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`
`US 20070197881/X1
`
`(19) United States
`(12) Patent Application Publication (10) Pub. No.: US 2007/0197881 A]
`Wolf et al.
`(43) Pub. Date:
`Aug. 23, 2007
`
`(54) WIRELESS HEALTH MONITOR DEVICE
`AND SYSTEM WITH (IOGNITION
`
`(76)
`
`Inventors:
`
`James I.. Wolf. Coitifer. (‘O (U S):
`Tllomas I’. Walker. Morrison. (‘O
`(US): Franz Huber. Denver. CO
`(US): Robert N. Caruso.
`Evergreen. CO (US)
`
`Correspottdtsllce Address:
`KYLE W. RUST
`5490 AUTUMN CT.
`GREENWOOD VILLAGE. CO 80111
`
`(21) Appl. No.:
`
`llJ'678,U52
`
`(22)
`
`Filed:
`
`Feb. 22, 2007
`
`Related U.S. Application Data
`
`(60) Provisional application No. 601966.963. filed o11 1-‘eb.
`22. 2006.
`
`Publication Classification
`
`(51)
`
`Int. Cl.
`A613 5X00
`G06Q I0/’t‘J0
`(52) U.S. ('.'|.
`
`(2006.01)
`(2006.01)
`600l3t|0: 12819920: 70512
`
`(57)
`
`ABSTR_A(.'T
`
`Al1oi:ne—based remote care solution provides sensors includ-
`ing a basic health monitor (BHM) that is a measurement and
`feedback system. The BIIM operates with low power inte-
`
`low
`grated communications combined with an in-lionie.
`power mesh network or programmable digital assistant
`(PDA) with cell phone technology. A cognitive system
`allows remote monitoring oi‘ the location and ll1e basic
`health of an individual. The 131-1M measures oxygen satu-
`ration (SaO2}. temperature of the ear canal. and motion.
`including detection of a 12111 and location within a facility.
`Optionally.
`the BUM measures CO2.
`respiration. EKG.
`EEG. and blood glucose. No intervention is required to
`deterniine the status of the individual and to convey this
`information to care providers. The cognitive system pro~
`vides ii-:edback and assistance to tl1e individual while learn-
`
`ing standard behavior patterns. An integrated audio speaker
`and microphone enable the Bl-IM to deliver audio alerts.
`current measurements. and voice prompts. A remote care
`provider can deliver reminders via the BHM. The device
`may be worn overnight to allow monitoring and interven-
`tion. Through the ability to inquire. the cognitive system is
`able to qualify events such as loss of uneonsciotlsness or
`falls. Simple voice conimands activate the device to report
`its measuretnents and to give alerts to care providers. Alerts
`|’rom care providers can be in a lamiliar voice to assist with
`compliance to medication regimens and disease n1anage~
`1ne11t
`instructions. Simple switches allow volume control
`and manual activation. The device communicates with a
`series of low-power gateways to an in-home cognitive server
`and point-ol‘-care (POC) appliance (computer). Alone the
`Bl-[M provides basic leedback and monitoring with limited
`cognitive capabilities such as low oxygen or fall detection.
`While connected to the cognitive server.
`full cognitive
`capabilities are attained. Full alerting capability requires the
`cognitive server to be connected through an Internet gate-
`way to the remote care provider.
`
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`U.S. Patent No. 8,923,941
`
`Apple Inc.
`APL1042
`U.S. Patent No. 8,923,941
`
`001
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`Patent Appiication Publication
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`Aug. 23, 200'? Sheet 1 of 14
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`US 2007;'019788l A1
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`Aug. 23, 2007 Sheet 8 of 14
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`Aug. 23, 2007 Sheet 12 of 14
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`Patent Application Publication
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`Aug. 23, 2007 Sheet 13 of 14
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`Patent Appiication Publication
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`

`
`US 2007f0 197881 A1
`
`Aug. 23, 2007
`
`WIRELESS HEALTH MONITOR DEVICE
`AND SYSTEM WITH COGNITIO;\'
`
`C ROSS-Rlilil-{R1-IENCIZ TU Rlil ,A'l'lF.l)
`Al-’l-’I..lC'_1‘\’l‘I(JN
`
`[0001] This application claims the benefit of U.S. Provi-
`sional Patent Application Ser. No. 602066.963. filed Feb. 22.
`2006. copending.
`
`l3ACI(("rR0tJND Oi" Tlili INV"liNl'ION
`
`2. Field of the Invention
`[0002]
`[0003] The invention generally relates to surgery as
`applied to diagnostic testing and to computer assisted inedi-
`cal diagnostics. More specifically. the invention relates to
`monitoring a plurality ofphysiological data. An aspect of the
`invention relates to cardiovascular testing and to testing and
`detecting diverse body conditions. Another aspect of the
`invention relates to telemetry. such as teletnetry by radio.
`telephone. or computer network.
`[0004]
`2. Description of Prior Art
`[0005] A large segment of elderly and disabled persons
`who would otherwise require institutional tned.ical care are
`able to live independently as long as monitoring of their
`condition and assistance with their needs are provided.
`Given a trend toward greater independence and convenience
`of in-hoi11e heaithcare. this is becoming increasingly impor-
`tant. Providing remote home-based care for high-risk
`patients typically cared for in hospitals can drive down costs
`and risks associated with transportation to and from points
`of care. This has also been shown to improve heahhcare
`access for disabled persons. connect socially isolated indi-
`viduals to their care providers, and enhance caregiver efl'ec—
`tiveness.
`
`I-lozne-based care as described here is not telemedi-
`[0006]
`cine. which has yet to fulfill the promise of remote care and
`appropriate intervention for disease management. European
`countries seem to be more advanced with the evaluation of
`
`tiilly integrated systems but they still have not achieved a
`hilly deployable system. As reported by Audrey Kinsella,
`MA. MS Research Director of lrtfortnation for Tolnorrow
`“The idea of home telehealthcare needs a serious makeover.
`
`Even today. home teleniedicine or teleltealthcare is associ-
`ated with high-tech. expensive devices and overall inacces-
`sibility for the average home care nurse. We need to get past
`these perceptions and misunderstandings.“
`[0007] The term. “home teleltealthcare," is defined as
`clinician-driven healthcare and education services that are
`
`delivered to the home via telecominttnieations to patients
`who have already been diagnosed in a standard medical
`setting. As used herein. the definition further includes other
`informal caregivers who are interested in monitoring and
`maintaining the health and welfare of an interested party.
`The definition also includes forms of connnunication other
`than the telephone.
`[0008] The term. “remote healtheare.” is defined to
`include this extended fonn of telehealthcare or home-based
`
`care. Remote healthcare is an urgently needed method of
`caring for individuals who can experience a higher degree of
`self-care independence when effective monitoring and con-
`trol is provided. Much of the elderly population and the
`disabled population fit this description. Persons undergoing
`trattsitionai care for a treated condition fit this category as
`well. All such persons will benefit from remote healthcare.
`
`[0009] The traditional approach to caring for such indi-
`viduals relies upon either relatives or care centers such as
`rehabilitation facilities and nursing homes. This approach is
`coming under ever increasing pressure due to the fact that
`relatives are working, thereby dirrtinisliing the tit11e available
`for personal attention to care giving. Also. living in care
`centers is very expensive. To the extent that remote health-
`care can provide an adequate level ofin-home monitoring of
`basic health status, a more cost-elfective alternative will
`have been created for a notable segment of this population
`without coinpromising the quality of their care. in addition.
`staying at home as long as possible is preferred by patients
`and is generally better for their welfare and spirit.
`[0010] Corrununication technologies,
`from well-known
`POTS (plain old telephone system) to the Intemet. have been
`used for many years to monitor. diagnose and treat persons
`remotely. Transmission of information. such as pictures.
`measurements of blood pressure etc.
`for diagnosis and
`treatment
`is the goal. Medical
`literature widely reports
`eliorts to provide 111edical care. remotely. Wireless technolo-
`gies are starting to be employed in teletnedicine as well.
`However. Audrey Kinsella has identified the need for spe-
`cialized high-technology knowledge (e.g.. rewiring house-
`holds for advanced telecornnninications capabilities. install-
`ing sophisticated health can: workstations. and requiring a
`suite of engineers to wait on the doorstep, ready to assist) as
`impediments to the adoption of tclemedicine.
`[0011] Current wireless technologies employing standards
`known as 802.1 lb,g and Bluetooth. used in a low power set
`of sensors. have significant problems. While 802.11 is
`successful in the home envirotnnent. it is not feasible for low
`power sensors due to large power consumption and is
`subject to coverage lapses which can only be found through
`use. Bluetooth has very limited range and also uses too much
`power to maintain a connection. The breakthrough in wire-
`less technology known as the ZigBee standard allows
`devices to route low data rate infonnation through multiple
`paths to ensure delivery of messages.
`[0012]
`It would be desirable to provide an improved
`method and apparatus for delivering remote liealthcare. An
`improved system of care giving may be based on high
`technology. but must be easy to use for people without basic
`computer and electronic experience. A desirable system
`might not provide every data point to the care provider, but
`will forward at least events or combinations of events that
`
`'Ihe underlying technology may be
`represent a problem.
`completely hidden from the patient or user.
`[0013] Dcsirably, such a system may be enabled by recent
`developments in computer and teleconnnunications technol-
`ogy. Most notably. these are: a) aflbrdable computer systems
`with touch screens and voice response. b) Internet, wireless
`communications standards of Blnetooth and ZigBee. c) low
`power electronics providing for long battery life. d} reliable
`low power (il-’S sensors and Zigbee triangulation technol-
`ogy. and e) cognitive. learning software systems.
`[0014] To achieve the foregoing and other objects and in
`accordance with the purpose of the present invention. as
`embodied and broadly described herein. the method and
`apparatus of this invention may comprise the following.
`
`BRIIEF SUMMARY OI’ Ti-lli lNVl'iNTl()N:
`
`[0015] Against the described background. it is therefore a
`general object of the invention to provide a method and
`apparatus that are capable of enhancing the quality of life for
`
`016
`
`016
`
`

`
`US 2007f0 197881 A1
`
`Aug. 23, 2007
`
`individuals whose mobility or self-care capabilities have
`been limited due to age or disease. Such an individual may
`be referred to as the user or patient. More specifically, an
`object of tl1e i11ve11tion is to enable such individuals to live
`i11 their own homes while receiving monitoring and care. An
`in-home care provider to monitor and assist in basic health
`needs may not be available. Many of these individuals are
`impaired mentally or are on some form of therapy such as
`oxygen or medication. In this case they are at risk of failure
`to comply with prescribed therapy_. thereby potentially lead-
`ing to a tmurtlatic event such as falling, loss of oxygen. or
`loss of consciousltess.
`
`[0016] Children and other relatives have increasing con-
`cerns for the welfare of parents or other family members
`with litnited self-care capabilities. These concerns are
`becoming manifested in a desire to directly monitor those
`family member patients and to more actively participate in
`giving. care. These trends create a demand for a new and
`innovative solution to caring.
`[0017] A home-based re111ote care solution must have the
`following. characteristics:
`(13: Requires little or no under-
`standing ofthe operation by the individual ofthe monitoring
`devices and system. (2) Monitors key physiological param-
`eters relevant to the disease or disability. These parameters
`include activity level, falls, and key measurements such as
`S1302 and consciousness. (3) Provides a determination of
`patient location, whether in-facility or in-home. (4) Provides
`cognitive understzutding ofsituations and treatments_. based
`on input from multiple sensors of physiological parameters
`coupled with interactive coaching of behavior. lnlerences
`must be made utilizing more than one sensor. (5) Provides
`natural interactions employing speech and provides simple
`interactions with a point-of-care {I-‘O-(T) appliance and a
`wearable monitor. (6) Provides full time monitoring capa-
`bility. both when the patient is in-home and when traveling.
`[7] Provides a link to a care provider and emergency
`services.
`
`technological
`recent
`invention employs
`[0018] The
`advances in low power measurements and plug-and-play
`wireless colnrnunicatiolt-‘i components to create a miniature
`measurement and feedback system that also provides loca-
`tion determination. Such a device may be called a basic
`health Inonitor (the BHM) or the “remote companion" that
`can accompany a patient throughout his day. Embodiments
`of the BHM include am earpiece, a pendant. a wrist-mounted
`BHM. a clip-on BHM for a belt. or pocket-carried BHM.
`The Bi-IM has low power integrated communications with
`an in-home low power mesh network. a progrintrnable
`digital assistant (PDA) with cell phone technology. and a
`cognitive system. These components allow location deter-
`mination and remote monitoring of the basic health of an
`individual.
`
`the BHM will be
`In the preferred embodiment
`[0019]
`wont around the ear in the same manner as a conventional
`hearing aid or the recently introduced Bluctooth wireless
`headsets or ear-pieces. The Bl-IM will be able to measure
`oxygen saturation (S2102). temperature of the ear canal. and
`motion. including detection ol'a fall. A key feature is that no
`intervention will be required to determine the status of the
`individual and to convey this information to care providers.
`A cognitive system provides feedback and assistance to the
`individual while learning standard behavior patterns.
`[0020] With an integrated audio speaker and nticrophone.
`the BI--IM is able to deliver audio alerts. current measure-
`
`ments. voice prompts. and reminders provided by a remote
`care provider. The device may be worn overnight to allow
`monitoring and intervention both day and night. Through the
`ability to inquire.
`|.l1e cognitive system is able to qualify
`events such as loss of consciousness or a fall. Anticipated
`improvements will allow other tneasurentents to be made
`such as CO3. respiration. EKG. EEG and blood glucose.
`[002]]
`Sitnple voice commands can activate the BH M to
`report its measurements and to give alerts to care providers.
`Alerts from care providers can be given in a familiar voice
`to assist the patient with compliance to medication regimens
`and disease management instructions. Simple switches will
`allow volume control and manual activation.
`
`[0022] The BHM conununicates through a series of low-
`power gateways to an in-home cognitive server and to a
`point-of-care appliance (the POC). which can be a computer.
`Acting alone. the BHM provides basic feedback and moni-
`toring with limited cognitive capabilities, such as detecting
`low oxygen or a fall. While connected to the oognitivc server
`or P()(.‘_. the BIIM attains full cognitive capabilities. Full
`alerting capability requires the cognitive server to be con-
`nected through an Internet gateway to the remote care
`provider. Using specialized technology within a wireless
`transceiver of the BHM, the relative position of the BHM
`within a home or facility may be determined by signal
`strength triangulation to the gateways.
`[0023] A key characteristic is the appropriate distribution
`of intelligence to the BHM through to the cognitive server.
`BHMS have limited ability to make decisions but in some
`cases may make decisions on their own. particularly if they
`are somehow not
`in communication with the cognitive
`server. Some decisions may require more information than
`is availabie from a single device in order to make decisions.
`The |3I'lM contains enough sensors within a single unit that
`some basic decisions such as fall detection may be made
`standalone. Leaming and trend detection require the full
`cognitive system to make decisions and ieedback new
`detection parameters.
`[0024] The cognitive system provides high-level qualita-
`tive information and quantitative data to the caregiver. The
`cognitive system compresses data at the re111ote_. in-home
`location into certain quantitative and qualitative states of
`health. Because of possible measurement errors and other
`uncertainties.
`the architecture of the cognitive system
`requires communication of health states and outputs as
`probability distributions. The cognitive system provides two
`levels of natural interaction with the patient: first. through a
`primary BIIM by speech otttput and input: and second.
`through the POC in the home or care facility, by both touch
`screen and speech interaction.
`[0025] The cognitive system also contains sensors for
`non-health parameters that are necessary to the overall
`safety of the individual patient. These sensors are modular in
`nature and can be placed according to individually deter-
`mined need. The sensors can measure multiple parameters
`such as ambient temperature, surface temperature (as of a
`cook top). motion. sotutds, and infrared signals. The sensors
`contain a speaker for delivering audio alerts. an LCD display
`for displaying tneasurements. and appropriate buttons for
`interaction. These sensors connnunicate through a ZigBee
`wireless connection.
`
`[0026] The sensors may be utilized in stand alone capacity.
`in a network. or in conjunction with a base module in which
`a sensor module may be docked. Stand alone. a sensor
`
`017
`
`017
`
`

`
`US 2007.1} 197881 A1
`
`Aug. 23, 2007
`
`module may interact in dilferent modes. such as wirelessly
`interacting with another sensor module or with a network
`controller of a system. A network controller is a special case
`ofa sensor module docked in a lOl3ase-'1' base module.
`[0027]
`13y docking a sensor module into a 10l3ase-‘l‘ base
`module. the sensor becomes part of a wired network of
`sensors to be consolidated into a set of remote objects.
`[0028] The POC has integrated communication capabili-
`ties along with the cognitive engine. The POC interacts with
`the user for scheduling activities. medication. and commit-
`nications with the care provider through integrated phone,
`voice ntessaging, email. mtisic, and graphics such as pic-
`tures and videos.
`
`[0029] The accompanying drawings, which are i11corpo-
`rated iii and form a part of the specification.
`illustrate
`preferred embodiments of the present
`invention. and
`together with the description. serve to explain the principles
`of the invention. In the draw'ings:
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 is a11 isometric front right side view of a
`[0030]
`basic health monitor (BI-IM), showing representative loca-
`tions ol‘ subcomponents.
`[0031]
`FIG. 2 is a view similar to FIG. 1, showing a Bl-IM
`from the left rear.
`[0032]
`FIG. 3 is a schematic view of an overall remote
`healthcare system. showing a BI-IM and modular sensors
`associated with the patient and an in-home setting.
`[0033]
`FIG. 4 is a functional block diagram of the internal
`components of a BI-IM. sensor. or similar modular device.
`showing functional interactions.
`[0034]
`FIG. 5 is a schematic communications level dia-
`gram showing software components and a communications
`path from a BIIM through a gateway to a cognitive server.
`[0035]
`FIG. 6 is a schematic block diagram of the cogni-
`tive operation soflware cornponents of the BHM and cog-
`nitive system.
`[0036]
`FIG. 7 is an isometric view of a modular sensor
`device. taken from bottom front.
`
`FIG. 8 is an exploded view of the sensor of FIG. 7.
`[0037]
`showing suggested component locations.
`[0038]
`1-‘IG. 9 is a view similar to FIG. 8. taken from top
`rear
`
`FIG. 10 is an isometric view taken from from right.
`[0039]
`showing a sensor attached to a base module.
`[0040]
`FIG.
`11
`is an isometric view of an alternate
`embodiment of a BHM. taken from the from lower left side.
`showing a pendant or belt clip mounted BHM.
`[0041]
`FIG. 12 is a view similar to FIG. 11. taken from
`upper right rear of the alternate embodiment of the BI-1M.
`[0042]
`FIG. 13 is a plan view of a remote healthcare
`system installed in a home. schematically showing the
`patient and a method of determining location.
`[0043]
`FIG. 14 is a front
`isometric view of die POC,
`showing interface components.
`
`I)l£'I'AILl-ED DESCRIP"ION OF 'l'I-IE
`PREFERRED EMBODIMENT
`
`[0044] The invention relates to a remote healthcare deliv-
`ery system that includes a basic health monitor (hereinafter
`“BHM"). The delivery system further includes a network of
`sensor modules that enables l1t)111t:-based care of indepen-
`dently living elderly and disabled persons, who will some-
`
`times be called the “patient" or “user." The BHM and sensor
`modules are similar to one another. with the BHM being
`primarily adapted to be worn by the patient while the sensor
`modules are primarily adapted to be distributed in the
`patient‘s home or care facility.
`[0045] The invention contemplates that a natural network
`surrounds a person or patient. Such a network may include
`both professional caregivers and other support individuals
`who might provide care on an informal basis. The informal
`caregivers are relatives. friends. co—workers. andlor neigh-
`bors. The professional caregivers are the individual’s net-
`work ofdoctors, nurses, emergency medical teclulicians, etc.
`[0046] Another portion of the invention for delivering
`remote healthcare is a cognitive system to evaluate health
`parameters and trends. Prior telehealthcare systems have not
`included this ability. A cognitive system can reduce the
`demands that the delivery of raw data otherwise places upon
`the infornial care givers, thereby avoiding a portion of false
`alarms. A cognitive system can work together with all
`sensors within the remote healthcarc system. especially with
`the BHM sensor. The BHM measures basic health function
`
`such as pulse rate. temperature. oxygen saturation. move-
`ment. acceleration. and location. The BI-IM also contains a
`speaker and microphone for speech interaction. The patient
`wears the BHM at all
`times. Through the speaker and
`micmpltone built into the BI IM. the cognitive system is able
`to give prompts to the patient and can receive answers from
`the patient. This ability is crucial
`for implementing the
`cognitive. learning soliware included in this remote health-
`care system and for enabling the prompting features of the
`system.
`[0047] A remote healthcare delivery system must fulfill
`three needs: a) safety, b) security. and C) social needs. Salety
`issues to be monitored include basic health assessments such
`
`as oxygen saturation. blood pressure, appropriate move-
`ment. and so on. Security is defined by the status of doors
`openfclosed. appliances oiv‘oli'. temperature in the house and
`so on. The importance of social interaction for the physical
`as well as emotional well being of the patients is becoming
`increasingly evident. Appointntents for social and recre-
`ational activities and integrated oommtntications form the
`basis of fulfilling these social needs. Information about
`safety. security. and social needs must be current. accurate
`and readily available both to the patient and to the person[s)
`involved in assisting him.
`is
`including the BHM,
`[0048] A network of sensors,
`located throughout the patient's dwelling. The sensors track
`and monitor the patient‘s health status and activities. The
`sensors provide input for proactive applications that will
`ofier a variety of assistance. ranging from reminders to take
`medications to accessing social support. The patient will
`access this network through a point-of-care appliance. here-
`inafter called “POC_.“ by using a variety of familiar inter-
`faces. such as integrated calendar. telephone. and simplified
`email
`that utilize appropriate assistivc technology. The
`patient will not need to learn new technology to receive
`assistance. These proactive systems enable relatives to
`assess the health and well-being of the patient remotely
`through private. secure Internet connections and will pro-
`vide social support to on-site caregivers. Such social suppor1
`to caregivers is necessary to avoid bumout. which is a
`co1Tu11on problem among caregivers.
`[0049]
`‘lhe remote healthcare delivery system is distrib-
`uted. which in certain circumstances might risk a full or
`
`018
`
`018
`
`

`
`US ZOOWU 197881 A1
`
`Aug. 23, 2007
`
`partial loss of communications. In order to ensure that the
`system is robust. the cognitive intelligence also is distrib-
`uted. especiaily to the Bi-1M. A fusion of the data from the
`network sensors enables a feedback of the patient‘s health
`state. This fusion enables an adaptive intelligent assistance
`to the patient even when there is a communication failure.
`[0050] The remote healthcare delivery system employs a
`mesh network. which enables a new approach to care for the
`patient. To date. most wireless systems have employed
`cellular-phone-type radio links implementing point—to-point
`or point—to—multipoint transmissions. These prior networks
`are dillicult to install, configure and maintain. Also. they are
`highly vulnerable to failure,
`thereby leading to dropped
`signals. In contrast. wireless mesh networks are multi-hop
`systems. where the components assist each other in trans-
`mitting signals. Signals may take several hops through
`diiferent components to reach their intended destination.
`Mesh networks are especially well suited to adverse condi-
`tions and are easy to install. self-configuring. and self-
`learning. Devices can he added to a mesh network without
`technical knowledge and by following simple installation
`instructions. This makes them particularly useful for the type
`of care, specific application. and targeted users as identified
`herein.
`
`In the following detailed description. one commu-
`[0051]
`t1icatio11 patl1 may be described for use by any particular
`component. Such descriptions should be understood to be
`representative. Many of the measurement components may
`follow similar communication paths. Therefore. all dis-
`closed communication paths are applicable to each compo-
`nent and for communicating each measurement.
`In the
`following description. the numbers from 1-99 are elements
`primarily shown in 1‘ [GS. 1-2. 1'll.l.l'1'llDt3l'5 ufllle 300. 400. 500.
`and 600 series refer to elements primarily shown in 1-‘ IGS. 3.
`4. 5, auid 6. respectively. Numbers of the 700 series refer to
`elements primarily shown in FIGS. 7-10. Numbers of the
`800 series refer to eletnents primarily shown in FIGS. 11-12
`and numbers in series 900 refer to elements primarily shown
`in FIGS. 13 and 14.
`
`FIGS. 1 and 2 show a basic health monitor (BI-IM]
`[0052]
`303 of a form factor suited to be wearable. As suggested i11
`these figures. a preferred configuration of the I31-IM 303 is as
`an eru-piece. A BHM 303 contains subcomponents that
`enable various functions. Other configurations of tlie BHM
`perform similar functions and contain similar subcompo-
`nents. In a BHM of the form factor in FIGS. 1 and 2. many
`of the subcomponents are intemal. Thus. various subcom-
`ponents are identified as representative locations on the
`earpiece 303. The subcomponents are microphone 1. ear-
`phone and temperature sensor 2. dual light emitting diodes
`([.El)s} 3. optical sensor 4. accelerometer 5. microprocessor
`6. and antemia 7. all as shown in FIG. 1. FIG. 2 shows
`additional components including volume controls 10, indi-
`cator LED 1l_. Zifiee radio transceiver 12. and onfofi" button
`13. The l.l'il)s 3 and optical sensor 4 are spaced apart. and
`the configuration ofthe earpiece 303 is suitable for the user’s
`earlobe to be located between the LED‘s 3 and optical sensor
`4 to enable measurements Inore fully described below.
`[0053] The wearable BI IM 303 and other system elements
`in the home are shown schematically i11 FIG. 3. A boxed
`portion 315 of the figure represents the home or care center
`and shows which components are found within the home
`315 or care center. Within the home 315. a smaller boxed
`ponion 302 represents the patient and shows devices such as
`
`the patient 302 carries or wears. Of
`the BHM 303 that
`course. the patient 302 is mobile and may leave the home.
`taking such devices 303 with him. This figure also shows
`multiple communication paths represented as ellipses. These
`are a Zigbee wireless path 320. a wired or wireless 801.11
`path 330. and an lntemet path 340. which may be by wired
`line 34 1 or a wireless cellular network 344. Lines connecting
`each device in the ligtire represent a communication path.
`with lines to an ellipse representing a connection to the
`respective network.
`[0054] One or more point—of—care (POC) appliances or
`computer terminals 301 are located in the patient‘s home for
`the patient’s use. A POC 301 has full touch screen and voice
`interactive capabilities and communicates through a local
`network 330 with a cognitive server 312.
`[0055] A router gateway module 300 has a USB link to the
`cognitive server 312. The router gateway module 300 pro-
`vides a communication bridge from the wireless Zighee
`network 320 to the network 330 through the cognitive server
`312. This bridge allows communications with the patient
`302 via the wearable basic health mortitor 303 through a
`Zigbee connection. Additional wireless Zigbee modular
`sensors 304 are deployed at other locations in the house. As
`a specific example. the additional sensors 304 may include
`a modular surface temperature sensor 305 that is located to
`monitor a cooking surface or range 306. The router gateway
`module 300 and sensor modules 304 are similar.
`
`[0056] The remote healthcare delivery system includes
`components operative outside the home 315. When the
`patient 302 is outside ol‘ the home. the accompanying 131 IM
`303 com.n1unicatcs thmugh Xigbee network 320 to the
`optional programnlable digital assistant (PDA) 313. which
`the patient 302 carries with him. The PDA 313 communi-
`cates with the cognitive server. either through the link 341
`or through a cellular connection to the Internet.
`in tum
`linking by connection 342 to the cognitive server 312. The
`cognitive server 312 communicates through the Internet 340
`to one or more desktop remote computers or patient moni-
`tors 308 located at a remote caregiver site. The remote
`healthcare system may include a remote PDA or remote
`patient monitor 30‘? connected through the lntemet by
`cellular network link 344.
`
`[0057] The general interactions and structure o i'l3I IM 303
`and the similar or parallel portions of sensor module 304 and
`the like are shown in