Classifications

• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
  • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
  • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation

Definitions

• the present invention provides a distributed system for communicating audio, video and medical data between patient monitoring sites, network servers and medical monitoring sites.
• This invention generally relates to the field of medical signal monitoring through a network. If the patient and doctor are located remotely with respect to each other, while connected to a network, then this circumstance is often referred to as telemedicine. If the doctor and the patient are located close to each other, perhaps within the same hospital building, then this is referred to as conventional medical monitoring. In either case, the information from the medical signal acquisition devices attached to the patient can be communicated to the medical monitoring site, and observed, reviewed, and analyzed by the doctor, by means of a network.
• a distributed system for acquiring, disseminating, and outputting audio, video, and medical data.
• the system comprises at least one patient monitoring site comprising a plurality of input devices by which selected audio, video and medical data are captured for a patient.
• each patient monitoring site is associated with a respective time server.
• At least one medical monitoring site comprising at least one output device at which audio, video and medical data can be selectively output for at least one selected patient monitoring site, in synchronization based on the time stamp. All of the data is communicated over a network, to which the plurality of input devices and the at least one output device are connected, so that a selected medical monitoring site may contemporaneously receive, review and analyze synchronized audio, video and medical data from at least one selected patient monitoring site.
• At least one patient monitoring site is located in physical proximity to its associated time server to ensure accurate synchronization of the time stamp on all data captured by the plurality of input devices.
• the system is configured so that each patient monitoring site further comprises at least one output device by which selected audio, video and medical data are output.
• the system of the present invention provides for a medical monitoring site to further comprise at least one input device by which selected audio, video and medical data may be input so as to provide bilateral communication between the medical monitoring site and the patient monitoring site.
• the system further comprises at least one intermediate server for selective storage of data captured by at least selected input devices from selected patient monitoring sites. This permits the review and analysis of the time stamped data at a time other than the actual instance when an event may occur.
• the at least one medical monitoring site may selectively output data for at least one selected patient monitoring site, in synchronization based on said time stamp, but at a later time than when the data is collected from the patient monitoring site.
• a selected medical monitoring site may receive, review and analyze stored synchronized audio, video and medical data from at least one selected patient monitoring site from said intermediate server, at any selected time.
• there may be a plurality of intermediate servers, wherein each of the intermediate servers stores data from a selected specific input device at each patient monitoring site.
• each of the intermediate servers may be arranged so as to store data from a selected group of patient monitoring sites.
• One method of overcoming this obstacle is to com ect each of the medical, video and audio devices together through the same master computer so that the master computer can form data streams that consist of simultaneous recording of the medical, video or audio data to the server system.
• the disadvantage of this arrangement is that the processing ability of a single computer will ultimately be restricted by the processing power of the computer, or the network bandwidth between the computer and the network servers.
• a playroom were constructed for the treatment of epilepsy patients, using a large number of medical devices, audio devices and video devices for the continuous simultaneous observation of those many patients across the many cameras, one computer cannot process all of the information.
• an expert physician such as a neurologist or neurophysiologist
• This arrangement may be required for reasons of sterility, convenience, or the desire to make the expert physician's expertise available to more than one operating procedure at the same time.
• video views of the surgical field may be required during any given procedure.
• video views of the surgical field either external or internal (laporascopic) views, or video data views generated by microscopes, surgical head mounted cameras, etc.
• video data views generated by microscopes, surgical head mounted cameras, etc. may be required during any given procedure.
• process of quantifying the relationship between interaction with neurological structures of the patient, and electrophysiological changes that may occur in the patient is another excellent example of the efficacy of the present invention showing the benefits thereof over the existing art, is in the area of long term sleep studies for the accurate diagnosis of sleep apnea, and the like.
• multiple camera views can be such as from conventional video cameras, or the video views may be generated by specialized imaging equipment such as fluoroscopy equipment, or imaging ultrasound equipment.
• Each of the devices can then digitize not only the medical, video or audio signal, but it will also record the time information associated with the moment of digitization of every data sample ⁇ or at least some periodic number of digital samples —such time coding being embedded in the data streams often enough to guarantee the accurate reconstruction of the complete medical information at a medical monitoring site.
• the medical monitoring site may be located inside the patient monitoring area or remotely, and it may be connected by TCP/IP protocols to intermediate servers, to the network, and to other patient and/or medical monitoring sites.
• the technique of counting frame information or digitized sample count cannot be used to accurately synchronize the information at a patient monitoring site.
• the present invention allows for the writing of medical, audio or video data from independent devices with time synchronization information encoded in the data, such time synchronization information being provided to all of the devices that make up the total of the devices in the patient monitoring site by an independent time server which broadcasts time information to all of the devices in the patient monitoring system.
• one of the devices in the patient monitoring system may assume the role of master time server, and it will broadcast time information to all of the other devices in the medical system associated with that patient monitoring site.
• Such time information can be broadcast to all of the devices by suitable network means including but not restricted to a LAN (local area network), WAN (wide area network), internet, intranet, extranet, wireless area network, wireless LAN, cable TV network, asynchronous transfer mode network, public switched telephone network, integrated services digital network, infrared network, microwave relay network, satellite network, or any other type of network capable of transmitting packets formatted in TCP/IP protocol.
• suitable network means including but not restricted to a LAN (local area network), WAN (wide area network), internet, intranet, extranet, wireless area network, wireless LAN, cable TV network, asynchronous transfer mode network, public switched telephone network, integrated services digital network, infrared network, microwave relay network, satellite network, or any other type of network capable of transmitting packets formatted in TCP/IP protocol.
• the patient monitoring site can be comprised of a great many data acquisition devices including but not limited to video, audio and medical content devices such as ecg, respiration, eeg, blood pressure and rate,
• multiple data acquisition devices of the same type can be connected at the patient monitoring site.
• Each data acquisition device is in communication with each of the other devices at the patient monitoring site to maintain time synchronization between all the devices.
• Each data acquisition device can format its data in TCP/IP protocol, but that fact is not germane to the present invention.
• video and audio of the patient may be gathered and transferred to an intermediate server via a high speed network like a LAN or DSL, while the patient medical data may be transmitted to an intermediate server by a low speed wireless network such as CDPD, CDMA or infrared. This allows to the patient the important mobility required to perform their normal tasks without being tethered to a machine.
• the medical system does not require independent audio, video or medical devices to be hard wired together.
• the data because it is time stamped, does not need to be aggregated into one control unit for communication to the intermediate servers via one network pathway.
• Independent data streams from each of the audio, video or medical devices can be communicated to one or several intermediate servers, which can be located anywhere on the internet, via TCP/IP over independent network pathways.
• the data stream from each independent audio, video or medical device contains time information allowing the data to be resynchronized at a later time at the medical monitoring site.
• Resynchronizalion is critical, because medical physiology must be identically correlated with video movement in for example the field of epilepsy diagnosis.
• small patient worn medical devices can transmit information to respective intermediate servers directly through wireless connection to the internet, while high bandwidth devices such as video cameras can simultaneously transmit information over higher bandwidth land lines to the same or different intermediate servers.
• high bandwidth devices such as video cameras can simultaneously transmit information over higher bandwidth land lines to the same or different intermediate servers.
• multiple synchronized audio, video and medical data feeds may be added to provide to remote medical practitioners more complete information about the current state of the patient.
• the medical monitoring site can be configured to display the appropriate video stream that shows the most relevant view of the patient, having regard to the medical data being viewed.
• the medical devices at the patient monitoring site can be made extremely simple.
• a patient monitoring site medical device can consist of a medical transducer, an analog to digital converter, and a small cpu to control the digitization and transmission of the data to the network.
• Software to store, process and display the data does not need to be located at the patient monitoring site or the medical monitoring site, but can be stored independently on intermediate servers that are connected to the network.
• This software can be uploaded from one or several of the intermediate servers at the time the particular data stream is chosen for review.
• software can be managed centrally so each individual medical monitoring site will always have the latest version of software without a difficult maintenance effort; further, the institution benefits because this software is available to all potential medical monitoring sites, including ordinary PC's.
• Another distinct advantage of the present invention is that the hardware for the processing and storage of many types of medical signals can be replaced by intermediate servers. Even more flexibility is achieved when individual medical devices are connected directly to the network, time synchronized with other devices on the network, and generate independent data streams.
• the acknowledgement of the storage operation by linked software can trigger other events.
• Data may be analyzed, the results of that analysis directed to either the medical monitoring system, the patient monitoring system, or an administrative system for appropriate action.
• the ability to encode time information with or into the medical data stream itself allows many independent medical devices to feed their data to independent files located on independent servers.
• the medical monitoring site can retrieve the data from many different locations and create a new medical montage.
• cardiac, eeg video, ultrasound, blood pressure data, among other feeds can be displayed on the same screen, thereby providing the opportunity for the medical practitioner to determine causality between the changes in one medical signal with another.
• For many tasks such as recording a blood pressure, taking a temperature, among others, are in fact providing documentation for the respective patient.
• a further advantage of the present invention is that the common infrastructure may be leveraged across many medical, audio or video acquisition devices, allowing additional devices to be added to the patient monitoring site at a fraction of the cost of conventional dedicated medical instruments.
• Another advantage of the present invention is the ability to develop time synchronized views of many modalities that are usually recorded in completely independent locations, and which are generally not well correlated with one another. An excellent example is when the volume and time of delivery of a drug by a networked drug delivery device forming part of the patient monitoring system is synchronized with an electrophysiological recording of the physiological parameters that the administered drug is meant to influence.
• Any medical monitoring site can connect through TCP/IP network protocols to one or several intermediate servers, and can request one or multiple data streams from files generated by devices located at the patient monitoring site.
• the high speed of networks and intermediate servers results in only a slightly delayed view of the patient monitoring site information.
• a further distinct advantage of the system is that multiple caregivers can comiect to the same patient at the same time, by simultaneously connecting to the intermediate servers. In this way, independent doctors and telehealth nurses may perform a simultaneous medical consultation without overloading the communication capacity of any of the audio, video or medical devices located at the patient monitoring site.
• a further advantage of the system is that the data is automatically archived to an intermediate server or servers in real time.
• the present invention provides a medical system for transmitting time coded audio, time coded video, and time coded medical data between patient monitoring sites and medical monitoring sites by means of network communication, and usually through one or several intermediate storage and broadcast servers.
• One or several control units can be located at each patient monitoring site, the control units receiving video, audio, and medical data from one or more video, audio, and medical monitoring devices in communication with the control units.
• the control units receive time data from a time server in communication with the respective control units.
• the control units encode time information with the video, audio, and medical data, and then deliver the time stamped data to communication devices in communication with the control units.
• the communication devices will then encapsulate the time stamped data into packets in accordance with a preselected communication protocol, and output the packets onto a network.
• the time stamped data may be sent for storage on an intermediate server, or it may go directly to a selected medical monitoring site, or both events will generally occur.
• a network connection is provided between the communication devices in communication with the audio, video and medical device control units, to allow time stamp information to be communicated between the respective control units.
• a plurality of medical monitor control units are located at one or more medical monitoring sites, the control units being in communication with a communication device. The communication device selectively requests and receives time stamped data packets from one or more intermediate storage servers on the network.
• the task of the communication device is to de-encapsulate the time stamped data packets to reconstruct time coded medical, audio and video data from one or many control units at the patient monitoring site.
• Medical monitoring site control unit software is provided to construct time synchronized representation of data from one or many medical device control units for further display or processing purposes.
• Figure 2 is a further general schematic showing an alternative distributed system in keeping with the present invention.
• any distributed system in keeping with the present invention will comprise a plurality of patient monitoring sites 12; and as shown, it will also comprise a plurality of medical monitoring sites 14a through 14n, and a plurality of intermediate servers 16a through 16n.
• Each medical monitoring site 14 includes at least one output device 15.
• Each patient monitoring station 12 includes an output control device 17, by which selected audio, video and medical data are output; all as noted hereafter.
• Audio capture devices are shown at 20a through 20n; video capture devices are shown at 22a through 22n; and medical data devices are shown at 24a through 24n.
• a time server is shown at 26, and it provides a base time signal which is referenced by all of the input devices so as to provide a synchronized time stamp on all the data captured by the plurality of input devices - all of which data is then output through an output control device 17 to the network 18, through a plurality of network connections shown generally at 30.
• an audio playback control unit 32 and a video display control unit 34 are also shown in the patient monitoring site 12.
• FIG. 1 shows another general layout for a distributed system in keeping with the present invention. Here, there are a plurality of patient sites 12a through 12n; and the time server 26 is shown as being separately located away from, and thus not part of, any individual patient monitoring site 12.
• the time server 26 is in close physical proximity to the patient monitoring sites 12 so as to ensure accurate synchronisation of the time stamp on all data captured by the plurality of the input devices at the plurality of patient monitoring sites.
• the close proximity of the time server 26 through the patient monitoring sites 12 precludes the likelihood of any delay artifacts that might otherwise occur as a consequence of network transmission of packetized, encapsulated data.
• the administrative site 40 may serve a number of different purposes; included among them may be the maintenance of patient billing records and the like.
• the administrative site may also be such as to allow for the intervention of a supervisory caregiver who might, for example, have the option of initiating drug administration to a patient at a patient site using bilateral communication with a drug administration device of some sort located at the patient monitoring site.

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• 2001
  • 2001-05-18 CA CA002374948A patent/CA2374948A1/en not_active Abandoned
  • 2001-05-18 JP JP2001584341A patent/JP2003533305A/ja active Pending
  • 2001-05-18 WO PCT/CA2001/000722 patent/WO2001088825A2/en active Application Filing
  • 2001-05-18 AU AU61953/01A patent/AU6195301A/en not_active Abandoned

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