`a2) Patent Application Publication 10) Pub. No.: US 2007/0197881 Al
`(43) Pub. Date:
`Aug.23, 2007
`Wolf et al.
`
`US 20070197881A1
`
`(54) WIRELESS HEALTH MONITOR DEVICE
`AND SYSTEM WITH COGNITION
`
`(76)
`
`Inventors:
`
`James L. Wolf, Conifer, CO (US);
`Thomas P. Walker, Morrison, CO
`(US); Franz Huber, Denver, CO
`(US); Robert N. Caruso,
`Evergreen, CO (US)
`
`Correspondence Address:
`KYLE W. ROST
`5490 AUTUMN CT.
`GREENWOOD VILLAGE, CO 80111
`
`(21) Appl. No.:
`
`11/678,052
`
`(22)
`
`Filed:
`
`Feb. 22, 2007
`
`Related U.S. Application Data
`
`(60)
`
`Provisional application No. 60/766,963, filed on Feb.
`22, 2006.
`
`Publication Classification
`
`(51)
`
`Int. Cl.
`(2006.01)
`AGIB 3/00
`(2006.01)
`G060 10/00
`(52) US. Ch ceeseessssessseerseeeessee 600/300; 128/920; 7053/2
`
`(57)
`
`ABSTRACT
`
`A home-based remote care solution provides sensors includ-
`ing a basic health monitor (BHM)that is a measurement and
`feedback system. The BHM operates with low power inte-
`
`low
`grated communications combined with an in-home.
`power mesh network or programmable digital assistant
`(PDA) with cell phone technology. A cognitive system
`allows remote monitoring of the location and the basic
`health of an individual. The BHM measures oxygen satu-
`ration (SaQ2),
`temperature of the ear canal, and motion,
`including detection of a fall and location within a facility.
`Optionally,
`the BHM measures CO2,
`respiration, EKG,
`EEG, and blood glucose. No intervention is required to
`determine the status of the individual and to conveythis
`information to care providers. The cognitive system pro-
`vides feedback and assistance to the individual while learn-
`ing standard behavior patterns. An integrated audio speaker
`and microphone enable the BHM 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. Throughthe ability to inquire, the cognitive system is
`able to qualify events such as loss of unconsciousness or
`falls. Simple voice commands activate the device to report
`its measurements and togivealerts to care providers. Alerts
`from care providers can be in a familiar voice to assist with
`compliance to medication regimens and disease manage-
`ment
`instructions. Simple switches allow volume control
`and manual activation. The device communicates with a
`series of low-powergatewaysto an in-home cognitive server
`and point-of-care (POC) appliance (computer). Alone the
`BHM provides basic feedback and monitoring with limited
`cognitive capabilities such as low oxygenor 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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`Aug. 23, 2007
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`WIRELESS HEALTH MONITOR DEVICE
`AND SYSTEM WITH COGNITION
`
`CROSS-REFERENCE TO RELATED
`APPLICATION
`
`[0001] This application claims the benefit of U.S. Provi-
`sional Patent Application Ser. No. 60/766,963, filed Feb. 22,
`2006, copending.
`
`BACKGROUNDOF THE INVENTION
`
`2. Field of the Invention
`[0002]
`[0003] The invention generally relates to surgery as
`applied to diagnostic testing and to computer assisted medi-
`cal diagnostics. More specifically, the invention relates to
`monitoring a plurality of physiological 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 telemetry by radio,
`telephone, or computer network.
`[0004]
`2. Deseription of Prior Art
`[0005] A large segment ofelderly and disabled persons
`who would otherwise require institutional medical care are
`able to live independently as long as monitoring of their
`condition and assistance with their needs are provided.
`Givena trend toward greater independence and convenience
`of in-home healtheare, this is becoming increasingly impor-
`tant. Providing remote home-based care for high-risk
`patients typically cared for in hospitals can drive downcosts
`and risks associated with transportation to and from points
`of care. This has also been shown to improve healthcare
`access for disabled persons, connect socially isolated indi-
`viduals to their care providers, and enhance caregiver effec-
`tiveness.
`
`[0006] Home-based care as described here is not telemedi-
`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
`fully integrated systems but they still have not achieved a
`fully deployable system. As reported by Audrey Kinsella,
`MA, MS Research Director of Information for Tomorrow
`“The idea of home telehealthcare needs a serious makeover.
`Even today, home telemedicine or telehealthcare is associ-
`ated with high-tech, expensive devices and overall inacces-
`sibility for the average homecare nurse. We need to getpast
`these perceptions and misunderstandings.”
`[0007] The term, “home telehealthcare,” is defined as
`clinician-driven healthcare and education services that are
`delivered to the home via telecommunications 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 communication other
`than the telephone.
`[0008] The term, “remote healthcare,” is defined to
`include this extended formof 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
`transitional care for a treated condition fit this category as
`well, All such persons will benefit from remote healtheare.
`
`[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 diminishing the time 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 of in-home monitoring of
`basic health status. a more cost-effective alternative will
`have been created for a notable segment ofthis population
`without compromising 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] Communication technologies,
`from well-known
`POTS(plainold telephone system) to the Internet, 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
`efforts to provide medical care, remotely. Wireless technolo-
`gies are starting to be employed in telemedicine as well.
`However, Audrey Kinsella has identified the need for spe-
`cialized high-technology knowledge (e.g.. rewiring house-
`holds for advanced telecommunications capabilities, install-
`ing sophisticated health care workstations, and requiring a
`suite of engineers to wait on the doorstep, ready to assist) as
`impediments to the adoption of telemedicine.
`[0011] Current wireless technologies employing standards
`knownas 802.11b,g and Bluetooth, used in a low powerset
`of sensors, have significant problems. While 802.11 is
`successful in the home environment, 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 lowdata rate information through multiple
`paths to ensure delivery of messages.
`[0012]
`It would be desirable to provide an improved
`method and apparatus for delivering remote healthcare. 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
`
`represent a problem. The underlying technology may be
`completely hidden from the patient or user.
`[0013] Desirably, such a system may be enabled by recent
`developments in computer and telecommunications technol-
`ogy. Most notably, these are: a) affordable computer systems
`with touch screens and voice response, b) Internet, wireless
`communications standards of Bluetooth and ZigBee, ¢) low
`powerelectronics providing for long batterylife, d) reliable
`low power GPS 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.
`
`BRIEF SUMMARY OF THE INVENTION:
`
`[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 oflife for
`
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`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 the invention is to enable such individuals to live
`in their own homes while receiving monitoring and care. An
`in-home care provider to monitor andassist in basic health
`needs may not be available. Many ofthese individuals are
`impaired mentally or are on some form oftherapy 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 traumatic event such as falling. loss of oxygen, or
`loss of consciousness.
`[0016] Children and other relatives have increasing con-
`cerns for the welfare of parents or other family members
`with limited 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 remote care solution must have the
`following characteristics: (1) Requires littke 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
`$pO2 and consciousness. (3) Provides a determination of
`patient location, whetherin-facility or in-home. (4) Provides
`cognitive understanding ofsituations and treatments, based
`on input from multiple sensors of physiological parameters
`coupled with interactive coaching of behavior. Inferences
`must be made utilizing more than one sensor. (5) Provides
`natural interactions employing speech and provides simple
`interactions with a point-of-care (POC) appliance and a
`wearable monitor. (6) Provides full time monitoring capa-
`bility, both when the patient is in-home and whentraveling.
`(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 communications components to create a miniature
`measurement and feedback system that also provides loca-
`tion determination. Such a device may be called a basic
`health monitor (the BHM)or the “remote companion”that
`can accompany a patient throughout his day, Embodiments
`ofthe BHM include an earpiece, a pendant, a wrist-mounted
`BHM,a clip-on BHM for a belt, or pocket-carried BHM.
`The BHM has low power integrated communications with
`an in-home low power mesh network, a programmable
`digital assistant (PDA) with cell phone technology, and a
`cognitive system, These components allow location deter-
`mination and remote monitoring ofthe basic health of an
`individual.
`
`the BHM will be
`In the preferred embodiment
`[0019]
`worn around the ear in the same manner as a conventional
`hearing aid or the recently introduced Bluetooth wireless
`headsets or earpieces. The BHM will be able to measure
`oxygen saturation (SaQ2), temperature ofthe ear canal, and
`motion, including detection ofa 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 microphone,
`the BHM 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, the cognitive system is able to qualify
`events such as loss of consciousness or a fall. Anticipated
`improvements will allow other measurements to be made
`such as CO,, respiration, EXG, EEG and blood glucose.
`[0021]
`Simple voice commands can activate the BHM to
`report its measurements andto 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 managementinstructions. Simple switches will
`allow volume control and manual activation.
`
`[0022] The BHM communicates 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 ora fall. While connected to the cognitive server
`or POC, the BHM 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 throughto the cognitive server.
`BHMshavelimited ability to make decisions but in some
`cases may make decisions ontheir own, particularly if they
`are somehow not
`in communication with the cognitive
`server. Some decisions may require more information than
`is available from a single device in order to make decisions.
`The BHM contains enough sensors within a single unit that
`some basic decisions such as fall detection may be made
`standalone. Learning and trend detection require the full
`cognitive system to make decisions and feedback 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 remote,
`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 BHM by speech output and input: and second,
`through the POC in the homeorcare facility, by both touch
`sereen and speech interaction.
`[0025] The cognitive system also contains sensors for
`non-health parameters that are necessary to the overall
`safety of the individualpatient. 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, sounds, and infrared signals. The sensors
`contain a speaker for delivering audio alerts, an LCD display
`for displaying measurements, and appropriate buttons for
`interaction. These sensors communicate 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
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`module may interact in different modes, such as wirelessly
`interacting with another sensor module or with a network
`controller of a system. A network controller is a special case
`of a sensor module docked in a 10Base-T base module.
`[0027] By docking a sensor module into a 10Base-T 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 commu-
`nications with the care provider through integrated phone,
`voice messaging, email, music, and graphics such as pic-
`tures and videos.
`[0029] The accompanying drawings, which are incorpo-
`rated in 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 drawings:
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 is an isometric front right side view ofa
`[0030]
`basic health monitor (BHM), showing representative loca-
`tions of subcomponents.
`[0031]
`FIG. 2 is a view similar to FIG. 1, showing aBHM
`from the left rear.
`[0032]
`FIG. 3 is a schematic view of an overall remote
`healthcare system, showing a BHM and modular sensors
`associated with the patient and an in-homesetting.
`[0033]
`FIG. 4 is a functional block diagram ofthe internal
`components of a BHM, 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 BHM through a gateway to a cognitive server.
`[0035]
`FIG. 6 is a schematic block diagram ofthe cogni-
`tive operation software components of the BHM and cog-
`nitive system.
`[0036]
`FIG. 7 is an isometric view of a modular sensor
`device, taken from bottomfront.
`[0037]
`FIG. 8 is an exploded view ofthe sensor of FIG. 7,
`showing suggested component locations.
`[0038]
`FIG. 9 is a view similar to FIG. 8, taken from top
`rear.
`
`FIG. 10 is an isometric view taken fromfrontright,
`[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 front lowerlefi 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 BHM.
`[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 the POC,
`showing interface components,
`
`DETAILED DESCRIPTION OF THE
`PREFERRED EMBODIMENT
`
`[0044] The invention relates to a remote healthcare deliv-
`ery systemthat includes a basic health monitor (hereinafter
`“BHM”). The delivery system further includes a network of
`sensor modules that enables home-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 personor 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, and/or neigh-
`bors. The professional caregivers are the individual’s net-
`work of doctors, nurses, emergency medical technicians, 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 informal care givers, thereby avoiding a portion offalse
`alarms. A cognitive system can work together with all
`sensors within the remote healthcare 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 BHM also contains a
`speaker and microphone for speech interaction. The patient
`wears the BHM at all
`times. Through the speaker and
`microphonebuilt into theBHM,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 software 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. Safety
`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
`open/closed, appliances on/off, temperature in the house and
`so on. The importance ofsocial interaction for the physical
`as well as emotional well being of the patients is becoming
`increasingly evident. Appointments for social and recre-
`ational activities and integrated communications 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 andto the person(s)
`involved in assisting him.
`is
`including the BHM,
`[0048] A network of sensors,
`located throughoutthe patient’s dwelling. The sensors track
`and monitor the patient’s health status and activities. The
`sensors provide input for proactive applications that will
`offer 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
`that utilize appropriate assistive 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 support
`to caregivers is necessary to avoid burnout, which is a
`common problem among caregivers.
`[0049] The remote healthcare delivery system is distrib-
`uted, which in certain circumstances might risk a full or
`
`018
`
`FITBIT, Ex. 1042
`
`018
`
`FITBIT, Ex. 1042
`
`
`
`US 2007/0197881 Al
`
`Aug. 23, 2007
`
`partial loss of communications. In order to ensure that the
`system is robust, the cognitive intelligence also is distrib-
`uted, especially to the BHM. 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 whenthere is a communicationfailure.
`[0050] The remote healthcare delivery system employs a
`mesh network, which enables a new approachto 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 difficult 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
`different components to reach their intended destination.
`Mesh networksare especially well suited to adverse condi-
`tions and are easy to install, self-configuring. and self-
`learning. Devices can be added to a mesh network without
`technical knowledge and by following simple installation
`instructions. This makes themparticularly useful for the type
`of care, specific application, and targeted users as identified
`herein.
`
`In the following detailed description, one commu-
`[0051]
`nication path 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 FIGS. 1-2, numbers ofthe 300, 400, 500,
`and 600series refer to elements primarily shownin FIGS. 3,
`4, 5, and 6, respectively. Numbers of the 700 series refer to
`elements primarily shown in FIGS. 7-10. Numbers ofthe
`800 series refer to elements 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 (BHM)
`[0052]
`303 of a formfactor suited to be wearable. As suggested in
`these figures, a preferred configuration ofthe BHM 303is as
`an earpiece. A BHM 303 contains subcomponents that
`enable various functions. Other configurations of the BHM
`perform similar functions and contain similar subcompo-
`nents. In a BHM ofthe form factor in FIGS. 1 and 2, many
`ofthe subcomponents are internal. 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
`(LEDs) 3, optical sensor 4, accelerometer 5, microprocessor
`6, and antenna 7, all as shown in FIG. 1. FIG. 2 shows
`additional components including volume controls 10, indi-
`cator LED 11, ZigBee radio transceiver 12, and on/off button
`13. The LEDs 3 and optical sensor 4 are spaced apart, and
`the configurationof the earpiece 303 is suitable for the user’s
`earlobe to be located between the LED's 3 and optical sensor
`4 to enable measurements more fully described below,
`[0053] The wearable BHM 303 and other system elements
`in the home are shown schematically in FIG. 3. A boxed
`portion 315 ofthe figure represents the homeor care center
`and shows which components are found within the home
`315 or care center. Within the home 315, a smaller boxed
`portion 302 represents the patient and shows devices such as
`
`the BHM 303 that the patient 302 carries or wears. Of
`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 Internet path 340, which may be by wired
`line 341 or a wireless cellular network 344. Lines connecting
`each device in the figure 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] Arouter 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 /igbee
`network 320 to the network 330 through the cognitive server
`312. This bridge allows communications with the patient
`302 via the wearable basic health monitor 303 through a
`Zigbee connection. Additional wireless Zigbee modular
`sensors 304 are deployedat 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 302is outside ofthe home, the accompanying BHM
`303 communicates through Zigbee network 320 to the
`optional programmable 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 turn
`linking by connection 342 to the cognitive server 312. The
`cognitive server 312 communicates throughthe Internet 340
`to one or more