Invented by Christopher William Connor, ANAESTHESIA ASSOCIATES OF MASSACHUSETTS PC
The ANAESTHESIA ASSOCIATES OF MASSACHUSETTS PC invention works as followsA patient monitoring system which allows a healthcare provider to interact directly with a patient monitor to access patient data and then sends the data to a portable communication device of the healthcare provider, regardless of where that device is located.
Background for Systems and Methods for Secure Portable Patient Monitoring
Patient Monitoring Systems are widely used by healthcare providers in the medical industry to monitor patients’ condition. Patient monitoring systems allow healthcare providers to monitor patients remotely from a central station (e.g. a nurses station) that is in contact with multiple local monitors. Local patient monitors (e.g. oximeters or ECGs) are usually connected to a central monitoring station in a hospital via a wireless or wired network. As part of an EMR system, the central station can store patient data and interface with databases.
Wired communication between a central station and a patient monitor is usually done via a local network using the Ethernet protocol. Wireless communication between a central station and a local monitor is usually done via a local area wireless network using the wireless Ethernet protocol, which is based on 802.11 standards. Some local monitors use a personal area networking such as Bluetooth for wireless communication with one or multiple patient sensors, or to communicate with a central monitoring station via an accesspoint.
The data that is being transmitted between a patient monitor local and a central station, or between a patient monitor local and a sensor can be encrypted. Some patient monitoring systems allow remote monitoring of physiological parameters of patients via pagers or personal digital assistants.
Unfortunately, current patient monitoring systems including local monitors do not offer a way for a healthcare professional, such as a physician, to access physiological data of monitored patients using a mobile communications device. In order to improve the security and efficiency of accessing local patient data, healthcare providers need to use portable computing devices or communications devices.
The application addresses, in different embodiments, the deficiencies of existing patient monitoring and management system by providing systems that allow a healthcare provider establish a secure and authenticated communications link between a monitoring system for patients and a portable communication device.
The systems and methods described in this document refer to portable communications devices (e.g. handheld), such as a smart phone, personal digital assistant, or pda, that can be used by a healthcare provider to access physiological data collected by one or multiple patient monitors. In a hospital, patients are spread out in different rooms on a floor or between floors. Patients may be spread out across an entire suite of operating room or in different locations for anesthesia. A central monitoring station, or nurses’ station, is connected to the patient bedside monitors located in multiple patient locations or rooms via a data networking so that the physiological data of each patient can be monitored at the central station. When patients are spread out across different anesthetizing areas, a clinician might want to monitor patients in the Interventional Radiology Department while also monitoring other patients in operating rooms and other rooms.
The healthcare personnel often visit patients’ bedsides to monitor their physical condition and bedside monitors. The present application allows a healthcare provider to use a portable communication device in close proximity to local or bedside monitors to request and gain access to the patient data collected by that device.
The systems and methods described here enable a healthcare professional to conveniently and advantageously obtain patient data by using a local wireless or wired link directly with a specific patient monitor. The system requires that the healthcare provider (e.g. a physician) and/or portable communications device be physically present in close proximity of a monitoring device or patient monitor. This ensures only healthcare providers with physical access to the patient will have access to the patient’s physiological data. A healthcare provider could be required to physically visit the patient to access the data via a portable communication device. Local wireless connections and/or channels used to request patient data access will be different (out of band) from the wireless connection or channel used by a patient monitoring device for sending patient data to remote display stations such as central monitoring stations. Out-of-band wireless channels may use a PAN protocol, such as Bluetooth or 802.11, to send data. The wireless channel that the patient monitoring device uses to transmit data to the central unit may be Bluetooth, 802.11, or other wireless standards.
When requesting patient data through a local monitor, the portable communication device can provide an access code. The access code can be a password, passcode, encrypted value or cryptographic response. The patient monitoring device can use the access code in order to determine if the portable communication device or healthcare provider should have access to the monitored patient data. To protect data, the wireless channel or any part of the communications between the local monitor and/or portable communication device, as well as communications with other systems, may be encrypted. The system can use secret keys or ephemeral keys that are changed depending on conditions and/or events.
Once the monitor has authorized a portable communication device or healthcare provider to access patient data, that portable communications device can receive patient data in real-time (or near-real-time) on a continuous basis. The portable monitoring device can use an additional interface and wireless channel in order to receive patient data, and then display it via a user-interface such as a graphic user interface. The portable communications device may use a different wireless channel to receive patient data than the one used to communicate with a local patient monitoring device. If the portable communication device is a 3GSM-capable smart phone, it may communicate with the mobile 3GSM provider via a 3GSM data wireless channel to obtain patient data. The local monitor may communicate with you via Bluetooth to access patient data. Once access to patient information is established, healthcare providers can move anywhere, even away from the monitoring device. They will still be able to receive the data via their portable communication device using the 3GSM connectivity.
The applicant’s instructions are not limited to the various embodiments described. The applicant’s teachings include various modifications, alternatives and equivalents. This will be understood by those with skill in the arts.
FIG. The general architecture of the patient monitoring system 100 is shown in Figure 1. This shows an example of one aspect of the invention. The system 100 comprises a number patient monitors 102 104 106 which monitor physiological parameters in one or multiple rooms or locations of a healthcare facility. The patient monitors 102, 104 are each connected to wireless remote telemeters 110 and 108, which collect, packageize, and transmit physiologic data from patients. As used in this document, the term “wireless” is defined as data that can be transmitted to and/or from a device over a wireless medium. Data is transmitted to or from the device via a wireless medium. Remote telemeters (108 and 110) may be patient-worn (ambulatory), which are connected directly to the patient, or instrument remotes, which connect to local monitors, such as those at a bedside, or to other local monitors, like those 102,104 and 106. The patient monitor 106 can include a network interface card or integrated transceiver (NIC) 112 capable of exchanging information via wired communications, such as an Ethernet cable. Transceiver and/or remote telemeters 108,110 and 112 can transmit physiologic data, such as real-time ECGs, blood pressure, CO2 and temperature. Remote telemeters (106, 110, and 112) may also sense and transmit non-physiologic information, such as data on battery status, loose-lead ECG status, or patient location. The term “patient data” can refer to both physiologic and non-physiologic data captured by the remote telemeters 106, 108, and 110. The term “patient data” may be used to refer to all the non-physiologic and physiologic data collected by the remote telemeters 110, 106 and 108.
The remote Telemeters 108, 110, can communicate bi-directionally to any number of radio transceivers (also known as access points, or AP) 114,116,118,120. The APs can use a variety of wireless standards and protocols, including time division multiple-access (TDMA), CDMA, 802.11, Wifi and Bluetooth, cellular technology, GPRS, LTE and EVDO. Each AP is capable of communicating with multiple remote telemeters simultaneously in one mode. The APs can be placed in a cell-like arrangement throughout the hospital. The coverage area consists of zones that overlap.
Different Access Points (APs) 114-120 may transmit and receive data on different RF frequency channels. APs with a sufficient distance between them to prevent interference can operate at similar frequencies. The remote telemeters (108 and 110) and APs in FIG. The remote telemeters 108 and 110, as well as the APs shown in FIG. Remote telemeters and APs that communicate via hardwire connections.
Referring to FIG. The APs 114 – 118 are connected to a router 124 by shielded twisted pairs 122. The router 124 can be used as a switch or relay, server gateway, repeater bridge and/or similar network communication device. In one configuration, a router 124 is able to accommodate up 16 APs. In some configurations, a router 124 may be able to accommodate more than 16 APs. In a typical installation in a hospital, one router 124 can service an entire floor. The router 124 can provide connectivity between APs in a hospital’s local area network 126. The LAN 126 can be used as a system to distribute real-time data, such as physiologic data for patients with a predetermined latency. The LAN 126 can include a 100 Mbit/second Ethernet protocol based 100BaseTx backbone. The term “backbone” is used to refer to the transmission medium and networking cards of the LAN. The term “backbone” may be used to refer to both the transmission medium as well as the networking cards in the LAN. Other LAN protocols that could be used are FDDI and ATM (Asynchronous transfer mode).
The LAN 126 can include one or multiple central stations 128, or charting servers, which allow hospital personnel to remotely monitor and view the real-time physiologic information of patients in the system 100. Each monitoring station is preferably a PC running conventional patient monitoring software. The LAN 126 can also include one of more gateway computers 130 to connect the LAN 126 with other networks 132 such as the Internet to allow the exchange patient information between other medical facilities and patients sites.
As will be evident, the architecture shown in FIG. The system 100 is highly scalable. The system 100 is initially installed with the central station 128 acting as a sole monitoring station. This station can include both hardwired and RF connections. The addition of a network 126 allows for the addition of new routers 124 and APs to the system 100. This will increase its patient capacity or coverage area. This architecture allows for the addition of new APs without a corresponding performance degradation caused by noise. The LAN 126 can be expanded to include monitoring or central stations 128, if needed, to allow remote viewing and control of patient data.
The system 100 includes portable communication devices 134 and 135 as well. Portable communications devices 134 or 136 can include a smart phone, cellular phone, pager protocol, Bluetooth, wireless LAN protocol, PAN protocol, GPRS, CDMA, LTE, etc. The devices 134 or 136 can use one or several communication protocols including 802.11, Wifi or WiMax, GPRS or CDMA, LTE or pager protocols. They may also utilize a PAN protocol or a wireless LAN or WAN protocol. Data provider 138 can be a PLMN or another wireless data provider. The AP 120 can include a cellular base station and an antenna for mobile network communication with the devices 134 & 136 via a channel wireless 140. The device 134 can communicate with the LAN 126 using a wireless channel 148.
The devices 134, 136, and 148 may communicate with patient monitors 102, 104, and 106, respectively, via channels 142, 144, and146. The channels 142,144 and146 can be wireless or wired. Transceivers 150,152,154 may be included in each patient monitor 102 104 106 to allow data exchange between the devices 134 136 and monitors 102 104 106. Transceivers 108 and 150, for instance, can be combined to form a single element. Transceivers 108 and 110, as well as 150, 152 and 154, are sometimes integrated with monitors 102 104 and 106.
During operation, telemeters 110, 112, and 108 send data packets using wireless protocol to individual APs (116, 118) and router 124, using wired protocol. These packets contain the patient data collected from the remote monitors (or telemeters) as well as the ID codes for the telemeters or monitors. These data packets are forwarded by the APs 116, 118 and NIC 112. The router 124 then broadcasts the data to the LAN 126 in real-time, allowing the central station 128, which can view and monitor the data. The system can also support patient location methods to monitor the remote location of each device and/or patient 134.
To support the mobility of patients, the APs 116 & 118 as well as remote telemeters 108 & 110 can implement a’switch-over’ protocol. The telemeters 108 & 110 are programmed to continuously try and establish connections with the APs offering the best link performance. In this protocol, the remote telemeters continuously evaluate the quality of the RF links to all APs within range. Telemeters 108, 110 and their associated link assessment data are stored and evaluated periodically to determine if a change to a different AP is desired. The remote telemeter 108 attempts to connect with the new AP when it determines an AP that is available (i.e. has an open channel) and offers a better link performance than the current AP. This involves sending a message of request to the selected AP 118 and waiting for a confirmation message. The remote telemeter 108 will drop its connection with the current AP 116 if the connection is successful. As a patient moves around the hospital, the remote telemeter will connect to a variety of APs. The clinician monitoring the patient may not notice any interruptions or data loss as the transitions between APs are seamless. The handheld device 134 can automatically reestablish secure communication links, even when a previously encrypted link is lost.
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