US20150070187A1 - Wireless Relay Module For Remote Monitoring Systems - Google Patents
Wireless Relay Module For Remote Monitoring Systems Download PDFInfo
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- US20150070187A1 US20150070187A1 US14/462,025 US201414462025A US2015070187A1 US 20150070187 A1 US20150070187 A1 US 20150070187A1 US 201414462025 A US201414462025 A US 201414462025A US 2015070187 A1 US2015070187 A1 US 2015070187A1
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Definitions
- the present application is directed to systems and methods for communicating between a series of medical devices and remote monitoring devices, and more particularly, to a wireless relay module for receiving communications from and transmitting communications to medical devices via a wireless relay network, and for transferring the communications received from the remote monitoring devices via an internet-accessible wireless communications network.
- the present disclosure is directed to a wireless relay module for providing networked communications between a series of medical devices and remote monitoring devices.
- one or more medical devices including but not limited to including for example, respirators, external feeding devices, pulse oximeters, blood pressure monitors, pulse monitors, weight scales and glucose meters
- An interface circuit is coupled to each medical device, and is configured for communicating with at least one of a plurality of the wireless relay modules via a wireless relay network and/or with other medical devices.
- the wireless relay modules and medical devices are advantageously further configured to communicate with a remote monitoring device over an internet-accessible wireless communication network, and preferably, a wireless wide-area network (WWAN) such as a mobile telephone data network including (for example, based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated wireless data channels).
- WWAN wireless wide-area network
- GSM Global System for Mobile Communications
- CDMA Code Division Multiple Access
- communications over each of the wireless networks are preferably conducted securely.
- Systems and methods for providing communications between a medical device to be used by a patient and a remote monitoring device via an internet-accessible wireless communications network include obtaining identification information identifying the patient, obtaining identification information identifying the medical device transmitting each of the patient identification information and the medical device identification information to the remote monitoring device via the internet-accessible wireless communications network, receiving an acknowledgement status from the remote monitoring device via the internet-accessible wireless communications network; and transmitting data corresponding to an output of at least one sensor of the medical device for said patient by the medical device via the internet-accessible wireless communications network when the received acknowledgement status represents a particular status.
- one or more medical devices including, for example, enteral feeding devices and systems, thermometers, pulse oximeters, respirators, blood pressure monitors, pulse monitors, weight scales and glucose meters) are provided at a patient facility.
- An interface circuit is coupled to each medical device, and is configured for communicating with one of a plurality of wireless relay modules via a wireless relay network.
- the wireless relay modules are further configured to communicate with a remote monitoring device over an internet-accessible wireless communication network, and preferably, a wireless wide-area network (WWAN) such as a mobile telephone data network, e.g. 3G or 4G network.
- WWAN wireless wide-area network
- communications over each of the wireless networks are preferably conducted securely.
- Each of the plurality of wireless relay modules includes a receiver capable of wirelessly receiving medical device data from respective interface circuits via the wireless relay network, a first transmitter capable of wirelessly transmitting medical device data to another one of the wireless relay modules over the wireless relay network, a second transmitter capable of wirelessly transmitting data over an internet-accessible wireless communications network; and a controller coupled to the first and second transmitters.
- the controller is configured to determine access status of the internet-accessible wireless communications network, and to select one of the first or second transmitters based on that status. For example, when the status indicates that the internet-accessible wireless communications network is accessible to the wireless relay module, the controller selects the second transmitter for transmitting medical device data transmitted by the interface circuit to the internet-accessible wireless communications network.
- the controller selects the first transmitter for transmitting the medical device data to another one of the wireless relay modules. In this manner, additional attempts to transmit the medical device data over the internet-accessible wireless communication network can be attempted by this other wireless relay module (and potentially additional ones of the wireless relay modules) until a successful transmission is achieved.
- the wireless relay module may also advantageously communicate its status and the status of other wireless relay modules via the wireless relay network and over the internet-accessible wireless communications network.
- the wireless relay module may further include a second receiver for receiving data and commands from the internet-accessible wireless communications network for communicating to specific interface circuits and corresponding medical devices.
- FIG. 1A is a block diagram of an embodiment of a medical device network architecture that incorporates a wireless relay module.
- FIG. 1B is a block diagram of an embodiment medical device network architecture that incorporates a wireless relay module.
- FIG. 1C is a block diagram of an embodiment medical device network architecture that incorporates a wireless relay module.
- FIG. 1D is a perspective diagram of a personal enclosure for a medical device and/or a relay device.
- FIG. 2A is a network diagram of a network including medical devices and/or relay devices.
- FIG. 2B is a network diagram of a network including medical devices and/or relay devices.
- FIGS. 3A-3D are block diagrams of embodiments of relay devices.
- FIGS. 3E-3G are top, front, and side views of a relay device.
- FIG. 3H is a diagram of a control panel associated with a relay device.
- FIG. 3I is a diagram of a control panel associated with a relay device.
- FIG. 4A and FIG. 4B are flow diagrams of processes for transmitting medical device data.
- FIG. 4C is flow diagram of a process including determining module status.
- FIG. 4D is a flow diagram of a process including determining WWAN status.
- FIG. 4E is a flow diagram of a process including determining WLAN/WPAN status.
- FIG. 4F is a flow diagram of a process including initiating a call to an emergency responder.
- FIG. 4G is a flow diagram of a process including producing location data.
- FIG. 4H is a table diagram of priority codes.
- FIG. 5 is a flow diagram of a process including determining whether an interface device is accessible.
- FIG. 6A and FIG. 6B are flow diagrams including producing an alert.
- FIG. 6C is a flow diagram including transmitting a power alarm.
- FIG. 6D is a flow diagram including transmitting a low battery alarm.
- FIG. 7A is a flow diagram including sending a heartbeat request to a medical device.
- FIG. 7B is a flow diagram including initiating patient/device synchronization.
- FIG. 7C is a flow diagram including adding patient information to a local directory.
- FIG. 8 is a flow diagram including logging in to a device set-up screen.
- FIG. 9A is a flow diagram including displaying a list of active devices available.
- FIGS. 9B-9D are screen displays for retrieving and viewing the medical data.
- FIG. 10A is a flow diagram illustrating a method for issuing a command to a medical device via the remote monitoring system.
- FIGS. 10B and 10C are screen displays for commanding a medical device.
- FIG. 11A is a flow diagram illustrating a method for recognizing and reporting an alert condition according to medical data logged via the remote monitoring.
- FIG. 11B is a screen display for selecting a recipient for receiving an alert message.
- FIG. 12 is a block diagram of a computer or server device suitable for use in the remote monitoring system.
- a network architecture for centralized monitoring of medical devices using wireless relay networks and/or internet-accessible wireless communications networks having emergency call functionality to provide a secondary level of protection when significant health conditions occur.
- the architecture in addition enables the approximate location of the monitored medical devices to be determined.
- FIG. 1 A schematic diagram of an architecture 100 for a system for monitoring medical devices is illustrated in FIG. 1 .
- One or more medical devices 10 are provided at a patient facility 20 for monitoring the medical condition and/or administering medical treatment to one or more patients.
- Patient facility 20 may comprise a critical care health service center (for example, including hospitals, clinics, assisted living centers and the like) servicing a number of patients, a home facility for servicing one or more patients, or a personal enclosure (for example, a backpack) that may attached to and/or be worn by an ambulatory patient.
- a critical care health service center for example, including hospitals, clinics, assisted living centers and the like
- a personal enclosure for example, a backpack
- each medical device 10 Associated with each medical device 10 is an interface circuit 15 that includes a transceiver having one or more of a transmitter and/or a receiver for respectively transmitting and receiving signals in a facility-oriented wireless network such as, for example, a Low-Rate Wireless Personal Area Networks or “LR-WPAN,” ZIGBEE network or other low-power personal area networks such as a low power BLUETOOTH network, e.g. Bluetooth 4.0, existing or presently under development or consideration, for emulating a mesh network (such as ZIGBEE network) or otherwise.
- LR-WPAN Low-Rate Wireless Personal Area Networks
- ZIGBEE network or other low-power personal area networks
- a low power BLUETOOTH network e.g. Bluetooth 4.0
- a mesh network such as ZIGBEE network
- a suitable access point 40 may include an inbound web server 41 that incorporates or otherwise has access to a transceiver for communicating with the relay modules 30 a over the WWAN. Medical device data received by the inbound web server 41 over the WWAN is forwarded to a secure data storage server 42 , which is configured for example to log the received data in association with identification information of the associated medical devices.
- medical device data and “data” as generally used herein means data from or about the medical device including, for example, medical device identification, medical device software, medical device settings or status information (including alarm information and/or alarm priority), patient identification information, patient personal identification number(s) “PIN(s)”, patient prescriptions, and/or patient medical and/or physiological data as is collected, produced and/or generated by the medical device.
- An outbound web server 43 (which may be associated with access point 40 ) is configured, for example, to receive and qualify data retrieval requests submitted by one or more of remote monitoring devices 61 , 62 and 63 over a broad-band network 50 (for example, over the Internet), to request associated medical device data to be retrieved from the secure data storage server 42 , and to format and transmit the retrieved data to the one or more remote monitoring devices 61 , 62 and 63 for display on associated device displays.
- a broad-band network 50 for example, over the Internet
- any architecture for the access point 40 that enables the receipt, storage and retrieval of medical device data on a device display of the one or more remote monitoring devices 61 , 62 and 63 is intended to be included within the scope of the technology disclosed here.
- Variations of the architecture may involve utilizing a web server integrated with a data storage server.
- storage server 42 may be integrated into the outbound web server 43 .
- Further alternative configurations may for example involve a plurality of mirror storage servers 42 each storing medical device data, and accessible as a plurality of outbound web servers 43 .
- communications over each of the facility-oriented wireless network and WWAN are preferably conducted securely using, for example, using a Secure Sockets Layer (SSL) protocol or a Transport Layer Security (TLS) protocol.
- SSL Secure Sockets Layer
- TLS Transport Layer Security
- FIG. 1B a diagram of another embodiment of a system 100 B for monitoring medical devices is illustrated. Some or all of the elements shown in FIG. 1B may be the same as or similar to the elements in FIG. 1 .
- One or more medical devices 10 are provided at a patient facility 20 for monitoring the medical condition and/or administering medical treatment to one or more patients.
- Patient facility 20 may comprise a critical care health service center (for example, including hospitals, clinics, assisted living centers and the like) servicing a number of patients, a home facility for servicing one or more patients, or a personal enclosure (for example, a backpack) that may be attached to or worn by an ambulatory patient.
- Examples of medical devices include, but are not limited to, include ventilators, urology devices, energy delivery devices, pulse oximeters, predictive thermometers, tympanic thermometers, patient electrodes, and food pumps.
- each medical device 10 Associated with each medical device 10 is an interface circuit 15 that includes a transceiver having one or more of a transmitter and/or a receiver for respectively transmitting and receiving signals in a facility-oriented wireless network 17 such as, for example, a Low-Rate Wireless Personal Area Networks or “LR-WPAN,” ZIGBEE network or another low-power personal area network such as a low power Bluetooth network, existing or presently under development or consideration.
- LR-WPAN Low-Rate Wireless Personal Area Networks
- ZIGBEE network another low-power personal area network
- a low power Bluetooth network existing or presently under development or consideration. See, e.g., Houda Labiod et al., Wi-Fi, Bluetooth, Zigbee and WiMax, Springer 2010, which is incorporated by reference herein in its entirety.
- interface circuit 15 may be contained within or disposed external to medical device 10 .
- Each relay module 30 a may include a first transceiver for receiving signals from and transmitting signals to the interface circuits 15 in the facility-oriented wireless network 17 , and further include a second transceiver for wirelessly transmitting signals to and receiving signals from an access point 40 via a wireless wide-area network (“WWAN”) 52 .
- WWANs include, for example, networks based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated with the 2G, 3G, 3G Long Term Evolution, 4G, WiMAX cellular wireless standards of the International Telecommunication Union Radiocommunication Sector (ITU-R).
- GSM Global System for Mobile Communications
- CDMA Code Division Multiple Access
- communications over each of the facility-oriented wireless network and WWAN are preferably conducted securely using, for example, a Secure Sockets Layer (SSL) protocol or a Transport Layer Security (TLS) protocol or other cryptographic protocols.
- SSL Secure Sockets Layer
- TLS Transport Layer Security
- the access point 40 includes an inbound server (“device integration server”) 41 that incorporates or otherwise has access to a transceiver for communicating with the relay modules 30 a over the WWAN.
- Medical device data, medical device identifier, and/or patient identifier received by the device integration server 41 over the WWAN is forwarded to a secure device web server 45 , which is configured for example to log the received data in association with identification information of the associated medical devices in a device control database 44 .
- Medical device data includes data from or about the medical device including, for example, medical device identification, medical device software, medical device settings or status information (including alarm information and/or alarm priority), patient identification information, patient personal identification number(s) “PIN(s)”, patient prescriptions, and/or patient medical and/or physiological data as is collected, produced and/or generated by at least one of the medical device and patient identification device; as well as wireless relay network information such as location or status information.
- An outbound web server 43 is configured, for example, to receive and qualify data retrieval requests submitted by one or more of first remote monitoring devices 62 over a broad-band network 50 (for example, over the Internet), and/or second remote monitoring devices 73 , 75 over a wired or wireless wide area network. It is advantageous for such requests be made in an encrypted format. Suitable encryption formats useable for such requests may include, for example, formats compliant with the HIPAA regulations described above.
- the outbound web server 43 requests associated medical device data or portions thereof to be retrieved from the device control database 44 via the secure device web server 45 , requests associated program data for constructing a display page from a metadata and applications database 46 , and requests associated patient data to be retrieved from a patient database 66 provided in a patient care database node 60 over a secure link 54 via a secure patient web server 64 .
- the secure link 54 can be implemented, for example as another WWAN using a SSL protocol or a TLS protocol.
- a third party service provider may host the access point 40 to simultaneously support a number of distinct patient and/or home care facilities, thereby eliminating the need for each of these facilities to configure and maintain their own private access point facilities and providing hosting service to each facility that are likely far less than the costs of configuring and maintaining dedicated access point facilities by each care facility provider.
- access point 40 and patient care database node 60 may nevertheless be integrated into a single access point or node (for example, by a provider of a very large-scale facility provider monitoring many hundreds or thousands of patients).
- the outbound web server 43 provides an interface for authenticated clinicians or other monitoring personnel to retrieve patient and medical device data from each of the patient care database node 60 and the access point 40 in a convenient and transparent manner such that the details of the configurations and operation of the access point 40 and patient care database node 60 are of no consequence to the clinicians or other monitoring personnel.
- the first remote monitoring devices 67 are intended to be used by healthcare providers such for example, clinicians, physicians, technicians, nurses and other healthcare specialists monitoring patients associated with medical devices 10 .
- Suitable first remote monitoring devices 67 may include, for example, desktop or laptop computers, tablet computer smart or other mobile phones, or other fixed or portable display devices.
- the second remote monitoring devices 73 , 75 are advantageously intended to be used by caregivers and/or relatives of the patient such as parents, located proximate the patient such as in a homecare environment or small healthcare facility, or nurses at a larger healthcare facilities, e.g., hospitals.
- Suitable second remote monitoring devices 73 , 75 likewise may include, for example, desktop or laptop computers, tablet computer, smart or other mobile phones, or other fixed or other portable communication devices.
- the outbound web server 43 is depicted coupled to a network status server 80 , which monitors the status of the facility-oriented wireless network 17 and associated medical devices 10 .
- the network status server 80 is intended to provide status information concerning the facility-oriented wireless network 17 and associated medical devices 10 to the outbound web server 43 .
- Status information concerning the facility-oriented wireless network 17 includes, for example, signal strength, data rates, particular transmission time stamps between modules comprising the network 17 , number active relay modules in the network 17 , unique identifier number for a particular relay module of the network 17 .
- the network status server 80 may be implemented in hardware or software running on an application specific or general purpose processor or computer, as part of or separate from the outbound web server 43 .
- the network status server 80 is shown coupled to the outbound web server 43 for ease of illustration and discussion purposes only.
- the network status server 80 may be coupled to any component or network of the access point 40 or facility-oriented wireless network 17 .
- the outbound web server 43 upon retrieving the requested medical device data and patient data from the patient care database node 60 , the outbound web server 43 then proceeds to format and transmit the retrieved medical device data and patient data (and/or provide status information concerning the facility-oriented wireless network 17 and associated medical devices 10 ) as respective webpages or other formats for display by corresponding first and second remote monitoring devices 67 , 73 , 75 according to the retrieved program data. It is possible for the webpages or other formatted information for display to include the same or differing content and format for the intended remote monitoring device user depending upon the retrieved program data.
- the detailed medical device data provided to and displayed on a first remote monitoring devices 67 for a clinician may differ from the less detailed information provided to and displayed on a second remote monitoring devices 73 monitored by a parent or visiting nurse or other healthcare professional in a homecare environment.
- the status information concerning the facility-oriented wireless network 17 and associated medical devices 10 may advantageously be provided to first and/or second remote monitoring devices 67 , 73 and 75 in the same or different encrypted formats as may be deemed appropriate.
- the device integration server 41 of FIG. 1B is configured to transmit information and commands to the relay modules 30 a , for example, for transmitting medical device or alert messages to other WWAN-reachable nodes (for example, cellular telephones of emergency attendants), and/or transmitting operating commands and/or software or firmware updates to the medical devices 10 via the interface circuits 15 and facility-oriented wireless network 17 .
- WWAN-reachable nodes for example, cellular telephones of emergency attendants
- the device integration server 41 may also be configured to receive and analyze patient metric information from the secure patient web server 64 via the outbound web server 43 and secure device web server 45 , or by an alternate and direct secure data link to the secure patient web server 64 in order to prevent unsafe medical device usage based upon the patient metrics information. It is possible for a database (not depicted) accessible, for example, by the device integration server 41 and/or device web server 45 , to store various safe and unsafe operating parameters and conditions for performing such analysis. In this manner, the device integration server 41 would function as an additional failsafe for preventing operating errors that could result in patient harm.
- the device integration server 41 may act, for example, to (1) discard remote monitoring commands programming large bolus or excessive feeding rates that could be harmful to a young child; and (2) provide a warning message or other notification to the user of the likely unsafe usage condition that may result by implementation of such comment.
- the device integration server may act to discard remote monitoring commands programming a rate or bolus that deviates from the prescription.
- an architecture 100 C may further include one or more wireless patient identification devices 17 in communication with one or more of the relay modules 30 a and/or medical devices 10 in proximity to the patient identification device 17 via the interface circuits 15 and 17 a operating over the facility-oriented wireless network.
- a wireless patient identification receiver may be integrated with each medical device 10 , and access the facility-oriented wireless network via an associated interface circuit 15 .
- the wireless patient identification devices 17 each receive patient identification data from a patient in proximity to the device 17 that uniquely identifies the patient using one of a variety of commercially-available sensors.
- each patient identification device 17 may include a camera or other optical scanner and associated circuitry for sensing a barcode (for example, a UPC code or a QR matrix barcode) attached to or otherwise uniquely associated with a patient, such as a patient's wristband.
- each patient identification receiver 17 may include a radio-frequency identification (RFID) sensor and associated circuitry for sensing an RFID tag embedded in the patient wristband, or another commercially-available radio-frequency sensor capable of sensing an identification signal generated by a radio-frequency transmitter embedded in the patient wristband or otherwise provided as attached to or in proximity to the patient.
- RFID radio-frequency identification
- each device 17 may in addition or instead include a commercially-available biometric sensor and associated circuitry for patient identification (for example, including one or more of a fingerprint reader, a retinal scanner or a vein-pattern scanner).
- the architecture 100 of FIG. 1A has a suitable access point 40 that includes an inbound web server 41 that incorporates or otherwise has access to a transceiver for communicating with the relay modules 30 a over the WWAN. Medical device data received by the inbound web server 41 over the WWAN is forwarded to a secure data storage server 42 , which is configured for example to log the received data in association with identification information of the associated medical devices.
- An outbound web server 43 is configured, for example, to receive and qualify data retrieval requests submitted by one or more of remote monitoring devices 61 , 62 and 63 over a broad-band network 50 (for example, over the Internet), to request associated medical device data to be retrieved from the secure data storage server 42 , and to format and transmit the retrieved medical device data to the one or more remote monitoring devices 61 , 62 and 63 for display on associated device displays.
- a broad-band network 50 for example, over the Internet
- any architecture for the access point 40 that enables the receipt, storage and retrieval of medical device data on a device display of the one or more remote monitoring devices 61 , 62 and 63 is suitable for use in conjunction with the disclosed concepts.
- medical device data and “data” as generally used herein means data from or about the medical device including, for example, medical device identification, medical device software, medical device settings or status information (including alarm information and/or alarm priority), patient identification information, patient personal identification number(s) “PIN(s)”, patient prescriptions, and/or patient medical and/or physiological data as is collected, produced and/or generated by at least one of the medical device and patient identification device.
- the remote monitoring system of FIG. 1C is capable of obtaining patient identification information to be associated with a particular medical device, securely transmitting the patient identification information with medical device identification information of the associated medical device to verify that the association of the patient with the medical device is authorized, and beginning operation of the medical device and monitoring of medical data generated by the medical device once authorization has been received.
- FIG. 1D illustrates a backpack 70 as may be suitable for use as a personal enclosure.
- the backpack 70 includes a pouch 71 for housing a relay module 30 a , a pouch 72 for housing a power and charging circuit 39 d for providing power to the relay module 30 a , and a power cord 39 e for supplying power from the power and charging circuit 39 d to the relay module 30 a .
- the power and charging circuit 39 d includes a battery compartment 39 f , and a charging circuit (not shown) and a power cord 39 g for providing external commercial AC power to the power and charging circuit 39 d in order to charge batteries in the battery compartment 39 f .
- the backpack 70 provides but one of a number of suitable backpack arrangements.
- FIG. 2A presents a block diagram that further illustrates components of the inventive architecture that are located within or otherwise associated with the patient facility 20 .
- a number of interface circuits 15 and relay modules 30 , 30 a are arranged in a network 16 , which may be a wireless relay network or mesh network 16 within the patient facility 20 .
- network 16 is shown for illustration purposes only; other interface circuits 15 and relay modules 30 , 30 a may communicate over other wireless relay networks that are the same as or similar to network 16 in the patient facility 20 .
- the interface circuits 15 and relay modules 30 , 30 a are configured to communicate with one another via associated wireless links.
- the network 16 is a self-configurable mesh network and can also be a self-healing mesh network, for example a ZIGBEE compliant-mesh network based on the IEEE 802.15.4 standard.
- the wireless relay network 16 or additional wireless relay networks in the patient facility may be organized according to a variety of other wireless local area network (WLAN) or WPAN formats including, for example, WiFi WLANs based on the IEEE 802.11 standard and BLUETOOTH WPANs based on the IEEE 802.15.1 standard.
- WLAN wireless local area network
- WPAN wireless personal area network
- Each of the relay modules 30 , 30 a includes at least one transceiver configured to communicate with other relay modules 30 , 30 a in the wireless relay network 16 .
- Relay modules 30 a also may include at least a second transceiver for communicating over the WWAN with the access point 40 .
- each relay module 30 and/or 30 a of FIG. 2A includes a first transceiver 31 for receiving signals from and transmitting signals to the interface circuits 15 in one or more of the facility-oriented wireless networks.
- Relay module 30 a as depicted in FIG. 3A for example, corresponds to relay modules 30 or 30 a in FIG.
- WWAN wireless wide-area network
- Suitable WWANs include, for example, networks based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated with the 2G, 3G, 3G Long Term Evolution, 4G, WiMAX cellular wireless standards of the International Telecommunication Union Radio communication Sector (ITU-R).
- GSM Global System for Mobile Communications
- CDMA Code Division Multiple Access
- Additional suitable WWANs include metropolitan area networks (MANs), campus area networks (CANs), local area networks (LANs), home area networks (HANs), personal area networks (PANs) and body area networks (BANs).
- the relay module 30 a may include additional transceivers for communicating with additional WWANs or additional facility-oriented wireless networks.
- the architecture may further include one or more wireless patient identification devices 17 in communication with one or more of the relay modules 30 a and/or medical devices 10 in proximity to the patient identification device 17 via the interface circuits 15 and 17 a operating over the facility-oriented wireless network.
- a wireless patient identification receiver may be integrated with each medical device 10 , and access the facility-oriented wireless network via an associated interface circuit 15 .
- the wireless patient identification devices 17 each receive patient identification data from a patient in proximity to the device 17 that uniquely identifies the patient using one of a variety of commercially-available sensors.
- each patient identification device 17 may include a camera or other optical scanner and associated circuitry for sensing a barcode (for example, a UPC code or a QR matrix barcode) attached to or otherwise uniquely associated with a patient, such as a patient's wristband.
- each patient identification receiver 17 may include a radio-frequency identification (RFID) sensor and associated circuitry for sensing an RFID tag embedded in the patient wristband, or another commercially-available radio-frequency sensor capable of sensing an identification signal generated by a radio-frequency transmitter embedded in the patient wristband or otherwise provided as attached to or in proximity to the patient.
- RFID radio-frequency identification
- each device 17 may in addition or instead include a commercially-available biometric sensor and associated circuitry for patient identification (for example, including one or more of a fingerprint reader, a retinal scanner or a vein-pattern scanner).
- each of the interface circuits 15 includes a communications interface such as, for example, a wired or wireless communications interface, to an associated medical device 10 .
- each of the relay modules 30 , 30 a includes at least one transceiver configured to communicate with other relay modules 30 , 30 a in the wireless relay network 16 .
- Relay modules 30 a further include at least a second transceiver for communicating over the WWAN with the access point 40 .
- Each of the transceivers 31 , 32 will typically include a mesh network transmitter (e.g. a ZIGBEE transmitter) for transmitting medical device data over one of the mesh network 16 or the WWAN, and a received for receiving medical device data transmitted over one of the mesh network 16 or the WWAN.
- a mesh network transmitter e.g. a ZIGBEE transmitter
- the network 16 is a ZIGBEE mesh network then there is little risk that communications from more than one medical device will contend for simultaneous access to the network 16 .
- the network 16 operates with a protocol in which a transmitting device checks for energy on a wireless bus component of the network 16 . If the bus is in use, the transmitting device waits a preselected amount of time before checking again, and only proceeds to transfer data when the energy level suggests that no other transmission is actively underway on the wireless bus. Nevertheless, for circumstances in which data packets transmitted by the medical devices 10 arrive at a relay module 30 , 30 a at nearly at the same time, there may be a need to manage an order of delivery by the relay module 30 .
- the representative ZIGBEE mesh network 16 provides the advantages of being self-configurable when one or more interface circuits 15 and/or relay modules 30 , 30 a are added to the network, and self-healing when one or more interface circuits 15 and/or relay modules 30 , 30 a are removed from or otherwise disabled in the network.
- Sub-groupings of the interface circuits 15 and relay modules 30 , 30 a may be provided in a defined geographic space (for example, on an individual floor or within a region of a floor in a multi-floor home or care facility).
- the relay module 30 a of FIG. 3A includes a first transceiver 31 for wirelessly communicating with interface circuits 15 and other relay modules 30 , 30 a in the WLAN or WPAN network 16 of FIG. 2A via an antenna 31 a .
- a transceiver as contemplated in this description may include a receiver and/or transmitter.
- the relay module 30 a further includes a second transceiver 32 for wirelessly communicating with the access point 40 over the WWAN via an antenna 32 a .
- Each of the transceivers 31 , 32 is in communication with a data processing circuit 33 , which is configured to operate under the control of a processor 34 to accept data received by the transceivers 31 , 32 and store the received data in a buffer element 35 .
- One or more of the data processing circuit 33 and/or controller 34 may also preferably include commercially available encryption circuitry for encrypting data to be sent by the transceivers 31 , 32 and to decrypt data received by the transceivers 31 , 32 , in accordance for example with HIPAA requirements.
- One or more of the data processing circuit 33 and/or controller 34 may also preferably include commercially available encryption circuitry for encrypting data to be sent by the transceivers 31 , 32 and to decrypt data received by the transceivers 31 , 32 , in accordance for example with HIPAA requirements
- Each rely module 30 , 30 a is capable of communicating with a number of medical devices 10 over a period of time. It is possible that communications with some of the medical devices 10 are more time-critical with regard to patient safety than other. For example, consider communications with medical devices 10 including each of a thermometer, a feeding pump and a ventilator. In this case, communications with the ventilator would likely be most time-critical among the three medical devices, while communications with the thermometer might be least time-critical among the three medical devices.
- the processor 34 is configured to determine whether the received medical device data indicates an emergency condition. This determination may be performed by the processor 34 in a number of ways. For example, the processor 34 may compare a condition code in the received medical device data to a condition table located in memory 35 b that, for example, includes one or more of corresponding codes for the emergency condition, a description of the emergency condition, symptoms of the emergency condition, an estimate of a future time at which the emergency condition may become harmful (or emergency condition harm time), rankings and/or weights for the emergency condition, related emergency conditions, physiological data (e.g., vital signs, blood pressure, pulse oximetry, ECG, temperature, glucose levels, respiration rate, weight, etc.) indicative of the medical condition, and so on.
- a condition table located in memory 35 b that, for example, includes one or more of corresponding codes for the emergency condition, a description of the emergency condition, symptoms of the emergency condition, an estimate of a future time at which the emergency condition may become harmful (or emergency condition harm time), rankings and/or weights for the emergency condition
- Longer term data storage may preferably be provided by a memory 35 b , for example storing instructions for the controller 34 , data encryption/decryption software for one of more of the data processing circuit 33 and/or controller 34 , a patient identification directory identifying patients using each of the medical devices 10 , and the like.
- the data in the condition table may be initially entered and/or periodically refreshed from a master store or central repository of emergency condition data, for example, maintained by a designated relay module 30 , 30 a or other device accessible over one of the available networks.
- Associated emergency condition data may be periodically transmitted on a scheduled or as-needed basis, for example, from the access point 40 to each of the relay modules 30 , 30 a .
- polling may be carried out, for example, by the central repository to determine whether any of the relay modules has been provided with emergency condition data not available in the central repository. This emergency condition data may then periodically be transmitted to the central repository, and the central repository may in turn transmit the data to the other modules that may be missing such data.
- emergency condition data may be time stamped or provided with another indicator of data currency. If a central repository is not used, the modules may exchange emergency condition information between themselves to ensure each module is synchronized.
- Other embodiments are possible, for example, using multiple central repositories according to conditions monitored, geographic location, and the like.
- rankings and/or weights may be applied by the processor 34 to assign priority to different emergency conditions and/or perform a triage.
- the processor 34 on receipt of multiple pieces of medical device data from different transceivers located in the same geographic location or a number of different geographic locations could determine that one medical device requires more immediate medical attention than the others.
- the priority analysis may also be performed, for example, using the emergency condition harm times.
- the ventilator should be assigned priority for transmitting to one or more of remote monitoring devices 61 , 62 and 63 (as shown in FIG. 1 ), while data transmissions from thermometer and pump are discontinued until a response to the data packet transmitted by the ventilator is received from one of the remote monitoring devices 61 , 62 and 63 .
- the ventilator might be assigned a priority of 1, while the feeding pump is assigned a priority of 2 and the thermometer is assigned a priority of 3.
- the assigned priority is preferably indicated in each data packet transmitted by and to the medical devices, for example, as a “priority nibble.”
- the processor 34 may be configured to read the priority nibble from each received data packet, and to instruct the data processing circuit 33 to place the data packet at a logical position in the buffer element 35 based upon the priority designation.
- critical-priority data packets for example, data packets including an indication of a life threatening condition
- the relay module 30 , 30 a for example, data packets including an indication of a life threatening condition
- other data packets are positioned in order according to their priority.
- the wireless relay module 30 , 30 a may in addition discontinue reception of any new medical device information from other medical devices until the urgent commands are relayed and an associated alarm condition has been terminated or released.
- the medical device data analyzed by the processor 34 may not match any of the emergency conditions in the table and/or database because there is a misspelling and/or the medical condition is known by other names and/or represents a new medical condition.
- the processor 34 may, for example, perform a similarity analysis between the medical device data received and the symptoms and/or physiological data in the table and/or database (see, e.g., the disclosure herein supra in reference to FIG. 4D ). Based on this similarity analysis, the processor 34 may select, if any, the emergency condition that closely approximates the medical device data. Also, the processor 34 may in addition or alternatively log the medical device data to a database and/or file to allow administrators to determine why the emergency condition did not match an exact emergency condition in the table and/or database.
- the processor 34 may compare the medical device data received at the transceiver to a list of prior determined emergency conditions and determine if there is a match or approximate match based on conventional interpolation and/or extrapolation techniques. In another embodiment, the processor 34 may also parse the medical device data to find a code which indicates that an emergency condition exists. Alternatively, the processor 34 may search a table and/or database located in a central repository to determine if the medical device data received indicates an emergency condition. In a another embodiment, the processor 34 in a relay module 30 and/or 30 a may query a processor 34 in another device (not the central repository) to determine if that other device knows whether the medical device data includes emergency condition data representing an emergency condition.
- a message may be transmitted to an access point 40 by the relay module 30 a (as shown in FIGS. 1 and 2 ), where the message is parsed to determine if alarms should be activated.
- the alarms could be anything from certain signals to care givers associated with the one or more medical devices which originated the alarms or alerting emergency responders.
- a monitoring unit 37 b may also be associated with the processor 34 , and responsible for identifying trends in emergency conditions.
- the monitoring unit 37 b may store the emergency conditions data received, the date/time, an identity of the medical device which provided the data, the location of the medical device, and so on. Using the emergency condition data and/or additional medical device data, the monitoring unit 37 b may analyze the data for trends. This trend information may be used, for example, to determine whether one or more medical devices should be monitored. In addition, the trend information may be communicated to one or more devices (for example, PDAs, cell phones, pager, tablets, and the like) associated with relatives, friends, or caregivers and the like, who may use the knowledge to provide more efficient care.
- devices for example, PDAs, cell phones, pager, tablets, and the like
- the processor 34 may transmit a message to a phone device 39 a (discussed below and shown in FIG. 3D ) to activate it and also initiate a connection (e.g., phone call, etc.) with an emergency responder, such as 911, relatives/friends, care givers, or police authorities, and the like.
- an emergency responder such as 911, relatives/friends, care givers, or police authorities, and the like.
- an automated voice message may be transmitted to the emergency responder as a prerecorded message stored in a signal generator 39 b (which is coupled to the phone device 39 a and the processor 34 ).
- the prerecorded message identifies an associated medical condition along with the location of the medical device.
- the signal generator 39 b may generate a dynamic speech signal that contains the determined emergency condition and other information
- the prerecorded or dynamic message described above may in addition include other relevant patient data to further allow the emergency responders to assess the situation.
- a patient table stored at the relay module may identify care givers of the patient, other present conditions of the patient, previous medical history (e.g., allergic to certain drugs, such as morphine), and additional relevant patient information.
- storage and use of the data in the patient table would conform to HIPAA requirements.
- the signal generator 39 b may transmit medical condition information in the form of a text message to the emergency responder.
- a text message may be sent over one of a Short Message Service (also known as “SMS”) and/or Multimedia Messaging Service (also known as “MMS”).
- SMS Short Message Service
- MMS Multimedia Messaging Service
- the phone device 39 a above could be connected via one or more of wireless relay network or internet-accessible wireless network to initiate the call over a voice over internet protocol (VoIP) network, a Public Switched Telephone Network (PSTN), or the like.
- VoIP voice over internet protocol
- PSTN Public Switched Telephone Network
- the call to the emergency responders may be unsuccessful for a variety of reasons (for example, associated E911 circuits may be busy or otherwise unavailable).
- the processor 34 and/or phone device 39 a may detect a non-response from the E911 circuits and transmit a non-response message to one or more of the medical device, the access point 40 , and/or one or more other designated devices to indicate the unsuccessful call.
- the processor 34 may periodically perform self-diagnostics on the relay module 30 a to confirm that each of the components of the modules 30 a that is used to detect the emergency condition and make the emergency call is operational
- multiple processors 34 may be used in as appropriate.
- the location of the medical device may be determined in a variety of ways well-known in the art. For example, location information may be provided to the processor 34 from a global positioning system signal (“GPS”) that is received and interpreted by the medical device located in the medical device data received, a GPS chip in the location device 38 (see e.g. FIGS. 3B and 3C ), and/or location algorithm in the location device 38 discussed further below. In another embodiment, (e.g., location) as discussed above.
- GPS global positioning system signal
- location information may be included in the medical condition data received by one of the relay modules 30 , 30 a to identify the location of the one or medical devices 10 .
- the relay modules' location may also be determined using a conventional GPS receiver provided in the location device 38 . In the latter case, at least an approximate or “zone” location of the one or more medical devices would be provided by the location information for the relay module 30 a.
- each of the relay modules 30 a may for example transmit and receive signals via the internet-accessible wireless communication network to two or more cell towers, beacons or other radio devices at fixed, known locations in order to determine a location of the relay module according to known geometric methods.
- Such techniques for determining location are well known in the art. See, e.g., Shu Wang et at Location-Based Technologies for Mobiles: Technologies and Standards, presentation at IEEE ICC Beijing 2008, IEEE, 2008, which is incorporated by reference herein in its entirety, for all purposes.
- triangulation may be carried out using other relay modules positioned at fixed, known locations in a facility.
- the data processing circuit 33 may be further configured to retrieve data from the buffer element 35 a under the direction of the processor 34 and provide the retrieved data to a selected one of the transceiver 31 or transceiver 32 for transmission.
- the processor 34 is configured to communicate with respective status modules 31 b , 32 b of the transceivers 31 , 32 in order to determine a communications status of each of the transceivers 31 , 32 .
- FIG. 3B depicts a block diagram illustrating components of an alternative configuration for the relay module 30 a to the configuration of relay module 30 a depicted in FIG. 3A .
- the relay module 30 a shown in FIG. 3B may be the same as or similar to the relay module 30 a shown in FIG. 3A .
- transceivers 31 and 32 , data processing circuit 33 and processor 34 may be the same or similar in both figures.
- the relay module 30 a includes transceiver 31 for wirelessly communicating with interface circuits 15 (shown in FIGS. 1 and 2 ) and other relay modules 30 , 30 a in a particular WLAN or WPAN network 16 (shown in FIG. 2 ) via antenna 31 a .
- the relay module 30 a further includes a transceiver 32 for wirelessly communicating with the access point 40 over a particular WWAN (shown in FIG. 2 ) via an antenna 32 a.
- Added components to the relay module 30 a in 3 B that are not present in FIG. 3A include an additional transceiver 37 , similar to transceiver 31 , for wirelessly communicating via antenna 37 a with interface circuits and other relay modules capable of communicating over a different WLAN or WPAN network than the network used by transceiver 31 .
- the relay module 30 a in FIG. 3A includes yet a further transceiver 38 , similar to transceiver 32 , for wirelessly communicating via antenna 38 a with an access point over a different WWAN than the WWAN used by transceiver 32 .
- Each of the transceivers 31 , 32 , 37 and 38 is in communication with data processing circuit 33 , which is configured to operate under the control of processor 34 to accept data received by the transceivers 31 , 32 , 37 and 38 and store the received data in buffer element 35 .
- the data processing circuit 33 is further configured to retrieve data from buffer element 35 under the direction of processor 34 and provide the retrieved data to a selected one of the transceivers 31 , 32 , 37 or 38 for transmission.
- Further embodiments can for example involve one or more processors 34 configured to accept medical device data from mesh network 16 and to send the medical device data through the WWAN without storing the medical device data in the relay module 30 a .
- the processor 34 is configured to communicate with respective status modules 31 b , 32 b , 37 b and 38 b of respective transceivers 31 , 32 , 37 or 38 in order to determine a communications status of the transceivers 31 , 32 , 37 or 38 .
- the data processing circuit 3 and processor 34 may be implemented as separate integrated circuits or chip sets or their functions may be combined and implemented on single integrated circuits or chip set
- the processor 34 is also preferably in communication with an input/output circuit 36 , which provides signals to one or more display elements of the relay module 30 a , for example, for indicating a start-up or current status of the relay module 30 a , including communication or connection status with the WLAN or WPAN networks and WWANs networks.
- Input/output circuit 36 may also be configured to provide signals to indicate an A/C power loss, and or to be responsive to signals provided by one or more input devices provided in proximity to the one or more display elements.
- a control panel useable for the module 30 a of FIG. 3B may be substantially similar to the control panel 380 depicted in FIG. 3H with corresponding multiple indicators 380 e for indicating the status of the different WLAN or WPAN networks, and/or multiple indicators 380 j for indicating the status of the different WWANs.
- the control panel 380 may include a synchronization switch 380 k (shown in FIG. 3I ), which may be used as further described herein to initiate a process for associating patient identification information with identification information of a medical device 10 .
- the processor 34 is also preferably in communication with a memory 35 b for storing an operating program of the processor 34 and/or data stored by and/or retrieved by the processor 34 .
- the processor 34 is also in communication with an input/output circuit 36 , which provides signals to one or more display elements (not shown) of the relay module 30 a , for example, for indicating a start-up or current status of the relay module 30 a , including communication or connection status with the WLAN or WPAN network 16 and WWAN.
- the input/output circuit 37 a may also be configured to provide signals to indicate an A/C power loss, and or to be responsive to signals provided by one or more input devices provided in proximity to the one or more display elements.
- the input/output circuit 37 a may also be connected to user buttons, dials or input mechanisms and devices of module 30 a .
- the input/output circuit 37 a is further usable for providing alarm signals to indicate, for example, A/C power loss or loss of accessibility to the WWAN.
- Relay module 30 a may preferably be provided as a small physical enclosure with an integral power plug and power supply circuit, such that the relay module 30 a may be directly plugged into and supported by a conventional wall outlet providing commercial A/C power.
- Relay module 30 a may also preferably include a battery back-up circuit (not shown) to provide uninterrupted power in the event of A/C power outage, an A/C power outage of short duration as well as for ambulatory use of the relay module.
- relay module 30 a may be provided with rechargeable and/or replaceable battery power as a primary power source for ambulatory use.
- processor 34 and devices 37 a - 39 b are shown as separate and distinct devices in FIG. 3 for illustration purposes only and that the functionality of devices 34 and 37 a - 39 b may be combined into a single or larger or smaller number of devices than illustrated.
- Battery back-up may also be advantageous, for example, for using the relay module 30 a in an ambulatory mode that enables the patient to move within and potentially at a distance from the facility 20 , for example, with a medical device 10 that is a portable feeding device.
- the medical device 10 , the interface circuit 15 and relay module 30 may be conveniently carried in a mobile platform such as any patient-wearable backpack, vehicle, or other transport vessel.
- the relay module 30 a configuration of FIG. 3B may be operated in a substantially similar manner to the relay module 30 a configuration of FIG. 3A employing, for example, corresponding methods of operation described below incorporating the use of a plurality of WWANs or WLAN or WPAN networks.
- the depicted steps described with respect the flow diagrams below may be employed with the further transceiver selections of the additional transceivers 37 and 38 .
- FIG. 3C depicts a block diagram of an embodiment of a relay module 30 a that enables voice communication and interaction between a caregiver proximate the relay module 30 a and a clinician or technician at the remote monitoring device.
- the identical components in the FIGS. 3A , 3 B, and 3 C are like numbered including, for example, the first and second transceivers 31 and 32 , data processing circuit 33 , processor 34 and data buffer 35 a .
- the relay module 30 a of FIG. 3C further includes a speech codec 105 connected to a microphone 110 and the speaker 37 .
- Suitable codecs for the speech codec 105 include, for example, fixed rate codecs such as voice-over-Internet-protocol (VoIP) codecs in compliance with the ITU standard H.323 recommended protocol.
- Speech coding standards in accordance with VoIP include ITU standards G.711 (PCM), G.723.1 (MP-MLQ & ACELP), G.729 (CSACELP), GSM-FR; or Adaptable Multi-Rate (AMR) standards such the European Telecommunication Standard Institute (ETSI) and Third Generation Partnership Project (3GPP) IMT-2000.
- PCM voice-over-Internet-protocol
- G.723.1 MP-MLQ & ACELP
- CSACELP G.729
- GSM-FR GSM-FR
- AMR Adaptable Multi-Rate
- ETSI European Telecommunication Standard Institute
- 3GPP Third Generation Partnership Project
- the configuration of the relay module 30 a of FIG. 3C enables a patient or caregiver proximate the relay module 30 a to engage in a conversation with a user (for example, a clinician or technician) proximate the remote monitoring device using, for example, a VoIP or VoIP-like exchange of encoded speech signals.
- a user for example, a clinician or technician
- speech uttered by the caregiver proximate the relay module 30 a is converted by microphone 110 to analog speech signals that are digitized and encoded by the codec 105 .
- the processor 34 transmits the corresponding digitized and encoded speech signals produced by the codec 105 directly over the wireless internet-accessible network alone or in combination with the wireless relay module network to the remote monitoring device.
- the remote monitoring device then decodes the digitized and encoded speech signals and converts such decoded signals into analog signals supplied to a speaker to generate the speech sounds heard by the clinician or technician.
- digitized and encoded speech signals representing speech of the clinician or technician transmitted by the remote monitoring device are received by the module 30 a wherein the processor 34 supplies such signals to the codec 105 which decodes the signals and converts the decoded signals to analog signals that are supplied to the speaker 37 .
- codec 105 and microphone 110 has been described with regard to exchanging VoIP signals, it should be readily understood that any method of communicating speech signals may be employed including, for example, utilizing a cellular or mobile telephone codec or modem for codec 105 to transmit and receive speech signals, e.g., CDMA- or GSM-compliant speech signals over a mobile telephone network. Further, it is possible for the codec 105 to be implemented as hardware and/or software in a single chip, chip set or as part of the processor 34 .
- speech detection and/or recognition functionality into the codec 105 or processor 34 to enable the relay module 30 a to identify specific command words to initiate the carrying out of a corresponding responsive/interactive action.
- speech recognition functionality may be triggered by processing signals supplied by the microphone 110 to identify terms “Help”, “Emergency” or “Call 911.”
- the processor 34 Upon detecting such trigger terms, the processor 34 initiates the process of dialing an emergency response service such as “911,” with or without using synthesized or recorded speech to request confirmation from the caregiver to place such a call and initiate communication between the caregiver and the emergency response service.
- the dialing may be performed by hardware or software implemented in the processor 34 , codec 105 or other components coupled to the processor 34 .
- the speech recognition functionality may alternatively or additionally transmit a text message or other text or audio-visual correspondence to the emergency response service based upon identified spoken works or commands by the caregiver.
- relay module 30 a of FIG. 3C is shown with the codec 105 and microphone 110 in combination with the display 37 for illustration purposes only. It is possible to implement a relay module with the codec without a display or a relay module with a display and not a codec (as depicted in FIG. 3 ).
- the processor 34 may instruct the location device 39 a to obtain location information of the wireless relay module, and compare this to location information obtained from the medical device and/or by other means (for example, by using a conventional triangulation algorithm measuring transit times of signals transmitted by the medical device 10 to several wireless relay modules 30 a with known locations) in order to determine whether the medical device 10 (for example, in the possession of an ambulatory patient) has moved outside of an area for safe communications with the relay module 30 a (i.e., is outside the “geo-fence”).
- a conventional triangulation algorithm measuring transit times of signals transmitted by the medical device 10 to several wireless relay modules 30 a with known locations
- the processor 34 may preferably transmit a “lost device” alarm message via at least one of the transceivers 31 , 32 to the access point 40 and/or to any other Internet-accessible and/or wireless network-accessible recipients.
- the processor 34 may suspend all other measurements made to determine communications health with the medical device 10 (for example, heartbeat requests and signal quality measurements) until it has been determined that the medical device 10 is back within the geo-fence.
- the elements used by the wireless relay module 30 a to determine whether communications with a particular medical device 10 can be transmitted and/or received over the wireless relay network may be replicated in the medical device 10 , such that the medical device 10 may determine whether communications with a particular wireless relay module 301 can be carried out over the wireless relay network, and to issue a visual and/or audible alarm at the medical device 10 when communications with the wireless relay module 30 a cannot be carried out.
- This feature would be particularly useful, for example, to a patient in an ambulatory setting as a means for learning that he/she has exited the geo-fence.
- the relay module 30 it is possible for the relay module 30 to have a substantially similar configuration as the relay module 30 a but excluding the transceiver for communicating over the WWAN with the access point 40 .
- the relay module 30 a of FIG. 3D further preferably includes a location device 39 a including, for example, a conventional global positioning system signal (“GPS”) chip for determining a GPS location of the relay module 30 a .
- the relay module 30 a of FIG. 3 includes a power monitoring device 39 b for monitoring a voltage level of a external AC power source (not shown) providing power to the relay module 30 a , and a secondary power source 39 c comprising for example non-rechargeable lead-acid batteries, rechargeable lithium-ion batteries or other conventional rechargeable energy storage devices for providing a secondary power source to the relay module 30 a , or a primary power source in the event of a failure of the external AC power source.
- a location device 39 a including, for example, a conventional global positioning system signal (“GPS”) chip for determining a GPS location of the relay module 30 a .
- the relay module 30 a of FIG. 3 includes a power monitoring device 39 b for monitoring a voltage level of a external AC power
- the power monitoring device may for example monitor a sensor for detecting a disconnection of the external AC power supply by mechanical means (for example, using a spring-loaded push-pin switch that disengages when an associated AC plug of the relay module 30 , 30 a is removed from an external AC receptacle), by electronic means (for example, using an inductive sensor incorporated in proximity to the AC power plug) and the like.
- mechanical means for example, using a spring-loaded push-pin switch that disengages when an associated AC plug of the relay module 30 , 30 a is removed from an external AC receptacle
- electronic means for example, using an inductive sensor incorporated in proximity to the AC power plug
- the processor 34 may be a single dedicated processor, a single shared processor, or a plurality of individual processors, some of which may be shared.
- explicit use of the term “processor” or “controller” should not be construed to refer exclusively to hardware capable of executing software, and may implicitly include, without limitation, digital signal processor (DSP) hardware, network processor, application specific integrated circuit (ASIC), field programmable gate array (FPGA), read-only memory (ROM) for storing software, random access memory (RAM), and non-volatile storage.
- DSP digital signal processor
- ASIC application specific integrated circuit
- FPGA field programmable gate array
- ROM read-only memory
- RAM random access memory
- non-volatile storage non-volatile storage.
- Other hardware conventional and/or custom, may also be implemented in one or more configurations.
- the medical device data received by one of the transceivers 31 , 32 from the one or more medical devices 10 may include, for example, information indicative of an alarm condition.
- the received information may include, for example, at least one of medical device description, medical device identification (e.g., unique device number), medical device location (e.g., device/patient room number), patient identification (e.g., patient identification number), alarm type, alarm error code, and/or alarm severity.
- medical device identification e.g., unique device number
- medical device location e.g., device/patient room number
- patient identification e.g., patient identification number
- alarm type e.g., alarm error code
- alarm severity e.g., alarm severity
- the relay module 30 a could receive such information from another relay module when the other relay module malfunctions. In this way, it is assured that the relay module 30 a provides the necessary redundancy for another relay module. Additionally, it is further possible for such information to be transmitted to the relay module 30 a from the other relay module when the information is indicative of a high severity alarm condition, e.g., a significant medical emergency, such as emergency 911. Such redundancy will enable a sufficient number of caregivers to be notified of the emergency condition through multiple relay modules to facilitate a prompt response.
- a high severity alarm condition e.g., a significant medical emergency, such as emergency 911.
- the relay module 30 a may be notified if another relay module is experiencing numerous alert conditions associated with other modules or medical devices and communicate the alarm information to caregivers. If this occurs, the other relay module may, for example, divert the information indicative of an alarm to the relay module 30 a using the WLAN or WPAN 16 .
- the particular relay module 30 a selected to receive the alarm information from the other relay module may be based on many factors such as, for example, relay module location, relay module availability, number of caregivers at a given location and/or floor, defined master/slave relationships among the relay modules 30 a , and the like.
- the relay module 30 a can be configured to transmit a message back to the one or more medical devices 10 confirming that an alarm was presented to the caregiver. If the message is not received within a predetermined amount of time by the one or more medical devices 10 , then one or more medical devices 10 may attempt to communicate with other relay modules to ensure the alarm is addressed. Similar factors, e.g., location, availability, number of caregivers, etc., as described above may be used to select the other relay module(s) for providing alerts for the one or more medical devices.
- the relay module 30 a may internally generate its own alarm and/or device signals in relation to the relay module 30 a , for example, the current status of the relay module 30 a (e.g., external AC power loss) and/or current communication or connection status (e.g., status with the WLAN or WPAN 16 or WWAN).
- the current status of the relay module 30 a e.g., external AC power loss
- current communication or connection status e.g., status with the WLAN or WPAN 16 or WWAN.
- the processor 34 may transmit a message containing alarm information including, for example, at least one of medical device description, medical device identification, medical device location, patient identification, alarm type, alarm error code, and/or alarm severity, to a display 36 attached to the relay module 30 a .
- an alarm alert may mirror an alarm alert emitted by the originating medical device.
- the particular type of display chosen for use with the relay module 30 a is not necessarily critical. Accordingly, it is possible for display 36 to be a monochrome or color dot matrix, LCD, LED or other display device.
- the processor 34 may transmit the message containing alarm information to a medical device 10 via the transceiver 31 , and/or to the access point 40 via the transceiver 32 .
- the processor 34 may also employ a speaker 37 , such as a loudspeaker, coupled to the relay module 30 a to emit an audible alert indicative of the alarm condition.
- a speaker 37 such as a loudspeaker
- the audible alert based on the alarm condition may be at least one of volume, pitch, tone, type, audible sequence or duty cycle, or recorded sound to indicate the type, urgency or severity of the alarm condition. It is advantageous for an alarm indicating a life-threatening emergency to be more attention-getting, e.g., loud siren, than alarms for less significant conditions that may be addressed by, for example, beeps or calmer tones.
- the emitted audible alerts may be spoken words, commands, tones or other sounds.
- the relay module 30 may also cause a signal to be transmitted by, for example, the first transceiver 31 over the WLAN or WPAN 16 to one or more devices including, for example, PDAs, cell phones, pagers, and tablets.
- the alarm information may be transmitted over the WWAN using the second transceiver 32 to the one or more devices.
- an input/output circuit 38 may be electrically connected to, for example, user-actuatable buttons, dials or input mechanisms associated with the relay module 30 a . Using these buttons, dials, or input mechanisms, the audible alerts produced by the relay module 30 a may be muted, i.e., disabled, or volumes substantially reduced. The muting or volume reduction may alternatively be in response to the relay module 30 a receiving a signal from the originating medical device transmitting the information, such as in response to a caregiver acknowledging that the emergency condition is being addressed by entering the proper inputs to the originating medical device. Such acknowledgements may preferably take the form of corresponding acknowledgement codes each associated with a particular alarm condition.
- the display 36 may continue to display alerts until likewise the alert condition is extinguished or confirmation from a caregiver at the originating medical device or the relay module 30 a is received.
- the processor 34 may control the display 36 to alternate or cycle displayed information intermittently with information from a single medical device or multiple medical devices. For instance, the processor 34 may cause a visual alarm alert indicating an alarm condition (based upon a portion of medical device data) from a first medical device to be shown on the display 36 , for example, for a time period of between 2 to 30 seconds before displaying information for another medical device. The visual alarm alerts corresponding to higher severity alarm conditions may be shown for longer durations than alerts of for lower severity alarm conditions. Also, the type of alarm condition may further dictate the display length of time for visual alarm alerts or other information from a particular medical device. Additionally, the processor 34 may also or alternatively display on the display 36 the number of medical devices communicating information indicative of alarm conditions to the relay module 30 a and/or show a description of such devices.
- the display 36 may display the alerts in different foreground or backlight colors, such as green backlight for normal operation or red backlight for alarm situations, to use color representing the respective severities of alarm conditions. It is further possible for the colors to correspond to specific alarm conditions (e.g., low glucose level) and/or general groups of conditions (e.g., heart conditions).
- the display may alternatively or in addition incorporate, for example, a multi-colored light-emitting diode array to display the status of the medical devices.
- the display 36 may also be used to display non-alarm related information including, for example, internal power supply charge level or status, software version, software download status, relay module network status, handshake status and signal strength of the received WLAN or WPAN 16 , and/or WWAN signals. Displayed information for the strength of respective monitored signals and other may be displayed alone or in a combination with the alerts.
- the signal strength information could be depicted by, for example, by sequential display segments such as, for example, more than one series of different sized light-emitting diodes (LEDs) that would advantageously enable simultaneous display of at least two different network signal strengths for viewing by the caregiver.
- LEDs light-emitting diodes
- alerts for internally generated information indicative of an alarm condition by the relay module 30 a may also be displayed by display 36 .
- alerts representative of information during start-up or current status of the relay module 30 a and/or current communication or connection status with the WLAN or WPAN 16 and WWAN may be shown on the display elements 36 .
- the processor 34 may cause the display 36 to include information associated with the charge level of a battery (not shown) contained within the relay module 30 a , whether by remaining minutes and/or hours of life or other graphical depictions.
- Relay module 30 a may preferably be provided as a small physical enclosure (not shown) optionally provided with an integral power plug and power supply circuit, such that the relay module 30 a may be directly plugged into and supported by a conventional wall outlet providing commercial A/C power.
- Relay module 30 a may also preferably include a battery back-up circuit (not shown) to provide uninterrupted power in the event of A/C power outage of short duration. Battery back-up may also be advantageous, for example, for using the relay module 30 a in an ambulatory mode that enables the patient to move within and potentially at a distance from the facility 20 , for example, with a medical device 10 that is a portable feeding device. In this configuration, for example, the medical device 10 , the interface circuit 15 and relay module 30 may be conveniently carried in a patient-wearable backpack.
- FIGS. 3A-3D Various embodiments of a relay device 30 or 30 a are shown in FIGS. 3A-3D .
- the relay device 30 or 30 a is not limited to the specific configurations shown.
- a relay device 30 30 a may include some or all of the components or features described with respect to any or all of FIGS. 3A , 3 B, 3 C, and 3 D.
- a relay device 30 or 30 a may also include additional features not shown in the figures.
- FIGS. 3E-3G respectively illustrate top, front and side views of a configuration 370 for the relay module 30 a .
- Configuration 370 includes a housing 370 a , which is shown in FIGS. 3E-3H configured essentially as a rectangular box or prism. It should however be noted that the housing may alternatively be configured in any of a variety of three-dimensional shapes having a sufficient interior volume for housing the associated circuits, having a sufficient area 370 c on a front panel 370 b of the housing 370 a for locating a control panel 380 (as further illustrated in FIG.
- the power plug 370 f may also be provided in a modular and replaceably removable configuration enabling power plugs 370 f to be configured according to a variety of international standards to be easily provided to the configuration 370 .
- FIG. 3H illustrates a control panel 380 of module configuration 370 that may constitute a portion of the one or more display elements.
- the control panel 380 preferably includes, for example, a power switch 380 a for powering and/or de-powering the module configuration 370 after it has been plugged into the conventional wall outlet or equipped with a charged battery back-up subsystem.
- the control panel 380 preferably includes an alarm switch 380 b which allows a user to mute and/or de-mute an audible alarm (for example, a conventional buzzer, not shown) which is coupled to an alarm circuit (not shown) that is configured to issue an alarm when A/C power to the module configuration 370 has been interrupted.
- the control panel 380 also includes an A/C power indicator 380 c which may preferably be provided as one or more light-emitting diode (LED) indicator segments which are activated when A/C power has been provided to the module configuration 370 .
- the indicator 380 c may be intermittently activated when A/C power is lost (for example, by means of back-up battery power) to signal the loss of A/C power.
- the control panel 380 of FIG. 3H also includes a battery indicator 380 d to indicate a status of the subsystem battery back-up circuit.
- the battery indicator 380 d may preferably include indicator segments 380 h which may be selectively activated to indicate a capacity of the back-up battery.
- Indicator segments 380 h may also be preferably provided as LED segments, or as one or more multicolor LEDs for which color is indicative of capacity.
- the segments 380 h may, for example, be activated to indicate that the back-up battery is fully charged, and ones of the segments 380 h may be progressively deactivated (for example, proceeding downwardly from an uppermost one of the segments 380 h ) as battery power is drawn down. In the event that remaining battery power is insufficient to operate the module configuration 370 , each of the segments 380 h may be deactivated.
- the indicator segments 380 h may be provided as one or more multicolor LED segments (for example, red, yellow, and green).
- all LED segments 380 h may be illuminated as green indicating a full backup battery charge and then progressively, sequentially deactivated as battery charge levels are reduced to a first low power threshold. Then, the LED segments 380 h may progressively, sequentially be illuminated red as power is further diminished so that all LED segments are illuminated red when battery power is no longer sufficient to power the module configuration 370 .
- control panel 380 may further include a relay module network indicator 380 e to indicate a status of the portion of the WLAN or WPAN network 16 .
- relay module network indicator 380 e to indicate a status of the portion of the WLAN or WPAN network 16 .
- A/C power indicator 380 c used to provide communications between the WLAN/WPAN network relay module 30 a and its associated interface circuits 15 and medical devices 10 .
- This relay module network status indicator 380 e is preferably backlit with one or more multi-color LEDs to indicate a relative “health” of the associated portion of the network (for example, using “green” to indicate a healthy (e.g., level of accessibility) network, “yellow” to indicate a network having one or more issues but still operable, and “red” to indicate a network that is inoperative and indicating an alarm condition).
- the indicator element 380 e may be intermittently or periodically activated when the WLAN/WPAN network portion of the WLAN or WPAN network 16 that provides communications between the relay module 30 a and its associated interface circuits 15 and medical devices 10 has relatively poor communications between these devices, or is unavailable to support such communications.
- an audible alarm for example, a conventional buzzer, bell or audible sound generator and associated loudspeaker, not shown
- a conventional buzzer, bell or audible sound generator and associated loudspeaker may be initiated under such conditions.
- Indicator elements 380 f may also be provided, for example, in an array to indicate the status is active or accessible, and either de-activated or intermittently activated when the WLAN/WPAN network status is inactive or inaccessible.
- the indicator elements may preferably be provided with multi-color LEDs 380 g capable, for example, of illuminating a green segment for a healthy a communications path, a yellow segment for operative communication path with issues, and a red segment to indicate a communications path that is inoperative.
- individual red, yellow and green LEDS may be used in place of the multi-color LEDs.
- one or more of elements 380 f , 380 g may each comprise a single bi-color LED.
- a WWAN indicator 380 j may preferably be provided to indicate a status of access to the WWAN network, (using, for example, “green” to indicate a healthy network, “yellow” to indicate a network having one or more issues but still operable, and “red” to indicate a network that is inoperative and indicating an alarm condition).
- the indicator 380 j includes indicator elements 380 f , 380 g for indicating the WWAN network status.
- the indicator element 380 f may be configured with a green LED indicator element that is activated when the WWAN network status is active or accessible, and the indicator 380 g may be configured with a red LED indicator element that is activated when the WWAN network is inactive or inaccessible (for example, may preferably be backlit with one or more multicolor LEDs.
- the indicator element 380 j may be intermittently or periodically activated, for example, when a signal strength of the WWAN network available to the module configuration 370 is insufficient to support communications.
- the indicator element 380 f may be intermittently too low to support communications, or is unavailable to support such communications.
- the audible alarm may be initiated under such conditions.
- control panel may include a WLAN/WPAN indicator 380 i to indicate an overall health of the entire WLAN/WPAN (or at least of the portion available to provide an alternate path for the relay module 30 a to the WWAN network).
- the WLAN/WPAN indicator 380 i may preferably indicate an overall status of the WLAN/WPAN (using “green” to indicate a healthy network, “yellow” to indicate a network having one or more issues but still operable, and “red” to indicate a network that is inoperative and indicating an alarm condition).
- the indicator 380 i may preferably be backlit with one or more multicolor LEDs.
- the indicator element 380 i may be intermittently or periodically activated when the signal strength of the WWANWLAN network is marginally sufficient, too low, or insufficient to support communications. In addition, the audible alarm may be initiated under such conditions.
- the alarm switch 380 b may be configured to allow a user to mute and/or un-mute one or more of the audible alarms entirely, or for a specified time period (similarly to a conventional clock alarm “snooze function) indicators of the module configuration 370 such as indicators 380 a - 380 j may preferably be electrically connected to the input-output circuit 36 depicted in FIG. 3A , for example.
- the wireless relay module 30 a may employ, for example, hardware or software to implement an International Telecommunication Standardization Sector (ITU-T) H.323 codec to enable voice and/or video communications between a caregiver located proximate the wireless relay module and a remote technician.
- the wireless relay module control panel 38 may optionally include microphone and speaker elements (not shown) for enabling the module configuration 37 to be operated in a voice communication mode to allow for voice communication, for example, between an operator, caregiver, and/or a help desk technician in event of a trouble condition reported by one of the medical devices 10 .
- control panel 380 may include one or more of a camera element (not shown) and/or a display element (not shown) coupled to the codec to be operated in a visual communication mode.
- the camera element may be used to transfer images from displays of one or more medical devices 10 to one of the remote monitoring devices 61 , 62 and 63 of FIG. 1 .
- FIG. 4A presents a flow diagram 400 illustrating a method of operation for the architecture according to FIG. 1A and relay module 30 , 30 a components of FIGS. 2 and 3 A- 3 H, relating to the transmission of medical device data obtained from a medical device 10 to the access point 40 .
- the medical device data is received at a first one of the relay modules 30 a from one of the interface circuits 15 and/or other relay modules 30 , 30 a over the wireless relay network 16 .
- the processor 34 of the one relay module 30 a determines whether the WWAN is accessible by that relay module 30 a.
- step 404 may be carried out in a variety of manners.
- the processor 34 may interrogate the status module 32 b of the transceiver 32 at the time of or after the receipt of the medical device data to determine a status parameter indicative of access for the transceiver 32 to the WWAN (for example, access for transceiver 37 to the WWAN may be determined as the result of the transceiver 32 detecting an access signal of the WWAN having adequate signal strength for maintaining data communication at a desired quality level).
- the processor 34 may interrogate the status module 32 b at a different time including, for example, at system start-up and/or periodically (for example, hourly), and maintain a status indicator such as in the buffer 35 or another storage element to be retrieved at the time of receipt of the medical device data.
- the relay module 30 , 30 a may be assigned a predetermined, fixed role within the network 16 .
- relay modules 30 a in the network 16 may be assigned a data routing assignments by a controller or controlling relay module or modules which may be preselected from among the relay modules 30 , 30 a .
- the WWAN status for relay module 30 that does not possess WWAN access capability shall have a fixed status of “WWAN inaccessible.”
- step 404 the processor 34 will proceed to step 406 to instruct the data processing circuit 33 of the one relay module 30 (or 30 a ) to retrieve the medical device data from the buffer 35 or 35 a (as necessary) and forward the medical device data to the transceiver 32 for transmission to the access point 40 over the WWAN.
- the status module 32 b may indicate that the WWAN is not accessible by the transceiver 32 .
- the processor 34 determines whether a second relay module 30 a is accessible via the WLAN or WPAN. Again, this determination may be made in a variety of manners including by instructing the transceiver 31 to send a handshake signal transmission directed to a second relay module 30 a and to listen for a reply, or by retrieving a stored status indicator for the second relay module 30 a.
- the processor 34 instructs the data processing circuit 33 of the one relay module 30 a to retrieve the medical device data from the buffer 35 or 35 a (as necessary) and forward the medical device data to the transceiver 31 for transmission to the second relay module 30 a over the WLAN or WPAN at step 410 .
- this portion of the process 400 may preferably be repeated to search for a further relay module 30 a that is accessible.
- the processor 34 of the one relay module 30 a may preferably issue an alarm notification at step 412 .
- Such an alarm notification may, for example, include one or more of local visual and audio alarms as directed by processor 34 via the input/output circuit 36 of the one relay module 30 a , alarm messages directed by the processor 34 to another accessible WPAN, WLAN or WWAN via one or more of the transceivers 31 , 32 , and/or alarm messages generated by the inbound web server 41 of the access point 40 .
- These notifications may be displayed or otherwise executed after a specified time period has been exceeded, for example, during which a handshake signal of the relay module 30 a is due but not received, at the inbound web server 41 from the wireless relay module 30 a.
- FIG. 4B depicts a method of operation 400 b for an embodiment of relay module 30 a .
- Methods 400 and 400 b include substantially identical steps except method 400 b substitutes steps 404 b and 406 b for steps 404 and 406 of method 400 .
- These substituted steps 404 b and 406 b are similar to the corresponding steps 404 and 406 expanded to utilize the additional transceivers 37 and 38 of FIG. 3B , for example.
- the relay module 30 a determines if any WWAN is accessible by transceivers 32 or 38 (e.g. in step 404 b ). If no WWAN is accessible the method 400 b then continues to step 408 and performs substantially the same operations as described with respect to steps 408 , 410 and 412 in FIG. 4 . Otherwise, if a WWAN is determined accessible in step 404 b , the method 400 b proceeds to step 406 b . In step 406 b , the method 400 b transmits the medical data over the available WWAN via transceiver 32 or 38 to the appropriate access point.
- step 406 b the controller 33 may determine which one of the accessible WWANs the medical data should be transmitted over by either of transceivers 32 or 38 . Such determination can be made by many different criteria or rules including, for example, based upon signal strength, cost, time of day, day of week or preferences of a network manager or other user.
- the relay module 30 a is preferably provided with a relay module network indicator 380 e to indicate a status of the portion of the WLAN or WPAN network 16 of FIGS. 1 , 2 used to provide communications between the relay module 30 a and its associated interface circuits 15 and medical devices 10 .
- FIG. 4C presents a flow diagram illustrating a method of operation 420 for generating status information that may be used by network indicator 380 e of FIG. 3H .
- the processor 34 is instructed to retrieve a current module performance measure or history, for example, from the memory 35 b for each medical device 15 accessible to the relay module 30 a via the WLAN/WPAN network 16 .
- Performance measures may, for example, include a measured signal strength, noise, bit rate, error rate, packet discard rate, occupancy, availability and the like as are conventionally measured for WLAN/WPAN networks. See, e.g., Pinto, WMM—Wireless Mesh Monitoring, Technical Report, INESC-ID, 2009, which is incorporated by reference in its entirety herein for all purposes. Measured performance may in addition take certain environmental information into account. For example, relatively elevated ambient operating temperature of the relay module 30 a , and the like, which may lead to possible corruption of data from the medical device caused by such elevated ambient temperature.
- the processor 34 at step 424 employs conventional means in the transceiver 31 (for example, via status module 31 b ) to obtain current performance measures by transmitting a request to and receiving current performance data from the interface circuit 15 of the associated medical device 10 , and preferably stores the current performance measures as part of the performance history in the memory 35 b .
- Currency may preferably be determined according to system performance, regulatory and/or other requirements for individual performance measures in prescribed time intervals (for example, for an interval older than 5 seconds, older than 1 minute, older than the most recent each hour, or the like), which may be stored in the memory 35 b for retrieval and reference by the processor 34 .
- the processor 34 After determining at steps 423 and 425 that current performance data has been obtained for each medical device accessible to the relay module 30 a , the processor 34 at step 426 determines a current module status as a function of the current performance data and the performance history. For example, if the current performance data indicate that each medical device 10 is currently accessible to the relay module 30 a , the module performance history indicates that the medical devices have been consistently accessible to the relay module 30 a for a predetermined time (for example, over a period of several hours), and throughput and/or occupancy are within predetermined limits, the processor 34 may determine that the wireless relay network 16 is “healthy” (indicated, for example, at step 427 by illuminating a green LED segment of indicator 38 e ).
- the processor 34 may determine a status of “partially accessible” (indicated, for example, at step 427 by illuminating a yellow LED segment of indicator 38 e ). If one or more of the medical devices 10 are presently inaccessible to the relay module 30 a , the processor 34 may determine a status of “inaccessible” (indicated, for example, at step 427 by illuminating a red LED segment of indicator 380 e ).
- step 428 it may be determined by the processor 34 for example in view of “partially accessible” or “inaccessible” statuses that an alarm condition has been generated, causing the processor 34 to present an alarm (for example, by causing the yellow or red LED segments to be illuminated in a blinking fashion, and/or by providing one or more audible alarms as previously described.
- the processor 34 may cause the transceiver 31 to transmit the status information to one or more of the medical devices 10 , or may cause the transceiver 32 to transmit the status information to a device in communication with the WWAN.
- FIG. 4D presents a flow diagram illustrating a method of operation 440 for generating the status information indicated by WWAN indicator 380 j of FIG. 3H .
- the processor 34 retrieves a WWAN performance history, for example, from the memory 35 b as to the status of the WWAN network 44 .
- Performance measures may, for example, include a measured signal strength, noise, bit rate, error rate, call set up time, dropped call rate, occupancy and network availability and the like as are conventionally measured for WWAN/cellular networks for example, via the status module 32 b . (See, e.g., Mike P.
- the processor 34 at step 444 employs conventional means in the transceiver 32 to obtain current performance measures by transmitting a request to and receiving data from the access point 40 of FIG. 1 , and preferably stores the current performance measures as part of the performance history in the memory 35 b .
- the transceiver 32 may transmit a request to the access point 40 and/or other device to retrieve the performance data.
- the processor 34 After determining at step 443 that the WWAN performance data is current, the processor 34 at step 445 determines a current WWAN status as a function of the current performance data and the performance history. For example, if the current performance data indicate that the WWAN 44 is currently accessible to the relay module 30 a , the module performance history indicates that the WWAN 44 has been accessible to the relay module 30 a for a predetermined time (for example, several hours), and throughput and/or occupancy are within predetermined limits, the processor 34 may determine that the WWAN 44 is “healthy” (indicated, for example, at step 446 by illuminating a green LED segment of the WWAN indicator 38 j ).
- the processor 34 may determine a status of “partially accessible” (indicated, for example, at step 446 by illuminating a yellow LED segment of the WWAN indicator 38 j ).
- the processor 34 may determine a status of “inaccessible” (indicated, for example, at step 446 by illuminating a red LED segment of the WWAN indicator 38 j ).
- a status of “inaccessible” indicated, for example, at step 446 by illuminating a red LED segment of the WWAN indicator 38 j .
- it may be determined by the processor 34 for example in view of “partially accessible” or “inaccessible” statuses that an alarm condition has been generated, causing the processor 34 to present an alarm (for example, by causing the yellow or red LED segments to be illuminated in a blinking fashion, and/or by providing one or more audible alarms as previously described.
- the processor 34 may cause the transceiver 31 to transmit the status information to one or more of the medical devices 10 , or may cause the transceiver 32 to transmit the status information to a device in communication with the WWAN.
- FIG. 4E presents a flow diagram illustrating a method of operation 460 for generating the status information that may be used by WLAN/WPAN indicator 380 i of FIG. 3H to indicate an overall health of the entire WLAN/WPAN (or at least of the portion available to provide an alternate path for the relay module 30 a to the WWAN network).
- the processor 34 retrieves current module performance history from the memory 35 b for communications with each other relay module that is accessible to the relay module 30 a via the WLAN/WPAN network 16 (“neighbor module”).
- performance measures may, for example, include a measured signal strength, noise, bit rate, error rate, occupancy, availability, path usage and the like as are conventionally measured for WLAN/WPAN networks (using, for example, the status module 31 b ).
- the processor operates the transceiver 31 to request that each neighbor module provide a WWAN status (prepared, for example, according to the method described with reference to FIG. 4D ).
- the processor 34 at step 466 employs conventional means in the transceiver 31 to obtain current performance measures by transmitting data to and receiving data from the neighbor modules, and preferably stores the current performance measures as part of the performance history in the memory 35 b .
- current performance measures may be obtained with respect to other neighboring devices, for example, having known or discernible performance (for example, network “beacons”).
- the processor 34 After determining at step 467 that current performance data has been obtained for each neighbor module accessible to the rely module 30 a , the processor 34 at step 468 determines a current module status as a function of the current neighbor module performance data (including neighbor module WWAN status) and the neighbor module performance history.
- the processor 34 may determine a status of “fully accessible” (indicated, for example, at step 469 by illuminating a green LED segment of WLAN/WPAN indicator 380 i ).
- the processor 34 may determine a status of “partially accessible” (indicated, for example, at step 469 by illuminating a yellow LED segment of WLAN/WPAN indicator 380 i ). If at least two of the neighbor modules 30 a are not presently accessible to the relay module 30 a , the processor 34 may determine a status of “inaccessible” (indicated, for example, at step 469 by illuminating a red LED segment of WLAN/WPAN indicator 38 i ).
- the processor 34 may be determined by the processor 34 for example in view of “partially accessible” or “inaccessible” statuses that an alarm condition has been generated, causing the processor 34 to present an alarm (for example, by causing the yellow or red LED segments to be illuminated in a blinking fashion, and/or by providing one or more audible alarms as previously described.
- the processor 34 may cause the transceiver 31 to transmit the status information to one or more of the medical devices 10 , or may cause the transceiver 32 to transmit the status information to a device in communication with the WWAN.
- FIG. 4F presents a flow diagram 413 illustrating a method of operation for emergency dialing.
- the processor 34 of the relay module 30 a of FIG. 3 determines whether to transmit over the facility-oriented wireless network or the WWAN and makes a determination based on the medical device data whether an emergency condition exists as represented by step 414 . If such a condition exists then, in step 415 , the processor 34 transmits a message to the phone device 39 a to activate it and also initiate a connection in step 416 (e.g., phone call, etc.) with an emergency responder, such as 911, relatives/friends, caregivers, or police authorities.
- an emergency responder such as 911, relatives/friends, caregivers, or police authorities.
- an automated voice message is preferably transmitted to the emergency responder by the signal generator 39 b indicating the emergency condition and location of the condition. If an emergency condition does not exist in step 414 , in step 417 then the medical device data is stored for further analysis by the monitoring unit 37 b.
- FIG. 4G presents a flow diagram 418 illustrating how a location signal may be generated.
- a determination is made in step 474 by the processor 34 as to whether GPS location data was received as a component of the medical device data received from a medical device. If yes, in step 476 , the processor 34 provides the location data for transmission with emergency condition data to the emergency responder. If that location data is not available, at step 478 a location device 38 of the relay module 30 a is instructed by the processor 34 to generate location data of the relay module 30 a .
- the processor 34 provides the location data for transmission with emergency condition data to the emergency responder as a component of the message transmitted by the phone device 39 a.
- FIG. 4H presents a table as may be stored for example in memory 35 b by the relay module 30 a for determining whether an emergency condition exists.
- the table 481 includes codes 482 to indicate predetermined emergency conditions, descriptions 486 for the emergency conditions, harm times 488 defining an elapsed time until the emergency condition becomes harmful, priorities 490 for triage purposes, related codes 492 to the coded emergency condition, and physiological data 494 used to identify the emergency condition. For example, as shown in line 1 of the table of FIG.
- a code value 482 of “2” is assigned to the description 486 “Significant fever condition,” which is assigned an unattended harm time 488 of “10 minutes” and an immediate priority of 490 of “5.”
- a related condition 492 indicates that this condition in related to a code value 482 of “7,” which corresponds to the description 486 “Vital signs decreasing.”
- the code value 2 in addition corresponds to physiological conditions 494 (“Temp. ⁇ 103 ”). ****
- FIG. 5 presents a flow diagram illustrating a method of operation 500 for the architecture according to FIG. 1 , relating to the transmission of a message from the access point 40 to be received by one of the medical devices 10 .
- This enables the access point 40 , for example, to communicate with medical devices in order to download new firmware or software, to respond to error messages initiated by the medical devices (for example, to re-set a device or remove it from service, or to run device diagnostics), and to operate the medical device (for example, to adjust a flow rate on a feeding pump).
- the message is received at the first one of the relay modules 30 a from the access point 40 via the WWAN.
- the one relay module 30 determines whether the message is intended to reach one of the interface circuits 15 and/or other relay modules 30 , 30 a located in the facility 20 . This may be accomplished, for example, by maintaining a list of active devices 15 and modules 30 , 30 a in the buffer 35 or in a manner otherwise accessible to the one relay module 30 a , or coding an identifier of the device 15 or module 30 , 30 a to include an identity of the facility 20 that is stored in the buffer 35 or is otherwise identifiable to the one relay module 30 or 30 a .
- the received message may include a device identifier such as a serial number or an assigned identifier.
- a device identifier such as a serial number or an assigned identifier.
- the one relay module 30 a may preferably proceed to discard the message at step 508 , and/or alternatively alert the access point 40 with a non-delivery message. If the interface circuit 15 is located in the facility 20 , the one relay module 30 a determines at step 510 whether the interface circuit 15 or relay module 30 , 30 a accessible to the one relay device 30 a via the WLAN or WPAN (for example, by consulting a list stored in the buffer 35 or that is otherwise accessible to the one relay module 30 a , or by instructing the transceiver 31 to send a handshake or test transmission directed to the interface circuit 15 and to listen for a reply).
- the one relay module 30 a determines at step 512 that the device 15 or relay module 30 , 30 a is accessible, then at step 514 , it transmits the message via network 16 to that device or relay module via the transceiver 31 , or to relay module 30 , 30 a via the transceiver 31 .
- the message may again be broadcasted to all devices 15 and modules 30 , 30 a in communication with the one relay module 30 a , and each device 15 or module 30 , 30 a may decide to act on or ignore the message (for example, by matching to an associated device ID or other identifier in the message).
- the one relay module 30 a alternatively determines at step 512 that the device or relay module is not accessible, then it proceeds at step 516 to determine whether a second relay module 30 , 30 a is accessible via the WLAN or WPAN (for example, by instructing the transceiver 31 to send a handshake transmission directed to the second relay module and to listen for a reply). If the second relay module 30 , 30 a is available, then the one relay module 30 forwards the message to the transceiver 31 for transmission to the second relay module 30 , 30 a over the WLAN or WPAN. If the second relay module 30 , 30 a is inaccessible, then this portion of the process 500 may preferably be repeated to search for a third relay module 30 , 30 a that is accessible.
- the one relay module 30 may preferably issue an alarm notification at step 522 , preferably in one of the same manners described above in reference to the methods described in conjunction with FIGS. 6A-6D below.
- the processor 34 may also issue alarm notifications upon failing to receive a handshake signal from other medical devices 10 and/or relay modules 30 , 30 a.
- FIG. 6A depicts a flow diagram 600 representing an alarm alert and display process.
- the processor 34 of the relay module 30 a receives information such as medical device data from a medical device, other rely module or internally generated by the relay module.
- the method 600 determines whether the information obtained in step 602 is indicative of an alarm condition or an alarm condition is otherwise present. If no alarm condition is detected at step 604 , then method 600 reverts back to step 602 . If, in step 604 , an alarm condition is detected based on the obtained information by step 602 , the method 600 proceeds to step 606 .
- step 606 the processor 34 produces an alarm alert by transmitting signals representing an alert to be displayed to the display 36 and/or transmits signals representing speech or other audible information (for an audible alarm) to the speaker. Then, the method 600 proceeds to step 608 .
- step 608 it is determined whether the module 30 a receives medical device data or other information instructing the module to mute or disable the audible alarm or an input signal is otherwise received requesting to mute the sound or disable the audible alarm. If such input signal is received then, in step 612 , the processor 34 mutes the speaker, i.e., disable the audible alarm. However, in step 608 , if no such input signal is received then the method 600 proceeds to step 610 .
- step 610 the processor 34 determines whether a user-actuatable switch associated with the input/output circuit 38 , e.g., a mute switch of the relay module 30 a , has been activated. If such a switch has been activated then the method 600 proceeds to step 612 and the speaker is muted to disable the emitted audible alarm. After the speaker is muted, the method 600 returns to step 602 and starts the process again. However, if in step 610 , it is determined that the mute switch has not been activated then the method 600 proceeds to step 614 where the processor again determines whether the alarm condition is still present based upon, for example, newly received medical device data.
- a user-actuatable switch associated with the input/output circuit 38 e.g., a mute switch of the relay module 30 a .
- step 612 the audible alarm is disabled.
- step 614 the audible alert is produced, i.e., continued.
- the emitted audible alarm may advantageously be changed or upgraded in decibel level, pitch, type of sound, duty cycle or speech command to draw greater attention and response to the alarm condition by potential responders.
- the relay module may transmit a signal to other nearby or remote relay module(s) to alert other potential responders of the alarm condition.
- the method of 600 may operate with information received from plurality of medical devices or other wireless relay modules, and may provide the intermittent displaying of respective alarm alerts for particular time intervals or employ different foreground or background colors based upon the type or severity of the alarm condition.
- FIG. 6B depicts a flow diagram representing a alarm alert and display process 600 a . Some of the steps in process 600 a may be the same as or similar to steps in process 600 .
- the processor 34 of the relay module 30 a of FIG. 3 receives information such as medical device data from a medical device, another relay module or internally generated by the relay module. Then, the method 600 a , in step 604 a , determines whether the information obtained in step 602 a is indicative of an alarm condition or an alarm condition is otherwise present. If no alarm condition is detected at step 604 a , then method 600 a reverts back to step 602 a . If, in step 604 a , an alarm condition is detected based on the obtained information by step 602 a , the method 600 a proceeds to step 606 a.
- step 606 a the processor 34 produces an audible and visual alarm alert by transmitting signals representing an alert to be displayed to the display 36 and/or transmits signals representing speech or other audible information (for an audible alarm) to the speaker.
- the processor 34 may transmit the alarm alert to a medical device 10 via the transceiver 31 , and/or to the access point 40 via the transceiver 32 . Then, the method 600 a proceeds to step 608 a.
- step 608 a it is determined whether the module 30 a receives medical device data or other information instructing the module to mute or disable the audible alarm or an input signal is otherwise received requesting to mute the sound or disable the audible alarm. If such input signal is received then, in step 612 a , the processor 34 mutes the speaker to disable the audible alarm. However, in step 608 a , if no such input signal is received then the method 600 a proceeds to step 610 a.
- step 610 a the processor 34 determines whether a user-actuatable switch associated with the input/output circuit 38 , e.g., a mute switch of the relay module 30 a , has been activated. If such a switch has been activated then the method 600 a proceeds to step 612 a and the speaker is muted to disable the emitted audible alarm. The method 600 a then proceeds at step 616 a to determine whether a mute timer has expired after a predetermined time interval (for example, 5 minutes). If so the mute signal is cleared and/or the mute switch is released at step 618 a , and the method 600 a returns to step 606 a to produce each of the audible and visual alerts.
- a user-actuatable switch associated with the input/output circuit 38 e.g., a mute switch of the relay module 30 a .
- step 610 a it is determined that the mute switch has not been activated, then the method 600 a proceeds to step 614 a where the processor again determines whether the alarm condition is still present based upon, for example, newly received medical device data. If the alarm condition is no longer present, the method 600 a proceeds to step 602 a and the alarm is disabled. However, if in step 614 a the alarm condition is still present, the method proceeds at step 423 to check a condition timer to determine whether the alarm condition has been present for a particular period of time (either fixed in duration for example of five minutes, or for a variable duration based upon the particular alarm condition).
- step 620 a the emitted audible alarm may advantageously be changed or upgraded in decibel level, pitch, type of sound, duty cycle or speech command to draw greater attention and response to the alarm condition by potential responders, and reapplied at step 606 a .
- the relay module 30 , 30 a at step 620 a may transmit a signal to other nearby or remote relay module(s) to alert other potential responders of the alarm condition.
- the method of flow diagram 600 a may operate with information received from a plurality of medical devices or other wireless relay modules, and may provide the intermittent displaying of respective alarm alerts for particular time intervals or employ different foreground or background colors based upon the type or severity of the alarm condition.
- FIG. 6C depicts a flow diagram 600 b representing an alarm monitoring process executed by the processor 34 and the power monitoring device 39 b with respect to the AC power supply to the relay module 30 a .
- the processor 34 interrogates the power monitoring device 39 b to determine whether the external AC power supply is providing a “normal” voltage (for example, 120 VAC, 60 Hz). If the external AC power supply is providing a normal voltage, the processor engages a timer 604 b to operate for a predetermined period of time (for example, 2 minutes) and then returns to step 602 b .
- a “normal” voltage for example, 120 VAC, 60 Hz.
- the processor 34 causes a power alarm message to be transmitted at step 606 b .
- the processor determines whether an audible portion of the alarm resulting from the transmitted alarm message has been muted (for example, by activating the mute switch of the relay module 30 a ). If yes, the processor 34 transmits a message to clear the alarm at step 610 b , engages a timer to operate for a second predetermined period (for example, 5 minutes), and then returns to step 602 b .
- the processor 34 engages a timer 614 b to operate for another predetermined time period (for example, 3 minutes), and then returns to step 602 b .
- the processor 34 may clear the muted condition rather than clearing the alarm, and release the alarm only if a normal voltage is detected as step 602 b.
- FIG. 6C depicts a flow diagram 600 c representing an alarm monitoring process executed by the processor 34 and the power monitoring device 39 b with respect to the secondary power source 39 c to the relay module 30 a .
- the processor 34 interrogates the power monitoring device 39 b to determine whether the secondary power source 39 c is providing a “normal” voltage (for example, 9 VDC). If the secondary power source 39 c is providing a normal voltage, the processor engages a timer 644 c to operate for a predetermined period of time (for example, 1 minute) and then returns to step 642 c.
- a “normal” voltage for example, 9 VDC
- the processor 34 interrogates the power monitoring device 39 b to at step 646 c to determine whether the secondary power source 39 c is providing a “low” voltage (for example, between 7 and 8.5 VDC). If yes, the processor causes a low battery alarm message to be transmitted at step 648 c . At step 650 c , the processor determines whether an audible portion of the alarm resulting from the transmitted alarm message has been muted (for example, by activating the mute switch of the relay module 30 a ).
- the processor 34 transmits a message to clear the alarm at step 652 c , and engages a timer 654 c to operate for a predetermined period (for example, 1 minute) and returns to step 642 c . If not, the processor 34 engages another timer 656 c to operate for another predetermined time period (for example, 2 minutes) and then returns to step 642 c.
- the processor 34 determines that the secondary power source 39 c is not providing a “low” voltage (for example, between 7 and 8.5 VDC)
- the processor 34 concludes at step 658 c that the voltage is a “near death” voltage (for example, less than 7 VDC).
- the processor 34 then begins at step 660 c to store medical device data arriving from one or more medical devices 10 via the wireless relay network and/or from the access point 40 via the internet-accessible wireless communications network in the memory 35 b , and causes a near death battery alarm message to be transmitted at step 662 c .
- the processor determines whether an audible portion of an alarm resulting from the transmitted alarm message has been muted (for example, by activating the mute switch of the relay module 30 a ). If yes, the processor 34 transmits a message to clear the alarm at step 666 c , and engages a timer 668 c to operate for a predetermined period (for example, 1 minute) and returns to step 642 c . If not, the processor 34 engages another timer 670 c to operate for another predetermined time period (for example, 2 minutes) and then returns to step 642 c .
- the processor 34 retrieves any medical device data that was stored in the memory 35 b during the period when a “near death” voltage was detected, and transmits the retrieved medical device data to intended destinations via one or more of the wireless relay network and/or the internet-accessible wireless communications network.
- FIG. 7A depicts a flow diagram 800 representing a process executed by the wireless relay module to determine whether communications with a particular medical device 10 can be carried out over the wireless relay network 16 .
- the process begins with the processor 34 of the wireless relay module 30 a engaging a timer 802 for a predetermined period of time (for example, 5 minutes). After expiration of the timer 802 , the processor 34 instructs the transceiver 31 to transmit a “heartbeat” request to the medical device 10 over the wireless relay network. If a response is received by the transceiver 31 to the request, the process concludes at step 808 and the processor once again engages the timer 802 .
- the processor 34 increments a request counter at step 810 and engages another timer 812 for another predetermined period of time (for example, 1 minute). Then, the processor 34 proceeds to resend the heartbeat request at step 814 . If a response is received by the transceiver 31 to the resent request, the process concludes at step 808 and the processor again engages the timer 802 . If no appropriate response is received, the processor 34 proceeds at step 818 to determine whether the request counter exceeds a predetermined value (for example, a predetermined value of 5).
- a predetermined value for example, a predetermined value of 5
- the processor 34 causes at step 820 , a heartbeat alarm to be displayed by the display 36 and/or be audibly signaled by the speaker 37 , and/or transmits a message via at least one of the transceivers 31 , 32 to the access point 40 and/or to another internet-accessible and/or wireless network-accessible recipient.
- the process then continues at step 808 and the processor once again engages the timer 802 . If the predetermined value of the request counter is not exceeded at step 818 , the process returns to step 810 .
- the processor 34 of the wireless relay module 30 a may alternatively instruct the status module 31 b associated with the transceiver 31 to determine one of a variety of measures of signal quality for the wireless relay network signals being received from a medical device 10 (for example, including a signal strength or data rate of the transmitted signal).
- the architecture disclosed herein for providing networked communications between a series of medical devices and a remote monitoring device provides a number of distinct advantages in comparison to other monitoring systems.
- wireless relay networks such as ZIGBEE networks based on the IEEE 802.15.4 standard
- power and size requirements can be minimized so that the interface circuits 15 can be easily and inexpensively applied to and/or integrated with the medical devices 10 .
- relay modules 30 a that are part of the wireless relay mesh networks with the capacity to access off-site monitoring devices via a WWAN
- access to and reliance on existing and potentially unreliable LAN facilities at a facility can be avoided.
- relay features into the relay modules 30 a that relay communications from a first relay module 30 a through a second relay module 30 a in the event that WWAN access to the first relay module 30 a has been compromised, reliability can be improved and the use of conventional, low-cost cellular transceivers can be enabled in the relay modules 30 a for accessing the WWAN.
- relay modules 30 a By limiting the configuration of cellular transceivers to just the relay modules 30 a , costs can be further reduced. In addition, providing the relay modules 30 a in a compact enclosure facilitates the relay modules 30 a to be easily connected to reliable commercial power sources and easily moved when needed to reconfigure the wireless relay networks (e.g. a to a mesh network) according to facilities changes. The portability for ambulatory use that is provided by battery back-up is an additional advantage.
- FIG. 7B presents a flow diagram illustrating a method 700 A of identifying a patient that is associated with (that is, intends to receive treatment from or provide patient identification information and/or patient medical and/or physiological data to) a medical device 10 (as depicted, for example, in FIG. 1 ).
- the process may be initiated, for example, by actuating the synchronization switch 38 k on the control panel 38 as illustrated in FIG. 3( e ) of a relay module 30 a in proximity to the medical device 10 .
- the relay module 30 a enters an identification signal reception mode, in which it waits for a first predetermined interval (for example, using a time-out algorithm) at step 704 A to receive patient identification data over the facility-oriented wireless network via the interface device 17 a of a patient identification device 17 .
- the relay module 30 a preferably indicates receipt by presenting an audible or visual signal at the control panel 38 , or by broadcasting a receipt signal to the patient identification device 17 over the facility-oriented wireless network.
- the relay module 30 a waits for a second predetermined interval to receive medical device identification information over the facility-oriented wireless network via the interface circuit 15 of a medical device 10 .
- the relay module 30 a preferably indicates receipt of this medical device data by presenting an audible or visual signal at the control panel 38 , or by broadcasting a receipt signal to medical device 10 over the facility-oriented wireless network. It should be understood that the order of receipt of the patient identification data and the medical device identification information (which may be respectively transmitted, for example, by a caregiver operating the patient identification device 17 and the medical device 10 ) may be inverted.
- inventive process 700 A may optionally first require the caregiver to transmit caregiver identification data (for example, via one of the patient identification device 17 or the medical device 10 , or via a sensor provided in the relay module 30 a ) which is validated by comparison to a caregiver identification table maintained for example in the memory 35 b of the relay module 30 a , or alternatively by forwarding a validation request to the remote monitoring system at the access point 40 over one or more of the facility-oriented wireless network and WWAN via an associated one of the transceivers 31 , 32 .
- caregiver identification data for example, via one of the patient identification device 17 or the medical device 10 , or via a sensor provided in the relay module 30 a
- a caregiver identification table maintained for example in the memory 35 b of the relay module 30 a
- forwarding a validation request to the remote monitoring system at the access point 40 over one or more of the facility-oriented wireless network and WWAN via an associated one of the transceivers 31 , 32 .
- step 708 A upon receipt of each of the patient identification data and the medical device identification data, a verification process is initiated. This process is carried out by the method 700 B illustrated in the flow diagram of FIG. 7C .
- a patient identification directory in the memory 35 b of the relay module 30 a is interrogated to determine whether a record is present including the received patient identification data and medical device information data, and if so, whether this record includes a “fresh” time stamp indicating that the record is current (for example, if patient identification is verified on a daily basis, a time stamp during the current day). If the time stamp is current, the record is retrieved from the patient identification directory at step 712 B, and an acknowledgement status identified is extracted from the record at step 710 B.
- the relay module 30 a proceeds to form a data packet including the patient identification information and medical device identification and to encrypt this packet (for example, using a suitable conventional encryption algorithm such as secure sockets layer (SSL) data encryption) at step 704 B, and then transmits the encrypted data packet at step 706 B for further validation to the remote monitoring system at the access point 40 over one or more of the facility-oriented wireless network and WWAN via an associated one of the transceivers 31 , 32 .
- the patient identification information and/or the medical device identification information may be encrypted by one or more of the patient identification information device or the medical device, and steps 702 B, 704 B and 712 B may be omitted.
- the relay module receives a reply packet from the remote monitoring system via one of the transceivers 31 , 32 , and decrypts that packet.
- the relay module 30 a extracts the acknowledgement status identifier from the decrypted packet.
- the relay module 30 a preferably adds a record to the patient identification directory in the memory 35 b that includes the patient identification information, the medical device identification information, the acknowledgement status identifier and a current time stamp.
- the relay module broadcasts the acknowledgement status identifier (preferably together with at least one of the patient identification data or the medical device identification data) via the transceiver 31 to the medical device 10 .
- the medical device 10 Upon receipt of the acknowledgement status identifier, the medical device 10 begins operation and transmits medical device data via an associated interface circuit 15 over the facility-oriented wireless network for receipt by the wireless network 30 a at step 712 A.
- the acknowledgement status identifier may preferably be encoded to instruct the medical device 10 to operate with predefined operating parameters.
- the medical device 10 may transmit a request via the interface circuit 15 to confirm preset operating parameters and/or request additional information. Once the operating parameters are confirmed and operation of the medical device 10 begins, the wireless network 30 a may operate according to the previously-described processes 400 , 500 of FIGS. 4 , 5 .
- FIG. 8 illustrates a flow diagram of a method 8200 for registering medical devices 10 with the system 100 B of FIG. 1B .
- the method 8200 begins at step 8202 , at which an authorized technician or other personnel having access to one of the remote monitoring devices 67 , 73 , 75 provides authenticating credentials (for example, a recognized log-in and password) to the outbound web server 43 , and the web server responds by transmitting a device set-up screen to the remote monitoring device 67 , 73 , 75 requesting medical device identifying information and associated patient identifying information.
- authenticating credentials for example, a recognized log-in and password
- the outbound web server 43 preferably queries the metadata and application database 46 according to one or more of identifying information for the technician and/or identifying information for the patient to identify an associated patient care database node 60 from a plurality of patient care database nodes for the patient and record a destination address for the associated patient care database node 60 in the metadata and application database 46 in association with the identifying data for the medical device 10 and/or identifying information for the patient.
- Identifying information for the patient is preferably generated anonymously (for example as a random number), and transmitted at step 8206 to the patient care database node 60 for association with securely-stored patient identifying information.
- the outbound web server 43 requests that the secure device web server 42 assign an area of the device control database 44 for logging associated medical device data for the medical device 10 as it is received by the device integration server 41 , such that it can be later retrieved by the outbound web server 43 upon receiving an authorized request from an authenticated user operating one of the remote monitoring devices 67 , 73 , 75 .
- step 8204 of method 8200 for identifying and storing the address of the patient care database node 60 may be omitted if a single patient care database node is utilized with system 100 B of FIG. 1B .
- FIG. 9A presents a flow diagram illustrating a method 9300 for retrieving and viewing medical device data on a remote monitoring device 67 , 73 , 75 for a registered medical device 10 according to the system of FIG. 1B .
- the method 9300 begins at step 9302 with a first authorized user having access to one of the first remote monitoring devices 67 provides authenticating credentials (for example, a recognized log-in and password) to the outbound web server 43 .
- authenticating credentials for example, a recognized log-in and password
- a second authorized user having access to one of the second remote monitoring devices 73 , 75 likewise provides respective authenticating credentials to the outbound web server 43
- the outbound web server 43 queries the metadata and applications database 46 to identify the address of patient care database node(s) 60 to which the respective first and second authorized users are entitled to obtain access, and at step 9306 , requests data from the patient care database node 60 relating to at least one identified patient for which the first and second user are respectively authorized to view medical device data, including for example a listing of medical devices 10 which are presently associated with the identified patient, and/or status information of the facility-oriented network 17 .
- the outbound web server 43 queries the device control database 44 via the secure device web server 42 for status information to determine which of the listed medical devices are presently active according to the data logged by the device control database 44 .
- a medical device 10 its associated interface device 15 , an associated wireless relay module 30 and/or the device integration server 41 may be programmed to provide data from the medical device 10 to the device integration server 41 at predetermined, preset intervals or otherwise, which can then be provided to server 43 in response to inquiries therefrom.
- the outbound web server 43 Upon obtaining the status information, the outbound web server 43 prepares respective display pages with encrypted medical device data, according for example to display information retrieved from the metadata and applications database 46 , to display listings of medical devices 10 available for monitoring by respective authorized users at the remote monitoring devices 62 , 70 , 75 .
- FIG. 9B presents a first screen display 9320 to the remote monitoring devices 62 , 70 , 75 that provides an array of medical devices 10 available for monitoring according to device type. For example, in the screen display 9320 of FIG.
- available device types include ventilators 9321 , urology devices 9322 , energy delivery devices 9323 , pulse oximeters 9324 , predictive thermometers 9325 , tympanic thermometers 9326 and food pumps 9327 .
- Each of the device types 9321 - 9327 in FIG. 9B is presented with an identifying label (for example, label 9321 A) and an identifying image (for example, image 9321 B) for ease of recognition.
- a second screen display 9330 as illustrated by FIG. 9C may preferably be transmitted by the outbound web server 43 for display at the remote monitoring devices 62 , 70 or 75 .
- labels 9337 A are provided in association with images 9337 B in order to identify individual food pumps (for example, by patient and/or by logical or physical location).
- Medical devices 10 that are unavailable may for example preferably be depicted with a label 9337 A′ (“Off Line”) and an image 9337 B′ (depicting the device with a slash or cross applied over the image or shaded or shadowed) that distinguish the unavailable medical devices 10 from available medical devices 10 .
- a label 9337 A′ (“Off Line”)
- an image 9337 B′ (depicting the device with a slash or cross applied over the image or shaded or shadowed) that distinguish the unavailable medical devices 10 from available medical devices 10 .
- a third screen display 9340 as illustrated by FIG. 9D may preferably transmitted by the outbound web server 43 for display at the corresponding remote monitoring device 62 , 70 , 75 .
- device information of the medical device 10 is displayed in a screen 9347 A preferably recreating a current screen generated and displayed by the medical device 10 .
- the screen display 9340 includes any of a panel 9347 B providing identifying information for the medical device 10 (in this case, a pump location), a panel 9347 C for displaying a message indicating a current error condition of the pump, and an icon button 9347 D for selecting an alternate “status” mode of the screen display 9340 .
- the screen display 9340 also includes a control icon button 9347 E for selecting a system set-up screen display, and a control icon button 9347 F for enabling device control from the remote monitoring device 62 .
- the screen display 9340 may preferably be refreshed to include the medical devices screen 9347 A and one or more operable buttons that mimic the appearance of control buttons on the medical device.
- the control button features are described in greater detail below in relation to FIGS. 10B and 10C .
- FIGS. 9B , 9 C and 9 D are for illustration purposes only and that many other user screen images displays and interface tools may be utilized, for example, computer screens that depict accessible medical devices by other means than device type as illustrated in FIG. 9B .
- FIG. 9D As a suitable alternative to the screen image 9340 of FIG. 9D that conveys information from a single medical device, it is possible to implement displays that provide information from multiple medical devices.
- outbound web server 43 will preferably be operable to prepare display pages with encrypted medical device data for display on any of a wide variety of display devices (including, for example, workstations, personal computers, tablet devices including tablet computers, and display-based mobile devices including personal digital assistants, smartphones, portable game systems and the like.
- display devices including, for example, workstations, personal computers, tablet devices including tablet computers, and display-based mobile devices including personal digital assistants, smartphones, portable game systems and the like.
- the computer screen images to be available to first and second users of the first and second remote monitoring devices may be different depending upon whether such user is a clinician, nurse, patient relative or other caregiver, i.e., dependent on level of entitlement of the particular authorized user.
- a display for a clinician at a first remote monitoring device 62 may enable the clinician to adjust the settings of a subject medical device 10 , in contrast to a display for a second remote monitoring device 70 , 75 used by a patient relative, which depicts only fundamental information from the medical device data with no option for the patient relative to adjust the medical device settings via the second remote monitoring device 70 , 75 .
- different encryption methods or formats may be employed for medical device data transmitted to the first remote monitoring device 62 than the second remote monitoring device 70 , 75 .
- FIG. 10A presents a flow diagram illustrating a method 1000 for issuing a command to a medical device 10 via the system 100 according to FIG. 1 .
- the method 1000 begins at step 1002 with an authorized user adjusts an operating parameter, such as a clinician (also referred to as a “authorized clinician” or “user” herein) logging into the outbound web server 43 using a first remote monitoring device 62 and navigating to the device screen display 9340 of FIG. 9D (for example, as described above with reference to FIGS. 9A-9D ).
- a clinician also referred to as a “authorized clinician” or “user” herein
- the clinician proceeds to select the “Enable Full Control” button 9347 F of FIG.
- patient authentication information provided by the clinician is forwarded by the outbound web server 43 to a patient care database node 60 according to a patient care database node address stored by the metadata and applications database 46 in association with the clinician, and the clinician is authenticated for the patient by the outbound web server 43 upon receipt of an authentication confirmed message from the patient care database node 60 .
- a control request is forwarded by the outbound web server 43 at step 1008 to the secure device web server 42 to be logged in the information record of the device control database 44 that is associated with the medical device 10 (and optionally, with an anonymous ID for the patient).
- the secure device web server forwards the control request, such as an encrypted control request, to the device integration server 41 , which transmits an associated device control command over the secure WWAN 52 for receipt by an associated wireless relay module 30 at step 1012 .
- the wireless relay module 30 wirelessly communicates the command to the medical device 10 via an associated device interface 15 , and awaits a reply confirming execution of the command transmitted by the device interface 15 .
- the device integration server 41 receives an update message from the wireless relay module 30 via the secure WWAN 52 which confirms that the command was executed by the medical device 10 .
- the device integration server 41 forwards the update message to the secure device web server 42 to be logged in the information record of the device control database 44 that is associated with the medical device 10 .
- the secure device web server 42 forwards information pertaining to the update message to the outbound web server 43 , and the outbound web server 43 prepares an updated display screen that is securely transmitted to the remote monitoring device 62 to indicate that the command has been executed.
- the authenticated clinician may select the “System Setup” control icon button 9347 E to perform a command other than an operational command directed to the medical device 10 .
- FIG. 10B illustrates a display screen 1050 that is presented to the clinician upon selecting the control icon button 9347 E.
- the display screen 1050 includes a number of icon buttons that may be selected by the clinician (for example, as the result of a mouse-over or mouse-click initiated by the clinician) to select a specific setup command.
- icon button 1051 may be selected to initiate a command for providing identification information of the medical device 10 .
- Icon button 1052 may be selected to provide text paging in response to an alert condition, as is further described herein.
- Icon button 1053 may be selected to initiate a software or firmware download for updating the medical device 10 .
- Icon button 1054 may be selected to initiate a diagnostic test of the medical device 10 .
- FIG. 10C illustrates a display screen 1060 that may be displayed to the clinician upon selection of the icon button 1054 .
- the clinician may select one or more of (including a progression of) a series of diagnostic tests 1061 directed to components of the medical device (for example, including power components, memory components, alarm components and the like).
- the clinician may select one or more of a series of performance statistics 1062 to be gathered and displayed (for example, including various device error statistics such as feed error, rotor error and flush error rates for a food pump).
- the clinician may select a version number test 1063 to obtain version identifying information for the software and/or firmware (preferably including, for example, a software and/or firmware download history).
- a version number test 1063 to obtain version identifying information for the software and/or firmware (preferably including, for example, a software and/or firmware download history).
- processes for performing the diagnostic tests 1061 , preparing the performance statistics 1062 and identifying the software and/or firmware version number 1063 may run automatically without specifically being selected by the clinician, with a complete reporting of all results on the display screen.
- a bandwidth priority command or instruction to a relay module, such as relay module 30 of FIG. 1 , for the relay module to grant priority for relaying information received from a particular medical device relative to other medical devices that may send or receive communications via this relay module.
- a critical care device such as a ventilator supporting the breathing function of a patient relative to a weight scale or thermometer.
- bandwidth priority levels assignable to respective medical devices based upon, for example, the critical nature of the data or function provided by such devices.
- icon button 1055 may be selected to enable the clinician to specify data transfer rates, priorities and other parameters relating to the wireless transceiver of the interface device associated with the medical device.
- Icon button 1056 may be selected to provide the clinician with the an alarm history, event history and other information as has been logged for example for the medical device in the device control database 44 of FIG. 1 .
- the method 1000 for remotely issuing a command to a medical device 10 was described with respect to a user of a first remote monitoring device 62 and not a user of the second remote monitoring 70 , 75 because as described for example throughout this application, it is assumed that the user of the first remote monitoring device 62 is a clinician, technician or other highly-skilled healthcare professionals, while the user of the second remote monitoring device 70 , 75 may be a patient relative or caregiver of lesser skill. Nevertheless, the method 1000 is likewise useable to enable a user of the second monitoring device 70 , 75 to also control particular settings of the medical device 10 .
- FIG. 11A presents a flow diagram illustrating a method 1100 for recognizing and reporting an alert condition according to medical device data (including the status of the facility-oriented network 17 ) logged via the system 100 according to FIG. 1 .
- the method 1100 begins at step 1102 with the transmission of an alert message by a wireless relay module 30 over the secure WAN 52 to the device integration server 41 .
- the wireless relay module 30 is configured to analyze (such as by detecting flag or status information or comparing message data to information stored in an associated database) a message type of a message transmitted by an associated medical device 10 to determine that the message is an alert message, and to transmit the message to the device integration server 41 upon determining that the message is an alert message (for example, as a priority message).
- the wireless relay module 30 may simply queue all messages for transmission to the device integration server 41 in order upon receipt, and rely upon the device integration server 41 to analyze an associated message type to determine that a message is an alert message.
- the device integration server 41 Upon determining that the transmitted message is an alert message, the device integration server 41 proceed, at step 1103 , to log the message in the device control database 44 , and at step 1104 , invokes a text messaging application that retrieves text messaging numbers associated with identifying information of the medical device 10 and/or anonymous patient identifying information.
- the determination of whether the transmitted message is an alert message may be carried out by, for example, detecting an alert flag or trigger identifier in the message or scanning the message for other information indicative of an alert condition.
- the text messaging application may preferably retrieve the text messaging numbers by querying the metadata and applications database 46 to identify the address of an associated patient care database node 60 , and either making a direct request or instructing the outbound web server 43 to request the text messaging numbers from the associated patient care database node 60 .
- the device integration server 41 sends one or more messages including the retrieved text messaging numbers and text message information according to the alert message to one or more wireless relay modules 30 over the secure WWAN 52 .
- the one or more wireless relay modules 30 transmit the text message information addressed to the text messaging numbers over one or more of the secure WWAN 52 and/or the facility-oriented wireless network 17 to complete the method 1100 .
- FIG. 11B illustrates a “Text Paging” 1052 screen display 1150 that may be invoked, for example, by using the method 1000 of FIG. 10A for issuing a command to a medical device 10 .
- the text paging screen 1150 is displayed at the first remote monitoring device 62 of an authenticated clinician upon the clinician's selection of the “System Setup” icon button 9347 e of the screen display 9340 , and thereafter upon the clinician's selection go the “Text Paging” icon button of the screen display 1050 .
- the “Text Paging” screen display 1150 include a listing of one or more names 1151 of individuals responsible for responding to alert messages of at least two types: “Error Messages” 1153 , which may for example indicate a malfunction of the medical device 10 , and/or “Info Messages” 1154 , which may for example indicate a significant patient health condition (for example, a patient respiration rate below a preset minimum rate specified for a ventilator device 9321 of FIG. 9B ).
- the information retrieved by the outbound web server 43 to prepare this display is preferable retrieved from the patient care database node 60 , by providing on one or more of identifying information for the medical device 10 and/or anonymous patient identifying information stored in the device control database 44 .
- the information provided on the “Text Paging” screen display may be retrieved by the device integration server 41 by querying the metadata and applications server 46 to retrieve address information for the patient care database node 60 , and forwarding a text paging information request to the patient care database node 60 based upon one or more of identifying information for the medical device 10 and/or anonymous patient identifying information stored in the device control database 44 .
- the recognition of whether the received message from the medical device 10 is an alert message may be carried out by, for example, detecting an alert flag or trigger identifier in the message or scanning the message for other information indicative of an alert condition.
- alerts may be communicated in other ways including email, audio messages via telephone calls, as well as any other wired and/or wireless text, audio, or multimedia based communication services receivable by, for example, by a smart phone or computer tablet software application or “App.”
- FIG. 12 shows an illustrative computer system 1200 suitable for implementing server and computer components (for example, including device integration server 41 , secure device web server 42 , outbound web server 43 , and secure patient web server 64 ).
- the computer system 1200 as described herein may comprise, for example, a personal computer running the WINDOWS operating system, or a server computer running, WINDOWS Server, LINUX or another UNIX-based operating system.
- the computer system 1200 described herein may comprise a mobile device, tablet devices or computers, or information appliance running, for example, an operating system in the group including Symbian, Android, Apple iOS, Blackberry, Microsoft Windows Phone, Linux, Palm/HP WebOS, BADA, MAEMO and MEEGO.
- the above-described methods carried out by the server and computer components may be implemented on the computer system 1200 as stored program control instructions directed to control application software.
- Computer system 1200 includes processor 1210 , memory 1220 , storage device 1230 and input/output devices 1240 .
- One of the input/output devices 1240 may preferably include a display 1245 .
- Some or all of the components 1210 , 1220 , 1230 and 1240 may be interconnected by a system bus 1250 .
- Processor 1210 may be single or multi-threaded, and may have one or more cores.
- Processor 1210 executes instructions which, in the disclosed embodiments, are the steps described, for example, in one or more of FIG. 8 , 9 A, 10 A or 11 A. These instructions may be stored in one or more of memory 1220 or in storage device 1230 . Information may be received and output using one or input/output devices 1240 .
- Memory 1220 may store information and may comprise a computer-readable medium, such as volatile or non-volatile memory.
- Storage device 1230 may provide storage for system 1200 including for the example, the previously described database, and may be a computer-readable medium.
- storage device 1230 may be one or more of a flash memory device, a floppy disk drive, a hard disk device, and optical disk device, and/or a tape device.
- Input devices 1240 may provide input/output operations for system 1200 .
- Input/output devices 1240 may include one or more of a keyboard, a pointing device, and/or microphone.
- Input/output devices 1240 may further include a display unit for displaying graphical user interfaces, a speaker and a printer and any of a number of other serial devices (for example, configured as Universal Serial Bus (USB)-based devices
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Abstract
Systems and methods for communication include one or more wireless relay devices having a first receiver capable of wirelessly receiving medical device data over a wireless relay network from at least one network device, a first transmitter capable of wirelessly transmitting data over an internet-accessible wireless communications network and a second transmitter capable of wirelessly transmitting medical device data to a second medical device or a wireless relay module over the wireless relay network. Patient identification information can be obtained and/or communicated.
Description
- This application is a continuation of co-pending U.S. patent application Ser. No. 14/308,881 filed Jun. 19, 2014, which is a continuation of U.S. patent application Ser. No. 13/241,620 filed Sep. 23, 2011, now. U.S. Pat. No. 8,798,527 which is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/352,575 filed Jan. 18, 2012, which is a continuation-in-part of U.S. patent application Ser. No. 13/241,620 filed Sep. 23, 2011 now. U.S. Pat. No. 8,798,527 which is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/352,575 filed Jan. 18, 2012, which is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/334,447 filed Dec. 22, 2011, which is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/334,459 filed Dec. 22, 2011, which is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation application of co-pending U.S. patent application Ser. No. 13/353,565 filed Jan. 19, 2012, which is a continuation-in-part of co-pending U.S. patent application Ser. No. 13/334,463 filed Dec. 22, 2011 and a continuation-in-part of application of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation application of co-pending U.S. patent application Ser. No. 13/352,608 filed Jan. 18, 2012, which is a continuation application of U.S. patent application Ser. No. 13/037,886 filed Mar. 1, 2011 now U.S. Pat. No. 8,694,600.
- This application is also a continuation application of co-pending U.S. patent application Ser. No. 14/154,285 filed Jan. 14, 2014, which is a continuation of U.S. patent application Ser. No. 13/037,886 filed Mar. 1, 2011 now U.S. Pat. No. 8,694,600.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/006,769 filed Jan. 14, 2011.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/006,784 filed Jan. 14, 2011.
- This application is also a continuation of co-pending U.S. patent application Ser. No. 13/334,463 filed Dec. 22, 2011.
- All patent applications listed in this section and listed in this document are hereby incorporated herein by reference in their entireties.
- The present application is directed to systems and methods for communicating between a series of medical devices and remote monitoring devices, and more particularly, to a wireless relay module for receiving communications from and transmitting communications to medical devices via a wireless relay network, and for transferring the communications received from the remote monitoring devices via an internet-accessible wireless communications network.
- In critical care and home care health service centers including hospitals, clinics, assisted living centers and the like, care giver-patient interaction time is at a premium. Moreover, response times by care givers to significant health conditions and events can be critical. Systems of centralized monitoring have been developed to better manage care giver time and patient interaction. In such systems, medical data from each patient is transmitted to a centralized location. At this centralized location, a single or small number of technicians monitor all of this patient information to determine patient status. Information indicating a patient alarm condition will cause the technicians and/or system to communicate with local care givers to provide immediate patient attention, for example via wireless pagers and/or cell phones, and/or by making a facility-wide audio page.
- Implementing such centralized monitoring systems using wireless networks may present a number of difficulties. In order to effectively monitor patient status using information provided by a variety of medical devices that may be dynamically assigned to patients in a variety of rooms and on a variety of floors in a facility, it would be desirable to establish communications between the medical devices and the centralized location by means of a local area network such as, for example, a “WiFi” network based on IEEE 802.11 standards. However, as such networks are typically already in place in facilities to support a variety of other functions (for example, physician access to electronic medical records (EMRs), facility administrative systems and other functions), it is often undesirable to secure sufficient local area network access for the purpose of providing centralized monitoring. Moreover, when a patient is located remotely from a critical care health service center (for example, at home), access to traditional local area network facilities such as a WiFi network may be unavailable or not sufficiently reliable to support critical care monitoring applications.
- The present disclosure is directed to a wireless relay module for providing networked communications between a series of medical devices and remote monitoring devices. In accordance with embodiments of the disclosed technology, one or more medical devices (including but not limited to including for example, respirators, external feeding devices, pulse oximeters, blood pressure monitors, pulse monitors, weight scales and glucose meters) are provided at a patient facility. An interface circuit is coupled to each medical device, and is configured for communicating with at least one of a plurality of the wireless relay modules via a wireless relay network and/or with other medical devices. The wireless relay modules and medical devices are advantageously further configured to communicate with a remote monitoring device over an internet-accessible wireless communication network, and preferably, a wireless wide-area network (WWAN) such as a mobile telephone data network including (for example, based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated wireless data channels). Also, for compliance for example with HIPAA regulations, communications over each of the wireless networks are preferably conducted securely.
- Systems and methods for providing communications between a medical device to be used by a patient and a remote monitoring device via an internet-accessible wireless communications network include obtaining identification information identifying the patient, obtaining identification information identifying the medical device transmitting each of the patient identification information and the medical device identification information to the remote monitoring device via the internet-accessible wireless communications network, receiving an acknowledgement status from the remote monitoring device via the internet-accessible wireless communications network; and transmitting data corresponding to an output of at least one sensor of the medical device for said patient by the medical device via the internet-accessible wireless communications network when the received acknowledgement status represents a particular status.
- In a further aspect, the concepts, systems and techniques described herein are directed toward network architectures for providing networked communications between a series of medical devices and remote monitoring devices. In accordance with one illustrative embodiment, one or more medical devices including, for example, enteral feeding devices and systems, thermometers, pulse oximeters, respirators, blood pressure monitors, pulse monitors, weight scales and glucose meters) are provided at a patient facility. An interface circuit is coupled to each medical device, and is configured for communicating with one of a plurality of wireless relay modules via a wireless relay network. The wireless relay modules are further configured to communicate with a remote monitoring device over an internet-accessible wireless communication network, and preferably, a wireless wide-area network (WWAN) such as a mobile telephone data network, e.g. 3G or 4G network. Also, for compliance for example with HIPAA regulations, communications over each of the wireless networks are preferably conducted securely.
- Each of the plurality of wireless relay modules includes a receiver capable of wirelessly receiving medical device data from respective interface circuits via the wireless relay network, a first transmitter capable of wirelessly transmitting medical device data to another one of the wireless relay modules over the wireless relay network, a second transmitter capable of wirelessly transmitting data over an internet-accessible wireless communications network; and a controller coupled to the first and second transmitters. The controller is configured to determine access status of the internet-accessible wireless communications network, and to select one of the first or second transmitters based on that status. For example, when the status indicates that the internet-accessible wireless communications network is accessible to the wireless relay module, the controller selects the second transmitter for transmitting medical device data transmitted by the interface circuit to the internet-accessible wireless communications network. When the status indicates that the internet-accessible wireless communications network is not accessible, the controller selects the first transmitter for transmitting the medical device data to another one of the wireless relay modules. In this manner, additional attempts to transmit the medical device data over the internet-accessible wireless communication network can be attempted by this other wireless relay module (and potentially additional ones of the wireless relay modules) until a successful transmission is achieved.
- The wireless relay module may also advantageously communicate its status and the status of other wireless relay modules via the wireless relay network and over the internet-accessible wireless communications network. In addition, the wireless relay module may further include a second receiver for receiving data and commands from the internet-accessible wireless communications network for communicating to specific interface circuits and corresponding medical devices.
- The subject of this disclosure will become more readily apparent from the Detailed Description, which proceeds with reference to the drawings, in which:
-
FIG. 1A is a block diagram of an embodiment of a medical device network architecture that incorporates a wireless relay module. -
FIG. 1B is a block diagram of an embodiment medical device network architecture that incorporates a wireless relay module. -
FIG. 1C is a block diagram of an embodiment medical device network architecture that incorporates a wireless relay module. -
FIG. 1D is a perspective diagram of a personal enclosure for a medical device and/or a relay device. -
FIG. 2A is a network diagram of a network including medical devices and/or relay devices. -
FIG. 2B is a network diagram of a network including medical devices and/or relay devices. -
FIGS. 3A-3D are block diagrams of embodiments of relay devices. -
FIGS. 3E-3G are top, front, and side views of a relay device. -
FIG. 3H is a diagram of a control panel associated with a relay device. -
FIG. 3I is a diagram of a control panel associated with a relay device. -
FIG. 4A andFIG. 4B are flow diagrams of processes for transmitting medical device data. -
FIG. 4C is flow diagram of a process including determining module status. -
FIG. 4D is a flow diagram of a process including determining WWAN status. -
FIG. 4E is a flow diagram of a process including determining WLAN/WPAN status. -
FIG. 4F is a flow diagram of a process including initiating a call to an emergency responder. -
FIG. 4G is a flow diagram of a process including producing location data. -
FIG. 4H is a table diagram of priority codes. -
FIG. 5 is a flow diagram of a process including determining whether an interface device is accessible. -
FIG. 6A andFIG. 6B are flow diagrams including producing an alert. -
FIG. 6C is a flow diagram including transmitting a power alarm. -
FIG. 6D is a flow diagram including transmitting a low battery alarm. -
FIG. 7A is a flow diagram including sending a heartbeat request to a medical device. -
FIG. 7B is a flow diagram including initiating patient/device synchronization. -
FIG. 7C is a flow diagram including adding patient information to a local directory. -
FIG. 8 is a flow diagram including logging in to a device set-up screen. -
FIG. 9A is a flow diagram including displaying a list of active devices available. -
FIGS. 9B-9D are screen displays for retrieving and viewing the medical data. -
FIG. 10A is a flow diagram illustrating a method for issuing a command to a medical device via the remote monitoring system. -
FIGS. 10B and 10C are screen displays for commanding a medical device. -
FIG. 11A is a flow diagram illustrating a method for recognizing and reporting an alert condition according to medical data logged via the remote monitoring. -
FIG. 11B is a screen display for selecting a recipient for receiving an alert message. -
FIG. 12 is a block diagram of a computer or server device suitable for use in the remote monitoring system. - Reference will now be made in detail to embodiments of systems, apparatuses, and methods for communicating medical data, including the best modes contemplated by the inventors. Examples of these embodiments are illustrated in the accompanying drawings. While the systems, apparatuses, and methods are described in conjunction with these embodiments, it will be understood that it is not intended to limit the claims to the described embodiments. Rather, the claims are also intended to cover alternatives, modifications, and equivalents as may be included within the spirit and scope of the claims.
- In the following description, specific details are set forth in order to provide a thorough understanding of the technology disclosed. The technology may be practiced without some or all of these specific details. In other instances, well-known aspects have not been described in detail in order not to unnecessarily obscure the description of the technology.
- In this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art.
- Further described herein is a network architecture for centralized monitoring of medical devices using wireless relay networks and/or internet-accessible wireless communications networks having emergency call functionality to provide a secondary level of protection when significant health conditions occur. The architecture in addition enables the approximate location of the monitored medical devices to be determined.
- A schematic diagram of an
architecture 100 for a system for monitoring medical devices is illustrated inFIG. 1 . One or moremedical devices 10 are provided at apatient facility 20 for monitoring the medical condition and/or administering medical treatment to one or more patients.Patient facility 20 may comprise a critical care health service center (for example, including hospitals, clinics, assisted living centers and the like) servicing a number of patients, a home facility for servicing one or more patients, or a personal enclosure (for example, a backpack) that may attached to and/or be worn by an ambulatory patient. Associated with eachmedical device 10 is aninterface circuit 15 that includes a transceiver having one or more of a transmitter and/or a receiver for respectively transmitting and receiving signals in a facility-oriented wireless network such as, for example, a Low-Rate Wireless Personal Area Networks or “LR-WPAN,” ZIGBEE network or other low-power personal area networks such as a low power BLUETOOTH network, e.g. Bluetooth 4.0, existing or presently under development or consideration, for emulating a mesh network (such as ZIGBEE network) or otherwise. See, e.g., ZIGBEE Wireless Sensor Applications for Health, Wellness and Fitness, the ZIGBEE Alliance, March 2009, which is incorporated by reference herein in its entirety, for all purposes. See, also, Nick Hunn, Essentials of Short-Range Wireless, Cambridge University Press, 2010, which is also incorporated by reference herein in its entirety; See also Honda Labiod et al., Wi-Fi, Bluetooth, Zigbee and WiMax, Springer 2010, which is incorporated by reference herein in its entirety. - As illustrated in
FIG. 1 , asuitable access point 40 may include aninbound web server 41 that incorporates or otherwise has access to a transceiver for communicating with therelay modules 30 a over the WWAN. Medical device data received by theinbound web server 41 over the WWAN is forwarded to a securedata storage server 42, which is configured for example to log the received data in association with identification information of the associated medical devices. As was previously described infra, “medical device data” and “data” as generally used herein means data from or about the medical device including, for example, medical device identification, medical device software, medical device settings or status information (including alarm information and/or alarm priority), patient identification information, patient personal identification number(s) “PIN(s)”, patient prescriptions, and/or patient medical and/or physiological data as is collected, produced and/or generated by the medical device. - An outbound web server 43 (which may be associated with access point 40) is configured, for example, to receive and qualify data retrieval requests submitted by one or more of
remote monitoring devices data storage server 42, and to format and transmit the retrieved data to the one or moreremote monitoring devices access point 40 that enables the receipt, storage and retrieval of medical device data on a device display of the one or moreremote monitoring devices storage server 42 may be integrated into theoutbound web server 43. Further alternative configurations may for example involve a plurality ofmirror storage servers 42 each storing medical device data, and accessible as a plurality ofoutbound web servers 43. - For compliance with HIPAA regulations, communications over each of the facility-oriented wireless network and WWAN are preferably conducted securely using, for example, using a Secure Sockets Layer (SSL) protocol or a Transport Layer Security (TLS) protocol.
- Referring to
FIG. 1B , a diagram of another embodiment of asystem 100B for monitoring medical devices is illustrated. Some or all of the elements shown inFIG. 1B may be the same as or similar to the elements inFIG. 1 . One or moremedical devices 10 are provided at apatient facility 20 for monitoring the medical condition and/or administering medical treatment to one or more patients.Patient facility 20 may comprise a critical care health service center (for example, including hospitals, clinics, assisted living centers and the like) servicing a number of patients, a home facility for servicing one or more patients, or a personal enclosure (for example, a backpack) that may be attached to or worn by an ambulatory patient. Examples of medical devices include, but are not limited to, include ventilators, urology devices, energy delivery devices, pulse oximeters, predictive thermometers, tympanic thermometers, patient electrodes, and food pumps. - Associated with each
medical device 10 is aninterface circuit 15 that includes a transceiver having one or more of a transmitter and/or a receiver for respectively transmitting and receiving signals in a facility-orientedwireless network 17 such as, for example, a Low-Rate Wireless Personal Area Networks or “LR-WPAN,” ZIGBEE network or another low-power personal area network such as a low power Bluetooth network, existing or presently under development or consideration. See, e.g., Houda Labiod et al., Wi-Fi, Bluetooth, Zigbee and WiMax, Springer 2010, which is incorporated by reference herein in its entirety. It should be understood thatinterface circuit 15 may be contained within or disposed external tomedical device 10. - Also provided within the
patient facility 20 are one ormore relay modules 30 a. Eachrelay module 30 a may include a first transceiver for receiving signals from and transmitting signals to theinterface circuits 15 in the facility-orientedwireless network 17, and further include a second transceiver for wirelessly transmitting signals to and receiving signals from anaccess point 40 via a wireless wide-area network (“WWAN”) 52. Suitable WWANs include, for example, networks based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated with the 2G, 3G, 3G Long Term Evolution, 4G, WiMAX cellular wireless standards of the International Telecommunication Union Radiocommunication Sector (ITU-R). See, e.g., Vijay Garg, Wireless Communications & Networking, Morgan Kaufmann 2007, which is incorporated by reference herein in its entirety. For compliance with HIPAA regulations, communications over each of the facility-oriented wireless network and WWAN are preferably conducted securely using, for example, a Secure Sockets Layer (SSL) protocol or a Transport Layer Security (TLS) protocol or other cryptographic protocols. - As illustrated in
FIG. 1B , theaccess point 40 includes an inbound server (“device integration server”) 41 that incorporates or otherwise has access to a transceiver for communicating with therelay modules 30 a over the WWAN. Medical device data, medical device identifier, and/or patient identifier received by thedevice integration server 41 over the WWAN is forwarded to a securedevice web server 45, which is configured for example to log the received data in association with identification information of the associated medical devices in adevice control database 44. “Medical device data” as generally used herein includes data from or about the medical device including, for example, medical device identification, medical device software, medical device settings or status information (including alarm information and/or alarm priority), patient identification information, patient personal identification number(s) “PIN(s)”, patient prescriptions, and/or patient medical and/or physiological data as is collected, produced and/or generated by at least one of the medical device and patient identification device; as well as wireless relay network information such as location or status information. - An
outbound web server 43 is configured, for example, to receive and qualify data retrieval requests submitted by one or more of firstremote monitoring devices 62 over a broad-band network 50 (for example, over the Internet), and/or secondremote monitoring devices outbound web server 43 requests associated medical device data or portions thereof to be retrieved from thedevice control database 44 via the securedevice web server 45, requests associated program data for constructing a display page from a metadata andapplications database 46, and requests associated patient data to be retrieved from apatient database 66 provided in a patientcare database node 60 over asecure link 54 via a securepatient web server 64. Thesecure link 54 can be implemented, for example as another WWAN using a SSL protocol or a TLS protocol. By separating medical device data and patient data to be respectively stored and managed byaccess point 40 and patientcare database node 60, certain economies of scale can be achieved by configuring theaccess point 40 to support a number of different patient care facilities each maintaining its own secure patientcare database node 60 to ensure privacy and control of its associated patient data. - In this case, for example, a third party service provider may host the
access point 40 to simultaneously support a number of distinct patient and/or home care facilities, thereby eliminating the need for each of these facilities to configure and maintain their own private access point facilities and providing hosting service to each facility that are likely far less than the costs of configuring and maintaining dedicated access point facilities by each care facility provider. It should be noted however thataccess point 40 and patientcare database node 60 may nevertheless be integrated into a single access point or node (for example, by a provider of a very large-scale facility provider monitoring many hundreds or thousands of patients). In either case, and as further described herein, theoutbound web server 43 provides an interface for authenticated clinicians or other monitoring personnel to retrieve patient and medical device data from each of the patientcare database node 60 and theaccess point 40 in a convenient and transparent manner such that the details of the configurations and operation of theaccess point 40 and patientcare database node 60 are of no consequence to the clinicians or other monitoring personnel. - The first
remote monitoring devices 67 are intended to be used by healthcare providers such for example, clinicians, physicians, technicians, nurses and other healthcare specialists monitoring patients associated withmedical devices 10. Suitable firstremote monitoring devices 67 may include, for example, desktop or laptop computers, tablet computer smart or other mobile phones, or other fixed or portable display devices. The secondremote monitoring devices remote monitoring devices - In addition, the
outbound web server 43 is depicted coupled to anetwork status server 80, which monitors the status of the facility-orientedwireless network 17 and associatedmedical devices 10. Thenetwork status server 80 is intended to provide status information concerning the facility-orientedwireless network 17 and associatedmedical devices 10 to theoutbound web server 43. Status information concerning the facility-orientedwireless network 17 includes, for example, signal strength, data rates, particular transmission time stamps between modules comprising thenetwork 17, number active relay modules in thenetwork 17, unique identifier number for a particular relay module of thenetwork 17. - The
network status server 80 may be implemented in hardware or software running on an application specific or general purpose processor or computer, as part of or separate from theoutbound web server 43. In addition, thenetwork status server 80 is shown coupled to theoutbound web server 43 for ease of illustration and discussion purposes only. Thenetwork status server 80 may be coupled to any component or network of theaccess point 40 or facility-orientedwireless network 17. - In
FIG. 1B , upon retrieving the requested medical device data and patient data from the patientcare database node 60, theoutbound web server 43 then proceeds to format and transmit the retrieved medical device data and patient data (and/or provide status information concerning the facility-orientedwireless network 17 and associated medical devices 10) as respective webpages or other formats for display by corresponding first and secondremote monitoring devices remote monitoring devices 67 for a clinician may differ from the less detailed information provided to and displayed on a secondremote monitoring devices 73 monitored by a parent or visiting nurse or other healthcare professional in a homecare environment. The status information concerning the facility-orientedwireless network 17 and associatedmedical devices 10 may advantageously be provided to first and/or secondremote monitoring devices - In addition, and as will be further described herein, the
device integration server 41 ofFIG. 1B is configured to transmit information and commands to therelay modules 30 a, for example, for transmitting medical device or alert messages to other WWAN-reachable nodes (for example, cellular telephones of emergency attendants), and/or transmitting operating commands and/or software or firmware updates to themedical devices 10 via theinterface circuits 15 and facility-orientedwireless network 17. - Further, in addition to monitoring and sending commands to medical devices, the
device integration server 41 may also be configured to receive and analyze patient metric information from the securepatient web server 64 via theoutbound web server 43 and securedevice web server 45, or by an alternate and direct secure data link to the securepatient web server 64 in order to prevent unsafe medical device usage based upon the patient metrics information. It is possible for a database (not depicted) accessible, for example, by thedevice integration server 41 and/ordevice web server 45, to store various safe and unsafe operating parameters and conditions for performing such analysis. In this manner, thedevice integration server 41 would function as an additional failsafe for preventing operating errors that could result in patient harm. - For example, in the case that the patient metric information indicates that an enteral feeding pump is associated with a neonate, the
device integration server 41 may act, for example, to (1) discard remote monitoring commands programming large bolus or excessive feeding rates that could be harmful to a young child; and (2) provide a warning message or other notification to the user of the likely unsafe usage condition that may result by implementation of such comment. Alternatively, if the patient metric information indicates that a specific feeding rate or bolus amount has been prescribed by a doctor or clinician, then the device integration server may act to discard remote monitoring commands programming a rate or bolus that deviates from the prescription. - As illustrated in
FIG. 1C , another embodiment of an architecture 100C may further include one or more wirelesspatient identification devices 17 in communication with one or more of therelay modules 30 a and/ormedical devices 10 in proximity to thepatient identification device 17 via theinterface circuits medical device 10, and access the facility-oriented wireless network via an associatedinterface circuit 15. The wirelesspatient identification devices 17 each receive patient identification data from a patient in proximity to thedevice 17 that uniquely identifies the patient using one of a variety of commercially-available sensors. For example, eachpatient identification device 17 may include a camera or other optical scanner and associated circuitry for sensing a barcode (for example, a UPC code or a QR matrix barcode) attached to or otherwise uniquely associated with a patient, such as a patient's wristband. Alternatively, eachpatient identification receiver 17 may include a radio-frequency identification (RFID) sensor and associated circuitry for sensing an RFID tag embedded in the patient wristband, or another commercially-available radio-frequency sensor capable of sensing an identification signal generated by a radio-frequency transmitter embedded in the patient wristband or otherwise provided as attached to or in proximity to the patient. Finally, eachdevice 17 may in addition or instead include a commercially-available biometric sensor and associated circuitry for patient identification (for example, including one or more of a fingerprint reader, a retinal scanner or a vein-pattern scanner). - For improved efficiencies in centralized monitoring of critical care and home care health service centers, it may be desirable to provide a single “off-site” centralized monitoring location for monitoring several geographically-dispersed critical care health service centers. The
architecture 100 ofFIG. 1A has asuitable access point 40 that includes aninbound web server 41 that incorporates or otherwise has access to a transceiver for communicating with therelay modules 30 a over the WWAN. Medical device data received by theinbound web server 41 over the WWAN is forwarded to a securedata storage server 42, which is configured for example to log the received data in association with identification information of the associated medical devices. Anoutbound web server 43 is configured, for example, to receive and qualify data retrieval requests submitted by one or more ofremote monitoring devices data storage server 42, and to format and transmit the retrieved medical device data to the one or moreremote monitoring devices access point 40 that enables the receipt, storage and retrieval of medical device data on a device display of the one or moreremote monitoring devices - As was previously described infra, “medical device data” and “data” as generally used herein means data from or about the medical device including, for example, medical device identification, medical device software, medical device settings or status information (including alarm information and/or alarm priority), patient identification information, patient personal identification number(s) “PIN(s)”, patient prescriptions, and/or patient medical and/or physiological data as is collected, produced and/or generated by at least one of the medical device and patient identification device.
- Thus, and as will be further described herein, the remote monitoring system of
FIG. 1C is capable of obtaining patient identification information to be associated with a particular medical device, securely transmitting the patient identification information with medical device identification information of the associated medical device to verify that the association of the patient with the medical device is authorized, and beginning operation of the medical device and monitoring of medical data generated by the medical device once authorization has been received. -
FIG. 1D illustrates abackpack 70 as may be suitable for use as a personal enclosure. Thebackpack 70 includes apouch 71 for housing arelay module 30 a, apouch 72 for housing a power and chargingcircuit 39 d for providing power to therelay module 30 a, and apower cord 39 e for supplying power from the power and chargingcircuit 39 d to therelay module 30 a. As depicted, the power and chargingcircuit 39 d includes abattery compartment 39 f, and a charging circuit (not shown) and apower cord 39 g for providing external commercial AC power to the power and chargingcircuit 39 d in order to charge batteries in thebattery compartment 39 f. One of ordinary skill in the art will readily appreciate that thebackpack 70 provides but one of a number of suitable backpack arrangements. -
FIG. 2A presents a block diagram that further illustrates components of the inventive architecture that are located within or otherwise associated with thepatient facility 20. InFIG. 2 , a number ofinterface circuits 15 andrelay modules network 16, which may be a wireless relay network ormesh network 16 within thepatient facility 20. It should be understood thatnetwork 16 is shown for illustration purposes only;other interface circuits 15 andrelay modules network 16 in thepatient facility 20. - In
FIG. 2 , theinterface circuits 15 andrelay modules FIG. 2 , thenetwork 16 is a self-configurable mesh network and can also be a self-healing mesh network, for example a ZIGBEE compliant-mesh network based on the IEEE 802.15.4 standard. However, thewireless relay network 16 or additional wireless relay networks in the patient facility may be organized according to a variety of other wireless local area network (WLAN) or WPAN formats including, for example, WiFi WLANs based on the IEEE 802.11 standard and BLUETOOTH WPANs based on the IEEE 802.15.1 standard. - Each of the
relay modules other relay modules wireless relay network 16.Relay modules 30 a also may include at least a second transceiver for communicating over the WWAN with theaccess point 40. As further described in greater detail with regard toFIG. 3A-3D , eachrelay module 30 and/or 30 a ofFIG. 2A includes afirst transceiver 31 for receiving signals from and transmitting signals to theinterface circuits 15 in one or more of the facility-oriented wireless networks.Relay module 30 a, as depicted inFIG. 3A for example, corresponds to relaymodules FIG. 2A and may include asecond transceiver 32 for wirelessly transmitting signals to and receiving signals from anaccess point 40 via a wireless wide-area network or “WWAN”. Suitable WWANs include, for example, networks based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated with the 2G, 3G, 3G Long Term Evolution, 4G, WiMAX cellular wireless standards of the International Telecommunication Union Radio communication Sector (ITU-R). Additional suitable WWANs include metropolitan area networks (MANs), campus area networks (CANs), local area networks (LANs), home area networks (HANs), personal area networks (PANs) and body area networks (BANs). It should be readily understood that therelay module 30 a may include additional transceivers for communicating with additional WWANs or additional facility-oriented wireless networks. - As shown in
FIG. 2B , the architecture may further include one or more wirelesspatient identification devices 17 in communication with one or more of therelay modules 30 a and/ormedical devices 10 in proximity to thepatient identification device 17 via theinterface circuits medical device 10, and access the facility-oriented wireless network via an associatedinterface circuit 15. The wirelesspatient identification devices 17 each receive patient identification data from a patient in proximity to thedevice 17 that uniquely identifies the patient using one of a variety of commercially-available sensors. For example, eachpatient identification device 17 may include a camera or other optical scanner and associated circuitry for sensing a barcode (for example, a UPC code or a QR matrix barcode) attached to or otherwise uniquely associated with a patient, such as a patient's wristband. Alternatively, eachpatient identification receiver 17 may include a radio-frequency identification (RFID) sensor and associated circuitry for sensing an RFID tag embedded in the patient wristband, or another commercially-available radio-frequency sensor capable of sensing an identification signal generated by a radio-frequency transmitter embedded in the patient wristband or otherwise provided as attached to or in proximity to the patient. Finally, eachdevice 17 may in addition or instead include a commercially-available biometric sensor and associated circuitry for patient identification (for example, including one or more of a fingerprint reader, a retinal scanner or a vein-pattern scanner). - In the illustrated
wireless relay network 16, each of theinterface circuits 15 includes a communications interface such as, for example, a wired or wireless communications interface, to an associatedmedical device 10. In addition, each of therelay modules other relay modules wireless relay network 16.Relay modules 30 a further include at least a second transceiver for communicating over the WWAN with theaccess point 40. - Each of the
transceivers mesh network 16 or the WWAN, and a received for receiving medical device data transmitted over one of themesh network 16 or the WWAN. - In accordance with IEEE 802.14.15, if the
network 16 is a ZIGBEE mesh network then there is little risk that communications from more than one medical device will contend for simultaneous access to thenetwork 16. Thenetwork 16 operates with a protocol in which a transmitting device checks for energy on a wireless bus component of thenetwork 16. If the bus is in use, the transmitting device waits a preselected amount of time before checking again, and only proceeds to transfer data when the energy level suggests that no other transmission is actively underway on the wireless bus. Nevertheless, for circumstances in which data packets transmitted by themedical devices 10 arrive at arelay module relay module 30. - The representative
ZIGBEE mesh network 16 provides the advantages of being self-configurable when one ormore interface circuits 15 and/orrelay modules more interface circuits 15 and/orrelay modules interface circuits 15 andrelay modules - Referring to
FIGS. 3A-3D , block diagrams illustrating components of embodiments of arelay module 30 a are shown. Therelay module 30 a ofFIG. 3A includes afirst transceiver 31 for wirelessly communicating withinterface circuits 15 andother relay modules WPAN network 16 ofFIG. 2A via anantenna 31 a. A transceiver as contemplated in this description may include a receiver and/or transmitter. Therelay module 30 a further includes asecond transceiver 32 for wirelessly communicating with theaccess point 40 over the WWAN via anantenna 32 a. Each of thetransceivers data processing circuit 33, which is configured to operate under the control of aprocessor 34 to accept data received by thetransceivers buffer element 35. One or more of thedata processing circuit 33 and/orcontroller 34 may also preferably include commercially available encryption circuitry for encrypting data to be sent by thetransceivers transceivers data processing circuit 33 and/orcontroller 34 may also preferably include commercially available encryption circuitry for encrypting data to be sent by thetransceivers transceivers - Each rely
module medical devices 10 over a period of time. It is possible that communications with some of themedical devices 10 are more time-critical with regard to patient safety than other. For example, consider communications withmedical devices 10 including each of a thermometer, a feeding pump and a ventilator. In this case, communications with the ventilator would likely be most time-critical among the three medical devices, while communications with the thermometer might be least time-critical among the three medical devices. - According to an embodiment, the
processor 34 is configured to determine whether the received medical device data indicates an emergency condition. This determination may be performed by theprocessor 34 in a number of ways. For example, theprocessor 34 may compare a condition code in the received medical device data to a condition table located inmemory 35 b that, for example, includes one or more of corresponding codes for the emergency condition, a description of the emergency condition, symptoms of the emergency condition, an estimate of a future time at which the emergency condition may become harmful (or emergency condition harm time), rankings and/or weights for the emergency condition, related emergency conditions, physiological data (e.g., vital signs, blood pressure, pulse oximetry, ECG, temperature, glucose levels, respiration rate, weight, etc.) indicative of the medical condition, and so on. One form of the possible table is described with reference toFIG. 5C , which will be discussed below. - Longer term data storage may preferably be provided by a
memory 35 b, for example storing instructions for thecontroller 34, data encryption/decryption software for one of more of thedata processing circuit 33 and/orcontroller 34, a patient identification directory identifying patients using each of themedical devices 10, and the like. - The data in the condition table may be initially entered and/or periodically refreshed from a master store or central repository of emergency condition data, for example, maintained by a designated
relay module access point 40 to each of therelay modules - According to one embodiment, rankings and/or weights may be applied by the
processor 34 to assign priority to different emergency conditions and/or perform a triage. For example, theprocessor 34 on receipt of multiple pieces of medical device data from different transceivers located in the same geographic location or a number of different geographic locations could determine that one medical device requires more immediate medical attention than the others. The priority analysis may also be performed, for example, using the emergency condition harm times. - For example, consider a data packet from a ventilator indicating disconnection from a comatose patient, with possible fatality. In this case, the ventilator should be assigned priority for transmitting to one or more of
remote monitoring devices FIG. 1 ), while data transmissions from thermometer and pump are discontinued until a response to the data packet transmitted by the ventilator is received from one of theremote monitoring devices - With reference to FIGS. 3 and 3A-3D, the
processor 34 may be configured to read the priority nibble from each received data packet, and to instruct thedata processing circuit 33 to place the data packet at a logical position in thebuffer element 35 based upon the priority designation. For example, critical-priority data packets (for example, data packets including an indication of a life threatening condition) for the ventilator would be positioned for first retrieval and transmission by therelay module - In addition, under circumstances where urgent commands may need to be transmitted by one of the
remote monitoring devices wireless relay module - In one embodiment, it is possible that the medical device data analyzed by the
processor 34 may not match any of the emergency conditions in the table and/or database because there is a misspelling and/or the medical condition is known by other names and/or represents a new medical condition. In this scenario, theprocessor 34 may, for example, perform a similarity analysis between the medical device data received and the symptoms and/or physiological data in the table and/or database (see, e.g., the disclosure herein supra in reference toFIG. 4D ). Based on this similarity analysis, theprocessor 34 may select, if any, the emergency condition that closely approximates the medical device data. Also, theprocessor 34 may in addition or alternatively log the medical device data to a database and/or file to allow administrators to determine why the emergency condition did not match an exact emergency condition in the table and/or database. - According to another embodiment, in order to make processing more efficient, the
processor 34 may compare the medical device data received at the transceiver to a list of prior determined emergency conditions and determine if there is a match or approximate match based on conventional interpolation and/or extrapolation techniques. In another embodiment, theprocessor 34 may also parse the medical device data to find a code which indicates that an emergency condition exists. Alternatively, theprocessor 34 may search a table and/or database located in a central repository to determine if the medical device data received indicates an emergency condition. In a another embodiment, theprocessor 34 in arelay module 30 and/or 30 a may query aprocessor 34 in another device (not the central repository) to determine if that other device knows whether the medical device data includes emergency condition data representing an emergency condition. - Once an emergency condition is determined and an alarm condition is activated by the
processor 34 of therelay module 30 a, a message may be transmitted to anaccess point 40 by therelay module 30 a (as shown inFIGS. 1 and 2 ), where the message is parsed to determine if alarms should be activated. The alarms could be anything from certain signals to care givers associated with the one or more medical devices which originated the alarms or alerting emergency responders. - A
monitoring unit 37 b (see e.g.FIG. 3B ) may also be associated with theprocessor 34, and responsible for identifying trends in emergency conditions. Themonitoring unit 37 b may store the emergency conditions data received, the date/time, an identity of the medical device which provided the data, the location of the medical device, and so on. Using the emergency condition data and/or additional medical device data, themonitoring unit 37 b may analyze the data for trends. This trend information may be used, for example, to determine whether one or more medical devices should be monitored. In addition, the trend information may be communicated to one or more devices (for example, PDAs, cell phones, pager, tablets, and the like) associated with relatives, friends, or caregivers and the like, who may use the knowledge to provide more efficient care. - Upon making a determination that an emergency condition exists, the
processor 34 may transmit a message to aphone device 39 a (discussed below and shown inFIG. 3D ) to activate it and also initiate a connection (e.g., phone call, etc.) with an emergency responder, such as 911, relatives/friends, care givers, or police authorities, and the like. When a call is received by the emergency responder, an automated voice message may be transmitted to the emergency responder as a prerecorded message stored in asignal generator 39 b (which is coupled to thephone device 39 a and the processor 34). Preferably, the prerecorded message identifies an associated medical condition along with the location of the medical device. Alternatively, thesignal generator 39 b may generate a dynamic speech signal that contains the determined emergency condition and other information - The prerecorded or dynamic message described above may in addition include other relevant patient data to further allow the emergency responders to assess the situation. For example, a patient table stored at the relay module (or alternatively/in addition at the centralized location) may identify care givers of the patient, other present conditions of the patient, previous medical history (e.g., allergic to certain drugs, such as morphine), and additional relevant patient information. Preferably, storage and use of the data in the patient table would conform to HIPAA requirements. As an alternative to these voice messages, the
signal generator 39 b may transmit medical condition information in the form of a text message to the emergency responder. For example, a text message may be sent over one of a Short Message Service (also known as “SMS”) and/or Multimedia Messaging Service (also known as “MMS”). - The
phone device 39 a above could be connected via one or more of wireless relay network or internet-accessible wireless network to initiate the call over a voice over internet protocol (VoIP) network, a Public Switched Telephone Network (PSTN), or the like. - The call to the emergency responders may be unsuccessful for a variety of reasons (for example, associated E911 circuits may be busy or otherwise unavailable). In this situation, the
processor 34 and/orphone device 39 a may detect a non-response from the E911 circuits and transmit a non-response message to one or more of the medical device, theaccess point 40, and/or one or more other designated devices to indicate the unsuccessful call. In addition, theprocessor 34 may periodically perform self-diagnostics on therelay module 30 a to confirm that each of the components of themodules 30 a that is used to detect the emergency condition and make the emergency call is operational Of course while asingle processor 34 is described,multiple processors 34 may be used in as appropriate. - The location of the medical device may be determined in a variety of ways well-known in the art. For example, location information may be provided to the
processor 34 from a global positioning system signal (“GPS”) that is received and interpreted by the medical device located in the medical device data received, a GPS chip in the location device 38 (see e.g.FIGS. 3B and 3C ), and/or location algorithm in thelocation device 38 discussed further below. In another embodiment, (e.g., location) as discussed above. - As discussed above, location information may be included in the medical condition data received by one of the
relay modules medical devices 10. Alternatively, the relay modules' location may also be determined using a conventional GPS receiver provided in thelocation device 38. In the latter case, at least an approximate or “zone” location of the one or more medical devices would be provided by the location information for therelay module 30 a. - As an alternative to GPS-based location, each of the
relay modules 30 a may for example transmit and receive signals via the internet-accessible wireless communication network to two or more cell towers, beacons or other radio devices at fixed, known locations in order to determine a location of the relay module according to known geometric methods. Such techniques for determining location (for example, including triangulation form cell towers) are well known in the art. See, e.g., Shu Wang et at Location-Based Technologies for Mobiles: Technologies and Standards, presentation at IEEE ICC Beijing 2008, IEEE, 2008, which is incorporated by reference herein in its entirety, for all purposes. In one embodiment, triangulation may be carried out using other relay modules positioned at fixed, known locations in a facility. - The
data processing circuit 33 may be further configured to retrieve data from the buffer element 35 a under the direction of theprocessor 34 and provide the retrieved data to a selected one of thetransceiver 31 ortransceiver 32 for transmission. In order to make a selection, theprocessor 34 is configured to communicate withrespective status modules transceivers transceivers -
FIG. 3B depicts a block diagram illustrating components of an alternative configuration for therelay module 30 a to the configuration ofrelay module 30 a depicted inFIG. 3A . Therelay module 30 a shown inFIG. 3B may be the same as or similar to therelay module 30 a shown inFIG. 3A . For example,transceivers data processing circuit 33 andprocessor 34 may be the same or similar in both figures. Therelay module 30 a includestransceiver 31 for wirelessly communicating with interface circuits 15 (shown inFIGS. 1 and 2 ) andother relay modules FIG. 2 ) viaantenna 31 a. Therelay module 30 a further includes atransceiver 32 for wirelessly communicating with theaccess point 40 over a particular WWAN (shown inFIG. 2 ) via anantenna 32 a. - Added components to the
relay module 30 a in 3B that are not present inFIG. 3A include anadditional transceiver 37, similar totransceiver 31, for wirelessly communicating viaantenna 37 a with interface circuits and other relay modules capable of communicating over a different WLAN or WPAN network than the network used bytransceiver 31. Correspondingly, therelay module 30 a inFIG. 3A includes yet afurther transceiver 38, similar totransceiver 32, for wirelessly communicating viaantenna 38 a with an access point over a different WWAN than the WWAN used bytransceiver 32. - Each of the
transceivers data processing circuit 33, which is configured to operate under the control ofprocessor 34 to accept data received by thetransceivers buffer element 35. In addition, thedata processing circuit 33 is further configured to retrieve data frombuffer element 35 under the direction ofprocessor 34 and provide the retrieved data to a selected one of thetransceivers more processors 34 configured to accept medical device data frommesh network 16 and to send the medical device data through the WWAN without storing the medical device data in therelay module 30 a. In order to make a selection, theprocessor 34 is configured to communicate withrespective status modules respective transceivers transceivers data processing circuit 3 andprocessor 34 may be implemented as separate integrated circuits or chip sets or their functions may be combined and implemented on single integrated circuits or chip set - The
processor 34 is also preferably in communication with an input/output circuit 36, which provides signals to one or more display elements of therelay module 30 a, for example, for indicating a start-up or current status of therelay module 30 a, including communication or connection status with the WLAN or WPAN networks and WWANs networks. Input/output circuit 36 may also be configured to provide signals to indicate an A/C power loss, and or to be responsive to signals provided by one or more input devices provided in proximity to the one or more display elements. - A control panel useable for the
module 30 a ofFIG. 3B may be substantially similar to thecontrol panel 380 depicted inFIG. 3H with correspondingmultiple indicators 380 e for indicating the status of the different WLAN or WPAN networks, and/ormultiple indicators 380 j for indicating the status of the different WWANs. Thecontrol panel 380 may include asynchronization switch 380 k (shown inFIG. 3I ), which may be used as further described herein to initiate a process for associating patient identification information with identification information of amedical device 10. - The
processor 34 is also preferably in communication with amemory 35 b for storing an operating program of theprocessor 34 and/or data stored by and/or retrieved by theprocessor 34. Theprocessor 34 is also in communication with an input/output circuit 36, which provides signals to one or more display elements (not shown) of therelay module 30 a, for example, for indicating a start-up or current status of therelay module 30 a, including communication or connection status with the WLAN orWPAN network 16 and WWAN. The input/output circuit 37 a may also be configured to provide signals to indicate an A/C power loss, and or to be responsive to signals provided by one or more input devices provided in proximity to the one or more display elements. The input/output circuit 37 a may also be connected to user buttons, dials or input mechanisms and devices ofmodule 30 a. The input/output circuit 37 a is further usable for providing alarm signals to indicate, for example, A/C power loss or loss of accessibility to the WWAN. -
Relay module 30 a may preferably be provided as a small physical enclosure with an integral power plug and power supply circuit, such that therelay module 30 a may be directly plugged into and supported by a conventional wall outlet providing commercial A/C power.Relay module 30 a may also preferably include a battery back-up circuit (not shown) to provide uninterrupted power in the event of A/C power outage, an A/C power outage of short duration as well as for ambulatory use of the relay module. Alternatively,relay module 30 a may be provided with rechargeable and/or replaceable battery power as a primary power source for ambulatory use. It should be readily understood by one skilled in the art thatprocessor 34 anddevices 37 a-39 b are shown as separate and distinct devices inFIG. 3 for illustration purposes only and that the functionality ofdevices - Battery back-up may also be advantageous, for example, for using the
relay module 30 a in an ambulatory mode that enables the patient to move within and potentially at a distance from thefacility 20, for example, with amedical device 10 that is a portable feeding device. In this configuration, for example, themedical device 10, theinterface circuit 15 andrelay module 30 may be conveniently carried in a mobile platform such as any patient-wearable backpack, vehicle, or other transport vessel. - The
relay module 30 a configuration ofFIG. 3B may be operated in a substantially similar manner to therelay module 30 a configuration ofFIG. 3A employing, for example, corresponding methods of operation described below incorporating the use of a plurality of WWANs or WLAN or WPAN networks. However, in performing methods of operation for therelay module 30 a ofFIG. 3A , the depicted steps described with respect the flow diagrams below may be employed with the further transceiver selections of theadditional transceivers -
FIG. 3C depicts a block diagram of an embodiment of arelay module 30 a that enables voice communication and interaction between a caregiver proximate therelay module 30 a and a clinician or technician at the remote monitoring device. The identical components in theFIGS. 3A , 3B, and 3C are like numbered including, for example, the first andsecond transceivers data processing circuit 33,processor 34 and data buffer 35 a. Therelay module 30 a ofFIG. 3C further includes aspeech codec 105 connected to amicrophone 110 and thespeaker 37. - The particular type or brand of speech codec selected for the
codec 105 is not necessarily critical as long as it is compatible and/or interoperable with the speech codec of the corresponding remote monitoring device. Suitable codecs for thespeech codec 105 include, for example, fixed rate codecs such as voice-over-Internet-protocol (VoIP) codecs in compliance with the ITU standard H.323 recommended protocol. Speech coding standards in accordance with VoIP include ITU standards G.711 (PCM), G.723.1 (MP-MLQ & ACELP), G.729 (CSACELP), GSM-FR; or Adaptable Multi-Rate (AMR) standards such the European Telecommunication Standard Institute (ETSI) and Third Generation Partnership Project (3GPP) IMT-2000. Alternatively, it is possible to employ codecs useable for transmitting encoded speech signals over a mobile telephone network. - The configuration of the
relay module 30 a ofFIG. 3C enables a patient or caregiver proximate therelay module 30 a to engage in a conversation with a user (for example, a clinician or technician) proximate the remote monitoring device using, for example, a VoIP or VoIP-like exchange of encoded speech signals. Specifically, in operation of therelay module 30 a ofFIG. 3C , speech uttered by the caregiver proximate therelay module 30 a is converted bymicrophone 110 to analog speech signals that are digitized and encoded by thecodec 105. Theprocessor 34 then transmits the corresponding digitized and encoded speech signals produced by thecodec 105 directly over the wireless internet-accessible network alone or in combination with the wireless relay module network to the remote monitoring device. The remote monitoring device then decodes the digitized and encoded speech signals and converts such decoded signals into analog signals supplied to a speaker to generate the speech sounds heard by the clinician or technician. - Conversely, digitized and encoded speech signals representing speech of the clinician or technician transmitted by the remote monitoring device are received by the
module 30 a wherein theprocessor 34 supplies such signals to thecodec 105 which decodes the signals and converts the decoded signals to analog signals that are supplied to thespeaker 37. - Although the implementation of the
codec 105 andmicrophone 110 has been described with regard to exchanging VoIP signals, it should be readily understood that any method of communicating speech signals may be employed including, for example, utilizing a cellular or mobile telephone codec or modem forcodec 105 to transmit and receive speech signals, e.g., CDMA- or GSM-compliant speech signals over a mobile telephone network. Further, it is possible for thecodec 105 to be implemented as hardware and/or software in a single chip, chip set or as part of theprocessor 34. - In an alternative embodiment, it is possible to implement speech detection and/or recognition functionality into the
codec 105 orprocessor 34 to enable therelay module 30 a to identify specific command words to initiate the carrying out of a corresponding responsive/interactive action. For example, such speech recognition functionality may be triggered by processing signals supplied by themicrophone 110 to identify terms “Help”, “Emergency” or “Call 911.” Upon detecting such trigger terms, theprocessor 34 initiates the process of dialing an emergency response service such as “911,” with or without using synthesized or recorded speech to request confirmation from the caregiver to place such a call and initiate communication between the caregiver and the emergency response service. The dialing may be performed by hardware or software implemented in theprocessor 34,codec 105 or other components coupled to theprocessor 34. The speech recognition functionality may alternatively or additionally transmit a text message or other text or audio-visual correspondence to the emergency response service based upon identified spoken works or commands by the caregiver. - It should be readily understood that the
relay module 30 a ofFIG. 3C is shown with thecodec 105 andmicrophone 110 in combination with thedisplay 37 for illustration purposes only. It is possible to implement a relay module with the codec without a display or a relay module with a display and not a codec (as depicted inFIG. 3 ). - Referring also to
FIG. 3D , alternatively or in addition, theprocessor 34 may instruct thelocation device 39 a to obtain location information of the wireless relay module, and compare this to location information obtained from the medical device and/or by other means (for example, by using a conventional triangulation algorithm measuring transit times of signals transmitted by themedical device 10 to severalwireless relay modules 30 a with known locations) in order to determine whether the medical device 10 (for example, in the possession of an ambulatory patient) has moved outside of an area for safe communications with therelay module 30 a (i.e., is outside the “geo-fence”). - In this case, the
processor 34 may preferably transmit a “lost device” alarm message via at least one of thetransceivers access point 40 and/or to any other Internet-accessible and/or wireless network-accessible recipients. In addition, in order to conserve power and or bandwidth of thewireless relay module 30 a, theprocessor 34 may suspend all other measurements made to determine communications health with the medical device 10 (for example, heartbeat requests and signal quality measurements) until it has been determined that themedical device 10 is back within the geo-fence. - One of skill in the art will also readily understand that the elements used by the
wireless relay module 30 a to determine whether communications with a particularmedical device 10 can be transmitted and/or received over the wireless relay network may be replicated in themedical device 10, such that themedical device 10 may determine whether communications with a particular wireless relay module 301 can be carried out over the wireless relay network, and to issue a visual and/or audible alarm at themedical device 10 when communications with thewireless relay module 30 a cannot be carried out. This feature would be particularly useful, for example, to a patient in an ambulatory setting as a means for learning that he/she has exited the geo-fence. - It is possible for the
relay module 30 to have a substantially similar configuration as therelay module 30 a but excluding the transceiver for communicating over the WWAN with theaccess point 40. - The
relay module 30 a ofFIG. 3D further preferably includes alocation device 39 a including, for example, a conventional global positioning system signal (“GPS”) chip for determining a GPS location of therelay module 30 a. In addition, therelay module 30 a ofFIG. 3 includes apower monitoring device 39 b for monitoring a voltage level of a external AC power source (not shown) providing power to therelay module 30 a, and asecondary power source 39 c comprising for example non-rechargeable lead-acid batteries, rechargeable lithium-ion batteries or other conventional rechargeable energy storage devices for providing a secondary power source to therelay module 30 a, or a primary power source in the event of a failure of the external AC power source. Alternatively and/or additionally, the power monitoring device may for example monitor a sensor for detecting a disconnection of the external AC power supply by mechanical means (for example, using a spring-loaded push-pin switch that disengages when an associated AC plug of therelay module - The
processor 34 may be a single dedicated processor, a single shared processor, or a plurality of individual processors, some of which may be shared. Moreover, explicit use of the term “processor” or “controller” should not be construed to refer exclusively to hardware capable of executing software, and may implicitly include, without limitation, digital signal processor (DSP) hardware, network processor, application specific integrated circuit (ASIC), field programmable gate array (FPGA), read-only memory (ROM) for storing software, random access memory (RAM), and non-volatile storage. Other hardware, conventional and/or custom, may also be implemented in one or more configurations. - In an embodiment, the medical device data received by one of the
transceivers medical devices 10 may include, for example, information indicative of an alarm condition. In addition to the types of medical device data previously provided herein, the received information may include, for example, at least one of medical device description, medical device identification (e.g., unique device number), medical device location (e.g., device/patient room number), patient identification (e.g., patient identification number), alarm type, alarm error code, and/or alarm severity. Methods in which an alarm condition may be determined include predetermined codes, look-up table(s) and or algorithms for identifying alarm conditions based on processing the received information. - In addition to information indicative of an alarm condition contained in the medical device data received from one or more
medical devices 10, it is also possible to receive the alarm indication from another relay module and/or as a result of an indication internally generated in therelay module 30 a itself. For example, therelay module 30 a could receive such information from another relay module when the other relay module malfunctions. In this way, it is assured that therelay module 30 a provides the necessary redundancy for another relay module. Additionally, it is further possible for such information to be transmitted to therelay module 30 a from the other relay module when the information is indicative of a high severity alarm condition, e.g., a significant medical emergency, such as emergency 911. Such redundancy will enable a sufficient number of caregivers to be notified of the emergency condition through multiple relay modules to facilitate a prompt response. - In another implementation, the
relay module 30 a may be notified if another relay module is experiencing numerous alert conditions associated with other modules or medical devices and communicate the alarm information to caregivers. If this occurs, the other relay module may, for example, divert the information indicative of an alarm to therelay module 30 a using the WLAN orWPAN 16. Theparticular relay module 30 a selected to receive the alarm information from the other relay module may be based on many factors such as, for example, relay module location, relay module availability, number of caregivers at a given location and/or floor, defined master/slave relationships among therelay modules 30 a, and the like. - In another embodiment, it is possible that the information indicative of an alarm condition is received at the
relay module 30 a, but for some reason, such as a malfunction and/or data transmission bottleneck, the alarm is not communicated audibly and/or visually to the caregivers. To prevent this occurrence, therelay module 30 a can be configured to transmit a message back to the one or moremedical devices 10 confirming that an alarm was presented to the caregiver. If the message is not received within a predetermined amount of time by the one or moremedical devices 10, then one or moremedical devices 10 may attempt to communicate with other relay modules to ensure the alarm is addressed. Similar factors, e.g., location, availability, number of caregivers, etc., as described above may be used to select the other relay module(s) for providing alerts for the one or more medical devices. - In a further embodiment, the
relay module 30 a may internally generate its own alarm and/or device signals in relation to therelay module 30 a, for example, the current status of therelay module 30 a (e.g., external AC power loss) and/or current communication or connection status (e.g., status with the WLAN orWPAN 16 or WWAN). - After identifying that received data is indicative of an alarm condition, the
processor 34 may transmit a message containing alarm information including, for example, at least one of medical device description, medical device identification, medical device location, patient identification, alarm type, alarm error code, and/or alarm severity, to adisplay 36 attached to therelay module 30 a. In this way, an alarm alert may mirror an alarm alert emitted by the originating medical device. The particular type of display chosen for use with therelay module 30 a is not necessarily critical. Accordingly, it is possible fordisplay 36 to be a monochrome or color dot matrix, LCD, LED or other display device. Alternatively and/or in addition, theprocessor 34 may transmit the message containing alarm information to amedical device 10 via thetransceiver 31, and/or to theaccess point 40 via thetransceiver 32. - In addition, the
processor 34 may also employ aspeaker 37, such as a loudspeaker, coupled to therelay module 30 a to emit an audible alert indicative of the alarm condition. It is possible for the audible alert based on the alarm condition to be at least one of volume, pitch, tone, type, audible sequence or duty cycle, or recorded sound to indicate the type, urgency or severity of the alarm condition. It is advantageous for an alarm indicating a life-threatening emergency to be more attention-getting, e.g., loud siren, than alarms for less significant conditions that may be addressed by, for example, beeps or calmer tones. - It is also possible for the emitted audible alerts to be spoken words, commands, tones or other sounds. In this way, if the alert emitted from the one or more
medical devices 10 is not directly addressed, then therelay module 30 a alarm sounds should alert any caregivers located outside of the patient's room. Theprocessor 34 may also cause a signal to be transmitted by, for example, thefirst transceiver 31 over the WLAN orWPAN 16 to one or more devices including, for example, PDAs, cell phones, pagers, and tablets. In addition, the alarm information may be transmitted over the WWAN using thesecond transceiver 32 to the one or more devices. - In addition, an input/
output circuit 38 may be electrically connected to, for example, user-actuatable buttons, dials or input mechanisms associated with therelay module 30 a. Using these buttons, dials, or input mechanisms, the audible alerts produced by therelay module 30 a may be muted, i.e., disabled, or volumes substantially reduced. The muting or volume reduction may alternatively be in response to therelay module 30 a receiving a signal from the originating medical device transmitting the information, such as in response to a caregiver acknowledging that the emergency condition is being addressed by entering the proper inputs to the originating medical device. Such acknowledgements may preferably take the form of corresponding acknowledgement codes each associated with a particular alarm condition. Even with the audible alerts muted or otherwise disabled, it may be advantageous to continue displaying the alerts on thedisplay 36. Thedisplay 36 may continue to display alerts until likewise the alert condition is extinguished or confirmation from a caregiver at the originating medical device or therelay module 30 a is received. - In accordance with another embodiment, the
processor 34 may control thedisplay 36 to alternate or cycle displayed information intermittently with information from a single medical device or multiple medical devices. For instance, theprocessor 34 may cause a visual alarm alert indicating an alarm condition (based upon a portion of medical device data) from a first medical device to be shown on thedisplay 36, for example, for a time period of between 2 to 30 seconds before displaying information for another medical device. The visual alarm alerts corresponding to higher severity alarm conditions may be shown for longer durations than alerts of for lower severity alarm conditions. Also, the type of alarm condition may further dictate the display length of time for visual alarm alerts or other information from a particular medical device. Additionally, theprocessor 34 may also or alternatively display on thedisplay 36 the number of medical devices communicating information indicative of alarm conditions to therelay module 30 a and/or show a description of such devices. - In addition, it is possible for the
display 36 to display the alerts in different foreground or backlight colors, such as green backlight for normal operation or red backlight for alarm situations, to use color representing the respective severities of alarm conditions. It is further possible for the colors to correspond to specific alarm conditions (e.g., low glucose level) and/or general groups of conditions (e.g., heart conditions). The display may alternatively or in addition incorporate, for example, a multi-colored light-emitting diode array to display the status of the medical devices. - The
display 36 may also be used to display non-alarm related information including, for example, internal power supply charge level or status, software version, software download status, relay module network status, handshake status and signal strength of the received WLAN orWPAN 16, and/or WWAN signals. Displayed information for the strength of respective monitored signals and other may be displayed alone or in a combination with the alerts. The signal strength information could be depicted by, for example, by sequential display segments such as, for example, more than one series of different sized light-emitting diodes (LEDs) that would advantageously enable simultaneous display of at least two different network signal strengths for viewing by the caregiver. - As with the display of externally generated information indicative of alarm conditions, it is possible for alerts for internally generated information indicative of an alarm condition by the
relay module 30 a to also be displayed bydisplay 36. For example, alerts representative of information during start-up or current status of therelay module 30 a and/or current communication or connection status with the WLAN orWPAN 16 and WWAN may be shown on thedisplay elements 36. In another embodiment, theprocessor 34 may cause thedisplay 36 to include information associated with the charge level of a battery (not shown) contained within therelay module 30 a, whether by remaining minutes and/or hours of life or other graphical depictions. -
Relay module 30 a may preferably be provided as a small physical enclosure (not shown) optionally provided with an integral power plug and power supply circuit, such that therelay module 30 a may be directly plugged into and supported by a conventional wall outlet providing commercial A/C power.Relay module 30 a may also preferably include a battery back-up circuit (not shown) to provide uninterrupted power in the event of A/C power outage of short duration. Battery back-up may also be advantageous, for example, for using therelay module 30 a in an ambulatory mode that enables the patient to move within and potentially at a distance from thefacility 20, for example, with amedical device 10 that is a portable feeding device. In this configuration, for example, themedical device 10, theinterface circuit 15 andrelay module 30 may be conveniently carried in a patient-wearable backpack. - Various embodiments of a
relay device FIGS. 3A-3D . However, therelay device relay device 30 30 a may include some or all of the components or features described with respect to any or all ofFIGS. 3A , 3B, 3C, and 3D. Arelay device -
FIGS. 3E-3G respectively illustrate top, front and side views of aconfiguration 370 for therelay module 30 a.Configuration 370 includes ahousing 370 a, which is shown inFIGS. 3E-3H configured essentially as a rectangular box or prism. It should however be noted that the housing may alternatively be configured in any of a variety of three-dimensional shapes having a sufficient interior volume for housing the associated circuits, having asufficient area 370 c on afront panel 370 b of thehousing 370 a for locating a control panel 380 (as further illustrated inFIG. 3H ), and having a sufficient area on arear panel 370 d for providing areceptacle support 370 e andpower plug 370 f for supportably plugging themodule configuration 370 into a conventional power outlet. Thepower plug 370 f may also be provided in a modular and replaceably removable configuration enabling power plugs 370 f to be configured according to a variety of international standards to be easily provided to theconfiguration 370. -
FIG. 3H illustrates acontrol panel 380 ofmodule configuration 370 that may constitute a portion of the one or more display elements. Thecontrol panel 380 preferably includes, for example, apower switch 380 a for powering and/or de-powering themodule configuration 370 after it has been plugged into the conventional wall outlet or equipped with a charged battery back-up subsystem. In addition, thecontrol panel 380 preferably includes analarm switch 380 b which allows a user to mute and/or de-mute an audible alarm (for example, a conventional buzzer, not shown) which is coupled to an alarm circuit (not shown) that is configured to issue an alarm when A/C power to themodule configuration 370 has been interrupted. Thecontrol panel 380 also includes an A/C power indicator 380 c which may preferably be provided as one or more light-emitting diode (LED) indicator segments which are activated when A/C power has been provided to themodule configuration 370. Optionally, theindicator 380 c may be intermittently activated when A/C power is lost (for example, by means of back-up battery power) to signal the loss of A/C power. - The
control panel 380 ofFIG. 3H also includes abattery indicator 380 d to indicate a status of the subsystem battery back-up circuit. For example, and as illustrated inFIG. 3H , thebattery indicator 380 d may preferably includeindicator segments 380 h which may be selectively activated to indicate a capacity of the back-up battery.Indicator segments 380 h may also be preferably provided as LED segments, or as one or more multicolor LEDs for which color is indicative of capacity. If implemented asindividual segments 380 h, thesegments 380 h may, for example, be activated to indicate that the back-up battery is fully charged, and ones of thesegments 380 h may be progressively deactivated (for example, proceeding downwardly from an uppermost one of thesegments 380 h) as battery power is drawn down. In the event that remaining battery power is insufficient to operate themodule configuration 370, each of thesegments 380 h may be deactivated. Alternatively, theindicator segments 380 h may be provided as one or more multicolor LED segments (for example, red, yellow, and green). In operation, it is possible for allLED segments 380 h to be illuminated as green indicating a full backup battery charge and then progressively, sequentially deactivated as battery charge levels are reduced to a first low power threshold. Then, theLED segments 380 h may progressively, sequentially be illuminated red as power is further diminished so that all LED segments are illuminated red when battery power is no longer sufficient to power themodule configuration 370. - As further illustrated in
FIG. 3H , thecontrol panel 380 may further include a relaymodule network indicator 380 e to indicate a status of the portion of the WLAN orWPAN network 16. Similarly to the A/C power indicator 380 c, used to provide communications between the WLAN/WPANnetwork relay module 30 a and its associatedinterface circuits 15 andmedical devices 10. This relay modulenetwork status indicator 380 e is preferably backlit with one or more multi-color LEDs to indicate a relative “health” of the associated portion of the network (for example, using “green” to indicate a healthy (e.g., level of accessibility) network, “yellow” to indicate a network having one or more issues but still operable, and “red” to indicate a network that is inoperative and indicating an alarm condition). Optionally, theindicator element 380 e may be intermittently or periodically activated when the WLAN/WPAN network portion of the WLAN orWPAN network 16 that provides communications between therelay module 30 a and its associatedinterface circuits 15 andmedical devices 10 has relatively poor communications between these devices, or is unavailable to support such communications. In addition, an audible alarm (for example, a conventional buzzer, bell or audible sound generator and associated loudspeaker, not shown) may be initiated under such conditions. -
Indicator elements 380 f may also be provided, for example, in an array to indicate the status is active or accessible, and either de-activated or intermittently activated when the WLAN/WPAN network status is inactive or inaccessible. The indicator elements may preferably be provided withmulti-color LEDs 380 g capable, for example, of illuminating a green segment for a healthy a communications path, a yellow segment for operative communication path with issues, and a red segment to indicate a communications path that is inoperative. Alternatively, individual red, yellow and green LEDS may be used in place of the multi-color LEDs. Alternatively or in addition, one or more ofelements - A
WWAN indicator 380 j may preferably be provided to indicate a status of access to the WWAN network, (using, for example, “green” to indicate a healthy network, “yellow” to indicate a network having one or more issues but still operable, and “red” to indicate a network that is inoperative and indicating an alarm condition). As depicted inFIG. 3H , theindicator 380 j includesindicator elements indicator element 380 f may be configured with a green LED indicator element that is activated when the WWAN network status is active or accessible, and theindicator 380 g may be configured with a red LED indicator element that is activated when the WWAN network is inactive or inaccessible (for example, may preferably be backlit with one or more multicolor LEDs. Optionally, theindicator element 380 j may be intermittently or periodically activated, for example, when a signal strength of the WWAN network available to themodule configuration 370 is insufficient to support communications. Optionally, theindicator element 380 f may be intermittently too low to support communications, or is unavailable to support such communications. In addition, the audible alarm may be initiated under such conditions. - Finally, the control panel may include a WLAN/WPAN indicator 380 i to indicate an overall health of the entire WLAN/WPAN (or at least of the portion available to provide an alternate path for the
relay module 30 a to the WWAN network). The WLAN/WPAN indicator 380 i may preferably indicate an overall status of the WLAN/WPAN (using “green” to indicate a healthy network, “yellow” to indicate a network having one or more issues but still operable, and “red” to indicate a network that is inoperative and indicating an alarm condition). As depicted inFIG. 3H , the indicator 380 i may preferably be backlit with one or more multicolor LEDs. Optionally, the indicator element 380 i may be intermittently or periodically activated when the signal strength of the WWANWLAN network is marginally sufficient, too low, or insufficient to support communications. In addition, the audible alarm may be initiated under such conditions. - As previously indicated, the
alarm switch 380 b may be configured to allow a user to mute and/or un-mute one or more of the audible alarms entirely, or for a specified time period (similarly to a conventional clock alarm “snooze function) indicators of themodule configuration 370 such asindicators 380 a-380 j may preferably be electrically connected to the input-output circuit 36 depicted inFIG. 3A , for example. - In addition, it is possible for the
wireless relay module 30 a to employ, for example, hardware or software to implement an International Telecommunication Standardization Sector (ITU-T) H.323 codec to enable voice and/or video communications between a caregiver located proximate the wireless relay module and a remote technician. In such an embodiment, the wireless relaymodule control panel 38 may optionally include microphone and speaker elements (not shown) for enabling themodule configuration 37 to be operated in a voice communication mode to allow for voice communication, for example, between an operator, caregiver, and/or a help desk technician in event of a trouble condition reported by one of themedical devices 10. Alternatively or in addition, thecontrol panel 380 may include one or more of a camera element (not shown) and/or a display element (not shown) coupled to the codec to be operated in a visual communication mode. For example, the camera element may be used to transfer images from displays of one or moremedical devices 10 to one of theremote monitoring devices FIG. 1 . -
FIG. 4A presents a flow diagram 400 illustrating a method of operation for the architecture according toFIG. 1A andrelay module medical device 10 to theaccess point 40. First, atstep 402 of themethod 400, the medical device data is received at a first one of therelay modules 30 a from one of theinterface circuits 15 and/orother relay modules wireless relay network 16. Atstep 404, theprocessor 34 of the onerelay module 30 a determines whether the WWAN is accessible by thatrelay module 30 a. - The determination of
step 404 may be carried out in a variety of manners. For example, theprocessor 34 may interrogate thestatus module 32 b of thetransceiver 32 at the time of or after the receipt of the medical device data to determine a status parameter indicative of access for thetransceiver 32 to the WWAN (for example, access fortransceiver 37 to the WWAN may be determined as the result of thetransceiver 32 detecting an access signal of the WWAN having adequate signal strength for maintaining data communication at a desired quality level). Alternatively, theprocessor 34 may interrogate thestatus module 32 b at a different time including, for example, at system start-up and/or periodically (for example, hourly), and maintain a status indicator such as in thebuffer 35 or another storage element to be retrieved at the time of receipt of the medical device data. As yet another alternative, therelay module network 16. For example,relay modules 30 a in thenetwork 16 may be assigned a data routing assignments by a controller or controlling relay module or modules which may be preselected from among therelay modules relay module 30 that does not possess WWAN access capability shall have a fixed status of “WWAN inaccessible.” - If, as provided for in
step 404, thestatus module 32 b indicates that the WWAN is accessible by thetransceiver 32, theprocessor 34 will proceed to step 406 to instruct thedata processing circuit 33 of the one relay module 30 (or 30 a) to retrieve the medical device data from thebuffer 35 or 35 a (as necessary) and forward the medical device data to thetransceiver 32 for transmission to theaccess point 40 over the WWAN. - Alternatively, in
step 404, thestatus module 32 b may indicate that the WWAN is not accessible by thetransceiver 32. For example, if the onerelay module 30 a is located on a basement floor of the building in an area that is substantially shielded with respect to WWAN signals, the WWAN may not be accessible to the onerelay module 30 a. In this event, atstep 408, theprocessor 34 determines whether asecond relay module 30 a is accessible via the WLAN or WPAN. Again, this determination may be made in a variety of manners including by instructing thetransceiver 31 to send a handshake signal transmission directed to asecond relay module 30 a and to listen for a reply, or by retrieving a stored status indicator for thesecond relay module 30 a. - If the
second relay module 30 a is accessible, then theprocessor 34 instructs thedata processing circuit 33 of the onerelay module 30 a to retrieve the medical device data from thebuffer 35 or 35 a (as necessary) and forward the medical device data to thetransceiver 31 for transmission to thesecond relay module 30 a over the WLAN or WPAN atstep 410. Alternatively, if thesecond relay module 30 a is inaccessible instep 408, this portion of theprocess 400 may preferably be repeated to search for afurther relay module 30 a that is accessible. Alternatively, or in the event that noother relay module 30 a is available, theprocessor 34 of the onerelay module 30 a may preferably issue an alarm notification atstep 412. Such an alarm notification may, for example, include one or more of local visual and audio alarms as directed byprocessor 34 via the input/output circuit 36 of the onerelay module 30 a, alarm messages directed by theprocessor 34 to another accessible WPAN, WLAN or WWAN via one or more of thetransceivers inbound web server 41 of theaccess point 40. These notifications may be displayed or otherwise executed after a specified time period has been exceeded, for example, during which a handshake signal of therelay module 30 a is due but not received, at theinbound web server 41 from thewireless relay module 30 a. - For example,
FIG. 4B depicts a method ofoperation 400 b for an embodiment ofrelay module 30 a.Methods method 400 b substitutes steps 404 b and 406 b forsteps method 400. These substituted steps 404 b and 406 b are similar to thecorresponding steps additional transceivers FIG. 3B , for example. - After medical device data is received over a WLAN or PLAN network by
transceivers step 402, therelay module 30 a determines if any WWAN is accessible bytransceivers 32 or 38 (e.g. in step 404 b). If no WWAN is accessible themethod 400 b then continues to step 408 and performs substantially the same operations as described with respect tosteps FIG. 4 . Otherwise, if a WWAN is determined accessible in step 404 b, themethod 400 b proceeds to step 406 b. In step 406 b, themethod 400 b transmits the medical data over the available WWAN viatransceiver - Moreover, to the extent to that in step 404 b there are more than one WWAN accessible, then in step 406 b the
controller 33 may determine which one of the accessible WWANs the medical data should be transmitted over by either oftransceivers - Referring now to
FIG. 4C andFIG. 4D , As previously described with reference to thecontrol panel 38 of therelay module configuration 370 ofFIGS. 3E-3H , therelay module 30 a is preferably provided with a relaymodule network indicator 380 e to indicate a status of the portion of the WLAN orWPAN network 16 ofFIGS. 1 , 2 used to provide communications between therelay module 30 a and its associatedinterface circuits 15 andmedical devices 10.FIG. 4C presents a flow diagram illustrating a method ofoperation 420 for generating status information that may be used bynetwork indicator 380 e ofFIG. 3H . - At
steps FIG. 4C , theprocessor 34 is instructed to retrieve a current module performance measure or history, for example, from thememory 35 b for eachmedical device 15 accessible to therelay module 30 a via the WLAN/WPAN network 16. Performance measures may, for example, include a measured signal strength, noise, bit rate, error rate, packet discard rate, occupancy, availability and the like as are conventionally measured for WLAN/WPAN networks. See, e.g., Pinto, WMM—Wireless Mesh Monitoring, Technical Report, INESC-ID, 2009, which is incorporated by reference in its entirety herein for all purposes. Measured performance may in addition take certain environmental information into account. For example, relatively elevated ambient operating temperature of therelay module 30 a, and the like, which may lead to possible corruption of data from the medical device caused by such elevated ambient temperature. - At
step 423, if the performance history is not sufficiently current (for example, as indicated by timestamp data) and/or missing, theprocessor 34 atstep 424 employs conventional means in the transceiver 31 (for example, viastatus module 31 b) to obtain current performance measures by transmitting a request to and receiving current performance data from theinterface circuit 15 of the associatedmedical device 10, and preferably stores the current performance measures as part of the performance history in thememory 35 b. Currency may preferably be determined according to system performance, regulatory and/or other requirements for individual performance measures in prescribed time intervals (for example, for an interval older than 5 seconds, older than 1 minute, older than the most recent each hour, or the like), which may be stored in thememory 35 b for retrieval and reference by theprocessor 34. - After determining at
steps relay module 30 a, theprocessor 34 atstep 426 determines a current module status as a function of the current performance data and the performance history. For example, if the current performance data indicate that eachmedical device 10 is currently accessible to therelay module 30 a, the module performance history indicates that the medical devices have been consistently accessible to therelay module 30 a for a predetermined time (for example, over a period of several hours), and throughput and/or occupancy are within predetermined limits, theprocessor 34 may determine that thewireless relay network 16 is “healthy” (indicated, for example, atstep 427 by illuminating a green LED segment of indicator 38 e). - If the current performance data indicate that each
medical device 10 is currently accessible to therelay module 30 a, but one or more of thedevices 10 have a recent performance history where one or more of throughput and/or occupancy were outside of the predetermined limits, theprocessor 34 may determine a status of “partially accessible” (indicated, for example, atstep 427 by illuminating a yellow LED segment of indicator 38 e). If one or more of themedical devices 10 are presently inaccessible to therelay module 30 a, theprocessor 34 may determine a status of “inaccessible” (indicated, for example, atstep 427 by illuminating a red LED segment ofindicator 380 e). Atstep 428, it may be determined by theprocessor 34 for example in view of “partially accessible” or “inaccessible” statuses that an alarm condition has been generated, causing theprocessor 34 to present an alarm (for example, by causing the yellow or red LED segments to be illuminated in a blinking fashion, and/or by providing one or more audible alarms as previously described. As an alternative to displaying display status information atstep 427, theprocessor 34 may cause thetransceiver 31 to transmit the status information to one or more of themedical devices 10, or may cause thetransceiver 32 to transmit the status information to a device in communication with the WWAN. - With further reference to
FIG. 1 ,FIG. 3 , andFIGS. 3A-3H ;FIG. 4D presents a flow diagram illustrating a method ofoperation 440 for generating the status information indicated byWWAN indicator 380 j ofFIG. 3H . Atsteps FIG. 4D , theprocessor 34 retrieves a WWAN performance history, for example, from thememory 35 b as to the status of theWWAN network 44. Performance measures may, for example, include a measured signal strength, noise, bit rate, error rate, call set up time, dropped call rate, occupancy and network availability and the like as are conventionally measured for WWAN/cellular networks for example, via thestatus module 32 b. (See, e.g., Mike P. Wittie, et al., MIST: Cellular Data Network Measurement for Mobile Applications, Broadband Communications, Networks and Systems Fourth International Conference, IEEE, 2007, which is incorporated by reference in its entirety herein for all purposes). Atstep 443, if the performance history is not sufficiently current (for example, as indicated by timestamp data), theprocessor 34 atstep 444 employs conventional means in thetransceiver 32 to obtain current performance measures by transmitting a request to and receiving data from theaccess point 40 ofFIG. 1 , and preferably stores the current performance measures as part of the performance history in thememory 35 b. Alternatively, if theaccess point 40 and/or another device in communication with theWWAN 44 collects performance measurement data for the WWAN, thetransceiver 32 may transmit a request to theaccess point 40 and/or other device to retrieve the performance data. - After determining at
step 443 that the WWAN performance data is current, theprocessor 34 atstep 445 determines a current WWAN status as a function of the current performance data and the performance history. For example, if the current performance data indicate that theWWAN 44 is currently accessible to therelay module 30 a, the module performance history indicates that theWWAN 44 has been accessible to therelay module 30 a for a predetermined time (for example, several hours), and throughput and/or occupancy are within predetermined limits, theprocessor 34 may determine that theWWAN 44 is “healthy” (indicated, for example, atstep 446 by illuminating a green LED segment of the WWAN indicator 38 j). - If the current performance data indicate that the
WWAN 44 is currently accessible to therelay module 30 a, but has a history where one or more of throughput and/or occupancy was outside of the predetermined limits, theprocessor 34 may determine a status of “partially accessible” (indicated, for example, atstep 446 by illuminating a yellow LED segment of the WWAN indicator 38 j). - If the
WWAN 44 is presently inaccessible to therelay module 30 a, theprocessor 34 may determine a status of “inaccessible” (indicated, for example, atstep 446 by illuminating a red LED segment of the WWAN indicator 38 j). Atstep 447, which may be performed before or concurrently withstep 446, it may be determined by theprocessor 34 for example in view of “partially accessible” or “inaccessible” statuses that an alarm condition has been generated, causing theprocessor 34 to present an alarm (for example, by causing the yellow or red LED segments to be illuminated in a blinking fashion, and/or by providing one or more audible alarms as previously described. As an alternative or in addition to displaying display status information atstep 446, theprocessor 34 may cause thetransceiver 31 to transmit the status information to one or more of themedical devices 10, or may cause thetransceiver 32 to transmit the status information to a device in communication with the WWAN. -
FIG. 4E presents a flow diagram illustrating a method ofoperation 460 for generating the status information that may be used by WLAN/WPAN indicator 380 i ofFIG. 3H to indicate an overall health of the entire WLAN/WPAN (or at least of the portion available to provide an alternate path for therelay module 30 a to the WWAN network). Atsteps FIG. 4E , theprocessor 34 retrieves current module performance history from thememory 35 b for communications with each other relay module that is accessible to therelay module 30 a via the WLAN/WPAN network 16 (“neighbor module”). - As previously described, performance measures may, for example, include a measured signal strength, noise, bit rate, error rate, occupancy, availability, path usage and the like as are conventionally measured for WLAN/WPAN networks (using, for example, the
status module 31 b). In addition, atstep 463, the processor operates thetransceiver 31 to request that each neighbor module provide a WWAN status (prepared, for example, according to the method described with reference toFIG. 4D ). - At
step 465, if the performance history relative to the neighbor modules is not sufficiently current (for example, as indicated by timestamp data) and/or missing, theprocessor 34 atstep 466 employs conventional means in thetransceiver 31 to obtain current performance measures by transmitting data to and receiving data from the neighbor modules, and preferably stores the current performance measures as part of the performance history in thememory 35 b. In addition, current performance measures may be obtained with respect to other neighboring devices, for example, having known or discernible performance (for example, network “beacons”). - After determining at
step 467 that current performance data has been obtained for each neighbor module accessible to the relymodule 30 a, theprocessor 34 atstep 468 determines a current module status as a function of the current neighbor module performance data (including neighbor module WWAN status) and the neighbor module performance history. For example, if the current performance data indicate that eachneighbor module 30 a is currently accessible to therelay module 30 a and has a WWAN status of “accessible”, the module performance history indicates that theneighbor modules 30 a have been accessible to therelay module 30 a for a predetermined period of time, and throughput and/or occupancy are within predetermined limits, theprocessor 34 may determine a status of “fully accessible” (indicated, for example, atstep 469 by illuminating a green LED segment of WLAN/WPAN indicator 380 i). - If the current performance data indicate that each
neighbor module 30 a is currently accessible to therelay module 30 a, but one or more of the neighbor modules 20 a have a recent performance history where WWAN status was inaccessible, theprocessor 34 may determine a status of “partially accessible” (indicated, for example, atstep 469 by illuminating a yellow LED segment of WLAN/WPAN indicator 380 i). If at least two of theneighbor modules 30 a are not presently accessible to therelay module 30 a, theprocessor 34 may determine a status of “inaccessible” (indicated, for example, atstep 469 by illuminating a red LED segment of WLAN/WPAN indicator 38 i). Atstep 470, it may be determined by theprocessor 34 for example in view of “partially accessible” or “inaccessible” statuses that an alarm condition has been generated, causing theprocessor 34 to present an alarm (for example, by causing the yellow or red LED segments to be illuminated in a blinking fashion, and/or by providing one or more audible alarms as previously described. As an alternative to displaying display status information atstep 469, theprocessor 34 may cause thetransceiver 31 to transmit the status information to one or more of themedical devices 10, or may cause thetransceiver 32 to transmit the status information to a device in communication with the WWAN. -
FIG. 4F presents a flow diagram 413 illustrating a method of operation for emergency dialing. In accordance with the flow diagram 413, theprocessor 34 of therelay module 30 a ofFIG. 3 determines whether to transmit over the facility-oriented wireless network or the WWAN and makes a determination based on the medical device data whether an emergency condition exists as represented bystep 414. If such a condition exists then, instep 415, theprocessor 34 transmits a message to thephone device 39 a to activate it and also initiate a connection in step 416 (e.g., phone call, etc.) with an emergency responder, such as 911, relatives/friends, caregivers, or police authorities. When the call is received by the emergency responder, an automated voice message is preferably transmitted to the emergency responder by thesignal generator 39 b indicating the emergency condition and location of the condition. If an emergency condition does not exist instep 414, instep 417 then the medical device data is stored for further analysis by themonitoring unit 37 b. -
FIG. 4G presents a flow diagram 418 illustrating how a location signal may be generated. A determination is made instep 474 by theprocessor 34 as to whether GPS location data was received as a component of the medical device data received from a medical device. If yes, instep 476, theprocessor 34 provides the location data for transmission with emergency condition data to the emergency responder. If that location data is not available, at step 478 alocation device 38 of therelay module 30 a is instructed by theprocessor 34 to generate location data of therelay module 30 a. Atstep 480, theprocessor 34 provides the location data for transmission with emergency condition data to the emergency responder as a component of the message transmitted by thephone device 39 a. -
FIG. 4H presents a table as may be stored for example inmemory 35 b by therelay module 30 a for determining whether an emergency condition exists. As illustrated, the table 481 includescodes 482 to indicate predetermined emergency conditions,descriptions 486 for the emergency conditions,harm times 488 defining an elapsed time until the emergency condition becomes harmful,priorities 490 for triage purposes,related codes 492 to the coded emergency condition, andphysiological data 494 used to identify the emergency condition. For example, as shown inline 1 of the table ofFIG. 4H , acode value 482 of “2” is assigned to thedescription 486 “Significant fever condition,” which is assigned anunattended harm time 488 of “10 minutes” and an immediate priority of 490 of “5.” Arelated condition 492 indicates that this condition in related to acode value 482 of “7,” which corresponds to thedescription 486 “Vital signs decreasing.” Thecode value 2 in addition corresponds to physiological conditions 494 (“Temp.≧103”). **** -
FIG. 5 presents a flow diagram illustrating a method ofoperation 500 for the architecture according toFIG. 1 , relating to the transmission of a message from theaccess point 40 to be received by one of themedical devices 10. This enables theaccess point 40, for example, to communicate with medical devices in order to download new firmware or software, to respond to error messages initiated by the medical devices (for example, to re-set a device or remove it from service, or to run device diagnostics), and to operate the medical device (for example, to adjust a flow rate on a feeding pump). - At
step 502 of themethod 500, the message is received at the first one of therelay modules 30 a from theaccess point 40 via the WWAN. Atstep 504, the onerelay module 30 determines whether the message is intended to reach one of theinterface circuits 15 and/orother relay modules facility 20. This may be accomplished, for example, by maintaining a list ofactive devices 15 andmodules buffer 35 or in a manner otherwise accessible to the onerelay module 30 a, or coding an identifier of thedevice 15 ormodule facility 20 that is stored in thebuffer 35 or is otherwise identifiable to the onerelay module interface circuits 15 in the facility and eachinterface circuit 15 determines if it was the intended recipient and should act upon or ignore the message. - If the one
relay module 30 a determines atstep 506 that theinterface circuit 15 ormodule relay module 30 a may preferably proceed to discard the message atstep 508, and/or alternatively alert theaccess point 40 with a non-delivery message. If theinterface circuit 15 is located in thefacility 20, the onerelay module 30 a determines atstep 510 whether theinterface circuit 15 orrelay module relay device 30 a via the WLAN or WPAN (for example, by consulting a list stored in thebuffer 35 or that is otherwise accessible to the onerelay module 30 a, or by instructing thetransceiver 31 to send a handshake or test transmission directed to theinterface circuit 15 and to listen for a reply). - If the one
relay module 30 a determines atstep 512 that thedevice 15 orrelay module step 514, it transmits the message vianetwork 16 to that device or relay module via thetransceiver 31, or to relaymodule transceiver 31. In this case, the message may again be broadcasted to alldevices 15 andmodules relay module 30 a, and eachdevice 15 ormodule relay module 30 a alternatively determines atstep 512 that the device or relay module is not accessible, then it proceeds atstep 516 to determine whether asecond relay module transceiver 31 to send a handshake transmission directed to the second relay module and to listen for a reply). If thesecond relay module relay module 30 forwards the message to thetransceiver 31 for transmission to thesecond relay module second relay module process 500 may preferably be repeated to search for athird relay module other relay module relay module 30 may preferably issue an alarm notification atstep 522, preferably in one of the same manners described above in reference to the methods described in conjunction withFIGS. 6A-6D below. Theprocessor 34 may also issue alarm notifications upon failing to receive a handshake signal from othermedical devices 10 and/orrelay modules -
FIG. 6A depicts a flow diagram 600 representing an alarm alert and display process. In accordance with the flow diagram 600, atstep 602 theprocessor 34 of therelay module 30 a receives information such as medical device data from a medical device, other rely module or internally generated by the relay module. Then, themethod 600, instep 604, determines whether the information obtained instep 602 is indicative of an alarm condition or an alarm condition is otherwise present. If no alarm condition is detected atstep 604, thenmethod 600 reverts back to step 602. If, instep 604, an alarm condition is detected based on the obtained information bystep 602, themethod 600 proceeds to step 606. - In
step 606, theprocessor 34 produces an alarm alert by transmitting signals representing an alert to be displayed to thedisplay 36 and/or transmits signals representing speech or other audible information (for an audible alarm) to the speaker. Then, themethod 600 proceeds to step 608. Instep 608, it is determined whether themodule 30 a receives medical device data or other information instructing the module to mute or disable the audible alarm or an input signal is otherwise received requesting to mute the sound or disable the audible alarm. If such input signal is received then, instep 612, theprocessor 34 mutes the speaker, i.e., disable the audible alarm. However, instep 608, if no such input signal is received then themethod 600 proceeds to step 610. - In
step 610, theprocessor 34 determines whether a user-actuatable switch associated with the input/output circuit 38, e.g., a mute switch of therelay module 30 a, has been activated. If such a switch has been activated then themethod 600 proceeds to step 612 and the speaker is muted to disable the emitted audible alarm. After the speaker is muted, themethod 600 returns to step 602 and starts the process again. However, if instep 610, it is determined that the mute switch has not been activated then themethod 600 proceeds to step 614 where the processor again determines whether the alarm condition is still present based upon, for example, newly received medical device data. If the alarm condition is no longer present, themethod 600 proceeds to step 612 and the audible alarm is disabled. However, if instep 614 the alarm condition is still present then themethod 600 reverts back to step 602 and the audible alert is produced, i.e., continued. - In an alternative embodiment, if in
step 614 the alarm condition is present for a particular period of time (either fixed in duration or based upon the particular alarm condition), then instep 606 the emitted audible alarm may advantageously be changed or upgraded in decibel level, pitch, type of sound, duty cycle or speech command to draw greater attention and response to the alarm condition by potential responders. In addition to, or in the alternative to, this change in emitted audible alarm in response to the determination instep 614 that the alarm condition is present for a particular period of time then the relay module may transmit a signal to other nearby or remote relay module(s) to alert other potential responders of the alarm condition. - It should be understood that the method of 600 may operate with information received from plurality of medical devices or other wireless relay modules, and may provide the intermittent displaying of respective alarm alerts for particular time intervals or employ different foreground or background colors based upon the type or severity of the alarm condition.
-
FIG. 6B depicts a flow diagram representing a alarm alert anddisplay process 600 a. Some of the steps inprocess 600 a may be the same as or similar to steps inprocess 600. - In accordance with the flow diagram 600 a, at
step 602 a theprocessor 34 of therelay module 30 a ofFIG. 3 receives information such as medical device data from a medical device, another relay module or internally generated by the relay module. Then, themethod 600 a, instep 604 a, determines whether the information obtained instep 602 a is indicative of an alarm condition or an alarm condition is otherwise present. If no alarm condition is detected atstep 604 a, thenmethod 600 a reverts back to step 602 a. If, instep 604 a, an alarm condition is detected based on the obtained information bystep 602 a, themethod 600 a proceeds to step 606 a. - In
step 606 a, theprocessor 34 produces an audible and visual alarm alert by transmitting signals representing an alert to be displayed to thedisplay 36 and/or transmits signals representing speech or other audible information (for an audible alarm) to the speaker. Alternatively and/or in addition, theprocessor 34 may transmit the alarm alert to amedical device 10 via thetransceiver 31, and/or to theaccess point 40 via thetransceiver 32. Then, themethod 600 a proceeds to step 608 a. - In
step 608 a, it is determined whether themodule 30 a receives medical device data or other information instructing the module to mute or disable the audible alarm or an input signal is otherwise received requesting to mute the sound or disable the audible alarm. If such input signal is received then, instep 612 a, theprocessor 34 mutes the speaker to disable the audible alarm. However, instep 608 a, if no such input signal is received then themethod 600 a proceeds to step 610 a. - In
step 610 a, theprocessor 34 determines whether a user-actuatable switch associated with the input/output circuit 38, e.g., a mute switch of therelay module 30 a, has been activated. If such a switch has been activated then themethod 600 a proceeds to step 612 a and the speaker is muted to disable the emitted audible alarm. Themethod 600 a then proceeds atstep 616 a to determine whether a mute timer has expired after a predetermined time interval (for example, 5 minutes). If so the mute signal is cleared and/or the mute switch is released atstep 618 a, and themethod 600 a returns to step 606 a to produce each of the audible and visual alerts. - If in
step 610 a, it is determined that the mute switch has not been activated, then themethod 600 a proceeds to step 614 a where the processor again determines whether the alarm condition is still present based upon, for example, newly received medical device data. If the alarm condition is no longer present, themethod 600 a proceeds to step 602 a and the alarm is disabled. However, if instep 614 a the alarm condition is still present, the method proceeds atstep 423 to check a condition timer to determine whether the alarm condition has been present for a particular period of time (either fixed in duration for example of five minutes, or for a variable duration based upon the particular alarm condition). If the condition timer has expired instep 423, then instep 620 a the emitted audible alarm may advantageously be changed or upgraded in decibel level, pitch, type of sound, duty cycle or speech command to draw greater attention and response to the alarm condition by potential responders, and reapplied atstep 606 a. In addition to, or in the alternative, therelay module step 620 a may transmit a signal to other nearby or remote relay module(s) to alert other potential responders of the alarm condition. - It should be understood that the method of flow diagram 600 a may operate with information received from a plurality of medical devices or other wireless relay modules, and may provide the intermittent displaying of respective alarm alerts for particular time intervals or employ different foreground or background colors based upon the type or severity of the alarm condition.
-
FIG. 6C depicts a flow diagram 600 b representing an alarm monitoring process executed by theprocessor 34 and thepower monitoring device 39 b with respect to the AC power supply to therelay module 30 a. Atstep 602 b, theprocessor 34 interrogates thepower monitoring device 39 b to determine whether the external AC power supply is providing a “normal” voltage (for example, 120 VAC, 60 Hz). If the external AC power supply is providing a normal voltage, the processor engages atimer 604 b to operate for a predetermined period of time (for example, 2 minutes) and then returns to step 602 b. If the external AC power supply is not providing a normal voltage (for example, a voltage less than 105 VAC, including 0 VAC resulting from an external AC power disconnect), theprocessor 34 causes a power alarm message to be transmitted atstep 606 b. Atstep 608 b, the processor determines whether an audible portion of the alarm resulting from the transmitted alarm message has been muted (for example, by activating the mute switch of therelay module 30 a). If yes, theprocessor 34 transmits a message to clear the alarm atstep 610 b, engages a timer to operate for a second predetermined period (for example, 5 minutes), and then returns to step 602 b. If not, theprocessor 34 engages atimer 614 b to operate for another predetermined time period (for example, 3 minutes), and then returns to step 602 b. Alternatively, atstep 608 b, theprocessor 34 may clear the muted condition rather than clearing the alarm, and release the alarm only if a normal voltage is detected asstep 602 b. -
FIG. 6C depicts a flow diagram 600 c representing an alarm monitoring process executed by theprocessor 34 and thepower monitoring device 39 b with respect to thesecondary power source 39 c to therelay module 30 a. Atstep 642 c, theprocessor 34 interrogates thepower monitoring device 39 b to determine whether thesecondary power source 39 c is providing a “normal” voltage (for example, 9 VDC). If thesecondary power source 39 c is providing a normal voltage, the processor engages atimer 644 c to operate for a predetermined period of time (for example, 1 minute) and then returns to step 642 c. - If the
secondary power source 39 c is not providing a normal voltage (for example, a voltage less than 8.5 VDC), theprocessor 34 interrogates thepower monitoring device 39 b to atstep 646 c to determine whether thesecondary power source 39 c is providing a “low” voltage (for example, between 7 and 8.5 VDC). If yes, the processor causes a low battery alarm message to be transmitted atstep 648 c. Atstep 650 c, the processor determines whether an audible portion of the alarm resulting from the transmitted alarm message has been muted (for example, by activating the mute switch of therelay module 30 a). If yes, theprocessor 34 transmits a message to clear the alarm atstep 652 c, and engages atimer 654 c to operate for a predetermined period (for example, 1 minute) and returns to step 642 c. If not, theprocessor 34 engages anothertimer 656 c to operate for another predetermined time period (for example, 2 minutes) and then returns to step 642 c. - If the
processor 34 atstep 646 c determines that thesecondary power source 39 c is not providing a “low” voltage (for example, between 7 and 8.5 VDC), theprocessor 34 concludes atstep 658 c that the voltage is a “near death” voltage (for example, less than 7 VDC). Theprocessor 34 then begins atstep 660 c to store medical device data arriving from one or moremedical devices 10 via the wireless relay network and/or from theaccess point 40 via the internet-accessible wireless communications network in thememory 35 b, and causes a near death battery alarm message to be transmitted atstep 662 c. Atstep 664 c, the processor determines whether an audible portion of an alarm resulting from the transmitted alarm message has been muted (for example, by activating the mute switch of therelay module 30 a). If yes, theprocessor 34 transmits a message to clear the alarm atstep 666 c, and engages atimer 668 c to operate for a predetermined period (for example, 1 minute) and returns to step 642 c. If not, theprocessor 34 engages anothertimer 670 c to operate for another predetermined time period (for example, 2 minutes) and then returns to step 642 c. If normal battery voltage is detected atstep 642 c, theprocessor 34 retrieves any medical device data that was stored in thememory 35 b during the period when a “near death” voltage was detected, and transmits the retrieved medical device data to intended destinations via one or more of the wireless relay network and/or the internet-accessible wireless communications network. -
FIG. 7A depicts a flow diagram 800 representing a process executed by the wireless relay module to determine whether communications with a particularmedical device 10 can be carried out over thewireless relay network 16. The process begins with theprocessor 34 of thewireless relay module 30 a engaging atimer 802 for a predetermined period of time (for example, 5 minutes). After expiration of thetimer 802, theprocessor 34 instructs thetransceiver 31 to transmit a “heartbeat” request to themedical device 10 over the wireless relay network. If a response is received by thetransceiver 31 to the request, the process concludes atstep 808 and the processor once again engages thetimer 802. - If no response to the request is received by the
transceiver 31, theprocessor 34 increments a request counter atstep 810 and engages anothertimer 812 for another predetermined period of time (for example, 1 minute). Then, theprocessor 34 proceeds to resend the heartbeat request atstep 814. If a response is received by thetransceiver 31 to the resent request, the process concludes atstep 808 and the processor again engages thetimer 802. If no appropriate response is received, theprocessor 34 proceeds atstep 818 to determine whether the request counter exceeds a predetermined value (for example, a predetermined value of 5). If this value is exceeded, theprocessor 34 causes atstep 820, a heartbeat alarm to be displayed by thedisplay 36 and/or be audibly signaled by thespeaker 37, and/or transmits a message via at least one of thetransceivers access point 40 and/or to another internet-accessible and/or wireless network-accessible recipient. The process then continues atstep 808 and the processor once again engages thetimer 802. If the predetermined value of the request counter is not exceeded atstep 818, the process returns to step 810. - One of skill in the art will readily understand that, in addition to requesting a “heartbeat” from the
medical device 10, a variety of other measures may be obtained to determine whether communications with a particularmedical device 10 can be carried out over thewireless relay network 16. For example, theprocessor 34 of thewireless relay module 30 a may alternatively instruct thestatus module 31 b associated with thetransceiver 31 to determine one of a variety of measures of signal quality for the wireless relay network signals being received from a medical device 10 (for example, including a signal strength or data rate of the transmitted signal). - The architecture disclosed herein for providing networked communications between a series of medical devices and a remote monitoring device provides a number of distinct advantages in comparison to other monitoring systems. By employing wireless relay networks such as ZIGBEE networks based on the IEEE 802.15.4 standard, for wireless communications between the
medical devices 10 andrelay modules interface circuits 15 can be easily and inexpensively applied to and/or integrated with themedical devices 10. - By introducing
relay modules 30 a that are part of the wireless relay mesh networks with the capacity to access off-site monitoring devices via a WWAN, access to and reliance on existing and potentially unreliable LAN facilities at a facility can be avoided. By incorporating relay features into therelay modules 30 a that relay communications from afirst relay module 30 a through asecond relay module 30 a in the event that WWAN access to thefirst relay module 30 a has been compromised, reliability can be improved and the use of conventional, low-cost cellular transceivers can be enabled in therelay modules 30 a for accessing the WWAN. - By limiting the configuration of cellular transceivers to just the
relay modules 30 a, costs can be further reduced. In addition, providing therelay modules 30 a in a compact enclosure facilitates therelay modules 30 a to be easily connected to reliable commercial power sources and easily moved when needed to reconfigure the wireless relay networks (e.g. a to a mesh network) according to facilities changes. The portability for ambulatory use that is provided by battery back-up is an additional advantage. -
FIG. 7B presents a flow diagram illustrating amethod 700A of identifying a patient that is associated with (that is, intends to receive treatment from or provide patient identification information and/or patient medical and/or physiological data to) a medical device 10 (as depicted, for example, inFIG. 1 ). Atstep 702A, the process may be initiated, for example, by actuating the synchronization switch 38 k on thecontrol panel 38 as illustrated inFIG. 3( e) of arelay module 30 a in proximity to themedical device 10. Therelay module 30 a enters an identification signal reception mode, in which it waits for a first predetermined interval (for example, using a time-out algorithm) atstep 704A to receive patient identification data over the facility-oriented wireless network via theinterface device 17 a of apatient identification device 17. Therelay module 30 a preferably indicates receipt by presenting an audible or visual signal at thecontrol panel 38, or by broadcasting a receipt signal to thepatient identification device 17 over the facility-oriented wireless network. - At
step 706A, after receipt of the patient identification information, therelay module 30 a waits for a second predetermined interval to receive medical device identification information over the facility-oriented wireless network via theinterface circuit 15 of amedical device 10. Once again, therelay module 30 a preferably indicates receipt of this medical device data by presenting an audible or visual signal at thecontrol panel 38, or by broadcasting a receipt signal tomedical device 10 over the facility-oriented wireless network. It should be understood that the order of receipt of the patient identification data and the medical device identification information (which may be respectively transmitted, for example, by a caregiver operating thepatient identification device 17 and the medical device 10) may be inverted. In addition, theinventive process 700A may optionally first require the caregiver to transmit caregiver identification data (for example, via one of thepatient identification device 17 or themedical device 10, or via a sensor provided in therelay module 30 a) which is validated by comparison to a caregiver identification table maintained for example in thememory 35 b of therelay module 30 a, or alternatively by forwarding a validation request to the remote monitoring system at theaccess point 40 over one or more of the facility-oriented wireless network and WWAN via an associated one of thetransceivers - At
step 708A, upon receipt of each of the patient identification data and the medical device identification data, a verification process is initiated. This process is carried out by themethod 700B illustrated in the flow diagram ofFIG. 7C . - At
step 702B ofFIG. 7C , a patient identification directory in thememory 35 b of therelay module 30 a is interrogated to determine whether a record is present including the received patient identification data and medical device information data, and if so, whether this record includes a “fresh” time stamp indicating that the record is current (for example, if patient identification is verified on a daily basis, a time stamp during the current day). If the time stamp is current, the record is retrieved from the patient identification directory atstep 712B, and an acknowledgement status identified is extracted from the record atstep 710B. - If the patient identification data and medical device identification data are not present in the patient identification directory, or if the time stamp does not indicate that a record including such data is current, the
relay module 30 a proceeds to form a data packet including the patient identification information and medical device identification and to encrypt this packet (for example, using a suitable conventional encryption algorithm such as secure sockets layer (SSL) data encryption) atstep 704B, and then transmits the encrypted data packet atstep 706B for further validation to the remote monitoring system at theaccess point 40 over one or more of the facility-oriented wireless network and WWAN via an associated one of thetransceivers - At
step 708B, the relay module receives a reply packet from the remote monitoring system via one of thetransceivers step 710B, therelay module 30 a extracts the acknowledgement status identifier from the decrypted packet. Atstep 714B, therelay module 30 a preferably adds a record to the patient identification directory in thememory 35 b that includes the patient identification information, the medical device identification information, the acknowledgement status identifier and a current time stamp. - Returning to
FIG. 7B , atstep 710A, the relay module broadcasts the acknowledgement status identifier (preferably together with at least one of the patient identification data or the medical device identification data) via thetransceiver 31 to themedical device 10. Upon receipt of the acknowledgement status identifier, themedical device 10 begins operation and transmits medical device data via an associatedinterface circuit 15 over the facility-oriented wireless network for receipt by thewireless network 30 a atstep 712A. The acknowledgement status identifier may preferably be encoded to instruct themedical device 10 to operate with predefined operating parameters. Optionally and alternatively, and before beginning operation, themedical device 10 may transmit a request via theinterface circuit 15 to confirm preset operating parameters and/or request additional information. Once the operating parameters are confirmed and operation of themedical device 10 begins, thewireless network 30 a may operate according to the previously-describedprocesses FIGS. 4 , 5. -
FIG. 8 illustrates a flow diagram of amethod 8200 for registeringmedical devices 10 with thesystem 100B ofFIG. 1B . Themethod 8200 begins atstep 8202, at which an authorized technician or other personnel having access to one of theremote monitoring devices outbound web server 43, and the web server responds by transmitting a device set-up screen to theremote monitoring device - At
step 8204, theoutbound web server 43 preferably queries the metadata andapplication database 46 according to one or more of identifying information for the technician and/or identifying information for the patient to identify an associated patientcare database node 60 from a plurality of patient care database nodes for the patient and record a destination address for the associated patientcare database node 60 in the metadata andapplication database 46 in association with the identifying data for themedical device 10 and/or identifying information for the patient. Identifying information for the patient is preferably generated anonymously (for example as a random number), and transmitted atstep 8206 to the patientcare database node 60 for association with securely-stored patient identifying information. Atstep 8208 of themethod 8200 ofFIG. 8 , theoutbound web server 43 requests that the securedevice web server 42 assign an area of thedevice control database 44 for logging associated medical device data for themedical device 10 as it is received by thedevice integration server 41, such that it can be later retrieved by theoutbound web server 43 upon receiving an authorized request from an authenticated user operating one of theremote monitoring devices - It should be readily understood by one skilled in the art that step 8204 of
method 8200 for identifying and storing the address of the patientcare database node 60 may be omitted if a single patient care database node is utilized withsystem 100B ofFIG. 1B . -
FIG. 9A presents a flow diagram illustrating amethod 9300 for retrieving and viewing medical device data on aremote monitoring device medical device 10 according to the system ofFIG. 1B . Themethod 9300 begins atstep 9302 with a first authorized user having access to one of the firstremote monitoring devices 67 provides authenticating credentials (for example, a recognized log-in and password) to theoutbound web server 43. In addition, instep 9302, a second authorized user having access to one of the secondremote monitoring devices outbound web server 43 - At
step 9304, based on verification of the authenticating credentials of the first and second authorized users, theoutbound web server 43 queries the metadata andapplications database 46 to identify the address of patient care database node(s) 60 to which the respective first and second authorized users are entitled to obtain access, and atstep 9306, requests data from the patientcare database node 60 relating to at least one identified patient for which the first and second user are respectively authorized to view medical device data, including for example a listing ofmedical devices 10 which are presently associated with the identified patient, and/or status information of the facility-orientednetwork 17. It should be readily understood that different authenticated users will likely have different levels of sophistication and skill for which a corresponding access level may be associated with their authentication account or status which may further be used, for example, to limit or expand the type and/or extent of medical device data that may be transmitted to the remote monitoring devices for such authenticated users. - At
step 9308 of themethod 9300 ofFIG. 9A , theoutbound web server 43 queries thedevice control database 44 via the securedevice web server 42 for status information to determine which of the listed medical devices are presently active according to the data logged by thedevice control database 44. It should be noted that one or more of amedical device 10, its associatedinterface device 15, an associatedwireless relay module 30 and/or thedevice integration server 41 may be programmed to provide data from themedical device 10 to thedevice integration server 41 at predetermined, preset intervals or otherwise, which can then be provided toserver 43 in response to inquiries therefrom. - Upon obtaining the status information, the
outbound web server 43 prepares respective display pages with encrypted medical device data, according for example to display information retrieved from the metadata andapplications database 46, to display listings ofmedical devices 10 available for monitoring by respective authorized users at theremote monitoring devices FIG. 9B presents afirst screen display 9320 to theremote monitoring devices medical devices 10 available for monitoring according to device type. For example, in thescreen display 9320 ofFIG. 9B , available device types includeventilators 9321,urology devices 9322,energy delivery devices 9323,pulse oximeters 9324,predictive thermometers 9325,tympanic thermometers 9326 and food pumps 9327. Each of the device types 9321-9327 inFIG. 9B is presented with an identifying label (for example,label 9321A) and an identifying image (for example,image 9321B) for ease of recognition. - Once a device type is selected by a user (for example, in response to an associated mouse-over or mouse-click executed by the authorized user), a
second screen display 9330 as illustrated byFIG. 9C may preferably be transmitted by theoutbound web server 43 for display at theremote monitoring devices display 9330, labels 9337A are provided in association withimages 9337B in order to identify individual food pumps (for example, by patient and/or by logical or physical location).Medical devices 10 that are unavailable may for example preferably be depicted with alabel 9337A′ (“Off Line”) and animage 9337B′ (depicting the device with a slash or cross applied over the image or shaded or shadowed) that distinguish the unavailablemedical devices 10 from availablemedical devices 10. - Once an individual device is selected by the first or second user (for example, once again, in response to an associated mouse-over or mouse-click executed by the authorized user), a
third screen display 9340 as illustrated byFIG. 9D may preferably transmitted by theoutbound web server 43 for display at the correspondingremote monitoring device display 9340, for example, device information of the medical device 10 (in this case, a food pump) is displayed in ascreen 9347A preferably recreating a current screen generated and displayed by themedical device 10. In addition, thescreen display 9340 includes any of apanel 9347B providing identifying information for the medical device 10 (in this case, a pump location), apanel 9347C for displaying a message indicating a current error condition of the pump, and anicon button 9347D for selecting an alternate “status” mode of thescreen display 9340. Thescreen display 9340 also includes acontrol icon button 9347E for selecting a system set-up screen display, and acontrol icon button 9347F for enabling device control from theremote monitoring device 62. For example, upon selecting thecontrol icon 9347F, thescreen display 9340 may preferably be refreshed to include themedical devices screen 9347A and one or more operable buttons that mimic the appearance of control buttons on the medical device. The control button features are described in greater detail below in relation toFIGS. 10B and 10C . - It should be readily understood that
computer screen images FIGS. 9B , 9C and 9D are for illustration purposes only and that many other user screen images displays and interface tools may be utilized, for example, computer screens that depict accessible medical devices by other means than device type as illustrated inFIG. 9B . For example, as a suitable alternative to thescreen image 9340 ofFIG. 9D that conveys information from a single medical device, it is possible to implement displays that provide information from multiple medical devices. In addition, it should be readily understood that theoutbound web server 43 will preferably be operable to prepare display pages with encrypted medical device data for display on any of a wide variety of display devices (including, for example, workstations, personal computers, tablet devices including tablet computers, and display-based mobile devices including personal digital assistants, smartphones, portable game systems and the like. - It should also be readily understood that the computer screen images to be available to first and second users of the first and second remote monitoring devices may be different depending upon whether such user is a clinician, nurse, patient relative or other caregiver, i.e., dependent on level of entitlement of the particular authorized user. For example, a display for a clinician at a first
remote monitoring device 62 may enable the clinician to adjust the settings of a subjectmedical device 10, in contrast to a display for a secondremote monitoring device remote monitoring device remote monitoring device 62 than the secondremote monitoring device -
FIG. 10A presents a flow diagram illustrating amethod 1000 for issuing a command to amedical device 10 via thesystem 100 according toFIG. 1 . Themethod 1000 begins atstep 1002 with an authorized user adjusts an operating parameter, such as a clinician (also referred to as a “authorized clinician” or “user” herein) logging into theoutbound web server 43 using a firstremote monitoring device 62 and navigating to thedevice screen display 9340 ofFIG. 9D (for example, as described above with reference toFIGS. 9A-9D ). Atstep 1004, the clinician proceeds to select the “Enable Full Control”button 9347F ofFIG. 9D to initiate an operational command directed to themedical device 10, and is preferably provided with a request for authentication pertaining in particular to the patient associated with themedical device 10. Atstep 1006, patient authentication information provided by the clinician is forwarded by theoutbound web server 43 to a patientcare database node 60 according to a patient care database node address stored by the metadata andapplications database 46 in association with the clinician, and the clinician is authenticated for the patient by theoutbound web server 43 upon receipt of an authentication confirmed message from the patientcare database node 60. - Upon receipt of the patient authentication, a control request is forwarded by the
outbound web server 43 atstep 1008 to the securedevice web server 42 to be logged in the information record of thedevice control database 44 that is associated with the medical device 10 (and optionally, with an anonymous ID for the patient). Atstep 1010, the secure device web server forwards the control request, such as an encrypted control request, to thedevice integration server 41, which transmits an associated device control command over thesecure WWAN 52 for receipt by an associatedwireless relay module 30 atstep 1012. Thewireless relay module 30 wirelessly communicates the command to themedical device 10 via an associateddevice interface 15, and awaits a reply confirming execution of the command transmitted by thedevice interface 15. - At
step 1014, thedevice integration server 41 receives an update message from thewireless relay module 30 via thesecure WWAN 52 which confirms that the command was executed by themedical device 10. Atstep 1016, thedevice integration server 41 forwards the update message to the securedevice web server 42 to be logged in the information record of thedevice control database 44 that is associated with themedical device 10. Optionally, and preferably, the securedevice web server 42 forwards information pertaining to the update message to theoutbound web server 43, and theoutbound web server 43 prepares an updated display screen that is securely transmitted to theremote monitoring device 62 to indicate that the command has been executed. - Alternatively, at
step 1004, the authenticated clinician may select the “System Setup”control icon button 9347E to perform a command other than an operational command directed to themedical device 10.FIG. 10B illustrates adisplay screen 1050 that is presented to the clinician upon selecting thecontrol icon button 9347E. Thedisplay screen 1050 includes a number of icon buttons that may be selected by the clinician (for example, as the result of a mouse-over or mouse-click initiated by the clinician) to select a specific setup command. For example,icon button 1051 may be selected to initiate a command for providing identification information of themedical device 10.Icon button 1052 may be selected to provide text paging in response to an alert condition, as is further described herein.Icon button 1053 may be selected to initiate a software or firmware download for updating themedical device 10. -
Icon button 1054 may be selected to initiate a diagnostic test of themedical device 10.FIG. 10C illustrates adisplay screen 1060 that may be displayed to the clinician upon selection of theicon button 1054. Via thedisplay screen 1060 ofFIG. 10C , the clinician may select one or more of (including a progression of) a series ofdiagnostic tests 1061 directed to components of the medical device (for example, including power components, memory components, alarm components and the like). Alternatively and/or in addition, the clinician may select one or more of a series ofperformance statistics 1062 to be gathered and displayed (for example, including various device error statistics such as feed error, rotor error and flush error rates for a food pump). In addition, perhaps most usefully before issuing a software and/or firmware download command, the clinician may select aversion number test 1063 to obtain version identifying information for the software and/or firmware (preferably including, for example, a software and/or firmware download history). Optionally, processes for performing thediagnostic tests 1061, preparing theperformance statistics 1062 and identifying the software and/orfirmware version number 1063 may run automatically without specifically being selected by the clinician, with a complete reporting of all results on the display screen. - In a similar manner to that performed by the method of
FIG. 10A , it is possible to issue a bandwidth priority command or instruction to a relay module, such asrelay module 30 ofFIG. 1 , for the relay module to grant priority for relaying information received from a particular medical device relative to other medical devices that may send or receive communications via this relay module. For example, it would be advantageous to provide greater bandwidth priority to a critical care device such as a ventilator supporting the breathing function of a patient relative to a weight scale or thermometer. It is also possible to a number of bandwidth priority levels assignable to respective medical devices based upon, for example, the critical nature of the data or function provided by such devices. - Referring again to
FIG. 10B ,icon button 1055 may be selected to enable the clinician to specify data transfer rates, priorities and other parameters relating to the wireless transceiver of the interface device associated with the medical device.Icon button 1056 may be selected to provide the clinician with the an alarm history, event history and other information as has been logged for example for the medical device in thedevice control database 44 ofFIG. 1 . - It should be readily understood that the
method 1000 for remotely issuing a command to amedical device 10 was described with respect to a user of a firstremote monitoring device 62 and not a user of the secondremote monitoring remote monitoring device 62 is a clinician, technician or other highly-skilled healthcare professionals, while the user of the secondremote monitoring device method 1000 is likewise useable to enable a user of thesecond monitoring device medical device 10. -
FIG. 11A presents a flow diagram illustrating amethod 1100 for recognizing and reporting an alert condition according to medical device data (including the status of the facility-oriented network 17) logged via thesystem 100 according toFIG. 1 . Themethod 1100 begins atstep 1102 with the transmission of an alert message by awireless relay module 30 over thesecure WAN 52 to thedevice integration server 41. In this case, thewireless relay module 30 is configured to analyze (such as by detecting flag or status information or comparing message data to information stored in an associated database) a message type of a message transmitted by an associatedmedical device 10 to determine that the message is an alert message, and to transmit the message to thedevice integration server 41 upon determining that the message is an alert message (for example, as a priority message). Alternatively, thewireless relay module 30 may simply queue all messages for transmission to thedevice integration server 41 in order upon receipt, and rely upon thedevice integration server 41 to analyze an associated message type to determine that a message is an alert message. - Upon determining that the transmitted message is an alert message, the
device integration server 41 proceed, atstep 1103, to log the message in thedevice control database 44, and atstep 1104, invokes a text messaging application that retrieves text messaging numbers associated with identifying information of themedical device 10 and/or anonymous patient identifying information. The determination of whether the transmitted message is an alert message may be carried out by, for example, detecting an alert flag or trigger identifier in the message or scanning the message for other information indicative of an alert condition. The text messaging application may preferably retrieve the text messaging numbers by querying the metadata andapplications database 46 to identify the address of an associated patientcare database node 60, and either making a direct request or instructing theoutbound web server 43 to request the text messaging numbers from the associated patientcare database node 60. - At
step 1106, thedevice integration server 41 sends one or more messages including the retrieved text messaging numbers and text message information according to the alert message to one or morewireless relay modules 30 over thesecure WWAN 52. Atstep 1108, the one or morewireless relay modules 30 transmit the text message information addressed to the text messaging numbers over one or more of thesecure WWAN 52 and/or the facility-orientedwireless network 17 to complete themethod 1100. -
FIG. 11B illustrates a “Text Paging” 1052 screen display 1150 that may be invoked, for example, by using themethod 1000 ofFIG. 10A for issuing a command to amedical device 10. Specifically, and with particular reference toFIGS. 9D and 10B , the text paging screen 1150 is displayed at the firstremote monitoring device 62 of an authenticated clinician upon the clinician's selection of the “System Setup” icon button 9347 e of thescreen display 9340, and thereafter upon the clinician's selection go the “Text Paging” icon button of thescreen display 1050. Likewise, it is possible for the paging screen 1150 ofFIG. 11B to be displayed on a secondremote monitoring device FIG. 11B , the “Text Paging” screen display 1150 include a listing of one ormore names 1151 of individuals responsible for responding to alert messages of at least two types: “Error Messages” 1153, which may for example indicate a malfunction of themedical device 10, and/or “Info Messages” 1154, which may for example indicate a significant patient health condition (for example, a patient respiration rate below a preset minimum rate specified for aventilator device 9321 ofFIG. 9B ). - The information retrieved by the
outbound web server 43 to prepare this display is preferable retrieved from the patientcare database node 60, by providing on one or more of identifying information for themedical device 10 and/or anonymous patient identifying information stored in thedevice control database 44. Upon recognizing an alert message for themedical device 10, the information provided on the “Text Paging” screen display may be retrieved by thedevice integration server 41 by querying the metadata andapplications server 46 to retrieve address information for the patientcare database node 60, and forwarding a text paging information request to the patientcare database node 60 based upon one or more of identifying information for themedical device 10 and/or anonymous patient identifying information stored in thedevice control database 44. The recognition of whether the received message from themedical device 10 is an alert message may be carried out by, for example, detecting an alert flag or trigger identifier in the message or scanning the message for other information indicative of an alert condition. - It should be readily understood that the use of communicating alert messages using text messaging in
FIGS. 11A and 11B is for ease of illustration purposes only and that such alerts may be communicated in other ways including email, audio messages via telephone calls, as well as any other wired and/or wireless text, audio, or multimedia based communication services receivable by, for example, by a smart phone or computer tablet software application or “App.” -
FIG. 12 shows anillustrative computer system 1200 suitable for implementing server and computer components (for example, includingdevice integration server 41, securedevice web server 42,outbound web server 43, and secure patient web server 64). Thecomputer system 1200 as described herein may comprise, for example, a personal computer running the WINDOWS operating system, or a server computer running, WINDOWS Server, LINUX or another UNIX-based operating system. Alternatively, thecomputer system 1200 described herein may comprise a mobile device, tablet devices or computers, or information appliance running, for example, an operating system in the group including Symbian, Android, Apple iOS, Blackberry, Microsoft Windows Phone, Linux, Palm/HP WebOS, BADA, MAEMO and MEEGO. The above-described methods carried out by the server and computer components may be implemented on thecomputer system 1200 as stored program control instructions directed to control application software. -
Computer system 1200 includesprocessor 1210,memory 1220,storage device 1230 and input/output devices 1240. One of the input/output devices 1240 may preferably include adisplay 1245. Some or all of thecomponents system bus 1250.Processor 1210 may be single or multi-threaded, and may have one or more cores.Processor 1210 executes instructions which, in the disclosed embodiments, are the steps described, for example, in one or more ofFIG. 8 , 9A, 10A or 11A. These instructions may be stored in one or more ofmemory 1220 or instorage device 1230. Information may be received and output using one or input/output devices 1240.Memory 1220 may store information and may comprise a computer-readable medium, such as volatile or non-volatile memory.Storage device 1230 may provide storage forsystem 1200 including for the example, the previously described database, and may be a computer-readable medium. In various aspects,storage device 1230 may be one or more of a flash memory device, a floppy disk drive, a hard disk device, and optical disk device, and/or a tape device. -
Input devices 1240 may provide input/output operations forsystem 1200. Input/output devices 1240 may include one or more of a keyboard, a pointing device, and/or microphone. Input/output devices 1240 may further include a display unit for displaying graphical user interfaces, a speaker and a printer and any of a number of other serial devices (for example, configured as Universal Serial Bus (USB)-based devices
Claims (30)
1. A process for providing communications between a medical device to be used by a patient and a remote monitoring device via an internet-accessible wireless communications network, said process comprising:
obtaining identification information identifying the patient;
obtaining identification information identifying the medical device transmitting each of the patient identification information and the medical device identification information to the remote monitoring device via the internet-accessible wireless communications network;
receiving an acknowledgement status from the remote monitoring device via the internet-accessible wireless communications network; and
transmitting data corresponding to an output of at least one sensor of the medical device for said patient by the medical device via the internet-accessible wireless communications network when the received acknowledgement status represents a particular status.
2. The process of claim 1 , wherein said particular status represents an authorization of use of the medical device by the patient based upon a pre-authorization record for the patient.
3. The process of claim 1 , further comprising encrypting the patient identification information prior to transmitting the patient identification information to the remote monitoring device.
4. The process of claim 1 , further comprising encrypting the medical device identification information prior to transmitting the medical device information to the remote monitoring device.
5. The process of claim 1 , wherein transmitting the patient identification information to the remote monitoring device comprises:
receiving the patient identification information at the medical device; and
transmitting the patient identification information from the medical device via the internet-accessible wireless communications network to the remote monitoring device.
6. The process of claim 5 , wherein the medical device performs said transmitting the medical device identification information to the remote monitoring device.
7. The process of claim 6 , wherein the patient identification information and the medical device identification information are transmitted by the medical device to the remote monitoring device in a single information block.
8. The process of claim 1 , wherein obtaining the patient identification information comprises reading the patient identification information by a patient identification information reader.
9. The process of claim 8 , further comprising coupling the patient identification information reader to the medical device.
10. The process of claim 8 , further comprising transmitting the patient identification information from the patient identification information reader to the medical device via a wireless relay network.
11. The process of claim 8 , further comprising transmitting the patient identification information from the patient identification information reader to a wireless relay module via a wireless relay network.
12. The process of claim 10 , further comprising providing wireless bandwidth priority for the patient identification information reader by the medical device.
13. The process of claim 11 , further comprising providing wireless bandwidth priority for the patient identification information reader by the relay module.
14. The process of claim 8 , wherein obtaining the patient identification information comprises reading bar-coded reader patient identification information.
15. The process of claim 8 , wherein obtaining the patient identification information comprises reading a radio frequency identification (RFID).
16. The process of claim 8 , wherein obtaining the patient identification information comprises obtaining one or more sources of identification information from one or more of fingerprints, retinal scans, vein-pattern scans and optical images.
17. The process of claim 8 , wherein the patient identification information reader comprises a device selected from one or more of smartphones, tablet computers, personal digital assistants (PDAs), cell phones and pagers.
18. The process of claim 1 , wherein one or more of transmitting the patient identification information or transmitting the medical device identification information to the remote device comprises transmitting the identification information via a wireless relay module.
19. The process of claim 18 , further comprising:
storing one or more of the patient identification information and the medical device identification information by the wireless relay module.
20. The process of claim 19 , wherein the wireless relay module transmits the patient identification information and the medical device identification information together in a single information block.
21. The process of claim 18 , further comprising transmitting one or more of the patient identification information or the medical device identification information via the internet-accessible wireless communications network from the wireless relay module to the remote monitoring device.
22. The process of claim 21 , wherein the wireless relay module transmits the patient identification information or medical device identification information to at least one other wireless relay module and the at least one other wireless relay module forwards the identification information via the internet-accessible wireless communications network to the remote monitoring device.
23. The process of claim 1 , wherein said particular status represents an authorized use of the medical device by the patient obtained in response to a confirmation query conducted by the remote monitoring device.
24. The process of claim 1 , further comprising transmitting a confirmation query request to the remote monitoring device via the internet-accessible wireless communications network.
25. The process of claim 24 , wherein the confirmation query request comprises authorization identification information.
26. The process of claim 18 , further comprising:
transmitting a prompt for the medical device identification information by the wireless relay module to the medical device; and
transmitting a prompt for the patient identification information by the wireless relay module to one on the medical device or to a patient identification device.
27. The process of claim 26 , wherein the patient identification information and the medical device identification information is transmitted by the wireless relay module in a single information block.
28. The process of claim 26 , further comprising receiving the medical device identification information from the medical device at the wireless relay module, and wherein transmitting the prompt for the patient identification information by the wireless relay module occurs after receiving the medical device information by the wireless relay module.
29. The process of claim 26 , further comprising receiving the patient identification information from the medical device or the patient identification device by the wireless relay module, and wherein transmitting the medical device identification information and the patient identification information by the wireless relay device module occurs after receiving the medical device identification information and receiving the patient identification information by the wireless relay module.
30. The process of claim 29 , wherein transmitting the medical device identification information and the patient identification information by the wireless relay module is performed after determining that the value of an indicator of an elapsed time at the wireless relay module between transmitting the prompt for the patient identification and receiving the patient identification information is within a predetermined time-out period.
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Also Published As
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US20120182894A1 (en) | 2012-07-19 |
US8798527B2 (en) | 2014-08-05 |
US20140348054A1 (en) | 2014-11-27 |
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