GB2423443A

GB2423443A - Use of location awareness to control radio frequency interference in a healthcare environment

Info

Publication number: GB2423443A
Application number: GB0602904A
Authority: GB
Inventors: Alan F Graves; Brian Johnson; Jeff Fitchett; Guy Duxbury; Brian Vezza
Original assignee: Nortel Networks Ltd
Current assignee: Nortel Networks Ltd
Priority date: 2005-02-11
Filing date: 2006-02-13
Publication date: 2006-08-23
Anticipated expiration: 2026-02-13
Also published as: GB0602904D0; GB2423443B

Abstract

A method of controlling RF interference in a healthcare establishment. The method comprises receiving data regarding a wirelessly detectable tag associated to a first piece of equipment within the healthcare establishment; determining whether the first piece of equipment is positioned relative to a second piece of equipment within the healthcare establishment such that an RF interference constraint is violated, based at least in part on the data regarding the wirelessly detectable tag; and responsive to the RF interference constraint being violated, causing a variation in RF power transmitted by at least one of the first piece of equipment and the second piece of equipment. In this way, wireless communication equipment can be used in the healthcare establishment without deleterious effects on sensitive medical equipment. Also disclosed is an equipment and personnel location monitoring system, authentication of personnel and event monitoring system.

Description

I USE OF LOCATION AWARENESS TO CONTROL RADIO FREOUENCY

2 INTERFERENCE IN A HEALTHCARE ENVIRONMENT 4 The present invention relates to communications systems and methods having application to a healthcare environment, and benefiting from enhanced 6 functionality and safety due to the availability of location awareness.

8 In recent years, use of electronic methods to store patient records has become 9 more commonplace, both due to ad-hoc actions by physicians and as an industry response to government pressures. To fully exploit the resultant 11 electronic health records (EHR), physicians and other clinicians need to be 12 given access to both read and write these records. However, patient data is of 13 a confidential nature, thus creating the problem of having to balance the need 14 for privacy against the desire to simplify existing access and authentication protocols and procedures, which are often cumbersome.

17 In addition, a wide range of communications typically take place in a 18 healthcare environment and are characterized by various degrees of criticality 19 from the perspective of both patients and clinicians. The efficiency with which communications occur in a healthcare environment often directly affects the 21 quality of the healthcare services provided to patients and, in some cases, has 22 a critical impact on the condition of patients. For instance, in some situations 23 where a few minutes can represent the difference between life and death for a 24 patient, the efficiency of communications may be a determining factor in saving the patient's life.

27 Moreover, while wireless technology has the potential to provide the desired 28 improvement in communications efficiency (such as improved clinician- clinician 29 voice contact and delivery of medical information from databases to the clinician at the point-of-care), the electromagnetic radiating nature of this 31 technology has led to concern over interference with sensitive medical 32 equipment.

1 There is a thus a need in the industry for improvements in communications 2 systems and methods having application in healthcare environments.

4 In accordance with a first broad aspect, the present invention seeks to provide a method of controlling RF interference in a healthcare establishment. The 6 method comprises receiving data regarding a wirelessly detectable tag 7 associated to a first piece of equipment within the healthcare establishment; 8 determining whether the first piece of equipment is positioned relative to a 9 second piece of equipment within the healthcare establishment such that an RF interference constraint is violated, based at least in part on the data regarding 11 the wirelessly detectable tag; and responsive to the RF interference constraint 12 being violated, causing a variation in RF power transmitted by at least one of 13 the first piece of equipment and the second piece of equipment.

In accordance with a second broad aspect, the present invention seeks to 16 provide a system for controlling RF interference in a healthcare establishment.

17 The system comprises a first functional entity adapted to receive location data 18 regarding a medical device and location data regarding a mobile 19 communication device that transmits RF power at a certain level, the location data regarding the mobile communication device being determined on a basis 21 of signals received from a wirelessly detectable tag associated with the mobile 22 communication device; a second functional entity adapted to determine, at 23 least partly based on the location data regarding the mobile communication 24 device and the location data regarding the medical device, whether the mobile communication device and the medical device are positioned relative to one 26 another such that a RF interference condition is met; and a third functional 27 entity adapted to cause the mobile communication device to reduce the level 28 at which it transmits RF power in response to the RF interference condition 29 being met.

31 In accordance with a third broad aspect, the present invention seeks to provide 32 a computer-readable storage medium comprising a program element for 33 execution by a computing device to control RF interference in a healthcare 34 establishment. The program element includes computer-readable program 1 code for receiving location data regarding a medical device and location data 2 regarding a mobile communication device that transmits RF power at a certain 3 level, the location data regarding the mobile communication device being 4 determined on a basis of signals received from a wirelessly detectable tag associated with the mobile communication device; computer-readable program 6 code for determining, at least partly based on the location data regarding the 7 mobile communication device and the location data regarding the medical 8 device, whether the mobile communication device and the medical device are 9 positioned relative to one another such that a RF interference condition is met; and computer-readable program code for causing the mobile communication 11 device to reduce the level at which it transmits RF power in response to the RF 12 interference condition being met.

14 These and other aspects and features of the present invention will now become apparent to those of ordinary skill in the art upon review of the following 16 description of specific embodiments of the invention in conjunction with the 17 accompanying drawings.

19 Preferred embodiments of the present invention will now be described by way of example only and with reference to the accompanying drawings in which: 22 Figs. 1A and lB are conceptual block diagrammatic views of a communications 23 network in a hospital, including a plurality of terminals, a hospital information 24 system (HIS) and a controller; 26 Fig. 1C is a detailed block diagrammatic view of the controller, in accordance 27 with an embodiment of the present invention; 29 Fig. 1D shows an example structure of an equipment database, a clinician database and an electronic health record; 32 Fig. 2A is a flowchart showing steps in an authentication process performed by 33 an authentication entity in the HIS, in accordance with an embodiment of the 34 present invention; 2 Fig. 2B shows interaction among various elements of the communications 3 network as a result of performing the authentication process, in accordance 4 with an embodiment of the present invention; 6 Fig. 3A illustrates two instances of a scenario where a clinician is located in 7 proximity to a terminal of the hospital communications network; 9 Fig. 3B is a flowchart showing steps in a session establishment process performed by the controller, in accordance with an embodiment of the present II invention; 13 Fig. 3C depicts a path of an established session through elements of the 14 communications network, in accordance with an embodiment of the present invention; 17 Fig. 4 is a flowchart showing steps in a session resumption process performed 18 by the controller, in accordance with an embodiment of the present invention; Fig. 5A illustrates a scenario in which a clinician who has an established session 21 with one terminal of the communications network is located in proximity to a 22 second terminal of the communications network; 24 Fig. 5B is a flowchart showing steps in a session transfer process performed by the controller, in accordance with an embodiment of the present invention; 27 Fig. 5C illustrates the scenario of Fig. 5A upon transfer of at least part of the 28 session to the second terminal, in accordance with one path in the flowchart of 29 Fig. 5B; 31 Figs. 5D through 5G illustrate the scenario of Fig. 5C after a re- transfer of part 32 of the session back to the first terminal, in accordance with various 33 embodiments of the present invention; I Figs. 6A and 6B are conceptual block diagram views of a communications 2 network, including a plurality of terminals, a hospital information system (HIS) 3 and a controller; Fig. 7 depicts detection of a burst of radio frequency emitted by a tag in order 6 to determine the location of the tag, in accordance with an embodiment of the 7 present invention; 9 Fig. 8 is a detailed block diagrammatic view of the controller of Figs. 6A and 6B, in accordance with an embodiment of the present invention; 12 Figs. 9A to 9C combine to create a flowchart showing steps in a process used 13 to establish communications with a target clinician in the hospital, in 14 accordance with an embodiment of the present invention; 16 Fig. 10 is a flowchart showing steps in a process used to establish 17 communications with a team of clinicians required to respond to a medical 18 event in the hospital, in accordance with an embodiment of the present 19 invention; 21 Fig. 11 shows an example structure of the equipment database that is 22 enhanced for the purposes of enabling a function that tracks equipment, in 23 accordance with an embodiment of the present invention; Fig. 12 shows an example structure of the equipment database that is 26 enhanced for the purposes of enabling a function that monitors RF 27 interference, in accordance with an embodiment of the present invention; 29 Fig. 13 is a flowchart showing steps in a process used to monitor and control RF interference, in accordance with an embodiment of the present invention; 32 Figs. 14 and 15 are flowcharts showing steps in two alternative versions of a 33 process used to describe control of, and interaction with, a charger of mobile 34 terminals, in accordance with an embodiment of the present invention.

2 1. FIRST SYSTEM ARCHITECTURE 4 Figs. 1A and lB show a conceptual view of a communications network 10 of a healthcare establishment, in accordance with a first example of 6 implementation of the present invention. For ease of reading, the healthcare 7 establishment will hereinafter be referred to as a hospital, but it should be 8 understood that the healthcare establishment may be of any size and may 9 consist of a single building or a campus including one or more buildings or pavilions and possibly one or more adjacent areas such as roads and parking 11 lots.

13 A plurality of fixed terminals 14A and a plurality of mobile terminals 14B serve 14 as entry points to the communications network 10. The terminals 14A, 14B are accessed by a plurality of "clinicians" 20 who are mobile within the 16 hospital. The term "clinician" is used to denote the broad category of 17 individuals who may require access to the communications network 10 in the 18 execution of their duties pertaining to diagnosis and/or treatment of one or 19 more patient. While not intended to be an exhaustive list, typically clinicians 20 can include physicians, radiologists, pharmacists, interns, nurses, laboratory 21 technicians and orderlies, who are all involved in patient diagnosis and/or 22 treatment. In contrast, hospital administrative management, building facilities 23 staff and janitorial staff are not considered to be "clinicians" under this 24 interpretation.

26 The communications network 10 also includes a tag / detector subsystem 27 (TDS) 16 connected to a controller 18, which is connected to a healthcare 28 information system (HIS) 12. In the non-limiting example of implementation 29 shown in greater detail in Fig. 1C, the HIS 12 includes a clinician database 22, a patient database 24, a departmental database 26 and an equipment 31 database 35, as well as an authentication entity 28 and a point-of- care (POC) 32 server 30. In addition, the HIS 12 may permit access to a trusted external 33 database 27, for instance a national electronic health record (EHR) database, 34 via a secure link 29.

2 The aforementioned components of the communications network 10 will now 3 be described in greater detail.

Trrninals 14A, 14B 7 The terminals 14A, 14B allow communication between the clinicians 20 and the 8 HIS 12 via the controller 18. Terminals 14A are fixed-wire terminals, such as 9 stationary terminals or workstations, connected to the controller 18 via communication links 57A. Terminals 14B are mobile terminals, such as 11 handheld units (e.g., personal digital assistant (PDA)) or laptop computers, 12 which communicate with the controller 18 via communication links 57B that 13 include wireless portions. The wireless portions of the communication links 14 57B are secure links that may be encapsulated within the communications network 10, as would be the case for a wireless local area network (WLAN) 16 using WLAN access points 60. In another embodiment, the wireless portions of 17 the communication links 57B may involve an external network connection, as 18 would be the case when the mobile terminals 14B are cellular phones or 19 cellular data devices.

21 Each of the terminals 14A, 14B has a display capability, which may be different 22 for different types of terminals. For example, mobile terminals 14B may have 23 display capabilities limited by the necessity of being portable and hence of 24 small size. On the other hand, certain ones of the fixed-wire terminals 14A may have superior display capabilities, not being faced with the same 26 constraints as mobile terminals. For example, some fixed-wire terminals 14A 27 may be uniquely qualified for displaying full diagnostic quality radiology 28 images.

Eciuioment database 35 32 With reference to Fig. 1D, the equipment database 35 stores information on 33 the hospital's equipment such as terminals and medical devices. For example, 34 the equipment database 35 comprises a plurality of fields for each piece of I equipment, including a unique equipment identifier 103 (e.g., a serial number) 2 and, in the case of equipment having a "tag" (further information regarding 3 tags is provided herein below), an equipment-specific tag ID 105 associated 4 with a tag that is expected to be associated with that piece of equipment. Still other information regarding the specific piece of equipment may include, inter 6 a/ia, an equipment type 107 (such as "terminal", "fixed terminal", "mobile 7 terminal", "PDA", "fetal heart monitor", etc.) and a display capability 109 (as 8 described in the preceding paragraph). Still other information may be stored 9 in the equipment database 35, such as a predetermined location of a static piece of equipment, if known.

12 Clinician Database 22 14 The clinician database 22 stores information regarding the clinicians 20. In one embodiment, with reference to Fig. 1D, the information regarding a 16 specific clinician 20 includes a unique clinician identifier 38 (e.g., an employee 17 number) for the specific clinician 20, as well as "authentication information" 40 18 for the specific clinician 20. The authentication information 40 can be, for 19 instance, a password and/or data indicative of a biometric characteristic such as a fingerprint or retina scan of the specific clinician 20. Other information 21 regarding the specific clinician 20 may include a clinician-specific tag ID 42 22 associated with a tag that is expected to be worn by the specific clinician 20.

23 (Further information regarding tags is provided herein below.) Still other 24 information regarding the specific clinician 20 may include, inter a/ia, a profile 44 of the specific clinician 20, which defines certain qualifications of the specific 26 clinician 20, as well as access privileges 46 defining types of information of the 27 HIS 12 that the specific clinician 20 is allowed to access. For example, if the 28 specific clinician 20 is a physician, still further other information regarding the 29 physician can include a list of patients under the responsibility of the physician and/or a list of facilities commonly used by the physician.

32 Patient Database 24 34 The patient database 24 stores information on the hospital's patients. In one I embodiment, with reference to Fig. 1D, the patient database 24 is configured 2 as a database of electronic health records, whereby the information on each 3 patient is stored as an electronic health record (EHR) 47 of the patient. For 4 example, the EHR 47 of a given patient can include information regarding: the long-term and short-term health history of the patient; the treatment and/or 6 surgical history of the patient; one or more diagnostics on the condition of the 7 patient; ongoing and/or planned treatments or surgery for the patient; results 8 of one of more tests performed on the patient (e.g., blood test results, images 9 from medical imaging techniques (e.g. x-rays, MRI images, etc.), or results from any other conceivable test performed on the patient); as well as other 1! information specific to the patient such as admissions records. Due to the 12 sensitive and confidential nature of this information, access to the information 13 contained in the patient database 24 is subject to various authentication and 14 access privilege verifications, as described in further detail below.

16 Deoartrnental Database 26 18 The departmental database 26 (there may be more than one) stores 19 information related to a respective department of the hospital. For instance, the radiology department of the hospital may have its own database storing x- 21 ray images and/or images from other modalities generated as a result of tests 22 performed on patients of the hospital. Similarly, other departments of the 23 hospital, such as the cardiology, chemotherapy, physiotherapy, pharmacy, 24 emergency room, admissions, billing, maintenance, supplies, administration, kitchen, cafeteria, and any other conceivable department of the hospital, may 26 have their own databases storing information pertaining to their respective 27 nature and activities. Again, it should be understood that Fig. 1C depicts only 28 one of many possible architectures for the HIS 12 and that various other 29 architectures are possible without leaving the scope of the present invention.

For example, in a possible architecture, the HIS 12 includes multiple 31 departmental databases 26, or includes no departmental database, with all of 32 the information related to the departments of the hospital being stored in a 33 global database (not shown) of the HIS 12.

I POC server 30 3 The POC server 30 comprises suitable software, hardware and/or control logic 4 for implementing a variety of functions, including a data mining function 48, one or more application functions 50, a display formatting function 52 and a 6 session management function 53.

8 The purpose of the session management function 53 is to administrate 9 "sessions" for authenticated clinicians interacting with the HIS 12 via the various terminals 14A, 14B in the communications network 10. As will be seen 11 later on, a session established for a given clinician is basically a connection 12 between a given terminal and the HIS 12, allowing the given clinician to run 13 clinical applications at the given terminal or within the HIS 12 and to exchange 14 information with the HIS 12 via the given terminal. The given terminal is said to "support" the session for the given clinician. Administrating a session 16 involves any one or more of establishing, canceling, suspending, resuming 17 and/or changing the data rate, accessible applications and/or accessible 18 information of the session, as a function of various factors such as 19 authentication and authorization levels.

21 During the course of a session for an authenticated clinician, the clinician may 22 input certain queries, commands or responses, which are processed by the 23 session management function 53, resulting in an action such as: a request for 24 data to be read from or written to the HIS 12 (via the data mining function 48), activation of a clinical application (via the application functions 50), 26 termination or suspension of the session, etc. Data destined for the 27 authenticated clinician during a session is sent via the display formatting 28 function 52. Further detail regarding the manner in which sessions are 29 established between the HIS 12 and the terminals 14A, 14B will be provided herein below.

32 The purpose of the data mining function 48 is to retrieve from the clinician 33 database 22, the patient database 24, the departmental database 26, the 34 equipment database 35 and the external database 27, information to be made I available at the terminals 14A, 146 for sessions established between the HIS 2 12 and the terminals 14A, 146. Similarly, the data mining function 48 is also 3 operative to modify information contained in the above-mentioned databases 4 or add new information to these databases as a result of sessions established between the HIS 12 and the terminals 14A, 14B. In this way, the data mining 6 function 48 acts as a conduit between the databases 22, 24, 26, 35, 27 and 7 the clinicians 20.

9 The purpose of the one or more application functions 50 is to run various applications that may be required to process information exchanged in the 11 course of sessions established between the HIS 12 and the terminals 14A, 12 14B. Examples of such applications are computerized physician order entry 13 (CPOE) applications, decision information support tools (DIST), and any other 14 conceivable applications that may be required based on the nature of the various sessions that can be established between the HIS 12 and the terminals 16 14A, 14B.

18 The purpose of the display formatting function 52 is to format the information 19 to be displayed on the display of a specific one of the terminals 14A, 14B in accordance with the display capability of that display. For instance, the display 21 formatting function 52 may cause an x-ray image to be displayed in its 22 entirety and with high-resolution at one of the fixed terminals 14A having a 23 display of relatively large size and high resolution, yet may cause the same x- 24 ray image to be displayed only in part and/or with low-resolution at one of the mobile terminals 14B (e.g., a PDA) having a display of relatively small size and 26 low resolution. Knowledge of the display capability of each of the terminals 27 14A, 14B may be stored in the display formatting function 52 or may be 28 obtained from the terminals themselves during sessions between the terminals 29 14A, 14B and the HIS 12.

31 The above-mentioned functions of the POC server 30 implement a socalled 32 "thin client" or "semi-thin client" architecture, whereby the bulk of the 33 processing, such as retrieval, modification, addition, and formatting of 34 information as well as running of applications involved in sessions established I between the terminals 14A, 146 and the HIS 12, is mainly handled by the POC 2 server 30. In such an architecture, the terminals 14A, 14B basically act as 3 dependent terminals, primarily providing display and input functions.

4 Advantageously, in such an architecture, sensitive information such as information regarding the hospital's patients does not need to be stored in 6 non-volatile form at the terminals 14A, 14B during established sessions, 7 thereby inhibiting access to such sensitive information via a given one of the 8 terminals, should such be stolen or otherwise compromised. However, it is to 9 be understood that, in other examples of implementation, part or all of the processing involved in sessions established between the terminals 14A, 14B 11 and the HIS 12 may be handled by the terminals 14A, 14B.

13 Tap / Detector Subsystem (TDS) 16 The TDS 16 basically includes a system of tags and tag detectors, with the 16 tags being attached to people (e.g., clinicians) or equipment (e.g., terminals, 17 medical devices) that are to be tracked (e.g., because they are mobile) , and 18 the detectors being attached to the entry points into the communications 19 network 10. The tags are referred to as being "wirelessly detectable", in the sense that their presence can be detected by a detector without requiring that 21 a fixed-wire connection be established between the tags and the detector.

23 As best seen in Fig. 16, the tags include a first plurality of tags 36A 24 respectively associated with the clinicians 20 and a second plurality of tags 36B respectively associated with the mobile terminals 14B. By way of specific 26 non-limiting example, the tags 36A attached to the clinicians 20 may be in the 27 form of badges clipped to, or sewn into, the clothing of the clinicians 20. As 28 for the tags 36B attached to the mobile terminals 14B, these may take the 29 form of embedded or adhesively mounted devices, Of course, other ways of associating tags 36A to clinicians 20, and associating tags 366 to mobile 31 terminals 14B, will be known to those of ordinary skill in the art and are within 32 the scope of the present invention.

34 A given tag 36A, 366 operates in such a way as to allow its location and I identity to be detected by a compatible detector. For instance, it may employ 2 a brief radio frequency signal that encodes an identifier of the given tag 36A, 3 36B, hereinafter referred to as a "tag ID" 58. Without being interpreted as a 4 limitation of the present invention, the tags 36A, 36B can be active (i. e. the tag frequently or periodically emits a signal), semi-active (i.e. the tag emits a 6 signal only in response to receiving another signal), or passive (i.e. the tag 7 only reflects a received signal). The decision to use active, semi- active or 8 passive tags depends on various factors such as the required range, precision, 9 and power consumption / battery lifetime / weight considerations. Also, other technologies may be used without departing from the scope of the present 11 invention, such as acoustical, ultrasonic, optical, infrared, etc. As a non- 12 limiting example, one may use the UWB precision location receivers and tags 13 from Multispectral Solutions, Inc. of Germantown, Maryland, USA.

The detectors include a first plurality of detectors 34A respectively associated 16 with the fixed-wire terminals 14A and a second plurality of detectors 34B 17 respectively associated with the mobile terminals 14B. The detectors 34A, 18 34B detects aspects of the location of the tags 36A, 36B as well as the tag ID 19 58. For instance, with detectors and tags utilizing RF transmission technologies, and depending on the type of tag used, each of the detectors 21 34A, 34B may include either a receiver for receiving radio frequency signals 22 emitted by active tags, or both a transmitter for emitting radio frequency 23 pulses and a receiver for receiving radio frequency signals emitted (or 24 reflected) by semi-active (or passive) tags in response to the emitted radio frequency pulses.

27 As shown in Fig. lB (which can be viewed as an overlay onto Fig. 1A), 28 detectors 34A are connected to the controller 18 via communication links 56A.

29 Since detectors 34A are associated with the fixed terminals 14A, it may prove economical or efficient to use the same physical medium for communication 31 links 57A and 56A. Similarly, detectors 34B are connected to the controller 18 32 via communication links 56B that may include wireless portions. Since 33 detectors 34B are associated with the mobile terminals 14B, it may prove 34 economical or efficient to use the same physical medium for communication I links 57B and 56B. However, this is not a requirement of the present 2 invention.

4 Moreover, it is noted that in the case of detectors 346, the associated mobile terminals 14B are also associated with the tags 36B as indicated above.

6 Hence, in some embodiments, it may prove economical or efficient to equip 7 each mobile terminal 14B with a single radio-frequency device that 8 incorporates an individual detector 34B as well as the associated tag 36B.

9 However, this is not a requirement of the present invention.

11 In view of the above, it will be apparent that the detectors 34A, 34B receive 12 signals from one or more nearby tags 36A, 36B, detect the tag IDs 58 in the 13 received signals and communicate the tag IDs 58 to the controller 18 along a 14 set of communication links 56. The information contained in the tag ID 58 is unique for the various tags 36A, 36B. Assuming that there is a one- to-one 16 physical association between the clinicians 20 and the tags 36A, then the tag 17 ID 58 for the tag 36Aattached to a given clinician 20 can contain the clinician 18 identifier 38 of the given clinician 20. (Alternatively, if the clinician identifier 19 38 needs to be kept confidential, then the tag ID 58 can contain the clinician - specific tag ID 42 for the given clinician 20.) Similarly, if there is a one-to-one 21 physical association between the mobile terminals 14B and the tags 36B, then 22 the tag ID 58 for the tag 36B attached to a given mobile terminal 14B can 23 contain a serial number or MAC address of the given mobile terminal 14B.

In addition to detecting the tag IDs 58 in the signals received from the tags 26 36A, 366 and forwarding the tag IDs 58 to the controller 18, the detectors 27 34A, 34B generate range messages 54 indicative of the distance between the 28 tags 36A, 36B and the detectors 34A, 34B. The generation of the range 29 messages 54 can be based on the intensity of the received signals, or on the round-trip travel time of individual tag IDs. The range messages 54 may 31 contain information permitting the determination of range (distance) between 32 a given detector and a given tag, or they may reflect the result of signal 33 processing at the given detector by virtue of which it was concluded that the 34 given tag is "in proximity" to the given detector. Those skilled in the art will I appreciate that still other parameters or characteristics of a signal received at 2 a particular detector may serve as the basis to generate the range messages 3 54 for a particular tag ID 58 relative to a particular detector 34A, 346.

It should also be understood that in cases where clinicians 20 are assumed at 6 all times to be using specifically assigned mobile terminals 14B, the need for 7 separate tags 36A, 36B attached to both the clinicians 20 and the mobile 8 terminals 146 may be obviated, as long as the single tag contains the ability to 9 convey authentication data from the clinician, as may be required in order to satisfy security constraints. Rather, a single set of tags (either 36A or 36B) 11 would suffice to enable the various functions described herein.

13 It will thus be appreciated from the foregoing, as well as from portions of the 14 description to follow, that detection by a particular detector of the tag ID 58 corresponding to a particular tag may lead to a conclusion that a clinician 20 or 16 mobile terminal 14B is somewhere in the vicinity of the particular detector. In 17 the case of a suspected nearby clinician 20, this implied knowledge should be 18 confirmed by way of an authentication process, which will be described in 19 further detail in the next section.

21 Authentication Entity 28 23 The authentication entity 28 comprises suitable software, hardware and/or 24 control logic for implementing an authentication process 70, which positively confirms the clinician's identity and which manages access of the clinicians 20 26 to the HIS 12 via the terminals 14A, 14B. It should be understood that the 27 authentication entity 28 may be a separate entity or it may be integrated to 28 the controller 18 or to the POC server 30, for example.

The authentication process 70 is now described in greater detail with additional 31 reference to Figs. 2A and 2B. More particularly, at step 202, the 32 authentication entity 28 receives from the controller 18 the clinician identifier 33 of a candidate clinician 20 who needs to be authenticated. This may be 34 triggered under various conditions described later on in greater detail. Let the I clinician identifier of the candidate clinician 20 be denoted 38* and let the 2 authentication information for the candidate clinician 20 be denoted 40*.

4 The authentication process 70 then proceeds to step 204, where authentication data is requested from the candidate clinician 20. One example of 6 authentication data is a password; another example of authentication data is 7 biometric information. To this end, the badges worn by clinicians 20 may 8 optionally be enhanced with a fingerprint reader operative to generate data 9 indicative of a fingerprint of anyone (including of course the clinician himself/herself) touching the fingerprint reader. A non- limiting example of a 1 1 fingerprint reader that is adequately dimensioned to be incorporated into a 12 badge in the manner contemplated herein is the FingerLoc AF-S2 fingerprint 13 sensor manufactured by AuthenTec, Inc. Melbourne, Florida, USA, (see also 14 www.authentec.com). The fingerprint of the candidate clinician 20 would be scanned by the sensor and the results of the scan transmitted to the 16 authentication entity 28. The results of the scan may be in the form of a 17 digitized image of the fingerprint or other metrics derived from local processing 18 of the image.

Responsive to receipt of the authentication data, the authentication process 70 21 proceeds to step 206, where the authentication entity 28 communicates with 22 the clinician database 22 (via the data mining function 48) to obtain, for 23 comparison purposes, the stored authentication information 40* for the 24 candidate clinician 20. This can be done by supplying to the clinician database 22 the clinician identifier 38* of the candidate clinician 20, which was supplied 26 by the controller 18 at step 202.

28 The authentication process 70 then proceeds to step 208, where an 29 authentication result is generated. Specifically, the received authentication data is compared to the stored authentication information 40* for the 3 I candidate clinician 20 as obtained from the clinician database 22 at step 206.

32 The authentication result will be a success when there is a match and a failure 33 otherwise. At step 210, the authentication result is returned to the controller 34 18, where consequential actions are taken in a manner that will be described I in greater detail herein below.

3 It should be understood that steps 206 and 208 of the authentication process 4 70 may be replaced by a single step whereby the authentication entity 28 sends the received authentication data to the clinician database 22, prompting 6 the latter to effect the comparison with the stored authentication information 7 40* for the candidate clinician 20 and to return the authentication result to the 8 authentication entity 28. This alternative approach may be advantageous from 9 the point of view of data security, since the stored authentication information 40* for the candidate clinician 20 need not exit the clinician database 22.

12 It should also be understood that other layers of security and authentication 13 may be provided without departing from the scope of the present invention.

14 For example, the tag IDS 58 may be encrypted to prevent spoofing of the authentication information by a non-valid tag. In addition, or alternatively, the 16 tags 36A can contain memory and processing to associate a clinician's 17 biometric data (such as a fingerprint) to that tag so that authentication is 18 performed locally at the tag either in addition to, or instead of, at the 19 authentication entity 28.

21 Controller 18 23 As previously mentioned, the controller 18 is connected to the TDS 16 by the 24 communication links 56A, 56B, to the terminals 14A, 14B by the communication links 57A, 57B, as well as to the authentication entity 28 and 26 to the POC server 30. In this first system architecture, the controller 18 27 comprises suitable software, hardware and/or control logic for implementing a 28 clinician proximity monitoring process 80 that operates in the background until 29 it detects that a certain condition is satisfied, whereupon further processing operations are performed. The detailed operation of the controller 18 is now 31 described, beginning with the clinician proximity monitoring process 80.

33 Clinician Proximity Monitoring Process 80 I The clinician proximity monitoring process 80 monitors the output of the TDS 2 15 to decide when individual clinicians 20, for whom sessions have not been 3 established, are considered "in proximity" to individual ones of the terminals 4 14A, 14B. As will be described later on, being deemed "in proximity" has attributes of distance (usually less than a pre-set threshold value) and may 6 also have attributes of time/duration, since a person transiting past a location 7 has a different intent than someone remaining within a certain distance of a 8 location for a certain duration. In one embodiment, the clinician proximity 9 monitoring process 80 operates in the background until it detects that a trigger condition is satisfied, whereupon further processing operations are performed 12 With reference to Fig. 3A, it is recalled that in this first system architecture, 13 clinicians 20 are associated with tags 36A, and detectors 34A, 34B are 14 terminal-specific. In other words, a given clinician of interest (denoted 20*) being "in proximity" to a given terminal of interest (denoted 14*) amounts to 16 the tag 36A associated with clinician 20* being "in proximity" to the detector 17 34A, 34B associated with terminal 14*. The ability of the clinician proximity 18 monitoring process 80 to make decisions regarding individual clinicians 20 19 (including clinician 20*) being in proximity to terminal 14* stems from the processing of tag IDs 58 and range messages 54 received from the TDS 16.

22 The definition of "in proximity" may vary in accordance with operational 23 requirements. In one embodiment, clinician 20* being "in proximity" to 24 terminal 14* may be defined as satisfaction of a computed "proximity condition", which occurs when the estimated distance between clinician 20* 26 and terminal 14* is below a threshold distance, continuously, for at least the 27 duration of a time window. Generally speaking, a judicious choice of distance 28 and/or the distance-time relationship ensures smooth, easy attachment and 29 authentication for clinicians desirous of such events while not triggering "false starts" due to transient clinician traffic passing nearby terminal 14*. Too 31 "close" a distance threshold leads to trouble triggering a greeting 32 message/opportunity to authenticate, while too "far" a distance threshold leads 33 to triggering numerous unnecessary greeting messages, which may ultimately 34 affect existing sessions and/or core system load. Moreover, too brief a "time I window" results in increased likelihood of false "in proximity" detections, while 2 too lengthy a "time window" (say more than 1-2 seconds) will make the 3 system seem sluggish and unresponsive. Additionally, the proximity condition 4 may be variable in terms of both distance and duration - for instance a closer distance requiring a shorter time window. Of course, it is within the scope of 6 the present invention to further refine the definition of the proximity condition 7 using additional factors. For instance, such additional factors may include the 8 identity or professional role of clinician 20*, the physical location of static 9 equipment in the hospital and/or the hospital department in which terminal 14* is located.

12 Once the clinician proximity monitoring process 80 has determined that the 13 proximity condition has been satisfied for clinician 20* with respect to terminal 14 14*, the controller 18 executes a session establishment process 82, shown in Fig. ic and now described with additional reference to Figs. 3B and 3C.

17 Session Establishment Process 82 19 Although the clinician proximity monitoring process 80 has deemed clinician 20* to be in proximity to terminal 14*, his or her intent to use terminal 14* 21 has not yet been established. Accordingly, at step 302 of the session 22 establishment process 82, the controller 18 sends a command to the display 23 formatting function 52, causing the latter to display a greeting message on the 24 display of terminal 14* for clinician 20*. For instance, assuming that clinician 20* is a certain Dr. Jones, the greeting message displayed on the display of 26 terminal 14* may be "Welcome Dr. Jones. Please confirm your identity if you 27 wish to use this terminal.", or any conceivable variant thereof. It is noted that 28 since the identity of terminal 14* is considered to be known by the display 29 formatting function 52, its display capabilities will also be known a priori.

31 Meanwhile, or following execution of step 302, the controller 18 proceeds to 32 step 304, which causes execution of a preliminary processing operation in 33 anticipation of potential establishment of a session for clinician 20* between 34 the HIS 12 and terminal 14*. In a non-limiting example of a preliminary 1 processing operation, the controller 18 sends a command to the data mining 2 function 48 in the POC server 30, causing the latter to pre-fetch information 3 from the clinician database 22, the patient database 24, the departmental 4 database 26, the equipment database 35 and/or the external database 27 in anticipation of potential establishment of a session for clinician 20*.

7 In the specific non-limiting case where clinician 20* is a physician, the pre- 8 fetched information may include one or more of the profile of the physician; 9 the access privileges of the physician; a list of patients under the responsibility of the physician; information (e.g., an electronic health record 47, or a portion 11 thereof) related to one or more patients in the list of patients under the 12 responsibility of the physician; and information related to one or more patients 13 in proximity to terminal 14*.

It should be appreciated that the identity of patients in proximity to terminal 16 14* can be obtained in various ways. In one embodiment, terminal 14* is one 17 of the fixed-wire terminals 14A, and the knowledge of nearby patients is 18 obtained on the basis of information stored in the patient database 24, the 19 departmental database 26, the equipment database 35 and/or the external database 27, such as the location of terminal 14* within the hospital and the 21 location of each patient's bed within the hospital. In another embodiment, 22 each patient is provided with a tag such as a tag in the form of a bracelet worn 23 by the patient. In such an embodiment, the tag of a patient interacts with the 24 detector 34A of terminal 14* in the aforementioned manner, allowing the controller 18 to learn of the relative proximity of each patient to terminal 14*.

26 Alternatively, a standard RF-ID tag could be used, although in such an 27 embodiment, there may be limitations in terms of range that need to be taken 28 into consideration.

In addition, the information that is pre-fetched may also be organized or 31 filtered by using the clinician's location and identity. For example, the list of 32 patients for a particular physician may be sorted by those whose assigned 33 beds are nearest the particular physician.

1 The information that is pre-fetched by the data mining function 48 is kept in a 2 holding location 74 that is accessible to the session management function 53 3 but as yet inaccessible to clinician 20* deemed to be in proximity to terminal 4 14*. More specifically, the pre-fetched information will become available to clinician 20* once a session is established for clinician 20*, but such a session 6 has not yet been established because (1) the intent of clinician 20* to use 7 terminal 14* is still not known; and (2) clinician 20* has not been 8 authenticated (for example, it has not yet been confirmed that the individual 9 who is presumed to be Dr. Jones by virtue of information received from the TDS 16 really is Dr. Jones).

12 At step 306, the controller 18 continues to attempt to establish the intent of 13 clinician 20* to use terminal 14* by waiting for input from clinician 20* in 14 response to the greeting message. At this point, two basic outcomes are possible. In the first outcome, clinician 20* ignores the greeting message.

16 Accordingly, the controller 18 will detect an absence of a response for a 17 predetermined amount of time and will conclude that there is no intent by 18 clinician 20* to use terminal 14*. This leads to execution of step 308, 19 whereby a command is sent to the display formatting function 52, causing the greeting message to disappear from the display of terminal 14*. In addition, 21 the controller 18 performs step 310, which is optional, whereby a command is 22 sent to the session management function 53 to delete the pre-fetched 23 information in the holding location 74 in order to avoid potential security leaks 24 due to hacking. In an alternative embodiment, step 310 is replaced by a different series of steps, whereby the pre-fetched data may be held in the 26 holding location 74 until clinician 20* leaves the vicinity of terminal 14*, so 27 that the pre-fetched data can be delivered quickly, should clinician 20* later 28 decide, during his/her patient encounter, to initiate a session. Thus, even 29 though a session is not established for clinician 20*, it can be said that the pre-fetched data is held in trust for clinician 20*.

32 However, in the alternate outcome of step 306, clinician 20* does indeed 33 respond to the greeting message in a timely manner, e.g., by pressing a key 34 or touching the screen. This is interpreted by the controller 18 as an intent to I use terminal 14*, and leads to step 312. Specifically, the controller 18 sends 2 a message to the authentication entity comprising the clinician identifier of 3 clinician 20*, denoted 38*. Receipt of clinician identifier 38* by the 4 authentication entity 28 triggers the authentication process 70 previously described with reference to Figs. 2A and 2B, which typically involves the 6 submission of authentication data 40* by clinician 20* (e.g., via a fingerprint 7 reader).

9 In an alternative embodiment, steps 302 and/or 312 may be omitted. For example, without having executed step 302, the controller 18 proceeds to step 11 304, which causes execution of a preliminary processing operation in 12 anticipation of potential establishment of a session for clinician 20* between 13 the HIS 12 and terminal 14*. At this point, without having displayed a 14 greeting message, the controller 18 is attentive to clinician 20* requesting a session by touching a fingerprint reader on clinician 20*'s badge. This will be 16 interpreted by the controller 18 as an intent to use terminal 14* as well as a 17 submission of authentication data 40* by clinician 20*. In other words, steps 18 302 and 312 can be omitted if the mere fact that authentication data is 19 submitted by clinician 20* serves to confirm the intent of clinician 20* to use terminal 14*. Hence, the use of greetings is not required. Of course, whether 21 or not a greeting message is used is a design consideration, and both 22 approaches are to be considered as being within the scope of the present 23 invention.

In either case, at step 314, the controller 18 receives an authentication result 26 from the authentication entity 28. If the authentication result is a failure, then 27 clinician 20* may be allowed to make one or more additional attempts to 28 authenticate himself or herself in accordance with security policies in effect.

29 However, if authentication fails each time, then clinician 20* is denied access to the information contained in the HIS 12, i.e. no session is established for 31 clinician 20*. Specifically, at step 316, the controller 18 sends a command to 32 the display formatting function 52, causing a change in the display of terminal 33 14* (e.g., blank screen). In addition, the controller 18 performs step 318, 34 whereby a command is sent to the session management function 53 to delete I the pre-fetched information in the holding location 74 in order to avoid 2 potential security leaks due to hacking.

4 On the other hand, the authentication result may be a success, in which case the controller 18 proceeds to step 320, where additional processing is 6 performed in order to effect establishment of a session for clinician 20*.

7 Specifically, the controller 18 sends a message to the session management 8 function 53 in the POC server 30, which indicates to the session management 9 function 53 that the clinician who is deemed to be at terminal 14* is permitted to access the pre-fetched information in the holding location 74 as well as 11 possibly other information in the HIS 12. With specific reference to Fig. 3C, 12 the session management function 53 establishes a connection 350 between 13 the HIS 12 and terminal 14*, allowing clinician 20* to exchange information 14 with the HIS 12 via terminal 14*. The connection 350 is hereinafter referred to as a "session", while terminal 14* is said to "support" the session 350 for 16 clinician 20*.

18 It will thus be appreciated that establishment of the session 350 for clinician 19 20* at terminal 14* has been facilitated by (1) preparing information in anticipation of the intent of clinician 20* to use terminal 14*, thereby reducing 21 the real-time computational load of the POC server 30 and other elements of 22 the HIS 12; and (2) simplifying the log-in procedure for clinician 20* to a 23 "confirmation of identity" procedure, whereby clinician 20* is simply required 24 to provide data for his or her authentication; this can advantageously be done by clinician 20* touching a fingerprint reader on his or her badge.

27 It should also be understood that, in some situations, two or more clinicians 20 28 may be in proximity to terminal 14* at a given instant. In those situations, 29 the controller 18 may then cause the POC server 30 to pre-fetch information related to each one of the nearby clinicians 20 in anticipation of potential 31 establishment of a session for one or more of these individuals at terminal 32 14*. In cases where more than one of the nearby clinicians 20 simultaneously 33 wish to use terminal 14*, the controller 18 may effect establishment and 34 management of a session for a given one of those individuals based on a "first 1 to authenticate" basis or based on an access priority for each one of those 2 individuals (e.g. the access privileges of the nearby clinicians 20 may specify 3 that one, e.g., a doctor, has access priority over the other, e.g., a nurse, etc.).

nduct Session Process 84 7 Once the session 350 is established, the controller 18 enters a "conduct 8 session" process 84 for the session 350, which is transparent to most of the 9 goings on between clinician 20* and the session management function 53. For example, the conduct session process 84 transparently allows the session 11 management function 53 to implement a graphical user interface (GUI) that 12 presents information and applications available for use by clinician 20* during 13 the session 350. Of course, the actual display of information on terminal 14* 14 will continually be formatted by the display formatting function 52 in accordance with the display capabilities of terminal 14*.

17 During the session 350, clinician 20* may perform a variety of activities 18 leading to any one of the following non-limiting example scenarios A- through 19 D-.

21 A- PROVIDE TRADITIONAL POINT-OF-CARE SERVICES 23 Consider the case where clinician 20* is a physician and terminal 14* is a 24 fixed-wire terminal near the bed of a particular patient. In this scenario, the physician accesses one of the application functions 50, which allows the 26 physician to retrieve information from, or add observations and diagnostic 27 information to, the electronic health record 47 of the patient, order a certain 28 treatment or test to be given to the patient, use various application functions 29 50 such as decision information support tools (DIST), etc. 31 B- PERFORM LOCATION-BASED POINT-OF-CARE FUNCTIONS 33 Consider the case where terminal 14* is a mobile terminal, such as a PDA, 34 which has inferior display capabilities to those required for a particular function 1 (e.g., viewing X-ray images). In this scenario, clinician 20* accesses a 2 location-based POC function (e.g., one of the application functions 50 in the 3 POC server 30, or a separate function in the controller 18) which informs 4 clinician 20* of the nearest available terminal having the required display capabilities.

7 Specifically, the indication provided by location-based POC function can be 8 based on knowledge of the particular communications link 57B and WLAN 9 access point 60 that the PDA (i.e., terminal 14*) is using to communicate with the POC server 30, thereby allowing a list of terminals in the "coverage zone" 11 of the WLAN access point 60 (or of a plurality of WLAN access points) to be 12 identified. Combined with knowledge at the POC server 30 of which of the 13 terminals in the list are available for use, the capabilities of these terminals 14 and the display quality required by the image to be viewed, this allows identification of the nearest available terminal having the required display 16 capability. Let this nearest available terminal be denoted 14+. As a possible 17 option, the location-based POC function may allow clinician 20* to "reserve" 18 terminal 14+ for a short period of time, say 2 minutes (to cover the estimated 19 walking time of clinician 20* to reach terminal 14+).

21 C- EXPLICITLY TERMINATE THE SESSION 23 Consider the case where clinician 20* wishes to terminate the session 350. In 24 this scenario, clinician 20* interacts with the session management function 53 to perform a log-off procedure to terminate the session 350. For example, this 26 can be effected by entering a log-off command at terminal 14*, e.g., by 27 clicking on a log-out icon on the display of terminal 14*. This command is 28 detected by the session management function 53 which, in response, sends a 29 command to the display formatting function 52, causing a change in the display of terminal 14* (e.g., blank screen). In addition, the session 31 management function 53 deletes session-related information it may have 32 stored (such as pre-fetched information in the holding location 74).

34 D- EXPLICITLY SUSPEND THE SESSION

I

2 Consider the case where clinician 20* wishes to suspend the session 350 for 3 various reasons (e.g., snack break, migration to another terminal, etc.) . In 4 this scenario, clinician 20* interacts with the session management function 53 to trigger a session suspend process to suspend the session 350. For example, 6 this can be effected by entering a suspend command at terminal 14*, e.g. , by 7 clicking on a suspend icon on the display of terminal 14*. This command is 8 detected by the session management function 53 which, in response, sends a 9 command to the display formatting function 52, causing a change in the display of terminal 14* (e.g., blank screen). However, the session 11 management function 53 does not delete session-related information, since the 12 session may be resumed by clinician 20* at a later time in a variety of ways.

14 If the session 350 remains suspended for a considerable length of time (e.g., beyond a certain threshold such as 10 minutes) without having been resumed 16 in one of the variety of ways alluded to above, then the session suspend 17 process in the session management function 53 may autonomously terminate 18 the session 350, which will result in deletion of session-related data such as 19 the pre-fetched data in the holding location 74.

21 Although it is transparent for most of the activities conducted during the 22 session 350, the conduct session process 84 nevertheless continues to monitor 23 the information from the TDS 16 in order to detect certain conditions of 24 clinician-terminal proximity and terminal-terminal proximity. Specifically, during the session 350, clinician 20* may perform a variety of activities in 26 addition to the above, which may lead to one of the following non- limiting 27 example scenarios E- through G-.

29 E- MOVE AWAY FROM TERMINAL 14* 31 Consider the case where clinician 20* leaves the vicinity of terminal 14* 32 without having terminated or suspended the session 350. One situation in 33 which this may occur is when clinician 20* has identified (or has been directed 34 to) a nearby terminal with superior display capabilities (see B- above) and I heads towards that terminal. Another situation in which this may occur is 2 whenclinician 20* simply forgets to terminate or suspend the session 350.

4 In each of these and myriad other example scenarios, the conduct session process 84 will detect, using the data available from the TDS 16, that clinician 6 20* is no longer within a certain distance of terminal 14*. More generally, 7 clinician 20* can be said to satisfy a computed "remoteness condition".

8 However, it is not yet clear whether clinician 20* did or did not intend to 9 terminate the session. Thus, instead of terminating the session immediately, the conduct session process 84 causes the session to be suspended by causing 11 the session management function 53 to autonomously execute the Session 12 suspension process (see D- above).

14 Clearly, the autonomous suspension of the session 350 based on deeming clinician 20* to have left the vicinity of terminal 14* reduces the potential of 16 confidential information being viewed at terminal 14* by a patient, passerby or 17 unauthorized clinician, as well as reduces the possibility of undesired access to 18 the HIS 12 via terminal 14* without having clinician 20* nearby. The overall 19 effect is an increase in the security of the HIS 12 and the information contained therein.

22 F- APPEAR IN PROXIMITY TO A TERMINAL (WITH PREVIOUSLY 23 SUSPENDED SESSION) Consider the case where the session 350 has been suspended as described 26 herein above (e.g., either by explicit action on the part of clinician 20* or 27 autonomously as a result of clinician 20* having left the vicinity of terminal 28 14*). In addition, clinician 20* approaches a terminal, denoted 14+, which 29 may or may not be the same terminal 14* as the one previously used by clinician 20* at the time the session 350 was suspended. The conduct session 31 process 84 will detect, using the data available from the TDS 16, that clinician 32 20* is in proximity to terminal 14+. This triggers a session resumption 33 process, now described with reference to Fig. 4.

I At this stage, it is not yet known whether clinician 20* intends to use terminal 2 14+. Thus, the conduct session process 84 begins by establishing the intent of 3 clinician 20* to access the HIS 12 at terminal 14+. Specifically, at step 402, 4 the conduct session process 84 sends a command to the display formatting function 52, causing the latter to display a greeting message on the display of 6 terminal 14+. Since the session 350 is in a suspended state, the greeting 7 message may be adapted to reflect this fact. For instance, assuming that 8 clinician 20* is still presumed to be Dr. Jones, the greeting message displayed 9 on the display of terminal 14+ may be "Welcome Dr. Jones. P/ease confirm your identity if you wish to resume your session at this terminal. ", or any 11 conceivable variant thereof. It is noted that since the identity of terminal 14+ 12 is considered to be known a priori by the display formatting function 52, its 13 display capabilities will also be known. Of course, if terminal 14+ is different 14 from terminal 14*, its display capabilities may be different as well. This leads to the advantageous situation where the information displayed to clinician 20* 16 is tailored to the terminal in use.

18 Meanwhile, or following execution of step 402, the controller proceeds to step 19 404, where a preliminary processing operation is caused to take place. In a non-limiting example of a preliminary processing operation, the conduct 21 session process 84 causes a command to be sent to the data mining function 22 48 in the POC server 30, causing the latter to pre-fetch information from the 23 clinician database 22, the patient database 24, the departmental database 26, 24 the equipment database 35 and/or the external database 27. Now, it is recalled that the session 350 for clinician 20* has been suspended. Hence, 26 portions of the preliminary processing operation that would otherwise be 27 required are not needed.

29 Specifically, in the case where clinician 20* is a physician, the prefetched information which is already in the holding location 74 due to the session 350 3! having been previously established may include one or more of the profile of 32 the physician; access privileges of the physician; a list of patients under the 33 responsibility of the physician; and information (e.g., an electronic health 34 record 47, or a portion thereof) related to one or more patients in the list of I patients under the responsibility of the physician. Thus, the preliminary 2 processing operation performed at step 404 can be limited to other information 3 specifically related to terminal 14+. For example, this information may relate 4 to one or more patients in proximity to terminal 14+. (If terminal 14+ is the same as terminal 14*, then even this last piece of information does not need 6 to be pre-fetched during execution of step 404.) 8 The information that is pre-fetched by the data mining function 48 during step 9 404 is added to the other information in the holding location 74 that is accessible to the session management function 53 but as yet inaccessible to 11 clinician 20*. More specifically, the pre-fetched information will become 12 available to clinician 20* once the session 350 is resumed, but it is not yet 13 appropriate to resume the session 350 because (1) the intent of clinician 20* 14 to use terminal 14+ is not known; and (2) clinician 20* has not been authenticated (in this example, it has not yet been confirmed that the 16 individual who is presumed to be Dr. Jones by virtue of information received 17 from the TDS 16 really is Dr. Jones).

19 From this point on, the remainder of the steps performed by the conduct session process 84 are similar, although sometimes not identical, to steps 306- 2! 320 described previously with reference to Fig. 3A. At step 406, the conduct 22 session process 84 continues to attempt to establish the intent of clinician 20* 23 to use terminal 14+ by waiting for input from clinician 20* in response to the 24 greeting message. At this point, two basic outcomes are possible. In the first outcome, clinician 20* ignores the greeting message. Accordingly, the conduct 26 session process 84 will detect an absence of a response for a predetermined 27 amount of time and will conclude that there is no intent by clinician 20* to use 28 terminal 14+. This leads to execution of step 408, whereby a command is 29 sent to the display formatting function 52, causing the greeting message disappear from the display of terminal 14+. However, no command is issued 31 to cause deletion of the pre-fetched information in the holding location 74, 32 since there is an underlying assumption that clinician 20* will eventually wish 33 to resume the session 350, although perhaps not at terminal 14+. Rather, 34 deletion of pre-fetched information related to the suspended session 350 may 1 occur for other reasons, such as the amount of time during which the session 2 350 has been suspended (see Dabove).

4 When clinician 20* does indeed respond to the greeting message in a timely manner, e.g., by pressing a key or touching the screen, this is interpreted by 6 the conduct session process 84 as an intent to use terminal 14+, and leads to 7 step 412. Specifically, the conduct session process 84 causes a message to be 8 sent the authentication entity 28, comprising the clinician identifier 38* of 9 clinician 20*. Receipt of the clinician identifier 38* by the authentication entity 28 triggers the authentication process 70 previously described with reference 11 to Figs. 2A and 2B, which typically involves the submission of authentication 12 data by clinician 20* (e.g., via a fingerprint reader). It should be understood 13 that step 412 can be omitted if the submission of authentication data (e.g., 14 touching the fingerprint reader) is itself used to confirm one's intent to use terminal 14+.

17 In either case, at step 414, the conduct session process 84 receives an 18 authentication result from the authentication entity 28. If the authentication 19 result is a failure, then clinician 20* may be allowed to make one or more additional attempts to authenticate himself or herself in accordance with 21 security policies in effect. However, if the authentication result is a failure 22 each time, then clinician 20* is denied access to the information contained in 23 the HIS 12, i.e. the session 350 is not resumed. In fact, the conduct session 24 process 84 may go so far as to cause termination of the suspended session 350 by issuing a command at step 416. This command is detected by the 26 session management function 53 which, as previously described (see C- 27 above), sends a command to the display formatting function 52, causing a 28 change in the display of terminal 14* (e.g., blank screen) and deletes session29 related information it may have stored (such as pre-fetched information in the holding location 74).

32 On the other hand, the authentication result may be a success, which leads to 33 resumption of the session 350 for clinician 20*. Specifically, at step 420, the 34 conduct session process 84 causes a message to be sent to the session I management function 53 in the POC server 30, which indicates to the session 2 management function 53 that the clinician deemed to be at terminal 14+ 3 should be permitted to regain access to the pre-fetched information in the 4 holding location 74 as well as other information in the HIS 12. The session management function 53 then establishes a new connection, this time between 6 the HIS 12 and terminal 14+, allowing clinician 20* to exchange information 7 with the HIS 12 and perform the various other functions referred to above.

8 The new connection represents a resumed version of the once suspended 9 session 350, and is now supported by terminal 14+.

11 It will thus be appreciated that resumption of a session for clinician 20* at 12 terminal 14+ has been facilitated by (1) relying on pre-fetched information in 13 anticipation of the clinician's intent to use terminal 14+, thereby reducing the 14 real-time computational load of the POC server 30 and other elements of the HIS 12; and (2) simplifying the re-log-in procedure for clinician 20* to a 16 "confirmation of identity" procedure, whereby clinician 20* is simply required 17 to provide data for his or her authentication; this can advantageously be done 18 by touching a fingerprint reader on his or her badge.

G- APPEAR IN PROXIMITY TO A NEW TERMINAL 14+, ACCOMPANIED 21 BY TERMINAL 14* (WHICH CONTINUES TO SUPPORT AN ONGOING 22 SESSION) 24 With reference to Fig. 5A, consider the case where clinician 20* approaches a new terminal, denoted 14+, while a session 550 is ongoing between the HIS 26 12 and terminal 14*. One situation in which this may occur is when clinician 27 20* is a physician communicating with the HIS 12 through the physician's PDA 28 (in this case terminal 14* which supports the session 550) and the physician 29 wishes to view certain information on a fixed terminal with advanced display capabilities (in this case terminal 14+ which is being approached) . Of course, 31 it should be understood that the following description also applies to the case 32 where the terminal being approached (i.e., terminal 14+) is a mobile terminal.

34 Based on data available from the TDS 16, the conduct session process 84 3' I detects that terminal 14* is in proximity to terminal 14+. This causes the 2 conduct session process 84 to trigger a live session transfer process, now 3 described with reference to the flowchart in Fig. 5B. Specifically, at step 502, 4 the conduct session process 84 causes a command to be sent to the display formatting function 52, which causing the latter to display a greeting message 6 on the display of terminal 14+ for clinician 20*. For instance, assuming that 7 clinician 20* is Dr. Jones, the greeting message displayed on the display of 8 terminal 14+ may be "Welcome Dr. Jones. Please confirm your desire to 9 transfer your session to this terminal. ", or any conceivable variant thereof. It is noted that since the identity of terminal 14+ is known to the display 11 formatting function 52, its display capabilities will also be known.

13 Meanwhile or following execution of step 502, the conduct session process 84 14 executes step 504, whereby a preliminary processing operation is performed.

In a non-limiting example of a preliminary processing operation, the conduct 16 session process 84 causes a command to be sent to the data mining function 17 48 in the POC server 30, causing the latter to pre-fetch information from the 18 clinician database 22, the patient database 24, the departmental database 26, 19 the equipment database 35 and/or the external database 27. However, it is recalled that the session 550 for Dr. Jones is ongoing between the HIS 12 and 21 terminal 14*. Therefore, certain elements of the preliminary processing 22 operation that would otherwise be required are not needed.

24 For example, where clinician 20* is a physician, the information which is already in the holding location 74 by virtue of prior establishment of the 26 session 550 includes one or more of: the profile of the physician, access 27 privileges of the physician, a list of patients under the responsibility of the 28 physician, and information (e.g., an electronic health record 47, or a portion 29 thereof) related to one or more patients in the list of patients under the responsibility of the physician. Thus, the preliminary processing operation 31 performed at step 504 can be limited to pre-fetching additional information 32 specifically related to terminal 14+, such as information relating to the patients 33 that may find themselves near terminal 14+.

1 Generally speaking, at this stage, the information in the holding location 74 2 pertains to two terminals that are related to one another by a common 3 clinician 20* and a common session 550. One of these terminals is the one 4 with which clinician 20* had an ongoing session before approaching the other.

Thus, one of these terminals can have the status of a "session transferor" and 6 the other can have the status of a "session transferee". In this example, 7 terminal 14* is the session transferor and terminal 14+ is the session 8 transferee. Moreover, each of the terminals is associated with a session page 9 delivery indicator that indicates which "pages" of the session 550 are currently being supported by that terminal. At this stage in the live session transfer 11 process, the session transferor supports the entirety of the session 550 and 12 the session transferee does not yet support any of the session 550.

14 In order to help keep track of which terminal is the session transferor and which terminal is the session transferee for a variety of sessions, the controller 16 18 may store a table 85 that is accessible to the conduct session process 84.

17 The table 85, which can be stored in the controller 18 or elsewhere, may 18 resemble the following (for the as yet untransferred session 550). Note that 19 terminal 14+ does not yet have the knowledge that it is about to have certain pages of the session 550 transferred to it: Terminal Session Status Pages 14* 550 Transferor All L14 N/A N/A None 23 Next, the conduct session process 84 proceeds to establish the intent of 24 clinician 20* to transfer at least a portion (e.g., certain pages) of the session 550 from terminal 14* (the session transferor) to terminal 14+ (the session 26 transferee). Thus, at step 506, the conduct session process 84 waits for input 27 from clinician 20* in response to the greeting message. At this point, two 28 basic outcomes are possible. In the first outcome, clinician 20* ignores the 29 greeting message. Accordingly, the conduct session process 84 will detect an absence of a response for a predetermined amount of time and will conclude 31 that there is no intent by clinician 20* to transfer any pages of the session 550 I to terminal 14+. This leads to execution of step 508, whereby a command is 2 sent to the display formatting function 52, causing the greeting message 3 disappear from terminal 14+. However, no command is issued to cause 4 deletion of the pre-fetched information in the holding location 74, since the session 550 is still ongoing between clinician 20* and terminal 14*. Thus, 6 operation of terminal 14* (the session transferor) remains unaffected.

8 In the other possible outcome, clinician 20* responds to the greeting message 9 in a timely manner to signal an intent to transfer at least a portion (e.g., some pages) of the session 550 to terminal 14+ or to resume a given session at a II given point or page. This can occur in the various ways previously described, 12 such as a pressing a key or touching the screen of terminal 14+.

14 In addition, the response provided by clinician 20* may indicate the pages of the session 550 that are to be transferred (e.g., the entire session, only 16 visualization of images, etc.) to the session transferee. Alternatively, the 17 portion of the session 350 to be transferred to terminal 14+ may be 18 established by the application context. For example, if clinician 20* has 19 requested an X-ray image on his/her PDA (terminal 14*) and the application has noted the unsuitability of the PDA display and has directed clinician 20* to 21 a terminal that does have a suitable display, then the application can remain in 22 control of displaying the X-ray image on the high quality terminal (terminal 23 14+), once clinician 20* is authenticated as being at that terminal.

Another way in which clinician 20* can signal an intent to transfer at least a 26 portion of the session 550 to terminal 14+ is by bringing terminal 14* closer to 27 terminal 14+ than what initially caused the conduct session process 84 to 28 deem that terminal 14* was "in proximity" to terminal 14+. Generally, this 29 can be referred to causing terminal 14* to satisfy a computed "terminal proximity condition" with respect to terminal 14+. The terminal proximity 31 condition may be defined by a different distance-time relationship than the 32 "proximity condition" defined earlier. Of course, it is within the scope of the 33 present invention to further refine the definition of the terminal proximity 34 condition using additional factors. For instance, such additional factors may I include the type of terminal 14* and the type of terminal 14+.

3 The conduct session process 84 therefore monitors the data available from the 4 TDS 16 to detect whether terminal 14* has indeed satisfied the terminal proximity condition relative to terminal 14+. If this is the case, then the 6 conduct session process 84 concludes that clinician 20* intends to transfer at 7 least a portion of the session 550 to terminal 14+. Whether the session is 8 fully or partly transferred is a design consideration, and may further be made 9 selectable (e.g., by requiring user input via a keyboard or by requiring that terminal 14* be moved so as to satisfy a computed "terminal remoteness II condition" and then moved again to satisfy the terminal proximity condition 12 within a predetermined amount of time, such as 5 seconds, etc.).

14 Yet another way in which clinician 20* can signal an intent to transfer at least a portion of the session 550 to terminal 14+ is by submitting biometric data 16 (e.g., the transmittal of which is triggered by touching a fingerprint reader on 17 a badge) in the absence of a request for authentication.

19 Whether the session 550 is fully or partly transferred is a design consideration, and may further be made selectable (e.g., by requiring user input via a 21 keyboard or by requiring that biometric data be resubmitted several times in a 22 given sequence). Alternatively, the pages to be transferred may be 23 established by the session application function 50. In either case, the conduct 24 session process 84 learns of a desired portion of the session 550 to be transferred from the session transferor to the session transferee.

27 Once the intent of clinician 20* to transfer certain desired pages the session 28 from terminal 14* to terminal 14+ has been confirmed, the conduct session 29 process 84 proceeds transfer the desired portion of the session 550 for clinician 20* from terminal 14* to terminal 14+. Specifically, the conduct 31 session process 84 causes a message to be sent to the session management 32 function 53 in the POC server 30, thereby indicating to the session 33 management function 53 which portion of the session 550 is now to be 34 conducted with terminal 14+ and which portion is no longer to be conducted I by terminal 14+.

3 Meanwhile, terminal 14* of course remains the "session transferor" and 4 terminal 14+ remains the "session transferee". However, the session page delivery indicator for these two terminals will change under the control of the 6 session management function 53. This change is reflected in the table 85 7 stored in the controller 18, which may now resemble the following: flfrninal Session Status Pages 550 Transferor All except pages __________ __________ __________ A..N 550 Transferee A..N Thus, with reference to Fig. 5C, the session 550, which previously existed only 11 between the HIS 12 and terminal 14*, now exists either between the HIS 12 12 and terminal 14+ alone, or has a first portion that exists between the HIS 12 13 and terminal 14+ in addition to a remaining portion that exists between the 14 HIS 12 and terminal 14*.

16 Clinician 20* can then perform a number of tasks during the session 550 while 17 using terminal 14+ (and possibly also terminal 14*). Moreover, clinician 20* 18 may continue conducting the session 550 with terminal 14+ as long as 19 necessary, after which point there are a number of possibilities, each of which is now discussed.

22 First Possibility (ExDlicit Transfer Of Session) 24 Under a first possibility, with reference to Fig. 5D, clinician 20* explicitly signals an intent to transfer the session 550 back to terminal 14*. For 26 example, clinician 20* may click on an appropriate "transfer back" icon on the 27 display of terminal 14+ (or terminal 14*). Alternatively, clinician 20* will 28 cause terminal 14* to re-satisfy the "terminal proximity condition" (with 29 respect to terminal 14+). In either case, an intent to transfer the session 550 back to the session transferor, i.e., terminal 14*, has been signaled by clinician 1 20*.

3 Clinician 20*'s intent to transfer the session 550 is detected by the conduct 4 session process 84, which causes a message to be sent to the session management function 53 in the POC server 30, indicating to the session 6 management function 53 that the session 550 is no longer to be conducted 7 with terminal 14+. In response, the session management function 53 sends a 8 command to the display formatting function 52, causing a change in the 9 display of terminal 14+ (e.g., blank screen). However, the session management function 53 does not delete session-related information, since the 11 session 550 continues to be conducted with terminal 14*.

13 In addition, the session page delivery indicator for terminal 14* and terminal 14 14+ will change under the control of the session management function 53.

This change is reflected in the table 85 stored in the controller 18, which may 16 now resemble the following: flminai Session Status Pages 550 Transferor All 550 Transferee None 19 As long as clinician 20* and terminal 14* remain in proximity to terminal 14+, the session 550 can continue to be transferred back and forth between the 21 two terminals as described above. If the session 550 is explicitly transferred 22 back to terminal 14*, and clinician 20* then moves away from terminal 14+, 23 this is detected by the conduct session process 84. The conduct session 24 process 84 then informs the session management function 53, which modifies the above to indicate that terminal 14+ has lost its status as "session 26 transferee" for the session 550. At this point, terminal 14+ will be treated like 27 any other terminal in the communications network 10.

29 Second Possibility (Mobility Scenario I) 31 Under a second possibility, with reference to Fig. 5E, clinician 20* takes 1 terminal 14* and moves away from terminal 14+ without having explicitly 2 transferred the session 550 back to terminal 14* before his or her departure 3 from terminal 14+. In other words, clinician 20* remains in proximity to 4 terminal 14* but not in proximity to terminal 14+. This is detected by the conduct session process 84 as satisfaction of a computed "terminal remoteness 6 condition". The conduct session process 84 then takes the necessary actions 7 to autonomously effect a transfer the session 550 back to terminal 14*. This 8 can be referred to, from the session 550's point of view, as "snapping back" to 9 the session transferor (i.e., terminal 14*).

11 Specifically, the conduct session process 84 causes a message to be sent to 12 the session management function 53 in the POC server 30, indicating to the 13 session management function 53 that the session 550 is no longer to be 14 conducted with terminal 14+. In response, the session management function 53 sends a command to the display formatting function 52, causing a change 16 in the display of terminal 14+ (e.g., blank screen). This eliminates the risk of 17 displaying sensitive data on the display of terminal 14+. However, the session 18 management function 53 does not delete session-related information from the 19 holding location 74, since the session 550 continues to be conducted with terminal 14*.

22 In addition, the session management function 53 modifies the aforementioned 23 table 85 to indicate that terminal 14+ has lost its status as "session 24 transferee" for the session 550, and also modifies the table 85 to indicate that the full session is supported by terminal 14*. From this point, terminal 14+ is 26 treated like any other terminal in the communications network 10.

28 Third Possibility (Mobility Scenario II) The third possibility is similar to the second possibility, in that clinician 20* 31 moves away from terminal 14+ without having explicitly transferred the 32 session 550 back to terminal 14* before his or her departure from terminal 33 14+. However, in this case and with reference to Fig. 5F, clinician 20* is 34 unaccompanied by terminal 14*. In other words, clinician 20* remains is no 1 longer in proximity to either terminal 14* or terminal 14+. This is detected by 2 the conduct session process 84, which then takes the necessary actions to 3 transfer the session 550 back to the session transferor, but to immediately 4 follow by suspending the session 550.

6 Specifically, the conduct session process 84 causes a message to be sent to 7 the session management function 53 in the POC server 30, indicating to the 8 session management function 53 that the session 550 is no longer to be 9 conducted with terminal 14+. In response, the session management function 53 sends a command to the display formatting function 52, causing a change 11 in the display of terminal 14+ (e.g., blank screen). This eliminates the risk of 12 displaying sensitive data on the display of terminal 14+. Accordingly, the 13 session management function 53 modifies the aforementioned table 85 to 14 indicate that terminal 14+ has lost its status as "session transferee" for the session 550, and also modifies the table 85 to indicate that the full session is 16 supported by terminal 14*. From this point, terminal 14+ is treated like any 17 other terminal in the communications network 10.

19 In addition, the conduct session process 84 suspends the session 550 by autonomously executing the session suspend process for terminal 14* (see E- 21 above), since clinician 20* is deemed to have moved away from terminal 14*.

23 Fourth Possibility (Mobility Scenario 1111 Under a second possibility, with reference to Fig. 5G, terminal 14* (which is 26 the session transferor for the session 550) leaves the vicinity of both clinician 27 20* and terminal 14+. Such a scenario may arise if clinician 20*'s PDA is lent 28 to a co-worker or is carried away while clinician 20* is viewing a large-screen 29 display on terminal 14+ (the session transferee). 31 It is noted that this scenario actually amounts to the equivalent of

clinician 20* 32 moving away from terminal 14* and satisfying a remoteness condition, which 33 is covered by E- above. Specifically, in accordance with E- above, the 34 conduct session process 84 would send a message to the session management I function 53, causing the latter to execute the session suspend process for 2 terminal 14*. Additionally, in view of Fabove, because clinician 20* is still in 3 proximity to terminal 14+, clinician 20* would then immediately be asked if he 4 or she wishes to resume the now suspended session at terminal 14+ (see F- above).

7 Now, although the above actions have the desirable effect of preventing a 8 security breach from arising, there may be a disruption to the activities taking 9 place at terminal 14+. To avoid such a disruption, an additional layer of complexity may be added to E- and F- above. Specifically, instead of 11 suspending the session 550 and then asking clinician 20* if he or she wishes to 12 resume the session 550, the session 550 can simply be transferred to terminal 13 14+, provided that terminal 14+ is the session transferee for the session 550 14 (which, in this case, it is).

17 2. SECOND SYSTEM ARCHITECTURE 19 In the first system architecture, advantageous use was made of the knowledge that individual clinicians and mobile terminals were in proximity to individual 21 fixed-wire of mobile terminals. This enabled various functions related to 22 establishment and management of sessions with the HIS 12. The second 23 system architecture enables these same functions, in addition to a variety of 24 other functions that make advantageous use of the position (or location) of individually "tagged" clinicians and equipment (e.g., terminals or medical 26 devices) within an overall "location-awareness area" in the hospital. These 27 include: 29 - communication with clinicians based depending on their deemed availability; 31 - assembling a team of clinicians in response to a medical emergency 32 occurring at a given location in the hospital; 33 - tracking of equipment associated with individual clinicians to detect 34 suspicious movement of such equipment; 1 - preventative control of communications devices when found to be in 2 proximity of sensitive medical devices.

4 The second system architecture differs from the first one in that: - an array of detectors is established across the entire location- awareness 6 area, which may be the overall campus or a significant portion thereof; and 7 - the absolute location of tagged clinicians and equipment (e.g., terminals 8 and medical devices) is detected, calculated and tracked.

From the location and tracking of absolute coordinates of tags, relative to the 11 building spatial grid, the distance between two tag-bearing people or pieces of 12 equipment can be calculated and from a history of these distance calculations, 13 it can be determined whether a given proximity or remoteness constraint is 14 satisfied.

16 Accordingly, Figs. 6A and 6B (which should be considered overlaid onto one 17 another) show a conceptual view of a communications network 610 of a 18 healthcare establishment, in accordance with a second example of 19 implementation of the present invention. Again, for ease of reading, the healthcare establishment will hereinafter be referred to as a hospital, but it 21 should be understood that the healthcare establishment may be of any size 22 and may generally consist of a single building or a campus including one Or 23 more buildings or pavilions and possibly one or more adjacent areas such as 24 roads and parking lots.

26 A plurality of fixed terminals 14A and a plurality of mobile terminals 14B serve 27 as entry points to the communications network 610. The terminals 14A, 14B 28 are accessed by a plurality of clinicians 20 who are mobile within the hospital.

29 The term "clinician" is used to denote any individual who may require access to the communications network 10 in the execution of their duties pertaining to 31 diagnosis and/or treatment of one or more patient. While not intended to be 32 an exhaustive list, typically clinicians 20 can include physicians, radiologists, 33 pharmacists, interns, nurses, laboratory technicians and orderlies. In either 34 case, when interpreting the present invention, the word "clinician" should not I be construed as limiting the invention to applicability in an environment where 2 individuals are required to have specific medical qualifications.

4 The communications network 610 also includes a tag / detector subsystem (TDS) 616 connected to a controller 618, which is connected to a healthcare 6 information system (HIS) 12 and a communications system head end 650. In 7 a non-limiting example of implementation, shown in and previously described 8 with reference to Fig. 1C, the HIS 12 includes a clinician database 22, a patient 9 database 24, a departmental database 26, an equipment database 35, as well as an authentication entity 28 and a point-of-care (POC) server 30. In 11 addition, the HIS 12 may permit access to a trusted external database 27, for 12 instance a national electronic health record (EHR) database, via a secure link 13 29.

Some of the aforementioned components of the communications network 10 16 will now be described in greater detail. However, a description of the clinician 17 database 22, the patient database 24, the departmental database 26, the 18 equipment database 35, the authentication entity 28 and the point-of- care 19 (POC) server 30 is omitted, since these components have already been described with reference to Fig. 1C, and any variations or modifications 21 required to support the second system architecture will be readily understood 22 and easily implemented by a person of ordinary skill in the art.

24 Terminals 14A, 14B 26 The terminals 14A, 14B allow communication between the clinicians 20 and the 27 HIS 12 via the controller 618. Terminals 14A are fixed-wire terminals, such as 28 stationary terminals or workstations, connected to the controller 618 via 29 communication links 57A. Terminals 14B are mobile terminals, such as handheld units (e.g., personal digital assistant (PDA)) or laptop computers, 31 which communicate with the controller 18 via communication links 57B that 32 include wireless portions. The wireless portions of the communication links 33 57B are secure links that may be encapsulated within the communications 34 network 610, as would be the case for a wireless local area network (WLAN) 1 using WLAN access points 60. In another embodiment, the wireless portions of 2 the communication links 57B may involve an external network connection, as 3 would be the case when the mobile terminals 14B are cellular phones or 4 cellular data devices.

6 Each of the terminals 14A, 14B has a display capability, which may be different 7 for different types of terminals. For example, mobile terminals 14B may have 8 inferior display capabilities, while certain ones of the fixed-wire terminals 14A 9 may have superior display capabilities.

11 ical devices 602 13 A plurality of medical devices 602 is also collectively shown in Figs. 6A and 6B.

14 A medical device refers to a piece of healthcare equipment used for a particular purpose in the hospital. Examples of medical devices 602 include 16 but are not limited to surgical instruments, wheelchairs, emergency 17 resuscitation carts (colloquially referred to as "crash carts"), life- support units, 18 computerized axial tomography (CAT) or magnetic resonance imaging (MRI) 19 scanners, and any other conceivable piece of equipment, either mobile or stationary, normally found in a healthcare environment.

22 It will be noted that a first subset of the medical devices 602 is connected to 23 the communications network 610, and these are shown in Fig. 6A. Non- 24 limiting examples of medical devices that may be members of the first subset include devices that are used to input data into the HIS 12 or extract data 26 from the HIS 12, for example CAT scanners and MRI scanners. Stationary 27 medical devices in the first subset may be connected to the communications 28 network 610 via the communication links 57A, while mobile medical devices in 29 the first subset may be connected to the communications network 610 by communication links 57B.

32 Aspects of operation of the medical devices 602 in the first subset (i. e., 33 connected to the communications network 610) can be controlled by the 34 controller 618. One example of operation that can be controlled would be 1 authorization/authentication to use a particular medical device, this being 2 limited to only those operatives trained in so-doing. This would be achieved by 3 Only allowing the medical device to be functional while a qualified, authorized, 4 authenticated operator is found to be in its vicinity. Another example of an aspect of operation is an on/off state of the medical device 602.

7 A second subset of the medical devices 602 is not connected to the 8 communications network 610 because there is no need to exchange data 9 between these devices and the HIS 12. Such medical devices may be referred to as "passive" from the communications standpoint and, although not 11 illustrated in Fig. 6A, they are represented in Fig. 6B. By way of nonlimiting 12 example, wheelchairs and stretchers may be members of the second subset of 13 the medical devices 602. However, it is envisaged that certain other 14 conventionally "passive" devices may be equipped with communication functionality and therefore whether a particular medical device belongs to the 16 first subset or the second subset might depend on factors other than simply 17 the nature of particular medical device.

19 Communications System Head End 650 21 Although clinicians 20 may communicate with one another using mobile 22 terminals 14B, the communications network 610 may further provide the 23 ability to use a more conventional communications system. To this end, the 24 communications system head end 650 enables telephony-style or other communication between individuals in the hospital or external to the hospital, 26 including the clinicians 20. In one embodiment, the communication system 27 head end 650 may comprise a switch and processing equipment, and may be 28 connected to an intercom system and speakers distributed throughout the 29 hospital for communicating with individuals or group of individuals in the hospital. Optionally, the communication system head end 650 may be 31 connected to a plurality of communication devices 614 via a plurality of paths 32 57C (fixed or partly wireless). Non-limiting examples of the communication 33 devices 614 include pagers and WLAN phones. The communication devices 34 614 are typically carried by the clinicians 20, allowing telephony- style I communications to be established with specific individuals in the hospital. The 2 communications system head end 650 could also comprise a PBX connected to 3 fixed and wireless telephones, with the location of the fixed telephones being 4 known a priori.

6 Tag / Detector Subsystem (TDS) 616 8 With specific reference now to Fig. 6B, the TDS 616 includes a plurality of tags 9 36A, 36B, 36C, 36D, a plurality of contact-less tag detectors 654 and a location calculation engine (LCE) 658, which may be integrated with the 11 controller 618 or separate therefrom. The tags 36A, 36B, 36C and 36D are 12 associated with the various people and equipment whose location needs to be 13 ascertained. In this case, as before, tags 36A are respectively associated with 14 the clinicians 20 and tags 36B are respectively associated with the mobile terminals 14B. In addition, tags 36C are respectively associated with the 16 medical devices 602 in both the first and second subsets, while tags 36D are 17 respectively associated with the fixed-wire terminals 14A.

19 Similarly to what was described with reference to the first system architecture, a given tag 36A, 36B, 36C, 36D operates in such a way as to provide a brief 21 radio frequency signal that encodes an identifier of the given tag 36A, 36B, 22 36C, 36D, hereinafter referred to as a "tag ID" 58. Without being interpreted 23 as a limitation of the present invention, the tags 36A, 36B, 36C, 36D can be 24 active (i.e. the tag frequently or periodically emits a signal), semi- active (i.e. the tag emits a signal only in response to receiving another signal), or passive 26 (i.e. the tag only reflects a received signal). The decision to select active, 27 semi-active or passive tags depends on various factors such as the required 28 range, precision, and power consumption / battery lifetime / weight 29 considerations.

31 In the selection of a suitable tag technology, care should also be taken to 32 ensure that the tags, which are themselves transmitters of RF energy, do not 33 interfere with sensitive medical equipment, e.g., certain ones of the medical 34 devices 602. In a non-limiting example, the use of a low-power multi- GHz 1 center-frequency Ultra Wideband (UWB) solution, which operates with RF 2 bursts of 1 nanosecond duration at a peak power of 15-30 mW (giving an 3 average power of nanowatts or picowatts), meets this requirement.

It is noted that the information contained in the tag IDs 58 is unique for the 6 various tags 36A, 36B, 36C, 36D. Assuming that there is a one-to-one 7 physical association between the clinicians 20 and the tags 36A, then the tag 8 ID 58 for the tag 36A attached to a given clinician 20 can contain the clinician 9 identifier 38 of the given clinician 20. (Alternatively, if the clinician identifier 38 needs to be kept confidential, then the tag ID 58 can contain the clinician - 11 specific tag ID 42 for the given clinician 20.) Similarly, if there is a one-to-one 12 physical association between the mobile terminals 14B, medical devices 602 13 and fixed-wire terminals 14A on the one hand, and the tags 36B, 36C and 36D 14 on the other, then the tag ID 58 for the tag attached to a given one of these pieces of equipment can contain a serial number or MAC address of the given 16 piece of equipment.

18 The detectors 654 are distributed throughout the hospital rather than being 19 collocated with the fixed-wire terminals 14A. The detectors 654 are positioned at known locations and may take the form of a grid or an array. Specifically, 21 the locations of the detectors 654 may be kept in a database 662 in the 22 location calculation engine (LCE) 658. In addition, the detectors 654 may span 23 multiple floors of a common building, thus effectively being distributed in three 24 dimensions. Also, the detectors 654 may be vertically separated on a given floor, thereby giving an improved capability for z-axis spatial resolution within 26 that floor.

28 Depending on the type of tag used, each of the detectors 654 may include 29 either a receiver for receiving radio frequency signals emitted by active tags, or both a transmitter for emitting radio frequency pulses and a receiver for 31 receiving radio frequency signals emitted (or reflected) by semi- active (or 32 passive) tags in response to the emitted radio frequency pulses.

34 Each of the detectors 654 detects tags in a surrounding threedimensional I volume which is a "coverage zone" for that detector 654. The union of the 2 coverage zones for all of the detectors 654 defines a location- awareness area 3 of the hospital. If a given tag is located within the location- awareness area of 4 the hospital, then the tag ID 58 that the given tag emits (or reflects) will be detectable by at least one of the detectors 654. The fact that the location of 6 the detectors 654 is known is sufficient to give an approximate idea as to 7 where a detected tag is located within the location-awareness area of the 8 hospital; however, it is insufficient to provide a precise estimate of the location 9 of that tag. Thus, the second system architecture utilizes the LCE 658 to provide the precision required in estimating the location of individual tags in 11 the location-awareness area of the hospital.

13 For example, assume that the desired precision in the relative location 14 between a clinician 20 and a piece of equipment (e.g., terminal 14A, terminal 14B, medical device 602), or between two pieces of equipment, is on of the 16 order of 10-25 cm. Thus, approximately twice this precision (i.e., 5-12.5 17 cm) on the absolute measurements is required, assuming that errors occur 18 randomly. The required precision can be achieved by use of high resolution 19 ultra-wideband radio-frequency transmitting tags, which emit sub- nanosecond bursts of radio frequency. Alternatively, the required precision can be 21 achieved by use of ultrasonic acoustic tags which emit sub-millisecond bursts 22 of acoustic energy, since the propagation length of both a 1 ns electromagnetic 23 burst and a 1 millisecond acoustic burst is of the order of 1 foot, limiting the 24 spatial resolution to around this level, depending upon exactly how the signal is received and measured.

27 One possible way to achieve adequate spatial resolution on the basis of time 28 measurements is now described. Specifically, the LCE 658 maintains an 29 absolute system time reference, which it distributes to the detectors 654.

With reference to Fig. 7, when a burst 702 corresponding to a particular tag 31 (denoted 36*) having a particular tag ID (denoted 58*) is received at a 32 particular detector (denoted 654k), the particular detector 654k measures the 33 absolute system time T1 at which the burst 702 was received. In addition, 34 other detectors (in this case three detectors denoted 6542, 6543, 6544) also I receive the same burst 702, possibly at different times. Upon receipt of the 2 burst 702, each of the detectors 654k, 6542, 6543, 6544 sends to the LCE 658 3 the detected tag ID 58* and the absolute system time T1, 12, T3, T4 at which 4 the burst 702 was received.

6 At the LCE 658, the received times T, T, T3, T4 can be compared to calculate 7 the differences in time of flight to each of at least 3 of the detectors 654k, 8 6542, 6543, 6544. These differences can then be used to estimate the position 9 of the tag 36* in two- or three-dimensional space, since the detectors' locations are known a priori from the installation grid and are available by 11 consulting the database 662 in the LCE 658.

13 In an alternative embodiment, rather than use an absolute system time 14 reference, one can measure received signal direction from multiple detectors.

To render such an embodiment capable of achieving the required precision, 16 one should consider enhancements such as the use of a large array of large 17 antennas, a very high (30-4O GHz) radio frequency combined with smaller 18 directional antennas, a directional and/or time difference-measuring optical 19 pulse, or other technologies, such as acoustic, infrared, ultrasonic, etc. 21 Of course, the greater the number of detectors used, the greater the number 22 of detectors that will receive a given burst 702 and thus, the more accurate 23 the position estimate will be. For example, while a two-dimensional position 24 estimate of the particular tag 36* requires a minimum of three detectors to detect the tag ID 58*, it may be desirable to use the data from four detectors 26 that receive the tag ID 58*. This will allow for "occlusion" of one detector; 27 alternatively, it allows the use of four sets of three measurements to produce 28 four position estimates, each of which will contain errors. The overall error can 29 be reduced by combining these in various ways including "least squares fit" as well as other methods. In this context, "occlusion" means that no useful signal 31 reaches the detector, and exemplifies an environment where ultra- wideband 32 (UWB) solutions are significantly more robust than optical or acoustic ones.

34 In addition, a position estimate can be obtained by integrating the results from 1 multiple bursts. This will lead to an increased location precision for static and 2 slow-moving tag-bearing people or pieces of equipment, but a velocity- related 3 lag in computing the location of fast-moving tag bearers. The effects are 4 dependent upon the pulse repetition rate, the number of pulses over which location data is integrated, the velocity of the tag bearer and the required 6 precision in the location measurement.

8 Similarly, to achieve a three-dimensional position estimate, one theoretically 9 requires only four measurements, but such a measurement is rendered difficult and error-prone due to a small vertical baseline (Z-axis) allowed by floor- 11 ceiling distance triangulation in the vertical axis. Thus, it may be preferable to 12 use multiple measurements and reduce error though processing operations.

13 For example, it may be advantageous to collect the data from six (6) 14 detectors, allowing 30 sets of position estimates to be made without receiver occlusion, or 5 sets of position estimates to be made with one receiver being 16 occluded.

18 To summarize the above, the detectors 654k, 6542, 6543, 6544 receive the 19 burst 702 from the nearby tag 36*, detect the tag ID 58* in the received burst 702 and communicate the tag ID 58* to the LCE 658 along a set of 21 communication links 656. Along with the tag ID 58*, the detectors 654 22 provide the absolute system time T1, T2, T3, T4 at which the burst 702 was 23 received (or, on the other hand, the direction from which the individual tag ID 24 58* is detected). Based on this information and on knowledge of the positions of the detectors 654, 6542, 6543, 6544 within the location- awareness area of 26 the hospital, the LCE 658 then determines the estimated position of the tag 27 36* within the hospital. The tag ID 58* and the estimated position of the 28 corresponding tag 36* (generally: tags 36A, 36B, 36C, 36D) are provided to 29 the controller 618, which will now be described in greater detail.

31 Controller 618 33 The controller 618 comprises suitable software, hardware and/or control logic 34 for implementing a variety of "monitoring processes" that operate in the I background until they detect that a certain trigger condition is satisfied, 2 whereupon further processing operations are performed. As shown in Fig. 8, 3 these include a clinician proximity monitoring process 810, a tagged equipment 4 monitoring process 820, a communications monitoring process 830, a medical event monitoring process 840 and an RF interference monitoring process 850.

6 The monitoring processes 810-850 may all run in parallel to one another.

7 Each of the aforementioned monitoring processes is now described in greater 8 detail.

EClinician Proximity Monitoring Process 810 12 Similar to the clinician proximity monitoring process 80 described earlier, the 13 clinician proximity monitoring process 810 monitors the output of the TDS 616 14 to decide when clinicians 20 who do not have sessions are found to be in proximity to individual ones of the terminals 14A, 14B. The definition of "in 16 proximity" may vary in accordance with operational requirements. In one 17 embodiment, a given clinician of interest (denoted 20*) is deemed to be "in 18 proximity" to a given terminal of interest (denoted 14*) when a computed 19 "proximity condition" is satisfied, e.g., when the relative distance between the estimated position of the tag 36A associated with clinician 20* and the 21 estimated position of the detector 34A, 34B associated with terminal 14* 22 remains less than a certain threshold distance, continuously, for at least the 23 duration of a time window.

Of course, it is within the scope of the present invention to further refine the 26 definition of the proximity condition using additional factors. For instance, 27 such additional factors may include the identity or professional role of clinician 28 20*. Another example of such an additional factor includes an indication of 29 whether terminal 14* is in clinician 20*'s "field of view". In one embodiment, determining whether terminal 14* is within clinician 20*'s field of view may 31 involve processing the intensity of the signal received from the tag associated 32 with clinician 20*. Based upon the estimated position of clinician 20*, relative 33 to the nearby detectors 654 and hence the known free space path length from 34 clinician 20* to those detectors, the expected received powers at the various 1 detectors 654 can be computed. Any differences from those powers, such as a 2 significant power level drop in one or two detectors, can be attributed to 3 absorption of the signal by the body of clinician 20*, which allows the direction 4 in which clinician 20* is facing to be inferred.

6 In other words, a lower-intensity signal may indicate that clinician 20*'s body 7 is in the way and hence it is possible to infer in which direction clinician 20* is 8 facing and determine whether terminal 14* is in clinician 20*'s field of view.

9 In another embodiment, the controller 618 computes a velocity vector of clinician 20* by tracking the location of clinician 20* over time. By taking into 11 account a certain angle on both sides of the velocity vector, and assuming that 12 clinician 20* is moving in the direction that he or she faces, the controller 618 13 can obtain a field of view of clinician 20* and determine whether terminal 14* 14 is in that field of view. Furthermore, the computed velocity of clinician 20* may allow for a determination of intent, in that if clinician 20* who intends to 16 use terminal 14* will approach it and slow down (and eventually stop), 17 whereas clinician 20* who does not intend to use terminal 14* will likely 18 remain at a high walking speed.

Thus, it will be appreciated that consideration of clinician 20*'s field of view 21 may be advantageous in order to take into account situations wherein clinician 22 20*, although "close" to terminal 14*, is oriented in such a way that he or she 23 cannot interact with terminal 14*. (For instance, clinician 20* has his or her 24 back facing terminal 14*.) Thus, the proximity condition may be satisfied not only when clinician 20* is "close" to terminal 14*, but when terminal 14* is

26 within clinician 20*'s "field of view".

28 Once the clinician proximity monitoring process 810 has deemed clinician 20* 29 to be in proximity to terminal 14* (i.e., the proximity condition is satisfied), the controller 618 executes a "session establishment" process, which is similar 31 to the session establishment process 82 previously described with reference to 32 Figs. 3B and 3C. This results in the establishment of a session for clinician 20* 33 between terminal 14* and the HIS 12.

I Once the session is established, the controller 618 enters a "conduct session" 2 process for the session, which is similar to the conduct session process 84 3 previously described. During the session, clinician 20* may perform a variety 4 of activities leading to any one of the previously described non- limiting example scenarios A- through D-. In addition, although it is transparent for 6 most of the activities conducted during the session, the conduct session 7 process nevertheless continues to monitor the information from the TDS 616 in 8 order to detect certain conditions of clinician-terminal proximity and terminal- 9 terminal proximity. Specifically, during the session, clinician 20* may perform a variety of activities in addition to the above, which may lead to one of the 11 previously described non-limiting example scenarios Ethrough G-.

13 In the specific case of scenario G- and mobility scenario III related thereto, it is 14 recalled that this scenario covered the case where clinician 20* had approached a new terminal, denoted 14+, while a session was ongoing 16 between the HIS 12 and terminal 14*. This was followed by terminal 14* 17 leaving the vicinity of both clinician 20* and terminal 14+. It is recalled that 18 such a scenario may arise if clinician 20*'s PDA is lent to a co- worker or is 19 carried away while clinician 20* is viewing a large-screen display on terminal 14+ (the session transferee). If the PDA is being lent to colleague, then there 21 may not be cause forconcern. However, if the PDA has been stolen, then it 22 may be desirable to detect this action so that the appropriate measures can be 23 taken. Specifically, potentially suspicious motion of tagged equipment in this 24 and other scenarios is handled by the tagged equipment monitoring process, as now described.

27 II- Tagged EguiDment Monitoring Process 820 29 In order to support the tagged equipment monitoring process 820, the equipment database 35 is expanded so as to include additional fields for each 31 piece of tagged equipment (e.g., terminal or medical device), including but not 32 limited to valuable mobile equipment, such as PDAs and tablet PCs.

33 Specifically, with reference to Fig. 11, an enhanced equipment database 1135 34 includes the same fields as the equipment database 35 in Fig. 1D, in addition 1 to an "authorized users" field 1110 and a "physical boundaries" field 1112.

3 For a given piece of tagged equipment, the authorized users field 1110 4 provides a list of clinicians who have the authorization to use the given piece of tagged equipment. The clinicians in this list can be identified by their clinician 6 ID 38 or clinician-specific tag ID 42, for example, or by any other conceivable 7 identifier. The list of clinicians who have the authorization to use a given piece 8 of tagged equipment may change over time and may be under the control of 9 hospital administration. I0

11 For a given piece of tagged equipment, the physical boundaries field 1112, 12 which is optional, may indicate specific areas of the hospital where the given 13 piece of tagged equipment is allowed to be present, with everywhere else 14 being considered Impermissible. Alternatively, the physical boundaries field 1112 may indicate specific areas of the hospital where the given piece of 16 tagged equipment is not allowed to be present, with everywhere else being 17 considered permissible. The chosen significance of the physical boundaries 18 field 1112 may be different for different pieces of tagged equipment, and may 19 depend on the most efficient representation in memory. By way of non- limiting example, it may be the case that a crash cart in a particular Ward 21 should not be removed from there but may be moved around within the ward; 22 hence, the physical boundaries for this particular piece of tagged equipment 23 could be the particular Ward in question.

Based on the data from the enhanced equipment database 1135 and the data 26 from the TDS 616, the tagged equipment monitoring process 820 determines, 27 for each piece of tagged equipment, the position of the tag associated with the 28 piece of tagged equipment, consults the authorized users field 1110 for the 29 piece of tagged equipment, determines the position of the tags for the clinicians who are authorized to use the piece of tagged equipment, and 31 determines the estimated distance between the tags of the piece of tagged 32 equipment and each of these authorized clinicians. If, for a particular piece of 33 tagged equipment, the estimated distance exceeds a threshold value for all of 34 the authorized clinicians (or is not within the threshold value for at least one of I the authorized clinicians), and if the particular piece of tagged equipment is in 2 motion (e.g., based on historical data), the tagged equipment monitoring 3 process 820 will conclude that the particular piece of tagged equipment is 4 being transported by someone or something other than one of the authorized clinicians of the particular piece of tagged equipment. The particular piece of 6 tagged equipment is said to be undergoing suspicious motion, which may be 7 the result of an act of theft. A suitable alarm signal can thus be generated, 8 which may lead to actions such as communicating with building security, 9 activation of cameras, locking of doors, erasure of data, etc. 11 In addition, having determined, for each piece of tagged equipment, the 12 position of the tag associated with the piece of tagged equipment, the tagged 13 equipment monitoring process 820 consults the physical boundaries field 1112 14 for the piece of tagged equipment and determines whether the piece of tagged equipment is in an area where it is (or is not) allowed to be, irrespective of 16 whether the piece of tagged equipment is in motion or not. If the piece of 17 tagged equipment in question is in an area where it is not allowed to be (or is 18 outside any and all areas where it is allowed to be) then a suitable alarm signal 19 can be generated as described above.

21 III- Communications MonitorpnQ Process 830 23 With reference to Figs. 9A, 9B and 9C, at step 902, the controller 618 detects 24 that a "source clinician" desires to reach a "target clinician" in the hospital.

This can be achieved by monitoring the communications system head end 650, 26 as well as the data exchanged during an ongoing session for the source 27 clinician, to detect a particular clinician identifier, or the address or directory 28 number of the communication device 614 (e.g., pager or WLAN phone) or 29 terminal 14A, 14B being used by a particular clinician. For the purposes of the discussion below, the particular clinician will be referred to as the "target" 31 clinician.

33 At step 904, the controller 618 consults the LCE 658 to determine the location 34 of the target clinician identified at step 902. At step 906, the controller 618 1 determines whether the target clinician is available by applying an 2 "unavailability policy" based at least in part of the location of the target 3 clinician determined at step 904. A non-limiting example of an unavailability 4 policy is to deem the target clinician as "unavailable" when located in a subset of the location-awareness area of the hospital, where the subset includes 6 operating rooms and emergency rooms. Conversely, if the target clinician 7 does not fall within this subset of the location-awareness area of the hospital, 8 the target clinician is deemed to be available.

Generally speaking, the subset of the location-awareness area of the hospital 11 where the target clinician will be deemed unavailable depends on knowledge of 12 the topography of the hospital, i.e., the layout and configuration of the various 13 rooms, floors and areas of the hospital. The topography of the hospital may 14 be stored in the controller 618 or it may be stored in the departmental database 26 and accessed by the controller 618 when needed.

17 Of course, the unavailability policy may be more complex than the mere 18 identification of certain fixed areas of the hospital where target clinicians are 19 deemed unavailable. For example, the unavailability policy may be a function of the professional role (e.g., doctor vs. nurse vs. orderly) of the target 21 clinician. In yet another example, the target clinician's schedule may impact 22 the result of applying the unavailability policy. For example, a target clinician 23 located in the scrub room before a planned surgical intervention may be 24 deemed unavailable, but would not be deemed unavailable if present in the scrub room after surgery is complete. Hence, the unavailability policy may 26 include an element of target clinician location history as well as actual location.

27 For instance, for the case of "history = general hospital area" and "current 28 location = scrub room" then the target clinician may be deemed unavailable, 29 whereas for "location history = operating theatre" and "current location = scrub room", then the target clinician may be deemed available.

32 Thus, it is apparent that the unavailability policy may range from simple to 33 complex, to the point where it involves the target clinician's professional role, 34 identity, schedule, etc. It should also be appreciated that the controller 18 1 may obtain the information relevant for application of the unavailability policy 2 from the clinician database 22, whereas the overall unavailability policy itself 3 may be stored in memory the controller 18, and changed from time to time by 4 hospital administrative staff.

6 If the outcome of step 906 is that the target clinician is deemed available, then 7 with reference to Fig. 9B, the controller 618 proéeeds to step 910, where a 8 paging message is sent to the target clinician. In a non-limiting example 9 embodiment, the paging message can be sent via the communication system head end 650 to reach the communication device 614 (e.g., pager or WLAN 11 phone) being used by the target clinician. Alternatively, the paging message 12 can be sent as an electronic message to the fixed-wire or mobile terminal 14A, 13 14B with which the target clinician has an ongoing session with the HIS 12. In 14 yet another embodiment, plural uses of a paging message to attempt to reach the target clinician (who, it is recalled, was deemed to be available) can be 16 employed in parallel.

18 At step 912, the controller 618 is attentive to receipt of a positive 19 acknowledgement from the target clinician, either by way of a response via the terminal 14A, 14B being used by the target clinician or via the communication 21 system head end 650. If a positive acknowledgement is received within a 22 certain amount of time (e.g., 10 seconds), then no further action needs to be 23 taken, since the target clinician has been reached and has positively 24 acknowledged that he or she is available. The remainder of the communication between the source clinician and the target clinician may occur 26 in a conventional manner.

28 However, if the controller 618 does not receive a positive acknowledgement 29 for a certain amount of time (e.g., 10 seconds) or receives a negative acknowledgement, then the controller 618 proceeds to step 914, where it 31 takes a specific action, depending on the circumstances. A simple example of 32 an action is the display of a reply message at a device being used by the 33 source clinician, which states something to the effect that "Dr. Smith cannot be 34 reached" and offers the source clinician a menu of choices. These may I include: 3 1) Attempt to reach a surrogate clinician for Dr. Smith.

4 2) Attempt to reach an alternative clinician for Dr. Smith; 3) Leave a message for Dr. Smith.

7 In this context, a "surrogate clinician" for Dr. Smith represents a clinician who 8 is located near Dr. Smith, and who can therefore contact Dr. Smith in case of 9 emergency, but who may not have a comparable skill set to that of Dr. Smith.

An "alternative clinician" for Dr. Smith represents a clinician who has a skill 11 set comparable to that of Dr. Smith, and who acts as a "backup" for Dr. Smith, 12 but who may not be located as near to Dr. Smith as the surrogate clinician.

13 The identity of a surrogate clinician and an alternative clinician for a given 14 target clinician represent additional data elements that are associated with the target clinician and it is envisaged that they may be stored in the clinician 16 database 22 alongside other data for the target clinician. Moreover, the 17 identity of the surrogate clinician may be updated by a function operating in 18 the controller 18, which relies on the LCE 658 to determine which clinician 19 should be the surrogate clinician for the target clinician. Also, there may be more than one alternative or surrogate clinician for any one target clinician.

21 Furthermore, the location of the alternative clinician and/or the skill set of the 22 surrogate clinician may be displayed for the source clinician to consider before 23 selecting one of the options 1), 2) and 3) above.

If the source clinician selects option 1) above, then the controller 618 proceeds 26 to step 916, where an attempt to reach the surrogate clinician is made, e.g., 27 by sending a paging message to the surrogate clinician. In a non- limiting 28 example embodiment, the paging message can be sent via the communication 29 system head end 650 to reach the communication device 614 (e.g., pager or WLAN phone) being used by the surrogate clinician. Alternatively, the paging 31 message can be sent as an electronic message to the fixed-wire or mobile 32 terminal 14A, 14B with which the surrogate clinician has an ongoing session 33 with the HIS 12. In yet another embodiment, plural uses of a paging message 34 to attempt to reach the surrogate clinician (who may or may not be available) 1 can be employed in parallel.

3 The paging message destined for the surrogate clinician may further contain 4 the message to be passed by the surrogate clinician to the target clinician.

Assuming again that the target clinician is Dr. Smith, the paging message sent 6 to the surrogate clinician could be "Kindly find out from Dr. Smith whether he 7 checked on Mrs. Jones this morning.", which exemplifies a simple message 8 asking the surrogate clinician to elicit a simple response from the target 9 clinician, and which cannot be answered until the target clinician is reached.

11 In the event that option 1) does not end in a satisfactory way (e.g., the 12 surrogate clinician does not positively acknowledge the paging message) , then 13 the controller 618 causes the above options to be re-presented to the source 14 clinician.

16 If the source clinician selects option 2) above, e.g., after execution of step 914 17 or after execution of step 916, the controller 618 proceeds to step 920, where 18 an attempt to reach the alternative clinician is made, e.g., by sending a paging 19 message to the alternative clinician. In a non-limiting example embodiment, the paging message can be sent via the communication system head end 650 21 to reach the communication device 614 (e.g., pager or WLAN phone) being 22 used by the alternative clinician. Alternatively, the paging message can be 23 sent as an electronic message to the fixed-wire or mobile terminal 14A, 14B 24 with which the alternative clinician has an ongoing session with the HIS 12. In yet another embodiment, plural uses of a paging message to attempt to reach 26 the alternative clinician (who may or may not be available) can be employed in 27 parallel.

29 In the event that this option does not end in a satisfactory way (e.g., the alternative clinician does not positively acknowledge the paging message), 31 then the controller 618 causes the above options to be re-presented to the 32 source clinician.

34 If the source clinician selects option 3) above, e.g., after execution of step 914 I or after execution of step 916 or after execution of step 920, then the source 2 clinician is prompted to leave a message for the target clinician. The message 3 is then delivered to, and accessed by, the target clinician in a conventional 4 manner.

6 It is noted that the selection of option 1), 2) or 3) can be automatic based on 7 source clinician preferences, or manual, based on the judgment of the source 8 clinician. For example, the source clinician may consider that it is preferable to 9 contact a surrogate clinician with a slightly inferior or superior skill set than to contact an alternative clinician who may be further from the target clinician.

11 In other circumstances, the source clinician may decide just the opposite, when 12 a very specific skill set is required.

14 Returning now to step 906, if the outcome of this step was that the target clinician is deemed unavailable, then with reference now to Fig. 9C, the 16 controller 618 proceeds to step 924, where a reply message is sent to the 17 source clinician. Assuming that target clinician is Dr. Smith, and that the 18 location of the target clinician was found to be "Operating Room 22", the reply 19 message may state something to the effect that "Dr. Smith is currently unavailable in Operating Room 22" and offers the source clinician a menu of 21 choices. These include: 23 4) Attempt to reach an alternative clinician for Dr. Smith; 24 5) Leave a message for Dr. Smith; 6) Wait for Dr. Smith to become available; 26 7) Attempt to reach a surrogate clinician for Dr. Smith.

28 If the source clinician selects option 4) above, then the controller 618 proceeds 29 to step 926, where an attempt to reach the alternative clinician is made, e.g., by sending a paging message to the alternative clinician. In a non-limiting 31 example embodiment, the paging message can be sent via the communication 32 system head end 650 to reach the communication device 614 (e.g., pager or 33 WLAN phone) being used by the alternative clinician. Alternatively, the paging 34 message can be sent as an electronic message to the fixed-wire or mobile I terminal 14A, 14B with which the alternative clinician has an ongoing Session 2 with the HIS 12. In yet another embodiment, plural uses of a paging message 3 to attempt to reach the alternative clinician (who may or may not be available) 4 can be employed in parallel.

6 In the event that this option does not end in a satisfactory way (e.g., the 7 alternative clinician does not positively acknowledge the paging message), 8 then the controller 618 causes the above options to be re-presented to the 9 source clinician.

11 If the source clinician selects option 5) above, e.g., after execution of step 924 12 or after execution of step 926, then the source clinician is prompted to leave a 13 message for the target clinician. The message is then delivered to, and 14 accessed by, the target clinician in a conventional manner.

16 If the source clinician selects option 6) above, e.g., after execution of step 924 17 or after execution of step 926, the controller 618 performs step 928, where 18 communication with the target clinician is delayed until continued application of 19 the unavailability policy reveals that the target clinician has become available.

At that point, a paging message is sent as described herein above with 21 reference to step 910 in Fig. 9B and the steps thereafter.

23 If the source clinician selects option 7) above, then the controller 618 proceeds 24 to step 930, where an attempt is made to reach the surrogate clinician, e.g., by sending a paging message to the surrogate clinician. In a non- limiting 26 example embodiment, the paging message can be sent via the communication 27 system head end 650 to reach the communication device 614 (e.g., pager or 28 WLAN phone) being used by the surrogate clinician. Alternatively, the paging 29 message can be sent as an electronic message to the fixed-wire or mobile terminal 14A, 14B with which the surrogate clinician has an ongoing session 31 with the HIS 12. In yet another embodiment, plural uses of a paging message 32 to attempt to reach the surrogate clinician (who may or may not be available) 33 can be employed in parallel.

I The paging message may further contain the message to be passed to the 2 target clinician. Assuming again that the target clinician is Dr. Smith, the 3 paging message sent to the surrogate clinician could be "Thank you for finding 4 out from Dr. Smith whether he checked on Mrs. Jones this morning.", which exemplifies a simple message having a "Yes/No" response but which cannot be 6 asked of any other clinician than the target clinician.

8 In the event that this option does not end in a satisfactory way (e.g., the 9 alternative clinician does not positively acknowledge the paging message), then the controller 618 causes the above options to be represented to the 11 source clinician.

13 It is noted that the selection of option 4), 5), 6) or 7) can be automatic based 14 on source clinician preferences, or manual, based on the judgment of the source clinician. For instance, option 7) should ideally be used only in cases of 16 extreme urgency, where Dr. Smith's personal input is vital, such as in a matter 17 of life and death. This is reasonable as a last resort since there is a chance 18 that even though Dr. Smith was deemed unavailable at step 908, he or she 19 may still be in a position to reprioritize his or her activities upon evaluating the merits the current situation.

22 Thus, it should be appreciated that application of an unavailability policy which 23 is sensitive to a target clinician's whereabouts can save valuable time in a 24 situation where one wishes to reach the target clinician. For example, if the target clinician is deemed unavailable, this will be known to the controller 618 26 and therefore the source clinician will not have to wait in vain for the lack of a 27 response before attempting to contact another clinician. Moreover, the ability 28 to contact a surrogate clinician who is in the vicinity of the target clinician also 29 has advantages.

31 IV- Medical Event Monitoring Process 840 33 With reference to Fig. 10, at step 1002, the controller 618 detects that an 34 emergency "medical event" has occurred in the hospital, along with its I location. The term "medical event" include but is not limited to an internal 2 hospital emergency that afflict a patient admitted to the hospital, such as the 3 occurrence of a heart attack, seizure, etc. However, the term "medical event" 4 should not be construed as applying only to admitted patients, and therefore is meant to include medical emergencies that may afflict a clinician or other 6 worker in the hospital or even a visitor of an admitted patient. In addition, the 7 term "medical event" should also be understood to include an occurrence that 8 is non-medical in nature (such as an electrical shock, hurricane, tornado, flood) 9 but that may require medical assistance.

11 For example, "Code Blue" is an expression indicative a medical event where a 12 person is possibly in danger of immediately dying. The procedure is to 13 immediately call for help (dial 911 or press the nearest "code blue button") 14 and begin life-saving techniques if necessary. Code Blue buttons (not shown in the drawings) are typically distributed throughout the hospital at known 16 locations, and in an embodiment of the present invention they may be in 17 communication with the controller 618 via a network and/or possibly the 18 communications system head end 650. The controller 618 therefore has the 19 ability to determine when a particular Code Blue button has been pressed as well as the location of that code blue button, which can be determined from 21 the hospital floor plan. Alternatively, for mobile Code Blue buttons, these can 22 be provided with their own tags (not shown) and the location of a Code Blue 23 button that has been pressed would be determined using the TDS 616.

Similarly, the controller 618 has the ability to monitor the communications 26 from the various communication devices 614 in order to detect if someone has 27 dialed 911 and the location of the communication device 614 that has dialed 28 911. In addition, the nature and location of the medical event can be entered 29 by anyone with access to one of the terminals 14A, 14B, which causes the controller 618 to obtain this information regarding the medical event.

32 At step 1004, the controller 618 determines a skill set associated with the 33 medical event. For example, a "Code Blue" may require a physician and two 34 nurses. The skill sets associated with various medical events can be encoded I in a mapping that is stored in a database (not shown) in the controller 618 or 2 in one of the databases 22, 24, 26, 35, 27.

4 At step 1006, the controller 618 determines the identity of clinicians whose skills match one or more of the requisite skills sets found at step 1004. For 6 example, by consulting the clinician profiles in the clinician database 22, the 7 controller 618 can determine the identity of the various clinicians who are on 8 duty and who have the requisite skill sets. These clinicians are considered to 9 be "potentially eligible assistance-providing clinicians".

II At step 1008, the eligibility of the potentially eligible assistanceproviding 12 clinicians is confirmed, at least in part on the basis of distance from where the 13 medical event is taking place. For example, the controller 618 consults the 14 LCE 658, which maintains location information regarding various clinicians based on detection of the tags worn by those clinicians. On the basis of the 16 location of the medical event and the locations of the potentially eligible 17 assistance-providing clinicians, the controller 618 determines which potentially 18 eligible assistance-providing clinicians are eligible to provide assistance for the 19 medical event. Thus, in one embodiment, eligibility can be a function of proximity to the medical event; in other words, the closer a potentially eligible 21 assistance-providing clinician is to the medical event, the more eligible he or 22 she is deemed to be to provide assistance. However, it should be understood 23 that a more complex, but still location-dependent, policy can be applied, based 24 additionally on schedule, historical data, etc. 26 The net result of this approach is that the nearest suitably qualified clinicians 27 (i.e., the eligible assistance-providing clinicians) are summoned, thereby 28 minimizing the time to bring the "code blue" team together.

At step 1010, the controller 618 requests assistance from the eligible 31 assistance-providing clinicians determined at step 1008. Specifically, this can 32 involve transmission of a message to the eligible assistance-providing clinicians 33 which specifies the nature and location of the medical event, as determined at 34 step 1002. The message destined for a particular eligible assistance- providing I clinician can be transmitted to that clinician via a fixed- wire or mobile terminal 2 14A, 14B being used by the clinician, or through a communication device 614 3 (e.g., pager or WLAN phone) being used by the clinician, etc. If the eligible 4 assistance-providing clinician is the only one having that skill set within a certain acceptable distance from the medical event, and if an that clinician is 6 not reachable for any reason, then a surrogate clinician in the vicinity may be 7 contacted to forward the message.

9 In a variant, steps 1006 and 1008 can be reversed. Specifically, the controller 618 may begin by applying a location-dependent policy to all clinicians, 11 regardless of their skill set. For example, the controller 618 may consult the 12 LCE 658 in order to obtain the identity and location of the clinician closest to 13 the medical event. In other cases, the location-dependent policy may be more 14 complex. In any event, the end result is the identification of an "eligible potentially assistance-providing clinician", i.e., a clinician who is located close 16 to the medical event, but whose skill set remains unknown. Accordingly, the 17 controller 618 then consults the clinician database 22 to determine whether 18 the skill set associated with the eligible potentially assistance- providing 19 clinician matches or exceeds one of the skill sets that is required in order to handle the medical event. If so, that particular skill set is considered to have 21 been met and the search for an eligible assistance-providing clinician is over 22 for that particular skill set (although there may be more than one requisite skill 23 set or a need for more than one clinician of the same skill set; in such cases, 24 the process is repeated as many times as needed). If, however, the eligible potentially assistance-providing clinician does not have any of the requisite skill 26 sets, then this clinician is not "assistance-providing" and the search continues 27 for the next closest clinician, et cetera, until an eligible assistance-providing 28 clinician for all requisite skill sets has been identified. Again, operation of the 29 controller 618 expedites formation of a response team to the medical event, by identifying the nearest clinicians of the requisite skill set. In this way, 31 precious seconds or minutes can be saved before the team is assembled.

33 V- RF Interference Monitoring Process 850 I In order to support the RF interference monitoring process 850, the equipment 2 database 35 is expanded so as to include additional fields for each piece of 3 tagged equipment (e.g., terminal or medical device), including but not limited 4 to RF-radiating terminals and sensitive medical devices. Specifically, with reference to Fig. 12, an enhanced equipment database 1235 includesthe same 6 fields as the equipment database 35 in Fig. 1D, in addition to a "maximum 7 transmitted RF power" field 1210 and an "exposed RF field strength limit" field 8 1220. Of course, an enhanced equipment database could be based on the 9 enhanced equipment database 1135 previously described with reference to the tagged equipment monitoring process 820.

12 For a given piece of tagged equipment, the "maximum transmitted RF power" 13 field 1210 indicates the maximum level of RF power that can be generated by 14 the given piece of tagged equipment under its current operating condition.

This may be given in units such as milliwatts (mW). For example, a WLAN 16 phone may generate in the range of 50-100 mW of RF power.

18 For a given piece of tagged equipment, the "exposed RF field strength limit" 19 field 1220 indicates the immunity of the given piece of tagged equipment, e.g., level of RF interference that the given piece of tagged equipment is 21 designed to withstand. One common way of expressing the exposed RF field 22 strength limit is in terms of a field strength (V/meter) over a given range of 23 frequencies. The immunity may be defined by a standard, a non-limiting 24 example of which is IEC-60601-1-2, 2001 edition, incorporated by reference herein. According to this standard, modern medical devices are 26 required to function in a 1OV/m radio frequency interfering field (over a wide 27 RF frequency range) if it is life-supporting equipment and 3V/m if it is not life- 28 supporting. In other words, life-supporting equipment manufactured to meet 29 the above standard may malfunction if exposed to RF interference having a level of greater than 1OV/m and non-life-supporting equipment manufactured 31 to meet the above standard may malfunction if it is exposed to RF interference 32 having a (somewhat weaker) level of more than 3 V/rn.

34 Based on the above example data, a WLAN phone operating at around 50100 I mW can come to within about 2 meters of a 3V/m-immune medical device or 2 to within about 0.6-0.7 meters of a 10 V/rn-immune medical device without 3 any deleterious effect, but coming any closer both violates IEC-60601-1- 2 and 4 puts the performance of the medical device in jeopardy. Those skilled in the art will appreciate that IEC-60601-1-2 defines adequate and ample margins 6 such that, irrespective of propagation conditions, a transmitter that does not 7 approach a medical instrument to closer that the transmit-power- dependent- 8 distance defined in that specification can never cause an RF field in excess of 9 the design limits of a medical instrument at that transmit power.

11 Also, it is recalled that the medical devices 602 themselves are equipped with 12 tags, which are transmitting elements in their own right. While this may seem 13 self-defeating at first glance, interference into the medical device 602 can be 14 avoided by using ultra-low-power transmission. This is possible because the bandwidth needed to convey a tag identifier at a required periodicity is 16 miniscule, relative to the bandwidth required for communication via a WLAN 17 phone. Specifically, by application of Shannon's limit theory on information 18 channels, the low data rate requirement allows the tags to operate at a 19 significantly lower power level than a WLAN phone.

21 For example, the tags may be UWB multi-GHz tags which transmit infrequent 22 (1-10/sec) RF bursts of very short duration (e.g. 1 nanosecond) and with burst 23 peak powers around 15-30 mW such that the integrated RF power over time is 24 extremely low (nanowatts or less), such that it does not interfere with narrowband or even wideband electronics found in a given medical device. On 26 the other hand, the spectral components of multi-GHz CW modulated 27 transmissions from a WLAN phone do interfere if received at a high enough 28 power, since non-linearities in the electronics of the medical device rectify the 29 high-frequency carrier, thereby injecting the resulting demodulated envelope into the rest of the medical device. This may contain signal components within 31 the passband of the medical device, causing the latter to malfunction.

33 Since a sensitive medical device may malfunction if strong sources of RF power 34 are brought so close as to overcome the immunity of the medical device in I question, it becomes highly advantageous to control the transmitted RF power 2 as a function of distance between the sensitive medical device and the source 3 of RF power. Specifically, as a source of RF power approaches the sensitive 4 medical device (or vice-versa), it is advantageous to reduce the transmitted RF power of the source. Conversely, when there is no longer any sensitive 6 medical device in the vicinity of the emitter, its transmitted RF power can be 7 increased again (e.g., in order to support a higher data rate).

9 The aforementioned principle is now described in somewhat greater detail with additional reference to Fig. 13, which is shown as being executed for a 11 particular piece of tagged equipment having a non-zero entry in the exposed 12 RF field strength limit field 1220. This is representative of a sensitive medical 13 device and will hereinafter be referred to as an "interferee". It should be 14 understood that a similar flowchart may be executed in parallel for all other interferees.

17 At step 1310, based on the data from the enhanced equipment database 1135 18 and the data from the TDS 616, the RF interference monitoring process 850 19 identifies those pieces of tagged equipment having a non-zero entry in the transmitted RF power field 1210. In other words, the RF interference 21 monitoring process 850 identifies potential sources of RF interference for the 22 interferee, which are hereinafter referred to as "interferors".

24 At step 1320, for each given interferor, the RF interference monitoring process 850 determines the position of the tag associated with the given interferor 26 (along with the position of the tag associated with the interferee, although this 27 could possibly be pre-computed or computed on a less frequent basis). At step 28 1330, the RF interference monitoring process 850 determines the estimated 29 distance between the positions computed at step 1320. At step 1340, the RF interference monitoring process 850 computes an estimate of the exposed RF 31 field strength at the interferee by computing a mathematical function of (i) the 32 current transmitted RF power of the given interferor and (ii) the estimated 33 distance between each given interferor and the interferee (found at step 34 1330).

2 In specific non-limiting examples, the mathematical function may be based 3 upon (a) textbook inverse-square-Iawbased free space propagation 4 properties; (b) a reference model (e.g. AWGN, HiperLAN) that tries to take into account median building properties; and/or (c) mathematical relationships 6 defined in IEC-6060j.-j.-2 or a similar direct EMI standard. Where a reference 7 is in place, such as the IEC-60601-j.-2 standard, the transmit-power / 8 interferee-sensitivpty / interferor-interferee-distance relationships from the 9 reference can be used to ensure that transmitters do not violate a safe power level according to that reference.

II

12 Generally speaking, the mathematical function may take into consideration 13 various useful, concrete and tangible factors, such as analytical data regarding 14 free space propagation and empirical data regarding propagation in the environment of the hospital in question (or hospitals in general). In addition, 16 the mathematical function may also take into consideration the location 17 coordinates of the tags associated with each given interferor and the interferee 18 with respect to topographical and structural knowledge of the hospital (e.g., 19 floor plan, number and thickness of walls between each given interferor and the interferee, as well as materials used to construct them), in addition to 21 knowledge of whether each given interferor and the interferee are located on 22 the same floor (to account for RF absorption by floors and ceilings). Still other 23 functions that permit the computation of an estimate of the exposed RF field 24 strength at the interferee are within the scope of the present invention.

26 At step 1350, the outcome of step 1340, which is an estimate of the exposed 27 RF field strength at the interferee due to each given interferor, is compared to 28 the value in the exposed RF field strength limit field 1220 for the interferee. If 29 the estimate of the exposed RF field strength is greater than the exposed RF field strength limit (or less than but to within a pre- determined delta thereof) 31 for at least one of the given interferors (hereinafter referred to as a "guilty 32 interferor" or "guilty interferors"), then the RF interference monitoring process 33 850 concludes that the current transmitted RF power level of the guilty 34 interferor(s) is excessive. In general terms, it can be said that an "RF I interference constraint" is violated). Thus, in response, the next step is step 2 1360, where the RF interference monitoring process 850 sends a message to 3 the power control entity 630, causing it to send a message to each guilty 4 interferor, ultimately causing the guilty interferors to reduce their transmitted RF power by a certain amount (hereinafter referred to as a step size) or to a 6 specific level.

8 The process then returns to step 1310, which eventually leads to a 9 computation of new estimates of the exposed RF field strength at the interferee due to various interferors (including the guilty interferor(s)) .

11 Assuming for argument's sake that the guilty interferor(s) and the interferee 12 have not moved relative to one another, the new exposed RF field strength 13 estimates at the interferee due to the guilty interferor(s) will tend to be lower 14 than the previous ones, and if the step size is chosen judiciously, the new estimates of the exposed RF field strength will fall below the value in the 16 exposed RF field strength limit field 1220 for the interferee, hence not 17 requiring a further reduction in the RF power generated by the guilty 18 interferors.

It is noted that in some cases where the interferor is a mobile terminal, a 21 session may be ongoing between the mobile terminal and the HIS 12 when the 22 above steps take place. By lowering the transmitted RF power of the mobile 23 terminal in accordance with step 1360, the mobile terminal may not be able to 24 maintain the same data rate for the ongoing session, in the direction from the mobile terminal to the HIS 12. In other words, reducing the transmitted RF 26 power may have the consequence of degrading the transmission capability 27 between the mobile terminal and the nearby WLAN access potnt 60. This can 28 be addressed by reducing the channel throughput and adapting the radio link 29 to the new conditions. Standard techniques may be used for this purposes, such as those described in IEEE standard 802.11.

32 Accordingly, before causing the mobile terminal to lower the transmitted 33 power, the RF interference monitoring process 850 may perform an additional 34 step 1355, whereby a command is sent to the session management function 1 53, such command being instrumental in causing the session management 2 function 53 to lower the data rate being used by the mobile terminal to 3 transmit over the communication network 610. This may be achieved by using 4 less dense coding constellations, resulting in lower throughput.

6 Returning now to step 1350, if execution of this step revealed that the 7 estimate of the exposed RF field strength at the interferee due to each given 8 interferor is less than the value in the exposed RF field strength limit field 9 1220 for the interferee, then the RF interference monitoring process 850 proceeds to step 1380, where it is determined whether those interferors who 11 are not at full power (i.e., transmitting at a level less than the value of the 12 "maximum transmitted RF power" field 1210 for the interferor in question), 13 would hypothetically cause the RF interference constraint to be violated if they 14 were to transmit at the next highest power setting.

16 If there is no such hypothetical violation of the RF interference constraint for a 17 particular interferoi-, the controller 18 / 618 proceeds to step 1390 where it 18 causes the transmitted RF power (and, correspondingly, the data rate) to be 19 increased for the particular interferor. On the other hand, if there would be a hypothetical violation of the RF interference constraint for a particular 21 interferor, there is no change in the transmitted power level for the particular 22 interferor. Similarly, for those interferors already transmitting at full power, 23 there is no change in the transmitted power level.

Thus, as a given interferor and the interferee get closer to one another, the RF 26 interference monitoring process 850 causes the given interferor to transmit at 27 ever lower RF power levels, and also causes the use of less dense coding 28 constellations. Despite the reduced throughput, a session can be maintained 29 while the interferor in question can be brought much closer to the interferee than would be possible at full power.

32 It should also be noted that the reduced throughput for a given interferor is 33 not a disadvantage in most cases, since it affects the relatively low data rate in 34 the direction from the given interferor to the HIS 12. There is typically no I need to adjust the transmit power of the WLAN access points 60 (i.e., in the 2 reverse direction), since they are strategically positioned in locations close to 3 the ceiling and may have complex antenna patterns, such that interference 4 with stationary sensitive medical device can be avoided by design. However, should a sensitive medical device be moved around (e.g., during surgery) to 6 approach a WLAN access point 60, it is within the scope of the present 7 invention to apply the principles described above to temporarily reduce the 8 transmit power of the WLAN access point.

The communications network 10 of the first system architecture and/or the 11 communications network 610 of the second system architecture may also 12 comprise a plurality of chargers disposed at various locations throughout the 13 hospital for the example purpose of replenishing the battery charge in hand- 14 held devices. The chargers are connected to the controller 18 / 618 by a communications link. In an embodiment, the chargers comprise charging 16 stations for receiving mobile terminals (such as PDAs or tablet PC5) and having 17 electrical connections for providing a recharging capability. The mobile 18 terminals in the charger do not support any session for any clinician.

A certain level of interaction between a given clinician (hereinafter denoted 21 20*) and a given charger occurs where clinician 20* inserts into the charger a 22 mobile terminal that he or she is currently using, for example, when leaving for 23 the day or when the battery is near exhaustion. In this case, clinician 20* 24 approaches the charger, where his or her presence will be detected by a clinician-charger proximity monitoring process executed by the controller 18 in 26 the first system architecture and/or the controller 618 in the second system 27 architecture. The controller 18 / 618 may then execute a series of steps, such 28 as (in the case where an ongoing session exists) causing the display of a 29 greeting message such as "Please insert this mobile terminal into a charging station and consider whether you wish to terminate or suspend your session", 31 or any conceivable variant thereof. Before inserting the mobile terminal into 32 the charger, clinician 20* may thus choose to explicitly terminate or suspend 33 an ongoing session (if there is one). Explicit termination or suspension of a 34 session has already been described herein above in the context of scenarios C- I and D-, respectively. it will be recalled that termination leads to ending the 2 session for clinician 20*, whereas suspending the session has the effect of 3 putting the session "on-hold" until clinician 20* authenticates himself/herself 4 when in the vicinity of another terminal.

6 Another level of interaction between clinician 20* and the charger may occur 7 where clinician 20* is deemed to not be using a mobile terminal and is also 8 deemed to be "in proximity" to the charger (i.e., has satisfied a proximity 9 condition). For example, this may occur when clinician 20* begins his or her shift, or has just inserted his or her mobile terminal into the charger, possibly 11 following suspension or termination of a session as described in the previous 12 paragraph. The fact that clinician 20* is in proximity to the charger and that 13 clinician 20* is not using a mobile terminal is detected by the aforementioned 14 clinician-charger proximity monitoring process executed by the controller 18 in the first system architecture and/or the controller 618 in the second system 16 architecture. In this case, the controller 18 / 618 executes a series of steps, 17 as now described with reference to Fig. 14.

19 At step 1410, a signal is provided to clinician 20* to suggest a particular mobile terminal that he or she may use. This may be done by controlling 21 (e.g., by way of colour or by blinking) a light located on the outside of the 22 suggested mobile terminal or causing the display of a personalized greeting 23 message on the suggested mobile terminal. This may also be done by 24 controlling a visual indicator on the charger itself so as to indicate to the clinician 20* the suggested mobile terminal. The suggested mobile terminal 26 may be selected on the basis of charge capacity or other parameter.

27 Optionally, at step 1420, a locking mechanism which is by default engaged for 28 all mobile terminals in the charger would be disengaged for the suggested 29 mobile terminal while remaining engaged for all other mobile terminals presently in the charger.

32 (It should be noted that in the absence of a locking mechanism, removal of a 33 mobile terminal may be possible by someone who does not have a clinician's 34 tag, and therefore it may be appropriate to detect this fact using the process 1 being described here. Even if this is not the case, such action would 2 nevertheless be detected as potentially suspicious motion by the tagged 3 equipment monitoring process 820 described above.) Once the suggested mobile terminal is extracted by clinician 20*, the controller 6 18 / 618 proceeds to step 1430, whereby authentication data is awaited from 7 clinician 20*, either in response to a request (such as may be issued via a 8 greeting message) or sua sponte. This represents an opportunity for clinician 9 20* to authenticate himself / herself. If a suitable response is not received within a predetermined amount of time (e.g., 3 seconds), the controller 18 / 11 618 proceeds to step 1440, where it infers that the mobile terminal has been 12 taken by someone who, although equipped with clinician 20*'s tag (resulting in 13 unlocking of the now extracted mobile terminal), is not familiar with the need 14 to authenticate oneself. Since this may arise in the context of theft, an action is taken at step 1450 to signal a problem. For example, an audible or visual 16 alarm may be triggered at the charger, and security personnel may be 17 advised.

19 On the other hand, authentication data may be received at step 1430, in which case the authentication process 70 previously described may be may be 21 executed at step 1460. If the result of the authentication process is a failure, 22 then at step 1450, similar action to the above may be taken (e.g., sounding of 23 an alarm, etc.) Assuming that the result of the authentication process is a success, then the 26 controller 18 / 618 proceeds to step 1470, where the clinician database 22 is 27 consulted, resulting in the acquisition of appropriate personalization or 28 customization parameters for the purposes of initializing the extracted mobile 29 terminal. The controller 18/ 618 then proceeds to step 1480, whereby if there is a suspended session for clinician 20*, the controller 18 / 618 causes the 31 session to be resumed in the manner previously described in this specification.

32 Where there is no suspended session for clinician 20*, the remaining steps as 33 described herein above in the context of the session establishment process 82 34 are performed in order to establish a session for clinician 20*.

2 An alternative sequence of steps in the interaction between clinician 20* and 3 the charger, following detection of the state where clinician 20* is in proximity 4 to the charger but is not using a mobile terminal, is now described with reference to Fig. 15. In this case, a locking mechanism is by default engaged 6 for all mobile terminals in the charger.

8 At step 1510, which is identical to step 1410 in Fig. 14, a signal is provided to 9 clinician 20* to suggest a particular mobile terminal that he or she may use.

This may be done by controlling (e.g., by way of colour or by blinking) a light 11 located on the outside of the suggested mobile terminal or causing the display 12 of a personalized greeting message on the suggested mobile terminal. The 13 suggested mobile terminal may be selected on the basis of charge capacity or 14 other parameter.

16 The controller 18 / 618 then proceeds to step 1520, whereby authentication 17 data is awaited from clinician 20*, either in response to a request or sua 18 sponte. If a suitable response is not received within a predetermined amount 19 of time (e.g., 3 seconds), then the controller 18 / 618 does not need to do anything, since the locking mechanism remains engaged with respect to the 21 mobile terminals in the charger.

23 On the other hand, authentication data may be received at step 1520, in which 24 case the authentication process 70 previously described may be may be executed at step 1530. If the result of the authentication process is a failure 26 then, again, the controller 18 / 618 does not need to do anything, since the 27 locking mechanism remains engaged with respect to the mobile terminals in 28 the charger.

However, assuming that the result of the authentication process is a success, 31 the controller 18 / 618 proceeds to step 1540, where the locking mechanism is 32 disengaged for the suggested mobile terminal, allowing the suggested terminal 33 to be extracted. Next, the controller 18 / 618 executes step 1550, where the 34 clinician database 22 is consulted, resulting in the acquisition of appropriate 1 personalization or customization parameters for the purposes of initializing the 2 extracted mobile terminal.

4 At this stage, clinician 20* is in possession of the suggested mobile terminal and is in fact detected to be in proximity to the suggested mobile terminal, 6 which may trigger the various session establishment and session resumption 7 processes described above. For example, if there is a suspended session for 8 clinician 20*, the controller 18 / 618 causes the session to be resumed in the 9 manner previously described in this specification. Where there is no suspended session for clinician 20*, the controller 18 / 618 causes the session 11 to be established in the manner previously described in this specification.

12 Since both of these processes require authentication of clinician 20*, it will be 13 seen that there are in fact two authentications that clinician 20* needs to 14 perform before gaining access to the HIS 12 in the embodiment of Fig. 15, as opposed to one in the embodiment of Fig. 14. However, the embodiment of 16 Fig. 15 guarantees that a mobile terminal will not be taken by an unauthorized 17 individual and hence obviates the step of signaling an alarm condition.

19 Thus, the present disclosure has shown how a healthcare information system (HIS) such as a hospital or clinical information system which allows clinicians 21 access to various hospital databases including patients' electronic health 22 records (EHRs) can be made more efficient, effective, safe and functional by 23 the exploitation of location awareness.

It should be mentioned that the examples of proximity and remoteness 26 conditions have been simplified for the benefit of the reader. Those skilled in 27 the art will appreciate that the parameters used to define the various 28 proximity and remoteness conditions can be tailored to suit specific operational 29 requirements, and that additional parameters can be used. Furthermore, different parameters can be used for declaring proximity or remoteness of 31 different types of terminals (e.g., fixed-wire vs. mobile), different professional 32 roles, different individual clinicians, different types of medical devices, etc. I Those skilled in the art will appreciate that in some embodiments, certain 2 functionality or functional entities of the controller 18 / 618, the authentication 3 entity 28 and/or the HIS 12 may be implemented as pre-programmed 4 hardware or firmware elements (e.g., application specific integrated circuits (ASICs), electrically erasable programmable read-only memories (EEPROMs), 6 etc.), or other related components. In other embodiments, the controller 18 / 7 618, the authentication entity 28 and/or the HIS 12 may comprise an 8 arithmetic and logic unit (ALU) having access to a code memory (not shown) 9 which stores program instructions for the operation of the ALU in order to implement the functional entities and execute the various processes and 11 functions described above. The program instructions could be stored on a 12 medium which is fixed, tangible and readable directly by the controller 18 / 13 618, the authentication entity 28 and/or the HIS 12, (e.g., removable diskette, 14 CD-ROM, ROM, or fixed disk), or the program instructions could be stored remotely but transmittable to the controller 18 / 618, the authentication entity 16 28 and/or the HIS 12 via a modem or other interface device (e.g., a 17 communications adapter) connected to a network over a transmission medium.

18 The transmission medium may be either a tangible medium (e.g., optical or 19 analog communications lines) or a medium implemented using wireless techniques (e.g., microwave, infrared or other transmission schemes).

22 Although various embodiments have been illustrated, this was for the purpose 23 of describing, but not limiting, the invention. Various modifications will become 24 apparent to those skilled in the art and are within the scope of the present invention, which is defined by the attached claims.

Claims

I CLAIMS: 2 1. A method of controlling RF interference in a healthcare

establishment, 3 said method comprising: 4 - receiving data regarding a wirelessly detectable tag associated to a first piece of equipment within the healthcare establishment; 6 - determining whether the first piece of equipment is positioned relative 7 to a second piece of equipment within the healthcare establishment 8 such that an RF interference constraint is violated, based at least in 9 part on the data regarding the wirelessly detectable tag; - responsive to the RF interference constraint being violated, causing a 11 variation in RF power transmitted by at least one of the first piece of 12 equipment and the second piece of equipment.

14 2. A method as defined in claim 1, wherein the data regarding the wirelessly detectable tag comprises: 16 - data indicative of an identifier of the wirelessly detectable tag; and 17 - data indicative of a respective distance between the wirelessly 18 detectable tag and each one of at least three detectors spatially 19 distributed in the healthcare establishment, each one of the at least three detectors being operative to detect a signal provided by the 21 wirelessly detectable tag.

23 3. A method as defined in claim 2, wherein the data indicative of a 24 respective distance between the wirelessly detectable tag and each one of at least three detectors spatially distributed in the healthcare 26 establishment comprises data indicative of a respective travel time of the 27 signal detected by each one of the at least three detectors.

29 4. A method as defined in claim 2, wherein the data indicative of a respective distance between the wirelessly detectable tag and each one of 31 at least three detectors spatially distributed in the healthcare 32 establishment comprises data indicative of a respective intensity of the 33 signal detected by each one of the at least three detectors.

1 5. A method as defined in claim 1, wherein determining whether the first 2 piece of equipment is positioned relative to a second piece of equipment 3 within the healthcare establishment such that an RF interference 4 constraint is violated, based at least in part on the data regarding the wirelessly detectable tag comprises: 6 - obtaining an indication of a location of the first piece of equipment 7 within the healthcare establishment based at least in part on the data 8 regarding the wirelessly detectable tag; 9 - obtaining an indication of a distance between the first piece of equipment and the second piece of equipment based at least in part 11 on the location of the first piece of equipment and a location of the 12 second piece of equipment within the healthcare establishment; 13 - obtaining an indication of RF power transmitted by one of the first 14 piece of equipment and the second piece of equipment; obtaining an indication of an exposed RF field strength limit at the 16 other of the first piece of equipment and the second piece of 17 equipment; 18 - deriving an indication of an exposed RF field strength at the other of 19 the first piece of equipment and the second piece of equipment based at least in part on the distance between the first piece of equipment 21 and the second piece of equipment and the RF power transmitted by 22 the one of the first piece of equipment and the second piece of 23 equipment; and 24 - concluding that the RF interference constraint is violated if the exposed RF field strength at the other of the first piece of equipment 26 and the second piece of equipment exceeds the exposed RF field 27 strength limit at the other of the first piece of equipment and the 28 second piece of equipment.

6. A method as defined in claim 5, wherein the wirelessly detectable tag is a 31 first wirelessly detectable tag, said method further comprising, prior to 32 obtaining an indication of a distance between the first piece of equipment 33 and the second piece of equipment based at least in part on the location 34 of the first piece of equipment and a location of the second piece of I equipment within the healthcare establishment: 2 receiving data regarding a second wirelessly detectable tag associated 3 to the second piece of equipment; 4 - obtaining an indication of a location of the second piece of equipment within the healthcare establishment based at least in part on the data 6 regarding the second wirelessly detectable tag.

8 7. A method as defined in claim 5, wherein obtaining an indication of RF 9 power transmitted by one of the first piece of equipment and the second piece of equipment comprises consulting a database containing data 11 indicative of the RF power transmitted by the one of the first piece of 12 equipment and the second piece of equipment.

14 8. A method as defined in claim 5, wherein obtaining an indication of an exposed RF field strength limit at the other of the first piece of equipment 16 and the second piece of equipment comprises consulting a database 17 containing data indicative of an exposed RF field strength limit at the 18 other of the first piece of equipment and the second piece of equipment.

9. A method as defined in claim 5, wherein deriving an indication of an 21 exposed RF field strength at the other of the first piece of equipment and 22 the second piece of equipment based at least in part on the distance 23 between the first piece of equipment and the second piece of equipment 24 and the RF power transmitted by the one of the first piece of equipment and the second piece of equipment, comprises deriving the indication of 26 an exposed RF field strength at the other of the first piece of equipment 27 and the second piece of equipment also based at least in part on data 28 regarding propagation of RF radiation within the healthcare establishment.

10. A method as defined in claim 5, wherein deriving an indication of an 31 exposed RF field strength at the other of the first piece of equipment and 32 the second piece of equipment based at least in part on the distance 33 between the first piece of equipment and the second piece of equipment 34 and the RF power transmitted by the one of the first piece of equipment I and the second piece of equipment, comprises deriving the indication an 2 exposed RF field strength at the other of the first piece of equipment and 3 the second piece of equipment also based at least in part on topographical 4 and structural data regarding the healthcare establishment.

6 11. A method as defined in claim 1, wherein causing a variation in RF power 7 transmitted by at least one of the first piece of equipment and the second 8 piece of equipment comprises causing a reduction in RF power transmitted 9 by at least one of the first piece of equipment and the second piece of equipment.

12 12. A method as defined in claim 11, wherein causing a reduction in RF power 13 transmitted by at least one of the first piece of equipment and the second 14 piece of equipment comprises causing a reduction in RF power transmitted such that the RF power transmitted is reduced to a specific level.

17 13. A method as defined in claim 1, wherein causing a variation in RF power 18 transmitted by at least one of the first piece of equipment and the second 19 piece of equipment comprises causing generation of a signal to effect the variation in RF power transmitted by at least one of the first piece of 21 equipment and the second piece of equipment.

23 14. A method as defined in claim 7, further comprising updating the database 24 containing data indicative of the RF power transmitted by the one of the first piece of equipment and the second piece of equipment following to 26 reflect the variation in RF power transmitted by at least one of the first 27 piece of equipment and the second piece of equipment.

29 15. A method as defined in claim 5, wherein the healthcare establishment includes a communications network having a healthcare information 31 system, wherein the one of the first piece of equipment and the second 32 piece of equipment is a terminal supporting a session with the healthcare 33 information system, said method further comprising, prior to causing a 34 variation in RF power transmitted by at least one of the first piece of 1 equipment and the second piece of equipment, causing a variation in a 2 rate of transmission of data from the terminal to the healthcare 3 information system.

16. A method as defined in claim 15, wherein causing a variation in RF power 6 transmitted by at least one of the first piece of equipment and the second 7 piece of equipment comprises causing a reduction in RF power transmitted 8 by at least one of the first piece of equipment and the second piece of 9 equipment, and wherein causing a variation in a rate of transmission of data from the terminal to the healthcare information system comprises 11 causing a reduction in a rate of transmission of data from the terminal to 12 the healthcare information system.

14 17. A method as defined in claim 1, further comprising: - responsive to the RF interference constraint not being violated, 16 determining whether a hypothetical increase in RF power transmitted 17 by at least one of the first piece of equipment and the second piece of 18 equipment would result in the RF interference constraint being 19 violated; and - responsive to determining that the hypothetical increase in RF power 21 transmitted by at least one of the first piece of equipment and the 22 second piece of equipment would not result in the RF interference 23 constraint being violated, causing an increase in RF power transmitted 24 by at least one of the first piece of equipment and the second piece of equipment in accordance with the hypothetical increase.

27 18. A method as defined in claim 15, wherein the terminal is a mobile 28 terminal.

19. A method as defined in claim 18, wherein the mobile terminal is a hand- 31 held device.

33 20. A method as defined in claim 15, wherein the terminal is a stationary 34 terminal.

I

2 21. A method as defined in claim 1, wherein the healthcare establishment 3 includes a communications network, wherein at least one of the first piece 4 of equipment and the second piece of equipment is a terminal of the communications network.

7 22. A method as defined in claim 21, wherein the terminal is a mobile 8 terminal.

23. A method as defined in claim 22, wherein the mobile terminal is a hand- ii held device.

13 24. A method as defined in claim 21, wherein the terminal is a stationary 14 terminal.

16 25. A method as defined in claim 1, wherein the healthcare establishment 17 includes a communications network, wherein at least one of the first piece 18 of equipment and the second piece of equipment is a wireless local area 19 network phone of the communications network.

21 26. A method as defined in claim 1, wherein at least one of the first piece of 22 equipment and the second piece of equipment is a wireless telephone.

24 27. A system for controlling RF interference in a healthcare establishment, comprising: 26 - a first functional entity adapted to receive location data regarding a 27 medical device and location data regarding a mobile communication 28 device that transmits RF power at a certain level, the location data 29 regarding the mobile communication device being determined on a basis of signals received from a wirelessly detectable tag associated 31 with the mobile communication device; 32 - a second functional entity adapted to determine, at least partly based 33 on the location data regarding the mobile communication device and 34 the location data regarding the medical device, whether the mobile 1 communication device and the medical device are positioned relative 2 to one another such that a RF interference condition is met; and 3 - a third functional entity adapted to cause the mobile communication 4 device to reduce the level at which it transmits RF power in response to the RF interference condition being met.

7 28. The system defined in claim 27, wherein the location data regarding the 8 medical device is determined on a basis of signals received from a 9 wirelessly detectable tag associated with the mobile communication device.

12 29. The system defined in claim 27, wherein the mobile communication device 13 transmits data at a certain rate over a communications network of the 14 healthcare establishment, the third functional entity being further adapted to cause the mobile communication device to reduce the rate at which it 16 transmits data.

18 30. The system defined in claim 27, wherein the mobile communication device 19 transmits data at a certain rate over a communications network of the healthcare establishment, the third functional entity being further adapted 21 to cause the mobile communication device to reduce the rate at which it 22 transmits data prior to causing the mobile communication device to 23 reduce the level at which it transmits RF power.

31. A computer-readable storage medium comprising a program element for 26 execution by a computing device to control RF interference in a healthcare 27 establishment, the program element including: 28 - computer-readable program code for receiving location data regarding 29 a medical device and location data regarding a mobile communication device that transmits RF power at a certain level, the location data 31 regarding the mobile communication device being determined on a 32 basis of signals received from a wirelessly detectable tag associated 33 with the mobile communication device; I - computer-readable program code for determining, at least partly 2 based on the location data regarding the mobile communication device 3 and the location data regarding the medical device, whether the 4 mobile communication device and the medical device are positioned relative to one another such that a RF interference condition is met; 6 and 7 - computer-readable program code for causing the mobile 8 communication device to reduce the level at which it transmits RF 9 power in response to the RF interference condition being met.

11 32. A method of controlling RF interference in a healthcare establishment 12 substantially as hereinbefore described with reference to the 13 accompanying drawings.

33. A system for controlling RF interference in a healthcare establishment 16 substantially as hereinbefore described with reference to the 17 accompanying drawings.

19 34. A computer-readable storage medium substantially as hereinbefore described with reference to the accompanying drawings.