WO2020021276A1

WO2020021276A1 - Medical monitoring system

Info

Publication number: WO2020021276A1
Application number: PCT/GB2019/052094
Authority: WO
Inventors: Norman Niven
Original assignee: Medication Support Limited
Priority date: 2018-07-26
Filing date: 2019-07-26
Publication date: 2020-01-30
Also published as: GB2575851B; GB201812180D0; GB2575851A

Abstract

A medical monitoring system to monitor patients by an external may comprise at least one monitoring device comprising and at least one hub device. The monitoring device may comprise monitoring means to allow the external user to monitor a patient user of the at least one monitoring device; communication means to allow communication between the external user and the patient user; storage means to allow the monitoring device to store a record of communication between the patient user and the external user; and a medical information component configured to store medical information related to the patient user. The hub device may be configured to communicate with the at least one monitoring device. The at least one hub device may comprise a display to display a video of the patient user of the at least one monitoring device; an input means to record each instance of the patient user taking at least one medication to produce a medicine intake record; means to unilaterally establish communication with any of the at least one monitoring device; and means to receive the record of communication.

Description

MEDICAL MONITORING SYSTEM

TECHNICAL FIELD

[0001] The present disclosure relates to a medical monitoring system, particularly but not exclusively to a medical monitoring system to monitor patients by an external user. Aspects of the invention relate to a medical monitoring system; to a patient monitoring device, to be used in the system; to a hub device configured to communicate with at least one monitoring device in the system; to a method of monitoring at least one patient by an external user of a hub device; to computer software; and to a computer-readable storage medium.

BACKGROUND

[0002] Monitored dosage (MDS) systems are a common method for community pharmacies to manage medication administration and have been used in care homes since the 1990s.

[0003] A monitored dosage system allows a pharmacist to prepare the dosage for a patient, so that the carer or nurse does not need to decide which or how many medicines to give to a patient. The systems may also incorporate a Medication Administration Record (MAR) chart to record all medicines administered with dose and time also recorded.

[0004] MDS systems reduce errors, speed up the administration process and the MAR charts record all the administration information However, the use of MDS Systems in the community is less widespread but where they are used, MAR charts do not commonly accompany them.

[0005] And yet the need to manage medication administration in the community is probably more important than in care homes, where the staff are more familiar with residents and are usually better trained. Many local authorities and social service providers use carers to visit service users’ homes to prompt or to assist them with their medication administration.

[0006] However, the use of carers to perform this task is expensive with many service users taking their medications up to four times each day and requiring four visits per day. This service is often provided by untrained or poorly trained carers who can do little more than provide a pair of hands to assist with the medication administration. Furthermore, in the vast majority of cases, there is no MAR chart record.

[0007] It is an aim of the present invention to address one or more of the disadvantages associated with the prior art.

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Examples are further described hereinafter with reference to the accompanying drawings, in which:

Figure 1 illustrates a medical management system in accordance with some examples; and

Figure 2 illustrates a method to monitor a patient in accordance with some examples.

DETAILED DESCRIPTION

[0009] Examples disclosed in the application address the problem of caring for an increasingly old population in a manner that is both more convenient for the user, and also more cost effective. Furthermore, examples also improve patient safety as they allow for patient records to be more conveniently recorded, and any changes to the patient’s situation quickly identified and resolved.

[0010] Figure 1 illustrates a system 100 to monitor patients by an external user. The system comprises at least one monitoring device 110 and at least one hub device 160. The hub device 160 is configured to communicate with the at least one monitoring device 110. Each of the at least one monitoring devices 110 comprise a monitoring means 115, communication means 120, storage means 130, and a medical information component 140. Each of the at least one hub device 160 comprises a display 170, an input means 180, communication means 190 and receiving means 195. The hub device may have access to memory in the form of local memory, remote storage or a combination of both.

[0011] The monitoring means 115 is to allow an external user to monitor a patient user of the monitoring device 110. The communication means 120 is to allow communication between an external user and the patient user. The storage means 130 is to allow the monitoring device to store a record of communication between the patient user and the external user. The medical information component 140 is configured to store medical information related to the patient user.

[0012] The display 170 is to display a video of the patient user of the at least one monitoring device 110. The input means 180 is to record each instance of the patient user taking at least medication to produce a medication record. In some examples a Medication Administration Record (MAR) chart may be produced.

[0013] The communication means 190 may unilaterally establish communication with any of the at least one monitoring devices 110. The communication means 190 allows the at least one hub device 160 to establish a connection with a monitoring device 110 without the patient user accepting or requesting the connection. This may be beneficial as it allows the patient user to be more properly monitored to ensure that the appropriate medication is taken. In some examples establishing unilateral communication may be limited to establishing audio communication with the monitoring device 110. The receiving means 195 is to receive a record of communication.

[0014] In some examples a patient user of the at least one monitoring device 110 may be required to give permission that the hub device 160 is able to unilaterally connect with the at least one monitoring device 110. This permission may be revoked at any time by the patient user. In some examples unilaterally establishing the call may comprise establishing audio communication only, as the patient user may be required to explicitly authorize video communication, for example pressing a button. In some examples the patient user may be required to give permission to allow unilateral calls.

[0015] The communication means 190 may contact the monitoring device 110 in a manner resembling a standard call. When the monitoring device 110 is receiving a call from the hub device 160, the monitoring device 110 may have a visual and/or audio signal that there is an incoming call. For example, the monitoring device 110 may include a light that flashes when there is an incoming call. The light may be adapted to emit different colour in different situations, for example, it may emit one colour for standby, change colour for an incoming call, and change to a still different colour when a call has been established. Additionally or alternatively, the light may use a flashing patter to convey information. The user of the monitoring device 110 may carry out call functions such as accepting, rejecting, pausing, or terminate the call. The user of the monitoring device 110 may carry out these call functions through the use of physical interaction with the monitoring device, for example, pressing a button; through an audio command such as a voice command, or a clapping noise; through gesture recognition; or using other suitable commands. The monitoring device may be adapted to have independent control over calls, thus not requiring any action from the hub device to allow the call to be accepted, rejected, paused, terminated or the like.

[0016] The monitoring means 115 may include a two-way audio link between the patient user and a user of the hub device 160. The monitoring means may also include a one-way video link, such that the user of the hub device 160 may view the patient user of the at least one monitoring device 110. In some examples the monitoring device may be configured to, in respect of communication, only allow one-way communication with the hub device and to not allow two-way video communication. However, in some examples the monitoring device may be configured to allow two-way video communication. The settings and configuration of the monitoring device may be adjusted remotely from the hub device 160. In this way, the monitoring device may be set-up remotely via the hub device.

[0017] In some examples, the monitoring device 110 may connect via a wireless or wired connection to the hub device 160. In some examples the monitoring device 110 may have a mobile data connectivity and may connect via 3G, 4G, 5G services, or other mobile data services.

[0018] In some examples, the monitoring means 115 may also comprise a temperature sensor. The temperature sensor allows the user of the hub device 160 to monitor the temperature of the monitoring device 110 surroundings and alert the appropriate services, for example a community carer or family member, if the temperature is too low. In some examples this alert process may be automated. In some examples the temperature may be monitored to ensure it is within a certain range. For example, the hub device 160 may be notified if the temperature falls below 15 °C or rises above 30 °C. The range may be set based on the climate and the specific needs or situation/preference of the patient user.

[0019] In some examples, the storage means 130 may be configured to store at least 15 minutes of video. In some examples, storage means 130 may store the record of the communication external to the monitoring device 110, for example in the cloud.

[0020] In some examples, the medical information component 140 may be configured to store medical information related to the patient. In some examples this may detail medications that are required by the patient user and dosage regimes. The information may be stored in the format of an e-MAR chart or any other suitable format. The monitoring device may be configured to provide the information stored in the medical information component 140 to the hub device, such that the hub device is not required to store any medical information related to the patient.

[0021] In some examples, the monitoring means 115 and communication means 120 may be configured to allow communication between the patient user of the monitoring device 110 and the user of the hub device 160 in full colour.

[0022] In some examples each monitoring device 110 may have an identifying number that uniquely identifies the patient user. A patient user may have more than one monitoring device 110, and each monitoring device 110 of the patient user may use the same identifying number.

[0023] The monitoring device 110 may also be configured to monitor a patient user’s activity, such that any change in behavior or activity is reported back to the hub device 160. This may allow patients with dementia to be monitored, and any changes in behavior to be determined and analyzed by the appropriately qualified person.

[0024] The hub device 160 may be configured to store basic data associated with the users of the monitoring devices 110 connected thereto. For example, the hub device may store one or more of a name of the user, a photo of the user, emergency contact information of the use. [0025] In some examples, the hub device 160 may be configured to display medical information related to the patient user of the monitoring device. In some examples, the medical information may be in the format of an electronic Medication Administration Record (e-MAR) chart. The hub device may also display any other information related to the patient, for example any prescriptions associated with the patient user of the monitoring device 110. The prescription may be scanned by a pharmacy and sent to the hub device 160. The MAR chart may comprise monitoring device user information, including personal information such as name, photo, address, contact numbers and an emergency contact; doctor, pharmacy and care agency contact details; allergy information; and other useful information

[0026] The MAR chart may be selected to be categorized by medicine, that is the classic Medication Administration Record listed by medicine with times of administration. The MAR chart may be selected to be categorized by session, where the medicines are shown grouped by administration times. A session categorized MAR allows a user of the hub device 160 to identify which medicines need to be taken or administered during a particular call.

[0027] In some examples, the hub device may also comprise software to compare two e- MAR charts to compare any changes in prescriptions, dosage, or any other information displayed on the e-MAR chart. In some examples, this may be performed by superimposing two e-MAR charts with each other and noting any differences.

[0028] The MAR charts may be reviewed, copied, updated, and amended via the hub device 160. In some examples, certain aspects of the MAR chart may only be amended by a clinical pharmacist.

[0029] In some examples, the medical monitoring system 100 may use a body map system to allow precise location of applied creams and ointments, or any other medications to be demonstrated. In some examples, the body map system may use the Medicon body system.

[0030] In some examples, the hub device 160 may be monitored by a qualified pharmacy technician and/or a supervising qualified pharmacist.

[0031] The medical monitoring system 100 allows a pharmacist or technician to record any medication that is taken by patient, and to create a record of the medication taken. It also may allow the pharmacist or technician to ensure that a correct dosage of the correct medicine is taken without physically having to be in the presence of the patient user. The system may be used to identify if the patient user is having any difficulty using the medicine, for example if the patient is having difficulty in swallowing the medicine, and appropriate measures may be taken. Such measures may include requesting that the prescription is amended or contacting emergency services or a carer. The hub device may provide prompts to the user thereof to facilitate the session with the user of the monitoring device. Such prompts may include descriptions of the medicines to the used in the session, e.g. blister-pack, bottle, cream etc.

[0032] The medical monitoring system 100 may also allow a patient user to contact the pharmacist or technician to answer any queries about the medicine at the time of taking the medicine. The medical monitoring system 100 also allows for a less disruptive monitoring process, as the team responsible for a particular patient may be kept the same, rather than having a different carer visit each time. The medical monitoring system 100 allows for professional oversight of any medicines taken, which is often not the case when being supervised by a carer. The medical monitoring system 100 also ensures that a detailed record of any medicine taken is recorded, both in form an e-MAR chart and also a video record of the instance of the medicine being taken.

[0033] In some examples, the monitoring device 110 may include a display. The display may be used to display relevant information to the user, for example a time of day, or a list of medicine to be taken in a specific session.

[0034] In some examples, the monitoring device 110 may allow connections external to the hub device to be made, for example the monitoring device 110 may allow a mobile phone to establish a call. In some examples, the monitoring device 110 may be configured to only allow pre-authorized users or hub devices to attempt to establish a call. In some examples, the monitoring device may only allow the hub device to attempt to establish a call.

[0035] In some examples, the monitoring device 110 may comprise means to dispense medicine to a patient user at the correct dosage at the correct time. In some examples, the monitoring device 110 may indicate to the patient user how to take the medicine, this may performed by allowing an instruction from the external user of the hub device to be conveyed via the monitoring device via a speaker and/or a display on the monitoring device.

[0036] Figure 1 illustrates there being two monitoring devices 110 and one hub device 160, however there may be any number of monitoring devices 110 and hub devices 160 in the medical monitoring system 100. The hub devices 160 may be connected together in a network. Such a network may include an administrator device (not shown) adapted to review, interface with and manage the hub devices 160 within the network. The administrator may itself be a hub device suitable for making calls to monitoring devices. The network may be implemented using known technologies for allowing communication between remote devices.

[0037] The administrator device may be able to monitor the status of hub devices in the network, for example the hub devices 160 may be currently online, offline, active or idle. The administrator device may be able adapted to control the network connections of the hub devices 160, for example instructing a hub device to connect to a particular network, such as a particular Wi-Fi network. Hub devices 160 within the network may be classified into groups by the administrator device. The administrator device may be able to receive incoming calls, whereas a hub device 160 may not be permitted to receive incoming calls.

[0038] The administrator device is adapted to gather data from other devices within its network, and collate the data into reports as required. Such reports may include: logged-in users; time stamp for login/out; call attempts, completed calls, missed calls and history of actions preformed, overall and categorised by patient and by session; MAR report, including reasons for any doses missed; medication compliance percentage, including overall, by patient, and by session; medication missed percentage, including reasons and timings; and report of medicines taken and compliance. An administrator device may be defined by the user thereof, wherein an administrator user, such as a manager or pharmacist logged into any hub device may had access to administrator-type functionality.

[0039] The administrator device may issue task schedules such as call schedules to hub devices, detailing the monitoring devices to be contacted and the times for the calls to be made. Hub devices may transfer scheduled but uncompleted tasks to other hub devices for completion. Hub devices may automatically set up calls to monitoring devices according to the received task schedule, however the user may be able to alter the task order.

[0040] The hub device may be implemented on any suitable computing device capable of data communication with a remote server. Such a computing device may include, but is not limited to, a desktop computer, a laptop computer, a tablet computer and similar devices. The computing device may access the functionality of a hub device 160 from a remote server, via the internet or other suitable data network.

[0041] The network of hub devices and at least one administrator may be implemented using a LAMP stack, comprising Linus, Apache, MySql, and PHP.

[0042] Hub devices may save records of their calls, including a video and/or audio recording of the call to local or remote storage. The recordings may be categorized by date, by patient, by hub device user, and in any other suitable manner.

[0043] Figure 2 illustrates a method 200 of monitoring at least one patient user by an external user of a hub device according to some examples. The method 200 may be used in conjunction with the medical monitoring system 100 described in relation to Figure 1. The method may be performed by hub device 160.

[0044] At 210 a monitoring device is called. The monitoring device may be similar to the monitoring device 110 described in relation to Figure 1. [0045] At 220 the hub device may establish communication with the monitoring device.

[0046] At 230 the hub device may begin monitoring the patient user of the monitoring device.

[0047] At 240 the hub device may allow the recording of each instance of the patient user of the monitoring device taking any medication to create a medicine intake record.

[0048] At 250 the hub device may receive a record of the call.

[0049] At 260 the hub device may store the record of the call.

[0050] At 270 the hub device may create a file including the record of the call and a record of each medicine taken by the patient user.

[0051] In some examples establishing communication with the monitoring device comprises unilaterally establishing communication with the at least one monitoring device such that the patient user is not required to accept the call. In some examples unilaterally establishing the call may comprise establishing audio communication only, as the patient user may be required to explicitly authorize video communication, for example pressing a button. In some examples the patient user may be required to give permission to allow unilateral calls. In some examples the patient user may revoke such permission at any time.

[0052] In some examples calling the monitoring device 210 may cause the monitoring device to make a ringing noise, or any other noise indicating that a call is in progress.

[0053] In some examples, the call may be established 220 by the patient user of the monitoring device accepting the call, for example by pressing a button on the monitoring device.

[0054] Monitoring the patient user 230 may include the external user of the hub device viewing a live video of the patient user and/or audio. In some examples the external user may also be able to monitor the patient user of the monitoring device by observing other measures related to the patient, such as a temperature of the surroundings of the patient.

[0055] Recording patient medicine intake 240 may be performed by an external user entering using an input means what medicines the patient user takes. The medicine taken by the patient user may be recorded in an e-MAR chart, or any other suitable format.

[0056] Receiving a record of the call 250 may comprise receiving a video file of the patient user from the monitoring device. The record of the call may also contain the time and length of the call.

[0057] The record of the call may be stored 260 in the hub device, or may be stored external to the hub device, for example in an external server or in the cloud. [0058] Creating a file 270 may include combining the record of the call and the record of the medicine intake into one file.

[0059] Throughout the description and claims of this specification, the word“medicines” is used. However, it is intended that the system is limited to only monitoring the use of medications. For example, the systems and method may also be used with any other item that is required to be given or applied to a patient, for example supplements or any other item related to the care or wellbeing of an individual.

[0060] Throughout the description and claims of this specification, the words“comprise” and “contain” and variations of them mean“including but not limited to”, and they are not intended to (and do not) exclude other components, integers or steps. Throughout the description and claims of this specification, the singular encompasses the plural unless the context otherwise requires. In particular, where the indefinite article is used, the specification is to be understood as contemplating plurality as well as singularity, unless the context requires otherwise.

[0061] All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive. Examples are not restricted to the details of any foregoing examples. The Examples may extend to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.

[0062] The reader's attention is directed to all papers and documents which are filed concurrently with or previous to this specification in connection with this application and which are open to public inspection with this specification, and the contents of all such papers and documents are incorporated herein by reference.

Claims

1. A medical monitoring system to monitor patients by an external user, the system comprising:

at least one monitoring device comprising:

monitoring means to allow the external user to monitor a patient user of the at least one monitoring device;

communication means to allow communication between the external user and the patient user; storage means to allow the monitoring device to store a record of communication between the patient user and the external user; and

a medical information component configured to store medical information related to the patient user;

at least one hub device configured to communicate with the at least one monitoring device, the at least one hub device comprising:

a display to display a video of the patient user of the at least one monitoring device;

an input means to record each instance of the patient user taking at least one medication to produce a medicine intake record;

means to unilaterally establish communication with any of the at least one monitoring device; means to receive the record of communication.

2. The system according to claim 1 , wherein the monitoring means comprises at least one of: a camera, a microphone, and a temperature sensor.

3. The system according to claim 1 , wherein the record of communication includes at least one of: an identifying time of the communication, an identification of the at least one patient user, and the medicine intake record.

4. The system according to claim 1 , wherein the system is configured, in respect of communication between the patient user and the external user to allow only one-way video communication, such that the external user may view the patient user.

5. The system according to claim 1 , wherein the storage means is configured to store up to 15 minutes of video.

6. The system according to claim 1 , wherein the at least one monitoring device is configured to allow the monitoring device to initiate a call with the at least one hub device, or one of a predetermined number of user devices.

7. The system according to claim 1 , wherein the monitoring means and the communication means allows monitoring and communication between the external user and the patient user in colour.

8. A patient monitoring device, to be used in the system according to any of claims 1-7, the monitoring device comprising:

monitoring means to allow an external user of a hub device to monitor a patient user of the monitoring device;

communication means to allow communication between the external user and the patient user; storage means to allow the monitoring device to store a record of communication between the patient user and the external user;

wherein the patient monitoring device is configured to allow the external user to unilaterally initiate communication with the monitoring device; and

the monitoring means and communication means are configured to allow the external user to record, in a medicine intake record, each instance of the patient user taking at least medication.

9. The patient monitoring device of claim 8, wherein the patient monitoring device comprises a display.

10. The patient monitoring device of claim 8, wherein the monitoring means comprises at least one of a camera, a microphone, and a temperature sensor.

11. The patient monitoring device of claim 8, wherein the record of communication includes at least one of an identifying time of the communication, an identification of the at least one patient user, and the medicine intake record.

12. The patient monitoring device of claim 8, wherein the patient monitoring device is configured, in respect of communication between the patient user and the external user to allow only one-way video communication, such that the external user may view the patient user.

13. The patient monitoring device of claim 8, wherein the storage means is configured to store up to 15 minutes of video.

14. The patient monitoring device of claim 8, wherein the monitoring device is configured to allow the monitoring device to establish a call with the at least one hub device, or one of a predetermined number of user devices.

15. The patient monitoring device of claim 8, wherein the monitoring means and the communication means allows monitoring and communication between the external user and the patient user in colour.

16. A hub device configured to communicate with at least one monitoring device in the system according to any of claims 1-7, the hub device comprising:

a display to display a video of a patient user of the at least one monitoring device;

an input means to record, in a medicine intake record, each instance of the patient user taking at least one medication;

means to unilaterally establish communication with any of the at least one monitoring device; means to receive a record of communication between the patient user and a user of the device.

17. The hub device according to claim 16, where the hub device is configured to display medical information related to the at least one patient user whilst the hub device is in communication with the at least one monitoring device.

18. A method of monitoring at least one patient by an external user of a hub device, the method comprising:

calling a monitoring device of at least one patient;

establishing communication with the monitoring device;

monitoring the at least one patient;

recording each instance of the at least one patient taking at least one medication to create a medicine intake record;

receiving, from the monitoring device, a record of the call;

storing the record of the call; and

creating a file including the record of the call and a record of each medication taken by the at least one patient.

19. The method according to claim 18, wherein establishing communication with the monitoring device comprises unilaterally establishing communication with the at least one monitoring device.

20. Computer software which, when executed, is arranged to perform a method according to any of claims 18 or 19.

21. The computer software of claim 20 stored on a computer-readable medium.

22. A non-transitory, computer-readable storage medium storing instructions thereon that when executed by one or more processors causes the one or more processors to carry out the method of any of claims 18 or 19.