201023062 1 wju^or/\ 九、發明說明： 【發明所屬之技術領域】 本發月疋有關於一種適應性個人化心血管遠距照護 ^及方法，且制是有料―種分散式及個人化之適應 性個人化心血管遠距照護系統及方法。 【先前技術】 近^於髓料料树展及公共設施的 曰益完 使得高齡化社會成為必然的趨勢。然而，屬慢性疾病 之腦也管及心臟疾病高居十大死因之第二順位及第三順 位，故心血管疾病可稱為人類頭號殺手之-，且心血管疾 病的患病率隨著年齡而快逮增加。根據美國統計，20歲至 29歲的人口’心血管疾病患病率只有5%至1〇%。然而75 歲以上的長者的心血管疾病患病率卻高達7〇%至8〇%。隨 著全球人口老化及飲食習慣的改變，心血管疾病的病患數 目將不斷增加。 然而，醫院的病床總數並未隨著病患數目而增加，反 而逐年減少。一般而言，心血管疾病的病患須要長期的照 護及治療，必須頻繁地往來於住家及醫院之間，造成生活 上的不便利性及交通上的不安全性。此外，現代人面對日 益升高的慢性病患病機率，追求健康生活品質的觀念日益 高漲，然而卻有工作時間長且至醫院健康檢查的機會少的 問題。因此，居家照護的概念興起，企圖打破時空的限制， 使得需要長期照護的心血管疾病病患在住家可以透過遠 201023062 距照護系統，讓醫師可隨時掌握病患的狀況。如此一來， 不僅能夠降低醫院端的醫療成本，亦可節省病患的時間及 金錢。 然而，目前國内外的心血管照護系統，其前端（病患 端）之健康照護盒都只有心血管生理訊號的收集及傳送之 功月b，心血管生理訊號的分析都在後端（醫院端）的主機上 執行。茲舉國外VISICU公司之美國專利號為US732 i 862 B2之即時性照護系統為例，請參照第丨圖，其繪示現有即 ❹時性照護系統之第一例之示意圓。於第i圖之即時性照護 系統100中，在醫院病房内的每一個病患均有近端監測設 備112或114來收集病患之生理參數，並將生理參數透過 閘道器130傳送到醫院的後端次系統12〇處理，後端次系 統包括資料庫伺服器140及應用伺服器150。然而，由於 每一個病患的生理參數均集中在後端次系統12〇進行分 析，故即時性照護系統1〇〇之架構若應用於大數量規模病 ❹患之遠距照護服務時，則後端次系統内主機之運算及通訊 負載將會太過沉重，會嚴重影響到整體系統的及時反應之 速度及服務品質。 另舉美國專利號US6913577 B2之系統架構為例，請 參照第2圖，其繪示現有即時性照護系統之第二例之示意 圖。於第2圖之即時性照護系統2〇〇中，前端（病患端）之 監測設備210只收集病患之生理參數，然後透過網際網路 230將所收集到的生理參數傳送到後端次系統220之伺服 器240進行分析處理。又舉中華民國專利號為1287976之 7 201023062201023062 1 wju^or/\ IX, invention description: [Technical field of invention] This issue of the moon has an adaptive personalized cardiovascular teletherapy and method, and the system is material-distributed and personalized Adaptive personalized cardiovascular remote care system and method. [Prior Art] Nearly the end of the marrow material tree exhibition and the public facilities have made the aging society an inevitable trend. However, the brain of chronic diseases and the heart disease are the second and third overall causes of the top ten causes of death, so cardiovascular disease can be called the number one killer of humans, and the prevalence of cardiovascular disease varies with age. Fast catch increases. According to US statistics, the prevalence of cardiovascular disease in the population aged 20 to 29 is only 5% to 1%. However, the prevalence of cardiovascular disease in elderly people over the age of 75 is as high as 7〇% to 8%. As the global population ages and eating habits change, the number of patients with cardiovascular disease will continue to increase. However, the total number of hospital beds has not increased with the number of patients, but has decreased year by year. In general, patients with cardiovascular disease require long-term care and treatment, and must frequently travel between homes and hospitals, resulting in inconvenience in life and insecurity in transportation. In addition, modern people are increasingly faced with the increasing risk of chronic diseases and the pursuit of a healthy quality of life. However, there are problems with long working hours and fewer opportunities for hospital health checkups. Therefore, the concept of home care has arisen in an attempt to break the limitations of time and space, so that patients with cardiovascular disease who need long-term care can pass the distance from 201023062 to the care system, so that doctors can keep abreast of the patient's condition. In this way, not only can the medical cost of the hospital end be reduced, but also the time and money of the patient can be saved. However, at present, the cardiovascular care system at home and abroad, the health care box of the front end (patient side) only has the collection and transmission of cardiovascular physiological signals. The analysis of cardiovascular physiological signals is at the back end (hospital end) ) is executed on the host. For example, the instant care system of US Patent No. US732 i 862 B2 of VISICU is taken as an example. Please refer to the figure, which shows the schematic circle of the first example of the existing instant care system. In the instant care system 100 of Figure i, each patient in the hospital ward has a proximal monitoring device 112 or 114 to collect the physiological parameters of the patient and transmit the physiological parameters to the hospital through the gateway 130. The back-end subsystem 12 is processed, and the back-end subsystem includes a database server 140 and an application server 150. However, since the physiological parameters of each patient are concentrated in the back-end subsystem 12, the structure of the immediate care system is applied to the remote care service for large-scale disease patients. The computing and communication load of the host in the terminal system will be too heavy, which will seriously affect the speed and service quality of the overall system. For example, the system architecture of U.S. Patent No. 6,913,577 B2 is taken as an example. Referring to Figure 2, a schematic diagram of a second example of an existing instant care system is shown. In the instant care system 2 of FIG. 2, the front end (patient end) monitoring device 210 collects only the physiological parameters of the patient, and then transmits the collected physiological parameters to the back end through the Internet 230. The server 240 of the system 220 performs an analysis process. Also, the Republic of China patent number is 1287976. 7 201023062
i w juyttrA 系統架構為例，請參照第3圖，其繪示現有即時性照護系 統之第三例之示意圖。於第3圖之即時性照護系統300 中’前端之監測設備310只收集病患之生理參數，然後將 所收集到的生理參數傳送到後端次系統320進行分析處 理。由於病患的生理參數均集中在後端次系統220及320 進行分析，故即時性照護系統200及300之架構於應用於 大數量規模病患之遠距照護服務時，後端次系統内主機之 運算及通訊負擔將會太過沉重》 【發明内容】 本發明係有關於一種適應性個人化心血管遠距照護 系統及方法，利用前端次系統收集心血管生理訊號並對心 血管生理訊號進行即時分析，並利用後端次系統對心血管 生理訊號進行長期分析，使得病患之個人化心血管照護準 則可以隨著病患的生理情況而更新，並減輕醫院後端次系 統内主機之運算及通訊負載。 根據本發明之第一方面，提出一種適應性個人化心血 管遠距照護系統’包括一後端次系統以及一前端次系統。 後端次系統包括--般化心血管監測準則產生區塊、一適 應性個人化心血管照護準則產生區塊及一照護準則傳送 區塊。一般化心血管監測準則產生區塊提供多個一般化心 血管監測準則。適應性個人化心血管照護準則產生區塊從 此些一般化心血管監測準則中選取以設定一組後端個人 化心血管照護準則及一組前端個人化心血管照護準則。照 201023062 護準則傳送區塊傳輸此組前端個人化心血管照護準則。前 端次系統包括一適應性個人化照護區塊。適應性個人化照 護區塊量測一待照護者之一心血管生理訊號，並依據此組 前端個人化心血管照護準則即時分析心血管生理訊號而 得到一前端分析資料。其中，適應性個人化心血管照護準 則產生區塊依據此組後端個人化心血管照護準則長期分 析心血管生理訊號而得到一後端分析資料，適應性個人化 心血管照護準則產生區塊並基於前端分析資料及後端分 ❿析資料從此些一般化心血管監測準則中重新設定此組後 端個人化心血管照護準則及此組前端個人化心血管照護 準則。 根據本發明之第二方面，提出一種適應性個人化心血 管遠距照護方法，係應用於一適應性個人化心血管遠距系 統，適應性個人化心血管遠距系統包括一後端次系統及一 前端次系統。適應性個人化心血管遠距照護方法包括下列 步驟。後端次系統提供多個一般化心血管監測準則。後端 ❹次系統從此些一般化心血管監測準則中選取以設定一組 後端個人化心企管照護準則及一組前端個人化心血管照 護準則。後端次系統傳輸此組前端個人化心血管照護準則 至前端次系統。前端次系統量測一待照護者之一心血管生 理訊號，並依據此組剛端個人化心血管照護準則即時分析 心血管生理訊號而得到一前端分析資料。後端次系統依據 此組後端個人化心血管照護準則長期分析心血管生理訊 號而得到一後端分析資料。後端次系統基於前端分析資料 9 201023062 λ. vr r\ 及後端分析資料從此些一般化心企管監測準則中重新設 定此組後端個人化心血管照護準則及此組前端個人化心 血管照護準則。 為讓本發明之上述内容能更明顯易懂’下文特舉實施 例，並配合所附圖式，作詳細說明如下： 【實施方式】 本發明係提出一種適應性個人化心血管遠距照護系 統及方法’利用前端次系統收集心血管生理訊號並對心血 管生理訊號進行即時分析，並利用後端次系統對心血管生 理訊號進行長期分析’使得病患之個人化心血管照護準則 可以隨著病患的生理情況而更新，並減輕醫院後端次系統 内主機之運算及通訊負載。 請參照第4圖，其繪示依照本發明一實施例之適應性 個人化心血管遠距照護系統之方塊圖。適應性個人化心血 管遠距照護系統400包括一後端次系統410以及一前端次 系統420。後端次系統410包括--般化心血管監測準則 產生區塊430、一適應性個人化心血管照護準則產生區塊 440以及一照護準則傳送區塊450。一般化心血管監測準 則產生區塊430提供多個一般化心血管監測準則。 適應性個人化心血管照護準則產生區塊440從此些 一般化心血管監測準則中選取以設定一組後端個人化心 血管照護準則及一組前端個人化心血管照護準則。其中’ 後端個人化心血管照護準則包括一組後端個人化心血管 201023062 監測準則及相對應之一組後端個人化事件處理機制，前端 個人化心血管照護準則包括一組前端個人化心血管監測 準則及相對應之一組前端個人化事件處理機制。其中’此 些準則例如以一程式或一準則引擎(rule engine)實現，每一 個準則可包括多個參數，並不做限制❶照護準則傳送區塊 450傳輸此組前端個人化心血管照護準則。 前端次系統420經由一廣域網路(Wide Area Network，WAN)從照護準貝1J傳送區塊45〇接收此組前端個 參人化心血管照護準則。前端次系統420包括一適應性個人 化照護區塊460。適應性個人化照護區塊460量測一符照 護者（例如為心血管疾病病患）之一心血管生理訊號’旅依 據此組前端個人化心血管照護準則即時分析心血管生理 訊號而得到一前端分析資料。其中’適應性個人化照護區 塊460例如為一健康照護盒。此外，前端次系統420玎以 包括多個適應性個人化照護區塊460，以分別照護多個待 照護者，並不做限制。前端次系統420會將量測到的心血 ®管生理訊號及前端分析資料回傳至後端次系統410。 後端次系統410之適應性個人化心血管照護準則產 生區塊440依據此組後端個人化心血管照護準則長期分析 心血管生理訊號而得到一後端分析資料，適應性個人化心 血管照護準則產生區塊440並基於前端分析資料及後端分 析資料從此些一般化心血管監測準則中重新設定此組後 端個人化心血管照護準則及此組前端個人化心血管照護 準則。亦即’適應性個人化心血管照護準則產生區塊440 201023062 i wji/y〇r/\ 依據待照護者之生理情況更新個人化心血管照護準則。 請參照第5圖，其緣示依照本發明另一實施例之適應 性個人化心血管遠距照護系統之詳細方塊圖。於第5圖 中’一般化心血管監測準則產生區塊430包括--般化心 血管生理訊號儲存單元432、一一般化心血管監測準則產 生單元434以及--般化心血管監測準則儲存單元436。 後端次系統410會接收從前端次系統420傳來的心血管生 理訊號’其中經醫師判讀後具病理特徵之心血管生理訊號 會被儲存於一般化心血管生理訊號儲存單元432。 ❹ 一般化心血管監測準則產生單元434可以利用現有 之諸多分析法則分析一般化心血管生理訊號儲存單元432 内具病理特徵之心血管生理訊號以產生多個一般化心血 管監測準則。一般化心血管監測準則儲存單元436儲存此 些一般化心血管監測準則。其中’此些一般化心血管監測 準則例如以一程式或一準則引擎實現，然並不限於此。此 外’一般化心血管監測準則儲存單元436可採用現有發展 完善之多個一般化心血管監測準則。如此一來，一般化心 _ 血管監測準則產生區塊430可省略一般化心血管生理訊號 儲存單元432以及一般化心血管監測準則產生單元434。 適應性個人化心血管照護準則產生區塊440包括一 生理訊號及分析資料儲存單元441、一適應性個人化心血 管照護準則產生單元442、一後端個人化照護單元444以 及—個人化心血管照護準則儲存單元448。生理訊號及分 析資料儲存單元441儲存並管理由前端次系統420所傳回 12 201023062 之心血管生理訊號及前端分析資料，同時也儲存後端個人 化照護單元444所分析得到之後端分析資料。 後端個人化照護單元444包括一後端個人化監測單 元445以及一後端個人化事件處理單元446。後端個人化 監測單元445依據此組後端個人化心血管監測準則長期分 析心血管生理訊號而得到後端分析資料，並將後端分析資 料儲存至生理訊號及分析資料儲存單元441。其中，後端 個人化監測單元445更長期分析心血管生理訊號中具病理 籲特徵之部份。後端個人化事件處理單元446依據後端分析 資料判斷心血管生理訊號之一特徵值超過一後端門檻 值，則後端個人化事件處理單元446對待照護者啟動對應 之此組後端個人化事件處理機制。後端個人化照護單元 444主要監測待照護者之長期生理情況，以處理非即時性 的事件。 適應性個人化心血管照護準則產生單元442基於前 端分析資料及後端分析資料從此些一般化心血管監測準 則中設定此組後端個人化心血管照護準則及此組前端個 人化心血管照護準則。適應性個人化心血管照護準則產生 單元442實質上係參照生理訊號及分析資料儲存單元441 所儲存之待照護者的心血管生理訊號、前端分析資料及後 端分析資料，以產生此些照護準則之參數變化之長期趨勢 及統計結果，使得醫師可以配合本身之專業知識據以從一 般化心血管監測準則產生區塊430所提供之多個一般化心 血管監測準則擷選出適用於待照護者此階段之後端個人 13 201023062 I WJU7〇r/\ 化心血管照護準則及前端個人化心血管照護準則。如此一 來’適應性個人化心血管照護準則產生單元442即可隨著 待照護者的生理情況來動態更新此組後端個人化心血管 照護準則及傳送至前端次系統420之此組前端個人化心血 管照護準則。 個人化心血管照護準則儲存單元448儲存此組前端 個人化心血管照護準則以輸出至照護準則傳送區塊450。 照護準則傳送區塊450將此組前端個人化心血管照護準則 經由廣域網路470傳輸至適應性個人化照護區塊460。其 中’傳送之機制可以採用如DSL Forum TR-069之機制或 OMADM之機制，並不做限制。此外，照護準則傳送區塊 450可傳輸一更新觸發訊號至前端次系統42〇，適應性個 人化照護區塊460更新此組前端個人化心血管照護準則。 適應性個人化照護區塊460包括一裝置介面461、一 廣域網路介面462、一照護準則執行單元463、一前端個 人化照護單元464以及一前端個人化管理單元468。裝置 介面461用以從一生理監測裝置（未繪示於圖）接收待照護 者之心血管生理訊號。其中，生理監測裝置係用以量測待 照護者之即時性心血管生理訊號，生理監測裝置可被整合 於適應性個人化照護區塊46〇内或前端次系統42〇内。廣 域網路介面462用以經由廣域網路47〇與照護準則傳送區 塊450溝通。照護準則執行單元463用以提供此組前端個 人化心血管照護準則之執行環境，照護準則執行單元祕 例如為-般之作業系統、Java之執行環境或是準則引擎。 201023062 前端個人化照護單元464包括一前端個人化監測單 疋465以及一前端個人化事件處理單元466。前端個人化 ▲測單元465依據此組前端個人化心血管監測準則即時分 析待照護者的心血管生理訊號而得到前端分析資料。若前 端個人化事件處理單元466依據前端分析資料判斷心血管 生理訊號之一特徵值超過一前端門檻值，則前端個人化事 件處理單元466發出一警示（alert)訊號給待照護者或特定 ⑩人士，並對待照護者啟動相對應之此組前端個人化事件處 理機制。前端個人化照護單元464實質上用以即時收集待 照護者之心血管生理訊號，並判斷前端分析資料是否符合 待照護者此階段之一正規化資料模板。亦即，前端個人化 照護單元464判斷待照護者是否於健康無即時性惡化之安 全範圍内以決定是否啟動相對應之即時性事件處理機 制。前端個人化照護單元464並將前端分析資料回傳至後 端次系統410。 鲁 前端個人化管理單元468具有諸屬功能，包括收集待 照護者之心血管生理訊號、接收並更新後端次系統410傳 送過來的此組前端個人化心血管照護準則，並讓此組前端 個人化心血管照護準則在適應性個人化照護區塊46〇内執 行、以及經由廣域網路介面462回傳心血管生理訊號及前 端分析資料至該後端次系統410，以作為適應性個人化心 血管照護準則產生單元442更新個人化心血管照護準則之 部份依據。 此外’前端個人化心血管照護準除了一組前端個人化 15 201023062 1 TT «/Χ/701. I~k. 心血管監測準則及相對應之一組前端個人化事件處理機 制外，更可包括一組前端個人化互動準則。前端個人化監 測單元465更依據此組前端個人化互動準則與待照護者進 行互動以接收該待照護者之一互動訊號，其中，此組前端 個人化互動準則係以一字串顯示機制或一語音機制實 現。適應性個人化照護區塊460將互動訊號傳送至後端次 系統410，如此一來，醫師即可以透過互動的方式得知待 照護者當下的生理情況而利於作出更適於待照護者現階 段的處理反應。因此’適應性個人化心血管照護準則產生 區塊442可基於互動訊號、前端分析資料及後端分析資料 從此些一般化心血管監測準則中重新設定此組後端個人 化心血管照護準則及此組前端個人化心血管照護準則。 凊參照第6圖，其緣示依照本發明一實施例之適應性 個人化心血管遠距照護方法之流程圖。本發明所揭露之適 應性個人化心血管遠距照護方法，係應用於一適應性個人 化心jk管遠距系統，此適應性個人化心血管遠距系統包括 一後端次系統及一前端次系統。於步驟S600中，後端次 系統提供多個一般化心血管監測準則。於步驟S610中， 後端次系統從此些一般化心血管監測準則中選取以設定 一組後端個人化心血管照護準則及一組前端個人化心血 管照護準則。於步驟S620中’後端次系統傳輸此組前端 個人化心血管照護準則至前端次系統。 於步驟S630中，前端次系統量測一待照護者之一心 企管生理訊號’並依據此組前端個人化心血管照護準則即 201023062 時分析心血管生理訊號而得到一前端分析資料。於步驟 S640中，後端次系統依據此組後端個人化心血管照護準則 長期分析心血管生理訊號而得到一後端分析資料。於步驟 S650中’後端次系統基於前端分析資料及後端分析資料從 此些一般化心企管監測準則中重新設定此組後端個人化 心血管照護準則及此組前端個人化心血管照護準則。 上述之適應性個人化心血管遠距照護方法，其操作原 理係已詳述於適應性個人化心血管遠距照護系統400中， •故於此不再重述。 接下來茲舉待照護者為心血管病患之情境為例做說 明。假設病患具有高血壓’醫師決定病患必須於住家利用 生理監測裝置（例如為血壓計）長期地量測自身之心血管生 理訊號’例如脈博及血壓值變化。病患之個人化健康照護 盒依據從後端次系統接收之前端個人化心血管照護準 則，設定病患之個人化脈博及血魔值之正常範圍的上下臨 _界值(threshold) 個人化健康照護盒收集病患之脈博及血 壓值資料，並進行及時分析以得到前端分析資料。前端分 析資料可為正常血壓值或異常血壓值。 醫師亦可利用個人化健康照護盒之一組前端個人化 互動準則與病患進行互動’以了解病患當日是否有不適的 症狀，例如頭暈、胸悶、胸痛或心悸等。若前端分析資料 為異常時’個人化健康照護盒會發出一警示訊號提醒病患 注意事項並通知醫師。醫師可即時監控病患的生理情況， 並可藉由網路告知病患須注意事項。前端次系統所監測到 17 201023062 1 TT Γ\ 的異常情況均由醫師來作決策以決定對應的事件處理機 制。其中，所有的心血管生理訊號、分析資料及互動結果 均會傳送到後端次系統。 後端次系統每隔一段時間（例如一週)就會參照所儲 存之病患的心血管生理訊號及分析資料，以產生此些照護 準則之參數變化之長期趨勢及統計結果，並據β預測病患 是否可能會產生不正常症狀。若醫師得知病患有胸病或胸 悶等不適的症狀，則可透過個人化健康照護盒通知病患到 醫院作進一步檢査。 若醫師於檢查後判斷病患除患有高血壓外，亦有心絞 痛及冠狀動脈阻塞的症況，則病患可回到住家考慮是否進 行心血管治療。在此考慮期間，醫師決定病患在住家須量 測ECG12導程以監測病患的生理情況《後端次系統更新 病患之個人化健康照護盒内之前端個人化心血管照護準 則，以設定病患之個人化脈博及血壓值之正常範圍的上下 臨界值’以及個人化ECG正規性生理訊號模板。個人化 健康照護盒收集病患之血壓及心電圖，並與個人化ECG 正規性生理訊號模板進行比較以得到前端分析資料。若前 端分析資料顯示異常，則會再進行心血管生理訊號異常分 析以判斷病患是否發生即時性心肌梗塞現象。其中，所有 的心血管生理訊號及前端分析資料均會傳送到後端次系 統。 後端次系統根據心血管生理訊號預測並監測病患的 生理情況’例如進行心肌缺氧ECG心電圖資料分析，以 201023062 分析病患之心肌缺血現象種類及嚴重度參數，以利於醫師 能夠即時掌握病患的生理情況的變化。若病患忽然發生即 時性心病及冒冷汗現象’病患可藉由個人化健康照護盒將 ECG訊號傳送並通知醫師。醫師判斷病患可能發生急性心 肌梗塞的症狀，則通知病患並派救護車將病患接至醫院診 斷。若醫師於醫院確定病患發生急性心肌梗塞，則立即安 排病患進行冠狀動脈血管支架置放手術。 病患於手術完後回家休養，並於住家持續由個人化健 ❹康照護盒監測自身之生理情況❶後端次系統更新病患之個 人化健康照護盒内之前端個人化心血管照護準則，以重新 設定此階段病患之個人化脈博及血壓值之正常範圍，以及 個人化ECG正規性生理訊號模板。個人化健康照護盒收 集病患之血壓及心電圖，並與個人化ECG正規性生理訊 號模板進行比較以得到前端分析資料。若前端分析資料顯 示異常，則會再進行心肌梗塞ECG心電圖資料分析，以 分析病患之心肌梗塞現象種類及嚴重度參數，以監測心肌 ®梗塞再發生狀況。若病患再度發生心肌梗塞，則個人化健 康照護盒發出警示訊號以提醒病患通知醫師。其中，所有 的心血管生理訊號及前端分析資料均會傳送到後端次系 統0 後端次系統根據心血管生理訊號預測並監測病患的 生理情況’例如進行心臟衰竭ECG心電圖資料分析，以 分析病患是否發生心臟衰竭先期現象，以利於醫師能夠即 時掌握病患的生理情況的變化。若後端次系統判斷病患可 19 201023062 Μ. ΨΨ \^Μ. Λ 能發生心臟衰竭先期現象時，後端次系統會主動提示醫 師。醫師於確認後端次系統之提示後，會通知病患到醫院 做進一步的檢查以確認是否有心臟哀竭現象。 若醫師確認病患具有心臟衰竭現象’則醫師會決定病 患於住家除使用血壓計及ECG等生理監測設備之外，還 必須搭配血氧濃度（SP02)量測設備，以隨時監測病患的生 理情況。後端次系統更新病患之個人化健康照護盒内之前 端個人化心血管照護準則’以重新設定此階段病患之個人 化脈博及血壓值之正常範圍、個人化ECG正規性生理訊 ® 號模板以及個人化血氧資料模板。個人化健康照護盒收集 病患之血壓、心電圖以及血氧資料，並與個人化ECG正 規性生理訊號模板及個人化血氧資料模板進行比較以得 到前端分析資料。 若前端分析資料顯示異常，則會再進行心肌梗塞ECG 心電圖資料分析’以分析病患之心肌梗塞現象種類及威重 度參數，以監測心肌梗塞再發生狀況。此外，亦進行心臟 衰竭血氧濃度分析，以分析病患是否發生心臟衰竭惡化現 象。若病患發生心臟衰竭惡化現象，則個人化健康照護盒 發出警示訊號以通知醫師，醫師經由個人化健康照護盒詢 問病患之生理情況，以決定後續之事件處理機制。此外， 如果病患發生胸痛或其他異常現象，病患亦可透過個人化 健康照護盒主動聯繫醫師並告知自身之生理情況。其中， 所有的心血管生理訊號及前端分析資料均會傳送到後端 次系統。 20 201023062 後端次系統根據前端次系統送來的心血管生理訊號 監測病患的生理情況，並參照所儲存之病患的心血管生理 訊號及分析資料，以產生此些照護準則之參數變化之長期 趨勢及統計結果。醫師可參考參數變化之長期趨勢及統計 結果，並透過後端系統傳送注意事項訊息至個人化健康照 護盒，以提醒病患注意自身的生理情況。 本發明上述實施例所揭露之適應性個人化心血管逮 籲距照護系統及方法，係藉由分散式的架構，由後端次系統 擷選出適用於待照護者之個人化心血管照護準則，旅由前 端次系統之適應性個人化照護區塊執行前端個人化心咖 管照護準則，以與待照護者互動、收集心血管生理訊號旅 對心血管生理訊號進行即時分析而決定是否需啟動前端 事件處理準則。此外，後端次系統依據後端個人化心血管 ❹ 照護準則對心血管生理訊號進行長期分析，並基於前端次 系統之及時分析資料及後端次系統之長期分析資料，隨著 待照護者的生理情況動態地調整前後端個人化心血管照 護準則。因此，由於上述之適應性個人化心血管遠距照護 系統及方法的为散式及個人化的架構，本發明所揭露之適 應性個人化心血管遠距照護系統及方法可以降低醫院後 端次系統内主機伺服器之運算及通訊負載，進而提高及時 反應的速度，並提供高彈性的個人化照護系統。 綜上所述’雖然本發明已以諸項實施例揭露如上，然 其並非用以限定本發明。本發明所屬技術領域中具有通常 21 201023062 JL VT ·ΖΛ//ΙΤΙ 4 k 知識者，在不脫離本發明之精神和範圍内，當可作各種之 更動與潤飾。因此，本發明之保護範圍當視後附之申請專 利範圍所界定者為準。 【圖式簡單說明】 第1圖繪示現有即時性照護系統之第一例之示意圖。 第2圖繪示現有即時性照護系統之第二例之示意圖。 第3圖繪示現有即時性照護系統之第三例之示意圖。 第4圖繪示依照本發明之一實施例之適應性個人化 心血管遠距照護系統之方塊圖。 第5圖繪示依照本發明另一實施例之適應性個人化 心血管遠距照護系統之詳細方塊圖。 第6圖繪示依照本發明一實施例之適應性個人化心 血管遠距照護方法之流程圖。 【主要元件符號說明】 100、200、300 :即時性照護系統 112、114 :近端監測設備 120、220、320 :後端次系統 130 :閘道器 140 :資料庫伺服器 150 :應用伺服器 210、310 :監測設備 230 :網際網路 240 :伺服器 201023062 400:適應性個人化心血管遠距照護系統 410 :後端次系統 420 :前端次系統 43 0 : —般化心血管監測準則產生區塊 432 : —般化心血管生理訊號儲存單元 434: —般化心血管監測準則產生單元 436: —般化心血管監測準則儲存單元 440:適應性個人化心血管照護準則產生區塊 • 441 :生理訊號及分析資料儲存單元 442:適應性個人化心血管照護準則產生單元 444 :後端個人化照護單元 445 :後端個人化監測單元 446 :後端個人化事件處理單元 448 :個人化心血管照護準則儲存單元 450 :照護準則傳送區塊 460 :適應性個人化照護區塊 ® 461 :裝置介面 462 :廣域網路介面 463:照護準則執行單元 464 :前端個人化照護單元 465 :前端個人化監測單元 466 :前端個人化事件處理單元 468 :前端個人化管理單元 470 :廣域網路 23For example, the i w juyttrA system architecture, please refer to FIG. 3, which shows a schematic diagram of a third example of the existing instant care system. In the immediate care system 300 of Fig. 3, the front end monitoring device 310 collects only the physiological parameters of the patient, and then transmits the collected physiological parameters to the back end subsystem 320 for analysis processing. Since the physiological parameters of the patients are concentrated in the back-end subsystems 220 and 320 for analysis, the systems of the immediate care systems 200 and 300 are used in the remote care system for large-scale patients. The computing and communication burden will be too heavy. [Invention] The present invention relates to an adaptive personalized cardiovascular remote care system and method for collecting cardiovascular physiological signals and performing cardiovascular physiological signals using a front-end subsystem. Real-time analysis, and long-term analysis of cardiovascular physiological signals using the back-end subsystem, so that the patient's personalized cardiovascular care guidelines can be updated with the patient's physiological conditions, and reduce the operation of the host in the hospital's back-end subsystem. And communication load. According to a first aspect of the present invention, an adaptive personalized cardiovascular long distance care system is provided comprising a back end subsystem and a front end subsystem. The back-end subsystem includes a generalized cardiovascular monitoring criteria generation block, an adaptive personalized cardiovascular care criteria generation block, and a care criteria delivery block. The generalized cardiovascular monitoring guidelines generation block provides multiple generalized cardiovascular monitoring guidelines. The adaptive personalized cardiovascular care guidelines generation block was selected from these generalized cardiovascular monitoring guidelines to establish a set of back-end personalized cardiovascular care guidelines and a set of front-end personalized cardiovascular care guidelines. The front-end personalized cardiovascular care guidelines are transmitted in accordance with the 201023062 guidelines. The front end system includes an adaptive personalized care block. The adaptive personalized care block measures the cardiovascular physiology signal of one of the caregivers, and obtains a front-end analysis data based on the analysis of the cardiovascular physiological signals by the front-end personalized cardiovascular care guidelines. Among them, the adaptive personalized cardiovascular care criteria generation block obtains a back-end analysis data based on the long-term analysis of cardiovascular physiological signals according to the group's back-end personalized cardiovascular care guidelines, and the adaptive personalized cardiovascular care guidelines generate blocks. Based on front-end analysis data and back-end analysis data, this group of back-end personalized cardiovascular care guidelines and this group of front-end personalized cardiovascular care guidelines were re-set from these generalized cardiovascular monitoring guidelines. According to a second aspect of the present invention, an adaptive personalized cardiovascular remote care method is proposed for use in an adaptive personalized cardiovascular remote system, the adaptive personalized cardiovascular remote system comprising a back-end subsystem And a front-end subsystem. The adaptive personalized cardiovascular remote care method includes the following steps. The back-end subsystem provides multiple generalized cardiovascular monitoring guidelines. The back-end system is selected from these generalized cardiovascular monitoring guidelines to establish a set of back-end personalized management guidelines and a set of front-end personalized cardiovascular care guidelines. The back-end subsystem transmits this set of front-end personalized cardiovascular care guidelines to the front-end subsystem. The front-end subsystem measures a cardiovascular health signal of one of the caregivers, and obtains a front-end analysis data based on the immediate analysis of the cardiovascular physiological signal by the group's personalized cardiovascular care guidelines. The back-end subsystem obtained a back-end analysis based on a long-term analysis of cardiovascular physiology signals based on this set of back-end personalized cardiovascular care guidelines. The back-end subsystem is based on front-end analysis data 9 201023062 λ. vr r\ and back-end analysis data to reset this group of back-end personalized cardiovascular care guidelines and this group of front-end personalized cardiovascular care from these generalized management guidelines. Guidelines. In order to make the above description of the present invention more comprehensible, the following specific embodiments, together with the accompanying drawings, are described in detail as follows: [Embodiment] The present invention provides an adaptive personalized cardiovascular remote care system. And the method of 'using the front-end subsystem to collect cardiovascular physiological signals and analyze the cardiovascular physiological signals in real time, and using the back-end subsystem to perform long-term analysis of cardiovascular physiological signals', so that the individualized cardiovascular care guidelines for patients can follow The patient's physiological condition is updated, and the computing and communication load of the host in the back-end system of the hospital is reduced. Referring to Figure 4, a block diagram of an adaptive personalized cardiovascular telehealth system in accordance with an embodiment of the present invention is shown. The adaptive personalized cardiovascular remote care system 400 includes a back-end subsystem 410 and a front-end subsystem 420. The back-end subsystem 410 includes a generalized cardiovascular monitoring criteria generating block 430, an adaptive personalized cardiovascular care criteria generating block 440, and a care criteria transfer block 450. The Generalized Cardiovascular Monitoring Guidelines Generation Block 430 provides a number of generalized cardiovascular monitoring guidelines. The Adaptive Personalized Cardiovascular Care Criteria Generation Block 440 is selected from such generalized cardiovascular monitoring guidelines to set a set of back-end personalized cardiovascular care guidelines and a set of front-end personalized cardiovascular care guidelines. The 'end-end personalized cardiovascular care guidelines include a set of back-end personalized cardiovascular 201023062 monitoring guidelines and a corresponding set of back-end personalized event handling mechanisms. The front-end personalized cardiovascular care guidelines include a set of front-end personal care hearts. Vascular monitoring guidelines and a corresponding set of front-end personalized event processing mechanisms. Wherein the criteria are implemented, for example, by a program or a rule engine, each of which may include a plurality of parameters, and is not limited to the care criteria delivery block 450 transmitting the set of front-end personalized cardiovascular care guidelines. The front-end subsystem 420 receives the front-end personalized cardiovascular care guidelines from the care-seeking 1J transport block 45 via a Wide Area Network (WAN). The front end subsystem 420 includes an adaptive personalized care block 460. Adaptive Personalized Care Block 460 measures a cardiovascular physiologic signal of a caregiver (eg, a cardiovascular disease patient). Brigade gets a front-end based on this group of front-end personalized cardiovascular care guidelines for immediate analysis of cardiovascular physiology signals. Analyze the data. The adaptive personalized care block 460 is, for example, a health care box. In addition, the front-end subsystem 420 includes a plurality of adaptive personalized care blocks 460 to care for a plurality of caregivers, respectively, without limitation. The front-end subsystem 420 will transmit the measured blood flow tube physiological signal and front-end analysis data to the back-end subsystem 410. The adaptive personalized cardiovascular care criteria generation block 440 of the back-end sub-system 410 obtains a back-end analysis data based on the long-term analysis of the cardiovascular physiological signals according to the set of back-end personalized cardiovascular care guidelines, and adaptive personalized cardiovascular care. The criteria generation block 440 re-sets the set of back-end personalized cardiovascular care guidelines and the set of front-end personalized cardiovascular care guidelines from such generalized cardiovascular monitoring criteria based on front-end analysis data and back-end analysis data. That is, the 'adaptive personalized cardiovascular care guidelines generation block 440 201023062 i wji/y〇r/\ update the personalized cardiovascular care guidelines according to the physiological condition of the caregivers. Referring to Figure 5, there is shown a detailed block diagram of an adaptive personalized cardiovascular telehealth system in accordance with another embodiment of the present invention. In Figure 5, the 'generalized cardiovascular monitoring criteria generation block 430 includes a generalized cardiovascular physiological signal storage unit 432, a generalized cardiovascular monitoring criteria generating unit 434, and a generalized cardiovascular monitoring criteria storage unit. 436. The back-end subsystem 410 receives the cardiovascular health signal transmitted from the front-end subsystem 420. The cardiovascular physiological signals having pathological features after being interpreted by the physician are stored in the generalized cardiovascular physiological signal storage unit 432. ❹ The generalized cardiovascular monitoring criterion generation unit 434 can analyze the cardiovascular physiological signals having pathological features in the generalized cardiovascular physiological signal storage unit 432 by using various existing analysis rules to generate a plurality of generalized cardiovascular monitoring criteria. The generalized cardiovascular monitoring criteria storage unit 436 stores these generalized cardiovascular monitoring criteria. Where such generalized cardiovascular monitoring criteria are implemented, for example, by a program or a criteria engine, are not limited thereto. In addition, the generalized cardiovascular monitoring criteria storage unit 436 can employ a number of generalized cardiovascular monitoring guidelines that are well developed. As such, the generalized cardiac vascular monitoring criteria generating block 430 can omit the generalized cardiovascular physiological signal storage unit 432 and the generalized cardiovascular monitoring criteria generating unit 434. The adaptive personalized cardiovascular care criteria generation block 440 includes a physiological signal and analysis data storage unit 441, an adaptive personalized cardiovascular care criteria generation unit 442, a back-end personalized care unit 444, and a personalized cardiovascular system. Care criteria storage unit 448. The physiological signal and analysis data storage unit 441 stores and manages the cardiovascular physiological signals and front-end analysis data transmitted by the front-end subsystem 420, and also stores the back-end analysis data analyzed by the back-end personalized care unit 444. The backend personalized care unit 444 includes a backend personalization monitoring unit 445 and a backend personalized event processing unit 446. The back-end personalization monitoring unit 445 obtains the back-end analysis data based on the long-term analysis of the cardiovascular physiological signals according to the set of back-end personalized cardiovascular monitoring criteria, and stores the back-end analysis data in the physiological signal and analysis data storage unit 441. Among them, the back-end personalization monitoring unit 445 analyzes the part of the cardiovascular physiological signal with pathological features in a longer term. The back-end personalized event processing unit 446 determines that one of the cardiovascular physiological signals has a feature value exceeding a back-end threshold according to the back-end analysis data, and the back-end personalized event processing unit 446 initiates the corresponding group of the back-end personalization to the caregiver. Event handling mechanism. The back-end personalized care unit 444 primarily monitors the long-term physiological condition of the caregivers to handle non-immediate events. The adaptive personalized cardiovascular care criterion generation unit 442 sets the set of back-end personalized cardiovascular care guidelines and the front-end personalized cardiovascular care guidelines from the generalized cardiovascular monitoring criteria based on the front-end analysis data and the back-end analysis data. . The adaptive personalized cardiovascular care criterion generation unit 442 substantially refers to the cardiovascular physiological signals, front-end analysis data, and back-end analysis data of the care recipient stored by the physiological signal and analysis data storage unit 441 to generate such care criteria. The long-term trends and statistical results of the parameter changes allow physicians to use their own expertise to select from a number of generalized cardiovascular monitoring criteria provided by the generalized cardiovascular monitoring guidelines generation block 430 for the caregivers. After the stage, individuals 13 201023062 I WJU7〇r/\ cardiovascular care guidelines and front-end personalized cardiovascular care guidelines. In this way, the adaptive personalized cardiovascular care criterion generating unit 442 can dynamically update the group of back-end personalized cardiovascular care criteria and the front-end individuals transmitted to the front-end subsystem 420 along with the physiological condition of the caregivers. Cardiovascular care guidelines. The personalized cardiovascular care criteria storage unit 448 stores the set of front end personalized cardiovascular care criteria for output to the care criteria transfer block 450. The care criteria delivery block 450 transmits the set of front end personalized cardiovascular care criteria to the adaptive personalized care block 460 via the wide area network 470. The mechanism of 'delivery' can adopt a mechanism such as DSL Forum TR-069 or a mechanism of OMADM, and is not limited. In addition, the care criteria transfer block 450 can transmit an update trigger signal to the front end subsystem 42 and the adaptive personalized care block 460 updates the set of front end personalized cardiovascular care criteria. The adaptive personalized care block 460 includes a device interface 461, a wide area network interface 462, a care criteria execution unit 463, a front-end personalized care unit 464, and a front-end personalization management unit 468. The device interface 461 is configured to receive a cardiovascular physiological signal of the caregiver from a physiological monitoring device (not shown). Among them, the physiological monitoring device is used to measure the immediate cardiovascular physiological signal of the care recipient, and the physiological monitoring device can be integrated into the adaptive personalized care block 46 or within the front end subsystem 42. The wide area network interface 462 is used to communicate with the care criteria delivery block 450 via the wide area network 47. The care criteria execution unit 463 is used to provide an execution environment for the front-end personalized cardiovascular care guidelines, such as a general operating system, a Java execution environment, or a criteria engine. 201023062 The front-end personalized care unit 464 includes a front-end personalized monitoring unit 465 and a front-end personalized event processing unit 466. Front-end personalization ▲The measurement unit 465 obtains the front-end analysis data based on the front-end personalized cardiovascular monitoring criteria to instantly analyze the cardiovascular physiological signals of the caregivers. If the front-end personalized event processing unit 466 determines that one of the cardiovascular physiological signals has a characteristic value exceeding a front-end threshold based on the front-end analysis data, the front-end personalized event processing unit 466 sends an alert signal to the care recipient or a specific 10 person. And treat the caregiver to initiate the corresponding set of front-end personalization event handling mechanisms. The front-end personalized care unit 464 is substantially used to instantly collect the cardiovascular physiological signals of the care recipient and determine whether the front-end analysis data conforms to one of the normalized data templates of the person to be treated at this stage. That is, the front-end personalized care unit 464 determines whether the care-seeker is within the security range of the health-free and immediate deterioration to decide whether to activate the corresponding immediate event handling mechanism. The front end personalized care unit 464 passes back the front end analysis data to the back end system 410. The Lu front-end personalization management unit 468 has the functions of collecting the cardiovascular physiological signals of the caregivers, receiving and updating the set of front-end personalized cardiovascular care guidelines transmitted by the back-end subsystem 410, and allowing the front-end individuals of the group. The Cardiovascular Care Guidelines are implemented within an adaptive personalized care block 46 and returning cardiovascular physiology signals and front-end analysis data to the back-end subsystem 410 via the WAN interface 462 for adaptive personalized cardiovascular The care criteria generation unit 442 updates part of the basis for the personalized cardiovascular care guidelines. In addition, the front-end personalized cardiovascular care is not limited to a set of front-end personalization 15 201023062 1 TT «/ Χ / 701. I ~ k. Cardiovascular monitoring guidelines and a corresponding group of front-end personalized event handling mechanisms, may include A set of front-end personalized interaction guidelines. The front-end personalization monitoring unit 465 further interacts with the care recipient according to the set of front-end personalized interaction criteria to receive an interactive signal of the caregiver, wherein the front-end personalized interaction criterion is a string display mechanism or a The voice mechanism is implemented. The adaptive personalized care block 460 transmits the interactive signal to the back-end subsystem 410, so that the physician can know the physiological condition of the caregiver in an interactive manner, which is beneficial to make the current situation suitable for the caregiver. Processing reaction. Thus, the 'Adapted Personalized Cardiovascular Care Criteria Generation Block 442 can re-set this set of back-end personalized cardiovascular care guidelines from these generalized cardiovascular monitoring guidelines based on interactive signals, front-end analysis data, and back-end analysis data. Group front-end personalized cardiovascular care guidelines. Referring to Figure 6, there is shown a flow chart of an adaptive personalized cardiovascular remote care method in accordance with an embodiment of the present invention. The adaptive personalized cardiovascular remote care method disclosed in the present invention is applied to an adaptive personalized heart-shaped jk tube remote system, and the adaptive personalized cardiovascular remote system includes a back-end subsystem and a front end. Secondary system. In step S600, the back-end subsystem provides a plurality of generalized cardiovascular monitoring criteria. In step S610, the back-end subsystem is selected from such generalized cardiovascular monitoring criteria to set a set of back-end personalized cardiovascular care guidelines and a set of front-end personalized cardiovascular care guidelines. In step S620, the back-end subsystem transmits the set of front-end personalized cardiovascular care criteria to the front-end subsystem. In step S630, the front-end subsystem measures a physiological signal of one of the caregivers and obtains a front-end analysis data according to the analysis of the cardiovascular physiological signal of the front-end personalized cardiovascular care criterion, 201023062. In step S640, the back-end subsystem obtains a back-end analysis data based on the long-term analysis of the cardiovascular physiological signals according to the set of back-end personalized cardiovascular care criteria. In step S650, the back-end subsystem re-sets the set of back-end personalized cardiovascular care guidelines and the front-end personalized cardiovascular care guidelines from the generalized cardiac management monitoring criteria based on the front-end analysis data and the back-end analysis data. The above-described adaptive personalized cardiovascular remote care method has been described in detail in the adaptive personalized cardiovascular remote care system 400, and therefore will not be repeated here. Next, the caregiver will be taken as an example for the situation of cardiovascular patients. Assuming that the patient has high blood pressure, the physician decides that the patient must use a physiological monitoring device (for example, a sphygmomanometer) to measure his or her cardiovascular health signals, such as pulse and blood pressure changes, for a long time. The patient's personalized health care box is based on receiving the personalized personal cardiovascular care guidelines from the back-end subsystem, setting the upper and lower thresholds of the patient's personalized pulse and the normal range of the Gorefiend value. The health care box collects the pulse and blood pressure data of the patient and conducts timely analysis to obtain the front-end analysis data. The front-end analysis data can be a normal blood pressure value or an abnormal blood pressure value. Physicians can also interact with patients using a set of front-end personalized interaction guidelines for personalized health care boxes to understand if the patient has symptoms of discomfort on the day, such as dizziness, chest tightness, chest pain, or palpitations. If the front-end analysis data is abnormal, the personalized health care box will send a warning signal to remind the patient of the precautions and notify the doctor. The physician can immediately monitor the patient's physical condition and inform the patient of the precautions through the Internet. The anomalies monitored by the front-end subsystems are determined by the physician to determine the corresponding event processing mechanism. All cardiovascular physiology signals, analytical data and interaction results are transmitted to the back-end subsystem. The back-end subsystem will refer to the cardiovascular physiological signals and analysis data of the stored patients at intervals (for example, one week) to generate long-term trends and statistical results of the changes in the parameters of these care criteria, and predict the disease according to β. Whether the patient may have abnormal symptoms. If the physician is aware of the symptoms of discomfort such as chest disease or chest tightness, the patient can be notified to the hospital for further examination through a personalized health care box. If the doctor determines that the patient has angina and coronary artery occlusion after the examination, the patient can return to the home to consider whether to undergo cardiovascular treatment. During this period of consideration, the physician decides that the patient must measure the ECG12 lead at home to monitor the patient's physiological condition. The back-end sub-system update patient's personalized health care kit is designed to personalize the cardiovascular care guidelines. The patient's personalized pulse and the upper and lower critical values of the normal range of blood pressure values' and the personalized ECG regular physiological signal template. Personalized health care boxes collect blood pressure and electrocardiograms from patients and compare them with personalized ECG regular physiological signal templates to obtain front-end analysis data. If the anterior analysis data shows abnormalities, an abnormal analysis of the cardiovascular physiological signals will be performed to determine whether the patient has an immediate myocardial infarction. All cardiovascular physiology signals and front-end analysis data are transmitted to the back-end subsystem. The back-end subsystem predicts and monitors the physiological condition of the patient based on cardiovascular physiological signals'. For example, ECG electrocardiographic data analysis of myocardial hypoxia is performed, and the type and severity parameters of myocardial ischemia are analyzed by 201023062, so that the physician can grasp the situation immediately. Changes in the physiological condition of the patient. If the patient suddenly develops immediate heart disease and cold sweats, the patient can transmit the ECG signal and notify the physician through a personalized health care box. If the physician determines that the patient may have symptoms of acute myocardial infarction, he or she will notify the patient and send an ambulance to pick up the patient to the hospital for diagnosis. If the physician determines in the hospital that the patient has an acute myocardial infarction, the patient is immediately placed in a coronary stent placement procedure. The patient goes home to recuperate after the operation, and monitors his or her own physical condition at the home by the personalized health care kit. The personalized cardiovascular care guidelines in the personalized health care box of the patients who update the patient in the back-end system. To re-set the normal range of personalized pulse and blood pressure values for patients at this stage, as well as personalized ECG regular physiological signal templates. The personalized health care box collects the patient's blood pressure and electrocardiogram and compares it with the personalized ECG regular physiological signal template to obtain front-end analysis data. If the front-end analysis data shows abnormalities, ECG ECG data analysis of myocardial infarction will be performed to analyze the type and severity parameters of myocardial infarction in patients to monitor the recurrence of myocardial infarction. If the patient has a recurrent myocardial infarction, the personalized health care box sends a warning signal to alert the patient to the physician. Among them, all cardiovascular physiological signals and front-end analysis data will be transmitted to the back-end subsystem 0. The back-end subsystem predicts and monitors the patient's physiological condition based on cardiovascular physiological signals'. For example, ECG ECG data analysis for heart failure is analyzed. Whether the patient has a pre-existing phenomenon of heart failure, so that the doctor can immediately grasp the changes in the physiological condition of the patient. If the back-end system determines the patient can be 19 201023062 Μ. ΨΨ \^Μ. 时 When the heart failure can occur in the early stage, the back-end system will prompt the doctor. After confirming the prompts of the back-end subsystem, the physician will notify the patient to go to the hospital for further examination to confirm whether there is heart failure. If the doctor confirms that the patient has heart failure, then the doctor will decide that the patient must be equipped with blood oxygen concentration (SP02) measurement equipment in addition to physiological monitoring equipment such as sphygmomanometer and ECG in order to monitor the patient's condition at any time. Physiological condition. The back-end sub-system updates the patient's personalized cardiovascular care guidelines in the personalized health care box to re-set the normal range of personalized pulse and blood pressure values for patients at this stage, personalized ECG regularity physiological information® Template and personalized blood oxygen data template. The personalized health care box collects the patient's blood pressure, electrocardiogram, and blood oxygenation data, and compares it with the personalized ECG regular physiological signal template and personalized blood oxygen data template to obtain front-end analysis data. If the data of the front-end analysis shows abnormality, ECG electrocardiographic data analysis of myocardial infarction will be performed to analyze the type of myocardial infarction and the severity parameter of the patient to monitor the recurrence of myocardial infarction. In addition, blood oxygen concentration analysis of heart failure was performed to analyze whether the patient developed heart failure. If the patient develops a worsening of heart failure, the personalized health care box sends a warning signal to inform the physician that the physician will ask the patient's physical condition through a personalized health care box to determine the subsequent event handling mechanism. In addition, if the patient develops chest pain or other abnormalities, the patient can also contact the physician through the personalized health care box and inform him of his or her physical condition. All cardiovascular physiological signals and front-end analysis data are transmitted to the back-end subsystem. 20 201023062 The back-end subsystem monitors the physiological condition of the patient based on the cardiovascular physiological signals sent by the front-end subsystem, and refers to the cardiovascular physiological signals and analysis data of the stored patients to generate parameters of these nursing guidelines. Long-term trends and statistical results. Physicians can refer to long-term trends and statistical results of parameter changes and transmit precautionary messages to personalized health care boxes through the back-end system to alert patients to their physical condition. The adaptive personalized cardiovascular arrest distance care system and method disclosed in the above embodiments of the present invention selects a personalized cardiovascular care criterion suitable for the care recipient by the back-end subsystem through a decentralized structure. The brigade adopts the front-end personalized care and care guidelines of the front-end sub-system to determine whether the front-end needs to be activated by interacting with the caregivers and collecting cardiovascular physiological signals to analyze the cardiovascular physiological signals. Event handling guidelines. In addition, the back-end subsystem performs long-term analysis of cardiovascular physiologic signals based on the back-end personalized cardiovascular care guidelines, and based on the timely analysis of the front-end subsystem and the long-term analysis of the back-end subsystem, along with the caregivers' Physiological conditions dynamically adjust the front and rear personalized cardiovascular care guidelines. Therefore, the adaptive personalized cardiovascular remote care system and method disclosed by the present invention can reduce the number of hospital back-ends due to the above-described adaptive personalized cardiovascular remote care system and method being a discrete and personalized architecture. The computing and communication load of the host server in the system, thereby improving the speed of timely response and providing a highly flexible personalized care system. In view of the above, the present invention has been disclosed in the above embodiments, but it is not intended to limit the present invention. In the technical field to which the present invention pertains, it is possible to make various changes and refinements without departing from the spirit and scope of the present invention. Therefore, the scope of the invention is defined by the scope of the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic view showing a first example of an existing instant care system. FIG. 2 is a schematic view showing a second example of the existing instant care system. FIG. 3 is a schematic diagram showing a third example of the existing instant care system. Figure 4 is a block diagram of an adaptive personalized cardiovascular telehealth system in accordance with an embodiment of the present invention. Figure 5 is a detailed block diagram of an adaptive personalized cardiovascular telehealth system in accordance with another embodiment of the present invention. Figure 6 is a flow chart showing an adaptive personalized cardiovascular remote care method in accordance with an embodiment of the present invention. [Main component symbol description] 100, 200, 300: Instant care system 112, 114: Near-end monitoring device 120, 220, 320: Back-end subsystem 130: Gateway 140: Database server 150: Application server 210, 310: Monitoring device 230: Internet 240: Server 201023062 400: Adaptive Personalized Cardiovascular Remote Care System 410: Backend Subsystem 420: Front End Subsystem 43 0: Generalized Cardiovascular Monitoring Guidelines Generation Block 432: Generalized Cardiovascular Physiology Signal Storage Unit 434: Generalized Cardiovascular Monitoring Criteria Generation Unit 436: Generalized Cardiovascular Monitoring Criteria Storage Unit 440: Adaptive Personalized Cardiovascular Care Criteria Generation Blocks • 441 : physiological signal and analysis data storage unit 442: adaptive personalized cardiovascular care criterion generation unit 444: back-end personalized care unit 445: back-end personalized monitoring unit 446: back-end personalized event processing unit 448: personalization Vascular Care Criteria Storage Unit 450: Care Criteria Transfer Block 460: Adaptive Personal Care Blocks® 461: Device Interface 462: WAN Interface 463: Care Guidelines Execution Unit 464: Front End Personalized Care Unit 465: Front End Personalized Monitoring Unit 466: Front End Personalized Event Processing Unit 468: Front End Personalized Management Unit 470: Wide Area Network 23