EP4701532A1 - Attachable sensing device - Google Patents

Abstract

An example sensing device includes a center module including processing circuitry and communication circuitry; housing configured to house the center module and configured to attach to a wristband; one or more extensions extending from the center module; a first sensor located on the housing; and a second sensor located outside of the housing communicatively coupled to the center module, wherein the first and second sensors are configured to detect one or more physiological parameters of a patient, and wherein the processing circuitry is configured to perform at least one of: determine a health event of the patient based on the detected physiological parameters; or transmit, via the communication circuitry, sensor data of the first and second sensors to an external computing device based on the detected physiological parameters to determine a health event of the patient.

Description

ATTACHABLE SENSING DEVICE

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63/498,928, filed April 28, 2023, the entire content of which is incorporated herein by reference.

TECHNICAL FIELD

[0002] This disclosure is related to medical devices, and, more particularly, to attachable sensing devices configured to monitor patient health.

BACKGROUND

[0003] A variety of devices are configured to monitor physiological signals of a patient. Such devices include wearable medical devices, as well as a variety of wearable health or fitness tracking devices. In some examples, wearable monitoring devices may include various sensors and be worn on a wrist of a patient to monitor physiological signals of the patient. The physiological parameters sensed by such devices may include as examples, electrocardiogram (ECG) signals, respiration signals, electroencephalogram (EEG) signals, perfusion signals, activity and/or posture signals, pressure signals, blood oxygen saturation signals, heart sounds signals, temperature signals, body composition signals, biochemical signals, fluid impedance signals, or blood constituent signals.

SUMMARY

[0004] Millions of patients worldwide are at an increased risk of an adverse health event, such as an acute health event like cardiac arrest, stroke, syncopal (fainting) events, or other falls, and yet few options exist for monitoring patient physiologic parameters before or as a health event occurs in these patients. Healthcare has become increasingly reliant on wearable devices, such as a smartwatch, to help monitor patient physiologic parameters. However, many people prefer not to wear a smartwatch for a variety reasons, such as cost, fashion, and/or feel of the smartwatch, which may prevent a large segment of the population from being able to monitor physiologic parameters before or as a health event occurs in these patients, which leads to worse outcomes for the patient (e.g., longer recovery, greater side-effects from the health event, and/or death) which also may lead to greater healthcare costs.

[0005] This disclosure describes sensing device(s) configured to attach to the back of a traditional watch or wristband in a discrete manner that is desirable to wear by a patient who prefers not to wear or does not have a smartwatch. The example sensing devices described herein are configured in a manner to provide improved patient health event monitoring by the sensing device and/or provide improved wireless connectivity of the sensing device compared to previous sensor-filled devices that can be attached to a wristwatch. In some examples, the sensing device may be worn independently of a wristwatch, such as on a wristband or adhesively attached to the skin.

[0006] For example, a sensing device may include a center module, housing, a first sensor on the housing, a second sensor outside the housing, and one or more extensions extending from the center module. In some examples, the second sensor may be positioned on an extension that enables the second sensor to be positioned at locations away from the first sensor that may help sensing device detect improved signal quality of detected signals of physiological parameters and/or reject noise in the detected signals of physiological parameters obtained via sensors positioned on the one or more extensions, which improves accuracy and reliability of determined health events of a patient based on detected physiological parameters of the patient. In some examples, the one or more extensions include an antenna extension that improves the wireless connectivity of sensing device.

[0007] In one example, this disclosure describes a sensing device comprising: a center module including processing circuitry and communication circuitry; housing configured to house the center module and configured to attach to a wristband; one or more extensions extending from the center module; a first sensor located on the housing; and a second sensor located outside of the housing communicatively coupled to the center module, wherein the first and second sensors are configured to detect one or more physiological parameters of a patient, and wherein the processing circuitry is configured to perform at least one of: determine a health event of the patient based on the detected physiological parameters; or transmit, via the communication circuitry, sensor data of the first and second sensors to an external computing device based on the detected physiological parameters to determine a health event of the patient. [0008] In another example, this disclosure describes a method for operating processing circuitry of a medical system comprising: detecting, by a first sensor located on a housing of a sensing device and a second sensor of the sensing device located on an extension extending from the housing and electrically coupled to the processing circuitry, one or more signals of a patient; determining, by the processing circuitry, an adverse health event of the patient based on the detected one or more signals; and outputting, by communication circuitry located in the housing, to a computing device an indication of the determined adverse health event of the patient.

[0009] The details of one or more examples are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims.

BRIEF DESCRIPTION OF DRAWINGS

[0010] FIG. 1 is a block diagram illustrating an example system configured determine health events of a patient accordance with one or more techniques of this disclosure.

[0011] FIG. 2 is a block diagram illustrating an example configuration of a sensing device, in accordance with one or more techniques of this disclosure.

[0012] FIG. 3A is a back-side view of an example sensing device in conjunction with a wristband in accordance with one or more techniques of this disclosure.

[0013] FIG. 3B is a front-side view of the example sensing device of FIG. 3A in conjunction with the wristband in accordance with one or more techniques of this disclosure.

[0014] FIG. 4 is a back-side view of another example sensing device in conjunction with a wristband in accordance with one or more techniques of this disclosure.

[0015] FIG. 5 is a back-side view of another example sensing device in accordance with one or more techniques of this disclosure.

[0016] FIG. 6 is a flow chart illustrating an example method to determine an adverse health event of a patient and output an indication of the adverse health event in accordance with one or more techniques of this disclosure. DETAILED DESCRIPTION

[0017] It will be understood that, although the terms first, second, etc. may be used herein to describe various elements, these elements should not be limited by these terms. These terms are only used to distinguish one element from another. For example, a first element could be termed a second element, and, similarly, a second element could be termed a first element, without departing from the scope of exemplary embodiments. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items.

[0018] It will be understood that when an element is referred to as being “connected” or “coupled” to another element, it can be directly connected or coupled to the other element or intervening elements may be present. In contrast, when an element is referred to as being “directly connected” or “directly coupled” to another element, there are no intervening elements present. Other words used to describe the relationship between elements should be interpreted in a like fashion (e.g., “between” versus “directly between,” “adjacent” versus “directly adjacent,” etc.).

[0019] The terminology used herein is for the purpose of describing only particular embodiments and is not intended to be limiting of exemplary embodiments. As used herein, the singular forms “a,” “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises,” “comprising,” “includes” and/or “including,” when used herein, specify the presence of stated features, integers, steps, operations, elements and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components and/or groups thereof. It should also be noted that in examples, the functions/acts noted may occur out of the order noted in the figures.

[0020] In some examples, the techniques described herein are directed to a sensing device comprising a center module, housing, one or more extensions, and one or more sensors, such as a first sensor and sensor. The center module may include processing circuitry and communication circuitry. The housing may be configured to house the center module. In some examples, the housing may be configured to attach to one or more of a wristwatch, wristband, or other piece of apparel. In some examples, the one or more extensions extend from the center module. In some examples, a first sensor may be located on the housing and a second sensor may be located on an extension and communicatively coupled to the center module. In some examples, the first and second sensors are configured to detect one or more physiological parameters of a patient. In some examples, the processing circuitry, or processing circuitry of another device or system configured to communicate with the sensing device, may be configured to determine a health event, such as an adverse health event, based on the detected physiological parameters.

[0021] FIG. 1 is a block diagram illustrating an example system 2 configured detect health events of a patient 4, and to respond to such detection, in accordance with one or more techniques of this disclosure. As used herein, the terms “detect,” “detection,” and the like may refer to detection of a health event presently (at the time the data is collected) being experienced by patient 4, as well as detection based on the data that the condition of patient 4 is such that they have a suprathreshold likelihood of experiencing the event within a particular timeframe, e.g., prediction of the health event. The example techniques may be used with one or more patient sensing devices, e.g., sensing device 10, which may be in wireless communication with one or more patient computing devices, e.g., patient computing device 12 and/or one or more patient implantable medical devices, e.g., implantable medical device (IMD) 14. Although not illustrated in FIG. 1, sensing device 10 include electrodes and other sensors to sense physiological signals of patient 4, and may detect and store sensed physiological data based on the signals and detect episodes based on the data.

[0022] IMD 14 may be implanted outside of a thoracic cavity of patient 4 (e.g., subcutaneously in the pectoral location illustrated in FIG. 1). IMD 14 may be positioned near the sternum near or just below the level of the heart of patient 4, e.g., at least partially within the cardiac silhouette. In some examples, IMD 14 takes the form of the LINQ II™ ICM. Although described primarily in the context of examples in which IMD 14 takes the form of an ICM, the techniques of this disclosure may be implemented in systems including any one or more implantable or external medical devices, including monitors, pacemakers, defibrillators, wearable external defibrillators, neurostimulators, or drug pumps. Furthermore, although described primarily in the context of examples including a single implanted patient sensing device, in some examples a system includes one or more patient sensing devices, which may be implanted within patient 4 or external to (e.g., worn by) patient 4. For example, a system with two IMDs 14 may capture different values of a common patient parameter with different resolution/accuracy based on their respective locations. In some examples, instead of or in addition to two IMDs 14, system 2 may include a ventricular assist device or WAED in addition to IMD 14.

[0023] Patient computing device 12 is configured for wireless communication with sensing device 10 and/or IMD 14. Computing device 12 retrieves event data and other sensed physiological data from sensing device 10 that was detected and stored by the sensing device 10. In some examples, computing device 12 takes the form of personal computing devices of patient 4. For example, computing device 12 may take the form of a smartphone of patient 4. In some examples, computing device 12 may be any computing device configured for wireless communication with sensing device 10, such as a desktop, laptop, or tablet computer. Computing device 12 may communicate with sensing device 10 and IMD 14 according to the Bluetooth® or Bluetooth® Low Energy (BLE) protocols, as examples.

[0024] One or more of sensing device 10 or computing device 12 may be configured to communicate with a variety of other devices or systems via a network 16. For example, one or more of sensing device 10 or computing device 12 may be configured to communicate with one or more computing systems, e.g., computing system 20 via network 16. Computing system 20 may be respectively managed by manufacturers of sensing device 10 and/or IMD 14 to, for example, provide cloud storage and analysis of collected data, maintenance and software services, or other networked functionality for their respective devices and users thereof. Computing system 20 may comprise, or may be implemented by, the Medtronic Carelink™ Network, in some examples. In the example illustrated by FIG. 1, computing system 20 implements a health monitoring system (HMS) 22, although in other examples, either of both of computing system 20 may implement HMS 22. As will be described in greater detail below, HMS 22 facilities detection of health events of patient 4 by system 2, and the responses of system 2 to such health events. [0025] Computing device 12 and/or sensing device 10 may transmit data, including data retrieved from sensing device 10, to computing system 20 via network 16. The data may include sensed data, e.g., values of physiological parameters measured by sensing device 10 and, in some cases one or more of IMD 14, data regarding health events detected by sensing device 10 and IMD 14, and other physiological signals or data recorded by sensing device 10 and/or IMD 14. [0026] Network 16 may include one or more computing devices, such as one or more non-edge switches, routers, hubs, gateways, security devices such as firewalls, intrusion detection, and/or intrusion prevention devices, servers, cellular base stations and nodes, wireless access points, bridges, cable modems, application accelerators, or other network devices. Network 16 may include one or more networks administered by service providers, and may thus form part of a large-scale public network infrastructure, e.g., the Internet. Network 16 may provide computing devices and systems, such as those illustrated in FIG. 1, access to the Internet, and may provide a communication framework that allows the computing devices and systems to communicate with one another. In some examples, network 16 may include a private network that provides a communication framework that allows the computing devices and systems illustrated in FIG. 1 to communicate with each other, but isolates some of the data flows from devices external to the private network for security purposes. In some examples, the communications between the computing devices and systems illustrated in FIG. 1 are encrypted.

[0027] As will be described herein, sensing device 10, IMD 14, computing device 12, and/or HMS 22 may be configured to detect health events of patient 4, based on data sensed by sensing device 10 and, in some cases, other data, such as data sensed by IMD 14 and/or computing device 12. To detect health events, sensing device 10, computing device 12, and/or HMS 22, for example, may apply rules or models to the data, which may be referred to as patient parameter data. In response to detection of a health event, sensing device 10 may wirelessly transmit a message to computing device 12. The message may indicate that sensing device 10 detected a health event of the patient. The message may indicate a time that sensing device 10 detected the health event. The message may include physiological data collected by sensing device 10, e.g., data which lead to detection of the health event, data prior to detection of the health event, and/or real-time or more recent data collected after detection of the health event. The physiological data may include values of one or more physiological parameters and/or digitized physiological signals. Examples of a health event that is an acute health event include sudden cardiac arrest (SCA), stroke, heart attack, myocardiac infarction, hypoglycemia, or a fall. Other example health events include those associated with chronic conditions such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), such as HF hospitalization or decompensation. [0028] In response to the message from sensing device 10, computing device 12 may output an alarm that may be visual and/or audible, and configured to immediately attract the attention of patient 4 or any person in environment 28 with patient 4, e.g., a bystander. Additionally or alternatively, computing device 12 may transmit an alert or alarm message to devices and users outside the visible/audio range of computing device 12, e.g., to loT devices 30, or HMS 22. Environment 28 may be a home, office, or place of business, or public venue, as examples. An alert or alarm message sent to HMS 22 via network 16, or other messages sent by computing device 12, may include the data received from sensing device 10 and, in some cases, additional data collected by computing device 12 or other devices in response to the detection of the health event by sensing device 10. For example, the message may include a location of patient 4 determined by computing device 12. In some examples, computing device 12 may further configure or change the content of alert or alarm messages based on the location of patient 4, e.g., different messages may be sent depending on whether patient 4 is at home, another residence, an office or business, a public location, or in a health care facility. The health care needed by patient, and thus the messaging of system 2, may vary depending on the location of patient 4.

[0029] Other devices in the environment 28 of patient 4 may also be configured to output alarms or take other actions to attract the attention of patient 4 and, possibly, a bystander, or to otherwise facilitate the delivery of care to patient 4. For example, environment 28 may include one or more Internet of Things (loT) devices, such as loT devices 3OA-3OC (collectively “loT devices 30”) illustrated in the example of FIG. 1. loT devices 30 may include, as examples, so called “smart” speakers, cameras, televisions, lights, locks, thermostats, appliances, actuators, controllers, or any other smart home (or building) devices. In the example of FIG. 1, loT device 30C is a smart speaker and/or controller, which may include a display. loT devices 30 may provide audible and/or visual alarms when configured with output devices to do so. As other examples, loT devices 30 may cause smart lights throughout environment 28 to flash or blink and unlock doors. In some examples, loT devices 30 that include cameras or other sensors may activate those sensors to collect data regarding patient 4, e.g., for evaluation of the condition of patient 4.

[0030] Computing device 12 may be configured to wirelessly communicate with loT devices 30 to cause loT devices 30 to take the actions described herein. In some examples, HMS 22 communicates with loT devices 30 via network 16 to cause loT devices 30 to take the actions described herein, e.g., in response to receiving the alert message from computing device 12 as described above. In some examples, sensing device 10 is configured to communicate wirelessly with one or more of loT devices 30, e.g., in response to detection of a health event when communication with computing device 12 is unavailable. In such examples, loT device(s) 30 may be configured to provide some or all of the functionality ascribed to computing device 12 herein.

[0031] Environment 28 includes computing facilities, e.g., a local network 32, by which computing device 12, loT devices 30, and other devices within environment 28 may communicate via network 16, e.g., with HMS 22. For example, environment 28 may be configured with wireless technology, such as IEEE 802.11 wireless networks, IEEE 802.15 ZigBee networks, an ultra- wideband protocol, near-field communication, or the like. Environment 28 may include one or more wireless access points, e.g., wireless access point 34A that provide support for wireless communications throughout environment 28. Additionally or alternatively, e.g., when local network is unavailable, computing device 12, loT devices 30, and other devices within environment 28 may be configured to communicate with network 16, e.g., with HMS 22, via a cellular base station 36 and a cellular network.

[0032] In some examples, computing device 12 and/or HMS 22 may implement one or more algorithms to evaluate the sensed physiological data received from sensing device 10, and in some cases additional physiological or other patient parameter data sensed or otherwise collected by the computing device(s) or loT devices 30, to confirm or override the detection of the health event by sensing device 10. In some examples, rather than sensing device 10, one or more of computing device 12 and/or HMS 22 may implement algorithms to detect health events based on parameter data received from sensing device 10, IMD 14, computing device 12, and/or other devices in the first instance. In some examples, computing device 12 and/or computing system 20 may have greater processing capacity than sensing device 10, enabling more complex analysis of the data. In some examples, the computing device 12 and/or HMS 22 may apply the data to a machine learning model or other artificial intelligence developed algorithm, e.g., to determine whether the data is sufficiently indicative of the health event. [0033] Any of sensing device 10, computing device(s) 12, IMD 14, loT device(s) 30, computing device(s) 38, or HMS 22 may, individually or in any combination, perform the operations described herein for detection of health events by applying rules, which may include one or more machine learning models, to patient parameter data to detect health events.

[0034] FIG. 2 is a block diagram illustrating an example configuration of sensing device 10 of FIG. 1. As shown in FIG. 2, sensing device 10 includes housing 14, processing circuitry 50 sensing circuitry 52, communication circuitry 54, memory 56, one or more of sensor(s) 58A, 58B and/or 58C, and a power source 59. Sensors 58A may be positioned inside housing 14. Sensors 58B may positioned on the housing 14. Sensors 58B may positioned external to the housing 14. Each of sensors 58A, 58B, and 58C may be communicatively coupled to sensing circuitry 52. Sensors 58A, sensors 58B, and sensor 58C may collectively be referred to as “sensors 58.” In some examples, memory 56 includes computer-readable instructions that, when executed by processing circuitry 50, cause sensing device 10 and processing circuitry 50 to perform various functions attributed herein to sensing device 10 and processing circuitry 50. Memory 56 may include any volatile, non-volatile, magnetic, optical, or electrical media, such as a randomaccess memory (RAM), read-only memory (ROM), non-volatile RAM (NVRAM), electrically-erasable programmable ROM (EEPROM), flash memory, or any other digital media.

[0035] Processing circuitry 50 may include fixed function circuitry and/or programmable processing circuitry. Processing circuitry 50 may include any one or more of a microprocessor, a controller, a digital signal processor (DSP), a graphical processing unit or tensor processing unit specialized for Al algorithm processing, an application specific integrated circuit (ASIC), a field-programmable gate array (FPGA), or equivalent discrete or analog logic circuitry. In some examples, processing circuitry 50 may include multiple components, such as any combination of one or more microprocessors, one or more controllers, one or more DSPs, one or more ASICs, or one or more FPGAs, as well as other discrete or integrated logic circuitry. The functions attributed to processing circuitry 50 herein may be embodied as software, firmware, hardware or any combination thereof. [0036] Sensing circuitry 52 may monitor signals from one or more sensors 58 in order to monitor electrical activity of a heart of a patient and produce ECG data for patient. Sensing device 10 may include one or more sensors 58 such as one or more electrodes, accelerometers, microphones, optical sensors, temperature sensors, biochemical sensors, and/or pressure sensors. Sensing circuitry 52 may include one or more filters and amplifiers for filtering and amplifying signals received from one or more sensors 58. In some examples, sensing circuitry 52 and/or processing circuitry 50 may include a rectifier, filter and/or amplifier, a sense amplifier, comparator, and/or analog-to-digital converter. [0037] Sensing circuitry 52 and/or processing circuitry 50 may be configured to determine sensor data that may include values or metrics of one or more physiological parameters of patient based on signals sensed by a sensing device, such as by sensors 58. Some examples of physiological parameters include one or more of heart rate, respiratory rate, respiratory effort, fluid status, sympathetic tone, heart rate variability (HRV), blood pressure, fluid redistribution, tissue perfusion, pulse oxygenation, sleep disordered breathing, heart sounds, ECG QRST morphology (R-wave amplitude, slope, width), EEG, biochemical sensor information, temperature, activity, and/or posture. In some examples, processing circuitry 50 (or processing circuitry of another device configured to communicate with sensing device 10, e.g., computing device 12 or computing system 20 of FIG. 1) may be configured to determine whether a patient is experiencing or just experienced a health event, such as an adverse health event, or determine a health event risk score, such as an adverse health event risk score, of a likelihood the patient to experience a health event within a predetermined amount of time based on the sensor data. In some examples, the health event and/or adverse health event may be an acute health event. For example, processing circuitry 50 may be configured to determine whether a patient is experiencing or just experienced an acute health event or determine an acute health event risk score of a likelihood the patient to experience an acute health event within a predetermined amount of time. Some examples of an acute health event include sudden cardiac arrest (SCA), stroke, heart attack, myocardiac infarction, hypoglycemia, or a fall. Other example health events include those associated with chronic conditions such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), such as HF hospitalization or decompensation. [0038] Processing circuitry 50 may determine whether collected sensor data satisfies one or more acute health event criteria. In some examples, satisfaction of one or more acute health event criteria may indicate an acute health event is occurring or occurred in patient or an acute health event risk score of patient is greater than or equal to an emergency threshold. In some examples, sensing device 10 may determine the acute health event and/or an acute health event risk score in accordance with U.S. Application No. 12/184,149 and 12/184,003 by Sarkar et al., entitled “USING MULTIPLE DIAGNOSTIC PARAMETERS FOR PREDICTING HEART FAILURE EVENTS,” and “DETECTING WORSENING HEART FAILURE BASED ON IMPEDANCE MEASUREMENTS,” both filed on July 31, 2008, U.S. Application No. 16/940,817 by Burnes et al., entitled “DETERMINING A FALL RISK RESPONSIVE TO DETECTING BODY POSITION MOVEMENTS,” filed July 28, 2020, and/or U.S. Application No. 17/246,331 by Cho et. al., entitled “ACUTE HEALTH EVENT MONITORING,” filed April 30, 2021, all of which are incorporated herein by reference in their entirety.

[0039] In some examples, to determine whether collected sensor data satisfies one or more health event criteria, processing circuitry may apply a set of rules to the sensor data to determine a risk score, determine whether the risk score satisfies a health event threshold, and in response to determining the risk score satisfies a health event threshold, determine the sensor data satisfies one or more health event criteria.

[0040] Processing circuitry 50 may compare the determined health event risk score to an emergency threshold. In some examples, the determined health event risk score being greater than or equal to the emergency threshold indicates a patient is highly likely to experience a health event in a short period of time, such as within the next 24 hours, within the next 12 hours, within the next 6 hours, or within the next 1 hour, and will need to seek immediate medical attention. In some examples, the short period of time may be longer than 24 hours, shorter than 1 hour, or anywhere between 1 hour and 24 hours. [0041] A patient having collected sensor data satisfying one or more health event criteria, such as a patient that is experiencing or experiences a health event or is about to experience a health event, may need immediate medical attention to reduce potential harm that may be caused by the health event and/or to save the life of a patient experiencing, just experienced, or about to experience the health event. In some examples, processing circuitry 50 determining detected sensor data does not satisfy one or more health event criteria, such as a health event did not occur or that a health event risk score is less than an emergency threshold, may be referred to as “normal operation” of sensing device 10. Processing circuitry 50 determining collected sensor data satisfies one or more health event criteria, such as a health event did occur or is occurring or that a health event risk score is greater than or equal to an emergency threshold, may be referred to as “emergency operation” of sensing device 10.

[0042] Communication circuitry 54 may include any suitable hardware, firmware, software or any combination thereof for communicating with another device. Communication circuitry 54 may be configured to communicate using any of a variety of wireless communication schemes, such as near-field communication technologies (e.g., inductive coupling, Near-Field Communication (NFC) or other communication technologies operable at ranges less than 10-20 centimeters (cm)), short-range wireless (e.g., Bluetooth® communication protocol or Bluetooth® Low Energy (BLE) communication protocol, and/or far-field communication technologies (e.g., cellular (e.g., 3G, 4G, 5G), Wi-Fi (e.g., 802.11 communication protocol or 802.15 ZigBee communication protocol), satellite communication (e.g., Starlink), or other communication technologies operable at ranges greater than short-range wireless communication technologies). In some examples, near-field communication technologies may communicate within a wireless range of the communication protocol ISO/IEC 14443. In some examples the near-field communication technologies may have a range of 4 centimeters or less.

[0043] In some examples, under the control of processing circuitry 50, communication circuitry 54 may receive downlink telemetry from, as well as send uplink telemetry to one or more other devices, such as computing device 12, IMD 14, computing system 20, HMS 22, computing devices 38, and/or loT 30 with the aid of an internal or external antenna, e.g., antenna(s) 26.

[0044] Sensing device 10 may include one or more antennas 26. For example, as illustrated in FIG. 2, sensing device 10 may include two antennas 26A, 26B. In some examples, having two or more antennas may improve the wireless connectivity of sensing device 10. In some examples, sensing device 10 may have one antenna to provide the communication capabilities of antennas 26A, 26B. In some examples, sensing device 10 may have more than two antennas. In some examples, one or more of the antennas 26 may be internal. In some examples, one or more of the antennas 26 may be external. In some examples, sensing device 10 may include one or more internal antennas 26 and one or more external antennas 26. In some examples, sensing device 10 may include only one or more internal antennas. In some examples, sensing device 10 may include only one or more external antennas.

[0045] FIGS. 3A-3B illustrate an example of sensing device 10A in conjunction with a wristband 70. When worn around a wrist of a user, a back-side of wristband 70 would be the side of the wristband facing the skin/wrist/arm of the user. When worn around a wrist of a user, a front-side of wristband 70 would be the side of the wristband facing outwards from the user. For instance, in an example in which wristband 70 is a watch, a watch-face of the watch that indicates time would likely be on a front-side of watch.

[0046] FIG. 3A illustrates a sensing device 10A attached to a back-side of a wristband 70. In some examples, wristband 70 may be a wristwatch. In some examples, sensing device 10A may include a center module 12 that includes processing circuitry 50 and communication circuitry 54, as shown in FIG. 2. In some examples, center module 12 may further include one or more of memory 56, power source 59, sensing circuitry 52, sensors 58, and/or antennas 26. In some examples, sensors 58 may comprise one or more of accelerometers, gyroscopes, microphones, optical sensors, temperature sensors, pressure sensors, and/or chemical sensors. In some examples, sensing device 10A may include housing 14. In some examples, center module 12 may be placed within housing 14. In some examples, one or more sensors 58 may be formed or placed on an outer surface of housing 14. In some examples, sensors 58 may include sensors 71A, 71B. In some examples, sensors 71 A, 7 IB may be examples of or in addition to sensors 58. In some examples, sensors 71 A, 7 IB may comprise one or more of accelerometers, gyroscopes, microphones, optical sensors, temperature sensors, pressure sensors, and/or chemical sensors.

[0047] In some examples, as shown in FIGS. 3A-3B, sensing device 10A may include a sensor 71A configured to sense physiological parameters, such as one or more of ECG signals, pulse, tissue oxygenation, activity, fall detection, impedance, temperature, chemical information, and/or biochemical information, via a first arm of a patient that is wearing the wristband 70. In some examples, sensor 71A may be configured to contact the first arm directly to sense physiological parameters, such as ECG signals. Sensing device 10A may further include an extension 72 attached to housing 14 of sensing device 10A. Extension 72 may be configured to extend in a direction of a band portion 70A of wristband 70. In some examples, extension 72 may comprise a conductive and flexible material, such as copper, titanium, stainless steel, and/or plastic. Sensing device 10A may further include a second sensor 7 IB positioned on extension 72 to be positioned on a front-side of wristband 70. The second sensor 7 IB is configured to sense physiological parameters, such as one or more of ECG signals, pulse, tissue oxygenation, activity, fall detection, impedance, temperature, chemical information, and/or biochemical information, via a second arm of a patient that is wearing the wristband 70. In some examples, second sensor 7 IB being positioned on extension 72 to be positioned on a front-side of wristband 70 while patient wears wristband 70 may help patient to more effectively and efficiently to sense physiological parameters, such as one or more of ECG signals, pulse, tissue oxygenation, activity, fall detection, impedance, temperature, chemical information, and/or biochemical information, via the first and second arms of the patient by providing easier access of the patient’s second arm, e.g., finger on the second arm, to second sensor 7 IB to measure the second arm while sensor 71A is able concurrently measure the first arm of the patient.

[0048] For example, a patient may periodically touch sensor 7 IB with a finger, such as an index finger, so sensor 7 IB may measure physiological parameters, such as one or more of ECG signals, pulse, tissue oxygenation, activity, fall detection, impedance, temperature, and/or chemical information, and/or biochemical information, via the patient’s first and second arms.

[0049] In some examples, one or both of sensors 71 A, 7 IB may be electrodes configured to sense physiological parameters, such as one or more of ECG signals, cardiac signals, impedance that indicate fluid status and/or respiration status of patient, pulse, tissue oxygenation, activity, fall detection, temperature, chemical information, and/or biochemical information. Sensor 71A may be formed or placed on an outer surface of housing 14. Sensor 7 IB may be formed or placed on an outer surface of extension 72. In some examples, one or both of sensors 71 A, 7 IB may be substantially flat, and outward facing. In some examples, sensors 71A, 71B may be formed of a plurality of different types of conductive material, such as biocompatible conductive material, e.g. stainless steel, titanium, platinum, iridium, or alloys thereof, and may utilize one or more coatings such as titanium nitride or fractal titanium nitride.

[0050] In some examples, sensing device 10A may be configured to attach to the wristband 70 via one or more of magnet, adhesive, or clip (not shown). In some examples, the one or more of magnet, adhesive, or clip may be coupled to or included in housing 14 of sensing device 10A. In some examples, center module 12 of sensing device 10A may be configured to attach to a back-side of a watch-face area 73 of a wristband 70. In some examples, extension 72 of sensing device 10A may be configured to attach to a front-side and/or back-side of a band potion 70A of wristband 70. In some examples, a front-side of watch-face area 73 may include a watch-face that indicates a time.

[0051] FIG. 4 illustrates an example sensing device 10B attached to a back-side of wristband 70. In some examples, sensing device 10B may include a center module 12 (not shown in FIG. 4) that includes processing circuitry 50 and communication circuitry 54, as shown in FIG. 2. In some examples, center module 12 may further include one or more of memory 56, power source 59, sensing circuitry 52, sensors 58, and/or antennas 26. In some examples, sensing device 10B may include housing 14. In some examples, center module 12 may be placed within housing 14. In some examples, one or more sensors 58 may be formed or placed on an outer surface of housing 14. In some examples, sensors 58 may include sensors 81 A, 8 IB. In some examples, sensors 81 A, 8 IB may be examples of or in addition to sensors 58.

[0052] In some examples, as shown in FIG. 4, sensing device 10B may include a sensor 81A positioned on housing 14, an extension 72 attached to housing 14 of sensing device 10B and configured to extend in a direction of a band portion 70A of wristband 70, and a second sensor 8 IB positioned on extension 72. In some examples, second sensor 8 IB may be positioned on a back-side of wristband 70. In some examples, first sensor 81A and second sensor 8 IB may both be positioned on a back-side of wristband 70. In some examples, sensors 81A and 8 IB may be optical sensors configured to sense physiological parameters, such as one or more of heart rate, blood pressure or blood oxygenation levels. In some examples, first sensor 81A is an optical sensor positioned on the housing 14 of the sensing device 10B to detect physiological parameters, such as one or more of heart rate, blood pressure or blood oxygenation, of a main radial artery of the patient, and second sensor 8 IB is an optical sensor positioned on an extension 72 attachable to a back-side of a band portion 70A of wristband 70 to detect physiological parameters, such as one or more of heart rate, blood pressure or blood oxygenation, of a source of the patient more than a distance threshold away from the position the first sensor 81A detects physiological parameters. In some examples, the distance threshold may be a distance away from the first sensor 81A to obtain improved accurate and reliable detection of physiological parameters of the patient, such as one or more of heart rate, blood pressure or blood oxygenation levels detected by optical sensors. In some examples, a distance threshold may be between 1 centimeter (cm) to 10 cm.

[0053] In some examples, sensing device 10B detecting physiological parameters, such as one or more of heart rate, blood pressure or blood oxygenation levels, from a first location of a patient and detecting physiological parameters, such as one or more of heart rate, blood pressure or blood oxygenation levels, from a second location of the patient away from the first location by a distance, such as a distance greater than a distance threshold, may help processing circuitry 50 reject noise in the detected signals obtained via optical sensors 81 A, 8 IB, which may improve accuracy and reliability of determined health events of a patient based on detected physiological parameters of the patient, such as one or more of heart rate, blood pressure or blood oxygenation levels detected by optical sensors.

[0054] In some examples, sensing device 10B may be configured to attach to the wristband 70 via one or more of magnet, adhesive, or clip (not shown). In some examples, the one or more of magnet, adhesive, or clip may be coupled to or included in housing 14 of sensing device 10B. In some examples, center module 12 of sensing device 10B may be configured to attach to a back-side of a watch-face area 73 of a wristband 70. In some examples, extension 72 of sensing device 10B may be configured to attach to a back-side of a band potion 70A of wristband 70. In some examples, a front-side of watch-face area 73 may include a watch-face that indicates a time.

[0055] FIG. 5 illustrates an example sensing device 10C attached to a back-side of wristband 70. In some examples, sensing device 10C may include a center module 12 (not shown in FIG. 5) that includes processing circuitry 50 and communication circuitry 54, as shown in FIG. 2. In some examples, center module 12 may further include one or more of memory 56, power source 59, sensing circuitry 52, sensors 58, and/or antennas 26. In some examples, sensing device 10C may include housing 14. In some examples, center module 12 may be placed within housing 14. In some examples, one or more sensors 58 may be formed or placed on an outer surface of housing 14. In some examples, sensors 58 may include sensors 91 A, 9 IB. In some examples, sensors 71A, 71B may be in addition to sensors 58.

[0056] In some examples, as shown in FIG. 5, sensing device 10C may include a sensors 91 A and 9 IB positioned on housing 14, a first extension 72A attached to housing 14 of sensing device 10C and configured to extend in a direction of a band portion 70A of wristband 70, and a second extension 72B attached to housing 14 of sensing device 10C and configured to extend in a direction of a band portion 70A of wristband 70 in a different direction than first extension 72A. While FIG. 4 shows two extensions 72A, 72B (collectively, extensions 72) of sensing device 10C attached to the housing 14, in some examples, sensing device 10C may include one extension 72 attached to the housing 14. In some examples, sensing device 10C may include three or more extensions 72 attached to the housing 14. In some examples, one or more of first extension 72A and second extension 72B may be an antenna electrically coupled to communication circuitry 54 and configured to transmit signals from sensing device to one or more other devices. In some examples, one or more of first extension 72A and/or 72B may have a length greater than a communication length threshold to generate a dipole so the sensing device 10C may be able to communicate via far-field communication technologies (e.g., cellular (e.g., 3G, 4G, 5G), Wi-Fi (e.g., 802.11 communication protocol or 802.15 ZigBee communication protocol), satellite communication (e.g., Starlink), or other communication technologies operable at ranges greater than short-range wireless (e.g., Bluetooth® communication protocol or Bluetooth® Low Energy (BLE) communication protocol)). In some examples, one or more of first extension 72A and/or 72B may have a length between 1 cm to 10 cm. For example, a communication length threshold may be between 1 cm to 10 cm. In some examples, extensions 72 may comprise a conductive and flexible material, such as copper, titanium, stainless steel, and/or plastic.

[0057] In some examples, as shown in FIG. 5, first extension 72 A may extend from housing 14 in a direction that is a substantially opposite to the direction the second extension 72B extends from housing 14. In some examples, first extension 72A may extend from housing 14 in a direction that is different than the direction the second extension 72B extends from housing 14. For example, second extension 72B may extend in a direction that is 45, 90, 135, 225, 270, 315 degrees rotation along a face of the housing 14 from the direction first extension extends 72A. In some examples, second extension 72B may extend in a direction that is between 1-179 degrees or between 181-359 degrees rotation along a face of the housing from the direction first extension extends 72A.In some examples, extensions 72 may be coil-shaped, zig-zag shaped, rectangular-shaped, or straight. In some examples, first extension 72A may be similarly shaped as second extension 72B. In some examples, first extension 72A may be differently shaped than second extension 72B.

[0058] In some examples, sensing device 10C may be configured to attach to the wristband 70 via one or more of magnet, adhesive, or clip (not shown). In some examples, the one or more of magnet, adhesive, or clip may be coupled to or included in housing 14 of sensing device 10C. In some examples, center module 12 of sensing device 10C may be configured to attach to a back-side of a watch-face area 73 of a wristband 70. In some examples, extension 72A of sensing device 10C may be configured to attach to a back-side of a band potion 70A of wristband 70. In some examples, extension 72B of sensing device 10C may be configured to attach to a back-side of a band potion 70B of wristband 70. In some examples, a front-side of watch-face area 73 may include a watch-face that indicates a time.

[0059] FIG. 6 is a flow diagram illustrating an example method of sensing a first ECG signal and a second ECG signal and determining a health event of the patient based on the sensed first and second ECG signals an example sensing device 10. While the example method illustrated in FIG. 5 is primarily described as sensing ECG signals from a patient, sensing device 10 may apply the example method described herein to sense other physiological parameters from the patient.

[0060] A first sensor 71 A, 81A and a second sensor 7 IB, 8 IB of sensing device 10 may sense one or more signals from a patient (502). Sensor 71 A, 8 IB may be positioned on a housing 14 of the sensing device 10 and the housing 14 is configured to attach to a wristband 70. Sensor 7 IB, 8 IB may be positioned on an extension 72 extending from the housing 14. In some examples, extension 72 may extend in a direction of a band portion 70A of wristband 70. In some examples, first sensor 71A and second sensor 7 IB may sense an ECG signal via a first arm and second arm of the patient while the wristband 70 is positioned on the first arm of the patient. In some examples, first sensor 81A may sense a first signal, such as an optical signal, and second sensor 8 IB may sense a second signal, such as an optical signal, of the patient while the wristband 70 is positioned on the first arm of the patient. In some examples, first sensor 81A may sense the first signal concurrently with second sensor 8 IB sensing the second signal. In some examples, one or both of first sensor 71 A, 81A and second sensor 7 IB, 8 IB may be electrodes.

[0061] Processing circuitry 50 positioned in the housing 14 of sensing device 10 may determine a health event, such as an adverse health event, of the patient based on the one or more sensed signals (506). Communication circuitry 54 may output an indication of the determined health event, such as the determined adverse health event, of the patient to one or more other devices.

[0062] In some examples, sensing an ECG signal, via both arms may help sensing device 10 determine health events of a patient more accurately. In some examples, sensing two signals, such as optical signals, via two sensors separated by a threshold distance may help sensing device 10 reduce noise of sensed signals and/or determine health events of a patient more accurately.

[0063] The techniques of this disclosure may be implemented in a wide variety of computing devices, medical devices, or any combination thereof. Any of the described units, modules, or components may be implemented together or separately as discrete but interoperable logic devices. Depiction of different features as modules or units is intended to highlight different functional aspects and does not necessarily imply that such modules of units must be realized by separate hardware or software components. Rather, functionality associated with one or more modules or units may be performed by separate hardware or software components, or integrated within common or separate hardware or software components.

[0064] The disclosure contemplates computer-readable storage media comprising instructions to cause a processor to perform any of the functions and techniques describes herein. The computer-readable storage media may take the example form of any volatile, non-volatile, magnetic, optical, or electrical media, such as a RAM, ROM, NVRAM, EEPROM, or flash memory that is tangible. The computer-readable storage media may be referred to as non-transitory. A server, client computing device, or any other computing device may also contain a more portable removable memory type to enable easy data transfer or offline data analysis. [0065] The techniques described in this disclosure, including those attributed to various modules and various constituent components, may be implemented, at least in part, in hardware, software, firmware or any combination thereof. For example, various aspects of the techniques may be implemented within one or more processors, including one or more microprocessors, DSPs, ASICs, FPGAs, or any other equivalent integrated, discrete logic circuitry, or other processing circuitry, as well as any combinations of such components, remote servers, remote client devices, or other devices. The term “processor” or “processing circuitry” may generally refer to any of the foregoing logic circuitry, alone or in combination with other logic circuitry, or any other equivalent circuitry.

[0066] Such hardware, software, firmware may be implemented within the same device or within separate devices to support the various operations and functions described in this disclosure. In addition, any of the described units, modules or components may be implemented together or separately as discrete but interoperable logic devices. Depiction of different features as modules or units is intended to highlight different functional aspects and does not necessarily imply that such modules or units must be realized by separate hardware or software components. Rather, functionality associated with one or more modules or units may be performed by separate hardware or software components, or integrated within common or separate hardware or software components. For example, any module described herein may include electrical circuitry configured to perform the features attributed to that particular module, such as fixed function processing circuitry, programmable processing circuitry, or combinations thereof.

[0067] The techniques described in this disclosure may also be embodied or encoded in an article of manufacture including a computer-readable storage medium encoded with instructions. Instructions embedded or encoded in an article of manufacture including a computer-readable storage medium encoded, may cause one or more programmable processors, or other processors, to implement one or more of the techniques described herein, such as when instructions included or encoded in the computer-readable storage medium are executed by the one or more processors. Example computer-readable storage media may include random access memory (RAM), read only memory (ROM), programmable read only memory (PROM), erasable programmable read only memory (EPROM), electronically erasable programmable read only memory (EEPROM), flash memory, a hard disk, a compact disc ROM (CD-ROM), a floppy disk, a cassette, magnetic media, optical media, or any other computer readable storage devices or tangible computer readable media. The computer-readable storage medium may also be referred to as storage devices.

[0068] In some examples, a computer-readable storage medium comprises non- transitory medium. The term “non-transitory” may indicate that the storage medium is not embodied in a carrier wave or a propagated signal. In certain examples, a non-transitory storage medium may store data that can, over time, change (e.g., in RAM or cache). [0069] Various examples are described herein, such as the following examples.

[0070] Example 1 : A sensing device includes a center module including processing circuitry and communication circuitry; housing configured to house the center module and configured to attach to a wristband; one or more extensions extending from the center module; a first sensor located on the housing; and a second sensor located outside of the housing communicatively coupled to the center module, wherein the first and second sensors are configured to detect one or more physiological parameters of a patient, and wherein the processing circuitry is configured to perform at least one of: determine a health event of the patient based on the detected physiological parameters; or transmit, via the communication circuitry, sensor data of the first and second sensors to an external computing device based on the detected physiological parameters to determine a health event of the patient.

[0071] Example 2 : The sensing device of example 1, wherein the housing is configured to attach to the wristband via one or more of magnet, adhesive, or clip, the one or more of magnet, adhesive, or clip being coupled to or included in the housing.

[0072] Example 3: The sensing device of any of examples 1-2, wherein the communication circuitry is configured to output an indication of the determined health event to a computing device.

[0073] Example 4: The sensing device of example 3, wherein the computing device is a smart phone.

[0074] Example 5 : The sensing device of any of examples 1-4, wherein the second sensor is located on the one or more extensions.

[0075] Example 6: The sensing device of any of examples 1-5, wherein the first sensor and the second sensor are electrodes. [0076] Example 7: The sensing device of any of examples 5-6, wherein the extension is configured to attach to a band portion of the wristband so the second sensor is positioned on a front-side of a band portion of the wristband, and the first sensor and the second sensor are configured to detect an electrocardiogram (ECG) signal via a first arm and a second arm of the patient while the wristband is positioned on the first arm of the patient.

[0077] Example 8: The sensing device of example 5, wherein the extension is configured to attach to a band portion of the wristband so the second sensor is positioned on a back-side of a band portion of the wristband, the first sensor is a first optical sensor, and the second sensor is a second optical sensor.

[0078] Example 9: The sensing device of example 8, wherein the first optical sensor is configured to detect one or more of heart rate, blood pressure or blood oxygenation of a main radial artery of the patient at a first position on the patient, and the second optical sensor is configured to detect one or more of heart rate, blood pressure or blood oxygenation of a source more than a distance threshold away from the first position.

[0079] Example 10: The sensing device of any of examples 1-4, wherein the one or more extensions include a first antenna extension extending in a first direction from the housing and a second antenna extension extending in a second direction from the housing, the second direction being different than the first direction.

[0080] Example 11: The sensing device of example 10, wherein the first direction is in a substantially opposite direction with respect to the second direction.

[0081] Example 12: The sensing device of any of examples 10-11, wherein the second sensor is located on the housing.

[0082] Example 13: The sensing device of any of examples 10-12, wherein each of the first antenna extension and the second antenna extension includes a dipole greater than a long-range communication threshold.

[0083] Example 14: The sensing device of any of examples 10-13, wherein the communication circuitry is configured to communicate with a computing device via a far- field communication protocol via the first antenna extension and the second antenna extension.

[0084] Example 15: The sensing device of any of examples 1-14, wherein the wristband is a wristwatch. [0085] Example 16: An apparatus includes a wristwatch; and the sensing device as recited in any of claims 1-14, the sensing device being attachable to the wristwatch.

[0086] Example 17: A method for operating processing circuitry of a medical system includes detecting, by a first sensor located on a housing of a sensing device and a second sensor of the sensing device located on an extension extending from the housing and electrically coupled to the processing circuitry, one or more signals of a patient; determining, by the processing circuitry, an adverse health event of the patient based on the detected one or more signals; and outputting, by communication circuitry located in the housing, to a computing device an indication of the determined adverse health event of the patient.

[0087] Example 18: The method of example 17, wherein the one or more signals include an ECG signal of the patient, and the method further comprises: detecting the ECG signal via the first sensor and the second sensor, the first sensor being positioned on a first arm of the patient and the second sensor being positioned to be contactable to a second arm of the patient while the sensing device is attached to a wristband positioned on the first arm of the patient.

[0088] Example 19: The method of example 17, wherein the method further comprises: detecting, via the first sensor, one or more of heart rate, blood pressure or blood oxygenation of a main radial artery of the patient at a first position on the patient; and detecting, via the second sensor, one or more of heart rate, blood pressure or blood oxygenation of a source more than a distance threshold away from the first position, wherein the first sensor is an optical sensor, and the second sensor is an optical sensor. [0089] Example 20: The method of any of examples 17-18, wherein the first sensor and the second sensor are electrodes.

[0090] Various examples of the disclosure have been described. Any combination of the described systems, operations, or functions is contemplated. These and other examples are within the scope of the following claims.

Claims

WHAT IS CLAIMED IS:

1. A sensing device comprising: a center module including processing circuitry and communication circuitry; housing configured to house the center module and configured to attach to a wristband; one or more extensions extending from the center module; a first sensor located on the housing; and a second sensor located outside of the housing communicatively coupled to the center module, wherein the first and second sensors are configured to detect one or more physiological parameters of a patient, and wherein the processing circuitry is configured to perform at least one of: determine a health event of the patient based on the detected physiological parameters; or transmit, via the communication circuitry, sensor data of the first and second sensors to an external computing device based on the detected physiological parameters to determine a health event of the patient.

2. The sensing device of claim 1, wherein the housing is configured to attach to the wristband via one or more of magnet, adhesive, or clip, the one or more of magnet, adhesive, or clip being coupled to or included in the housing.

3. The sensing device of any of claims 1-2, wherein the communication circuitry is configured to output an indication of the determined health event to a computing device.

4. The sensing device of claim 3, wherein the computing device is a smart phone.

5. The sensing device of any of claims 1-4, wherein the second sensor is located on an extensions of the one or more extensions.

6. The sensing device of any of claims 1-5, wherein the first sensor and the second sensor are electrodes.

7. The sensing device of any of claims 5-6, wherein the extension of the one or more extensions is configured to attach to a band portion of the wristband so the second sensor is positioned on a front-side of a band portion of the wristband, and the first sensor and the second sensor are configured to detect an electrocardiogram (ECG) signal via a first arm and a second arm of the patient while the wristband is positioned on the first arm of the patient.

8. The sensing device of claim 5, wherein the extension of the one or more extensions is configured to attach to a band portion of the wristband so the second sensor is positioned on a back-side of a band portion of the wristband, the first sensor is a first optical sensor, and the second sensor is a second optical sensor.

9. The sensing device of claim 8, wherein the first optical sensor is configured to detect one or more of heart rate, blood pressure or blood oxygenation of a main radial artery of the patient at a first position on the patient, and the second optical sensor is configured to detect one or more of heart rate, blood pressure or blood oxygenation of a source more than a distance threshold away from the first position.

10. The sensing device of any of claims 1—4, wherein the one or more extensions include a first antenna extension extending in a first direction from the housing and a second antenna extension extending in a second direction from the housing, the second direction being different than the first direction.

11. The sensing device of claim 10, wherein the first direction is in a substantially opposite direction with respect to the second direction.

12. The sensing device of any of claims 10-11, wherein the second sensor is located on the housing.

13. The sensing device of any of claims 10-12, wherein each of the first antenna extension and the second antenna extension includes a dipole greater than a long-range communication threshold.

14. The sensing device of any of claims 10-13, wherein the communication circuitry is configured to communicate with a computing device via a far-field communication protocol via the first antenna extension and the second antenna extension.

15. An apparatus comprising: a wristwatch; and the sensing device as recited in any of claims 1-14, the sensing device being attachable to the wristwatch.