FR2760962A1 - Remote medical aid and monitoring system - Google Patents
Remote medical aid and monitoring system Download PDFInfo
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- FR2760962A1 FR2760962A1 FR9704014A FR9704014A FR2760962A1 FR 2760962 A1 FR2760962 A1 FR 2760962A1 FR 9704014 A FR9704014 A FR 9704014A FR 9704014 A FR9704014 A FR 9704014A FR 2760962 A1 FR2760962 A1 FR 2760962A1
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- devices
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- patients
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H20/13—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered from dispensers
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- 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
Abstract
Description
SYSTEME D'ASSISTANCE ET DE SURVEILLANCE MEDICALE A
DISTANCE.MEDICAL ASSISTANCE AND SURVEILLANCE SYSTEM A
DISTANCE.
L'invention concerne un système de surveillance et d'assistance médicale à distance, utilisant des appareils de mesure et d'enregistrement automatiques de données physiologiques sur des patients, installés aux domiciles des patients ou dans des chambres de clinique, d'hôpital, de, maison de convalescence, etc., de façon à ce que des mesures de données physiologiques puissent être effectuées automatiquement sur les patients à des moments prédéterminés, sans nécessiter la présence d'un médecin ou d'un personnel spécialisé. The invention relates to a remote medical monitoring and assistance system, using automatic measurement and recording devices of physiological data on patients, installed in the homes of patients or in rooms of clinics, hospitals, , convalescent home, etc., so that physiological data measurements can be performed automatically on patients at predetermined times, without requiring the presence of a doctor or specialized personnel.
On a déjà proposé, dans le brevet français 2 717 332, un système de ce type qui permet de fournir à des medécins des informations immédiatement interprétables et utilisables sur l'évolution des données mesurées sur leurs patients et sur les effets des thérapies prescrites, et qui comprend des appareils de mesure et d'enregistrement automatiques de paramètres physiologiques sur des patients, et des moyens de connexion automatique à un serveur par l'intermédiaire d'un réseau de transmission de données, ce serveur comportant des moyens d'identification des appareils connectés, d'acquisition des données enregistrées dans ces appareils, de traitement de ces données et de transmission des données traitées à des terminaux informatiques installés chez les médecins prescripteurs, ce qui permet de centraliser et de traiter automatiquement les données transmises par les appareils installés chez les patients pour les mettre à disposition des médecins prescripteurs sous une forme directement utilisable. French patent 2,717,332 has already proposed a system of this type which makes it possible to provide doctors with immediately interpretable and usable information on the evolution of the data measured on their patients and on the effects of the prescribed therapies, and which includes devices for automatic measurement and recording of physiological parameters on patients, and means for automatic connection to a server via a data transmission network, this server comprising means for identifying the devices connected, acquiring the data stored in these devices, processing this data and transmitting the processed data to computer terminals installed at prescribing physicians, which makes it possible to centralize and automatically process the data transmitted by the devices installed at patients to make them available to prescribing physicians so us a directly usable form.
La présente invention a pour objet des perfectionnements importants à ce système, permettant notamment aux médecins prescripteurs de modifier les conditions d'exécution des mesures effectuées sur leurs patients et d'intervenir sur les prises de médicaments par ces patients. The subject of the present invention is significant improvements to this system, allowing in particular prescribing physicians to modify the conditions for carrying out the measurements carried out on their patients and to intervene on the medication taken by these patients.
Elle propose, à cet effet, un système d'assistance et de surveillance médicale à distance du type précité, comprenant des appareils de mesure et d'enregistrement automatiques de paramètres physiologiques sur des patients, des moyens de connexion à un serveur informatique par l'intermédiaire d'un réseau de transmission de données, ce serveur comprenant des moyens d'identification des appareils, des moyens d'acquisition, de traitement et de transmission de données enregistrées par lesdits appareils, le système comprenant de plus des terminaux informatiques réservés à des médecins et reliés au réseau de transmission de données pour recevoir les données traitées et transmises par le serveur, caractérisé en ce que les appareils précités comprennent des mémoires programmables à partir des terminaux informatiques réservés aux médecins ou à partir d'autres terminaux connectables auxdits appareils, ces mémoires étant associées à des microprocesseurs de commande du fonctionnement desdits appareils et permettant à des médecins de déterminer ou de modifier à volonté, sur place ou à distance, les conditions de mesure et d'enregistrement des paramètres précités sur les patients. To this end, it proposes a system of remote medical assistance and monitoring of the aforementioned type, comprising automatic measurement and recording devices of physiological parameters on patients, means of connection to a computer server by the via a data transmission network, this server comprising means for identifying the devices, means for acquiring, processing and transmitting data recorded by said devices, the system further comprising computer terminals reserved for doctors and connected to the data transmission network to receive the data processed and transmitted by the server, characterized in that the aforementioned devices include memories programmable from the computer terminals reserved for doctors or from other terminals connectable to said devices, these memories being associated with microprocessors of comma nde of the functioning of said devices and allowing doctors to determine or modify at will, locally or remotely, the conditions for measuring and recording the above parameters on patients.
L'invention permet donc une transmission de données bi-directionnelle entre les appareils de mesure et les médecins, permettant aux médecins de modifier à distance les conditions dans lesquelles les mesures sont effectuées, en fonction par exemple des résultats de mesure qui leur ont été transmis. The invention therefore allows bi-directional data transmission between the measuring devices and the doctors, allowing doctors to remotely modify the conditions under which the measurements are carried out, depending for example on the measurement results which have been transmitted to them. .
Selon une autre caractéristique de l'invention, ces appareils comprennent des moyens de signalisation visuelle et/ou sonore pour indiquer à un patient qu'il doit prendre des médicaments. According to another characteristic of the invention, these devices include visual and / or audible signaling means to indicate to a patient that he must take medication.
Avantageusement, ces moyens de signalisation sont commandés ou programmés par les médecins par l'intermédiaire desdites mémoires programmables et des microprocesseurs associés. Advantageously, these signaling means are controlled or programmed by the doctors via said programmable memories and associated microprocessors.
Ainsi, les médecins peuvent non seulement intervenir sur les conditions d'exécution des mesures, mais également sur les prises de médicaments par les patients, ce qui leur permet de déterminer avec une certaine précision l'efficacité d'une thérapie prescrite et de modifier cette thérapie pour renforcer son efficacité. Thus, doctors can not only intervene on the conditions for carrying out the measurements, but also on the medication taken by the patients, which allows them to determine with a certain precision the effectiveness of a prescribed therapy and to modify this therapy to enhance its effectiveness.
Selon encore une autre caractéristique de l'invention, les appareils précités comprennent des moyens de vérification ou de contrôle des prises de médicaments par les patients, ces moyens étant par exemple associés à un distributeur de médicaments, du type pilulier ou analogue. According to yet another characteristic of the invention, the aforementioned devices include means for verifying or controlling the medication taken by the patients, these means being for example associated with a medication dispenser, of the pill type or the like.
Les médecins peuvent ainsi, non seulement modifier les conditions de prise des médicaments par les patients, mais constater si les prises de médicaments ont bien eu lieu et si elles ont lieu aux moments prévus. Doctors can not only change the conditions for taking medication by patients, but can also check whether the medication has been taken and if it takes place at the scheduled times.
Dans un mode de réalisation perfectionné de l'invention, les appareils précités comprennent également des moyens de vérification ou de détermination de l'identité de la personne prenant des médicaments. In an improved embodiment of the invention, the aforementioned devices also include means for verifying or determining the identity of the person taking medication.
Un tel perfectionnement se révèle utile lorsque plusieurs patients à surveiller se trouvent au même endroit. Such an improvement proves useful when several patients to be monitored are in the same place.
Bien entendu, l'invention prévoit également que les appareils précités comprennent des moyens de contrôle d'accès auxdites mémoires programmables, ces moyens de contrôle d'accès comprenant par exemple des moyens de vérification d'un code d'identification propre à chaque médecin. Of course, the invention also provides that the aforementioned devices include means for controlling access to said programmable memories, these access control means comprising for example means for verifying an identification code specific to each doctor.
Il faut en effet éviter que des personnes non compétentes ou non responsables puissent intervenir sur les conditions de mesure des paramètres physiologiques sur les patients et sur les prises de médicaments. Care must be taken to prevent people who are not competent or not responsible from intervening in the conditions for measuring physiological parameters in patients and in taking medication.
L'invention sera mieux comprise et d'autres caractéristiques, détails et avantages de celle-ci apparaîtront plus clairement à la lecture de la description qui suit, faite à titre d'exemples en référence au dessin annexé qui est une représentation schématique du système selon l'invention. The invention will be better understood and other characteristics, details and advantages thereof will appear more clearly on reading the description which follows, given by way of examples with reference to the appended drawing which is a schematic representation of the system according to the invention.
Ce système comprend, pour l'essentiel, des appareils 10 de mesure de données physiologiques sur des patients, installés en un lieu quelconque, par exemple au domicile des patients, les appareils 10 permettant, de façon connue, de mesurer et d'enregistrer automatiquement des données telles que la tension artérielle, le taux de glucose, un électrocardiogramme, etc. This system essentially comprises apparatuses 10 for measuring physiological data on patients, installed at any location, for example at the patient's home, the apparatuses 10 making it possible, in known manner, to measure and record automatically data such as blood pressure, glucose level, an electrocardiogram, etc.
Ces moyens 10 de mesure et d'enregistrement comprennent ou sont associés à des moyens 12 de connexion à un serveur informatique 14 par l'intermédiaire, par exemple, du réseau téléphonique 16 et d'un réseau 18 de transmission de données numériques. De façon générale, ces moyens de connexion 12 comprennent un modem et des circuits électroniques .intégrés assurant les fonctions suivantes
- lecture et enregistrement des données fournies par les capteurs équipant les appareils de mesure 10, et des dates et heures précises de mesure,
- transmission automatique au serveur 14 des données mesurées (cette transmission comportant une prise de ligne téléphonique, une composition automatique du numéro d'appel du serveur, la transmission des données et une fermeture de la ligne téléphonique en fin de transmission)
- un contrôle du transfert des données au serveur (par exemple vérification d'un contrôle de parité et vérification d'une réception correcte par le serveur),
- une identification d'accès au serveur,
- éventuellement, un cryptage et un décryptage des données,
- une procédure de rappel du serveur si les lignes sont occupées,
- une capacité d'envoi différé des mesures,
- un contrôle et une signalisation du fonctionnement général de l'appareil 10.These measurement and recording means 10 comprise or are associated with means 12 for connection to a computer server 14 via, for example, the telephone network 16 and a network 18 for transmitting digital data. In general, these connection means 12 include a modem and integrated electronic circuits ensuring the following functions
- reading and recording of the data provided by the sensors equipping the measuring devices 10, and of the precise dates and times of measurement,
- automatic transmission to the server 14 of the measured data (this transmission comprising a telephone line socket, an automatic dialing of the server call number, the data transmission and a closure of the telephone line at the end of transmission)
- a control of the data transfer to the server (for example verification of a parity check and verification of a correct reception by the server),
- server access identification,
- possibly, encryption and decryption of data,
- a procedure to call back the server if the lines are busy,
- a capacity for deferred sending of measurements,
- a control and a signaling of the general functioning of the apparatus 10.
Par exemple, chaque appareil 10 peut être conçu pour être connecté en permanence à une prise téléphonique au domicile du patient, celui-ci laissant son téléphone branché en parallèle dans la même prise. For example, each device 10 can be designed to be permanently connected to a telephone socket at the patient's home, the latter leaving his telephone plugged in parallel in the same socket.
En variante, les appareils 10 peuvent être équipés de moyens du type téléphonie sans fil ou analogue, leur permettant d'être à distance des moyens de connexion 12. As a variant, the devices 10 can be equipped with means of the wireless telephony or similar type, allowing them to be remote from the connection means 12.
Le serveur 14 qui reçoit les données mesurées sur un patient, comprend des moyens d'identification de l'appareil 10 qui vient de se connecter, des moyens de traitement des données qui lui sont transmises et des moyens d'enregistrement de ces données dans une mémoire ou une base de données. The server 14 which receives the data measured on a patient, comprises means for identifying the device 10 which has just connected, means for processing the data which are transmitted to it and means for recording this data in a memory or database.
Le serveur 14 est de plus destiné à transmettre les données qu'il vient de traiter aux médecins qui suivent les patients, et comprend donc des moyens lui permettant d'appeler automatiquement un terminal informatique 20 installé au cabinet d'un médecin traitant ou d'être appelé par ce terminal, de se connecter sur ce terminal et de lui transmettre un certain nombre de données comprenant le code d'identification d'un patient, le type du ou des capteurs de mesure utilisés par ce patient et les mesures qui viennent d'être reçues et traitées par le serveur 14. The server 14 is further intended for transmitting the data which it has just processed to the doctors who follow the patients, and therefore comprises means enabling it to automatically call a computer terminal 20 installed in the office of a treating doctor or to be called by this terminal, to connect to this terminal and to transmit to it a certain number of data including the identification code of a patient, the type of measurement sensor (s) used by this patient and the measurements that come from 'be received and processed by the server 14.
Les terminaux 20 installés chez les médecins peuvent être des micro-ordinateurs équipés de modem et de moyens de téléchargement de données, ou encore des dispositifs du type "Minitel" associés à des téléscripteurs ou des télécopieurs par exemple. The terminals 20 installed in doctors' offices can be microcomputers equipped with a modem and means for downloading data, or else devices of the "Minitel" type associated with teletypewriters or fax machines for example.
Selon l'invention, ces terminaux informatiques permettent également aux médecins d'intervenir sur les mesures effectuées par les appareils 10, et sur les prises de médicaments par les patients utilisant ces appareils. According to the invention, these computer terminals also allow doctors to intervene on the measurements made by the devices 10, and on the medication taken by the patients using these devices.
De préférence, les instructions envoyées par un médecin à partir de son terminal 20, sont transmises à un appareil 10 d'un patient par l'intermédiaire du serveur 14, qui enregistre ces instructions et les transmet à l'appareil 10 lors de la connexion suivante réalisée par les moyens 12 associés à l'appareil 10. Preferably, the instructions sent by a doctor from his terminal 20, are transmitted to a device 10 of a patient via the server 14, which records these instructions and transmits them to the device 10 during connection following performed by the means 12 associated with the device 10.
Ces moyens de connexion 12 comprennent une mémoire programmable 22 associée à un microprocesseur 24 permettant de commander le fonctionnement de l'appareil 10. These connection means 12 comprise a programmable memory 22 associated with a microprocessor 24 making it possible to control the operation of the device 10.
Avantageusement, les moyens de connexion 12 et/ou l'appareil 10 sont reliés à des moyens de signalisation 26, par exemple du type visuel et/ou sonore, permettant de faire savoir au patient qu'il doit effectuer certaines mesures ou qu'une mesure va être effectuée automatiquement par l'appareil 10. Advantageously, the connection means 12 and / or the apparatus 10 are connected to signaling means 26, for example of the visual and / or audible type, making it possible to let the patient know that he must perform certain measurements or that a measurement will be performed automatically by the device 10.
Les moyens 12 de connexion et/ou l'appareil 10 peuvent également être associés à d'autres moyens 28 de signalisation visuelle et/ou sonore, permettant d'informer le patient qu'il doit prendre un médicament donné à un moment donné. The connection means 12 and / or the apparatus 10 can also be associated with other means 28 for visual and / or sound signaling, making it possible to inform the patient that he must take a given medication at a given time.
Dans un développement particulièrement intéressant de l'invention, les appareils 10 et/ou les moyens de connexion 12 sont également équipés de moyens 30 permettant de contrôler ou de vérifier la prise d'un médicament par le patient, ces moyens 30 pouvant être par exemple d'un type connu, tel qu'un pilulier équipé d'un détecteur d'utilisation transmettant un signal chaque fois qu'il est manipulé par un patient pour la prise d'un médicament. In a particularly interesting development of the invention, the apparatuses 10 and / or the connection means 12 are also equipped with means 30 making it possible to control or verify the intake of a medicament by the patient, these means 30 being able for example of a known type, such as a pill box equipped with a usage detector transmitting a signal each time it is handled by a patient for taking a medication.
Ces moyens 30 peuvent être associés à des moyens 32 d'identification ou de reconnaissance de la personne prenant le médicament, ce moyen 32 pouvant être de tout type approprié (des moyens opto-électroniques, comprenant par exemple une ou plusieurs lignes de capteurs CCD ou analogues, ou des moyens d'identification vocale, ou encore des circuits électroniques comprenant par exemple un clavier permettant d'entrer un code d'identification du patient). These means 30 can be associated with means 32 for identifying or recognizing the person taking the medication, this means 32 can be of any suitable type (opto-electronic means, comprising for example one or more lines of CCD sensors or analogues, or means of voice identification, or even electronic circuits comprising for example a keyboard for entering a patient identification code).
Dans une variante, le serveur 14 et le terminal 20 d'un médecin peuvent être confondus, le serveur 14 n'étant alors acccessible qu'aux appareils 10 installés chez les patients de ce médecin. In a variant, the server 14 and the terminal 20 of a doctor can be combined, the server 14 then being only accessible to devices 10 installed in the patients of this doctor.
Les données fournies par les moyens 30 et 32 sont bien entendu transmises au serveur 14 avec les mesures de données effectuées sur le patient et les dates de ces mesures, et retransmises par le serveur 14 aux terminaux informatiques 20 installés chez les médecins ou réservés à leur usage, les médecins pouvant en retour accéder aux moyens 22,.24 de commande des appareils de mesure 10, des moyens de signalisation 26, 28 et des moyens de contrôle 30, 32, après avoir fait la preuve de leur identité, par exemple par envoi d'un code secret d'identification. The data provided by the means 30 and 32 are of course transmitted to the server 14 with the data measurements carried out on the patient and the dates of these measurements, and retransmitted by the server 14 to the computer terminals 20 installed at the doctors or reserved for their use, the doctors being able in return to access the means 22, .24 for controlling the measuring devices 10, the signaling means 26, 28 and the control means 30, 32, after having proved their identity, for example by sending a secret identification code.
Les modifications des conditions de mesure de données et des prises de médicaments qui sont décidées par les médecins peuvent également être entrées directement dans les moyens 22, 24 précités, par exemple par branchement sur les moyens de connexion 12 d'un terminal portable 34 utilisé par un médecin qui rend visite à son patient, ou par un assistant du médecin. The modifications to the conditions for measuring data and the medication taken which are decided by the doctors can also be entered directly into the aforementioned means 22, 24, for example by connection to the connection means 12 of a portable terminal 34 used by a doctor who visits his patient, or a doctor's assistant.
L'invention permet donc à des médecins de recevoir des mesures de données physiologiques ou physiques en même temps que des informations sur les prises de médicaments (heures et doses) pour un contrôle médical complet des patients, et de modifier à distance ou sur place les conditions de prise des mesures et de prise de médicaments. The invention therefore allows doctors to receive measurements of physiological or physical data at the same time as information on the medication taken (hours and doses) for a complete medical control of patients, and to modify remotely or on site. conditions for taking measurements and taking medication.
Les médecins peuvent ainsi acquérir une connaissance précise du comportement de leurs patients en réponse aux traitements prescrits et, en conséquence, modifier ces traitements pour augmenter leur efficacité. Doctors can thus acquire precise knowledge of the behavior of their patients in response to prescribed treatments and, consequently, modify these treatments to increase their effectiveness.
Les médecins peuvent également étudier l'influence des heures de prise des médicaments sur leur efficacité et faire de la chronothérapie. Doctors can also study the influence of medication hours on their effectiveness and do chronotherapy.
Claims (9)
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FR9704014A FR2760962B1 (en) | 1997-03-20 | 1997-03-20 | REMOTE MEDICAL ASSISTANCE AND SURVEILLANCE SYSTEM |
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FR9704014A FR2760962B1 (en) | 1997-03-20 | 1997-03-20 | REMOTE MEDICAL ASSISTANCE AND SURVEILLANCE SYSTEM |
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