EP4104189A1 - Procédé, dispositif et système de surveillance à distance d'un dispositif médical - Google Patents

Procédé, dispositif et système de surveillance à distance d'un dispositif médical

Info

Publication number
EP4104189A1
EP4104189A1 EP21705121.8A EP21705121A EP4104189A1 EP 4104189 A1 EP4104189 A1 EP 4104189A1 EP 21705121 A EP21705121 A EP 21705121A EP 4104189 A1 EP4104189 A1 EP 4104189A1
Authority
EP
European Patent Office
Prior art keywords
patient
terminal
medical device
medical
data
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.)
Pending
Application number
EP21705121.8A
Other languages
German (de)
English (en)
Inventor
Lars Offermanns
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.)
Fresenius Medical Care Deutschland GmbH
Original Assignee
Fresenius Medical Care Deutschland GmbH
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 Fresenius Medical Care Deutschland GmbH filed Critical Fresenius Medical Care Deutschland GmbH
Publication of EP4104189A1 publication Critical patent/EP4104189A1/fr
Pending 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
    • 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
    • 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

  • the present invention relates to the remote monitoring of a medical device by means of a device that is separate from the medical device and designed as a mobile terminal.
  • the invention is particularly directed to a method for remote monitoring of a medical device used in an, in particular, closed, patient treatment room for medical monitoring or treatment of a specific patient, in particular from outside the patient treatment room, by means of a mobile terminal separate from the medical device .
  • the invention is directed in each case to a computer program, terminal and system configured to carry out the method.
  • the medical staff In order to control, in particular to monitor, configure or control or otherwise operate a medical device used to monitor or treat such a patient, the medical staff must usually wear additional protective clothing, which is typically required before entering the patient treatment room, in which the patient is, must be put on and disposed of before leaving the room.
  • protective clothing usually consists of disposable hoods, mouthguards, gowns and gloves.
  • hygienic hand disinfection usually has to be carried out before entering and leaving the patient treatment room.
  • medical devices can be used to monitor or treat patients during use, in particular for the care of these devices Medical staff may require longer walking distances for medical staff during their deployment, which can be time-consuming and therefore shorten the time available for other patient care measures.
  • the present invention is based on the task of improving the control of medical equipment, especially in hygienically sensitive areas.
  • a first aspect of the invention relates to a, in particular computer-implemented, method for remote monitoring of a medical device used, in particular in a closed patient treatment room, for medical monitoring or treatment of a certain patient, in particular from outside the patient treatment room, such as from an upstream vestibule or aisle the end.
  • the method is carried out by means of a mobile terminal device which is separate from the medical device and comprises: (i) sensory detection of a machine-readable patient identifier assigned to the patient, in particular arranged in the local spatial environment of the patient; (ii) initiating a data link between the medical device and the terminal based on the recorded patient identifier in order to establish a wireless, in particular bidirectional, communication link for the exchange of data associated with the patient identifier between the medical device and the terminal; (iii) Receiving, via the established communication link, information transmitted by the medical device to the terminal with regard to the patient identified by means of the patient identifier or with regard to his monitoring or treatment by the medical device; and (iv) outputting a, in particular optical, e.g. written and / or visual, or acoustic representation of the received information to a man-machine interface (MMI) of the terminal.
  • MMI man-machine interface
  • Remote monitoring of a medical device is to be understood in the context of the invention as a control of the device from the terminal, in which the device and the terminal over a spatial distance (typically one or several meters) are wirelessly connected via a communication link, with information being exchanged via the communication link between the device and the terminal, which enables a control in the sense of monitoring or operation of the device from the terminal with regard to at least one monitoring or operating aspect will.
  • the "remote control" of the device from the end device is thus a subtype of remote monitoring, in which control data is sent from the end device via the communication Connection are transmitted to the device in order to control it in terms of a configuration or other operation.
  • a “mobile terminal” within the meaning of the invention is to be understood as a portable, in particular hand-held, data processing device.
  • it can contain one or more processors and an information memory coupled therewith and be controlled by software.
  • the terminal can be or have a hand-held computer, in particular a “general purpose” computer, such as a tablet computer or a smartphone, configured to carry out the method, in particular by means of software.
  • a hand-held computer in particular a “general purpose” computer, such as a tablet computer or a smartphone, configured to carry out the method, in particular by means of software.
  • it is equally possible to use application-specific end devices.
  • a “machine-readable patient identifier” is to be understood as an identifier assigned individually to a patient, in particular a code, which is present in a machine-readable representation.
  • a representation can be present optically in particular by means of letters or numbers or other symbols, for example as a one-dimensional or multi-dimensional barcode (e.g. data matrix code or QR code).
  • Such an optical representation can in particular be applied to a substrate, such as a paper or plastic label, or formed in some other way, or be shown on a display device, for example on a screen, in particular temporarily.
  • a machine-readable patient identifier can also be present as a signal that can be detected by means of a corresponding sensor device and thus “machine-readable”, in particular as an electromagnetic signal (e.g.
  • the machine-readable patient identifier can be assigned to the associated patient in particular by being spatially assigned to himself, to his clothing, to a device assigned to him, such as his patient couch, in a spatial area assigned to him within his patient treatment room or to a Access or vestibule of his patient treatment room is arranged.
  • a "data link" between the medical device and the terminal based on the recorded patient identifier is, for example, in contrast to a mechanical link, to be understood as a signal coupling by means of which a wireless, in particular bidirectional, communication link is used to exchange data associated with the patient identifier is made available between the medical device and the terminal device.
  • the coupling can in particular be of a temporary nature, the duration of the coupling in particular by a predefined time lapse, active removal of the coupling or replacement of the coupling can be caused by a coupling between the terminal and another medical device, or an interruption of the coupling due to the loss or excessive weakening of the signal connection.
  • the initiation of the data link between the medical device and the terminal on the basis of the recorded patient identifier can in particular include that the patient identifier recorded by the terminal is transmitted from the terminal to the medical device.
  • the medical device itself to receive the patient information independently of the terminal, for example through its own acquisition or a user input.
  • a data exchange specifically related to this patient identifier or the associated patient can be implemented.
  • the wireless communication link can in particular be a radio communication link.
  • radio technology based on a known LAN (Local Area Network) or PAN (Personal Area Network) radio standard, such as WLAN (WIFI), Bluetooth or Zigbee, can be used for this purpose.
  • WLAN Wireless Local Area Network
  • WIFI Wireless Fidelity
  • Bluetooth Wireless Fidelity
  • Zigbee Wireless Fidelity
  • a spatial separation of the medical device located with the patient on the one hand and the mobile device used for remote monitoring on the other hand can be achieved.
  • this can be done in particular so that the mobile device is used outside the patient treatment room to monitor the medical device located in the patient treatment room via a wireless communication link in the sense of remote monitoring.
  • This monitoring can thus be carried out by operating personnel, in particular by medical specialists such as a doctor or a nurse, without them having to enter the hygienically sensitive area of the patient treatment room while taking the appropriate hygiene protection measures.
  • Such walking distances can also be saved in situations in which monitoring over a significant distance, e.g. of at least a few meters, regardless of whether this takes place in a particularly hygienically sensitive environment or whether there is a closed patient treatment room one or more medical devices is to be carried out.
  • the mobility of the terminal allows it to be used not only in connection with a specific medical device or only a specific patient treatment room. Rather, several different operators, in particular doctors or nursing staff, each have their own terminal device that they can use for remote monitoring, in particular remote control, of various suitable medical devices in one or more different patient treatment rooms. It is also possible for a certain medical device to be cared for by different operators using their respective terminal devices as part of ongoing patient monitoring or treatment, which is particularly important with regard to shift changes in hospital wards or patient care by a patient care team comprising several people is advantageous.
  • the time and hygiene effort required for monitoring the medical device or devices can thus be reduced.
  • these time and cost savings can be used to provide the medical staff with more time for other types of patient care.
  • the data-technical coupling of the respective medical device and the terminal based on the patient identifier assigned to the patient can therefore be used to ensure in a simple and fast manner that the monitoring carried out by means of the terminal, in particular in the case of the presence of several patients or devices in the patient treatment room , relates to the correct patient and the correct medical device monitoring or treating him, so that incorrect treatment due to incorrect allocation can be effectively avoided.
  • the sensory acquisition of the patient identifier has at least one of the following processes: (i) Acquisition of a pictorial representation of the patient identifier, in particular a representation of the patient identifier using a one-dimensional or multi-dimensional barcode, using an image sensor assigned to the terminal and machine, in particular computer-aided evaluation of the image data captured by the image sensor in order to determine the patient identification therefrom; (ii) Acquisition of a radio signal representing the patient identification by means of a radio receiver assigned to the terminal and machine, in particular computer-aided, evaluation of the radio signal acquired by the radio receiver in order to determine the patient identification therefrom.
  • Process (i) is distinguished in particular by the fact that the patient identification can be represented very easily, for example by means of printing on a substrate.
  • the substrate can, for example, be a label, a label, or a plug-in card for insertion into a card holder.
  • the representation of the patient identification by means of its display on a display device, for example on a flat screen, is also possible.
  • the radio signal can in particular originate from a radio transmitter, for example a radio transponder, which is coupled to the patient.
  • the range of the radio transmitter is ideally limited to a little more than the typical dimensions of a patient treatment room, for example a few meters.
  • the radio solution according to process (ii) can be used to advantage in particular when the lighting conditions are poor, in particular at night, and an alternative optical detection of a patient identifier by process (i) might be impaired as a result.
  • Another advantage is that the radio signal, unlike the optical solution, does not necessarily require a clear line of sight to represent the patient identification or to the radio transmitter, so that a particularly high level of reliability and ease of use can be achieved here.
  • the method further comprises: (i) at least partial image sensor detection of the patient and display of a representation of the image data generated in the process on the MMI of the terminal so that the image of the patient is shown at least partially in the display and is augmented -Reality (AR) overlay is highlighted as a selection; (ii) Receiving a user input on the MMI of the terminal to confirm the selection of the patient proposed by means of the marking. The data link between the medical device and the end user is initiated. advises on the basis of the recorded patient identification only if the user input to confirm the patient selection was received beforehand. In this way, in these embodiments, a check is made to determine whether the correct patient is selected.
  • AR augmented -Reality
  • the sensory acquisition of a machine-readable patient identifier assigned to the patient furthermore comprises a sensory acquisition of at least one further machine-readable patient identifier assigned to a different patient present in the treatment room
  • the method further comprises: (i) in each case at least from section-wise image sensor detection of two or more of the patients whose patient identification was detected by sensors; (ii) Displaying a representation of the image data generated during the image sensor acquisition on the MMI of the terminal device in such a way that the display contains the respective at least partial image of the image sensor and by means of a respective, in particular different, such as differently colored, augmented reality - Overlay is highlighted; and (iii) receiving a user input on the MMI of the terminal device for selecting a specific one of the patients displayed on the MMI using the image data based on their respective marked image.
  • the initiation of the data link between the medical device and the terminal takes place on the basis of the recorded patient identifier for the particular patient selected according to the user input.
  • the patient identifications are preferably each arranged in the local spatial environment of the associated patient, for example on their patient bed or on the patient's body or clothing. These embodiments are also used to enable a correct patient assignment to the medical device and the terminal to be checked, where- in this case, not only a confirmation, but even a selection between different recognized patients or patient identifications is provided.
  • the at least partial image sensor detection of the patient (s) includes a respective automatic recognition of the patient (s) on the basis of the image data.
  • the recognition of the patient (s) relates to at least recognition of their image within the image represented by the image data.
  • the AR marking can be designed, for example, as a frame around this patient image, which can in particular run along the contour of the patient image.
  • the recognition can optionally also relate to an identification of the patient (s), which in particular makes it possible to compare these identifications with the machine-readable patient identifier (s) recorded for the corresponding patient (s) for the purpose of checking the consistency. The latter can in particular be used again to increase the reliability of the assignment of a specific patient to a specific medical device and to the terminal.
  • the automatic recognition of the patient or patients takes place on the basis of the image data in at least one of the following ways: (i) automatic pattern recognition for recognizing the respective image of the patient within the image data; (ii) automatic identification of the respective patient on the basis of his assigned machine-readable patient identifier represented in the image data; (iii) automatic object recognition of at least one object or optical signal uniquely assigned to the patient, such as the signal of a light source, within the image data; (iv) automatic detection of at least one AR marker spatially assigned to the patient within the image data. All of these paths have in common that they each enable reliable automatic recognition of the patient or patients on the basis of the image data.
  • patient identification can be used analogously for the identification of a medical device (object) used for remote monitoring for monitoring or treating the selected patient.
  • the devices that are potentially to be recognized can each have an individual device identifier that is used analogously to the patient identifier.
  • the information received by the medical device on the terminal and output on the MMI of the terminal contains at least one of the following information: (i) an operating mode of the medical device currently set on the terminal; (ii) a patient monitoring or patient treatment functionality currently running on the terminal; (iii) one or more measured actual parameters or currently set target operating parameters of the medical device; (iv) one or more measured values relating to the physiological state of the patient monitored or treated by the medical device; (v) one or more warning notices relating to the current status or operation of the medical technical device or the ongoing monitoring or treatment of the patient by the medical technical device.
  • the correct functioning of the medical device or a currently running patient monitoring or treatment or a current physiological condition of the patient can be monitored from the terminal, in particular without the medical staff performing the monitoring having to enter the patient treatment room, in particular must enter while taking the appropriate, usually complex, hygienic protection measures.
  • the output of the information received from the medical device is configured to be user-configurable and the method further comprises: (i) receiving a user input on the MMI of the terminal to define a configuration with regard to the selection or display type of the information to be output on the MMI; and (ii) configuring the terminal in such a way that the information received from the terminal with regard to its selection or display type or both is carried out on the MMI in accordance with the configuration established by means of the user input.
  • the output of the received information on the MMI of the user terminal can be configured in a configurable manner, which in particular enables a user-specific, application-specific, or patient-specific configuration with regard to the medical device used.
  • the device or patient states that are particularly critical for this patient monitoring or treatment can preferably be displayed on the MMI, for example in the top display level of a several display levels specified operating menus.
  • information that is irrelevant for this patient monitoring or treatment can, for example, be masked out or suppressed in order not to overload the display on the MMI and to make incorrect readings more difficult.
  • initiating the data link between the medical device and the terminal on the basis of the recorded patient identifier includes establishing a bidirectional wireless communication connection for bidirectional data exchange of data assigned to the patient identifier between the medical device and the terminal, and the method also has : (i) Receiving a user input on the MMI of the terminal device for remote control of the medical device by means of the terminal device; and (ii) transmission of control data to the medical device via the communication link, which data represent the remote control of the medical device determined by means of the user input. In this way, not only a monitoring of the medical device but also its control in the sense of a remote control from the terminal can be implemented.
  • control data represent a change in a configuration or function of the medical terminal according to the user input, such as activating or deactivating a functionality thereof
  • control data is only transmitted and only if one or more previously by means of the terminal the following actions were successfully carried out again: (i) selection or confirmation of the patient monitored or treated by means of the medical technical device; (ii) Authorization, in particular by authentication, of the user making the user input to change a configuration or function of the medical terminal in order to carry out the corresponding remote control of the medical device.
  • the operational reliability of the medical device can be increased when it is operated by means of the terminal, in particular with a view to avoiding incorrect user inputs.
  • the method further includes processing the information received from the medical device for automatic detection of one or more of the following: (i) Potentially critical monitoring or treatment situations with regard to the medical device Device monitored or treated patients; (ii) potentially critical states of the medical technical device; (iii) Optimization potential with regard to the operation of the medical device, in particular in the context of remote monitoring, in particular special remote control, of the device from the terminal.
  • this enables, in particular, a quick and automatic detection of critical situations that potentially require intervention by the medical staff without direct observation of the medical device or reading of information from the device itself got to.
  • Variant (iii) also makes it possible to automatically identify optimization options for work processes on the basis of an automatic recording and an evaluation based thereon of actually carried out operating processes with regard to the medical device.
  • the dialysis machine can be reconfigured to this effect, in particular from the terminal take place that in the future such an alarm is triggered earlier, that is, when the bag is still filled to an even greater extent, in order to give the medical staff more time to react in good time.
  • the processing of the information received from the medical device for automatic detection of potentially critical monitoring or treatment situations or critical states of the medical device can be performed using one or more data analysis methods using machine learning, for example by means of a artificial neural network.
  • machine learning for example by means of a artificial neural network.
  • the method for remote monitoring of the medical device used for medical monitoring or treatment of a specific patient is carried out while the medical device is running is in a closed patient treatment room and at the same time the mobile terminal is outside the patient treatment room.
  • a second aspect of the invention relates to a mobile terminal for remote monitoring of a medical device used, in particular in a closed patient treatment room, for medical monitoring or treatment of a specific patient, in particular from outside the patient treatment room, the terminal device being separated from the medical device and is configured to perform the method according to the first aspect of the invention.
  • the device has in particular (i) a sensor device for sensory detection of a patient identifier provided locally by means of an identifier provision device; (ii) a communication device for exchanging data with the medical device; (iii) a man-machine interface, MMI, for capturing user inputs and for outputting information to a user of the terminal; and (iv) a data processing unit for processing user inputs recorded via the MMI, data received via the communication device and information recorded by means of the sensor device.
  • the identifier provision device can in particular be designed as a display device, such as a screen, or as a signal transmitter, in particular a radio transmitter. In particular, as already described above, it can also be present on a substrate by means of printing.
  • the substrate can be, for example, a label, a label, or a plug-in card to be inserted into a card holder.
  • the communication device is preferably configured for wireless data exchange over a distance of regularly no more than 15 m, preferably no more than 10 m.
  • This can in particular facilitate the selective data-technical coupling of the end device with a specific medical technical device, since due to the limited transmission range in cases of high device density, as often occurs in hospitals in particular, only the devices available in the transmission range for such a coupling from the outset are available for selection.
  • the required transmission power can also be kept small, which can be used in particular to reduce or avoid undesired radio signal-related interference with other equipment and for spatially differentiated reuse of radio frequencies.
  • a third aspect of the invention relates to a computer program which is configured to run on a data processing unit of the terminal according to the second aspect of the invention and to cause the terminal to execute the method according to the first aspect of the invention.
  • the computer program can in particular be stored on a non-volatile data carrier.
  • This can in particular be a data carrier in the form of an optical data carrier or a flash memory module. This can be particularly advantageous if the computer program as such is to be acted independently of a processor platform on which the one or more programs are to be executed.
  • the computer program can be present as a file on a data processing unit, in particular on a server, and can be downloaded via a data connection, for example the Internet or a dedicated data connection, such as a proprietary or local network, in particular to the terminal itself
  • a data connection for example the Internet or a dedicated data connection, such as a proprietary or local network, in particular to the terminal itself
  • the computer program can have a plurality of interacting individual program modules.
  • the terminal device can accordingly have a memory in which the computer program is stored.
  • the terminal can also be set up to access an externally available computer program via a communication link, for example on one or more servers or other data processing units, in particular to exchange data with it that are used during the course of the method or computer program or represent outputs of the computer program.
  • a fourth aspect of the invention relates to a system for monitoring or treating a patient.
  • the system has: (i) a medical device for monitoring or treating the patient; (ii) an identifier providing device for providing a machine-readable patient identifier uniquely assigned to the patient in the local environment of the patient or on the patient himself; and (iii) a mobile terminal according to the second aspect of the invention.
  • the terminal is configured to control the medical device according to the method according to the first aspect of the invention in terms of remote monitoring, in particular remote control, and the medical device is configured to be controlled accordingly by the terminal.
  • the medical device has at least one of the following medical functionalities: a dialysis radio functionality; a blood treatment functionality; an infusion pump functionality, a patient monitoring functionality.
  • a dialysis radio functionality In the case of devices with one or more of these functionalities in particular, it often happens that, on the one hand, they are used in a particularly hygienically protected environment by means of appropriate protective measures, in particular hygienically specially protected patient treatment rooms, and, on the other hand, they are used with a high frequency of medical Specialist personnel have to be monitored and / or operated. Therefore, the savings made possible according to the invention in terms of time and protection expenditure and thus also costs and waste expenditure (in particular for disposable protective clothing) come into play particularly well.
  • the system also has a wearable electronics device to be carried by the patient, the wearable electronics device having a memory device for storing patient-related data, in particular a patient identifier assigned to the patient, and a communication device for wireless communication of data stored in the storage device to the mobile terminal device or the medical device's rule.
  • a wearable electronics device to be carried by the patient, the wearable electronics device having a memory device for storing patient-related data, in particular a patient identifier assigned to the patient, and a communication device for wireless communication of data stored in the storage device to the mobile terminal device or the medical device's rule.
  • the wearable electronics device can in particular further comprise one or more of the following elements: (i) a safety device for making unauthorized removal of the wearable electronics device from a patient wearing it more difficult; (ii) a signaling device for outputting an optical or acoustic signal in response to the receipt of a specific signal via the communication device.
  • a safety device for making unauthorized removal of the wearable electronics device from a patient wearing it more difficult
  • a signaling device for outputting an optical or acoustic signal in response to the receipt of a specific signal via the communication device.
  • Variant (i) is primarily used to make unauthorized or unintentional removal of the wearable electronics device from the patient more difficult, ideally to prevent it, in order to avoid the effort required for a reattachment.
  • this variant (i) can also be advantageous to ensure the data-technical coupling can be used in the context of the method according to the invention.
  • the wearable electronics device is configured as one of the following: an arm, ankle, or collar or chain; Stickers for applying to the patient's body surface or clothing, belt, part of patient clothing. All of these embodiments allow, in particular, a reliable and mechanically robust coupling of the wearable electronics device to the patient or his or her clothing, without impairing the patient's well-being essential Lich.
  • FIG. 1 schematically shows a hospital ward with a patient treatment room and anteroom to it, and a system used in this environment according to an embodiment of the invention for monitoring or treatment of patients present in the patient treatment room, the system in particular again as shown in FIG. 1 below terminal shown enlarged; and
  • 2A-C show a flow chart to illustrate a preferred embodiment of the method according to the invention.
  • the hospital ward 100 shown in FIG. 1 has a patient treatment room 105 as well as an anteroom 110 upstream of this and connected to an intermediate door 115 serving as a hermetic barrier or sluice.
  • the anteroom 110 in turn has an outer door 111 through which it can be entered.
  • the intermediate door 115 has a window (shown in dashed lines) through which the interior of the patient treatment room 105 can be seen from the vestibule 110.
  • the patient treatment room 105 there are two patients P1 and P2, each on a patient couch 120a or 120b made available to them.
  • the hygienically particularly sensitive patient treatment room 105 is separated from the anteroom 110, which is subject to less hygienic requirements, also from a hygienic point of view.
  • protective clothing To enter the patient treatment room 105, protective clothing must typically be worn with a view to maintaining the required hygiene standard, which must be disposed of by means of a corresponding disposal device 165 when leaving the patient treatment room 105 before leaving it. In this way, the risk can be reduced that on the one hand germs may be brought into the patient treatment room 105 by the medical staff and on the other hand germs possibly present in the patient treatment room 105 from the patients P1 and P2 get to the outside.
  • the intermediate door can in particular also be omitted.
  • a first identifier providing device is provided on each patient couch 120a or 120b, which displays a machine-readable first patient identifier 125a or 125b in the form of a QR barcode, for example, which is clearly assigned to the patient on the respective patient couch 120a or 120b this can be detected by image sensors from the vestibule 110 through the window of the intermediate door 115, in particular by means of a camera.
  • second patient identifiers 130a or 130b in anteroom 110 are displayed again as second patient identifiers 130a or 130b in anteroom 110 by means of second identifier provision devices, for example on the partition between the patient treatment room 105 and the anteroom 110 and ideally in spatial assignment to the respective position of the patient couch 120a or 120b of the patient P1 or P2 belonging to the respective patient identifier.
  • the identification provision devices for the machine-readable patient indications 125a or 125b and 130a or 130b can in particular be in the form of printed substrates, such as paper cards, or by means of corresponding display devices (e.g. screens) on the patient beds 120a or 120b or in the anteroom 110 to be provided.
  • display devices e.g. screens
  • Waste (substrates that are no longer required) to flexibly replace the displayed patient IDs with a different one when the occupancy of the patient treatment room 105 changes.
  • the devices 135a 135b can in particular be dialysis devices or blood purification devices or, inter alia, have a dialysis functionality or blood purification functionality. Other medical-technical functionalities are equally possible.
  • Each of the devices 135a and 135b can be operated via a user interface provided on the respective device.
  • the medical staff For immediate operation of the respective device, the medical staff must therefore enter the patient treatment room 105 while observing the applicable hygiene protection regulations, in particular wearing protective clothing, and cover the path from the intermediate door 115 to the respective device 135a or 135b and back again.
  • the direct operation of the devices 135a, b is therefore associated with a high level of effort.
  • the patient P1 has an electronic element (wearable electronics device) designed to be worn on the body, which is fastened to his arm and secured against unintentional and unauthorized removal, for example so that removal is only possible using a tool is.
  • the arm band 150 has a radio transmitter which is configured to send the individual patient identification previously assigned to the patient P1, which corresponds to that depicted in the barcodes 125a and 130a, by means of a radio signal 155.
  • the bracelet 150 has a storage device in which, in addition to the patient identification, other patient-related data (e.g. biographical information, medical protocols, treatment history, etc.) can be stored so that these data can be transmitted via the radio signal 155 on the terminal 140 and / or the device 135a are available.
  • the bracelet can also be equipped with optical or acoustic signaling means. Instead of an armband, designs as a belt, collar, and stickers that can be variably positioned on the patient are also conceivable.
  • the embodiment of a system according to the invention shown in FIG. 1 includes, in addition to the identification provision devices 125a, b and 130a, b, and the medical devices 135a, 135 and the bracelet 150, also a mobile terminal 140, which is used in particular as a tablet Computer or smartphone can be designed with appropriate programming to carry out the method according to the invention. Instead, an application-specific terminal is also possible.
  • the terminal 140 has an image sensor 141 designed as a camera, a communication device 142, a processor, in particular an application processor 143, and a preferably non-volatile memory 144 for storing data and computer programs.
  • the method 200 can be designed accordingly as a computer-implemented method and implemented or controlled by a corresponding computer program stored in the memory 144.
  • the terminal 140 has a human-machine interface (MMI) 145 which, in the case of a tablet computer or smartphone, has a touch-sensitive screen and optionally one or more real buttons or switches in a known manner.
  • MMI human-machine interface
  • the medical devices 135a and 135b are each set up to communicate, preferably bidirectionally, with the communication device 142 of the end device 140 via a wireless communication link in the event of their data connection with the end device 140.
  • Fig. 1 the case is shown that the terminal 140 is data-technically coupled to the medical device 135a with respect to the patient identifier of the patient P1 and a wireless communication link 160 exists between the two.
  • the terminal 140 could alternatively also be coupled to the medical technical device 135b of the patient P2 with regard to the patient's patient identification, as shown, for example, by barcode 125b.
  • the terminal 140 can optionally and in particular temporarily alternatively be data-technically coupled to one or the other medical device 135a or 135b in order to exchange data assigned to the respective patient P1 or P2 on the basis of his or her respective patient identification.
  • the terminal 140 can enter into a bidirectional communication connection, in particular via a corresponding data communication connection, with an external server or computer network 165. Via this, the terminal can, in particular, also enter into or be in communication with other comparable terminals.
  • This enables the combination of the invention with other common applica- tions based on data communication, such as. B. InstantMessenger (for text / voice communication with colleagues in the staff), time synchronization (time, work planning, appointments, etc.), remote authorization of treatment steps, automatic archiving of data processed by the end device and user behavior, voice recognition and
  • FIG. 2A to 2C linked to one another by means of connectors A and B, whereby for the purpose of better illustration also to the one already explained Reference is made to the arrangement shown in FIG.
  • a machine-readable patient identifier assigned to the patient P1 is detected by sensors.
  • this can optionally be one of the patient identifications 125a or 130a, respectively represented as a QR code code, or the patient identifier transmitted by means of the radio signal 155 from the armband 150 to the terminal 140, the named patient joints correspond to the requirements.
  • the terminal 140 has an image sensor 141, in particular a camera, and a radio communication device 142.
  • the acquisition of one of the patient identifications is typically carried out by a user, normally this will be medical personnel such as a doctor or a nurse, operating and holding the terminal 140 in such a way that the patient identifier 125a or 130a is in the field of view of the image sensor 141 and can thus be read by the terminal 140, or in such a way that the radio signal 155 can be received by the radio communication device 142.
  • the patient P1 is detected by image sensor through the viewing window of the intermediate door 115 by means of the image sensor 141 of the terminal device 140, with corresponding image data being generated.
  • the image data are analyzed by means of automatic object recognition in order to identify a contour of the image of the patient P1 in the recorded image.
  • the image of the patient P1 can also be approximately identified with the aid of a recognition of one or more augmented reality (AR) markers attached to the patient or his clothing (not shown).
  • AR augmented reality
  • the image recorded in real time by image sensor 141 is displayed on the terminal and scanned for trigger features. These features correspond to the common triggers for "Augmented Reality" (AR) applications, e.g.
  • step 215 the previously recognized image of the image sensor is The detected patient P1 is shown graphically on the MMI 145 of the terminal 140, the recognized contour being highlighted by means of an AR marking, for example by means of a colored frame. In FIG. 1, this is illustrated by way of example by means of the contour of the patient P1 shown with a larger line width compared to that of the patient P2.
  • the terminal 140 now waits for the receipt of a user input B1 on the MMI 145 in a subsequent step 220 for the purpose of confirming or selecting the recorded patient P1.
  • This confirmation or selection can in particular take place in that the user touches the area delimited by the AR marking on a touchscreen of the MMI and this is recorded accordingly by the terminal 140 and interpreted as a confirmation or selection of the patient P1.
  • the terminal 140 is ready in a further step 230 to detect a medical device to be used for monitoring or treatment of the selected patient P1 by image sensors.
  • a medical device to be used for monitoring or treatment of the selected patient P1 by image sensors.
  • this is the device 135a located in the immediate vicinity of the patient P1.
  • the user again holds the terminal 140 appropriately aligned so that the image-sensing detection of the device 135a can take place from the front room 110 along a line of sight through the viewing window of the intermediate door 115.
  • a contour of the image of the terminal device 135a being shown here in step 235 in a manner comparable to that in step 210 for the patient P1 Image data captured in step 230 is recognized and this contour is represented by means of an AR marking in the displayed image on the MMI 145. If the further device 135b was also detected during the image sensor detection in step 230 and recognized as a potentially selectable medical device in the context of object detection, this is additionally shown on the MMI 145 together with another, in particular differently colored, AR marking.
  • steps 240 and 245 then wait for the receipt of a user input B2 on the MMI 145 for confirmation or selection of the device 235a marked AR in the MMI 145 for use by the patient P1.
  • the staff can select a specific of the Select both devices 135a, b, whereby this selected device is preferably focused, ie a change in the filmed image section (or change in the end device position) no longer changes the displayed position of the device on the MMI 145 was received and this user input B2 was correctly interpreted as a confirmation or selection of the medical device to be used for monitoring or treatment of the previously selected patient P1 (245 - yes), a step 250 follows in which a data link between the terminal 140 and the selected medical device (in the present case this should be device 235a) is initiated.
  • the initiation of the technical data coupling between the medical device 235a and the terminal 140 based on the previously recorded patient identifier of the patient P1 includes establishing a bidirectional wireless communication link 160 for bidirectional data exchange of the patient identifier of the patient P1 assigned data between the medical device Device 135a and the terminal device 140.
  • the patient identifier of the patient P1 recorded in step 205 is transmitted from the terminal 140 to the selected device 135a via the established communication connection 160.
  • the device 135a can also detect this patient identification itself, for example by receiving the radio signal from the bracelet 150 or by scanning the barcode 125a. It is crucial that both the medical device 135a and the terminal device 140 know the patient identifier of the patient P1 and, within the framework of the data link, they exchange data that relate exclusively to the associated patient P1, in particular to his monitoring or treatment by the device 135a, or to the device 135a itself, but not to the other patient P2 or to another medical device used to care for him (in the example from FIG. 1, this is the device 135b).
  • the successful data link is optically displayed on the MMI 145, e.g. B. by said AR marking of the device 135a, and on the device 135a itself, for. B. confirmed by lighting up the device screen and / or by lighting means on the patient couch 120a of P1.
  • operating data are transmitted wirelessly from the terminal device 140 to the device 135a (using common encrypted wireless communication, for example WiFi). This confirmation ensures that the operating personnel can clearly identify the selected device 135a from a distance (and possibly through a pane of glass).
  • the data link established in step 250 between the terminal 140 and the medical device 135a is typically of a temporary nature and is generally maintained as long as the wireless communication link 160 exists or until the terminal 140 is instead connected to another medical device, for example the device 135b for the care of the patient P2 is technically coupled with data.
  • the terminal 140 is preferably data-technically coupled at any given point in time to at most one medical device in the manner described above, although alternative embodiments in which data connections to different medical devices exist simultaneously, for example in different ways on the MMI Windows or menu levels are also possible.
  • the MMI 145 of the terminal 140 can, however, also have a configuration option for the user. In principle, such a configuration or reconfiguration can take place at different times during the operation of the terminal 140. However, since reconfiguring the MMI 145 is particularly useful in connection with the selection of a specific medical device, it will now be described in the present example, beginning with the next method step 255, in which a corresponding user input B3 for activating a reconfiguration mode and for defining a Reconfiguration of the MMI 145 is received at the terminal 140.
  • the user input B3 can accordingly comprise several individual inputs. The same also applies to the other user inputs B1, B2 and B4 described in connection with FIGS. 2A to 2C.
  • the reconfiguration established by user input B3 can in particular relate to the selection of the information or control elements to be displayed or their type of representation on the MMI 145.
  • an authorization of the operator follows in the sense of authentication, in particular by means of PIN entry on the MMI 145 or by means of biometric identification, for example by means of a fingerprint sensor or a facial or Iris recognition at the end device 140 can take place. If the authorization fails (270 - no), for example due to the entry of an incorrect PIN, the method branches back to step 255. Otherwise (270 - yes), the terminal 140 reconfigures its MMI in step 275
  • step 280 proceeds to the following step 280 away. If, on the other hand, it was determined in step 260 that the reconfiguration mode was not initiated and accordingly no user input P3 for reconfiguration was received (260 - no), steps 265 to 275 are skipped and the method is continued immediately with step 280. Instead, the authorization can also be provided at an earlier stage of the process, in particular also at the beginning of the process.
  • a signal that can be perceived by staff e.g. a tone or illumination of the device screen or other patient-related lighting means
  • a signal that can be perceived by staff can optionally be output on the device 135a , which signals that the device 135a is ready to accept changes to be entered on the terminal device 140.
  • the terminal device 140 is then able to transfer control data to the device 135a to be remotely controlled.
  • the terminal 140 receives data related to the patient P1 or his associated patient identifier from the previously selected device 135a, which can in particular contain monitoring or treatment information and / or device information relating to the device 135a itself.
  • the entire amount of data collected by the device 135a is potentially available for selection for this purpose. First and foremost, these are typically the data that (can) also be displayed on the user interface of the device itself. This does not have to be exclusively treatment-related data.
  • Such values can, for example, especially with regard to dialysis or blood washing, current treatment option, (blood) pressure, pulse, (body / fluid / machine part) temperatures, patient data (ID, name, age, gender, medical protocols etc.), patient weight, (treatment / running) times, parameters relating to dialysis effectiveness (clearance, Kt / V), (ultrafiltration) volumes, dialysis filters / tubes / solvents (compositions) used, Flow rates, pump rates, or electr. Relate to voltages and machine information (e.g. serial number, software version, machine type, GPS position, connected equipment). The subset of data to be displayed can be correlated with previously defined access rights of the medical staff.
  • the information received in step 280 is then output in step 285 on the MMI 145 of the terminal 140 in accordance with the possibly previously defined configuration of the MMI. This can be done in the most varied of ways, for example by means of one or more symbols, graphics, numerically or in writing. Additional It is also possible to display further information, such as information generated by the terminal 140 itself or further information transmitted by the device 135a.
  • the information received can also be automatically evaluated in a further step 290, which can be done in particular by means of one or more methods from the field of artificial intelligence, in particular based on machine learning.
  • certain information patterns can be identified in a flexible and also continuously improved manner, which indicate the occurrence of potentially critical events or states with regard to the device or the patient or his care. If, for example, one or more of the aforementioned medical values (for example blood pressure, pulse) reaches a critical range, the output of an alarm on the terminal can generally also be triggered on the medical device 135h.
  • the server 165 can optionally be accessed and the evaluation can be stored at least partially on it, which makes it possible to use its computing power, which is usually higher than that of the mobile terminal, and thus to achieve a gain in speed for the evaluation. In this way, more effective and faster machine learning based on the information received from several end devices can also be implemented centrally.
  • One possible objective particularly in the intensive care context, that is to be achieved through such evaluations, primarily serves to support staff and patients in everyday clinical practice.
  • Potential effects of the invention in this context include, for example, faster / better reaction to critical situations, higher patient safety, higher hygiene, reduced workload for staff, reduced material consumption, fewer operating errors, reduced risk of accidents, among others.
  • the method branches back to step 255 or optionally (not shown) to step 280. Otherwise (295 - yes), warning messages corresponding to the detected potentially critical event or states are output on the MMI 145 of the terminal device 140, for example acoustically and / or by means of a corresponding display. As a rule, corresponding warning messages are also output on the medical device 135a itself.
  • the terminal 140 then waits for the receipt of a user input B4 for recording a user reaction to the warning message (s) issued. If and as soon as a corresponding user input B4 has been received on the MMI 145 in a step 305 (310 - yes), with which, for example, a warning has been acknowledged or another control command for controlling the medical device 135a has been entered, the medical device is controlled in step 315 Device 135a in the sense of a remote control according to the captured user inputs B4.
  • the warning signal can be switched off or, for example, muted, or the function of device 135A can be controlled in some other way in order to respond to the warning message.
  • the medical device 135a can also be controlled independently of a previous receipt of a warning message by means of a corresponding control input on the MMI 145 of the terminal, as long as the data technology coupling exists between the two devices. Carrying out the changes made by remote control or reconfiguration via the terminal 140 on the device 135a can in particular be acknowledged again by a corresponding signal output on the device 135a and optionally also on the MMI 145 of the terminal 140 itself.
  • Remote monitoring system 105 patient treatment room
  • MMI of the end device 140 Wearable electronics device in the form of a patient bracelet with radio transmitter for patient identification 155 wireless communication link between the wearable electronics device 150 and the end device 140

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  • General Business, Economics & Management (AREA)
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Abstract

L'invention concerne un procédé et un système de surveillance à distance d'un dispositif médical qui est utilisé pour surveiller ou traiter médicalement un patient spécifié, en particulier dans une zone de traitement de patient fermée, en particulier de l'extérieur de la zone de traitement du patient. Le procédé comprend les étapes consistant à : détecter un identifiant de patient lisible par machine, qui est attribué au patient, à l'aide d'un capteur ; initier une liaison entre le dispositif médical et le terminal de manière à transmettre des données sur la base de l'identifiant de patient détecté afin d'établir une connexion de communication sans fil pour échanger des données attribuées à l'identifiant de patient entre le dispositif médical et le terminal ; réceptionner, par l'intermédiaire de la liaison de communication établie, des informations qui sont transmises par le dispositif médical au terminal et qui se rapportent au patient identifié par l'identifiant de patient ou au processus de surveillance ou au traitement du patient au moyen du dispositif médical ; et fournir en sortie une représentation des informations reçues sur une interface homme-machine du terminal. L'invention concerne en outre un programme informatique configuré pour mettre en œuvre le procédé et un terminal conçu de manière correspondante en tant que partie du système.
EP21705121.8A 2020-02-10 2021-02-09 Procédé, dispositif et système de surveillance à distance d'un dispositif médical Pending EP4104189A1 (fr)

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DE102020201627.5A DE102020201627A1 (de) 2020-02-10 2020-02-10 Verfahren, vorrichtung und system zur fernüberwachung eines medizintechnischen geräts
PCT/EP2021/053007 WO2021160576A1 (fr) 2020-02-10 2021-02-09 Procédé, dispositif et système de surveillance à distance d'un dispositif médical

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CN100443045C (zh) 2004-06-15 2008-12-17 皇家飞利浦电子股份有限公司 采集患者的生理信号的传感器
US8798527B2 (en) 2011-01-14 2014-08-05 Covidien Lp Wireless relay module for remote monitoring systems
KR101368751B1 (ko) * 2012-02-22 2014-03-03 삼성메디슨 주식회사 영상 진단 장치를 제어하는 방법 및 그를 위한 이동 단말, 및 영상 진단 장치의 동작 방법 및 그를 위한 영상 진단 장치
DE102014202893A1 (de) * 2014-02-18 2015-08-20 Siemens Aktiengesellschaft Verfahren zur Bedienung einer Bildgebungsmodalität und Bildgebungsmodalität
JP7030770B2 (ja) 2016-07-27 2022-03-07 コーニンクレッカ フィリップス エヌ ヴェ 患者監視システム
US11058498B2 (en) * 2017-12-28 2021-07-13 Cilag Gmbh International Cooperative surgical actions for robot-assisted surgical platforms
US11559308B2 (en) * 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure

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CN115362508A (zh) 2022-11-18

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