JP3993236B2 - 患者の健康状態をモニターする方法 - Google Patents
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Description
本発明は、測定を利用することによって患者の健康状態をモニターする方法に関する。本発明はさらに患者の健康状態をモニターするためのシステムに関するものであり、該システムには、患者の健康状態を評価するために測定を行うための携帯用測定装置、及び患者を治療する人が利用でき、また、行われた測定の結果についてのデータを保持するデータ処理システムが含まれる。本発明はまた患者の健康状態を評価するために測定を行うための携帯用測定装置にも関する。
本発明は特にセルフケア及び糖尿病患者の健康状態のモニターに関するものであるが、本発明の方法、システム及び測定装置は他との関連においても利用することができる。しかし、以下に、具体的に糖尿病の治療との関連で例を挙げて本発明を説明する。
先行技術の記載
周知のように、糖尿病患者の健康状態のモニターは主として患者の血糖値の定期的な測定に基づいている。患者の血糖値が明確に許容範囲内にあり、患者の薬物治療が最適であることを確信するために糖尿病治療には定期的な測定と測定結果の定期的なモニターが必要とされる。
しかし、現在のヘルスケア・システムでは、糖尿病治療を専門とする人が直接継続的に患者の健康状態をモニターすることは財政的並びに実際的理由のために不可能であり、患者の健康状態のモニターは患者自身に依存する部分が大きい。したがって患者自身が定期的に測定を行わなければならない。測定を行うために、患者は数種の器具を使用しなければならない。そのような器具として、現在例えば皮膚を刺すためのランセット、血液サンプルを採取するためのストリップ、血糖値を測定するために血液サンプルを含むストリップを配備する測定装置などがある。従来の測定装置では通常血糖値の測定は電気的な方法か光学的方法のいずれかで行われる。長期間にわたる血糖値などの患者の健康状態の進展についてのデータを入手するために、患者は例えば血液サンプルの結果の記録などもつけなければならない。
比較的多数の糖尿病患者が例えば心臓血管疾患、神経障害あるいは失明などの2次疾患(これらの疾患も少なからぬ社会的コストを生み出す因となるものであるが)も患っているという事実によっても、現在医師たちが糖尿病患者を十分に効果的に治療できないこと、あるいは、患者がセルフケアを行うのを助けることができないことが明らかに示されている。この1つの理由として、一人の各医師が非常に多数の患者を治療することが多く、そのため、例えば診察のアポイントメントが非常に少なくなるために一人一人の患者個人と医師との触れ合いが不十分となって、医師が一人一人の患者の健康状態の進展を十分効果的にモニターすることができないということが挙げられる。また、医師へ提出されるデータが患者自身の記録によるものであるため測定結果が誤って記録されていたり、まったく記録されていなかったりする可能性が絶えずある。
米国特許第5,415,167は、患者の内臓の大きさに基づいて、自動的のその状態を診断する方法を開示している。本特許は、電話線を通じて遠隔のモニター装置にデータを転送させるためにモデムに結合されたセンス装置を開示している。また別のシステムでは、遠隔のモニター装置の受信機にセンサの送信機から無線信号を直接送信するようにされている。しかしこれらのシステムはいずれも、固定化された陸上通信線による電話の近傍又は遠隔のモニター装置にモニタリングが制限されるので、規則的かつ周期的なモニタリングが必要とされる糖尿病などの状態をモニタするのには実用的でない。
発明の概要
本発明の目的は上記の問題を解決し患者を治療する医師が自分の管理の下で以前よりより正確にかつ効果的に患者の健康状態をモニターすることができる方法を提供することである。この目的は、患者が独立に測定を行い、無線データ送信リンクを利用する通信装置を介して、患者の健康状態をモニターする人が利用できるデータ処理システムへ前記測定の結果を送り、前記データ処理システムに格納されたデータによって患者の健康状態をモニターすることを特徴とする本発明の方法を用いて達成される。
ついでながら、”患者の健康状態をモニターする人”という表現は、患者の治療に関係し、患者の健康状態の進展をモニターする必要のある全ての人を指すものである。したがってこの人は必ずしも医師である必要はなく、例えば子供の治療との関連で両親が患者の健康状態をモニターする場合もある。
本発明はまた本発明の方法を利用できるシステムにも関する。本発明のシステムは、測定装置が、測定ユニット、及び無線データ伝送リンクを利用し、かつ、前記ユニットに接続される通信装置から構成され、該測定装置が、前記測定ユニットによって行われた測定の結果を前記データ伝送リンクを介して前記データ処理システムへ送るための手段を有することを特徴とする。前述のデータ処理システムは例えば、ある病院のデータ処理システムであってもよいし、あるいは他の対応する支援ユニットであってもよい。
本発明は更に、本発明の方法を適用できる携帯用測定装置に関する。本発明の測定装置は、該測定装置が測定ユニット、及び無線データ伝送リンクを利用し、かつ、前記ユニットに接続された通信装置から構成され、前記測定ユニットが、患者を治療する人が利用できるデータ処理システムへ前記通信装置を介して前記測定の結果を送るための手段を有することを特徴とする。
本発明は更に、携帯用測定装置で使用される測定ユニットであって、該装置が、患者の健康状態を評価するために測定を行うようになっているものに関する。本発明の測定ユニットは、無線データ伝送リンクを用いる移動電話を有し、前記測定ユニットが前記移動電話の電池スペース中に配置され、かつ、前記移動電話の通信バスに接続されるようになっており、かつ、通信バスを介して前記移動電話へ前記測定の結果を送る手段を有しており、それによって患者を治療する人が利用できるデータ処理システムへ移動通信ネットワークを介して前記結果をさらに伝送することができることを特徴とする。
ついでながら、”通信装置”という用語は、患者が現在いる場所に関係なく、患者の担当医が利用できるデータ処理システムへ患者が自分の測定結果を伝送できる無線通信に適した任意の装置を指す。そのような通信装置の例として、基地局あるいは場合によっては人工衛星を介して作動する移動電話、若しくは双方向ページャーなどのような任意の無線送信機が挙げられよう。
本発明は、患者自身が行った測定の結果が無線データ伝送リンクを介して自動的に直接患者を治療する人又は人達へ伝送されたとき、医師が患者の健康状態の進展を前よりもより良くモニターすることができ、患者が自分でセルフケアを行うのを手助けでき、その結果患者の治療が少なからず改善されるという考えに基づくものである。無線データ伝送によって医師は、必要な場合には患者の現在いる場所に拘らず患者の健康状態に関する測定結果を実時間で入手できる。したがって患者の健康状態の最新の状況を医師が知るために患者と医師とが直接面会する必要はなく、患者は、例えば遠隔地に在る避暑地の別荘などから最新の測定結果を医師へ伝送することができる。その後で、必要であれば患者と医師とは電話などによって更なる治療について話し合うことできる。また、例えば患者の最近の測定結果を調べながら、医師は患者の薬物治療を変更した方がよいと判断し、患者に更に詳細な検査を受けるために診察の予約をするよう求めることができる。したがって本発明の構成の主要な利点には、患者から医師への測定結果の正確で迅速な伝送と、患者の実際の運動レベルおよび/または規定食などが測定結果からより明らかであり、病院の環境によって結果が歪められることがないような患者の平常の環境での測定結果の収集と、患者が医師と面会する必要なく患者の健康状態の最近の進展状況を医師がモニターできることが含まれる。この場合、患者は、所定のスケジュールに従うのではなく本当に必要な場合にのみ医師や病院を訪れることができる。
本発明の測定装置の好適な実施例では、該測定装置は、移動電話及び移動電話の電池収納スペースに配置された測定ユニットと電池との組合せから構成される。すなわち例えばGSMシステムと現存の移動通信システムの移動電話などの従来の構成部品を利用して実現することができるために本発明の構成を適用することは非常に経済的であるので本発明のこの実施例は非常に大きな利点を有する。また、移動電話の電池収納スペースに配置できるように該測定ユニットが設計される場合には患者が携帯しなければならない物品の数は最小ですむ。したがって患者は、分離した測定装置を持ち歩くときと同じように他人の注意をひくことなく容易にこの測定装置を携帯することができる。この移動電話のもう一つの利点は、例えば血糖低下の危険性が増した場合のような、患者の最近の測定結果に基づいて直接コンタクトを取る必要を医師が認めた状況で医師が患者といつでも電話で連絡を取ることができる点である。
本発明の方法、システム及び測定装置の好適な実施例は従属請求の範囲第2項、第4項及び第6項乃至第11項に開示されている。
【図面の簡単な説明】
以下に、添付図面で例示した好適な実施例により例を挙げてさらに詳細に本発明を説明する。
図1は本発明のシステムを示す第1の好適な実施例を例示する。
図2及び3は本発明の測定装置を示す第1の好適な実施例を例示する。
図4は図3に示すストリップを例示する。
好適な実施例の説明
図1は本発明のシステムの第1の好適な実施例のブロック図である。図1に示す測定装置1は移動電話と測定ユニットから成る。該測定ユニットは血糖値の測定手段から成るものと仮定して、例を挙げて以下本発明を説明する。但し、この測定ユニットには血圧、熱または脈拍の測定のような他の測定を行うための手段も含まれていてもよい。
測定装置1から成る測定ユニットを利用して患者が測定を行ったとき、測定装置1は、病院2のデータ処理システム9へその測定結果を伝送する。測定装置1の一部を形成し、1例として、GSM移動通信システム(Groupe Special Mobile)の移動電話であると仮定されている移動電話がショートメッセージ3の形で測定ユニットから基地局4へ送られた測定結果を伝送するという方法でこの伝送は行われる。基地局4は、基地局コントローラ5、移動サービス交換センター(MSC)6及びゲートウェイセンター7を介して移動システムのショートメッセージサービスセンター(SMSC)8へこのメッセージを発信する。GSMシステム及びそのショートメッセージサービスについては、例えば、M. Mouly and M. -B. Pautet, Palaiseau著「移動通信のためのGSMシステム」(France、1992、ISBN: 2-9507190-0-7)により詳細に説明されている。したがってこれに関連してはこれ以上詳細には説明しない。
病院の患者データベースにショートメッセージが記憶されている病院2のデータ処理システム9へ患者の測定装置1から直接受信したショートメッセージを伝送するために、それぞれの場合に具体的にショートメッセージサービスセンター8をプログラムすることができる。あるいは、病院2のデータ処理システム9を介して、もしくは自分の移動電話10などを介して患者を治療する医師が読むまで、このメッセージをショートメッセージサービスセンター8のバッファに一時的に蓄えておくこともできる。したがって患者を治療する医師は、医師および/または患者の現在いる位置に拘らず、患者の測定結果にいつでもアクセスすることができる。
病院データ処理システム9には、患者自身の測定装置1で行われた若しくは病院で行われたそれぞれの患者についての測定の結果が数年間にわたって蓄えられていることが望ましい。それによって患者を治療する医師は、医師と患者とが直接お互いに連絡を取りあっていない場合にも、トレンド分析などを利用することによってデータ処理システム9を介して、患者の健康状態の進展をモニターすることができる。
必要な場合には、患者は、自分の測定装置1から測定結果と測定時刻以外の情報を送信することもできる。このようにして、糖尿病患者は例えば自分の規定食、インシュリンの服用量、運動などに関するデータを測定装置のキーボードを介して入力することができる。そしてまたこの情報は患者を治療する医師が利用するデータ処理システム9へショートメッセージによって送信される。
病院のデータ処理システム9は、ある一定の疾患をもつ個々の患者および/または例えば全ての患者に関する他のレポートを提供することも望ましい。このようにして、患者自身の医師以外のユーザーも、異なるタイプの統計や治療指示を起草する目的などのためにデータ処理システムで収集されたデータを利用することができる。そのような考えられる他のユーザーとして、例えば当局、保険会社、研究センターなどが含まれる。
図2と3に本発明の測定装置の第1の好適な実施例を例示する。図2に測定装置の斜め正面図、図3に背面図を示す。測定装置1は移動電話MS及び移動電話の電池収納スペースに配置された測定ユニット11から構成される。この測定ユニットと移動電話とは当然、ケーブルなどによって接続された全く分離した構成部品にすることもできる。しかしながらその場合患者は1つの部品の代わりに2つの分離部品を持ち運ばなければならない。
図2と3に示す移動電話MSは、例えば、電池収納スペースに配置された測定ユニット11を電話の通信バスに接続できるコネクターを備えたそれ自体周知のGSMシステムの電話であってもよい。測定ユニット11が電話のディスプレイ12とキーボード13を利用することができるようにこの電話にそのソフトウェアに関する変更を施すこともできる。
測定ユニット11は、電話の標準の電池をそこから取り外したとき移動電話MSの電池収納スペースにぴったり収まるように設計される。したがってこの測定手段に加えてこの測定ユニットには移動電話MSと測定ユニット11自身に動作電圧を供給する電池14も含まれる。この測定ユニットは、電池14が消耗して移動電話から呼を行えなくなったときにもこの測定ユニットで測定を行うことができるように、さらにバックアップ用電池を備えていることが望ましい。
測定装置1の測定ユニットに設けられている測定手段を図3に例示する。図3の測定装置にはそれ自体周知の電気的方法で血糖値を測定するための手段が含まれる。但し、この測定装置に光学的あるいは皮膚を通す必要のない測定を行うための手段を設けることもできる。
測定ユニット11は、患者が簡単に皮膚を刺すことができるように例えばバネで操作できる一体型ランセット19を含む。その後患者は測定ユニット11の例えばリール15などに配置されたそれ自体周知のストリップ16を引き出す。このストリップは血液の滴が含浸されている(ストリップの構造は図4により詳細に例示する)。測定ユニット11に備えられた1つのリールは1週間の間必要とされる例えばストリップなどを含んでいてもよい。ストリップに備えられた、その間で血液の滴が吸収される電極は測定ユニット11に設けられている電子セクションに接続されており、このセクションには血糖値を測定するための手段が含まれる。この目的のために、電子セクション20には、例えばA/Dコンバーター及び、異なる電気的測定値に対応する血糖値が格納されている例えばROMテーブルなどのメモリが含まれる。この測定ユニットが抵抗値測定の代わりに光学測定を用いている場合には、それに応じてROMテーブルには異なる光学的測定値に対応する血糖値が格納される。
この電子セクション20には測定結果を格納できるメモリも含まれることが望ましい。したがって、測定の実施には、測定時に測定ユニット11に接続されるべき移動電話MSを必要とせず、測定ユニットは独立して作動することができ、測定結果はユニットに設けられたメモリに格納される。次に、測定ユニット11が移動電話MSに接続されているとき(あるいは、測定ユニットが継続的に移動電話に接続されている場合には、測定が完了したとき)、測定ユニット11の電子セクションは、患者を治療する医師のデータ処理システムへ測定結果を送信するために、図1との関連で説明したショートメッセージ伝送を起動させる。
患者が以前の測定結果を通じて閲覧し、移動電話MSのキーボード13とディスプレイ12を用いて自分の健康状態の進展をモニターすることができるように、電子セクション20にはメモリ中にいくつかの以前の測定結果を格納するための手段及び測定結果についての統計を処理する(コンパイルする)手段を含むことが望ましい。この電子セクションには又患者が測定を行う際に例えばディスプレイ12を介してアドバイスなどをしながらガイドしてくれる測定行為に関する特別のプログラムを格納することもできる。このプログラムは例えば、測定結果が所定の閾値を超えたり、それ以下に落ちたりした場合に直ちに医師に連絡を取るように患者に促すプロンプトを患者に提供する。
図3に示したストリップ16を図4に例示する。例えば外形寸法2mm x 7mmのそれ自体周知のこのストリップ16には2つの一体型電極17と18が含まれる。これらの電極の間に血液サンプルを含浸するキャピラリーがある。その後、ストリップから突き出ている電極17と18の両端を測定ユニットに接続することによってこの血液サンプルを電気的測定にかけることができる。
上記の説明及び関連図は単に本発明を例示することを意図したものにすぎないことが理解されるべきである。本請求の範囲に開示された本発明の範囲と精神を逸脱せずに、本発明の異なる変形と改変を行えることは当業者には明らかであろう。
Claims (6)
- 携帯用測定装置(1)であって、
前記携帯用測定装置(1)が、測定ユニット(11)、及び無線データ伝送リンク(3,4,5,6,7,8)を利用し、かつ、前記測定ユニット(11)に接続された移動電話(MS)または双方向ページャーから構成され、前記測定ユニット(11)が、データ処理システム(9)へ前記移動電話(MS)または双方向ページャーを介して前記測定の結果を送るための手段を有し、
ここに前記携帯用測定装置(1)が、血糖値を測定するための手段(15,16,19,20)をそなえ、前記の測定手段は、前記携帯用測定装置(1)の内側のリール(15)上に保持された測定用ストリップ(16)と協働し、前記リール上に保持された前記測定用ストリップの数が数日間という要件に一致することを特徴とする携帯用測定装置。 - 携帯用測定装置(1)であって、
前記携帯用測定装置(1)が、患者の健康状態をモニターするための測定ユニット(11)、及び無線データ伝送リンク(3,4,5,6,7,8)を利用し、かつ、前記測定ユニット(11)に接続された移動電話(MS)または双方向ページャーから構成され、前記測定ユニット(11)が、データ処理システム(9)へ前記移動電話(MS)または双方向ページャーを介して前記測定の結果を送るための手段を有し、
ここに前記携帯用測定装置(1)が移動電話(MS)と、前記移動電話(MS)の電池(14)のスペース中に配置され、かつ、前記移動電話の通信バスに接続されている測定ユニット(11)とを有し、前記測定ユニット(11)が、前記移動電話の通信バスを介して前記移動電話(MS)へ、更に前記無線データ伝送リンク(3,4,5,6,7,8)を介して前記データ処理システム(9)へ前記測定の結果を送るための手段を含む電子セクション(20)を有することを特徴とする携帯用測定装置。 - 前記測定ユニット(11)が、血糖値を測定し、かつ、前記移動電話または双方向ページャーを介して前記データ処理システム(9)へ前記測定の結果を送るための手段を含む電子セクション(20)を有することを特徴とする請求項2に記載の携帯用測定装置。
- 前記測定ユニット(11)は、患者の健康状態をモニターし、かつ、前記測定ユニットが前記移動電話または双方向ページャーから分離しているとき前記測定の結果を格納するためのメモリー手段、及び前記測定ユニットが前記移動電話または双方向ページャーに接続されているとき前記移動電話または双方向ページャーを介して前記データ処理システム(9)へ前記の格納された測定の結果を送るための手段を含む電子セクション(20)を有することを特徴とする請求項1又は2に記載の携帯用測定装置。
- 前記測定ユニット(11)が、皮膚を通す必要なしに前記血糖値の測定を行うための手段を有することを特徴とする請求項1に記載の携帯用測定装置。
- 携帯用測定装置(1)で使用される、患者の健康状態をモニターするための測定ユニット(11)であって、
前記携帯用測定装置(1)が無線データ伝送リンク(3,4,5,6,7,8)を用いる移動電話(MS)を有し、前記測定ユニット(11)が前記移動電話(MS)の電池(14)のスペース中に配置され、かつ、前記移動電話の通信バスに接続されるようになっており、かつ、前記通信バスを介して前記移動電話へ前記測定の結果を送るための手段を含む電子セクション(20)を有しており、それによってデータ処理システム(9)へ前記無線データ伝送リンクを介して前記測定の結果がさらに伝送されることを特徴とする測定ユニット。
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EP (1) | EP0959755B1 (ja) |
JP (1) | JP3993236B2 (ja) |
KR (2) | KR20040069348A (ja) |
AU (1) | AU1726697A (ja) |
DE (1) | DE69737106T2 (ja) |
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DK0959755T3 (da) | 2007-01-22 |
WO1997028736A1 (en) | 1997-08-14 |
JP2000504597A (ja) | 2000-04-18 |
KR19990082003A (ko) | 1999-11-15 |
DE69737106D1 (de) | 2007-01-25 |
EP0959755A1 (en) | 1999-12-01 |
US5772586A (en) | 1998-06-30 |
FI960636A (fi) | 1997-08-13 |
AU1726697A (en) | 1997-08-28 |
DE69737106T2 (de) | 2007-04-19 |
KR20040069348A (ko) | 2004-08-05 |
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