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  • 专利说明
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    • 专利摘要:
    SUMMARY A patient monitoring device (100, 200, 300) receives sensor data from an external sensor (400). The sensor data is processed by a drug titration module (120, 220, 320) to automatically provide information on a current dose of a prescribed drug developed in accordance with a drug titration algorithm. A training module (140, 240, 340) uses sensor data to select a training class from among several available training classes and provides a training instruction belonging to the selected training class. This provided training instruction is displayed with the information about the current dose on a screen (150, 250, 350).
    公开号:SE1200508A1
    申请号:SE1200508
    申请日:2012-08-23
    公开日:2014-02-24
    发明作者:Andreas Blomqvist；Fredrik Westman
    申请人:Careligo Ab；
    IPC主号:
    专利说明:

    TECHNICAL FIELD The present invention relates generally to medical devices, and more particularly to patient monitoring devices and systems that include such devices.
    BACKGROUND Heart failure is a very common disease in industrialized nations. In Sweden alone, there are about 250,000 people who suffer from heart failure. The prevalence is 2-3% in relation to the entire population and as high as 10- 10 15% among those over 75 years. The prognosis for heart failure patients is actually better than for patients diagnosed with breast or prostate cancer, with a fern mortality of about 50%.
    Heart failure is intimately associated with high healthcare costs. Today, approximately 2-3 (:) / 0 of Sweden's total health care budget goes to the treatment of heart failure. In contrast to other medical conditions associated with high healthcare costs, only about 2-8 (:) / 0 of the total cost for heart failure treatment of medications, while costs associated with hospitalizations make up about 70%.
    Over the past decade, more than 30 randomized clinical trials with thousands of patients have been conducted, with the aim of studying different ways to reduce the frequency of hospitalizations for heart failure patients. These studies show that different intervention modalities, such as remote monitoring of physiological parameters, patient education, home visits and telephone support and telephone follow-ups, could halve the frequency of hospital admissions compared to control groups. These different intervention modalities achieved the effect of increasing patients 'adherence to the prescribed treatment, and it is generally considered that the most potent way to reduce heart failure-related costs is by increasing patients' adherence.
    Similar problems associated with lack of adherence to prescribed treatment and high costs of hospitalization are also found among other groups of elderly patients than those with heart failure. Various techniques have been proposed to solve the problems they have.
    US 2009/0062727 describes a system for controlling body fluids by automatically infusing diuretics and / or other drugs into a human patient. The infusion rate of the diuretic is adjusted based on the patient's measured weight. This weight is sent wirelessly to a portable diuretic infusion device attached to the patient. 2 US 2010/0228566 describes a portable throat monitoring and medication system that provides personal medical care and daily medication routines. The system includes a medication unit, a blood sample unit and monitoring of other vital parameters in a portable and wireless device. The system informs the user about the correct times for taking the drug and automatically provides the patient with the correct prescribed dose.
    US 2007/0260487 describes a system for managing prescribed medication for a user with an electronic device for interactive communication between the user and a server. The server contains an analysis unit which has access to a database with drug characteristics and a processor for comparing the measured characteristics of a drug in an electronic device in order to be able to identify the drug and provide, to the electronic device, an indication 1) 6 about the drug is compatible with the patient's prescribing drug regimen.
    Suh et al., WANDA B .: Weight and Activity with Blood Pressure Monitoring System for Heart Failure Patients, IEEE Trans Inf Technol Biomed, 2010 June 14: 1-6 describes "WANDA B. wireless throat technology" that utilizes sensor technology and wireless communication for to monitor activity in heart failure patients and provide tailored guidance. Patients with cardiovascular disease can automatically feed their weight, herring blood pressure, activity levels and other vital parameters in real time.
    However, the systems and devices described above are all encumbered with being complex or responsive to patients. Thus, there is a need for improvement in this area of technology.
    SUMMARY It is a general object to provide a patient monitoring device that can be used as a tool by patients for treatment compliance.
    It is a special purpose to provide such a tool that can reduce the risk of patients being admitted to hospital.
    These and spirit objects are achieved by embodiments as described herein. One aspect of the embodiments relates to a patient monitoring device comprising a communication unit configured to receive, from an external sensor, a signal representing a current value of a medical characteristic of a patient. A memory is connected to the communication device and is configured to store the current value. A drug titration module is connected to the memory and is configured to process the current value according to a drug titration algorithm stored in the memory. Thereby, the drug titration module outputs information about a current dose of a prescribed drug. An education module is implemented and linked to memory. The training module includes a class selector configured to select, at least in part based on the current value, a training class among several predefined training classes. Each such training class includes at least one respective training instruction. A training instruction provider of the training module is configured to provide, from memory, a training instruction belonging to the training class selected by the class selector. The patient monitoring device is configured to present information about the current dose and training instruction provided by the training instruction provider.
    Another aspect of the embodiments relates to a heart rate monitoring system comprising a scale with a processor configured to generate a signal representing a current weight of a patient standing on the scale. The carriage also includes a communication unit configured to transmit the signal to the communication unit or patient monitoring device.
    The patient monitoring device also includes a memory coupled to the communication unit and configured to store a value representing the current weight. A drug titration module is connected to the memory and is configured to process the value in accordance with a drug titration algorithm stored in the memory. The drug titration module thereby outputs information on a current dose of a prescribed diuretic drug. A training module is also connected to the memory and includes a class selector and a training instruction provider. The class selector is configured [Or to select, at least in part based on the value, an education class among several predefined education classes. Each such training class includes at least one respective training instruction. The education instruction provider is configured to provide, from memory, an education instruction belonging to the education class selected by the class selector. A screen of the patient monitoring device is configured to present, to the patient, information about the current dose and the training instruction provided by the instruction provider. 4 The embodiments provide a valuable tool for assisting the patient with his / her treatment and are designed to improve compliance with the treatment. As a direct result of this, the risk of hospitalizations can be reduced through a more correct adherence to treatment. The embodiments improve the armed patient's quality of life by placing them at the center, and in control of their treatment.
    BRIEF DESCRIPTION OF THE DRAWINGS The invention, together with further objects and advantages thereof, is best understood by reference to the following description taken in conjunction with the accompanying drawings, in which: Fig. 1 is a schematic overview of a patient monitoring system comprising an external sensor and a patient monitoring device according to a embodiment; Fig. 2 is a schematic block diagram of a training module according to an embodiment; Fig. 3 is a schematic block diagram of a drug titration module according to an embodiment; Fig. 4 is a schematic block diagram of a patient monitoring device according to another embodiment; Fig. 5 is a schematic block diagram of a patient interaction module according to an embodiment; Fig. 6 is a schematic block diagram of a patient monitoring device according to a further embodiment; Fig. 7 illustrates an embodiment of a patient monitoring device; Fig. 8 illustrates presentation of current dose information along with a provided training instruction according to an embodiment; Fig. 9 illustrates presentation of available education classes according to an embodiment; Fig. 10 illustrates presentation of patient data accessible by using a patient interaction module according to an embodiment; Fig. 11 illustrates presentation of contact information for neckward device according to an embodiment; and Fig. 12 illustrates an embodiment that connects a patient monitoring system to external devices and services.
    DETAILED DESCRIPTION The same male reference numerals are used throughout the drawings for similar or corresponding elements.
    The present embodiments generally relate to a patient monitoring device and a patient monitoring system comprising such a device. The patient monitoring device can be used as an intuitive tool to increase a patient's compliance with a prescribed drug regimen and / or treatment instructions from the patient's physician. The patient monitoring device is particularly useful for older patients or other patient groups within which there is a risk of legal adherence to a prescribed treatment, or where patients have responsibilities to interpret a prescribed treatment correctly.
    The present embodiments lower the thresholds for the patient to follow a prescribed treatment and medication and can therefore be an important tool and helped to prevent hospitalizations and constriction of the patient's neck.
    Fig. 1 is a schematic view of a patient monitoring system 1 including a patient monitoring device 100 in accordance with one embodiment. The patient monitoring system 1 comprises at least one external sensor 400 configured to supply a medical characteristic or parameter to the patient. This medical characteristic can generally be the parameter heist used by the patient monitoring device 100 to determine, among other things, an appropriate dose of a prescribed drug. Thus, the specific external sensor 400 of the patient monitoring system 1 depends on various factors, such as the patient's disease or throat condition, the specific drug (s) prescribed by the patient, and the drug titration algorithm currently used by the patient monitoring device 100. Non-limiting examples of external sensor embodiments which can be used in the patient monitoring system 1 comprises a vague, a blood pressure sensor, as in the form of a blood pressure cuff, cardiac activity sensor, as in the form of a portable electrocardiogram module (ECG module). The patient's specific medical characteristics determined by the external sensor 400 may, in these examples, be the patient's current weight, the patient's current blood pressure, the patient's current pulse, or the patient's current heart rhythm morphology.
    Preferably, the external sensor 400 includes, regardless of the particular type of sensor and what medical characteristics the external sensor 400 measures, a processor 420 configured to generate a signal representing a current value of the patient's medical characteristics. The external sensor 400 also includes a communication unit 410 configured to send this signal generated by the processor 420 to a corresponding communication unit 110 in the patient monitoring device 100.
    The communication between the external sensor 400 and the patient monitoring device 100 may be wireless, such as based on electromagnetic signals such as radio frequency (RF), e.g. via Bluetooth or WiFi, or infrared (IR) signals, inductive signals, etc., or wired communication. In the first case, the communication unit 410 in the external sensor 400 may be in the form of a transmitter or a sand receiver if bidirectional communication is desired. The corresponding communication unit 110 in the patient monitoring device 100 is then preferably implemented as a receiver or sand receiver. In the case of wired communication, the communication unit 410 in the external sensor 400 may be a public output unit or a combined input and output unit (I / O unit) with the communication unit 110 of the patient monitoring device 100 as a matching input or I / O unit.
    The patient monitoring device 100 according to the embodiment illustrated in Fig. 1 thus comprises a communication unit 110 configured to receive, from the external sensor 400, a signal representing a current value of a medical characteristic of the patient. This current value is stored in a memory 120 which is connected to the communication unit 110.
    The patient monitoring device 100 comprises at least two modules, units or devices which, by their integration or inboard connection, provide a patient monitoring device 100 which can be used as a treatment compliance tool for the patient.
    Thus, a drug titration module 130 is implemented in the patient monitoring device 100 and connected to the memory 120. This drug titration module 130 is configured to process the current value stored in the memory 120 in accordance with a drug titration algorithm available for the drug titration module 130 in the memory array. of the current value by means of the drug titration algorithm generates information about a current dose of a prescribed drug. Thus, the drug titration algorithm 130 outputs this dose information. In a specific embodiment, the drug titration module 130 may generate information about the current dose not only by processing the current value but also the previous value from the external sensor 400, which is further discussed herein.
    The patient monitoring device 100 also includes a training module 140 coupled to the memory 120. This training module 140 also processes and uses the current value stored in the memory 120.
    The training module 140 preferably includes, as schematically illustrated in Fig. 2, a class selector 142 and a training instruction provider 144. The class selector 142 is configured to select a training class from a plurality of training classes. Each such training class then includes at least one, typically several different, training instruction (s). The class selector 142 performs some training class choices based at least in part on the current value of the patient's medical characteristics. The training instruction provider 144 is then configured to provide, typically from memory 120, a training instruction belonging to the training classes selected by the class selector 142.
    The patient monitoring device 100 also includes a screen or display 150, configured to present to the patient the information on the current dose discharged from the drug titration module 130 and the training instruction provided by the training instruction provider 144 of the training module 140. Fig. 8 is an example of such display of information. about the current dose and a training instruction.
    The patient monitoring device 100 determines and presents, on the screen 150, therefore information on a current dose of a prescribed drug and a training instruction, both of which have been determined by respective modules 130, 140 of the patient monitoring device 100 at least in part based on the current value of the patient's medical characteristics received. from the external sensor (400).
    In general, a lack of knowledge or understanding of the patient's disease or medical condition correlates the choice with lawful compliance with an prescribed treatment. This in combination with inadequate handling of drug administration in the patient is the main reason for exacerbation of the disease state and hospitalization of the patient. The patient monitoring device 100 solves these problems by determining appropriate drug doses and training instructions or "tips of the day" based on the current patient situation, as represented by the sensor output from the external sensor 400. This meant that the patient monitoring device 100 can provide the most appropriate information. drug dose and training instruction, given the patient's current condition. The information is preferably provided to the patient in a simple and intuitive manner as shown in the example of Fig. 8. This means that the information is readily accessible and easy to understand for the patient and is preferably conveyed by another patient with similar diagnosis and similar demographics.
    A module 130, 140 connected to the memory 120 may be implemented via a direct or indirect electrical connection between the memory 120 and the module 130, 140. Alternatively, the module 130, 140 is implemented in the software stored in the memory 120 and executed by a processor of the patient monitoring device 100.
    Fig. 3 illustrates various units of the drug titration module 130. In one embodiment, the drug titration module 130 first verifies whether the current value retrieved from memory is reasonable and not a food error. This verification reduces the risk that the drug titration algorithm determines inappropriate drug doses based on incorrectly entered values. In one embodiment, therefore, the drug titration module 130 includes a signal generator 132 configured to verify whether the current value is within the template value range. If the current value is within the malvari range, it is likely that the current value correctly represents the patient's current medical characteristics as determined by the external sensor and a correct drug dose can thereby be determined. If, on the other hand, the current value is outside the target area, it is probable that the current value is due to some food defect and this current value should not allow anyone else to determine a drug dose.
    In one embodiment, the signal generator 132 is configured to generate a blocking signal if the current value is outside the template value range. The drug titration module 130 then responds to the blocking signal and is configured to block processing of the current value according to the drug titration module based on the blocking signal. Thus, no drug dose is determined at this incorrect current value.
    In an alternative approach, the signal generator 132 is configured to generate a progress signal if the current value is within the target value range. In such cases, the drug titration module 130 processes the current value according to the drug titration algorithm only if the signal generator 132 generates this progress signal.
    These two alternative embodiments can be combined so that the signal generator 132 generates each time a new current value is received from the external signal, either a progress signal or a blocking signal depending on the current value. The drug titration module 132 thus blocks or allows the processing of the current value depending on whether the signal generator 132 outputs the blocking signal or the progress signal.
    The comparison between the current value and the template value area can be a simple comparison between the current value and a single threshold value. Ants & if the current value exceeds (or falls below) the threshold value, then it is judged to be within the template area. In an alternative approach, the target value range is defined by a lowest threshold value and a highest threshold value so that the signal generator 132 then compares the current value with these several threshold values. In the latter case, the area may be defined as ± Y% of an initial value of the patient's medical characteristics. The value Y can be predefined or set by the doctor.
    The drug titration module 130 may have access to several drug titration algorithms, as stored in the memory 120. In this approach, the patient monitoring device 100 is configured for use with different patient groups, where each group has at least one appropriate drug titration algorithm then used in the memory system. to select which specific drug titration algorithm to use for the patient in question. In such cases, the patient monitoring device 100 includes a user input 160 configured to receive an algorithm selection signal. This user input 160 may be in the form of a key pressed or activated by a laker. Alternatively, the screen 150 may be in the form of a pressure sensitive screen 150. In such cases, the doctor may activate the user feeder 160 by pressing a specific portion of the pressure sensitive screen 150. The user feeder 160 may also be in the form of a receiver configured to receive a algorithm selection signal from a (wireless or wired) connected keyboard, computer mouse, keyboard or other device.
    The drug titration module 130 is then configured to select one of the multiple drug titration algorithms stored in memory 120 based on the algorithm selection signal.
    The user feeder 160 mentioned above may also or alternatively be used by the physician to enter information to calibrate (the selected) drug titration algorithm for the specific patient. For example, the physician may use the user feeder 160 to provide information about a starting dose of the prescribed drug, information about an incremental dose increase, and / or information about a day number. The drug titration module 130 is then configured to define the drug titration algorithm based on the information received. In it has specific example, the starting dose represents the initial dose of the prescribed drug. Incremental dose increase represents the dose increase that is desired in response to a defined change in the current value received from the external sensor 400 compared to a standard value or a previously received value on the patient's medical characteristics. The optional day number can be set to define which previous value the current value from the current day is to be compared with, such as the previous value from yesterday, the previous value from the previous day, and so on, or an output value from a mathematical operation performed on the previously stored values.
    The drug titration algorithm is preferably executed by the drug titration module 130 in conjunction with the patient monitoring device 100 receiving the signal representing the current patient patient's drug shake characteristics.
    Furthermore, the patient's drug regimen can be tailored to the specific patient if the physician sets control parameters for the drug titration algorithm as previously described, using the user feeder 160. In this way, the patient accesses the dose recommended by the physician each day, based on the patient's condition.
    A specific example will now be presented of how a drug titration algorithm can be defined based on information received by the physician through the user input device 100 of the patient monitoring device 100. In some specific examples, the patient is a heart failure patient and the drug prescribed is diuretic. The external sensor 400 is exemplified by an external scale with a sensor configured to generate a signal representing a current value on the weight of a patient standing on the scale. The drug titration module 130 then processes the current value and information about a starting dose stored in the memory 120 in accordance with the drug titration algorithm to output information about the current dose of diuretic. In one embodiment of this example, the drug titration module 130 includes a first control processor 134 configured to output a first control parameter having a first value of WnWn-iXi and a second value of Wn-Wr_i.A dose processor 138 of the drug titration module 130 is configured to determine the actual dose, Dn, of the prescribed drug, preferably diuretic, to be equal to one of i) to v) below: the starting dose of the memory 120 does not store the previous value of the weight at day n-1; the starting dose plus an incremental dose of memory 120 does not store the previous value by weight at day n3 but stores the previous value by weight on day n-1 and the first rule parameter has the first value; iii) the starting dose of memory 120 does not store the previous value by weight for day n-3, but stores the previous value by weight by day n-1 and the first rule parameter has the second value; the initial dose plus an incremental dose of memory 120 stores the previous values by weight at day n-day and day n-3 and the first rule parameter has the first value or the second rule parameter has the first value; the starting dose of memory 120 stores the previous values by weight at day n-1 and day n-3 and the first rule parameter has the second value and the second rule parameter has the second value.
    The memory 120 stores the starting dose and the incremental dose, both of which have preferably been set by the doctor via the user feeder 160 as previously discussed.
    The above example is based on the European Society of Cardiology (ESC) guidelines which suggest that a weight gain of 2 kg Over 3 days should trigger a dose increase and the American College of Cardiology / 12 American Heart Association (ACC / AHA) guidelines which recommend that a weight gain at 2 lbs over a day should trigger a dose increase.
    The above drug titration algorithm can be defined according to: n = 0; Ds = starting dose; // set by the physician via the user feeder Di „= incremental dosing in case of weight gain; // set by the physician via the user feeder Dn // recommended dose day n The first control processor 134 can then implement the ACC / AHA requirements with the threshold Xi = 1 (where 2 lbs are rounded to 1 kg): if Wn-Wn_il Rule1 = TRUE; else Rule1 = FALSE; end The second rule processor 136 can then implement the ESC requirements with the threshold X2 = 2: if Wn-W3> 2 Rule2 = TRUE; else Rule2 = FALSE; end The dose processor 138 will then use these two Boolean variables (TRUE and FALSE) to determine whether or not the dose should be titrated based on a logical OR function between these two rules. In other words, as long as one of the rules is TRUE, the diuretic should be titrated. In an optional case, the drug titration module 130 delivers the elevated dose in e.g. two days regardless of what happens to the patient's weight the day after the weight gain. This is of course optional and can be selected by the doctor via the user feeder 160. if n <1 // If the first day is of course D = D. 13 D = Ds; elseif Dn-1> Dn-2 // Okades dosen igar Dn = Dn-1; // Maintain the high dose. This is wafritt. elseif 0// Update dose on weight gain. // No dose update.
    The training module 140 of the patient monitoring device 100 preferably selects the training class not only based on the current value of the patient's medical characteristics. In preferred embodiments, other parameters may be used in the class selection. Fig. 9 illustrates the screen 150 of the patient monitoring device 100 when the training instruction or tip tab has been selected by the patient. The figure shows four examples of different education classes: medicine education class, lifestyle education class, disease education class, in this case represented as heart failure education class, and symptom education class. The disease / heart failure education class then includes at least one instructional instruction with information about the disease (heart failure) that the patient is suffering from. The medical education class includes at least one educational instruction with information related to drugs prescribed to the patient and the lifestyle education class includes at least one educational instruction with information related to lifestyle change tips to improve the patient's disease status. The symptom education class includes educational instructions related to symptoms associated with the particular disease.
    The patient can then, via the user input 160, select one of these training classes. The user input 160 generates a class selection signal representing the education class selected by the patient by activating the user input 160. belonging to the chosen education class. In another embodiment, the training instruction provider goes step by step through the training instructions in the usual training class. This means that first * again a patient selects a specific training class provider and preferably presents the training instruction provider 144 the first training instruction in the training class, the second * again that this training class is selected is provided to the second training instruction, and so on. Once all of the instructional instruction in a training class has been provided, the training instruction provider 144 may return to present the first instructional instruction to begin a new cycle.
    The training instruction provider 144 may be configured to present the training instruction in a manner other than that shown in Fig. 9. For example, words may be accentuated in a short text and activation of such an accented word by the user input 160 causes the training instruction provider 144 to provide a training instruction similar to hyperlinks.
    The above-described functionality of the training module 140 concerning the provision and presentation of training instructions is activated when the patient spiv activates the training tab. However, in one embodiment, the training module 140 may also use this information about previously selected training classes as it automatically selects a training class and provides a training instruction in connection with the presentation of the drug dose information, see Fig. 2.
    In this embodiment, the memory 120 thus stores information about educational classes previously selected by the patient, i.e. stores information based on the selection signal generated when the user activates the user input 160 to select one of the training classes. The class selector 142 is then configured to select the education class At least in part based on the current value of the patient's medical characteristics and the information about the previously selected education classes.
    This meant that in this approach, the education class is selected not only based on the patient's current characteristics and condition, as represented by the current value of the external sensor 400, but also based on the patient's preferences. That is, if the patient is more interested in one of the education classes and therefore has previously chosen this education class more often than other education classes, the class selector 142 preferably weighs this education class more heavily than other education classes in the selection. The reason for this is that it is more advantageous to present information to the patient that he / she is interested in in order to encourage him / her to follow prescribed treatment rather than to present information that the patient is likely to ignore.
    In one embodiment, therefore, the training module 140 includes a probability determiner 146 configured to determine a respective probability for each training class, based on the current value and based on the information of previously selected training classes. For example, depending on the current value, it may be more favorable to choose one of the education classes over the others. In such cases, this education class preferably has a higher probability of being elected. Similarly, if the patient is particularly interested in one of the education classes, he or she preferably has a higher probability of being selected from the other education classes. This probability of being elected can in an example be represented by weights, such as one weight per education class. Each such weight could then be a product of two terms where one is determined based on the current value and the other based on the patient's preferences for educational classes. The higher the weight of an education class, the higher the probability that this education class will be chosen by the class elector 142.
    Another implementation of some pseudo-random choices of education classes may be that of N consecutive education instructions presented together with the particular drug dose, M education instructions are picked from the education class that the patient has studied the most times, where MThe class selector 142 is in this embodiment configured to pseudo-randomly select the training class from several predefined training classes based on the probabilities of being selected, determined by the probability determiner 146. The training instruction provider 144 then provides one of the training instructions associated with this training class. randomly select one of the training instructions or by providing the next training instruction in accordance with a defined order.
    Also other parameters beyond the current value and anyandar preferences linked to education classes can be anyandas by the class selector 142 when selecting education class. For example, 16 information about the specific time of day at which the patient performs the sensor depletion in order to M the current value of the medical characteristics and / or the frequency with which the patient performs the sensor debris can be used in the selection of training classes.
    The training module 140 of the patient monitoring device 100 provides training for the patient in a specific way based on free behavioral science and tailored to the specific patient. The training module 140 is, as mentioned above, preferably intelligent and allows what the patient is interested in and focuses on conveying information in a way that is perceived as positive and opportunity-oriented for the patient. The training module 140 therefore provides this information in a simple "tips of the day" format in connection with the presentation of the particular drug dose, which optimizes the understanding of the training instructions. Furthermore, the training module 140 enables the patient to manually select and present further training instructions if the patient so wishes.
    Lack of knowledge or understanding of the patient's medical condition correlates vast choices with legal adherence to a prescribed treatment, while high levels of understanding and knowledge predict more responses to treatment. It is even the case that not only adherence to drug treatment but also results are positively affected through training and education.
    The training module 140 of the patient monitoring device 100 provides this information in a manner and format that is easy to absorb and user-friendly.
    The training module 140 preferably presents the training instruction automatically in connection with the presentation of the determined drug dose. This training instruction is advantageously in a format that talks about what the patient can Ora, as opposed to what he cannot Ora, ie. in a positive way. The training instruction is presented with the advantage of another patient who suffers from the same patient as the patient in question as indicated in Figs. 8 and 9. This approach has proven to be a powerful way to improve training admissions. Thus, the training instructions are given in a positive way with an emphasis on possibilities rather than focusing on what the patient does not Mr Ora, and are given with advantage as comments or suggestions rather than orders or directives, and / or given with the benefit of a patient in the same or similar seat.
    The patient monitoring device 200 may, as shown in Fig. 4, also have a patient interaction module 270 in addition to the modules or devices presented in Fig. 1. This patient interaction module 270 17 allows the patient to interact with the patient monitoring device 200 and obtain information about their disease history. In such a case, the memory 220 of the patient monitoring device 200 advantageously stores the information on the current dose determined by the drug titration module 230 based on the current value of the medical characteristics obtained from the external sensor 400. The patient interaction module 270 includes, as shown in Fig. 5, a dose processor 272 configured to process the information on the current dose to generate information representing the current dose over time for the patient. Fig. 10 illustrates such information graphically presented on the screen 250 of the patient monitoring device 200. The patient interaction module 270 also includes a characteristic processor 274 configured to process the current value of the medical characteristic to generate information representing the current value of the medical characteristic over time for the patient.
    In such cases, the patient may use the user input device 260 of the patient monitoring device 200 to select one of several types of interaction. Fig. 10 illustrates this concept by showing three alternative possibilities: "weight", "drug dose" and "choice position". The user input 260 then generates an interaction signal representing the selected interaction type (s). The patient interaction module 270 responds to this interaction signal and is configured to present, based on the interaction signal, one of the information generated by the dose processor 272 and the information generated by the characteristic processor 274 on the screen 250.
    The patient interaction module 270 thus enables the patient to follow the determined dose of drug over time and / or his medical characteristics over time. The patient interaction module 270 can therefore feed information related to the throat status and dose prescription directly to the patient to enable self-estimated symptom tracking and throat status and medication trends.
    The patient interaction module 270 may also include additional processors as illustrated by the symptom processor 276 in Fig. 5. This symptom processor 276 is configured to present, on the screen 250, information prompting the patient to indicate a current patient symptom. Della can be done with a simple format such as a choice between feeling good, ok versus bad, to more detailed symptom information. The patient then uses the user input 260 to generate a symptom signal representing the current symptom indicated by the patient. The symptom processor 276 stores this symptom signal in the memory 220. In a specific embodiment, the symptom processor 276 generates a hospitalization signal based on the symptom signal, the current value and information about a previous hospitalization period for the patient stored in the memory 220. The patient monitoring device 200 stores information about a previous period. was hospitalized due to deterioration of his throat status. This information is stored together with the symptom signal and the current values in the memory 220 during and / or immediately before the hospitalization period. The symptom processor 276 can then compare the current symptom signal and the current value with the corresponding symptom signal and the value of the medical characteristic that occurred in the previous hospitalization case. If the current signal and values are very similar to the previous signal and values, there is an increased risk of a new hospitalization period for the patient. The patient monitoring device 200 can then, based on this hospitalization signal generated by the symptom processor 276, present an increase in hospitalization risk to the patient.
    Hereinafter, a typical use of the patient monitoring device and system according to the embodiments will be further discussed in connection with such a device and system adapted for a heart failure patient.
    The heart failure patient is prescribed the patient monitoring system according to the embodiments of his physician, which is installed directly in the patient's home. Preferably, the patient also takes the system's patient monitoring device with him to his doctor during follow-ups or doctor visits at the doctor's ward. In such cases, the doctor may, at the first visit, enter necessary information, such as the choice of drug titration algorithm and start parameters for the drug titration algorithm. In another embodiment, the physician can access the patient monitoring device via the mobile network, the Internet, or by other means such that the patient does not need to bring his patient monitoring device to the physician.
    Below is a description of a typical or normal flood for what a normal day looks like when the patient monitoring system is used in the patient's home.
    The patient wakes up in the morning and stands on the road, which constitutes the patient monitoring system's external sensor in some special examples. The patient monitoring device may optionally display a throat message on the screen indicated in Fig. 7. The patient's weight is transferred automatically and wirelessly to the patient monitoring device, where the drug titration algorithm determines, based on the conditions preferably set by the physician, what the current diuretic dose should be. In connection with the presentation of the determined dose, as immediately before, together with or immediately after the presentation of the determined dose, the patient monitoring device also presents a "tip of the day", ie. training instruction, which acts in a personal way to train the patient. The determined diuretic dose, given the patient's unique weight trend and medical installations, is also presented on the screen, see Fig. 8.
    This completes the daily procedure and takes up approximately one minute of the patient's time. It is very easy for the patient, because you do not have to look for something you may have put away, nothing should be written down anywhere, nothing should be compared with something you should remember - everything is fully automated and neatly served in an efficient way.
    For the patient who so wishes, however, he can learn more at the touch of a button about what the patient in question is most interested in through the inclusion of the training module and preferably through the patient interaction module in the patient monitoring device, see Figs. 9 and 10.
    If the physician has chosen to activate this feature, the patient will also be asked to estimate the day's symptoms, or rather describe how he / she feels by choosing the appropriate symbol presented on the screen.
    If the patient is interested in seeing how he / she is doing, the patient can be presented with graphs that show long-term and short-term weight variations through the action of the patient interaction module by simply pressing a button on the screen. How the diuretic dose has varied over time is also presented. If activated, the patient can also see how his / her choice position has changed over time and link this to other factors presented to the patient, which thereby further increases the feedback to the patient and justifies the patient, see Fig. 10.
    The following are various examples of how the various modules of the patient monitoring device interact and perform their intended functions, based on output signals from the external sensor. In these examples, the patient is assumed to be a heart failure patient and the drug titration module is configured to output information on a current dose of a prescribed diuretic.
    If a patient's nominal diuretic dose is zero, and diuretics will only be prescribed after a weight gain, then it may be important to ensure that the "tip of the day" that day is a description of what diuretics are, ie. one tip frail medication tab sails. Thus, in some cases, the drug titration module uses a drug titration algorithm set, preferably by the physician, which has a starting dose equal to zero. If, on the other hand, the signal received from the carriage indicates a weight gain in excess of a threshold, preferably set by the physician, then the drug titration module outputs information that the non-zero diuretic dose should be taken by the patient that day. Furthermore, the class selector of the training module is configured to select, based on the weight gain, the medical training class, thereby enabling the training instruction provider to provide and present a training instruction that rhymes the patient with valuable information on diuretics.
    In one embodiment, the class selector may select all of the particular training class to be a training class that includes the most important information and instructions if the patient is not regularly ventured. In such a case, the training module guarantees that at least the aura most important training instructions are presented to the patient when he / she finally uses the patient monitoring system. In a specific embodiment, the physician may use the patient monitoring device to define or select which training class (s) is to be considered most important.
    In one embodiment, if the patient performs a weighing procedure at very different times in the morning, e.g. spread between 4 and 10 in the morning, then the patient is likely to suffer from sleep deprivation. Sleep tips, specifically designed for heart failure patients, can then be included in an education class.
    The class selector can then use this information about at what times the patient monitoring device receives the sensor signal to determine whether training instructions taken from the training class with sleep tips would be beneficial to the patient or not.
    In one embodiment, if a slowly rising weight is detected, i.e. over weeks / months rather than days, then it is likely that the patient has put on fat. The class selector is then preferably configured to select training classes including training instructions linked to diet and exercise, ie. from a lifestyle education class.
    In one embodiment, the patient monitoring device may present a screen on the screen that urges the patient to contact their physician if patients begin to venture more frequently and at the same time detect a general increase in self-reported symptoms.
    In an embodiment where the frequency with which the patient uses the patient monitoring system decreases and the symptoms become less common as other types of interactions then the class selector can choose a 21 education class with educational instructions that informs the patient what generally precedes a hospitalization and thereby encourages the patient to contact their doctor .
    In one embodiment if the symptom function is activated by the physician but patients do not use it to enter their symptoms, the class selector can select an education class with educational instructions that educate the patient how important it is to use the function of the day tip.
    In one embodiment, if the patient uses the opportunity to enter the date when a possible hospitalization has taken place, then a composite overview of what led to the hospitalization in terms of symptoms, dose, weight, etc. can be shown to the patient to teach the patient which are the warning signals for imminent pre-assembly or hospitalization.
    Fig. 10 illustrates an example of the screen when the patient has activated the patient interaction module to present information about the patient's medical history, as recorded by the patient monitoring device. The so-called history tab on the screen allows the patient to choose, in some examples, from three choices, which are "drug dose", "weight" and "choice feeling". It is also possible to overlay all three parameters to create links between the trends, e.g. "can I see that my weight went up, I started ma samre, the dose went up then, the weight went down, and I started to ma better again", or "I can see that my weight has dropped and I mar bathe alit since I started exercising as I reloaded in that tip! Wonder what more I can do to improve my choice - let's go to the tips tab.
    The patient monitoring device advantageously stores each weight and each dose of saliva as each entered symptom characteristic (if that choice is used) and they can then be studied by the patient at any time. This is a powerful way to get the patient to take control of their self-esteem.
    A number of other variants are conceivable and the embodiments are not limited by what exactly is described. For example, it can be implemented with relative ease to give the patient the opportunity to, for example, plan diets and weight loss plans and the system can help the patient to follow these up. Similarly, an exercise module can be added so that the patient either enters heart rate (or lasers them automatically from a heart rate monitor) or completely the dates of exercise activities so that these can then be correlated to weight loss and / or symptom change. The patient monitoring device according to the embodiments is extremely flexible and allows the patient's physician to take an active role in defining how the modules work. For example, the physician may use the patient monitoring device to set diuretic parameters for the patient in question by selecting and / or defining the parameters of the drug titration algorithm. This meant that the physician could, among other things, enter the starting dose for the patient and choose which drug titration algorithm or rule to use. In one example, a standard installation may be a logical OR combination of both the US and European guidelines previously discussed. However, the doctor may choose to am / arid alite between one or more, and for each of these rules (unless the standard installation is chosen) the doctor then specifies which dose change (+ or - tablets) a weight change over a period of time should result in.
    Thus, the patient can create a patient-specific drug titration algorithm by means of the patient monitoring device. In such cases, the physician advantageously also sets, in addition to the above-mentioned parameters, the maximum dose for the patient (as a safety measure as anyands of the patient monitoring device to avoid over-titration to the patient). Furthermore, the doctor can choose to enter contact information to the caregiver (and information about the next follow-up). There may also be the possibility of free text entry where the doctor can enter information about how the patient should contact their caregiver, the date of the next follow-up, which in their yard can be linked to an alarm function to assist patients, or something else that could be unchangeable for patient to always have available, see Fig. 11.
    The physician may also use the patient monitoring device to define which functionalities are mandatory or not for the specific patient. This can be achieved by having different "check-boxes". For example, say: Check-box 1: Should the patient be asked to contact the doctor as soon as the patient monitoring system has increased the dose "Yes" / "No" • Check-box 2: Should a patient after a dose increase remain on the new dose for an additional period of time, regardless of the patient's weight these days "1 day" / 2 days "/" No "Check-box 3: Should the symptom monitoring function be activated " Yes "/" No "Check-box 4: Should an alarm be set to warn the patient of an imminent follow-up " Yes + date "/" No "All this data can be entered in tabular form to Ora det lattanvant.
    In specific embodiments, the physician may also be able to identify the patient with some features such as age and Icon etc. This information may be used by the patient monitoring system to bring the 23 steering wheel patients to be the ones performing to provide advice, tips and stories in the section " today's tips "at the patient recovery device.
    The graphical user interface (GUI) of the patient monitoring device is advantageously designed adapted for the specific patient group that will use the patient monitoring device. For example, the average person diagnosed with heart failure over 75 is 6 years old and usually has no or little experience with computers. Yellow is therefore preferably designed to mimic classic catalogs that people have used for hundreds of years and it is a very intuitive and unique design that makes it easier to adopt this technology. A rough sketch of where GUlt can be seen in any of the pictures in Fig. 7-11. The principle is to use colored tabs in, for example, a phone book or an indexed folder when you are looking for something and the color coding makes it easy to understand where you are.
    Other solutions for GUlt in addition to tabs are also possible and within the scope of the embodiments.
    In a specific embodiment, it is desirable to display as little information as possible during the daily use of the patient monitoring device, so as not to discourage computer-savvy users. In one example, Fig. 8 shows that the information on the current dose is simply shown as the number of pills to be taken of the prescribed drug.
    The patient recovery system is deliberately designed to be modular in its construction. This means that almost any type of sensor can be connected to the patient monitoring device, in order to either improve the care of the (heart failure) patient or broaden the patient base that can benefit from the patient monitoring system and extend it beyond heart failure. For example, a blood pressure feeder that communicates wirelessly with the patient unit may facilitate the analysis of the heart failure patient's status, but may also be valuable to patients with high blood pressure. Blood pressure relief can be used to titrate blood pressure medications using the same principle as described herein for diuretics. The values can be followed over time and displayed to the patient and of course the training module can be updated to also contain hypertension-related information. Another example might be to use the flagon shape of the ECG module to look for atrial fibrillation (AF) or other arrhythmias and the same principles are applicable. It can titrate warfarin, show arrhythmia behavior over time and educate the patient. These are only a few examples of how this patient monitoring system can be expanded and should not be considered as an exhaustive list, 24 but only an illustration of how the patient monitoring system is intended to be used to help as many patients as possible.
    Fig. 12 schematically illustrates this concept by showing several different sensors that can interact with the patient monitoring device. The patient monitoring device can also be connected to a neck care facility as shown in the figure to transmit collected data to the neck care facility. It enables the physician to obtain updated data on patient status and may also allow detection of acute throat congestion. All data from the patient monitoring device can also be stored centrally. In such cases, external expert systems, using more advanced algorithms than those implemented in the patient monitoring device modules, can be used to process patient data as indicated in the figure.
    In the foregoing text, the patient monitoring device has been mainly described in connection with automatic determination of a dose of a prescribed drug based on the output signal from the external sensor.
    However, the patient monitoring device can also occur in situations where the patient has been prescribed several different drugs. In such cases, the optimal dose of all or at least one of these may be determined by the drug titration module, possibly using a respective drug titration algorithm for conventional drugs, based on the actual value of the patient's medical characteristics. It may also be possible for some of the medicines to be taken in a dose that is not dependent on the current value. In such cases, the memory of the patient monitoring device can store the fixed or semi-static (Urn doctor can reprogram a new dose value in the memory) dose. Another variant is to have a patient monitoring system comprising several external sensors that feed different medical characteristics of the patient. In such cases, the dose of at least one first drug may depend on the actual value from a first external sensor, while the dose of at least one second drug may depend on the current value from a second external sensor or even on the actual values from ram external sensors. The drug titration module then has access to various drug titration algorithms that act on the respective current values from the external sensors to output certain current doses for the drugs. In all of these embodiments, the screen preferably presents the respective dose, either determined by the drug titration module or simply retrieved from memory, to the patient. Thus, in a preferred embodiment, the patient monitoring device provides the patient with all the drug dosage information needed to be able to follow the patient's prescribed treatment schedule.
    The patient monitoring device can be implemented in hardware, in software or a combination of hardware and software. The patient monitoring device can be implemented as a barb & computer, tablet or other form of, preferably portable, user equipment.
    Although the respective units described in connection with Figs. 1-5 have been described as physically separate units in the patient monitoring device and they may all be specific circuits, such as ASIC (Application Specific Integrated Circuits), alternative embodiments of the patient monitoring device are possible dar flaw or all devices are implemented as computer program modules that are executed on a general processor. Such an embodiment is described in Fig. 6.
    Fig. 6 schematically illustrates an embodiment of a patient monitoring device 300 including the aforementioned screen 350, the communication unit 310, the optional user input 360 and the memory 320. The patient monitoring device 300 also includes a processor unit 390, such as a DSP (Digital Signal Processor) or CPU (Central Processing Unit). ). The processor unit 390 may be a single unit or a plurality of units performing different functions described herein.
    Furthermore, the patient monitoring device 300 comprises at least one computer program product in the form of a non-volatile memory 320, for example an EEPROM (Electrically Erasable Programmable Read-Only Memory), a flash memory or a hard disk. The computer program product includes a computer program 388, including code means which, when executed on or executed by or on the patient monitoring device 300, as by the processor unit 390, causes the patient monitoring device 300 to perform the functions previously described in connection with Figs. 1 and 4. In one embodiment, the code means in the computer program 380 thus comprises a drug titration module 330, a training module 340 and optionally a patient interaction module 370. These modules 330, 340, 370 mainly perform the functions corresponding to the modules in Figs. 1 and 5 when executed on the processor unit 390.
    The above-described embodiments are to be considered as a few illustrative examples of the present invention. It will be appreciated by those skilled in the art that various modifications, combinations, and modifications may be made by the embodiments without departing from the scope of the present invention. In particular, different partial solutions in the different embodiments can be combined in other configurations, where this is technically possible. The scope of the present invention is, however, defined by the appended claims.
    权利要求:
    Claims (9)
    [1]
    A patient monitoring device (100, 200, 300) comprising: a communication unit (110, 210, 310) configured to receive, from an external sensor (400), a signal representing a current value of a medical characteristic of a patient ; a memory (120, 220, 320) connected to the communication unit (110, 210, 310) and configured to store the current value; a drug titration module (130, 230, 330) coupled to the memory (110, 210, 310) and configured to process the current value according to a drug titration algorithm, stored in the memory (120, 220, 320), to output information about a topical dose of a prescribed drug; a screen (150, 250, 350) configured to present, to the patient, information on several predefined training classes, used in each training class among the several training classes, comprising at least one training instruction; a user input (160, 260, 360) configured to generate a class selection signal representing an education class selected by the patient by activating the user input (160, 260, 360), used in memory (120, 220, 320) configured to store, based on the class selection signal, information about the education class chosen by the patient; and a training module (140, 240, 340) coupled to the memory (120, 220, 320) and comprising: a class selector (142) configured to select, at least in part based on the current value and information of the training class selected by the patient, an education class among the several predefined education classes; and a training instruction provider (144) configured to provide, from memory (120, 220, 320), a training instruction which the training class selected by the class selector (142) used in the screen (150, 250, 350) is configured to present, to the patient, the information on the current dose and the training instruction provided by the training instruction provider (144).
    [2]
    The patient monitoring device of claim 1, wherein the training module (140) comprises a probability determiner (146) configured to determine a respective probability of being selected for the selected training class by the plurality of predefined training classes based on the current value and the training class information; and the class selector (142) is configured to pseudo-randomly rank the education class among the several predefined education classes based on the probabilities of being selected by the probability determiner (146). 27
    [3]
    A patient monitoring device according to any one of claims 1 or 2, wherein the drug titration module (130) comprises a signal generator (132) configured to generate a blocking signal if the current value is outside a target range and / or generate a progress signal if the current value is within the target range; and the drug titration module (130) responds to the blocking signal and / or the progress signal and is configured to block all processing of the current value in accordance with the drug titration algorithm based on the blocking signal and / or proceed to process the current value in accordance with the drug treatment.
    [4]
    The patient monitoring device according to any one of claims 1 to 3, further comprising a user feeder (160, 260, 360) configured to receive information about a starting dose, information about an incremental dose increase and information about a day number, used in the drug titration module (130, 230 , 330) is configured to define the drug titration algorithm based on the initial dose information, the incremental dose increase information and the day number information.
    [5]
    The patient monitoring device according to any one of claims 1 to 4, further comprising a user input (160, 260, 360) configured to receive an algorithm selection signal, the memory (120, 220, 320) configured to store a plurality of drug titration algorithms; and the drug titration module (130, 230, 330) is configured to select the drug titration algorithm from the plurality of drug titration algorithms based on the algorithm selection signal.
    [6]
    The patient monitoring device according to any one of claims 1 to 5, the memory (220, 320) configured to store the information on the current dose; and the patient monitoring device (200, 300) further comprises: a user input (260, 360) configured to generate an interaction signal representing an interaction type selected by the patient by activating the user input (260, 360); and a patient interaction module (270, 370) comprising: a dose processor (272) configured to process the current dose information to generate information representing the current dose over time for the patient; and 28 a characteristic processor (274) configured to process the current value to generate information representing the current value of the medical characteristic over time for the patient, used in the patient interaction module (270, 370) is configured to present, based on the interaction signal, a of the information generated by the dose processor (272) and the information generated by the characteristic processor (274) on the screen (250, 350).
    [7]
    The patient monitoring device of claim 6, wherein the patient interaction module (270.370) comprises a symptom processor (276) configured to present information prompting the patient to indicate a current symptom in the patient; the user input (260, 360) is configured to generate, based on the activation of the user input (260, 360), a symptom signal representing the current symptom; the symptom processor (276) is configured to store the symptom signal in memory (220, 320) and generate a hospitalization signal based on the symptom signal, the current value and information about a previous hospitalization period for the patient stored in memory (220, 320); and the screen (250, 350) is configured to display, to the patient and based on the hospitalization signal, an alert for a hospitalization risk.
    [8]
    A patient monitoring device according to any one of claims 1 to 7, wherein the communication unit (110, 210, 310) is configured to receive, [from an external scale (400), a signal representing a current value of the patient's weight; and the drug titration module (130, 230, 330) is configured to process the current value and information about a starting dose, stored in the memory (120, 220, 320), in accordance with the drug titration algorithm for outputting the information about the current dose.
    [9]
    A heart failure patient monitoring system (1) comprising: a scale (400) comprising: a processor (420) configured to generate a signal representing a current weight of a patient standing on the scale (400); and a communication unit (410) configured to send the signal; a screen (150, 250, 350) configured to present, to the patient, information on several predefined training classes, accustomed to training class among the several training classes, comprises at least one training instruction; and a patient monitoring device (100, 200, 300) comprising: 29 a communication unit (110, 210, 310) configured to receive the signal from the carriage (400) communication unit (410); a memory (120, 220, 320) coupled to the communication unit (110, 210, 310) and configured to store a value representing the current weight; a drug titration module (130, 230, 330) coupled to the memory (120, 220, 320) and configured to process the value according to a drug titration algorithm, stored in the memory (120, 220, 320), to output information about a current dose of a prescribed diuretic; a user input (160, 260, 360) configured to generate a class selection signal representing an education class selected by the patient by activating the user input (160, 260, 360), used in memory (120, 220, 320) configured to store, based on the class selection signal, information about the education class chosen by the patient; and a training module (140, 240, 340) coupled to the memory (120, 20, 320) and comprising: a class selector (142) configured to select, at least in part based on the value and information of the training class selected by the patient, a training class among the several predefined education classes; and a training instruction provider (144) configured to provide, from memory (120, 220, 320), a training instruction belonging to the training class selected by the class selector (142), used in the screen (150, 250, 350) configured to present , for the patient, the information on the current dose and the training instruction provided by the training instruction provider (144). - COMMUNICATION UNIT 400 I '4 (, 1/8 1 1 1 / EXTERNAL SENSOR i, 4
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    同族专利:
    公开号 | 公开日
    EP2701089A3|2017-05-17|
    EP2701089A2|2014-02-26|
    SE537225C2|2015-03-10|
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    法律状态:
    优先权:
    申请号 | 申请日 | 专利标题
    SE1200508A|SE537225C2|2012-08-23|2012-08-23|Patient monitoring device comprising drug titration and training modules|SE1200508A| SE537225C2|2012-08-23|2012-08-23|Patient monitoring device comprising drug titration and training modules|
    EP13180982.4A| EP2701089A3|2012-08-23|2013-08-20|Patient monitoring device|
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