electronically. For example, emails may be sent to those patients (e.g. an outpatient) that may take measurements on their own or have them taken by a non-professional caregiver such a family member. Emails, text messages, or other electronic communications can also include reminders, requests for data, advice based on data obtained, or any other similar personal or medical information.
Electronic Medical Data Integration Processes
• FIGS. 6A and 6B show methods for integrating medical data records in accordance with embodiments disclosed herein. Atblock352, in an embodiment, a signal indicative of the patient physiological reading is received and/or detected at a sensor of the personal health organizer (or an associated health data collection device). Atblock354, the personal health organizer (or an associated health data collection device) can process the signal to derive or calculate reading data (e.g. derive blood glucose level based on signal received). At theblock360, the reading data can be stored locally (e.g. in the storage204) along with other medical data of the patient user. Atblock362, the personal health organizer can use the reading data to customize local content at the personal health organizer, including games and educational materials. Atblock364, the personal health organizer can use the reading data to generate health reminders and/or recommendations that are personalized for the patient user.
• At block356, the reading data can be forwarded to a remote electronic medical storage. In an embodiment, related medical data can be forwarded with the reading data as well. Atblock372, the records kept at a centralized medical data storage can be synchronized with the forwarded reading data and/or related medical data. Atblock374, the forwarded reading data and/or medical data can be used to generate alerts to healthcare providers. Atblock376, the records kept at healthcare providers can be synchronized with the forwarded reading data and/or medical data. The healthcare providers can use the forwarded data to generate feedback such as alerts, data updates, and diagnoses, which are received at the personal health organizer at block358 in accordance with an embodiment.
• The synchronization of data records is further illustrated inFIG. 6B, where apatient420 is shown to provide reading data to apersonal health organizer402, which in turns forwards the reading data and/or other related medical data of thepatient420 to anetwork124. Thenetwork124 can include a remote computing network (e.g. cloud computing network) comprising of LANs, WANs, and the Internet. The reading data can be relayed tohealthcare providers404, who can provide feedback such as alerts, reminders, and/or diagnoses to thepersonal health organizer402 via thenetwork124. Thehealthcare providers404 can also synchronize their records based on the forwarded reading data (and/or related medical data) and in turn provide synchronized and/or updated medical data back to thepersonal health organizer402. Similarly, the reading data (and/or related medical data) can be forwarded to the electronicmedical record storage406 via the network, and the electronicmedical record storage406 can synchronize its records based on the forwarded reading data (and/or related medical data) and in turn provide synchronized and/or updated medical data back to thepersonal health organizer402 via the network. The returned results from thehealthcare providers404 and/or the electronicmedical record storage406 can be displayed back to thepatient420 and/or used by the personal health organizer for other purposes such as completing financial costs and deductions to users' medical expense accounts.
Gaming Module
• In an embodiment, the personal health organizer includes agaming module324 that includes and/or supports a variety of health-related games. For example, thegaming module324 can allow the user to purchase or download games associated with health training on the disease and written to motivate the emotional state of the user. As another example, thegaming module324 can provide a game that provides a customizable digital pet for children to disassociate from the disease but learn how to care for the digital pet and themselves. The digital pet can include interchangeable configuration data that relate to the appearance of the pet. As a further example, thegaming module324 can display a screen saver that displays a tree either in good or failing condition depending on a user's ability to live successfully with diabetes. For example, a user with a small number of doctor visits, missed insulin injections, bad food choices, and few exercise activities can be shown a withering tree. Conversely, a user who maintains few spikes and drops can be shown a healthy, vibrant tree. In another embodiment, thegaming module324 can provide an interactive game based on training/flash cards and tests. The cards and tests can be based on device usage, health condition/standing, disease knowledge, latest news findings on cures, etc. The testing and training can be synchronized over Internet to allow friend and group competition and participation.
• Thegaming module324 can also be associated with a running companion module. The module can be used to synchronize training records for a user based on the user's shoe type or needs. The module could further be adapted to work with the accelerometer to function as a pedometer or perform some other assessment of movement. A skilled artisan would appreciate that thegaming module324 could use measurements from the pedometer or other assessments of travel to deduce the required shoe type for a user or life span of a particular shoe. For example, thegaming module324 can determine based on distance traveled, the best shoe type for a user or the life span of the shoe the user has been using. Thegaming module324 can utilize theaccelerometer216 in the personal health organizer to enhance the gaming experience.
• External Reading from Additional Health Data Collection Devices
• Embodiments of the personal health organizer include asensor interface module306 that is adapted to connect to sensors for measuring physiological readings of a user. In an embodiment, the personal health organizer includes the communications I/O interface module304 that is configured to interface with various health data collection devices and to obtain reading data from those devices. For example, the personal health organizer can connect to an insulin pump to obtain performance and historical record of pump behavior and dosing. In an embodiment, the personal health organizer connects via the Bluetooth® protocol (e.g. Near Field Connect (NFC) Bluetooth 2.1+EDR) or any other short range wireless connection protocol. In another example, the personal health organizer device can connect to a kidney urine test (sensor), which is a separate sensor adapted to scan the litmus urine test to check protein level in the blood and kidney function. This urine test reading data can be tracked along with other reading and/or patient medical data by the one or more of the modules disclosed herein, e.g., medicaldata analysis module326, to detect whether changes have occurred. The detected changes can be correlated with other medical data such as medication schedules to determine whether the changes have occurred as a result of new medication or progression of disease and damage to organs.
• In an embodiment, the personal health organizer is adapted to obtain reading from a weight scale (e.g. specific brands of electronics scales) to gather weight reading. In another embodiment, an optional thin pad sensor or digital scale tennis shoes can connect via a long cable or wirelessly to the personal health organizer device via, e.g., theinterface component208 shown inFIG. 4. The user stands on connected pad and the weight data is input into the medical data record of the user as kept by the personal health organizer or sent to a remote computing network (e.g. cloud computing network) for medical data synchronization.
• In another embodiment, the personal health organizer is adapted to connect to a sleep sensor, which includes a finger or a toe adhesive sensor that records data to a solid state drive. The recorded data can then be downloaded to the personal health organizer device the next morning to obtain hours of reading data recorded while the user was asleep. The connection to the sleep sensor can be wireless, e.g., the personal health organizer device can near field connect (NFC) to the sensor. Optionally, the sleep sensor can include a component that sends reading data in real time to the personal health organizer device (e.g. via Bluetooth® 2.1+EDR (300′ range)), and instructs the personal health organizer to contact medical personnel or an emergency contact if the reading data indicates a urgent medical need.
• In other embodiments, sensors and/or devices measuring physiological parameters such as Glucose, PR, CO, SpO₂, Cholesterol, LDL, HDL, SpHb, Hemoglobin A1C, SpHet, SpMet, oxygen content, bilirubin, etc. can be connected to the personal health organizer device. In an embodiment, theinterface208 includes a universal interface that is adapted to connect to various kinds of home used medical equipment such as blood pressure measuring devices, body temperature thermometers, etc. In other embodiments, the personal health device connects these external health data collection devices through one or more wired or wireless connections as discussed above in conjunction with theinterface208 shown inFIG. 4.
Medical Information and Education—Rankings and Reviews
• The personal health organizer can also include a medical information andeducation module328 that provides healthcare-related information. For example, the medical information andeducation module328 can download and provide endocrinologist rankings, hospital rankings, ophthalmologist rankings, podiatrist rankings, surgeon rankings, etc. Endocrinologist rankings can, for example, provide a specialist listing service for best ranked doctors in a user's area (based on GPS location or ZIP code) or elsewhere. These hospital, surgeon, and/or ophthalmologist rankings could also provide reviews based on care of diabetes. In addition or in lieu of the rankings, the medical information andeducation module328 can provide diabetes product reviews. These reviews could include reviews of equipment, needles, pumps, medications, etc. These reviews and rankings can be periodically updated via the use of the networkcomputing support module302 and/or the communications I/O interface module304.
Medical Information and Education—Other Information and Online Communities
• In an embodiment, the medical information andeducation module328 includes one or more of the following sub-modules. First, it can include a gestational diabetes sub-module that allows for the integration of information and settings specific to the term of pregnancy and the user's concerns. The gestational diabetes sub-module can show pictures of the fetus in each stage of development, and can further be synchronized with the user's calendar and week by week progression. The sub-module can also assist with monitoring timers, medication reminders, and prenatal timers etc. Second, the medical information andeducation module328 can include a “Personal Nurse Educator” sub-module. The sub-module can be paid for by an insurance company to provide a 24-hour nurse on call service, with the service specifically allowed to access the user's medical information stored within a remote computing network (e.g. cloud computing network), including data stored on the personal health organizer device. The sub-module enables the user to chat with, send text messages to, email, or phone (including video conference) the on-call nurse with specific questions.
• Third, the medical information andeducation module328 can include an online health information and chat forum access sub-module. For example, the sub-module can provide latest information on diabetes provided by the diabetes community, including medication information, medical definitions, medical theories, leading developments in cures, and equipment available in various countries. The sub-module can also provide access to support groups. In an embodiment, the sub-module can play back recorded phonic files of correct pronunciations of medications or medical terms. Fourth, the medical information andeducation module328 can include a diabetes events calendar sub-module that shows local events and/or global events about diabetes (e.g., world diabetes day, fundraisers etc.), including information on how to get involved or donate directly from the personal health organizer device.
Additional Features
• In an embodiment, the personal health organizer includes the communications I/O interface module304 for providing wireless access to the Internet. Access can be provided via any known protocols such as Wi-Fi, WiMAX, 3G, 4G, CDMA, GSM, etc. For instance, thecommunications module304 can be configured to provide free Wi-Fi access at doctor's office. Similarly,communications module304 can be associated with an IP Telephony program such as Skype. This could allow video conferencing (e.g., using built-in camera214) between a user of the personal health organizer and his or her physician. The program can also allow Internet based calling via Vonage, Skype or other VOIP providers.
Verification/Security
• In an embodiment, thedevice security module342 provides a number of security features to secure data stored on the personal health organizer device or otherwise prevent unauthorized access to the device. In an embodiment, if the personal health organizer device is lost, thedevice security module342 enables the device to be located with a remote computing network (e.g. cloud computing network). For example, the owner of a lost device can trace the location of the device via the GPS receiver embedded in the device, or through network address (e.g. IP address) tracing when the device is logged onto a network. Additionally, if the user misplaced the device, thedevice security module342 can generate audible or visual alerts such as whistle, beep, vibrate or blink (e.g. through the audio component244) when the user calls it or accesses it through a network.
• In another embodiment, if the device is used by a new user, based on the new user's reading (e.g. blood glucose reading), thedevice security module342 can recognize that the user has changed. The device can then prompt the new user to enter a password. Thedevice security module342 can also utilize biometric identification, for example, through the built-incamera214. Thedevice security module342 can recognize the face and expressions of the user from the camera. Another embodiment includes an additional rear sub CCD or CMOS camera placed behind an LCD or OLED screen so the user could be prompted for finger print or palm identification. In addition, a CCD or CMOS camera can be embedded in the sensor to take picture of the user's finger print. In addition to or in place of external biometric identification, a special near infrared emitter detector can absorb the unique vein pattern of the finger. Thedevice security module342 can also utilize the CCD or CMOS camera to distinguish among patients when the device is shared among multiple patients (e.g. in a hospital setting for where a healthcare personnel is using the device for multiple patients). Once a patient's finger print is recognized, the device automatically brings up the patient's file.
Example Health Data Collection Device
• FIG. 7 illustrates an example of a healthdata collection device112. In the depicted embodiment, themonitoring device118 includes afinger clip sensor116 connected to amonitor118 via a cable452. In the embodiment shown, themonitor118 includes adisplay456, control buttons454 and a power button. Moreover, themonitor118 can advantageously include electronic processing, signal processing, and data storage devices capable of receiving signal data from saidsensor116, processing the signal data to determine one or more output measurement values indicative of one or more physiological parameters of a monitored patient, and displaying the measurement values, trends of the measurement values, combinations of measurement values, and the like.
• The cable452 connecting thesensor116 and themonitor118 can be implemented using one or more wires, optical fiber, flex circuits, or the like. In some embodiments, the cable452 can employ twisted pairs of conductors in order to minimize or reduce cross-talk of data transmitted from thesensor116 to themonitor118. Various lengths of the cable452 can be employed to allow for separation between thesensor116 and themonitor118. The cable452 can be fitted with a connector (male or female) on either end of the cable452 so that thesensor116 and themonitor118 can be connected and disconnected from each other. Alternatively, thesensor116 and themonitor118 can be coupled together via a wireless communication link, such as an infrared link, radio frequency channel, or any other wireless communication protocol and channel.
• Themonitor118 can be attached to the patient. For example, themonitor118 can include a belt clip or straps that facilitate attachment to a patient's belt, arm, leg, or the like. Themonitor118 can also include a fitting, slot, magnet, snap-click connector (e.g., connectors manufactured by LEMO S.A. of Switzerland), or other connecting mechanism to allow the cable452 andsensor116 to be attached to themonitor118.
• Themonitor118 can also include other components, such as a speaker, power button, removable storage or memory (e.g., a flash card slot), an AC or DC power port, and one or more network interfaces, such as a universal serial bus interface or an Ethernet port. For example, themonitor118 can include adisplay456 that can indicate a measurement for glucose, for example, in mg/dL. Other analytes and forms of display can also appear on themonitor118.
• In addition, although asingle sensor116 with asingle monitor118 is shown, different combinations of sensors and device pairings can be implemented. For example, multiple sensors can be provided for a plurality of differing patient types or measurement sites or even patient fingers.
• FIG. 8 is a block diagram that illustrates the components of an example of a healthdata collection device112. In certain embodiments, the healthdata collection device112 noninvasively measures a blood analyte, such as oxygen, carbon monoxide, methemoglobin, total hemoglobin, glucose, proteins, glucose, lipids, a percentage thereof (e.g., saturation) or for measuring many other physiologically relevant patient characteristics. Thedevice112 can also measure additional blood analytes and/or other physiological parameters useful in determining a state or trend of wellness of a patient.
• Thedata collection device112 can be capable of measuring optical radiation from the measurement site. For example, in some embodiments, thedata collection device112 can employ photodiodes defined in terms of area. In an embodiment, the area is from about 1 mm²-5 mm²(or higher) that are capable of detecting about 100 nanoamps (nA) or less of current resulting from measured light at full scale. In addition to having its ordinary meaning, the phrase “at full scale” can mean light saturation of a photodiode amplifier (not shown). Of course, as would be understood by a person of skill in the art from the present disclosure, various other sizes and types of photodiodes can be used with the embodiments of the present disclosure.
• Thedata collection device112 can measure a range of approximately about 2 nA to about 100 nA full scale. Thedata collection device112 can also include sensor front-ends that are capable of processing and amplifying current from the detector(s) at signal-to-noise ratios (SNRs) of about 100 decibels (dB) or more, such as about 120 dB in order to measure various desired analytes. Thedata collection device112 can operate with a lower SNR if less accuracy is needed for an analyte like glucose.
• Thedata collection device112 can measure analyte concentrations, including glucose, at least in part by detecting light attenuated by ameasurement site502. Themeasurement site502 can be any location on a patient's body, such as a finger, foot, ear lobe, or the like. For convenience, this disclosure is described primarily in the context of afinger measurement site502. However, the features of the embodiments disclosed herein can be used withother measurement sites502.
• In the depicted embodiment, thedevice112 includes an optional tissue thickness adjuster ortissue shaper522, which can include one or more protrusions, bumps, lenses, or other suitable tissue-shaping mechanisms. In certain embodiments, thetissue shaper522 is a flat or substantially flat surface that can be positioned proximate themeasurement site502 and that can apply sufficient pressure to cause the tissue of themeasurement site502 to be flat or substantially flat. In other embodiments, thetissue shaper522 is a convex or substantially convex surface with respect to themeasurement site502. Many other configurations of thetissue shaper522 are possible. Advantageously, in certain embodiments, thetissue shaper522 reduces thickness of themeasurement site502 while preventing or reducing occlusion at themeasurement site502. Reducing thickness of the site can advantageously reduce the amount of attenuation of the light because there is less tissue through which the light must travel. Shaping the tissue in to a convex (or alternatively concave) surface can also provide more surface area from which light can be detected.
• The embodiment of thedata collection device112 shown also includes anoptional noise shield526. In an embodiment, thenoise shield526 can be advantageously adapted to reduce electromagnetic noise while increasing the transmittance of light from themeasurement site502 to one or more detectors506 (described below). For example, thenoise shield526 can advantageously include a conductive coated glass or metal grid electrically communicating with one or more other shields of thesensor116 or electrically grounded. In an embodiment where thenoise shield526 includes conductive coated glass, the coating can advantageously include indium tin oxide. In an embodiment, the indium tin oxide includes a surface resistivity ranging from approximately 30 ohms per square inch to about 500 ohms per square inch. In an embodiment, the resistivity is approximately 30, 200, or 500 ohms per square inch. As would be understood by a person of skill in the art from the present disclosure, other resistivities can also be used which are less than about 30 ohms or more than about 500 ohms. Other conductive materials transparent or substantially transparent to light can be used instead.
• In some embodiments, themeasurement site502 is located somewhere along a non-dominant arm or a non-dominant hand, e.g., a right-handed person's left arm or left hand. In one embodiment, thedata collection device112 can recognize a user's or patient's non-dominant arm/hand by comparing the two arms/hands according to various types of physiological data/measurements. For example, in some patients, the non-dominant arm or hand can have less musculature and higher fat content, which can result in less water content in that tissue of the patient. Tissue having less water content can provide less interference with the particular wavelengths that are absorbed in a useful manner by blood analytes like glucose. Accordingly, in some embodiments, thedata collection device112 can be used on a person's non-dominant hand or arm.
• Thedata collection device112 can include a sensor116 (or multiple sensors) that is coupled to a processing device orphysiological monitor118. In an embodiment, thesensor116 and themonitor118 are integrated together into a single unit. In another embodiment, thesensor116 and themonitor118 are separate from each other and communicate one with another in any suitable manner, such as via a wired or wireless connection. Thesensor116 and monitor118 can be attachable and detachable from each other for the convenience of the user or caregiver, for ease of storage, sterility issues, or the like. Thesensor116 and themonitor118 will now be further described.
• In the depicted embodiment shown inFIG. 8, thesensor116 includes anemitter504, atissue shaper522, a set ofdetectors506, and a front-end interface508. Theemitter504 can serve as the source of optical radiation transmitted towards measurement site102. As will be described in further detail below, theemitter504 can include one or more sources of optical radiation, such as LEDs, laser diodes, incandescent bulbs with appropriate frequency-selective filters, combinations of the same, or the like. In an embodiment, theemitter504 includes sets of optical sources that are capable of emitting visible and near-infrared optical radiation.
• In some embodiments, theemitter504 is used as a point optical source, and thus, the one or more optical sources of theemitter504 can be located within a close distance to each other, such as within about a 2 mm to about 4 mm. Theemitters504 can be arranged in an array, such as is described in U.S. Publication No. 2006/0211924, filed Sep. 21, 2006, titled “Multiple Wavelength Sensor Emitters,” the disclosure of which is hereby incorporated by reference in its entirety. In particular, theemitters504 can be arranged at least in part as described in paragraphs [0061] through [0068] of the aforementioned publication, which paragraphs are hereby incorporated specifically by reference. Other relative spatial relationships can be used to arrange theemitters504.
• For analytes like glucose, currently available non-invasive techniques often attempt to employ light near the water absorbance minima at or about 1600 nm. Typically, these devices and methods employ a single wavelength or single band of wavelengths at or about 1600 nm. However, to date, these techniques have been unable to adequately consistently measure analytes like glucose based on spectroscopy.
• In contrast, theemitter504 of thedata collection device112 can emit, in certain embodiments, combinations of optical radiation in various bands of interest. For example, in some embodiments, for analytes like glucose, theemitter504 can emit optical radiation at three (3) or more wavelengths between about 1600 nm to about 1700 nm. In particular, theemitter504 can emit optical radiation at or about 1610 nm, about 1640 nm, and about 1665 nm. In some circumstances, the use of three wavelengths within about 1600 nm to about 1700 nm enable sufficient SNRs of about 100 dB, which can result in a measurement accuracy of about 20 mg/dL or better for analytes like glucose.
• In other embodiments, theemitter504 can use two (2) wavelengths within about 1600 nm to about 1700 nm to advantageously enable SNRs of about 85 dB, which can result in a measurement accuracy of about 25-30 mg/dL or better for analytes like glucose. Furthermore, in some embodiments, theemitter504 can emit light at wavelengths above about 1670 nm. Measurements at these wavelengths can be advantageously used to compensate or confirm the contribution of protein, water, and other non-hemoglobin species exhibited in measurements for analytes like glucose conducted between about 1600 nm and about 1700 nm. Of course, other wavelengths and combinations of wavelengths can be used to measure analytes and/or to distinguish other types of tissue, fluids, tissue properties, fluid properties, combinations of the same or the like.
• For example, theemitter504 can emit optical radiation across other spectra for other analytes. In particular, theemitter504 can employ light wavelengths to measure various blood analytes or percentages (e.g., saturation) thereof. For example, in an embodiment, theemitter504 can emit optical radiation in the form of pulses at wavelengths about 905 nm, about 1050 nm, about 1200 nm, about 1300 nm, about 1330 nm, about 1610 nm, about 1640 nm, and about 1665 nm. In another embodiment, theemitter504 can emit optical radiation ranging from about 860 nm to about 950 nm, about 950 nm to about 1100 nm, about 1100 nm to about 1270 nm, about 1250 nm to about 1350 nm, about 1300 nm to about 1360 nm, and about 1590 nm to about 1700 nm. Of course, theemitter504 can transmit any of a variety of wavelengths of visible or near-infrared optical radiation.
• Due to the different responses of analytes to the different wavelengths, certain embodiments of thedata collection device112 can advantageously use the measurements at these different wavelengths to improve the accuracy of measurements. For example, the measurements of water from visible and infrared light can be used to compensate for water absorbance that is exhibited in the near-infrared wavelengths.
• As briefly described above, theemitter504 can include sets of light-emitting diodes (LEDs) as its optical source. Theemitter504 can use one or more top-emitting LEDs. In particular, in some embodiments, theemitter504 can include top-emitting LEDs emitting light at about 850 nm to 1350 nm.
• Theemitter504 can also use super luminescent LEDs (SLEDs) or side-emitting LEDs. In some embodiments, theemitter504 can employ SLEDs or side-emitting LEDs to emit optical radiation at about 1600 nm to about 1700 nm.Emitter504 can use SLEDs or side-emitting LEDs to transmit near infrared optical radiation because these types of sources can transmit at high power or relatively high power, e.g., about 40 mW to about 100 mW. This higher power capability can be useful to compensate or overcome the greater attenuation of these wavelengths of light in tissue and water. For example, the higher power emission can effectively compensate and/or normalize the absorption signal for light in the mentioned wavelengths to be similar in amplitude and/or effect as other wavelengths that can be detected by one or more photodetectors after absorption. However, the embodiments of the present disclosure do not necessarily require the use of high power optical sources. For example, some embodiments may be configured to measure analytes, such as total hemoglobin (tHb), oxygen saturation (SpO₂), carboxyhemoglobin, methemoglobin, etc., without the use of high power optical sources like side emitting LEDs. Instead, such embodiments may employ other types of optical sources, such as top emitting LEDs. Alternatively, theemitter504 can use other types of sources of optical radiation, such as a laser diode, to emit near-infrared light into themeasurement site502.
• In addition, in some embodiments, in order to assist in achieving a comparative balance of desired power output between the LEDs, some of the LEDs in theemitter504 can have a filter or covering that reduces and/or cleans the optical radiation from particular LEDs or groups of LEDs. For example, since some wavelengths of light can penetrate through tissue relatively well, LEDs, such as some or all of the top-emitting LEDs can use a filter or covering, such as a cap or painted dye. This can be useful in allowing theemitter504 to use LEDs with a higher output and/or to equalize intensity of LEDs.
• Thedata collection device112 also includes adriver520 that drives theemitter504. Thedriver520 can be a circuit or the like that is controlled by themonitor118. For example, thedriver520 can provide pulses of current to theemitter504. In an embodiment, thedriver520 drives theemitter504 in a progressive fashion, such as in an alternating manner. Thedriver520 can drive theemitter504 with a series of pulses of about 1 milliwatt (mW) for some wavelengths that can penetrate tissue relatively well and from about 40 mW to about 100 mW for other wavelengths that tend to be significantly absorbed in tissue. A wide variety of other driving powers and driving methodologies can be used in various embodiments.
• Thedriver520 can be synchronized with other parts of thesensor116 and can minimize or reduce jitter in the timing of pulses of optical radiation emitted from theemitter504. In some embodiments, thedriver520 is capable of driving theemitter504 to emit optical radiation in a pattern that varies by less than about 10 parts-per-million.
• Thedetectors506 capture and measure light from themeasurement site502. For example, thedetectors506 can capture and measure light transmitted from theemitter504 that has been attenuated or reflected from the tissue in themeasurement site502. Thedetectors506 can output adetector signal524 responsive to the light captured or measured. Thedetectors506 can be implemented using one or more photodiodes, phototransistors, or the like.
• In addition, thedetectors506 can be arranged with a spatial configuration to provide a variation of path lengths among at least some of thedetectors506. That is, some of thedetectors506 can have the substantially, or from the perspective of the processing algorithm, effectively, the same path length from theemitter504. However, according to an embodiment, at least some of thedetectors506 can have a different path length from theemitter504 relative to other of thedetectors506. Variations in path lengths can be helpful in allowing the use of a bulk signal stream from thedetectors506. In some embodiments, thedetectors506 may employ a linear spacing, a logarithmic spacing, or a two or three dimensional matrix of spacing, or any other spacing scheme in order to provide an appropriate variation in path lengths.
• The front-end interface508 provides an interface that adapts the output of thedetectors506, which is responsive to desired physiological parameters. For example, the front-end interface508 can adapt asignal524 received from one or more of thedetectors506 into a form that can be processed by themonitor118, for example, by asignal processor510 in themonitor118. The front-end interface508 can have its components assembled in thesensor116, in themonitor118, in connecting cabling (if used), combinations of the same, or the like. The location of the front-end interface508 can be chosen based on various factors including space desired for components, desired noise reductions or limits, desired heat reductions or limits, and the like.
• The front-end interface508 can be coupled to thedetectors506 and to thesignal processor510 using a bus, wire, electrical or optical cable, flex circuit, or some other form of signal connection. The front-end interface508 can also be at least partially integrated with various components, such as thedetectors506. For example, the front-end interface508 can include one or more integrated circuits that are on the same circuit board as thedetectors506. Other configurations can also be used.
• The front-end interface508 can be implemented using one or more amplifiers, such as transimpedance amplifiers, that are coupled to one or more analog to digital converters (ADCs) (which can be in the monitor118), such as a sigma-delta ADC. A transimpedance-based front-end interface508 can employ single-ended circuitry, differential circuitry, and/or a hybrid configuration. A transimpedance-based front-end interface508 can be useful for its sampling rate capability and freedom in modulation/demodulation algorithms. For example, this type of front-end interface508 can advantageously facilitate the sampling of the ADCs being synchronized with the pulses emitted from theemitter504.
• The ADC or ADCs can provide one or more outputs into multiple channels of digital information for processing by thesignal processor510 of themonitor118. Each channel can correspond to a signal output from adetector506.
• In some embodiments, a programmable gain amplifier (PGA) can be used in combination with a transimpedance-based front-end interface508. For example, the output of a transimpedance-based front-end interface508 can be output to a PGA that is coupled with an ADC in themonitor118. A PGA can be useful in order to provide another level of amplification and control of the stream of signals from thedetectors506. Alternatively, the PGA and ADC components can be integrated with the transimpedance-based front-end interface508 in thesensor116.
• In another embodiment, the front-end interface508 can be implemented using switched-capacitor circuits. A switched-capacitor-based front-end interface508 can be useful for, in certain embodiments, its resistor-free design and analog averaging properties. In addition, a switched-capacitor-based front-end interface508 can be useful because it can provide a digital signal to thesignal processor510 in themonitor118.
• As shown inFIG. 8, themonitor118 can include thesignal processor510 and a user interface, such as adisplay512. The monitor109 can also include optional outputs alone or in combination with thedisplay512, such as astorage device514 and anetwork interface516. In an embodiment, thesignal processor510 includes processing logic that determines measurements for desired analytes, such as glucose, based on the signals received from thedetectors506. Thesignal processor510 can be implemented using one or more microprocessors or subprocessors (e.g., cores), digital signal processors, application specific integrated circuits (ASICs), field programmable gate arrays (FPGAs), combinations of the same, and the like.
• Thesignal processor510 can provide various signals that control the operation of thesensor116. For example, thesignal processor510 can provide an emitter control signal to thedriver520. This control signal can be useful in order to synchronize, minimize, or reduce jitter in the timing of pulses emitted from theemitter504. Accordingly, this control signal can be useful in order to cause optical radiation pulses emitted from theemitter504 to follow a precise timing and consistent pattern. For example, when a transimpedance-based front-end interface508 is used, the control signal from thesignal processor510 can provide synchronization with the ADC in order to avoid aliasing, cross-talk, and the like. As also shown, anoptional memory518 can be included in the front-end interface508 and/or in thesignal processor510. Thismemory518 can serve as a buffer or storage location for the front-end interface508 and/or thesignal processor510, among other uses.
• Theuser interface112 can provide an output, e.g., on a display, for presentation to a user of thedata collection device112. Theuser interface112 can be implemented as a touch-screen display, an LCD display, an organic LED display, or the like. In addition, theuser interface112 can be manipulated to allow for measurement on the non-dominant side of patient. For example, theuser interface112 can include a flip screen, a screen that can be moved from one side to another on themonitor118, or can include an ability to reorient its display indicia responsive to user input or device orientation. In alternative embodiments, thedata collection device112 can be provided without auser interface112 and can simply provide an output signal to a separate display or system.
• Astorage device514 and anetwork interface516 represent other optional output connections that can be included in themonitor118. Thestorage device514 can include any computer-readable medium, such as a memory device, hard disk storage, EEPROM, flash drive, or the like. The various software and/or firmware applications can be stored in thestorage device514, which can be executed by thesignal processor510 or another processor of themonitor118. Thenetwork interface516 can be a serial bus port (RS-232/RS-485), a Universal Serial Bus (USB) port, an Ethernet port, a wireless interface (e.g., Wi-Fi such as any 802.1x interface, including an internal wireless card), or other suitable communication device(s) that allows themonitor118 to communicate and share data with other devices. Themonitor118 can also include various other components not shown, such as a microprocessor, graphics processor, or controller to output theuser interface112, to control data communications, to compute data trending, or to perform other operations.
• Although not shown in the depicted embodiment, thedata collection device112 can include various other components or can be configured in different ways. For example, thesensor116 can have both theemitter504 anddetectors506 on the same side of themeasurement site502 and use reflectance to measure analytes. Thedata collection device112 can also include a sensor that measures the power of light emitted from theemitter504.
CONCLUSION
• In general, the word “module,” as used herein, refers to logic embodied in hardware or firmware, or to a collection of software instructions, possibly having entry and exit points, written in a programming language, such as, for example, Java, Lua, C or C++. A software module may be compiled and linked into an executable program, installed in a shared library, or may be written in an interpreted programming language such as, for example, BASIC, Perl, Python or in a scripting language. It will be appreciated that software modules may be callable from other modules or from themselves, and/or may be invoked in response to detected events or interrupts. Software instructions may be embedded in firmware, which is stored on a memory such as an EPROM. It will be further appreciated that hardware modules may be comprised of connected logic units, such as gates and flip-flops, and/or may be comprised of programmable units, such as programmable gate arrays or processors. The modules described herein are preferably implemented as software modules, but may be represented in hardware or firmware. Generally, the modules described herein refer to logical modules that may be combined with other modules or divided into sub-modules despite their physical organization or storage.
• Conditional language used herein, such as, among others, “can,” “could,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or states. Thus, such conditional language is not generally intended to imply that features, elements and/or states are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or states are included or are to be performed in any particular embodiment.
• While certain embodiments of the inventions disclosed herein have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions disclosed herein. Indeed, the novel methods and systems described herein can be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein can be made without departing from the spirit of the inventions disclosed herein. The claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of certain of the inventions disclosed herein.

Claims (11)

What is claimed is:

1. A physiological monitoring system for identifying a life threatening condition of a patient, the system comprising:

one or more light sources;

one or more optical sensors configured to measure light from the one or more light sources attenuated by tissue of a patient;

one or more hardware processors in communication with the one or more optical sensors, the one or more hardware processors configured to:

receive as signal from the one or more optical sensors;

determine a pulse rate based on the received signal;

determine a presence of an alert condition based on the pulse rate; and

in response to determining the presence of the alert condition:

determine a proximity of the one or more of a contact relative to a determined location of the physiological monitoring system;

contact the one or more of a contact based on the determined location of the physiological monitoring system; and

provide the determined location of the user to the one or more of the contact.

2. The physiological monitoring system ofclaim 1, wherein the one or more of a contact comprises an emergency service system or care provider.

3. An electronic device, comprising:

a motion sensor configured to gather motion sensor data;

a pulse rate sensor configured to measure pulse rate;

a location determination module configured to determine a location of the electronic device; and

a processing system connected with the motion sensor, a location determination module, and the pulse rate sensor;

the processing system configured to:

determine a location of the electronic device using the location determination module;

monitor the pulse rate using the pulse rate sensor;

determine a presence of an alert condition;

in response to determining the presence of the alert condition:

access one or more of a contact in an electronic address book associated with the processing system;

determine a proximity of the one or more of a contact relative to the determined location of the electronic device;

contact the one or more of a contact based on the determined location of the electronic device; and

provide the determined location of the user.

4. The electronic device ofclaim 3, wherein the processing system is configured to transmit an alert to an emergency service system.

5. The electronic device ofclaim 4, wherein the emergency service system is selected based on the determined location of the electronic device.

6. The electronic device ofclaim 3, wherein the processing system is further configured to determine nearby medical devices or equipment and alert the user to use the nearby medical devices or equipment.

7. The electronic device ofclaim 3, wherein the alert condition is determined based at least in part on the pulse rate.

8. An electronic device, comprising:

a motion sensor configured to gather motion sensor data;

a pulse rate sensor configured to measure pulse rate;

a location determination module configured to determine a location of the electronic device; and

a processing system connected with the motion sensor, a location determination module, and the pulse rate sensor;

the processing system configured to:

determine a location of the electronic device using the location determination module;

monitor the pulse rate using the pulse rate sensor;

determine a presence of an alert condition;

in response to determining the presence of the alert condition:

access one or more of a contact in an electronic address book associated with the processing system;

determine a proximity of the one or more of a contact or an emergency service system relative to the determined location of the electronic device;

contact the one or more of a contact or emergency service system based on the determined location of the electronic device; and

provide the determined location of the user.

9. The electronic device ofclaim 8, wherein the processing system is configured to transmit an alert to an emergency service system.

10. The electronic device ofclaim 8, wherein the processing system is further configured to determine nearby medical devices or equipment and alert the user to use the nearby medical devices or equipment.

11. The electronic device ofclaim 8, wherein the alert condition is determined based at least in part on the pulse rate.

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