WO2010099488A1 - Suivi de contacts au moyen de badges sans fil - Google Patents

Suivi de contacts au moyen de badges sans fil Download PDF

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Publication number
WO2010099488A1
WO2010099488A1 PCT/US2010/025659 US2010025659W WO2010099488A1 WO 2010099488 A1 WO2010099488 A1 WO 2010099488A1 US 2010025659 W US2010025659 W US 2010025659W WO 2010099488 A1 WO2010099488 A1 WO 2010099488A1
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WO
WIPO (PCT)
Prior art keywords
transceiver
hygiene
proximity
room
history
Prior art date
Application number
PCT/US2010/025659
Other languages
English (en)
Inventor
Theodore Herman
Philip Polgreen
Original Assignee
University Of Iowa Research Foundation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by University Of Iowa Research Foundation filed Critical University Of Iowa Research Foundation
Publication of WO2010099488A1 publication Critical patent/WO2010099488A1/fr

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Classifications

    • G—PHYSICS
    • G08—SIGNALLING
    • G08B—SIGNALLING OR CALLING SYSTEMS; ORDER TELEGRAPHS; ALARM SYSTEMS
    • G08B21/00—Alarms responsive to a single specified undesired or abnormal condition and not otherwise provided for
    • G08B21/18—Status alarms
    • G08B21/24—Reminder alarms, e.g. anti-loss alarms
    • G08B21/245—Reminder of hygiene compliance policies, e.g. of washing hands
    • 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
    • G16H40/20—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 management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
    • 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
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/80—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for detecting, monitoring or modelling epidemics or pandemics, e.g. flu

Definitions

  • the present subject matter relates to hand hygiene compliance systems and in particular hand hygiene compliance systems using wireless badges.
  • the CDC estimates only 40% adherence rate of hand hygiene practices in US hospitals and recommends establishing a performance indicator by monitoring and recording hand washings to help improve the adherence. Although good hand hygiene can prevent the spread of disease, once a disease is detected, understanding the migration of the disease both before and after detection can assist in containing the disease and in preventing and minimizing the effects of the disease in a subsequent outbreak.
  • the transceiver device is portable and includes a radio, memory and a power source.
  • the transceiver device detects other transceiver devices and records the history of proximity to each of the other device using the memory.
  • a method embodiment includes receiving health information at a portable first transceiver device and calculating an exposure potential using the health information and a history of proximity to other transceiver devices.
  • the transceiver device processes a simulation using the recorded history and the health information to calculate the exposure potential.
  • a system embodiment includes a computer to receive health information, a portable first transceiver device and one or more second transceiver devices.
  • the portable first transceiver device includes a wireless transceiver, memory and a processing component.
  • the portable first transceiver device is configured to detect and record a history of proximity to the one or more second transceiver devices.
  • at least one of the other transceiver devices includes a hygiene device.
  • FIG. 1 shows a hand hygiene tracking system according to one embodiment of the present subject matter.
  • FIG. 2 shows a block diagram of a hand hygiene station, wearable badge, proximity device and computer according to one embodiment of the present subject matter.
  • FIG. 3 shows a badge and computer according to one embodiment of the present subject matter.
  • FIG. 4 shows a badge according to one embodiment of the present subject matter.
  • FIG. 5 shows a flow chart of a method for detecting hand cleaning hygiene data in a hand hygiene compliance system according to one embodiment of the present subject matter.
  • FIG. 6 is a flowchart of a method for collecting hand hygiene data in a hand hygiene compliance tracking system according to one embodiment of the present subject matter.
  • FIG. 7 shows a flowchart for a method to extend the battery life of a badge battery according to one embodiment of the present subject matter.
  • FIG. 8 illustrates a flowchart of a method for synchronizing a device clock within a system according to one embodiment of the present subject matter.
  • FIG. 9 is a flowchart of a method for tracking hand hygiene compliance according to one embodiment of the present subject matter.
  • FIG. 10 includes a flowchart of a method to estimate a probability of infection according to one embodiment of the present subject matter.
  • the present subject matter provides a tracking system for monitoring and recording hand hygiene practices as well as for tracking contact between personnel and contact between personnel and equipment monitored as part of the system.
  • Components of the system include small wireless transceiver devices that can be easily deployed at various locations and in concealed manners when desired.
  • the system also includes wearable transceiver devices such as badges, key fobs, bracelets, belt clips, or similar items that contain small computers with wireless networking and memory.
  • the wireless transceiver devices are adapted to detect, among other things, hand hygiene related events and communicate data related to those events to the wearable badges. Such events include, but are not limited to, a person activating a hand sanitizer, soap dispenser and/or hand washing station.
  • the system is useful for detecting compliance with hand hygiene policies established by a health care provider.
  • Data related to the hand hygiene events is collected and stored by the badges.
  • the data is subsequently transferred to a computer for processing and analysis.
  • data is transferred from the badges to the computer via wireless communications.
  • data is transferred from the badge memory using a wired connection, including but not limited to, a Universal Serial Bus (USB) connection.
  • USB Universal Serial Bus
  • FIG. 1 shows a hand hygiene compliance system 100 according to one embodiment of the present subject matter.
  • the system includes a computer 101, hand hygiene stations 102, proximity devices 103 and radio badges 104.
  • the system 100 generates data related to the operation of the hand hygiene stations 102 and the movement of badge wearing people within the facility.
  • the illustrated system 100 monitors hand hygiene in a hospital. It is understood that other installations of a system are possible where hand hygiene compliance can benefit the welfare of personnel within or outside such a facility including, but not limited to, schools, restaurants, hospices, clean room facilities, laboratories and food processing, food preparation and food services facilities.
  • the illustrated embodiment includes a hand hygiene station 102 next to a nurses' station 110.
  • the system tracks hand hygiene using radio badges 104 to record and store hand hygiene related data.
  • radio badges 104 In a hospital facility, doctors, nurses, staff, patients and visitors may all wear a radio badge 104.
  • Each hand hygiene station 102 includes radio electronics that are triggered when the station is used. Upon being triggered, the radio electronics transmit data.
  • a radio badge in proximity to an activated hygiene station receives the transmission.
  • the badge 104 records data within the transmission for subsequent processing using the computer 101.
  • the badge 104 responds to the transmission and exchanges and records data with the hand hygiene station 102. In various embodiments, the badge 104 and station 102 will exchange identifying information and data related to the hand hygiene activity initiating the communications. In some embodiments, the badge 104 stores one or more pieces of data in memory including, but not limited to, a unique identification code (ID) associated with the hand hygiene station, signal strength of received transmissions, time of day, date or combinations thereof. The data is subsequently downloaded from each badge in the system to the computer and then processed and analyzed to track hand hygiene compliance. In some embodiments, the hand hygiene station transmits data related to its operation or condition including, but not limited to, the levels of any consumable products, battery status, operational status or combinations thereof. Such information is used to schedule maintenance and upkeep of the hand hygiene stations.
  • ID unique identification code
  • the system 100 also monitors hand hygiene compliance using proximity devices 103.
  • the proximity devices 103 are mounted near each patient bed 105.
  • proximity devices are mounted in hallways.
  • proximity devices are mounted both near each patient bed and in the hallways.
  • the proximity devices 103 include radio electronics and periodically emit transmissions for reception by the radio badges 104.
  • a badge 104 Upon detecting a proximity device transmission, a badge 104 records data related to the transmission including, but not limited to, an ID code associated with the proximity device, and signal strength of received transmissions.
  • the badge 104 saves the data to memory with a time stamp including the time and date. The saved data is subsequently downloaded from each badge in the system and then processed and analyzed to track hand hygiene compliance.
  • the proximity device 103 and a badge 104 engage in a two-way communication in which the proximity device also stores data.
  • the proximity device records data including, but not limited to, an ID code associated with one or more badges within communication range of the device, signal strength of received transmissions or combinations thereof.
  • the proximity device 103 saves the data to memory with a time stamp including the time and date.
  • proximity devices are adapted for specialized functions that differentiate one proximity device from another.
  • a room memory device is a specialized proximity device.
  • a room memory device includes a low-power computer with sufficient memory to contain the history of room status over a period of several weeks, where room status includes information of patient presence and nature of possible patient infections.
  • a room memory device may have data display and data entry capabilities.
  • a room memory devices is portable and can be set up or removed quickly from a room.
  • Room memory devices can have wireless, wired or both wireless and wired network connections to interoperate with other system components.
  • Room memory devices can be powered by a stand-alone power source such as a battery, a standard electric outlet, by energy harvested from an ambient power supply or combinations thereof.
  • Ambient power supplies for harvesting energy can include, but are not limited to, light, heat and vibration.
  • a room memory device communicates with other transceivers, such as transceivers associated with visitors, health care workers or equipment proximate or within the room associated with the room memory device.
  • a room memory device records interaction information for subsequent analysis in estimating disease migration.
  • the room memory device can receive information that mitigates disease migration. For example, where a room has been exposed to a contagious disease, such as a patient with Clostrididium difficile (C-diff), a health care worker assigned to clean the room can enter information indicating the room has been cleaned using a display interface of the room memory device. Such information can mitigate the probability of subsequent patients, health care workers and visitors of contracting C-diff. The information is also useful in providing an accurate simulation of disease migration.
  • C-diff Clostrididium difficile
  • a unit memory device is a specialized a proximity device.
  • a unit memory device includes a small computer with sufficient memory to contain the history of activity within a unit over a period of several weeks, if not months or years. In some embodiments, such activity history includes the accumulated data from room memory devices for all rooms in a unit.
  • Unit memory devices may have data display and data entry capabilities. In various embodiments, unit memory devices are powered by standard electric outlets. Unit memory devices include wireless, wired, or both wireless and wired network connections to interoperate with other system components. In various embodiments, unit memory devices include unit displays to provide feedback to HCWs on the status of the system, their performance, or other metrics related to system objectives.
  • Network gateways are devices that connect other system components to other computers or networks, so that the system components may exchange information with larger information technology systems. For example, some health information useful for accurately simulating disease migration may be located on other databases outside the system. Such information may include, but is not limited to, health records of patients, HCWs, visitors, contractors, etc., and maintenance records related to instrument and room cleaning. Network gateways may also transmit service requests to other computers; such requests may offload data, request current time or configuration data, or provide remote servers statistical data concerning the other system components.
  • a unit memory device includes a network gateway.
  • the system computer includes the unit memory device.
  • location and time anchors are specialized proximity devices.
  • a location and time anchor is a single device.
  • a location and time anchor either alone or in a combined device, includes small, low-power processors with sufficient computational resources to engage in wireless protocols for the purpose of identifying a location or a name of a room, and for assisting in ongoing clock synchronization. These devices may include a battery, use a standard electric outlet, use power scavenging methods (e.g. from light, heat, vibration, etc) or combinations thereof for power.
  • location and time anchors transmit unsolicited messages including location and/or time information. In some embodiments, the unsolicited messages are transmitted at a higher power than other transceiver devices such as wearable transceiver devices, for example.
  • a proximity device can be preprogrammed to emit a beacon of wireless information at a time resolution adequate to determine movement about a facility by a badge wearer and which provides suitable badge lifetime.
  • the wireless electronics of the system can be adapted to turn on for a portion of time in a period to allow for transmissions of the proximity device and reception by the badges. This time period is adjustable for different applications.
  • Typical considerations can include, but are not limited to, one or more of: the speed with which a badge-wearing person can migrate about the facility, the variation in signal strength experienced, conservation of the "on" time for the receivers in the badge to reduce power consumption and/or combinations of these considerations.
  • the amount of power consumed by each badge is related to the amount of "on" time where the badge is listening for the proximity device or the actuated device (such as a hand hygiene station).
  • the system provides a self-synchronizing function that allows for gated, periodic reception of transmissions to reduce power consumed by the wireless badges. Since all systems experience at least slight timing drift, the various badges are synchronized with the proximity device(s) near them to achieve a uniform time for devices in proximity. As badges move about the facility, these synchronizations can take place to ensure that all of the proximity devices and badges are within an acceptable timing skew to facilitate gated reception of signals.
  • the badges in the system are programmed to transmit their clock information.
  • the proximity device can differentiate the times and adopt the latest time transmitted by the badges. The badges then all adopt that time. This synchronizes the clocks of all of the badges and proximity devices. It is understood that variations can occur without departing from the scope of the present subject matter. For example, the system could adopt the earliest time to perform synchronization. Other timing approaches are possible without departing from the scope of the present subject matter.
  • the hand hygiene stations 102 record data in memory when the station is activated.
  • the data may include, but is not limited to, an ID code associated with one or more badges within communication range of the station, signal strength of received transmissions, status information associated with the hand hygiene station, time of day, date or combinations thereof.
  • the badges, hand hygiene stations and proximity devices reciprocate communications, the system is less likely to generate erroneous data.
  • hand hygiene stations 102 include the functionality of proximity devices 103.
  • signal strength data is used to determine if the badge wearer entered a hand hygiene sensitive area.
  • a hand hygiene sensitive area 106 may include any area close enough for a person to touch a patient. In some hospitals, entering such an area requires that the person wash their hands prior to entering and immediately after exiting the area.
  • use of signal strength data from one or more devices can assist in determining violations of, or conformance to, hand hygiene protocol with respect to hand hygiene sensitive areas 106 without constant visual monitoring.
  • the badges are adapted to communicate with each other. For example, such embodiments provide for the exchange of data 120.
  • each badge monitors the duration of badge-to- badge contact based on the amount of time the badges are engaged in wireless communication.
  • FIG. 2 shows a block diagram of a hand hygiene station 202, wearable badge 204, proximity device 203 and system computer 201 according to one embodiment of the present subject matter.
  • the hand hygiene station includes wireless communication electronics 211, hand hygiene apparatus 212 and a sensor 213 to monitor the hand hygiene apparatus.
  • the wireless electronics 211 are compatible with the Institute of Electrical and Electronic Engineers (IEEE) 802.11 standard.
  • the wireless electronics 211 are compatible with the IEEE 802.15 standard. It is understood that use of electronics conforming to other radio frequency wireless communication standards or custom protocols are possible without departing from the scope of the present subject matter.
  • the hand hygiene apparatus 212 includes devices used for one or more hygiene related activities, including but not limited to, hand washing, hand sanitizing, hand drying and/or hand disinfecting.
  • the sensor 213 monitors one or more conditions of the hygiene station such as, but not limited to, dispensing of soap, dispensing of sanitizer, flow of water, dispensing of towels or tissue, level of sanitizer products used with the station, duration of sensed conditions, battery status or combinations thereof.
  • the sensor is a switch.
  • multiple sensors are employed to monitor conditions of the hand hygiene station.
  • the wireless electronics 211 processes signals received from the sensor 213 to identify hand hygiene related activity and generate hand hygiene data related to the activity.
  • the wireless communication electronics 211 transmits the hand hygiene data to one or more badges 204.
  • a proximity device 203 is located within communication range of a hand hygiene station 202, the proximity device receives and records data associated with transmissions from the hand hygiene station 202.
  • proximity devices 203 are at least located near areas where the status of hand hygiene is important or is likely to change. In a hospital setting, such locations include, but are not limited to, areas near patients and or near an access area of a patient bed or a patient room, such as the door.
  • the proximity devices 203 include wireless electronics 214, a clock 215 and, in some embodiments, memory for storing data.
  • the wireless electronics 214 are compatible with the Institute of Electrical and Electronic Engineers (IEEE) 802.11 standard.
  • the wireless electronics 214 are compatible with the IEEE 802.15 standard. It is understood that use of electronics conforming to other radio frequency wireless communication standards or custom protocols are possible without departing from the scope of the present subject matter.
  • the proximity device 203 transmits a signal at a predetermined interval for reception by any badges 204 within communication range.
  • a badge 204 Upon receiving a transmission from a proximity device 203, a badge 204 will record data associated with the transmission.
  • recording data at the badge 204 includes responding to the proximity device transmission and exchanging data with the proximity device 203.
  • Data recorded in the memory of the badge 204 and/or the proximity sensor 203 includes, but is not limited to, signal strength of received data, data to identify the transmitting device, status information of each device or combinations thereof.
  • the badge 204 and the proximity device 203 saves the data to memory with a time stamp including the time and date.
  • the proximity devices are precisely located to provide a location anchor within a facility such that interactions recorded by either the proximity device or a portable wireless transceiver device can be used to map the movement of the portable wireless transceiver devices.
  • the badges 204 are worn by persons working in and/or visiting a facility that utilizes a hand hygiene compliance system.
  • the badges 204 include wireless electronics 216 for receiving radio frequency transmissions, processing electronics 222 including a memory 217 for storing data associated with received transmissions and a clock 220 for time stamping saved data, and a power source, such as a battery 218, to provide power.
  • the memory 217 includes flash memory.
  • the data downloaded from the badge 204 is used to track hand hygiene compliance of the badge wearer.
  • the signal strength provides an indication of how close a badge wearer was to the proximity device 203.
  • each patient, or patient bed may include a proximity device 203.
  • Some hand hygiene compliance protocols require hand washing before and after a person touches or gets close to a patient.
  • the system determines when a badge 204 was close to a patient to require the person to wash their hands before and after the encounter. Further analysis of the badge data determines whether the person complied with the protocol.
  • the system determines the position of the badge 204 and tracks the movement of the badge to assess hand hygiene compliance.
  • the probable position of the badge 204 can be derived from the relative signal strengths of each of the transmissions associated with the stationary transceiver devices.
  • subsequent processing identifies the position of the badge 204 using the signal strength of the transmission recorded in the two or more other devices.
  • the accuracy of the location depends on the accuracy of the known location of the two or more other devices. Therefore, if the two or more other devices include stationary devices such as hand hygiene stations 202 or proximity devices 203, the probable location of the transmitting badge should be quite accurate, as the system, upon configuration, should have a location identified with each of the hand hygiene stations 202 and the proximity sensors 203.
  • both badges receive the transmission from the hand hygiene station.
  • both badges record the hygiene related data and subsequent processing determines which badge was associated with the hand hygiene related activity.
  • the station evaluates the relative strength of the received transmission signals, identifies which badge to associate with the hand hygiene activity and attenuates subsequent transmissions to isolate communication with the identified badge.
  • badges record all discernable transmissions.
  • only data associated with transmissions exceeding a predetermined signal strength threshold is saved to memory.
  • all discernable data is saved.
  • configuration of the system includes mapping the communication range and signal strengths of the various hand hygiene stations and proximity devices. Such configuration data allows the system computer to process and analyze signal strength data downloaded from the badges to accurately map the movement of one or more badges and determine specific occasions of hand hygiene compliance and non-compliance. At some point in time, such as the end or a day, the end of a visit, or the end of a shift, a person wearing a radio badge 202 turns the badge in or takes care of downloading the data stored in the memory of the badge to the computer 201.
  • the badge 202 is connected to a system computer 206 to retrieve the hygiene related activity data from the memory 217 of the badge 204.
  • the badge 204 is connected to the computer 201 using a wired connection 208, such as, a USB connection, to download the data from the badge to the computer.
  • the wired connection 208 is used to recharge the badge battery 218.
  • FIG. 3 shows a badge and computer according to one embodiment of the present subject matter.
  • the badge includes wireless electronics 316, processing electronics 322 including a memory 317 for storing data associated with received transmissions and a clock 320 for time stamping saved data, and a power source, such as a battery 318, to provide power.
  • the memory 317 is flash memory.
  • the badge 304 downloads hand hygiene related data to the computer 301 using a wireless connection 309.
  • the wireless electronics are also used to communicate to the hand hygiene stations and the proximity devices.
  • the wireless electronics are compatible with the Institute of Electrical and Electronic Engineers (IEEE) 802.11 standard.
  • the wireless electronics are compatible with the IEEE 802.15 standard.
  • the badge 304 includes separate wireless electronics for communicating to the computer 301.
  • the badge automatically downloads saved data anytime the badge can communicate with the system computer.
  • badges upload information from other system devices including other badges, hand hygiene stations and/or proximity sensors and transfer the information to the system computer whenever the badges can communicate with the computer.
  • the system includes one or more nodes coupled to the system computer to accommodate badge downloads.
  • FIG. 4 shows a badge according to one embodiment of the present subject matter.
  • the badge 404 includes wireless electronics 416, processing electronics 422 including a memory 417 for storing data associated with received transmissions and a clock 420 for time stamping saved data, a power source, such as a battery 418, to provide power and an annunciation device 421.
  • the annunciation device 421 is activated to remind the wearer to comply with a hand hygiene protocol. For example, if the badge 404 detects that it has moved into close proximity to a patient area, then out of the close proximity of the patient area and then into close proximity of another patient area without using a hand hygiene station, the annunciation device 421 activates.
  • activation of the annunciation device 421 is to remind the badge wearer to comply with a hand hygiene protocol requiring hand washing between visits to different patients. It understood that a variety of annunciation devices 421 are possible for use with the badge 404 without departing from the scope of the present subject matter including, but not limited to, devices producing vibration, light, and sound. It is also understood that is possible to program the badge to use the annunciation device to alert the wearer to other conditions without departing from the scope of the present subject matter.
  • a hand hygiene compliance system improves hand-cleaning compliance and reduces the risk of spreading contamination among people or equipment within a facility.
  • the use of wireless communications allows for easy installation of a hand hygiene compliance system in an existing facility.
  • Wireless communication reduces the need for wired infrastructure to support the system.
  • wireless communication-enabled badges store and download all the pertinent information, thus the hand wash stations and proximity devices are not required to be directly networked to the system computer.
  • the components can include an independent power source, such as a battery for example, thus reducing installation costs associated with providing additional outlets.
  • a facility need only replace existing hand wash stations with, battery powered, wireless communications enabled, hand wash stations to complete the installation of a system.
  • existing hand wash stations are easily modified to incorporate the one or more sensing devices and wireless electronics.
  • FIG. 5 shows a flow chart of a method 530 for detecting hand hygiene data in a hand hygiene compliance system according to one embodiment of the present subject matter.
  • the method 530 includes detecting hand hygiene activity at a hand cleaning station 531, transmitting data related to the hand cleaning station 532, receiving the data at a radio badge 533, and measuring the signal strength of the received data 534.
  • FIG. 6 is a flowchart of a method for collecting hand hygiene data in a hand hygiene compliance tracking system according to one embodiment of the present subject matter.
  • the method includes detecting hand hygiene data 630, saving the data to memory of a radio badge 641, detecting and saving additional hand hygiene data until collection period is complete 642, download data to a computer 643 and processing the data to determine compliance to hand hygiene policy 644.
  • hand-cleaning data is recorded each time the badge is associated with hand cleaning activity at a hand cleaning station.
  • the collection period ends at a predetermined time, such as for example, the end or a day, the end of a visit, or the end of a shift.
  • the badge is connected to a system computer to retrieve the hand cleaning data from the memory of the badge and clear the badge memory for another collection period.
  • the data is then analyzed to determine hand hygiene compliance.
  • the system depends on time stamps to determine event sequences related to hand hygiene tracking. In some embodiments, precise timing coordinates communication events between devices.
  • FIG. 7 shows a flowchart for a method 750 to extend the battery life of a badge by limiting the availability of wireless communications in a badge.
  • the method includes saving a transmission schedule to the badge memory 751, synchronizing the badge clock according to the schedule 752, enabling the wireless electronics according to the schedule 753, disabling the wireless electronics according to the schedule 754, and repeating the schedule 755.
  • the wireless electronics are enabled longer than they are disabled.
  • the wireless electronics are enabled as long as they are disabled, thus extending the battery life.
  • the transmission schedule enables the wireless electronics for a fraction of the time they are disabled, thus extending the battery life even further. Reducing the time the wireless electronics are enabled conserves energy but burdens the devices to adhere to a precise schedule for Communications. Devices with such a precise schedule rely on clocks that are synchronized which the clocks in the other system devices.
  • FIG. 8 illustrates a flowchart of a method 860 for synchronizing a device clock within a system according to one embodiment of the present subject matter.
  • the method includes transmitting synchronization data from the device at a predetermined time 861, receiving synchronization data from one or more other devices 862, and resetting the device clock based on the received data 863.
  • the synchronization data includes the value of the device clock at the predetermined time.
  • the received data includes the synchronization data from the other devices.
  • the device's synchronization data is compared to the received data and the clock is reset according to the highest clock data.
  • the device's synchronization data is compared to the received data and the clock is reset according to the lowest clock data.
  • the hand hygiene stations synchronize their clock with the badges and emit their synchronization data according to the same predetermined time.
  • the proximity devices synchronize their clock with the badges and emit their synchronization data according to the same predetermined time.
  • the proximity devices and the hand hygiene stations synchronize their clocks with the badges and emit their synchronization data according to the same predetermined time.
  • one or more devices emit their synchronization data with higher power than transmissions associated with other hand hygiene tracking events.
  • collecting signal strength data allows the system to track badge movement and estimate hand hygiene compliance of the badge wearer based on the movement and corresponding hygiene related data. For example, if during the course of a shift, a badge records a number of transmissions from hand hygiene stations, proximity sensors and/or other badges, the identity of these devices, their location and the signal strength data can be processed to determine the movement of the badge, thus, the wearer, throughout the shift. If the movement shows the badge entering and exiting hand compliant sensitive areas but there is no corresponding hand hygiene related data indicating the wearer washed their hands, the system can estimate the wearer of the badge was not in compliance with a hand hygiene protocol requiring hand washing before and after entering hand hygiene sensitive areas.
  • FIG. 9 is a flowchart of a method for estimating hand hygiene compliance of a badge wearer according to one embodiment of the present subject matter.
  • the method includes receiving a plurality of signal strength data related to a badge from one or more system devices 991, receiving hand hygiene activity data related to the badge from one or more system devices 992, mapping the badge position and hand hygiene activities with respect to time 993 and comparing the map of badge movement and hand hygiene activity with to a predetermined hand hygiene protocol to estimate hand hygiene compliance of the badge wearer 994.
  • the signal strength data and hand hygiene activity related data is received from the badge.
  • the signal strength data and hand hygiene activity related data is received from a device other than the badge.
  • the signal strength data and hand hygiene activity related data is received from a group of devices including the badge.
  • the signal strength data and hand hygiene activity related data is received from a group of devices not including the badge.
  • badges are enabled to communicate (broadcast and receive signal strength messages) with other badges as well as with the wireless transceiver devices placed in specific locations (e.g., patient rooms, nurses stations).
  • wireless transceiver devices placed in specific locations (e.g., patient rooms, nurses stations).
  • they can also be given to patients, visitors, suppliers, contractors or other persons or equipment allowed on-site.
  • the system measures the duration and approximate location of interactions between the badge wearers, such as between different healthcare workers, between patients and healthcare workers, and between different patients, for example.
  • visitors are assigned badges, or a wireless transceiver device in some other form, such that interactions with the visitors are measured.
  • the portable nature of the wireless communication devices allows rapid deployment of a system for either temporary or permanent use.
  • the system computer receives health related information about the entities associated with the badges, the hygiene stations and the proximity devices.
  • the system computer can receive health related information about a person associated with a wearable badge, including a medical history. Such information can include information about diseases the badge wearer has recently been exposed to, diseases the badge wearer currently is infected with, inoculations the wearer has received that can mitigate the wearer's ability to contract or transmit a disease, or combinations thereof.
  • the system computer can receive information associated with the facility and the equipment within the facility that can be useful in tracking disease migration.
  • a proximity device or badge can be associated with a room or a piece of equipment.
  • the system computer can receive history information associated with the room or piece of equipment.
  • the system computer can receive the room or equipment history information from a number of sources including, but not limited to, analysis of collected interaction information, one or more other databases, other proximity or mobile devices or a combinations thereof.
  • the present subject matter enhances other patient-safety-and-quality activities.
  • the system includes information to trace interactions and movement of patients and healthcare workers exposed to equipment, rooms and other people associated with a contagious disease.
  • the system can trace interactions and movements of patients and health care workers exposed to equipment that has been used to treat, or simply exposed to, a contagious disease.
  • the system can trace interactions and movements of patients and health care workers using a room that has been used to treat a patient having a contagious disease or had been entered by a person known to be infected with a contagious disease.
  • Such information can allow officials to know exactly which healthcare workers came into close contact (e.g., 3 - 6 feet) or direct contact with other healthcare workers, patients or other badge wearer, for given period of time.
  • Such information can expose the history of people infected with contagious or communicable conditions, but before such conditions or symptoms are recognizable.
  • diseases include, but are not limited to, severe acute respiratory syndrome (SARS), influenza, mumps, lice, chickenpox, strep, Clostrididium difficile (C-diff), Methicillin resistant S. aureas, or combinations thereof.
  • SARS severe acute respiratory syndrome
  • influenza influenza
  • mumps lice
  • chickenpox strep
  • Clostrididium difficile C-diff
  • Methicillin resistant S. aureas or combinations thereof.
  • the system can further identify current infected-but-asymptomatic healthcare workers, patient and visitors who could spread disease or continue to spread the disease unintentionally.
  • Such information can allow officials to act to notify potentially infected people such that steps can be taken to avoid further migration of the disease.
  • contact tracing is done early enough to enable the rapid isolation or treatment of exposed patients, it reduces the spread of an outbreak within healthcare facilities or other facilities utilizing the system.
  • Badge-to-badge communications allow for more precise tracking of person-to-person exposure.
  • Such a system can be adapted to identify the identity of a person whose proximity or contact history has been tracked, to provide a title associated with the person (for example, "patient,” “doctor,” “nurse” titles may be associated with the person in contact to anonymize data if preferred), and/or to completely render the identity of the person anonymous (for example, the patient was in contact with 3 other people at the facility).
  • Wireless-enabled, contact tracking identifies healthcare workers, patients or other personnel, who may have a contagious condition, earlier than current methods (e.g., inquiring or inferring contacts based on work schedules). Wireless-enabled contact tracking reduces the spread of outbreaks within a facility including, but not limited to, hospitals, long-term care facilities, and outpatient settings. In non-outbreak settings, a wireless-enabled contact-tracing approach is used for training and teaching purposes to improve infection control practices.
  • wireless-enabled contact tracking is used to measure healthcare quality by recording the length of interactions between healthcare providers (i.e., nurse, physician) and patients.
  • healthcare providers i.e., nurse, physician
  • hospital administrators are able to measure how long patients spend in waiting rooms or unattended in clinic rooms compared to how long they spend actually talking or interacting with healthcare providers.
  • Such measurements available in near-real time, serve to increase the efficiency of healthcare visits.
  • wireless-enabled contact tracking increases patient safety. For example, there have been reports that patients in contact isolation receive less care (fewer interactions with healthcare providers) because contact isolation policy requires healthcare workers to wear gowns and gloves before entering a contact isolation room.
  • a system according to present subject matter can be deployed without reliance on a grid-powered infrastructure.
  • low-level communication protocols of the transceivers can be peer-to-peer, ad hoc, or personal area networks (PAN) that support direct data communication between any of the system components described previously, without the need for infrastructure supplying power, repeaters, or even the establishment of a mesh network control structure.
  • PAN personal area networks
  • the transceivers of the system do not necessitate "pairing" or other credentials as a prerequisite for communication. Such security and integrity features may optionally be employed.
  • the transceiver devices include four internal service protocols, layered above the (possibly standardized) wireless communication protocol, enable subsequent relay, aggregation, processing and control of data in the system. These four services are synchronization, location, history exchange, and device status. Each of these four services defines message format, specifies timing and reliability needs, and entails operational considerations to control, maintain, and monitor the service.
  • the synchronization service provides each device access to a virtual clock.
  • Two properties of the virtual clock are that it advances at the same rate as real time and that any two devices in the deployment which access their virtual clocks observe the same clock value.
  • the value of a virtual clock coincides with accepted standard clocks (Universal Coordinated Time, for instance); in other embodiments, the virtual clocks may be set to some internal clock standard.
  • the virtual clock service may be implemented by periodic exchange of messages between devices, or may be implemented by some assisting infrastructure (such as WWVB, NTP or other standard mechanism).
  • the protocol is opportunistic, such that, system components exchange messages with other components that are within wireless communication range.
  • proximity sensors that function as location and time anchors are either within range of each other or, with high probability, are periodically within range of wearable devices that bridge connectivity gaps and thus provide acceptably frequent resynchronization between components.
  • the location service is provided by proximity sensors functioning as location and time anchors, though other non-mobile components can also provide this service in some embodiments.
  • Each component that supports the location service is programmed with a location designation, either an abstraction (such as room name or unambiguous object placement) or with spatial coordinates of the placement of the component. This programming can be done prior to deployment, at the time of deployment, or in- field if the component can be relocated dynamically.
  • the location service operates in "push” mode, that is, the components periodically transmit (broadcast) location messages to any receiving component within range.
  • the location messages can include, but are not limited to, the location identity, location abstraction or the coordinates of the transmitting component.
  • the location service operates in "pull" mode where a requesting component transmits (broadcasts) a location query message to all components within range, and any provider of the location service responds to the query with a location message.
  • Location queries and location messages may be attenuated in transmission power, to enable greater accuracy of inferring location by receiving units; alternate radio frequencies may also be employed, and other technologies for range finding can also be used including, but not limited to, infrared signals and ultrawide band ranging.
  • Wearable devices can approximate current location based on the history of location messages they receive, taking into account received signal strength information or other characteristics of the messages they receive which contain location information. Wearable devices have sufficient computational power to analyze maps of the deployment region, perform calculations on the history of recently received messages, and to approximate a probable current location.
  • the history exchange service enables components within wireless range to exchange recent history of events recorded by the components. Using a history exchange service enables one component to assemble a view of the combined histories of other components that it has recently seen. Such a view makes possible computations about disease transmission metrics within the component. History exchange messages can be pull mode or push mode; in some cases, the information exchanged between two components will use several messages, because low-layer data protocols have size limitations on the payloads of packets or frames.
  • Device status service supports diagnostic reporting and control of the components.
  • non-mobile components such as time and location anchors, room memory devices, unit memory devices, and so forth
  • typical management of the components involves knowing the status of the components including, but not limited to, current battery level, ratio of successful to unsuccessful communication, and which communication links are most reliable.
  • gateways connected to traditional networks administrators could remotely inspect the current status of the deployment's components by querying the gateway; the gateway would aggregate the status of components on an ongoing basis by periodically using the device status service.
  • the mechanism of disease migration on a macro scale is briefly mentioned above.
  • the event of infection that is, the transfer of disease from one individual to another, is generally described statistically such that there is a potential of infection by exposure, such as contact or breathing droplet-laden air, but infection is not certain.
  • the exposure potential can depend on many factors (susceptibility of individuals, history of mitigation events, cumulative contact with many infected individuals, virulence of infecting agents, etc.). Given a history of individual movement, proximity or contact between individuals, and mitigating events, it is possible to construct a model of how disease may spread. These models can be analytic (mathematical) or approximations generated by simulation.
  • Forward results are quantities calculated by running a simulation forward in time
  • backward results are quantities calculated by running a simulation backward in time.
  • Forward or backward results can be projected to individuals or groups of individuals such that the potential quantities can include, but are not limited to, probabilities of having been infected (forward) or probabilities of being initially infected (backward).
  • Simulations depend on scenarios of contact between individuals and spatial and temporal configurations (movement of HCWs, etc).
  • the choice of scenario can be artificial (say by random number generation conforming to statistical models previously obtained that characterize valid ranges of choice), or the scenario can be a replay of actual movement and contact history from a clinical study or combinations thereof.
  • Simulations can also be hybrid simulations, where the scenario choices are fed into the simulation in real time, as they are observed by instrumented hospitals and clinics, such as are described in this document.
  • One other choice of simulation is whether to calculate probabilities, in the style of analytic models, or to randomly choose outcomes during the simulation (so-called Monte Carlo methods), where the random choices are governed by probabilities of infection, contamination, and disease duration.
  • the results of these simulations can be lists of infected individuals and contaminated rooms.
  • simulations can also be used to uncover patterns of behavior and structural observations on the nature of how disease may spread. For example, it can be that one area in a hospital exhibits higher contagion than another area, or it can be that one shift in a clinic has lower infection rates than another.
  • the running of the simulation is repeatable, being derived ultimately from deterministic computation, and patterns (based on scenarios, spatial, temporal, and initial configurations) may be studied and understood. Finding and understanding these patterns is a key to improving healthcare processes.
  • simulations can be implemented distributively, computed on the same devices that record contacts, mitigating events, and movement within a health care facility such as a hospital or clinic, without the need for a permanently installed computing infrastructure.
  • simulations and models can be computed distributively in each device, or the event and contact data can be uploaded to traditional information systems for later analysis and simulation, or both computed distributively an uploaded for later analysis and simulation.
  • Simulations and models computed in each device collectively can be referred to as distributed infection models.
  • FIG. 10 includes a flowchart of a method to estimate a probability of infection according to one embodiment of the present subject matter.
  • the method 1000 includes associating a transceiver device with an entity 1001, receiving health information of the entity 1002, recording interaction information of interactions of the transceiver device with other transceiver devices 1003, and estimating a probability of infection using a simulation based on the recorded interaction information and the health information 1004.
  • the recorded interaction information includes interaction information related to mitigating disease migration including, but not limited to, interaction information from a hygiene station, health information from a room memory unit indicating a recently cleaned room, health information from a transceiver device associated with a person having an active inoculation to a disease or combinations thereof.
  • the estimated potential for threat of infection or condition of infection is derived from one or more simulations using the recorded interaction information and the health information.
  • transceiver devices process local simulations using interaction information and health information collected by the transceiver. Local simulation can be used to estimate potentials of infection for the entity associated with the transceiver device.
  • a potential for infection exceeding a threshold value will trigger an annunciation device of the transceiver device. An entity alerted to a potential for infection exceeding a threshold can then take mitigating action to reduce the potential.
  • the potential for infection may be a probability of infection of a specific disease.
  • the potential for infection may be an overall probability of infection of a number of specific diseases the system is configured to track.
  • the potential may include a probability of being infected, a probability of infecting someone else, or both.
  • the potential for infection may be represented by using outcomes other than probabilities including, for example, a binary outcome, a range of discrete outcomes or a combination thereof.
  • the system is used for training and research purposes. For example, where a contagious disease outbreak has occurred, collected interaction data can be used to research better practices to prevent such an outbreak to reduce the ability of the disease to migrate. Such research uses the system to perform simulations using the collected interaction data to understand the actual disease migration.
  • Additional simulations can introduce new interaction information or alter the collected interaction information to investigate ideas to prevent future outbreaks.
  • Such simulation may include moving hygiene stations, placing additional hygiene stations, changing sterilization protocols, changing hygiene protocols or combinations thereof.
  • the system simulations using the collected interaction data can illustrate the importance of hygiene compliance in reducing the ability of a disease to migrate.
  • collected data can be altered in various training simulations to illustrate and compare the effects of good hygiene practice and risky hygiene practice in mitigating disease migration.
  • the simulations are set-up as an interactive game to give a trainee hands-on experience in understanding what hygiene practices are most effective in protecting themselves from contracting or spreading one or more contagious diseases, especially in a health care environment. Calculating simulations can also assist in identifying conditions that affect disease migration.
  • Such conditions include, but are not limited to, identifying risky behavior that may assist disease migration, identifying opportunities for intervention and mitigation of disease migration, identifying patterns of risky, non risky and mitigating behavior of individuals, indentifying risky, non-risky and mitigating group behavior,
  • Risky behavior includes behavior that is more likely to spread disease, fail to contain disease, or become infected than would nonrisky behavior. Classification of what is risky is based on thresholds for probability of being infected or contaminated. Generally, probabilities are obtained from the models outlined above. However, rather than using a complete simulation, a local model can approximate probabilities within a wearable unit. The combination of local history of contact and path information obtained from other wearable units, room memory units, location and time anchors, and the combined recent history of direct contact and indirect contacts enables simulation based on interaction information (spatial and temporal). This interaction information includes enough information to approximate probabilities of infection.
  • individual A with a wearable device comes into range of individual B, who recently visited a room with an infected patient but did not engage in mitigating hygiene measures.
  • the history of B can be available to A by the history exchange protocol.
  • Opportunities for mitigation occur after potential contact with infected individuals or contaminated areas, and when the probability of infection rises above some threshold. These opportunities can be identified on wearable devices. Such observations can trigger alerts on the wearable devices or be relayed to other components (room or unit memory devices). Intervention opportunities can be observed when a combination of individual probabilities in a unit (ward, clinic, etc) rise above some threshold, and this can be detected from data in a unit memory device or gateway.
  • Patterns of individual behavior can also be approximately identified based upon local models, within wearable devices, room memory, unit memory devices or combinations thereof. If individuals generate high probability of infection repeatedly, this fact can be recorded or transmitted for subsequent analysis. Similarly, if individuals have abnormally low infection probability, then that fact can be recorded and later be studied. Beyond identification of singular risky behavior, systemic patterns or team patterns can be extracted from unit statistics. One advantage of this metric is that individual behaviors can be hidden from reporting of group behaviors.

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Abstract

La présente invention concerne un appareil et des procédés permettant le suivi de contacts entre différentes entités dans une région. Un appareil comprend un dispositif émetteur-récepteur portatif doté d'une radio, d'une mémoire et d'un bloc d'alimentation. Ledit dispositif émetteur-récepteur portatif peut détecter et enregistrer un historique de proximité par rapport à d'autres dispositifs émetteurs-récepteurs. Il peut également recevoir des informations portant sur l'exposition du dispositif émetteur-récepteur à une maladie et comprendre un composant de traitement qui sert à calculer un potentiel d'exposition à une maladie contagieuse à l'aide de l'historique de proximité et des informations d'exposition à une maladie.
PCT/US2010/025659 2009-02-27 2010-02-26 Suivi de contacts au moyen de badges sans fil WO2010099488A1 (fr)

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WO2021188043A1 (fr) * 2020-03-17 2021-09-23 Voxp Pte. Ltd. Dispositif, serveur et système pour détecter des articles ou des personnes venant à proximité d'un/une autre
US20210296008A1 (en) * 2020-03-20 2021-09-23 Masimo Corporation Health monitoring system for limiting the spread of an infection in an organization
EP3893527A1 (fr) * 2020-04-09 2021-10-13 Scheidt & Bachmann GmbH Procédé de reconstruction des chaînes d'infection
US20210319910A1 (en) * 2020-04-10 2021-10-14 Dualiti Interactive LLC Contact tracing of epidemic-infected and identification of asymptomatic carriers
WO2021224795A1 (fr) * 2020-05-06 2021-11-11 Fleetwood Group, Inc. Système de proximité décentralisé avec multiples liaisons radio
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SE2050701A1 (en) * 2020-06-11 2021-12-12 Saaz Eng Ab Hygiene compliance monitoring
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WO2022000028A1 (fr) * 2020-06-29 2022-01-06 Urban.io PTY LTD Procédés, systèmes et dispositifs de suivi d'interactions entre des individus
CN111785393A (zh) * 2020-07-08 2020-10-16 蒋芳 一种基于公共场所定位传感器的流行病调查方法与系统
WO2022015724A1 (fr) * 2020-07-15 2022-01-20 Lifelens Technologies, Inc. Système de capteur portable configuré pour alerter des premiers intervenants et des soignants locaux
US20220037036A1 (en) * 2020-07-31 2022-02-03 Léon DesRoches Methods and systems for mitigating transmission of a contagious infection within a shared workspace
US20220139567A1 (en) * 2020-10-30 2022-05-05 The Boeing Company Methods for modeling infectious disease test performance as a function of specific, individual disease timelines
US11818624B1 (en) 2020-11-19 2023-11-14 Wells Fargo Bank, N.A. System and methods for passive contact tracing

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