GB2409951A - Wireless local area network of medical sensors - Google Patents

Wireless local area network of medical sensors Download PDF

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Publication number
GB2409951A
GB2409951A GB0400339A GB0400339A GB2409951A GB 2409951 A GB2409951 A GB 2409951A GB 0400339 A GB0400339 A GB 0400339A GB 0400339 A GB0400339 A GB 0400339A GB 2409951 A GB2409951 A GB 2409951A
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United Kingdom
Prior art keywords
user interface
data
apparatus according
medical
monitor
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Withdrawn
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GB0400339A
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GB0400339D0 (en
Inventor
Graham Murphy
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* REMOTE DIAGNOSTIC TECHNOLOGIES Ltd
REMOTE DIAGNOSTIC TECHNOLOGIES
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REMOTE DIAGNOSTIC TECHNOLOGIES
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Priority to GB0400339A priority Critical patent/GB2409951A/en
Publication of GB0400339D0 publication Critical patent/GB0400339D0/en
Publication of GB2409951A publication Critical patent/GB2409951A/en
Application status is Withdrawn legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0015Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by features of the telemetry system
    • A61B5/002Monitoring the patient using a local or closed circuit, e.g. in a room or building
    • GPHYSICS
    • G06COMPUTING; CALCULATING; COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F19/00Digital computing or data processing equipment or methods, specially adapted for specific applications
    • G06F19/30Medical informatics, i.e. computer-based analysis or dissemination of patient or disease data
    • G06F19/34Computer-assisted medical diagnosis or treatment, e.g. computerised prescription or delivery of medication or diets, computerised local control of medical devices, medical expert systems or telemedicine
    • G06F19/3418Telemedicine, e.g. remote diagnosis, remote control of instruments or remote monitoring of patient carried devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04Constructional details of apparatus
    • A61B2560/0431Portable apparatus, e.g. comprising a handle or case
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04Constructional details of apparatus
    • A61B2560/0443Modular apparatus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04Constructional details of apparatus
    • A61B2560/0456Apparatus provided with a docking unit
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0004Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by the type of physiological signal transmitted
    • A61B5/0006ECG or EEG signals
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/0205Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021Measuring pressure in heart or blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/08Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/083Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
    • A61B5/0836Measuring rate of CO2 production
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7232Signal processing specially adapted for physiological signals or for diagnostic purposes involving compression of the physiological signal, e.g. to extend the signal recording period
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/74Details of notification to user or communication with user or patient ; user input means
    • A61B5/7465Arrangements for interactive communication between patient and care services, e.g. by using a telephone network
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04WWIRELESS COMMUNICATION NETWORKS
    • H04W84/00Network topologies
    • H04W84/02Hierarchically pre-organised networks, e.g. paging networks, cellular networks, WLAN [Wireless Local Area Network] or WLL [Wireless Local Loop]
    • H04W84/10Small scale networks; Flat hierarchical networks
    • H04W84/12WLAN [Wireless Local Area Networks]
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04WWIRELESS COMMUNICATION NETWORKS
    • H04W84/00Network topologies
    • H04W84/18Self-organising networks, e.g. ad-hoc networks or sensor networks

Abstract

An apparatus for medically monitoring a plurality of people comprises a plurality of portable medical monitors (Mn) each having a short range wireless transceiver (28), and a portable user interface (2) having a short range wireless transceiver (64). The medical monitors (Mn) and the user interface (2) are arranged to form a short range wireless local area network (LAN) in which the user interface and the monitors are operable remotely, but within the said short range, of one another. The plurality of portable medical monitors each have at least two medical sensors (Sm) for sensing medical data and are operable to transmit to the user interface, via the LAN, the sensed medical data. The portable user interface (2) has display means for displaying the said medical data of the plurality of monitors to allow the user of the interface to monitor the medical conditions of the monitored people. That allows the user to move about and engage with a monitored person whilst retaining the ability to monitor the others. A communications device (4) is co-operable with at least the user interface to receive the said medical data, and to transmit the received medical data to a remote location at a range from the communications apparatus which is large compared to the said short range. The device may be a cell phone combined in one module with the user interface.

Description

240995 1

MEDICAL MONITORING APPARATUS

The present invention relates to medical monitoring.

It is known from W0 98/40009 to provide a medical monitoring apparatus for monitoring one person. In the apparatus medical sensors are connected to a processor comprising a PC and modems. The modems are connected to respective low power transmitter/receivers The transmitter/receivers communicate with corresponding receiver/transmitters connected to a long range transmitter/receiver such as a satellite communications link. An operator of the apparatus has a hands free handset comprising a microphone and earpieces. An electronic camera may also be provided.

Medical data from the sensors and images from the camera and voice signals from the microphone are processed by the processor, and transmitted to a remote location, for use by a doctor having a corresponding processor and display to diagnose the condition of a patient. The doctor can talk to the operator to advise on the condition and treatment of the patient.

It is desired to provide apparatus which may be used to monitor a plurality of people.

According to one aspect of the present invention, there is provided apparatus for medically monitoring a plurality of people, the apparatus comprising: a) a plurality of portable medical monitors each having a short range wireless transceiver, and b) a portable user interface having a short range wireless transceiver, the medical monitors and the user interface being arranged to form a short range wireless local area network (LAN) in which the user interface and the monitors are operable remotely, but within the said short range, of one another, wherein the plurality of portable medical monitors each have at least two medical sensors for sensing medical data and are operable to transmit to the user interface, via the LAN, the sensed medical data and the portable user interface has display means for displaying the said medical data of the plurality of monitors to allow the user of the interface to monitor the medical conditions of the monitored people, and a communications device co-operable with at least the user interface to receive the said medical data, and operable to transmit the received medical data to a remote f location at a range from the communications apparatus which is large compared to the said short range.

Short range in this context means upto 500 metros.

By partitioning the apparatus into the plurality of separate portable modules, that is the medical monitors and the user interface, a single user of the user interface, e.g. a paramedic, is able to move about and actively attend to people independently of the monitors and at the same time be able to monitor the conditions of a plurality of people. Thus, the user interface is not just a central monitor of the patients fixed in position. In addition, the medical data is transmissible to a more remote location, for example a response centre where others, for example medical personnel of greater expertise, can also monitor the people. The apparatus allows, by virtue of the LAN and the communications device, the remote location to monitor the medical data produced by the monitors independently of the user.

The user interface is preferably not only easily portable but also wearable. In one preferred example the user interface is mountable on the wrist of the user. It may be a PDA (Personal Digital Assistant).

The user interface is, in preferred examples of the invention, the only device in the LAN able to display vital signs. The monitors preferably are not able to display significant vital signs except, in one example monitors have means for indicating alarm limits have been reached.

The user interface is preferably able to generate control data for controlling the monitors. The control data is transmitted to the monitors via the LAN. Preferably the control data is also transmitted to the remote location. The remote location in some embodiments of the invention can transmit control data via the communications device and the LAN to the monitors.

Such apparatus is considered to be useful at for example the scene of an automobile accident. Consider for example an accident where several people are injured. The emergency services have taken a decision to treat one, apparently most badly injured, person before the others but they need to monitor the conditions of the other people. The apparatus allows one paramedic to monitor all the injured people via the user interface. At the same time, the communications device can transmit the medical data of any of the injured people, for example the most badly injured, to a hospital for triage and/or to give the hospital staff advance reliable data relating to the condition of the people they should expect to treat when they arrive at the hospital.

Preferably the user interface includes a microphone and an audio reproducer, the user interface and communications device being operable to provide two way voice communication between the user and the remote location. Thus the user and an expert at the remote location are able to speak to each other. The user can thus obtain advice on action to take. Preferably the voice data is time division multiplexed with the medical data but can, in some embodiments be transmitted on respective ones of two channels.

The communications device may be combined with the user interface as one module. In that case, the communications device is a cellular telephone for example a GSM phone or a CDMA phone amongst other examples.

The communications device may be a separate communications module which has a short range wireless transceiver arranged so that the communications module is part of the LAN and co-operates with the user interface and the monitors via the LAN. The communications module may be placed at a convenient location at which it can transmit to, and receive from, an external long range communications network. Examples of such a network include: satellite communications networks: a satellite telephone, e.g. an Iridium phone; and the PSTN.

In accordance with another aspect of the invention, there is provided a system for disseminating medical data and voice data comprising a data processing center operable to: a) receive the medical data and voice data; b) retransmit the voice data to a desired recipient at a desired location; c) process the medical data using medical data processing software to produce a display of the medical data in a predetermined format; and d) provide the said recipient with access to the processed medical data, the recipient using browser software to access the medical data.

Thus the data processing center is at the remote location and it allows for example hospitals to access the medical data using browsers run on standard PCs avoiding the need for special purpose software at the hospitals.

These and other aspects of the invention are set out in the claims to which attention is invited.

For a better understanding of the present invention and to show how the same may be carried into effect, reference will now be made by way of example to the accompanying drawings in which: Figure 1 is a schematic block diagram of an example of apparatus according to the invention in an illustrative configuration: Figure 2 is a schematic diagram of a medical monitor; Figure 3 is a schematic block diagram of the medical monitor; Figure 4 is a schematic diagram of a container for containing the apparatus; Figure 5 is a circuit diagram of a battery charger; Figure 6 is a schematic block diagram of a user interface; Figures 7A to C are illustrations of Graphical User Interfaces provided by the user interface; Figure 8 is a schematic block diagram of a communications module; Figure 9 illustrates an alternative example of a user interface; Figure 10 is a schematic block diagram of another example of apparatus according to the invention in an illustrative configuration: Figure 11 is a schematic block diagram of a combination of a user interface and a medical monitor; Figure 12 illustrates attachments usable with a monitor or a user interface; Figure 13 is a schematic block diagram of voice signal processing in a user interface; Figures 14A and B are time charts illustrating time division multiplexed voice and data signals; Figures 15 and 16 are schematic block diagrams of voice signal processing in a data reception apparatus; and Figure 17 illustrates a system for disseminating medical data and voice data in accordance with another aspect of the invention.

Description of the Preferred Embodiments

First System and variants thereof Figure 1 shows an illustrative embodiment of the present invention in the configuration in which it is used.

For ease of description and understanding, consider the following illustrative scenario. Emergency services are attending the scene of an automobile accident involving several automobiles and many people are injured. The paramedic deploys the apparatus shown in Figure 1. He is skilled both in the use of the apparatus and in monitoring and treating injured people at the scene of the emergency. He and his colleagues can not personally attend all the injured people continuously. They need to make decisions as to whom to treat first but also need to monitor the conditions of all the injured people.

The apparatus comprises separate portable modules: that is a plurality of medical monitoring modules Mn; a user interface 2; and a communications module 4.

The paramedic (also referred to herein as the "user") allocates one monitoring module M1, M2, Mn to each injured person attaching various medical sensors S1 to Sm to each person. The paramedic has a user interface 2 with which he can monitor the medical conditions of each of the people. The user interface displays, in respect of each person the medical data sensed by the sensors S1 to Sm. The user interface can also be used to send control data to the monitoring modules.

The monitoring modules M1 to Mn each have transceivers 28. The user interface 2 has a transceiver 64 and the communications module 4 has a transceiver 82. The transceivers are short range radio transceivers and network interfaces. The modules M1 to Mn, the user interface 2 and communications module 4 form a short range wireless local area network LAN. The particular set of monitoring modules M1 to Mn are associated only with (or are "tied to") one particular user interface 2. The system is configured so that they will not co-operate with other user interfaces (with one possible exception of a roaming interface discussed below). That avoids problems of crosstalk which may occur if two or more LANs, LAN1 and LAN2, are in operation close together as shown in Figure 1. The network is preferably centred on the user interface 2 in that all other modules transmit and receive to and from the user interface 2 as indicated by the dash lines in Figure 1. Alternatively the network may be centred on the communications module 4 in that the modules M1 to Mn and the l user interface transmit to and receive from the communications module. Other network configurations may be possible. Preferably, the wireless LAN complies with the Bluetooth standard. (Bluetooth is a Trade Mark) The communications module 4 additionally has a communications interface 81 for communicating with a remote response location 6. The response location may be for example a hospital many miles from the scene of the accident.

The transceivers 28, 64 and 82 operate over a maximum range which may be upto 500 metres for example 100 metros.

The paramedic has voice communication with the remote response location 6.

In this example, the paramedic may have a headset comprising a headphone and microphone linked to the user interface by a wired or wireless link. The user interface links the voice channel to the communications module 4 via the LAN1. The communications module links the voice signals to the response location.

As shown in Figure 1 by block 2', the communications module 4 may be in communication with another LAN, LAN1, having a user interface 2' which monitors another set of medical monitors (not shown).

The elements of the apparatus shown in Figure 1 will now be described in more detail.

Medical Monitor An example of a medical monitor Mn is shown schematically in Figures 2 and 3.

Referring to Figure 2 the monitor Mn is in the form of a box. The box may, for example, be about 15 to 20 cm wide and of similar width and about 5 cm depth.

The example shown in Figure 2 the box has recesses in a major face thereof for receiving, for example, 6 sensors 10, 12, 14, 16, 18 and 20. All the sensors may have wired connections to the monitoring module. Alternatively all the sensors may have wireless connections. Alternatively some of the sensors may have wired connections and others wireless connections. In the present example only one of the sensors has a wireless connection and all the others have wired connections.

The module of Figure 2 has a small LCD display 22 for displaying the operational status of the module. It also has visual indicators 24, which may, for example be high brightness LEDs the functions of which are to indicate alarm conditions as will be described later. One of the LEDs 24 indicates visually that the module is in active communication with the user interface 2.

In addition the module has an electrical connector 23, e.g. a socket into which a corresponding connector of a medical sensor may be plugged.

It will be noted that this example of the module Mn is not arranged to display the medical data sent by any of the sensors connected to it. That medical data is displayed at the user interface 2. The medical monitors of the present example are useful for providing medical data to diagnose the condition of a person only when used in conjunction with the user interface 2.

Referring to Figure 3, the monitor Mn comprises a microprocessor 26 having a store. The microprocessor 26 is connected to a bus 38 to which the sensors 10, 12, 14, 16 and 18 are connected by wired connections. In this example sensor 10 is a 3 and 5 lead ECG sensor with 3 lead as standard plus wrist and leg electrodes. Sensor 12 is an SpO2 sensor. Sensor 14 is a blood pressure sensor. Sensor 16 senses end tidal CO2 and/or TcCo2.

A sensor detector may be provided for the SpO2 sensor so the sensor can be simply plugged into the module woken up from a stand-by mode. The processor 26 polls the sensors to detect which are coupled to it and to activate them.

Sensor 20 is a 12 lead ECG sensor which may be wired or wireless, In this example it has a wireless connection to the microprocessor 26. In this example the wireless connection is provided by a "Bluetooth" device. (Bluetooth is a Trade Mark.) Thus the 12 lead ECG 20 has a Blue Tooth transceiver 21 and there is a corresponding Blue Tooth transceiver 30 coupled to the microprocessor 26. In this example the Blue Tooth transceiver 30 is connected directly to the microprocessor 26 but it may be connected to the bus 38.

In addition, Figure 3 shows a capnometer 17 which plugs into the connector 23 in the module. Connector 23 has a part connected to the bus for communicating said medical data to the microprocessor 26. It has another part for receiving power from the module.

The microprocessor 26 controls the display 22 and the indicators 24. The microprocessor 26 also responds to a docking sensor 371, the purpose of which will be described with reference to Figure 4.

The module is powered by a rechargeable battery 32 which is, for example, a lithium ion smart battery. A smart battery is a battery having a microprocessor for controlling the charging and discharging of the battery. The battery has contacts 461 for connection to a charger.

The module additionally has a short range wireless transceiver 28 which also functions as a network interface.

The microprocessor 26 receives "raw" medical data from the sensors 10, 12, 14, 16, 18, 20 and 17 and processes that data. The processor packages the data into a form suitable for transmission.

The processed data is sent via the transceiver 28 and the LAN to the user interface 2. The processed data is displayed at the user interface.

The microprocessor 26 also receives control data from the LAN. That control data may originate at the user interface 2. Alternatively the control data may originate at the remote response location 6.

One type of control data sets one or more alarm limits. An alarm limit for a particular sensor is a threshold level with which the medical data from that sensor is compared. If the alarm limit is reached then an alarm signal is transmitted to the user interface 2. That alarm signal may be indicated visually and/or audibly at the user interface. In addition the alarm limit may also be displayed on the display 22 of the module Mn.or by one of the alarm indicators 24 on the monitor.

The microprocessor 26 also controls the display 22. The display 22 displays the operational status of the monitor. For example it displays: battery charge level, and operating mode of the monitor. The operating modes of the monitor are: a standby mode; and an active mode in which it is actively transmitting data to and/or receiving data from the LAN.

The medical monitor may be arranged to automatically shut down to preserve battery life when its associated user interface shuts down as is described in more detail below.

Container When the apparatus shown in Figure I is not in use, at least the monitors Ml to Mn are contained in a container 40 shown in Figure 4. In the example of Figure 4 the container is a carrying case having compartments 46 for receiving respective ones of the modules Mn. The container 40 also contains a battery charger 42 having a lead 44 for connecting the battery charger to a source of electrical energy for example AC mains. Other power sources which could be used include vehicle power supply.

Referring to Figures 3 and 5, the charger 42 has electrical connectors 461 in each of the compartments 46 for receiving the monitors and which connect to the corresponding connections 461 on the rechargeable batteries of the monitors.

Also referring to Figure 3, the docking sensor 371 of each monitor senses whether the monitor is in a compartment in the container or has been removed from the container. Removal of a monitor from the container is sensed by the docking sensor which then prompts the microprocessor to enter the standby mode. Thus the paramedic does not need to think about manually activating the monitor when deploying the apparatus in an emergency.

In the example of Figure 4 the container has a compartment 47 for receiving the communications module and another compartment 48 for receiving the user interface 2. As shown in Figure 5 those compartments have battery charging contacts 471 and 481 for connection to the rechargeable batteries of the communications module and user interface respectively.

Whilst the container has been illustrated as a carrying case, the container could be some other form of container for example a container in an emergency vehicle for example an ambulance or fire engine.

User Interface 2 Referring to Figure 6 the user interface 2 comprises: a microprocessor 60; a touch sensitive display 62; an audio interface 61 together with a microphone 611 and a speaker for example headphones 612; a docking sensor 65; and a short range wireless transceiver 64 which is also a network interface. The display 62 is preferably readable in direct sunlight. A camera 661 responsive to visible light may be provided.

A camera 662 responsive to infra-red may be provided additionally to, or as an alternative to, camera 661. The camera may have a wired connection to the microprocessor 60 or a wireless connection to the microprocessor 60 for example using Blue Tooth devices. Optionally, an input device 63 additional to the touch sensitive display may be provided. Examples of input devices are: a pointing device, e.g. a mouse; a keyboard; and a small set of keys for functions which are used often.

The small set may be 4 keys for example.

The microprocessor 60 and touch sensitive display provide graphical user interfaces examples of which are shown in Figure 7A to 7C, to allow the paramedic to view the sensed medical data produced by the monitors, send control data to the monitors and send configuration data to the communications module 4.

Further graphical user interfaces may be provided. One example is for controlling a sensor, for example a blood pressure cuff.

Another example of a graphical user interface is for shutting down the user interface. Shutting down the user interface may automatically generate a signal transmitted via the LAN to all the associated medical monitors causing them to shut down too.

The user interface also comprises a rechargeable battery having connections 481 for connecting to the charger in the container 40 of Figure 4. In this example the battery is a smart lithium ion battery.

The voice data is processed by the processor 60. Processing of voice data is described in more detail below.

The user interface may include other graphical user interfaces which emulate medical data displays commonly used by, and familiar to, paramedics and other users of medical display devices Display of Medical data Figure 7A Figure 7A shows a graphical user interface for displaying sensed medical data.

On the left-hand side of the user interface is a column of tabs T1 to Tn for respective ones of the monitors Mn. The tabs identify the monitors and thus the people being monitored. Selection of a tab preferably changes the appearance of the tab.

Preferably, in addition, an indicator 24 on the selected monitor lights up to show the monitor is in communication with the user interface.

At the top of the display is a row of tabs associated with respective ones of different data views DV1 to DVp.

One data view for example DV1 as shown in Figure 7A may show a plurality of sensed medical data. In the example of Figure 7A body temperature, blood pressure, blood CO2 and TCCO2 are displayed. Alternatively those data may be shown on respective data views. Another data view, for example DV2, may display only 3/5 lead ECG. Another view, for example DV3, may display 12 lead ECG. Another view, for example DV4, may display capnometer data. The number of views required and what they display and what combinations of data they display is a matter of choice for the designer of the apparatus.

Alarm Limits - Figure 7B Referring to Figure 7B, the graphical user interface again comprises on the left hand side a column of tabs T1 to Tn relating to respective ones of the monitors Mn.

The display also comprises, at the top, a row of tabs AL1 to ALq. The graphical user interface of Figure 7B is used to set the alarm limits for the monitored medical data.

Selection of a tab preferably changes the appearance of the tab. Preferably, in addition, an indicator 24 on the selected monitor lights up to show the monitor is in communication with the user interface. A particular monitor is selected using a tab Tn. A particular item of medical data or set of medical data for which an alarm limit(s) is/are to be set is selected using the tabs ALq. The user interface has one or more data entry zones 621A for setting alarm limits to values which are shown at 621B.

Configuring Communications Module - Figure 7C Referring to Figure 7C the user interface also has a display 621 for configuring the communications module 4. The communications module 4 may comprise 2 or more interfaces for interfacing the module with different types of network, for example PSTN and GSM, amongst many other possibilities (a list of some other networks are given below). Figure 7C envisages that the selection of the network takes place manually by selecting one of the networks using the graphical user interface.

Other parameters of the communications module 4 may also be set at the user interface. In the example shown in Figure 7C the data rate at which the communications module 4 transmits and receives data to and from the remote location may be set.

In an alternative example, the selection of a network takes place using a control panel on the communications module. In this example the user interface does not need the graphical user interface on the user interface 2 for configuring the communications module.

Alarms - Ficure 7A As shown in Figure 7A, the user interface may have a group of alarm indicators 71 which are always displayed. This group may indicate situations such as:- a medical alarm limit; user interface out of range of monitor or the communications module 4; battery low on a module Mn, user interface 2 or communication module 4; faults; and disconnection of a medical sensor.

Roaming Interface 200 Referring to Figure 1 a roaming interface 200 may be provided. In this example of the invention, the roaming interface is configured to be a read-only interface able to display the medical data produced by any medical monitor in two or more LANs LANl and LAN2. This would enable for example a Doctor to review the condition of any monitored patient.

Example of user interface 2. Figure 9 The user interface 2 may be a PDA (personal digital assistant) having a suitable short range wireless communications interface 64. Alternatively the user interface 2 may be a personal computer for example a pen tablet PC or a lap top computer, having a short range wireless communications interface 64.

As another alternative, as shown in Figure 9, the user interface 2 is a PDA integrated with a camera or cameras 661 and/or 662 in a wearable device 90 which may be strapped by a strap 91 to the wrist of the user. As shown in Figure 9, the PDA has a display 62 which is a touch sensitive screen which may be operated by a stylus 62S.

Expert and non-expert GUIs Two types of graphical user interfaces may be provided, one for expert users as is described above; and another for nonexpert users.

For expert users the user interface 2 has graphical user interfaces as shown in Figures 7A to C. It is assumed that expert users will be fully trained and practiced in the use of the apparatus, especially the user interfaces and will be fully trained and practiced in applying sensors to people and providing first-aid treatment of the people.

In an apparatus designed for non-expert users, the user interface 2 displays the interfaces of the expert user and additionally displays "help screens" (which are not needed for an expert user) and which provide detailed instructions on how to use the apparatus including instructions on how apply the sensors to people and such other details considered important by the designer of the apparatus.

Communications module 4, Figure 8.

Referring to Figure 8, the communications module comprises a microprocessor 80 having a store 801; a short range wireless transceiver 82 which is also a network interface; a long range communications interface 81; and a battery 84.

The battery 84 may be for example a lithium ion smart battery having connections 471 for connecting with the charger in the container 40 of Figure 4.

The communications module also has a docking sensor 372 for sensing its removal from the container 40 avoiding the need for the user to switch the device on.

The communications module optionally has one or more visual indicators 86 for example an LCD display andlor one or more LEDs for indicating the operational status of the module. One of the LEDs may light up when, for example, the user interface 2 is being used to configure the module 4 to indicate the module 4 is in communication with the user interface.

The long range communications interface 81 may be designed to operate with only one type of network for example a satellite telephone amongst other examples.

However, in the example shown in Figure 8 the interface is designed to operate with a plurality of different networks and has p network interfaces 811 to 8 1p. Examples of networks to which the long rangecommunications interface may be connected include: IEEE 802.11b WAN; GSM; wired Ethernet; DECT; ISDN TA; Serial; and Iridium, amongst others (Iridium is a Trade Mark).

In the example of Figure 7C and Figure 8, the long range communications interface 81 has a selector 81 responsive to a network selection made at the user interface 2 to select the appropriate one of the network interfaces 811 to 81 p. As described above, the communications module may have a control panel via which a user selects the appropriate one of the network interfaces 811 to 81 p. Local Area Network and routine data to one or more remote locations The local area network LAN is implemented using known wireless interfaces 28, 64 and 82 operating with known operating software. An example of a suitable standard for a wireless I,AN is Bluetooth. The LAN operates in a well known way and does not need to be further described.

The monitors Mn, user interface 2 and the communications module 4 have identifiers. The network interfaces have identifiers. In addition the monitors Mn and the user interface 2 and the communications module may have IF addresses.

When the apparatus of Figure 1 is deployed from the container of Figure 4, one or more of the monitors may be left in the container. When each monitor is removed from the container, the docking sensor senses its removal and it enters the standby mode. In that mode the monitor indicates its presence in the active LAN by signalling its identifier to the user interface. The user interface then displays its tag Tn on the GUIs.

The LAN comprising the monitors, the user interface and the communications module uses a software protocol in which TCP or UDP is run over IP.

Voice and Data Communication and Texting In this example of the invention, voice is carried to and from the user interface as low-rate coded (i.e. compressed) voice data. Medical data from the monitors is carried in data packets to the user interface, to the communications module and from it to the remote location.

Additionally to voice, or alternatively to voice, text may be transmitted to and from the user interface. Using text may be valuable if the user interface is operated in an environment in which noise levels are too high to sustain a voice conversation.

The text may be entered onto the user interface using: a stylus on a PDA; or pen tablet PC; or via a keyboard, especially if a laptop computer is used as the user interface.

Communications systems may operate in circuit mode, data mode or both. For example, the PSTN operates in circuit mode, the Internet operates in data mode and.

GSM and CDMA can provide both modes. Voice data, text and medical data can be transmitted in any of the modes. Voice may be transmitted in circuit mode and data in data mode for example..

Second System and variants thereof Referring to Figure 10, a second illustrative system is shown. It comprises separate portable modules (PIM) Ml to Mn and 202. Modules M1 to Mn are patient monitoring modules identical to those of Figure 1 (with one exception described below). Module 202 is a user interface (UIM) which is similar to the interface 2 of Figure 1 but differs from it mainly in that the interface 202 includes a cellular telephone 202 instead of communicating with the communications module 4 of Figure 1. The cellular telephone may operate in accordance with any cellular telephone system, for example GSM and CDMA, amongst others. The phone 202 may be a satellite phone for example an Iridium phone. Preferably the phone 202 is a tri-band cellular phone operable in USA, Europe and elsewhere. The modules M1 to Mn and the interface 202 are linked via a network LAN1 which is a short range wireless network as described with reference to Figure 1 and which preferably is a Bluetooth network.

As shown in Figure 11, the patient monitoring modules PIM and the user interface UIM may be modified by the provision of an electro-mechanical connector C 1 by which a patient monitoring module may be electrically and mechanically, but separably, coupled with the user interface. The combination forms a combined patient monitor and user interface as is more commonly used by paramedics.

Preferably, the user interface 200 when coupled to the patient monitor Mn derives its power supply from the patient monitor Mn. The patient monitor may have a further connector C2 which connects to an external battery pack B 1 for supplementing the battery internal to the module Mn. The patient monitor has a connector 461 (also shown in Figure 3) for connection to a charger 421. Preferably, the patient monitor or the combination of the patient monitor and the user interface may be powered by the charger 421.

Referring to Figure 12, the patient monitor Mn may be provided with at least an attachment AT 1 for attaching the monitor to a rail for example a hospital bed rail.

The monitor may have a stand AT3 so it can stand on a horizontal surface and/or a device AT2 which allows it to be attached to a complementary attachment (not shown) fixed to for example a vertical surface, e.g. a wall. The user interface 200 preferably comprises at least the stand AT3 to enable the display to be viewed without the user holding the interface. It may additionally or alternatively have the attachment AT2 and/or ATT. The attachments AT1 to 3 may be used with the user interface 2 of Figure 1 and/or the wrist mounted interface of Figure 9.

The wrist mounted interface of Figure 9 is, in accordance with this example of the invention, modified to incorporate the features of the interface 200 of Figures 10 to 14.

This example of the invention is operable with low bandwidth data communications. A GSM phone for example provides a circuit mode data channel of 9.6K bits per second (bps or Baud). An Iridium channel may be only 2.4K bits per second. This example of the invention provides: a) simultaneous voice and data in the same channel by time division multiplex using a 9. 6K channel; or b) voice and data alternately in a 2.4K channel.

Even if a greater bandwidth channel is available, the use of low bandwidth is advantageous because many other users want to use the available bandwidth of a channel.

Referring to Figure 13, the user interface has a processor 60 which incorporates a voice compressor which compresses the data rate of voice data to, for example, 2.4Kbits per second. The medical data is transmitted at as high a bandwidth as is available. However data may be transmitted at a low rate of e.g. 2.4Kbaud. A multiplexer MUX packetises the voice and medical data, and time division multiplexes the packets onto a single channel for supply to a data input of the phone 202.

If the phone channel, for example a cell phone, has a data bandwidth of say 9.6Kbps then the voice and medical data packets share the available bandwidth allowing simultaneous transmission of voice and data as shown schematically in Figure 14A.

If the phone channel, for example an Iridium phone, has a data channel having a bandwidth of 2.4Kbps then the voice packets and the data packets cannot share the available bandwidth. Thus at some time intervals voice packets occupy all the available bandwidth and at others medical data packets occupy all the available bandwidth. In other words voice and data are toggled as shown in Figure 14B. In examples of the invention, the toggling is controlled manually by the user who has a switch which switches between voice and medical data.

Referring to Figure 15, a call center is connected to a network 154 ( which may be the PSTN for example) on which voice data and medical data are received from apparatus such as that shown in Figure 10. Also connected to the network 154 are terminals 152 of which only one is shown. For each user 151 there is a terminal 152 (e.g. a computer) for processing and displaying medical data received from the user interface200 of Figure 1 and a telephone 153 for sending and receiving voice signals. It is assumed here that the terminal 151 does not have means such as a sound card for processing voice data. The medical data and voice data are multiplexed onto the same data stream as described above either as TDM data or as "toggled" voice and medical data. The network 154 feeds the medical data and voice data to the correct terminal 151. For that purpose the data includes an address which identifies the terminal. A demultiplexer 150 separates the medical data and the voice data into separate streams... The voice data is routed to the telephone 153 in the following way.

In one example, the voice data is sent to a converter 155 which converts the voice data into a conventional telephone signal (which may be analogue or digital) and routes the voice data to a PBX of the call center, or alternatively to the PSTN, which in turn routes the voice signal to the telephone 153 of the user location 151. The voice data in the multiplexed stream includes an address which identifies the user location 151. The converter 155 converts the address to a form which enables the PBX to route the voice data to the telephone 153 at the correct location 151. Other ways of routing the voice data to the telephone will be apparent to those skilled in the art.

S As shown in Figure 16 a call center may be equipped only with computers 151 having sound cards 157 and not have conventional telephones. The computers may be coupled to a network 154. In that case the multiplexed voice and medical data are routed via the network to a terminal 151 which processes the data directing the voice data to the sound card 157 and processing and displaying the medical data.

In a prior proposal for a call center for use with a system as shown in Figure 1 or 10, the call center has for each user interface 2, 200, a corresponding terminal which runs special purpose software. A user at the call center is a skilled medical practitioner who analyses the data and advises the paramedic attending a patient on what action to take. There may be several call centers which may for example be hospitals where the required skilled medical practitioners work. The software may for example display at the terminal exactly what is displayed on the user interface and replicate all actions taken at the user interface, In addition the software may allow the terminal user to control the user interface 2, 200. The call center thus requires as many terminals as there are user interfaces and for each terminal special purpose software. The cost of providing terminals and software and maintaining the software can be large especially if it is needed at several sites.

Referring to Figure 17 a system which reduces such problems is illustrated.

Reference 171 indicates the scene of an incident at which the system of Figure 1 or 10 is deployed. Voice and medical data is transmitted via a communications network 172, 173 to a data processing center 174. The data processing center 174 receives the medical data and voice data and processes it using the special purpose software. A call center or centers 176, 178, which in this example are hospitals, use standard computers running conventional Internet browser software (e.g Internet Explorer* or Netscape Navigator* - * Trade Marks) which enables computers at hospitals 176 and 178 to access the processed data at the data processing center 174. This system allows for example a hospital 176 away from the incident to provide Triage, and/or advice about the treatment of patients to the paramedic at the scene of the incident. That leaves staff, at a hospital 178 near to the incident, free to treat patients received from the incident. The hospitals do not need the special purpose software. Because the special purpose software is concentrated in the data processing center it is easier and cheaper to install and maintain. The data processing center 174 may separate the voice data and medical data and forward the voice data to the hospital 176 and/or 178 as a normal voice call via the PSTN or as voice over IP. Medical data may be transmitted separately from the voice data to the hospital(s).

At a hospital a computer may deal with several sets of medical data from different user interfaces 2, 200.

These measures allow a system to have more medical monitors Mn and user interfaces 2, 200 without requiring extra terminals running special purpose software at the call center(s). That allows the system to be scaled up more economically

Claims (68)

1. Apparatus for medically monitoring a plurality of people, the apparatus comprlsmg: a) a plurality of portable medical monitors each having a short range wireless transceiver, and b) a portable user interface having a short range wireless transceiver, the medical monitors and the user interface being arranged to form a short range wireless local area network (LAN) in which the user interface and the monitors are operable remotely, but within the said short range, of one another, wherein the plurality of portable medical monitors each have at least two medical sensors for sensing medical data and are operable to transmit to the user interface, via the LAN, the sensed medical data and the portable user interface has display means for displaying the said medical data of the plurality of monitors to allow the user of the interface to monitor the medical conditions of the monitored people; and a communications device co-operable with at least the user interface to receive the said medical data, and operable to transmit the received medical data to a remote location at a range from the communications apparatus which is large compared to the said short range.
2. Apparatus according to claim 1, wherein the communications device is a radio transceiver combined with the user interface in one module.
3. Apparatus according to claim 2, wherein the radio transceiver is a cellular telephone.
4. Apparatus according to claim 2 wherein the cellular telephone is selected from the group comprising GSM and CDMA.
5. Apparatus according to claim 1 wherein the communications device is a separate communications module having a short range wireless transceiver and arranged to be part of the said LAN, and means for communicating with an external communications network.
6. Apparatus according to claim 5, wherein the communications module comprises a plurality of network interfaces for connecting to respective communications networks for linking the communications module to the said remote location, and a selector for selecting one of the interfaces.
7. Apparatus according to claim 6 wherein the communications module comprises two or more network interfaces for interfacing with networks selected from the group comprising GSM, ISDN, PSTN, Satellite link, wireless digital wide area network, and wired digital wide area network.
8. Apparatus according to claim 6 or 7, wherein the communications module comprises a control means for controlling the said selector to select one of the 1 5 interfaces.
9. Apparatus according to any preceding claim, wherein each of the monitors comprises sensors for sensing at least two of: ECG: blood pressure, and SpO2
10. Apparatus according to claim 9, wherein each of the monitors comprises sensors for sensing one or more of respiration rate, temperature, invasive blood pressure, end tidal CO2, and blood gases other than CO2.
11. Apparatus according to any preceding claim wherein the monitors are each operable to receive control data setting at least one alarm limit relating to a sensed medical parameter, compare the limit with the parameter and signal when the limit is reached.
12. Apparatus according to claim 11, wherein each monitor has an indicator for indicating an alarm limit has been reached.
13. Apparatus according to claim 11 or 12, wherein each monitor is operable to transmit to the user interface via the LAN indications that respective alarm limits have been reached.
14. Apparatus according to any preceding claim wherein each monitor has an indicator arranged to indicate the operational status of the monitor.
15. Apparatus according to claim 14, wherein the said indicator comprises a display device operable to display data indicating the operational status of the monitor.
16. Apparatus according to any preceding claim wherein each monitor comprises a wireless link for linking at least one of the sensors with the monitor.
17. Apparatus according to any preceding claim wherein each monitor comprises a rechargeable cell or battery for powering the monitor.
18. Apparatus according to claim 17, wherein each monitor is dockable with a container for containing the plurality of monitors each monitor comprising a docking sensor operable to sense the removal of the monitor from the container.
19. Apparatus according to claim 18, wherein each monitor is arranged to enter, when the docking sensor senses the removal of the monitor from the container, a standby mode in which the monitor is receptive of control data from the LAN.
20. Apparatus according to any preceding claim, wherein the user interface includes a microphone and an audio reproducer, the interface and the said communications device being operable to provide two way voice communication between the user and the remote location.
21. Apparatus according to any preceding claim, wherein the user interface is operable to transmit control data to the monitors via the LAN.
22. Apparatus according to claim 21 wherein the apparatus is operable to transmit the control data to remote location via the communications device.
23. Apparatus according to claim 21 or 22, wherein the apparatus is operable to receive control data for controlling the monitors from the remote location
24. Apparatus according to any preceding claim, wherein the user interface is arranged to provide a graphical user interface for setting, in respect of each monitor, one or more alarm limits for sensed medical parameters, the user interface being operable to transmit the or each alarm limit to the monitor via the LAN.
25. Apparatus according to claim 24, wherein the user interface is arranged to receive from the monitors, and to provide to the user indications that respective alarm limits have been reached.
26. Apparatus according to claim 25 wherein the said indications that respective alarm limits have been reached are visual and/or audible indications.
27. Apparatus according to any preceding claim wherein the user interface is arranged to provide a graphical user interface for displaying, in respect of each monitor, the medical data sensed by that monitor.
28. Apparatus according to claim 6 or 7, wherein the user interface is arranged to provide a graphical user interface for producing configuration data for the communications module, the user interface being operable to transmit the configuration data to the communications module via the LAN.
29. Apparatus according to claim 28, wherein the configuration data produced by the user interface includes selection data for controlling the said selector to select one of the interfaces.
30. Apparatus according to any preceding claim wherein the user interface is selected from the group comprising a pen-tablet PC, a laptop portable computer and a PDA.
31. Apparatus according to claim 30, wherein the user interface comprises a PDA having a touch sensitive screen.
32. Apparatus according to claim any preceding claim, wherein the user interface is arranged to display user instructions for instructing the user in the use of the apparatus.
33 Apparatus according to any preceding claim, further comprising at least one camera for producing image signals, and the image signals are transmissible to the communications device for transmission to the remote location.
34. Apparatus according to claim 33, wherein the at least one camera is combined with the user interface in one module.
35. Apparatus according to claim 33 or 34 comprising a first camera sensitive to infra-red and a second camera sensitive to visible light.
36. Apparatus according to any preceding claim wherein the user interface is the sole device in the said LAN able to display vital signs data received from the monitors.
Wearable
37. Apparatus according to any one of claims 20 to 36 wherein the user interface is housed in a housing shaped to fit on the wrist/forearm of the user.
38. Apparatus according to any preceding claim, further comprising a container for containing at least the medical monitors, the container containing a charger for charging rechargeable cells or batteries.
39. Apparatus according to claim 38, wherein the container is arranged to contain the user interface.
40. Apparatus according to claim 38 or 39 wherein the medical monitors and /or the user interface have charging contacts which connect with the said charger for charging batteries thereof when in the container.
41. Apparatus according to any preceding claim wherein the LAN is arranged to run TCP or UDP over IF.
42. Apparatus according to claim 41, when dependent directly or indirectly on claim 5, 6, 7 or 8, wherein the user interface and the communications module are arranged to provide said two way voice communication within the LAN in accordance with TCP/IP or UDP/IP.
43. Apparatus according to claim 41 or 42, wherein the communications module is arranged to transmit data to the remote location and receive data from the remote location using one of: data packets; TCP/IP: UDP/IP: circuit mode of GSM; and data mode of GSM.
44. Apparatus according to claim 20, wherein the communications device provides respective channels linked to the remote location for the medical data and for the voice communication. s
45. Apparatus according to any one of claims 1 to 43, wherein the communications device provides a single channel linked to the remote location for time division multiplexed medical data and voice data.
46. Apparatus according to claim 45 when dependent directly or indirectly on claim 20, wherein the user interface comprises means for compressing voice data.
47. Apparatus according to claim 45 or 46, wherein the voice data and the medical data share the bandwidth of the channel.
48. Apparatus according to claim 45 or 46, wherein the voice data and medical data are transmitted alternately, each occupying the whole bandwidth of the channel when transmitted.
49. A system for disseminating medical data and voice data comprising a data processing center operable to: e) receive the medical data and voice data; f) retransmit the voice data to a desired recipient at a desired location; g) process the medical data using medical data processing software to produce a display of the medical data in a predetermined format; and h) provide the said recipient with access to the processed medical data, the recipient using browser software to access the medical data.
50. A system according to claim 49, wherein the data processing center enables the said recipient to manipulate the data.
51. A system according to claim 49 or 50, wherein the data processing center is operable to receive the medical data and the voice data time division multiplexed in the same channel, the center having means for demultiplexing the voice and medical data.
52. A system according to claim 49, 50 or 51 in combination with apparatus according to anyone of claims 1 to 48 for providing the medical data and voice data to the data processing center.
53 A communications module comprising a short range wireless transceiver which also acts an interface of a LAN, and means for communicating with an external communications network additional to said LAN.
54 A communications module according to claim 53, wherein the communications module comprises a plurality of network interfaces for connecting to respective external communications networks for linking the communications module to a remote location, and a selector for selecting one of the interfaces.
55. A communications module according to claim 54 wherein the communications module comprises two or more network interfaces for interfacing with networks selected from the group comprising GSM, ISDN, PSTN, Satellite link, wireless digital wide area network, and wired digital wide area network.
56. A communications module according to claim 54 or 55, wherein the communications module comprises a control means for controlling the said selector to select one of the interfaces.
57. A portable medical monitor comprising a short range wireless transceiver which also acts an interface of a LAN, means for sensing a plurality of vital signs, means for indicating that an alarm limit of a vital sign has been reached, and means for indicating the operational status of the monitor.
58. A monitor according to claim 57 which is dockable in a container, and comprising a docking sensor for activating the monitor when it is removed from the container,
59. A user interface comprising a short range wireless transceiver which also acts an interface of a LAN, a processor for processing vital signs data received from the LAN via the said transceiver, a display for displaying the processed vital signs data, and a voice communications interface for sending and receiving voice data.
60. A user interface according to claim 59, in combination with a cell phone for sending voice and vital signs data to a remote location and for receiving at least voice data from the remote location.
61. A user interface according to claim 59 or 60, comprising a camera sensitive to visible light, the interface being operable to transmit an image produced thereby to the LAN or to the cell phone.
62. A user interface according to claim 59, 60 or 61, comprising a camera sensitive to infra red the interface being operable to transmit an image produced thereby to the LAN or to the cell phone.
63. A user interface according to claim 59, 60, 61 or 62, wherein the user interface is housed in a housing shaped to fit on the wrist/forearm of the user.
64. Apparatus according to any one of claims 1 to 48 and substantially as hereinbefore described with reference to Figures I to 16 the accompanying drawings.
65. A system according to claim 49, 50 or 51 and substantially as hereinbefore described with reference to Figure 17 of the accompanying drawings.
66. A communications module substantially as hereinbefore described with reference to Figure 8 of the accompanying drawings.
67. A portable medical monitor substantially as hereinbefore described with reference to Figure 3 of the accompanying drawings.
68. A user interface substantially as hereinbefore described with reference: to Figure 6 optionally with Figure 7, or Figure 9 of the accompanying drawings.
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