WO2016099521A1

WO2016099521A1 - Control of alarm annunciation and operation features of patient monitor based on caregiver proximity

Info

Publication number: WO2016099521A1
Application number: PCT/US2014/071299
Authority: WO
Inventors: Christopher J. BROUSE
Original assignee: Draeger Medical Systems, Inc.
Priority date: 2014-12-18
Filing date: 2014-12-18
Publication date: 2016-06-23

Abstract

A proximity-based medical system is provided. The system can be configured to determine the proximity of one or more caregivers to a bedside patient monitor, and based on the proximity, changes one or more operation features of the bedside patient monitor including, for example, deactivating one or more displays of the bedside patient monitor when no caregiver is in proximity, or activating the displays when a caregiver is in proximity. The system can also be configured to determine where to annunciate an alarm (e.g., at the patient's bedside or at a remote station) based on the proximity of one or more caregivers. Related method, apparatus, and non-transitory computer readable medium are also provided.

Description

Control of Alarm Annunciation and Operation Features of Patient Monitor Based on Caregiver Proximity

TECHNICAL FIELD

[0001] The subject matter described herein relates to the control of alarm annunciation and operation features of patient monitors, including the display of patient data, based on caregiver proximity.

BACKGROUND

[0002] In existing alarm systems in healthcare settings, alarms are always annunciated at the bedside, regardless of whether a caregiver is present to respond to them. Bedside alarms can be harmful to the patient, for example, disrupting sleep and contributing to delirium. They can also create stress and anxiety for the patient and the visitors.

[0003] Moreover, in existing systems, patient physiological information is always displayed on the patient monitor and central station screens, irrespective of whether a caregiver is present to observe the information. Bedside display of physiological waveforms and trends can be harmful to the patient; there are reports of patients becoming fixated on the monitors, and reacting with panic to perceived physiological events. Furthermore, indiscriminate display of patient's physiological data (e.g., at a remote station) can increases the risk of confidential data leaks to the public.

SUMMARY

[0004] Variations of the present subject matter are directed to methods, systems, devices, and other articles of manufacture that are provided to control alarm annunciation and patient information display based on caregiver proximity. [0005] The present subject matter provides a proximity-based medical system that includes a patient monitor, a location tracking device, and a data processor configured to determine a distance between the patient monitor and the location tracking device. The patient can include a display for displaying physiological data of a patient. The location tracking device can be movable with respect to the patient monitor. The patient monitor can be configured to deactivate an operation feature of the patient monitor if the distance between the patient monitor and the location tracking device exceeds a threshold. In some variations, the patient monitor can be further configured to generate an alarm when the physiological data exceeds a physiological threshold, and annunciate the alarm near the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold, or annunciate the alarm at a remote location if the distance between the patient monitor and the location tracking device exceeds the threshold without annunciating the alarm near the patient monitor.

[0006] The present subject matter also provides a proximity-based medical system that includes a patient monitor, a location tracking device, and a data processor configured to determine a distance between the patient monitor and the location tracking device. The patient monitor is configured for monitoring one or more physiological data of a patient. The location tracking device is movable with respect to the patient monitor. The patient monitor can be configured to generate an alarm when the physiological data exceeds a physiological threshold, and annunciate the alarm near the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold, or annunciate the alarm at a remote location if the distance between the patient monitor and the location tracking device exceeds the threshold without annunciating the alarm near the patient monitor.

[0007] One or more of the following features can be included in any feasible combination. For example, in some variations, the patient monitor can be further configured to activate the operation feature of the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold. The operation feature can include, for example, displaying at least some of the physiological data of the patient.

[0008] In some variations, the distance is a linear distance. In some variations, the distance is a transit distance corresponding to an estimated transit time for the location tracking device to move to the patient monitor. The transit distance can be determined, for example, based on a map of an area in which the patient monitor and the location tracking device are located.

[0009] In some variations, the threshold can be determined based on one or more dimensions of a patient room in which the patient monitor is located.

[0010] In some variations, the system can further include a door sensor operative connected to the patient monitor to allow the patient monitor to determine whether a door of the patient room is open or closed; the patient monitor being further configured to annunciate the alarm at the remote location when the door is determined to be closed and the distance between the patient monitor and the location tracking device exceeds the threshold.

[0011] In some variations, the system can be further configured to generate a targeted alarm and send the targeted to an identified target device when the distance exceeds the threshold and the location tracking device is not proximate the remote location.

[0012] In some variations, the system can further include a manual override mechanism configured to activate the operation feature when the manual override is activated.

[0013] In some variations, the operation feature is deactivated after a time period after the first distance exceeds the threshold.

[0014] In some variations, the tracking device comprises a Bluetooth device.

[001.5] The present subject matter also provides a method of changing a behavior of a bedside patient monitor based on caregiver proximity. The method can include determining, by at least one data processor, a distance between a tracking device and the bedside patient monitor; and deactivating, by at least one data processor, an operation feature of the bedside patient monitor if the distance between the tracking device and the bedside patient monitor exceeds a threshold.

[001.6] In some variations, the method can also include determining, by at least one data processor, a second distance between the tracking device and a remote patient monitor, and annunciating an alarm near the bedside patient monitor if the first distance is lower than the second distance, or annunciating the alarm near the remote patient monitor if the second distance is lower than the first distance.

[001.7] The present subject matter also provides a method of alarm annunciation based on caregiver proximity. The method can include determining, by at least one data processor, a distance between a tracking device and the bedside patient monitor; generating, by at least one data processor, an alarm when the physiological data exceeds a physiological threshold; and annunciating the alarm near the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold, or annunciate the alarm at a remote location if the distance between the patient monitor and the location tracking device exceeds the threshold without annunciating the alarm near the patient monitor.

[0018] One or more of the following features can be included in any feasible combination. For example, in some variations, the method can further include activating, by at least one data processor, the operation feature of the bedside patient monitor if the first distance does not exceed the threshold. The operation feature can include, for example displaying physiological data of the patient on a display.

[0019] In some variations, the first distance (and/or the second distance) is a linear distance. In some variations, the first distance (and/or the second distance) is a transit distance corresponding to an estimated transit time for the location tracking device to move to the patient monitor. The transit distance can be determined based on a map of an area in which the patient monitor and the location tracking device are located.

[0020] In some variations, the threshold is determined based on one or more dimensions of the patient room.

[0021] In some variations, the method can further include determining, by at least one data processor, a door of the patient room is open or closed; and annunciating, by at least one data processor, an alarm near a remote patient monitor when the door is determined to be closed and the first distance exceeds the threshold. [0022] In some variations, the method can further include, generating and transmitting, by at least one processor, a targeted alarm to a targeted communications device when the first distance exceeds the threshold and an alarm event is triggered.

[0023] In some variations, the method can further include activating, by at least one data processor, the operation feature when a manual override signal is received. The operation feature can be deactivated after a time period when the first distance exceeds the threshold.

[0024] In some variations, the tracking device comprises a Bluetooth device.

[0025] Non-transitory computer program products (i.e., physically embodied computer program products) are also described that store instructions, which when executed by one or more data processors of one or more computing systems, causes at least one data processor to perform operations herein. Similarly, computer systems are also described that may include one or more data processors and memory coupled to the one or more data processors. The memory may temporarily or permanently store instructions that cause at least one processor to perform one or more of the operations described herein. In addition, methods can be implemented by one or more data processors either within a single computing system or distributed among two or more computing systems. Such computing systems can be connected and can exchange data and/or commands or other instructions or the like via one or more connections, including but not limited to a connection over a network (e.g. the Internet, a wireless wide area network, a local area network, a wide area network, a wired network, or the like), via a direct connection between one or more of the multiple computing systems, etc. [0026] The subject matter described herein provides many advantages. For example, by providing a system and method that can control alarm annunciation based on caregiver proximity, disturbances to the patient can be minimized. Moreover, by providing a system and method that can control the display of patient information (e.g., physiological information) based on caregiver proximity, the risk of leaking patient's private/confidential data to the public can be minimized.

BRIEF DESCRIPTION OF THE FIGURE

[0027] FIG 1 is a diagrammatic illustration of an example of an environment in accordance with the current subject matter;

[0028] FIG. 2 is a diagrammatic illustration of a system in accordance with the current subject matter;

[0029] FIG. 3 is a process flow view of an example of the current subject matter;

[0030] FIG. 4 is a process flow view of another example of the current subject matter; and

[0031] FIG. 5 is an illustration of an example of a graphical user interface of a patient monitor in accordance with some variations of the current subject matter.

DESCRIPTION

[0032] The current subject matter provides an alarm annunciation control system and method that annunciates the alarm only where it is needed (or can be heard by a caregiver), and where a caregiver can use the information to respond to the clinical event that triggered the alarm. The current subject matter also provides a system and method that disables one or more screens that display patient data when there is no caregiver in proximity to observe the information, and display the patient data (see, for example, FIG. S, which shows an example of a display of a patient monitor) when there is a caregiver in proximity to observe the information. For example, in some variations, the system can determine the distance between one or more caregivers and a particular bedside patient monitor (and/or a remote station), and determine the one or more operation features (behavior) such as the operation of display(s) and/or alarm

annunciator(s) as well as the operation features of a remote displays) and/or alarm annunciator(s) based on that distance.

[0033] FIG. 1 is a diagrammatic illustration of an example of an environment 100 implementing the current subject matter. Here, each patient room (141 , 142, 143, and 144) includes a patient monitor (171 , 172, 173, and 174). Each patient monitor can include one or more displays for displaying patient information such as, for example, physiological information (e.g., heart rate, blood pressure, and other sensor data). FIG. 5 shows an example of a graphical user interface 500 of a patient monitor. Each patient monitor can also include an alarm annunciator, which can provide, for example, an audio and/or visual alarm. In some variations, the alarm annunciator can be separately provided from the patient monitor.

[0034] The environment 100 also includes a remote station 121 (e.g., a central station), which includes a remote patient monitor 175. The remote patient monitor 175 can include one or more displays for displaying, for example, patient information of one or more of the patients in rooms 141-144. The remote patient monitor 175 can also include a remote alarm annunciator, which can provide, for example, an audible alarm and/or visual alarm. In some variations, the remote alarm annunciator can be separately provided from the remote patient monitor. And in some variations, the remote alarm annunciator can show the room and/or other data associated with the alarm.

[0035] In this example, there are three caregivers (131, 132, and 133) in the environment 100. Caregiver 131 is at the patient's bedside in room 141. Caregiver 132 is just outside of room 143. Caregiver 133 is at the remote station 121. Each of the caregivers can be provided with a location tracking device (e.g., including a Bluetooth chip), which can be implemented in, for example, a mobile device or an identification badge carried by the caregiver. The location tracking device can be in data

communication with a central system 110 via, for example, one or more of cellular networks 161, WiFi network 151, and the like.

[0036] In some variations, the current subject matter provides a proximity- based medical system that utilizes location awareness control the information display of patient monitor and/or route alarm messages. For example, if a caregiver is at the patient's bedside (caregiver 131), the system can be configured to annunciate the alarm at the bedside and display physiological information (for example) on one or more screens of the patient monitor 171. If no caregiver is near the patient (e.g., at the patient's bedside, or in the room, see for example rooms 142 and 144), the system does not annunciate the alarm at the bedside and disables the screens of the patient monitors 172 and 174. Similarly, a remote station screen (e.g., at remote patient monitor 175) can be activated and an alarm can be annunciated at the remote station 121 only if a caregiver is present there to receive the information (as is the case in Fig. 1 because caregiver 133 is at the remote station 121). [0037] Location awareness can be achieved with various wireless

technologies. For example, one or more Bluetooth beacons (191, 192, 193, and 194) can be provided to measure the linear distance between two Bluetooth devices. In some variations, triangulation in three-dimensional space can be allowed by using fixed Bluetooth reference points affixed to e.g., the ceiling or walls. In some variations, location may alternatively be estimated using triangulation with cellular 161, Wi-Fi 151, GPS (Global Positioning System) signals 162, or combinations thereof.

[0038] In some variations, the patient monitor can be configured to sense the linear distance to the nearest caregiver. For example, a Bluetooth chip can be included (e.g., embedded) in the patient monitor (171, 172, 173, 174), and a Bluetooth chip can be associated with each caregiver (e.g., embedded in the caregiver's identification badge or mobile device).

[0039] In some variations, the patient monitor can be configured to determine a transit distance (e.g., corresponding to a "transit" time, or an estimated time that it would take a particular caregiver to reach the patient). This can be determined, for example, using a map of the facility (e.g., a dataset representative of the dimensions and objects, etc.) and taking into account variables such as elevators and stairs.

[0040] Referring to FIG. 2, the system 110 (and/or each patient monitor (171 , 172, 173, 174)) can include, for example, one or more data processors 111, Bluetooth Chip 113 (or, for example, a network adapter for system 110) and memory 112 (e.g., a non-transitory computer medium) storing instructions that when executed by the one or more data processors, senses the presence of each caregiver's location tracking device (e.g., Bluetooth chip) in range, calculates the distance from each caregiver to a reference position (e.g., a patient room, patient monitor, remote station, etc.), and determines the distance to the nearest Bluetooth chip (i.e., the nearest caregiver) to the reference position. If the distance to the nearest caregiver is greater than, for example, the dimensions of the patient's room, then the system and/or the patient monitor can be configured to annunciate the alarm remotely (e.g., at the remote station 121 or sent to the caregiver's mobile device as a targeted alarm) and do not annunciate at the bedside. Furthermore, the monitor displays) at that room may be disabled.

[0041] As shown in FIG.2, the system 110 can be in data communication with data storage 114 via a data connection 115 to store and retrieve one and more data (e.g., the distance from each caregiver to each reference position, the nearest caregiver to each reference position, etc.). Although data storage 114 is shown as being separate, it can be implemented as part of the system 110. Similarly, each patient monitor can be provided with data storage as well.

[0042] In some variations, the patient monitor can be configured to receive a list of caregiver locations as coordinates in three-dimensional space. An article including a location device such as a Bluetooth chip (e.g., an ID badge) can be associated with each caregiver, and one or more fixed Bluetooth reference points can be used to triangulate the caregiver's location. The monitor can be configured to be aware of its own location, and/or the boundaries of the room in three-dimensional space. Thus, for example, if no other caregiver is present within the boundaries of the patient's room, then the alarms annunciate remotely (e.g., at the remote station 121 or as a targeted alarm) and do not annunciate at the bedside. Furthermore, the monitor display may be disabled. [0043] In some variations, the monitor can be configured to receive the opened/closed state of the door (181-184) to the patient's room, in addition to the distance/location of caregivers. If the door is closed and no caregiver is present in the room (e.g., room 143), then the alarms would be annunciated remotely (e.g., at the remote station 121 or as a targeted alarm) and do not annunciate at the bedside 143. Furthermore, one or more displays of patient monitor 173 may be disabled. However, if the door is open, the monitor may use more nuanced logic to decide where to annunciate. For example, if a caregiver (e.g., 132) is close enough to the door 183 to hear a bedside alarm, then patient monitor 173 may choose to annunciate at the bedside.

[0044] In some variations, each door can be provided with a sensor for sensing the open/closed state of the door of each patient room. The sensor can be in data communications with system 110 and/or one or more patient monitors.

[0045] In some variations, the remote station is configured to sense the linear distance to the nearest caregiver. If the system has decided not to annunciate at the bedside (e.g., when the system determines that there is no caregiver in proximity to the patient), then it will next consider whether to annunciate at the remote station 121. If no caregiver is in proximity to the remote station 121 (e.g., close enough to hear an alarm), then the alarm will not annunciate at that location 121. Instead, the system can be configured to route the alarm to a caregiver carrying a mobile communications device, for example, via a targeted alarm system.

[0046] In some variations, the remote station 121 can be configured to receive a list of caregiver locations as coordinates in three-dimensional space. The remote station 121 can be configured to be aware of its own location, and/or the boundaries of its room. If the system has decided not to annunciate at the bedside, then it will consider whether or not to annunciate at the remote station 121. If no caregiver is in proximity to the remote station 121 (e.g., close enough to hear an alarm), then the alarm will not annunciate at that location. Instead, the system can be configured to route the alarm to a specific caregiver carrying a mobile communications device via a targeted alarm system.

[0047] In some variations, one or more operation features or behavior (e.g., operation of the displays and alarm annunciators of the patient monitor and/or remote station) can be determined based on the proximity of a caregiver. For example, referring to FIG. 3, an example of a method in accordance with the current subject matter can include determining a distance between a tracking device and a bedside patient monitor (310). Based on that distance, one or more operation features (e.g., activation of displays and/or alarm annunciators) of the bedside patient monitor and the remote patient monitor can be determined. For example, if that distance exceeds a threshold (e.g., the caregiver is not in proximity to the bedside patient monitor), the bedside patient monitor can be configured to deactivate an operation feature (e.g., deactivate one or more displays) of the bedside patient monitor. An operation feature (e.g., one or more display) of a remote patient monitor can be activated (340) if no caregiver is in proximity of the bedside patient monitor. In some variations, one or more operation features (e.g., the display) of the remote patient monitor is only activated if there is a caregiver in proximity to the remote patient monitor (e.g., by determining a distance between the tracking device and the remote patient monitor and determining if that distance exceeds a threshold).

[0048] If the distance between the tracking device and the bedside patient monitor does not exceed the threshold, however (e.g., the caregiver is in proximity to the bedside patient monitor), the bedside patient monitor can be configured to activate an operation feature (e.g., a display) of the bedside patient monitor (330).

[0049] In some variations, the operation features that are controlled based on caregiver proximity can include, for example, deactivating/activating one or more displays of the bedside patient monitor (or the remote patient monitor), the annunciation of an alarm (e.g., when a physiological condition of the patient triggers an alarm). For example, when a caregiver is in proximity to the patient (e.g., near the bedside patient monitor or in the patient room), the system can annunciate the alarm near the bedside patient monitor. On the other hand, if no caregiver is in proximity to the patient, the alarm can (instead) be annunciated at a remote station. In some variations, if no caregiver is in proximity to the patient and no caregiver is in proximity to the remote station either, the system can be configured to generate an alarm message (e.g., a targeted alarm) and transmit that alarm message to one or more caregivers, for example, via a mobile communication device. In some variations, this can be done, for example, when no caregiver is in proximity to the patient regardless whether any caregiver is in proximity to the remote station.

[0050] In some variations, when no caregiver is in proximity, the patient monitor (e.g., the bedside patient monitor and/or the remote station patient monitor) can be configured to change one or more behaviors instead of or in addition to disabling its displays). Such behaviors can include, for example, displaying a screen saver, or selective/critical information (e.g., the condition triggering the alarm such as displaying the heart rate when it is above a threshold). [0051] In some variations, the one or more displays of a patient monitor (or a remote patient monitor) continues to display the information for a specified amount of time after a caregiver leaves its proximity and times out (e.g., disables the displays, or shows a screen saver, etc.) after the specified amount of time expires.

[0052] In some variations, the patient monitor can be configured to update its location within the environment when it has moved so that the relevant distances (e.g., to each of the caregivers) can be recalculated accordingly. For example, when a patient switches rooms, and the patient monitor moves with the patient to the new location, the patient monitor can be configured to update its location to the new location and determine the relevant distances (e.g., to each caregiver, the closest caregiver, etc.). Using a location map pre-set in a database, the monitor can determine the dimensions of its current room, and the distance to its walls and doorway. These distances can be used as boundaries for local annunciation.

[0053] In some variations, the patient monitor (or the remote patient monitor) is provided with a manual override, which when activated, activates the display(s) of the patient monitor even if no caregiver is sensed to be in proximity. This can provide additional safety in case, for example, the location tracking device is not working.

[0054] As discussed above, in some variations, the system can determine where to annunciate an alarm based on caregiver proximity. For example, referring to FIG. 4, the system can be configured to generate an alarm when the physiological data (e.g., monitored by a patient monitor) of a patient exceeds a physiological threshold (410). The system can be configured to annunciate the alarm near the bedside patient monitor if the distance does not exceed a threshold (e.g., if a caregiver is in proximity to the patient/patient monitor). The system can also be configured to annunciate the alarm at a remote location (e.g., the remote patient monitor 115 at the remote station 121) if the distance exceeds a threshold (e.g., no caregiver is in proximity to see/hear the alarm at the patient's bedside) (430).

[0055] One or more aspects or features of the subject matter described herein can be realized in digital electronic circuitry, integrated circuitry, specially designed application specific integrated circuits (ASICs), field programmable gate arrays (FPGAs) computer hardware, firmware, software, and/or combinations thereof. These various aspects or features can include implementation in one or more computer programs that are executable and/or interpretable on a programmable system including at least one programmable processor, which can be special or general purpose, coupled to receive data and instructions from, and to transmit data and instructions to, a storage system, at least one input device, and at least one output device. The programmable system or computing system may include clients and servers. A client and server are generally remote from each other and typically interact through a communication network. The relationship of client and server arises by virtue of computer programs running on the respective computers and having a client-server relationship to each other.

[0056] These computer programs, which can also be referred to as programs, software, software applications, applications, components, or code, include machine instructions for a programmable processor, and can be implemented in a high-level procedural language, an object-oriented programming language, a functional

programming language, a logical programming language, and/or in assembly/machine language. As used herein, the term "machine-readable medium" refers to any computer program product, apparatus and/or device, such as for example magnetic discs, optical disks, memory, and Programmable Logic Devices (PLDs), used to provide machine instructions and/or data to a programmable processor, including a machine-readable medium that receives machine instructions as a machine-readable signal. The term "machine-readable signal" refers to any signal used to provide machine instructions andor data to a programmable processor. The machine-readable medium can store such machine instructions non-transitorily, such as for example as would a non-transient solid- state memory or a magnetic hard drive or any equivalent storage medium. The machine- readable medium can alternatively or additionally store such machine instructions in a transient manner, such as for example as would a processor cache or other random access memory associated with one or more physical processor cores.

[0057] To provide for interaction with a user, one or more aspects or features of the subject matter described herein can be implemented on a computer having a display device, such as for example a cathode ray tube (CRT) or a liquid crystal display (LCD) or a light emitting diode (LED) monitor for displaying information to the user and a keyboard and a pointing device, such as for example a mouse or a trackball, by which the user may provide input to the computer. Other kinds of devices can be used to provide for interaction with a user as well. For example, feedback provided to the user can be any form of sensory feedback, such as for example visual feedback, auditory feedback, or tactile feedback; and input from the user may be received in any form, including, but not limited to, acoustic, speech, or tactile input. Other possible input devices include, but are not limited to, touch screens or other touch-sensitive devices such as single or multi-point resistive or capacitive trackpads, voice recognition hardware and software, optical scanners, optical pointers, digital image capture devices and associated interpretation software, and the like.

[0058] In the descriptions above and in the claims, phrases such as "at least one of or "one or more of may occur followed by a conjunctive list of elements or features. The term "and/or" may also occur in a list of two or more elements or features. Unless otherwise implicitly or explicitly contradicted by the context in which it is used, such a phrase is intended to mean any of the listed elements or features individually or any of the recited elements or features in combination with any of the other recited elements or features. For example, the phrases "at least one of A and Β;" "one or more of A and Β;" and "A and/or B" are each intended to mean "A alone, B alone, or A and B together." A similar interpretation is also intended for lists including three or more items. For example, the phrases "at least one of A, B, and C;" "one or more of A, B, and C;" and "A, B, and/or C" are each intended to mean "A alone, B alone, C alone, A and B together, A and C together, B and C together, or A and B and C together." In addition, use of the term "based on," above and in the claims is intended to mean, "based at least in part on," such that an unrecited feature or element is also permissible.

[0059] The subject matter described herein can be embodied in systems, apparatus, methods, and/or articles depending on the desired configuration. The implementations set forth in the foregoing description do not represent all

implementations consistent with the subject matter described herein. Instead, they are merely some examples consistent with aspects related to the described subject matter. Although a few variations have been described in detail above, other modifications or additions are possible. In particular, further features and/or variations can be provided in addition to those set forth herein. For example, the implementations described above can be directed to various combinations and subcombinations of the disclosed features and/or combinations and subcombinations of several further features disclosed above. In addition, the logic flows depicted in the accompanying figures and/or described herein do not necessarily require the particular order shown, or sequential order, to achieve desirable results. Other implementations may be within the scope of the following claims.

Claims

WHAT IS CLAIMED IS:

1. A proximity-based medical system comprising:

a patient monitor including a display for displaying physiological data of a patient; a location tracking device movable with respect to the patient monitor; and a data processor configured to determine a distance between the patient monitor and the location tracking device;

wherein the patient monitor is configured to deactivate an operation feature of the patient monitor if the distance between the patient monitor and the location tracking device exceeds a threshold.

2. A proximity-based medical system comprising:

a patient monitor for monitoring one or more physiological data of a patient;

a location tracking device movable with respect to the patient monitor; and a data processor configured to determine a distance between the patient monitor and the location tracking device;

wherein the patient monitor is configured to:

generate an alarm when the physiological data exceeds a physiological threshold, and

annunciate the alarm near the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold, or annunciate the alarm at a remote location if the distance between the patient monitor and the location tracking device exceeds the threshold without annunciating the alarm near the patient monitor.

3. The system according to claim 1 , wherein the patient monitor is further configured to: generate an alarm when the physiological data exceeds a physiological threshold, and

4. The system according to any of the preceding claims, wherein the patient monitor is further configured to activate the operation feature of the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold.

5. The system according to any of the preceding claims, wherein the operation feature includes displaying at least some of the physiological data of the patient.

6. The system according to any of the preceding claims, wherein the distance is a linear distance.

7. The system according to any of the preceding claims, wherein the distance is a transit distance corresponding to an estimated transit time for the location tracking device to move to the patient monitor.

8. The system according to claim 7, wherein the transit distance is determined based on a map of an area in which the patient monitor and the location tracking device are located.

9. The system according to any of the preceding claims, wherein the threshold is

determined based on one or more dimensions of a patient room in which the patient monitor is located.

10. The system according to any of the preceding claims, further comprising a door sensor operative connected to the patient monitor to allow the patient monitor to determine whether a door of the patient room is open or closed; the patient monitor being further configured to annunciate the alarm at the remote location when the door is determined to be closed and the distance between the patient monitor and the location tracking device exceeds the threshold.

11. The system according to any of the preceding claims, wherein the system is further configured to generate a targeted alarm and send the targeted to an identified target device when the distance exceeds the threshold and the location tracking device is not proximate the remote location.

12. The system according to any of the preceding claims, further comprising a manual override mechanism configured to activate the operation feature when the manual override is activated.

13. The system according to any of the preceding claims, wherein the operation feature is deactivated after a time period after the first distance exceeds the threshold.

14. The system according to any of the preceding claims, wherein the tracking device comprises a Bluetooth device.

15. A method of changing a behavior of a bedside patient monitor based on caregiver proximity, the method comprising:

determining, by at least one data processor, a distance between a tracking device and the bedside patient monitor; and

deactivating, by at least one data processor, an operation feature of the bedside patient monitor if the distance between the tracking device and the bedside patient monitor exceeds a threshold.

16. The method according to claim 15, further comprising:

determining, by at least one data processor, a second distance between the

tracking device and a remote patient monitor, and

annunciating an alarm near the bedside patient monitor if the first distance is lower than the second distance, or annunciating the alarm near the remote patient monitor if the second distance is lower than the first distance.

17. A method of alarm annunciation based on caregiver proximity, the method

comprising:

determining, by at least one data processor, a distance between a tracking device and the bedside patient monitor;

generating, by at least one data processor, an alarm when the physiological data

exceeds a physiological threshold; and

annunciating the alarm near the patient monitor if the distance between the patient monitor and the location tracking device is below the threshold, or annunciate the alarm at a remote location if the distance between the patient monitor and the location tracking device exceeds the threshold without annunciating the alarm near the patient monitor.

18. The method according to any of claims 15-17, further comprising activating, by at least one data processor, the operation feature of the bedside patient monitor if the first distance does not exceed the threshold.

19. The method according to claim 18, wherein the operation feature includes displaying physiological data of the patient on a display.

20. The method according to any of claims 15-19, wherein the first distance is a linear distance.

21. The method according to any of claims 15-20, wherein the distance is a transit

distance corresponding to an estimated transit time for the location tracking device to move to the patient monitor.

22. The method according to claim 21 , wherein the transit distance is determined based on a map of an area in which the patient monitor and the location tracking device are located.

23. The method according to any of claims 15-22, wherein the threshold is determined based on one or more dimensions of the patient room.

24. The method according to any of claims 15-23, further comprising:

determining, by at least one data processor, a door of the patient room is open or closed; and

annunciating, by at least one data processor, an alarm near a remote patient

monitor when the door is determined to be closed and the first distance exceeds the threshold.

25. The method according to any of claims 15-24, generating and transmitting, by at least one processor, a targeted alarm to a targeted communications device when the first distance exceeds the threshold and an alarm event is triggered.

26. The method according to any of claims 15-25, further comprising activating, by at least one data processor, the operation feature when a manual override signal is received.

27. The method according to any of claims 15-26, wherein the operation feature is deactivated after a time period when the first distance exceeds the threshold.

28. The method according to any of claims 15-27, wherein the tracking device comprises a Bluetooth device.

29. A non-transitory computer readable medium storing instructions, which when

executed by at least one data processor of at least one computing system, result in operations implementing a method according to any of claims 15-28.