EP2939160A1 - Système et procédé d'évaluation itérative du bienfait thérapeutique de la télésanté - Google Patents

Système et procédé d'évaluation itérative du bienfait thérapeutique de la télésanté

Info

Publication number
EP2939160A1
EP2939160A1 EP13826697.8A EP13826697A EP2939160A1 EP 2939160 A1 EP2939160 A1 EP 2939160A1 EP 13826697 A EP13826697 A EP 13826697A EP 2939160 A1 EP2939160 A1 EP 2939160A1
Authority
EP
European Patent Office
Prior art keywords
patient
telehealth
score
care
plan
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP13826697.8A
Other languages
German (de)
English (en)
Inventor
Soundararajan Srinivasan
Trish CAVESTANY
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Robert Bosch GmbH
Robert Bosch Healthcare Systems Inc
Original Assignee
Robert Bosch GmbH
Robert Bosch Healthcare Systems Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Robert Bosch GmbH, Robert Bosch Healthcare Systems Inc filed Critical Robert Bosch GmbH
Publication of EP2939160A1 publication Critical patent/EP2939160A1/fr
Withdrawn legal-status Critical Current

Links

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
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • 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
    • 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
    • G16H80/00—ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Definitions

  • This disclosure relates generally to the fields of medical information and patient management, and, more particularly, to methods and systems for evaluating and modifying telehealth treatments.
  • telehealth and home healthcare have experienced strong growth in recent years.
  • a patient is geographically removed from the presence of a doctor or other healthcare provider.
  • the patient could be at home instead of being treated at a healthcare facility.
  • Telehealth devices enable the healthcare provider to monitor the health status of a patient much more frequently, and help identify and address potential health-related problems without the need for the patient to travel to the healthcare facility.
  • the use of telehealth systems has the potential to reduce the cost of healthcare, improve healthcare staff work efficiency, and to improve the quality of healthcare through increased patient monitoring.
  • Various known telehealth systems provide an interface to a patient that enables the patient to transmit medical data to a doctor or healthcare provider. Some devices are configured to record biosignals, such as heart rate, blood pressure, and oxygen saturation levels, and transmit data of the recorded biosignals to a database for later review. Other telehealth systems enable remote visits between a patient and a healthcare provider and can provide real time medical data to the provider during the visits.
  • biosignals such as heart rate, blood pressure, and oxygen saturation levels
  • telehealth systems have numerous potential advantages, such systems can also present challenges to the healthcare system. For example, during a prolonged course of telehealth treatment, the condition of the patient often changes, with some symptoms receding and new symptoms presenting during the course of telehealth treatment. In some cases, a patient who receives a strong initial benefit from the telehealth treatment receives fewer benefits due to a changing medical condition. In other cases, the patient loses interest or does not participate in the telehealth treatment during a prolonged plan of care. In some cases, an alternative plan of care other than telehealth becomes more efficacious due to the changes in the condition of the patient.
  • a method for modifying a plan of care for a patient includes presenting with a telehealth device a plurality of queries for medical data to a patient, the plurality of queries corresponding to a plan of care stored in a memory of the telehealth device, receiving from the telehealth device a plurality of responses to the plurality of queries entered by the patient into the telehealth device, storing the received plurality of responses in a database that is stored in a memory of a controller, identifying with the controller a behavior pattern for the patient with reference to the plurality of responses stored in the database, generating with the controller a score for the patient with reference to the identified behavior pattern, modifying with the controller the plan of care for the patient in response to the score being less than a first predetermined threshold, and sending the modified plan of care to the telehealth device.
  • a method for modifying a plan of care for a patient includes presenting to the patient interface a plurality of queries for medical data to a patient, the plurality of queries corresponding to a plan of care stored in a memory of the patient interface, receiving from the patient interface a plurality of responses to the plurality of queries entered by the patient into the patient interface, storing the received plurality of response in a database that is stored in a memory of a controller, identifying with the controller at least one symptom associated with the patient with reference to the plurality of responses stored in the database, generating with the controller a score for the patient with reference to the identified at least one symptom, modifying with the controller the plan of care for the patient in response to the score being less than a first predetermined threshold, and sending the modified plan of care to the telehealth device.
  • a healthcare system in another embodiment, includes a telehealth device configured to present a plurality of queries for medical data to a patient, the plurality of queries corresponding to a plan of care stored in a memory of the telehealth device, and to transmit a plurality of responses to the plurality of queries to a telehealth analysis system through a data network.
  • the telehealth analysis system includes a memory configured to store database including a plurality of responses received from the telehealth device and a controller operatively connected to the memory and the data network.
  • the controller is configured to receive from the telehealth device the plurality of responses to the plurality of queries entered by the patient into the telehealth device, store the received plurality of responses in the database, identify a behavior pattern for the patient with reference to the plurality of responses stored in the database, generate a score for the patient with reference to the identified behavior pattern, modify the plan of care for the patient in response to the score being less than a first predetermined threshold, and send the modified plan of care to the telehealth device.
  • FIG. 1 is a schematic diagram of a telehealth system.
  • FIG. 2 is a block diagram of a process for evaluating the efficacy of a telehealth treatment for a patient.
  • FIG. 3 is a block diagram of a process for identifying a score for the efficacy of telehealth treatment for a patient based on an observed behavior pattern of the patient.
  • FIG. 4 is a block diagram of a process for identifying a score for the efficacy of telehealth treatment for a patient based on observed symptoms in the patient.
  • telehealth refers to a form of medicine in which a patient and healthcare provider electronically communicate with one other to enable the patient, who is not located in the healthcare provider's facility, to receive medical treatment from the healthcare provider.
  • telehealth device refers to any device (hardware or software- based) that is configured to electronically transmit and/or receive data pertaining to a telehealth treatment received by a patient from a healthcare provider practicing telehealth on the patient.
  • a telehealth device is one example of a more general category of medical devices, which include any device having diagnostic and/or therapeutic uses, such as respirators, pacemakers, blood sugar testing devices, inhalators, heart monitors, and the like. While the specific embodiments described herein are directed to telehealth devices, the systems and methods described herein are also suitable for use with a wide variety of medical devices.
  • the term "behavior pattern" refers to identified actions and habits in a patient who is undergoing telehealth treatment. Behavior patterns include, but are not limited to, the actions that the patient takes for his or her diet, exercise, medication, and therapeutic routines. Behavior patterns also include information about how the patient uses a telehealth terminal during the plan of care. For example, in one embodiment the telehealth terminal presents queries to the patient including questions pertaining to symptoms that the patient experiences, the diet and exercise activities for the patient, and general health questions that educate the patient. The telehealth terminal records the response times to one or more questions in each query, and identifies instances where the patient fails to respond to queries.
  • the term "symptom" refers to any departure from normal function or feeling in the body of the patient that is noticed by the patient and recorded with a telehealth terminal.
  • the telehealth terminal is configured to query the patient for information regarding symptoms that the patient is expected to experience due to diagnosed medical conditions.
  • the telehealth terminal optionally prompts the patient to rate the severity of symptoms.
  • the telehealth terminal also presents more general queries to the patient in case additional symptoms present themselves, which may indicate that the patient is experiencing a previously undiagnosed medical condition.
  • FIG. 1 depicts a medical information system 100 that is configured to identify the efficacy of a telehealth treatment that is delivered to a patient with a telehealth device.
  • the system 100 includes a telehealth terminal 104 that communicates with a telehealth analysis system 150.
  • the telehealth terminal 104 includes a visual output device 108, audio output device 112, an input device 116, a processor 120, memory 122, timer 124, and a network interface device 128.
  • the telehealth analysis system 150 includes a controller 162, a memory 164, and another network interface device 190.
  • the telehealth terminal 104 and the telehealth analysis system 150 send and receive data through a data network 132.
  • the data network 132 is, for example, a wired or wireless local area network (LAN) or wide area network (WAN), or any other suitable network that enables communication between the telehealth terminal 104 and telehealth analysis system 150.
  • LAN local area network
  • WAN wide area network
  • the controller 162 is an electronic processing device such as a microcontroller, application specific integrated circuit (ASIC), field programmable gate array (FPGA), microprocessor including microprocessors from the x86 and ARM families, or any electronic device that is configured with programmed instructions and electronic components to perform the functions described herein.
  • the memory 164 includes one or more data storage devices including volatile data storage devices, such as random access memory (RAM), and non-volatile data storage devices, which include solid state storage devices, magnetic disk drives, optical disk drives, and the like.
  • the controller 162 is communicatively coupled to the memory 164 to enable the controller 162 to obtain data that are stored in the memory 164 and to store data in the memory 164.
  • the controller 162 executes stored
  • the telehealth analysis system 150 is a personal computer (PC) with the controller 162 being a microprocessor implementing a version of the x86 or ARM microarchitecture that is configured to run a general purpose operating system.
  • the telehealth analysis system 150 is formed from a cluster of multiple computing devices including multiple data processing, memory, and network devices.
  • the memory 164 stores the patient profile database 168.
  • the patient profile database 168 includes medical data associated with each patient that is monitored by the system 100, such as the patient 102 illustrated in FIG. 1.
  • the patient profile database 168 is implemented as a relational database, a key- value store, one or more files holding comma separated value (CSV) data, an object-oriented database, a hierarchical database, or any data storage scheme that enables the controller 162 to store and retrieve medical data for one or more patients.
  • CSV comma separated value
  • the patient profile database 168 includes patient medical record and treatment data 172, a plurality of telehealth questions 176, a record of patient responses 180, a record of identified patient engagement and behavior patterns 184, and a record of patient signs and symptoms 188.
  • the patient medical record and treatment data 172 include medical records for the patient 102 and a prescribed plan of care for the patient in the telehealth system 100.
  • the medical records include a history of diagnosed medical conditions for the patient 102 and symptoms that the patient 102 has experienced due to his or her medical condition(s).
  • the telehealth questions 176 include questions that are presented to the patient 102 pertaining to the type and severity of signs and symptoms that the patient 102 experiences, the medications or therapeutic devices that the patient 102 uses, the health management behaviors that the patient 102 may or may not engage in, and health education that the patient 102 learns in order to manage his or her medical condition(s). Examples of health education include questions about diet and exercise that are used to teach the patient about behaviors that improve the efficacy of the plan of care for the patient.
  • the patient profile database 168 stores responses 180 that the patient 102 enters to different questions.
  • the telehealth terminal 104 periodically presents a set of questions, which includes some or all of the telehealth treatment questions 176, to the patient 102.
  • the telehealth terminal 104 sends the responses to the questions to the telehealth analysis system 150 and the responses are stored with the patient responses 180 of the patient profile database 168.
  • the patient responses 180 include a history of responses to questions that the patient 102 has entered at different times during the telehealth treatment process.
  • the patient responses 180 include metadata about the responses in addition to the actual content of the responses.
  • a timer 124 records the amount of time that elapses as the patient 102 receives and answers each telehealth question.
  • the patient responses 180 store the response time in association with each response to the different telehealth questions.
  • the patient profile database 168 stores a history of identified behavior patterns 184 and patient symptoms 188 that are identified during the course of the telehealth treatment process.
  • the patient behavior patterns 184 are identified from both the content of the patient responses 180 and other factors that affect entry of the responses, including the time taken to enter the responses to the questions and a number of occasions in which the patient fails to enter responses to the questions.
  • the patient behavior pattern is affected by answers to questions regarding the diet of the patient and by a number of times that the patient fails to respond to survey questions during the telehealth treatment.
  • the patient symptoms data 188 include symptom data that are directly derived from responses to the telehealth questions (e.g.
  • the controller 162 generates numeric scores for the identified behavior patterns and symptoms for the patient 102.
  • the numeric scores are stored with the patient behavior pattern data 184 and patient symptom data 188 for use in identifying the efficacy of the telehealth treatment over time.
  • the telehealth terminal 104 is an electronic device that is stored at the home of the patient 102 or carried with the patient 102 in a mobile embodiment.
  • the processor 120 is includes one or more integrated components such as central processing unit (CPU) cores, and a graphical processing unit (GPU).
  • the memory 122 typically includes a non- volatile solid state storage device for long-term storage of stored program instructions and telehealth question data for the processor 120, and RAM for temporary storage of data during operation of the telehealth terminal 104.
  • the timer 124 is implemented in software that is executed by the processor 120, while in other embodiments the timer 124 is implemented with hardware circuits in the telehealth terminal 104.
  • the network interface device 128 is a wireless network interface device, such as a wireless LAN (WLAN) or wireless WAN (WW AN) device, although alternative embodiments use wired network interface devices such as Ethernet or analog modems.
  • the processor 120 is operatively connected to the network interface device 128 and is configured to send data to the telehealth analysis system 150 and to receive data from the telehealth analysis system 150.
  • some or all of the processor 120, memory 122, timer 124, and the wired or wireless network interface device 128 are integrated into a system on a chip (SoC) device.
  • SoC system on a chip
  • the processor 120 In the telehealth terminal 104, the processor 120 generates a user interface through one or both of the visual output device 108 and audio output device 112 and receives input through the input device 116.
  • the user interface can include both input and output (I/O) devices.
  • I/O devices include, but are not limited to, a keyboard, mouse, touchscreen, voice input, and pen input device.
  • Output devices include, but are not limited to, visual displays including visual displays that depict a graphical user interface (GUI), audible output, and various printing devices.
  • GUI graphical user interface
  • the visual output device 108 and input device 116 are integrated in a touchscreen device where the patient 102 enters responses to telehealth queries and other information by touching GUI controls that are displayed on a screen.
  • the controller 162 sends the telehealth treatment questions 176 to the telehealth terminal 104 through the network 132.
  • the telehealth terminal 104 presents the questions to the patient 102 using, for example, one or both of the visual output device 108 and the audio output device 112.
  • the processor 120 in the telehealth terminal 104 records the responses to the questions and additional data including response time data and optionally data from other medical monitoring devices.
  • the processor 120 sends the recorded data to the telehealth analysis system 150 through the network 132 using the network interface device 128.
  • the telehealth analysis system 150 uses the responses and other data received from the telehealth terminal to evaluate the ongoing efficacy of the telehealth treatments for the patient.
  • the telehealth analysis system 150 identifies that the telehealth treatment process is less efficacious than desired, the telehealth analysis system sends one or more updates to the telehealth terminal to either modify the telehealth treatment program or to discontinue the telehealth treatment program.
  • FIG. 2 depicts a process 200 for evaluating the efficacy of a telehealth treatment and for modifying the telehealth treatment to improve the efficacy or discontinuing the treatment.
  • a reference to the process 200 performing or doing some function or action refers to one or more controllers or processors that are configured to execute programmed instructions stored in a memory to implement the process performing the function or action or to operate one or more components to perform the function or action.
  • Process 200 is described with reference to the telehealth system 100 of FIG. 1 for illustrative purposes.
  • Process 200 begins after a patient has been issued a telehealth device, such as the telehealth terminal 104 in the system 100.
  • the telehealth terminal 104 presents queries to the patient 102 and receives responses that the patient 102 enters with the input device 116 (block 204).
  • the queries include predetermined questions that are received from the telehealth analysis system 150.
  • the telehealth treatment questions 176 are generated with reference to the diagnosed medical conditions, physiological and psychological information, and medical history data stored in the patient medical record and treatment data 172.
  • a doctor or healthcare provider selects the treatment questions 176, while in other embodiments the telehealth treatment questions 176 are selected automatically based on medical record data 172.
  • the terminal 104 periodically generates an output for the patient 102 including a set of the telehealth queries that are received from the telehealth analysis system 150.
  • the terminal 104 selects a subset of the queries during each session and changes the order of the queries so that the patient 102 does not answer the same questions in the same order during each session.
  • the terminal 104 presents the telehealth queries at regular intervals, such as daily at a predetermined time of day or at regular periods when a patient 102 is scheduled to take medication.
  • Process 200 continues as the telehealth terminal sends the responses to the telehealth queries to the telehealth analysis system (block 208).
  • the processor 120 sends the data corresponding to the responses, including response time data, with the network interface device 128 through the network 132 to the corresponding network interface device 190 in the telehealth analysis system 150.
  • the telehealth terminal 104 encrypts the response data and sends the encrypted response data to the telehealth analysis system 150 for decryption.
  • the encryption of data that are sent over the network 132 provides privacy for the patient responses and other data collected by the telehealth terminal 104.
  • the telehealth analysis system 150 receives the response data from the telehealth terminal 104 and identifies one or both of a behavior pattern or symptoms for the patient 102 from the response data (block 212).
  • the controller 162 identifies the behavior patterns using a history of the responses stored in the patient responses 180 and previously identified behavior patterns 184 corresponding to a history of behavior patterns that the patient has exhibited over time.
  • the most recently received responses from the telehealth terminal 104 can indicate changes in the behavior patterns of the patient from earlier behavior patterns.
  • the controller 150 also identifies one or more symptoms in the responses received from the telehealth terminal 150.
  • the identified symptoms are compared to previously identified patient symptoms 188 to enable the telehealth analysis system 150 to monitor chronic symptoms that the patient 102 experiences over time during multiple queries for patient responses, and to identify acute symptoms that manifest for shorter times during the telehealth treatment.
  • the telehealth analytical system 150 stores the identified behavior patterns and symptoms for later review by doctors or other healthcare professionals who are treating the patient 102.
  • the telehealth analysis system 150 identifies the ongoing efficacy of the telehealth treatment by generating a numeric score value for either or both of the identified behavior patterns and symptoms for the patient (block 216).
  • the score is generated from the most recently identified behavior patterns and symptoms, while in another configuration the score is an aggregate of behavior patterns and symptoms that have been identified from responses that are received over an extended period of time, such as a week or a month of responses. Two processes for identification and generation of numeric scores for behavior patterns and symptoms are described in more detail below in FIG. 3 and FIG. 4, respectively.
  • the numeric score is generated in a predetermined numeric range, such as 0 to 100, with the lowest numeric score indicating the lowest level of efficacy for the telehealth treatment and the highest numeric score indicating the highest level of efficacy.
  • Alternative embodiments generate scores using different scales and optionally use smaller score values to indicate higher levels of efficacy.
  • the telehealth analysis system 150 sends one or more messages to the telehealth terminal 104 to either modify the plan of care or recommend discontinuation of telehealth (block 236).
  • the minimum score threshold is 30 in a scale of 0 to 100. If the identified score for the treatment drops below 30, then the telehealth analysis system 150 generates new telehealth questions 176 that are directed to the identified behavior patterns or symptoms in the patient that result in the low score. The telehealth analysis system 150 processes the patient response data 180 to identify one or more of the behavior patterns 184 that are associated with the manner in which the patient 102 responds, or fails to respond, to telehealth questions.
  • the telehealth system 150 sends a different set of questions to the telehealth terminal 104 to change the telehealth treatment and encourage the patient 102 to use the telehealth terminal 104. If the response times to some questions are unusually long or unusually short, then the telehealth analysis system 150 can remove those questions from the queries that are presented to the patient. Additionally, the telehealth analysis system 150 is configured to modify the plan of care by updating the telehealth terminal 104 with revised frequencies and times at which the telehealth terminal 104 presents queries to the patient 102.
  • the telehealth analysis system 150 sends a revised schedule to the telehealth terminal 104 to present the telehealth queries to the patient at more convenient times.
  • the telehealth system 150 sends a discontinuation message to the telehealth terminal 104 to end the plan of care. For example, if the identified score drops below the predetermined minimum threshold and remains below the minimum threshold after one or more modifications of the plan of care with the telehealth device, then the telehealth analysis system 150 is configured to discontinue the telehealth treatment program.
  • a doctor or other healthcare professional reviews the results of the telehealth treatment including data in the patient medical record data 172, the identified behavior patterns 184, and the patient symptoms 188, before approving the discontinuation of treatment in favor of a different plan of care for the patient 102.
  • the telehealth terminal 104 displays an output message to the patient 102 to inform the patient that the telehealth treatment is ending and with instructions to contact his or her doctor for further treatment and return of the telehealth terminal 104.
  • the telehealth analysis system 150 identifies whether a difference between the identified score and one or more previously identified scores exceeds a predetermined variance threshold (block 224). For example, if the aggregate score for the telehealth treatment in January is 60, and the aggregate score for the telehealth treatment in February is 70, then the difference between the two scores is +10. If the newer score is lower than the previously identified score, then the difference is a negative value. The telehealth analysis system 150 compares the change in score to the predetermined variance threshold to measure changes in the behavior patterns or symptoms in the patient. If the differences in the scores exceed the predetermined threshold, then the telehealth treatment continues and process 200 returns to the processing described above with reference to block 204 to receive additional responses from the patient 102.
  • the telehealth analysis system 150 identifies whether both the previous scores and the current score are above a predetermined efficacy threshold (block 228). For example, in one configuration a predetermined score of 80 on a scale of 0 to 100 indicates that the telehealth treatment is highly efficacious in treating the patient 102. If the scores for the patient remain above 80 and show only small amounts of variation over an extended period of several weeks or several months, then the telehealth analysis system 150 identifies that the efficacy of the telehealth treatment has plateaued (block 232). In some instances, the telehealth treatments continue and process 200 returns to the processing described above with reference to block 204 to receive additional responses from the patient 102.
  • the telehealth analysis system 150 sends a message to the telehealth terminal 104 to indicate that the treatment is being discontinued. For example, if the telehealth treatment is originally prescribed to treat an acute medical condition in the patient 102, the telehealth treatment can be discontinued once the scores for the behavior patterns and symptoms in the patient 102 indicate that the patient has recovered.
  • the telehealth analysis system 150 identifies that the efficacy of the telehealth treatment has plateaued, and optionally modifies the telehealth treatment (block 234).
  • the scores corresponding to the behavior patterns and symptoms for the patient 102 indicate that the telehealth treatment is efficacious, but that additional benefits may be provided if the plan of care is modified.
  • the telehealth analysis system 150 sends messages to the telehealth terminal 104 including modified questions for use in the telehealth queries and changes to the schedule for the telehealth terminal 104 presenting the telehealth queries to the patient 102.
  • the telehealth treatments continue and process 200 returns to the processing described above with reference to block 204 to receive additional responses from the patient 102.
  • Process 200 is performed in an iterative manner to monitor the efficacy of the telehealth treatment for the patient 102 during the course of the telehealth treatment.
  • the telehealth analysis system 150 stores data corresponding to trends in the behavior patterns and symptoms in the patient 102 to provide additional information to doctors and other healthcare professionals about the condition of the patient 102.
  • the modifications to the telehealth treatment and optional discontinuation of the telehealth treatment ensure that the telehealth treatment provides the greatest benefit to the patient 102 and ensures that alternative treatment options are provided to the patient 102 if the telehealth treatment loses efficacy.
  • the telehealth analysis system 150 identifies behavior patterns of the patient 102 using the response data received from the telehealth terminal 104.
  • FIG. 3 depicts a process 300 that the telehealth analysis system 150 uses to identify the behavior patterns and generate the score in more detail.
  • a reference to the process 300 performing or doing some function or action refers to one or more controllers or processors that are configured to execute programmed instructions stored in a memory to implement the process performing the function or action or to operate one or more components to perform the function or action.
  • Process 300 is described with reference to the telehealth system 100 of FIG. 1 for illustrative purposes.
  • Process 300 is performed when the telehealth analysis system 150 receives responses to telehealth queries (block 304).
  • the responses include both the actual responses that the patient 102 enters into the telehealth terminal 104 when presented with telehealth questions, and timing data describing the response times for each question.
  • the telehealth analysis system 150 receives messages from the telehealth terminal 104 if the patient 102 fails to respond to some or all of the questions in a telehealth query.
  • Process 300 continues as the telehealth analysis system 150 identifies a behavior pattern from the response data using, for example, the response, content, and reliability of the responses to identify the behavior pattern (block 308).
  • the response time indicates how long the patient takes to answer a question after the telehealth terminal 104 presents the question to the patient.
  • An unusually long response time indicates that the patient 102 is having difficulty in responding to the question.
  • An unusually short response time indicates that the patient is entering responses without taking time to consider the questions carefully.
  • the content of the responses can indicate how well the patient 102 is adhering to a diet and exercise plan that is issued by a doctor or other healthcare professional. For example, a question pertaining to the number of times that the patient 102 consumed fruits and vegetables during meals.
  • the telehealth monitoring system 150 identifies the degree to which the patient 102 is following the diet and exercise plan using the responses to the questions. In monitoring the reliability of responses, the telehealth monitoring system 150 identifies the number of times that the patient 102 fails to enter responses to questions. In some instances, the patient 102 fails to respond to specific questions, while in other instances the patient 102 skips an entire set of questions in a telehealth query session. The telehealth analysis system 150 identifies the reliability of patient responses to determine if the patient is being diligent in using the telehealth terminal 104 and to identify if particular questions in the telehealth queries are difficult for the patient 102 to answer.
  • the telehealth analysis system 150 generates the numeric score for the identified behavior pattern for the patient through a comparison with a baseline behavior pattern (block 312).
  • the baseline behavior pattern is a predetermined set of behaviors that are identified for the response time, content, and reliability of response entry to the telehealth queries.
  • the baseline is a synthetic "ideal" behavior pattern for a patient who follows the telehealth treatment plan in a perfect manner.
  • the baseline is an average behavior pattern that is identified from responses entered by large population of patients who are undergoing telehealth treatments that are similar to the treatment of the patient 102.
  • the baseline is generated from responses that the patient 102 enters during a guided training process where a healthcare professional provides training and guidance to the patient 102 for performing the telehealth treatment plan and for operating the telehealth terminal 104.
  • the numeric score reflects the efficacy of the telehealth treatment based on how the identified behavior pattern for the patient 102 corresponds to the baseline behavior pattern. For example, if the baseline behavior pattern refiects an ideal patient, then the numeric score is inversely related to the deviation between the behavior pattern of the patient 102 and the ideal baseline behavior pattern. In other instances, the score is determined based on whether the behavior pattern for the patient 102 is above or below an average baseline behavior pattern for a large population of patients who are undergoing the telehealth treatments. For example, the telehealth analysis system 150 assigns a high score for the patient 102 if the behavior pattern for the patient 102 exceeds the baseline profile by one standard deviation or more.
  • the telehealth analysis system 150 assigns a high score to the behavior pattern, which complies with the training that the patient 102 receives from the healthcare professional. If the behavior patterns begin to degrade, then the telehealth analysis system 150 assigns a lower score to indicate that the patient 102 may require reinforcement to follow the telehealth treatment plan.
  • the telehealth analysis system 150 stores the behavior data and scores that are associated with the behavior patterns for the patient 102 as the patient behavior patterns 184 in the patient database 168. As described above, during the process 200 the telehealth analysis system 150 modifies telehealth questions or other aspects of the telehealth treatment when the patient behavior pattern scores indicate that the efficacy of the telehealth treatment would increase with a different behavior pattern.
  • FIG. 4 depicts a process 400 that the telehealth analysis system 150 uses to identify the symptoms and to generate a score that corresponds to the efficacy of addressing the symptoms with the telehealth system 100.
  • a reference to the process 400 performing or doing some function or action refers to one or more controllers or processors that are configured to execute programmed instructions stored in a memory to implement the process performing the function or action or to operate one or more components to perform the function or action.
  • Process 400 is described with reference to the telehealth system 100 of FIG. 1 for illustrative purposes.
  • Process 400 is performed when the telehealth analysis system 150 receives responses to telehealth queries (block 404).
  • the responses include answers to questions that are presented to the patient 102 for specific symptoms that the patient 102 has experienced due to one or more diagnosed medical conditions.
  • the responses include answers to questions about the severity of symptoms as well.
  • Some telehealth queries also include questions directed to the general well-being of the patient 102 to elicit responses from the patient 102 for identifying new symptoms that may indicate changes in the condition of the patient 102.
  • Process 400 continues as the telehealth analysis system 150 identifies the presence and severity of symptoms in the patient 102 from the response data (block 408).
  • the telehealth analysis system 150 assigns severity levels for the symptoms that have been observed in the patient from the responses that the patient 102 enters using the telehealth terminal 104. For example, if the patient 102 experiences headaches, the telehealth analysis system 150 sends questions to the telehealth terminal 104 to inquire as to the frequency of the headaches, duration of each headache, response of the headaches to medication, and the degree to which the headaches interfere with the activities of the patient 102. The telehealth analysis system 150 assigns a severity to the group of symptoms related to the headaches from the responses received from the telehealth terminal 104.
  • the telehealth terminal 104 also presents general questions to the patient 102 for the identification of new symptoms. For example, the telehealth terminal 104 presents a question to the patient asking for the patient to identify each part of the body that is experiencing pain, including parts of the body that have not experienced pain in the past. [0047] After identifying the severity of existing symptoms and new symptoms for the patient 102, the telehealth analysis system 150 generates a score for the efficacy of the telehealth treatment based on a difference between the identified symptoms and a baseline for the patient (block 412). In the telehealth system 100, the baseline for the patient 102 includes information in the medical history 172 for the types of symptoms that the patient 102 has experienced in the past.
  • the telehealth analysis system 150 assigns a higher score for the identified symptoms. If the symptoms increase in severity compared to the baseline, then the telehealth analysis system 150 assigns a lower score to the identified symptoms. Additionally, previously unreported symptoms can indicate complications with a diagnosed condition or a new medical condition, and the telehealth analysis system 150 assigns a low score accordingly. In some instances, if the responses indicate that the patient 102 is experiencing a sudden increase in symptom intensity or is experiencing serious new symptoms, then the telehealth analysis system 150 generates an alert message for a doctor or other healthcare professional to contact the patient 102 for further medical treatment.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Primary Health Care (AREA)
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  • Business, Economics & Management (AREA)
  • General Business, Economics & Management (AREA)
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Abstract

L'invention porte sur un procédé qui modifie un plan de soins d'un patient dans un système de télésanté. Selon l'invention, des demandes de données médicales correspondant à un plan de soins sont présentées à un patient au moyen d'un dispositif de télésanté et les réponses aux demandes saisies par le patient sont stockées dans une base de données d'une mémoire connectée à un contrôleur. Le contrôleur identifie un modèle de comportement relatif au patient en référence aux réponses stockées dans la base de données et génère un score en référence au modèle de comportement identifié. Le contrôleur génère des modifications suggérées pour un plan de soins élaboré pour le patient en réponse à un score inférieur à un premier seuil prédéfini. Le plan de soins modifié, conjointement avec une analyse clinique effectuée par les fournisseurs de services de télésanté, est envoyé à un dispositif de télésanté pour permettre la présentation de demandes de données médicales cohérentes avec le plan de soins modifié.
EP13826697.8A 2012-12-31 2013-12-29 Système et procédé d'évaluation itérative du bienfait thérapeutique de la télésanté Withdrawn EP2939160A1 (fr)

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US201261747869P 2012-12-31 2012-12-31
PCT/US2013/078170 WO2014106138A1 (fr) 2012-12-31 2013-12-29 Système et procédé d'évaluation itérative du bienfait thérapeutique de la télésanté

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US20070021979A1 (en) * 1999-04-16 2007-01-25 Cosentino Daniel L Multiuser wellness parameter monitoring system
US20080258922A1 (en) * 2007-04-17 2008-10-23 Coronaria Impact Oy Electronic patient treatment query
US20090055221A1 (en) * 2007-08-24 2009-02-26 Brian David Loftus Health Profile Database Management System
US8632485B2 (en) * 2009-11-05 2014-01-21 Fresenius Medical Care Holdings, Inc. Patient treatment and monitoring systems and methods
US8755938B2 (en) * 2011-05-13 2014-06-17 Roche Diagnostics Operations, Inc. Systems and methods for handling unacceptable values in structured collection protocols

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