Classifications

• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
  • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
  • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation

Definitions

• TITLE Apparatus for clinical automation
• the invention refers in general to the biomedical engineering and telemedicine field, more in particular it refers to a remote control system of bedridden patients and to the relative components it is made up of.
• the centralised supervision system that can: support the new functionalities, automatically generating the connection between the patient who generated a service request signal and the staff responsible for such request; reaching the staff and acquiring the necessary resources by automatically sending text messages, e-mails and video phone calls.
• multimedia systems of computer-patient interaction activated by the movement of limbs or the head or voice commands from the patient are employed together with multimedia patience telesurveillance systems with the application of image processing techniques to identify the patient's clinical status.
• Computerised systems are employed for moving the patient's bed or surfaces by remote control, by manual or vocal patient gestures, together with remote clinical data collection systems for automatic diagnostics and automatic systems for drug administration and dosing. All interactions between system and patients take place by: elementary voice commands actions on a remote control or by pressing a specific push button the automatic video surveillance system recognising a body or limb movement. Visual control and reading access functions are foreseen for reading the clinic parameters by both the doctors and the family using ordinary video telephones. The operator can program the system so that the patient's emergency situations can automatically be communicated to family and relatives by automatically sending SMS text messages.
• the GSM and UMTS communications modules used by the system can transmit the data collected for the patient to the management centre and to authorised personnel.
• Figure 1 is a schematic block diagram of the apparatus in this invention.
• Figure 2 is a schematic indication of the hardware modules that make up the system. With particular reference to Fig. 1, the following elements stand out:
• GSM Global System for Mobile communications
• Multimedia module that interfaces Hi-Fi, TV and DVD devices, loudspeakers and microphone, headsets, video cameras, fixed phones, mobile phones and video telephones.
• the functional part of the system is made up of a group of modules aimed at applying the concepts of automation, telesurveillance and remote control for the treatment of patients temporarily immobilised on equipped beds.
• the system performs all operations for reading, collecting and archiving the clinical parameters coming from the clinical instruments connected to the patient.
• the system uses multimedia dialogue with the patient, using procedures that will be described below.
• the system connects to drug administrators so that they can function automatically without the intervention of operators, when there are no risks for the patient.
• the system automatically opens a multimedia connection with a remote operator.
• the operator evaluates the clinical state of the patient and can interact with the onboard bed equipment: medical instrumentation, automatic drug administrators, devices for moving the bed and any mechanical elements such as surfaces for monitor and TV camera positioners.
• the system can make multimedia interconnection with the patient's doctor or family.
• the system of this invention collects all historical information in real time and transmits it to a distant control centre where it is examined by a clinical diagnostics program that automatically evaluates the physical state of the patient to see whether or not it is necessary to request operator intervention.
• the system of this invention uses an image processing software to recognise the state of agitation or anomaly of the patient and generates the programmed alarms.
• the system takes into account not only the clinical needs of the immobilised patient but gives additional comfort, thanks to the multimedia connection to relatives and clinical personnel, and for making amusement apparatus available to the patient.
• the entire interface with the patient is managed with a program based on image processing and the patient can give commands to the system either by moving limbs, with voice commands, by wireless mouse, or using a guided procedure displayed on the onboard bed monitor and commented by a synthesized voice over the onboard bed speakers. Commands sent this way allow telephone or multimedia connection by the patient with the outside world, moving the bed and any motorised surfaces, moving the monitor and management of multimedia instruments (radio, TV, etc.).
• the invention provides for a multimedia TV- surveillance system with image processing and telephone transmission to the remote supervision centre where a warning sound requires the intervention of the operator only when the alarm is effective or probable and displays the images acquired on the monitor. Automatic connection with the doctor and family is also guaranteed.
• a warning sound requires the intervention of the operator only when the alarm is effective or probable and displays the images acquired on the monitor. Automatic connection with the doctor and family is also guaranteed.
• this invention returns the local automatic reading of equipment data with continuous elaboration and registration, automatic alarm generation and generation of probable diagnosis with telephone transmission of data to the remote supervision centre.
• This invention introduces automatic drug administration and dosing with the aid of dedicated instruments, an operation that is impossible today without manual intervention. d.
• the invention resolves the problem of sector studies based on infrequent and reduced statistical data, providing the necessary conditions to be based on data collected continually and on a large number of instruments.
• This invention introduces multimedia systems of surveillance and comfort with access to the system by doctors and family, which is inexistent in present technology.
• the invention surpasses cable data transmission that prevents the dislocation of beds to external structures, introducing in their place data and image transmission via GSM and UMTS that allow the patient to be moved to external structures.
• the system includes three sub-systems, which are:
• the onboard bed system that contains remote control hardware and the multimedia system of video surveillance and video communication,
• the central remote control and surveillance system, palmtop computers for the doctor and family who want to access the systems permitted by the system are the central remote control and surveillance system, palmtop computers for the doctor and family who want to access the systems permitted by the system.
• the onboard bed system is constituted by the apparatus for the acquisition of data coming from the clinical equipment prearranged for monitoring the clinical parameters concerning the patient, managing the administrators and the drug dosers, manage the servo motors of the available mechanical equipment and manage the multimedia system of remote surveillance, manage the patient's communications with the outside world using mobile telephony.
• patient monitoring systems are only displays on electronic screens or monitors of the data and images of patients in observation regardless of the type of data concentration, elaboration or management.
• the unit concerned in this invention when acquiring data and transferring it to a surveillance information system, permits computerised management of patient data, case histories, etc.
• a TV camera that can also be used for other purposes is located above the patient and monitors the patient's movements, for recognising conventional movements requesting services and comfort, and movements showing critical states requiring assistance, or monitoring the presence of motor activity for prompt recognition of the patient's state of health.
• the system is made up of a series of hardware modules, some essential, others optional.
• the modules used are:
• Connection module with the clinical instruments near the patient's bed, in order to read all the available clinical parameters (optional)
• Connection module with the available mechanical equipment that consents movement of the bed, motorised surfaces for positioning the monitor and the TV camera (optional)
• Multimedia module (optional) composed as follows:
• Module for connection with the clinical instruments near the patient's bed for reading all clinical parameters available is an optional module made up of a group of standard entries, such as:
• the module is composed of an electronic card containing an onboard microprocessor with RAM memory and FLASH memory with preinstalled firmware that contains the program for managing the hardware interface with the clinical instruments, the communications protocols to be used with these instruments and the communications protocol with the onboard bed computer.
• the functions and the firmware are programmable by remote computer so that they can be adapted, even in the future, to all possible cases. Programming is done by local access using a programming device on one of the channels of the module or by using the onboard bed computer.
• the card obviously contains all the electronic circuits inherent to the entries and the feed circuits.
• Module for connection to the automatic drug dosing and administration equipment is an optional model made up of a series of standard exits such as:
• the module is made up of an electronic card containing an onboard microprocessor with
• RAM memory and FLASH memory where a firmware is pre-installed containing the program for hardware management interfacing with the clinical instruments, the communication protocols to be used with these instruments and the protocol for communication with the onboard bed computer.
• the functions and the firmware can be remotely programmed by computer for future adaptation to all possible cases. Programming is done through local access with a programming device on one of the module channels or by using the onboard bed computer.
• the card obviously contains all the electronic circuits inherent to the input/output channels and the feed circuits.
• a module for connection with the mechanical equipment available for movement of the bed, the motorised surfaces for positioning the monitor and the TV camera (optional), includes a commutation feeder to supply energy to the mechanical organs operated by remote control, the power circuits for the motor commands and the interface with the onboard bed processor.
• a remote programmable microcontroller on the electronic circuit. Programming is done by local access using a programming device on one of the serial channels of the module or by using the onboard bed computer.
• a Multimedia module that interfaces Hi-Fi, TV, DVD, loudspeakers and microphones, headsets, video cameras, fixed and mobile telephones and video telephones is provided too.
• a characteristic of the module is that the multimedia components interface with USB channels, in Ethernet, with serial communication channels and with PCI interface or IDE interface to the onboard bed computer.
• the module is made up of an electronic circuit that sorts and concentrates signals from the multimedia peripherals so they can organically interface the onboard bed computer.
• the processing unit is a computer on industrial PC base with a multimedia operating system with an extended interface capacity, with backup unit and uninterrupted power supply.
• An added feature of the computer is an optional double circuit with devices capable of mechanically switching from one computer to the other if one of them has a breakdown.
• a module for radio, mobile phone, satellite and telephone connection to the surveillance centre is made up of a series of a set RS232 or RS485 serial channels, USB channels and Ethernet lines that connect the onboard bed computer to commercial modems for connection via radio, mobile phone, telephone or satellite with the surveillance centre and with other network devices.
• a feature of the module is that the communication protocols used are both proprietary and standard. Data transmission is encrypted in order to protect the system from intrusions.
• the system of onboard bed software modules include:
• Image processing module for recognising states of patient agitation or anomaly
• Image processing module for recognition and execution of commands given by the patient using just limb movement
• Voice recognition module for recognition and execution of commands given by the patient with voice commands
• Synthetic voice module to interact with the patient
• Module for facilitated access to the onboard computer by the patient for recognition and execution of the commands given by the patient with the remote control
• the onboard bed computer operating system is of the Microsoft Windows multimedia type that, using a remote control, allows to keeps the interfaced multimedia devices under control.
• the remote control software for this invention runs in background under this operating system and carries out all the automation functions previously described.
• An image processing software is always active, executing an algorithm measuring the speed and duration of the patient's changes of position.
• the programmer of this service has a table available that sets the state of alarm. Some of them are listed below as examples:
• This image processing software is always active, creating an algorithm identifying the position of a limb or the direction the patient's head moves. Identifying a raised limb, left or right, identifying lateral movement of the head left to right (meaning no) or up and down movement of the head (meaning yes) and the head being still, with the aid of a synthesised voice from the computer, are the elements for starting a conversation on the onboard bed monitor between computer and patient so that the patient can request attention from the operators, make phone calls to relatives, use the multimedia amusement system, move their bed, etc.
• the onboard bed computer manages a voice synthesis module to aid the patient in using the multimedia services offered.
• a module for facilitated access to the onboard computer by the patient is employed in order to recognise and execute the commands given by the patient with the remote control.
• There is facilitated access software allowing the patient to use the onboard bed computer with the remote control keypad.
• Module for diagnostics, remote control, telesurveillance and data collection of the clinical devices connected to the system continually collects the data arriving from the clinical instruments connected to the system, elaborates them and transmits them to the control centre. If enabled, the software commands the drug dosing and administration instruments.
• the software performs continuous diagnosis of the functionality of the electronic parts that comprise the system and, lastly, activates the alarms when situations of anomaly or doubtful interpretation are recognised.
• the onboard computer When the onboard computer either receives commands from the remote control or the onboard bed keypad, or receives sign commands from the patient, it activates bed movement following the movement parameters for the specific type of bed.
• the onboard bed computer manages the communications protocol with the control centre, it uses the cryptographic algorithms for data transmission and manages network communications with other devices
• the onboard computer manages all the telephone functions serving the patient. It manages a diary/address book for use by the patient and activates a telephone service starting from either the commands entered on the remote control or the gesture commands.
• the onboard bed computer communicates with the palmtop computer being used for the patient's relatives and doctors.
• the computer gives access to the patient's clinical data requested by the palmtop computer and puts the patient in communication with the palmtop user.
• the central control and video surveillance system is made up in its basic version by a PC.
• the system When it expands, the system becomes a network of PCs and client/server stations with access to the Internet.
• the PC has a series of modems for radio, GSM, GPRS, UMTS and telephone connection with the onboard bed modules throughout the territory.
• the PC is equipped with one or more monitors and a video-telephone system.
• Automation software periodically interrogates the onboard bed systems and responds to their requests for services, and collects the data they have processed.
• the system allows performing the following functions:
• This software contains the communications protocols and passwords necessary for network connection with the system and allows displaying of all the parameters from the clinical instruments, consultation of archive data, conversing with the patient, bed movement and programming multimedia apparatus, we well as establishing therapies by programming drug administration.
• the palmtop's critical functions are protected by password and checks and consents by the surveillance centre, others are reserved solely to attending doctors.
• the main innovation introduced by the invention is undoubtedly the application of automated techniques for intensive patient care together with automated management of medical and paramedic staff, providing the patient with health service and comfort and radically changing the patient's state of isolation.
• One advantage introduced by the patent is that patients do not necessarily have to be concentrated inside one or more hospital structures; they can be somewhere near where they live, as long as they have a properly equipped bed, which also increases medical attention and patient comfort.
• the end result is structuring a system that can give complete hospital medical assistance to patients in structures outside the hospital, increasing surveillance, rationalising the work of hospital medical personnel and increasing the patient's comfort and services. More comfort and better services are made available to the patient, and all this decreases management costs thanks to automation techniques that allow intervention by the health operator only when it becomes necessary.
• One further advantage of this invention is the possibility to support clinical intervention without the need for geographical movement of medical personnel, when the multimedia connection is more than sufficient to resolve the problem, otherwise making an early request for an on-site intervention by health operators. This type of management reduces the number of medical staff needed. Furthermore, the doctor can be reached at his home or else replaced by personnel on duty in the area nearest the patient.
• An innovative aspect of the invention is the creation of an integral, efficient system for managing the entire hospitalisation of patients in an automatic, computerised way, with patients no longer just concentrated in centralised structures but dislocated in the area, near their homes, integrating professional services with specialist personnel who may be anywhere in the territory, and for requests for medical personnel intervention where the patient is located, making use of conventional interventions at medical health structures nearby the patient, which can intervene under video surveillance by the attending doctor assigned.

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• Health & Medical Sciences (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Business, Economics & Management (AREA)
• General Business, Economics & Management (AREA)
• Epidemiology (AREA)
• General Health & Medical Sciences (AREA)
• Medical Informatics (AREA)
• Primary Health Care (AREA)
• Public Health (AREA)
• Measuring And Recording Apparatus For Diagnosis (AREA)
• Medical Treatment And Welfare Office Work (AREA)

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• 2006
  • 2006-11-13 IT IT000615A patent/ITRM20060615A1/it unknown
• 2007
  • 2007-11-08 WO PCT/IT2007/000788 patent/WO2008059546A1/en active Application Filing
  • 2007-11-08 EP EP07849746A patent/EP2097847A1/en not_active Withdrawn

Non-Patent Citations (1)

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