`
`
`
`
`
`3B239533
`
`US0075
`
`(12) United States Patent
`Tran
`
`(10) Patent No.:
`(45) Date of Patent:
`
`US 7,539,533 B2
`May26, 2009
`
`(54) MESH NETWORK MONITORING
`APPLIANCE
`
`(76)
`
`Inventor:
`
`BaoTran, 6768 MeadowVista Ct., San
`Jose, CA (US) 95135
`
`(*) Notice:
`
`Subject to any disclaimer, the term ofthis
`patent
`is extended or adjusted under 35
`ULS.C. 154(b) by 445 days.
`
`(21) Appl. No.: 11/435,068
`
`(22)
`
`Filed:
`
`May 16, 2006
`
`(65)
`
`Prior Publication Data
`US 2007/0273504 Al
`Nov. 29, 2007
`
`(51)
`
`Int. Cl
`AGIB 5/04
`(2006.01)
`.. 600/509; 600/513
`(52): USs Chousasaiannanan
`(58) Field of Classification Search ................. 600/528,
`600/509, 513; 128/903
`See applicationfile for complete searchhistory.
`
`(56)
`
`References Cited
`U.S. PATENT DOCUMENTS
`
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`
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`
`(Continued)
`OTHER PUBLICATIONS
`
`U.S. Appl. No, 10/938,783, Wen,
`
`
`Primary Examiner—Carl H Layno
`Assistant Examiner—Brian T Gedeon
`(74) Attorney, Agent, or Firm—Tran & Associates
`
`(57)
`
`ABSTRACT
`
`A health care monitoring systemfor a person includes one or
`more wireless nodes forming a wireless mesh network; a
`wearable appliance having a sound transducer coupled to the
`wireless transceiver; and a bioelectric impedance (BI) sensor
`coupled to the wireless mesh network to communicate B] data
`over the wireless mesh networkto detect a heart attack or a
`stroke attack.
`
`
`
`
`
`
`
`
`0001
`
`20 Claims, 14 Drawing Sheets
`
`Apple Inc.
`APL1046
`U.S. Patent No. 8,652,040
`
`Apple Inc.
`APL1046
`U.S. Patent No. 8,652,040
`
`0001
`
`

`

`US 7,539,533 B2
`
`Page 2
`
`U.S. PATENT DOCUMENTS
`
`§,441,047 A *
`5,458,620 A
`5,462,065 A
`§,497,781 A
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`5,544,661 A
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`5,551,435 A
`5,551,438 A
`5,579,001 A
`5,579,775 A
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`5,623,939 A
`5,633,910 A
`5,652,570 A
`5,662,118 A
`5,671,741 A
`5,683,425 A
`§,692,215 A
`5,694,940 A
`5,708,417 A
`5,709,215 A
`5,710,551 A
`5,720,771 A
`5,722,420 A
`5,733,230 A
`5,738,104 A
`5,738,105 A
`5,743,268 A
`5,772,603 A
`5,775,330 A
`5,776,073 A
`5,785,960 A
`5,788,643 A
`5,857,975 A
`5,865,755 A
`5,876,350 A
`5,935,077 A
`5,945,112 A
`5,964,719 A
`5,967,975 A
`5.987.519 A
`5,996,889 A
`6,002,957 A
`6,004,312 A
`6,010,454 A
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`6.032.035 A
`6,038,469 A
`6,047,202 A
`6,050,940 A
`6,052,619 A
`6,056,671 A
`6,063,051 A
`6,070,140 A
`6,076,011 A
`6,108,685 A
`6,171,237 BI
`6.175.308 Bl
`6,176,831 BI
`6,184,797 BL
`6,228,034 Bl
`6,230,056 BI
`6,246,894 Bl
`6,280,393 Bl
`6,287,252 BL
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`6.336.900 Bl
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`
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`
`0002
`
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`6.374.614 B2
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`6.416.480 BI
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`6,440,067 BI
`9/2002.
`Tinget al.
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`7/2003 Cybulski etal.
`6,595,316 B2
`7/2003. Hadas
`6,597,944 Bl
`8/2003. Telleret al.
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`6,615,074 B2
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`6,615,075 B2
`9/2003. Goodman
`6,616,613 BL
`12/2003 Curcie etal.
`6,660,042 BL
`12/2003 Lanzoetal.
`6,661,161 Bl
`1/2004 Coneroetal.
`6,676,600 BI
`‘1/2004. Cusimano
`6,678,549 B2
`1/2004 Maaloufetal.
`6.678.551 B2
`2/2004 Steueret al.
`6,687,519 B2
`3/2004 Gallantetal.
`6,705,990 BL
`4/2004 Jorgensenet al.
`6.720.984 Bl
`4/2004 Gallant et al.
`6,730,038 B2
`5/2004. Amano
`6.740.045 B2
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`6.747.561 Bl
`7/2004 Sippens Groenewegen
`6,760,620 B2
`8/2004: Dominguez etal.
`6,783,492 B2
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`6,829,501 B2* 12/2004 Nielsen etal.
`.........-.-. 600/513
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`7,285,090 B2* 10/2007 Stivoric etal. ........... 600/300
`
`0002
`
`

`

`US 7,539,533 B2
` Page 3
`
`6/2005 Park et al.
`2005/0143667 Al
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`
`2004/0254493 Al=12/2004 Chervin et al. 2006/0009697 Al 1/2006 Banet etal.
`
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`
`* cited by examiner
`
`0003
`
`0003
`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 1 of 14
`
`US 7,539,533 B2
`
`REMOTE SERVER 200
`
`
`
`
`
`—
`
`
`AUTHORIZED THIRD
`
`PARTY (DOCTOR,
`FAMILY, EMERGENCY
`Internet
`
`SERVICES,
`100
`
`CAREGIVER, HOSPITAL,
`NURSING HOME, CALL
`CENTER, ETC.) 210
`
`a) ee) Le Gel
`
`BASE STATION-
`LOCAL SERVER 20
`
`90
`
`
`
`
`
`
`
`0i
`
`Mesh Network
`Appliances 8
`
`0004
`
`0004
`
`

`

`U.S. Patent
`
`May 26, 2009
`
`Sheet 2 of 14
`
`US 7,539,533 B2
`
`Place a calibration sheet with known dots at a known distance
`and perpendicular to a camera view
`
`Take snap shotof the sheet, and correlate the position of the
`dots to the camera image
`
`Place a different calibration sheet that contains known dots at
`another different known distance and perpendicular to camera
`view.
`
`defining a cone center where the camera can view
`
`Take snap shotof the sheet and correlate the position of the
`dots to the camera image
`
`Smooth the dots to the pixels to minimize digitization errors
`
`For each pixel, draw a line from Dotl(x,y,z) to Dot2 (x, y, z)
`
`FIG. 2A
`
`@eo@euocle@eced
`
`omomono ds
`
`@epceoe@ec edb
`
`omomonos
`
`ecececed
`
`omomomeos
`
`ececlec ecb
`
`om OoOmomos
`
`FIG. 2B
`
`0005
`
`0005
`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 3 of 14
`
`US 7,539,533 B2
`
`
`
`
`
`Find floor space area
`
`Define camera view
`background 3D scene
`
`Calculate patient’s key features
`
`Detect fall
`
`
`
`
`
`FIG. 3
`
`Find floor space area
`
`
`
`Define camera view background 3D scene
`
`Detect facial expression
`
`Calculate patient’s key features
`
`Extract facial objects
`
`Detectfacial orientation
`
`FIG. 4
`
`0006
`
`0006
`
`

`

`U.S. Patent
`
`May 26, 2009
`
`Sheet 4 of 14
`
`US 7,539,533 B2
`
`Set up mesh network appliances (1000)
`
`Determinepatient position using in-door positioning system (1002)
`
`
`
`
`
` Determinepatient movement using accelerometer output (1004)
`Determine vital parameter including patient heart rate (1006)
`
`
`
`Determineif patient needs assistance based on in-doorposition,fall
`
`
`
`
`
`
`detection and vital parameter (1008)
`
`Confirm priorto calling third party (1010)
`
`If confirmed or non-responsive, make connection with third party and
`
`
`
`
`
`send voice over mesh networkto appliance worn by the patient (1012)
`
`If needed, call emergency personnel to get medical care (1014)
`
`FIG. 5
`
`1382
`
`1388
`
`FIG. 6A
`
`0007
`
`0007
`
`

`

`U.S. Patent
`
`May 26, 2009
`
`Sheet 5 of 14
`
`US 7,539,533 B2
`
`HEAD BAND OR HEAD CAP
`1402
`
`/ ;
`
`PATCH
`1400
`
`MEDICINE
`CONTAINER(S)
`
`HDTV REMOTE
`CONTROL 1399
`
`f
`
`LIGHTING
`
`CONTROL 1398
`
`ROOM
`THERMOSTAT
`CONTROL 1396
`
`HOME SECURITY
`MONITOR1394
`
`FIRE ALARMS
`1393
`
`1182
`1391 HOME
`INTERNET
`
`
`APPLIANCE(S)
`
`
`BASE STATION
`
` POTS/PSTN OR THE
`OR PERSONAL
`
`SERVER 1390
`
`
`1392
`
`AUTHORIZED THIRD PARTY (FRIEND, FAMILY, COMMUNITY, EMERGENCY SERVICES,
`HOSPITAL, CAREGIVER, OR MONITORING CALL CENTER, AMONG OTHERS)1194
`
`FIG. 6B
`
`0008
`
`0008
`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 6 of 14
`
`US 7,539,533 B2
`
`Star @ PAN Coordinator (FFD)
`
`©) Router Node (FFD)
`@ EndDevice (RFD or FFD)
`
`FIG. 7
`
`130
`
`152
`
`FIG. 8
`
`0009
`
`0009
`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 7 of 14
`
`US 7,539,533 B2
`
`
`
`FIG. 9
`
`149
`
`FIG. 10
`
`0010
`
`0010
`
`

`

`May 26, 2009
`
`Sheet 8 of 14
`
`U.S. Patent
`
`US 7,539,533 B2
`
`FIG. 11
`
`
`
`FIG. 12
`
`0011
`
`0011
`
`

`

`May26, 2009
`
`Sheet 9 of 14
`
`US 7,539,533 B2
`
`wo
`
`U.S. Patent
`
`“Aitalrm
`n¥"Aeeneit
`
`FIG. 14A
`
`0012
`
`0012
`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 10 of 14
`
`US 7,539,533 B2
`
`
`
`
`
`(NOLYLISS.3SUNN‘6e)
`
`
`
`INJNOSMOMLSNW
`
`Lg| xOf
`
`WYOISAVM
`
`Y3AN3S
`
`Lhe.
`
`XY
`
`ZH
`
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`
`MALLIWSNYYLL#LN3ILWd
`
`HILLINSNYALZ#LNSULYd
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`oe
`
`On
`£0F
`
`02S
`
`FIG, 15A
`
`0013
`
`SISSON
`
`yBLNdNOD
`
`WLIdSOH
`
`LN3UVd
`
`ISVEVLYC
`
`gaia
`
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`
`GOF
`
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`gsZ
`
`0013
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`
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`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 11 of 14
`
`US 7,539,533 B2
`
`Lhe
`
`LN3NDHYOMLANYK
`
`SOLBE
`
`INVd
`Naz
`
`
`
`
`
`LWS9DVYSLNI9THV9
`
`£2E
`
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`aemailaeAsllchnMlnlell
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`fomonna~ sareemacaaiasaiei
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`
`YIANIS
`
`1#INSU
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`YMILLINSNVEL
`
`FIG. 15B
`
`0014
`
`0014
`
`
`
`
`
`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 12 of 14
`
`US 7,539,533 B2
`
`Patient A
`
`Patient B
`
`Patient C
`
`Patient N
`
`Bir oe ee ee
`
`0 WSS
`
`
`
`
` cei
`
`
`ao oe
`
`
`
`FIG. 13C
`
`FIG. 15D
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`0015
`
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`
`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet13 of 14
`
`US 7,539,533 B2
`
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`

`

`U.S. Patent
`
`May26, 2009
`
`Sheet 14 of 14
`
`US 7,539,533 B2
`
`Generate a blood pressure model of a patient (2002)
`
`
`
`
`
`Provide the blood flow velocity to the blood pressure model to
`continuously estimate blood pressure (2006)
`
`Determine a blood flow velocity using a piezoelectric transducer (2004)
`
`FIG. 16A
`
`Attach monitoring device and calibration device to patient (2010)
`
`Determine blood flow velocity from the monitoring device and actual
`blood pressure from the calibration device (2012)
`
`Generate a blood pressure model based on the blood flow velocity and the
`actual blood pressure (2014)
`
`Removecalibration device (2016)
`
`Determine blood flow velocity (2018)
`
`pressure (2020)
`
`Provide blood flow velocity to the blood pressure modelto estimate blood
`
`FIG. 16B
`
`0017
`
`0017
`
`

`

`US 7,539,533 B2
`
`1
`MESH NETWORK MONITORING
`APPLIANCE
`
`BACKGROUND
`
`This inventionrelates generally to methods and apparatus
`for monitoring a person.
`According to the National Center for Health Statistics
`Monitoring Health Care in America, Quarterly Fact Sheet.
`September 1996, cerebrovascular disease is the third leading
`cause of death in America, accounting for over 154,000
`deaths in 1994. This fact is true despite death rates from stroke
`having actually dropped nearly every year since 1950, In
`1993, 109 years of potential life were lost due to stroke for
`every 100,000 persons under age 65. Strokeis the third lead-
`ing cause ofdeath for all people age 45 and over. In 1993 the
`national death rate from stroke was 26.5 deaths per 100,000
`population. During the period 1990-92, age-adjusted death
`rates by State ranged from 20.8 for Rhode Island to 40.0 for
`South Carolina. Regionally, cerebrovascular disease mortal-
`ity is highest for Indiana and whatis referred to as the “stroke
`belt,” the southeastern states of Louisiana, Mississippi, Ala-
`bama, Georgia, North Carolina, South Carolina, Virginia,
`Tennessee, Kentucky, and Arkansas. The lowest rates are in
`Colorado, New Mexico, Arizona, Nebraska,
`Iowa, and
`Florida, as well as the northeastern states of Maine, Vermont,
`New York. Massachusetts, Connecticut, and Rhode Island.
`According to 1994 data, nearly 3 million Americans have
`suffered strokes at some point, or | per 100 population. Five
`percent of males aged 65 and over and 6 percent of womenin
`the same age group havesuffered a stroke.
`A stroke occurs when a blood vessel (artery) that supplies
`blood to the brain bursts or is blocked by a blood clot. Within
`minutes, the nerve cells in that area of the brain are damaged,
`and they may die within a few hours. As a result, the part of the
`body controlled by the damaged section of the brain cannot
`function properly. An ischemic stroke is caused by a reduc-
`tion in blood flow to the brain. This can be caused by a
`blockage or narrowing in an arterythat supplies blood to the
`brain or whenthe blood flow is reduced because ofa heart or
`
`other condition. A hemorrhagic stroke develops when an
`artery in the brain leaks or bursts and causes bleeding inside
`the brain tissue or near the surface ofthe brain. Prior to a
`stroke, a person may have one or more transient ischemic
`attacks (TLAs), which are a warning signal that a stroke may
`soon occur. TLAs are often called mini strokes because their
`
`symptomis are similar to those of a stroke. However, unlike
`stroke symptoms, TLA symptomsusually disappear within 10
`to 20 minutes, although they may last up to 24 hours. Symp-
`toms of a stroke begin suddenly and may include: numbness,
`weakness, or paralysis of the face, arm, or leg, especially on
`one side of the body; vision problems in one or both eyes,
`such as double vision or loss of vision; confusion. trouble
`speaking or understanding; trouble walking,dizziness, loss of
`balance or coordination, or severe headache.
`
`Early detection and treatment of stroke is essential
`recovery from a stroke.
`
`to
`
`SUMMARY
`
`In one aspect, a health care monitoring systemfor a person
`includes one or more wireless nodes forming a wireless mesh
`network; a wearable appliance having a sound transducer
`coupled to the wireless transceiver; and a bioelectric imped-
`ance (BI) sensor coupled to the wireless mesh network to
`communicate B] data over the wireless mesh network.
`
`2
`In another aspect, a heart monitoring system for a person
`includes one or more wireless nodes forming a wireless mesh
`network and a wearable appliance having a sound transducer
`coupled to the wireless transceiver; and a heart disease rec-
`ognizer coupled to the sound transducerto determine cardio-
`vascular health and to transmit heart sound over the wireless
`mesh network to a remote listener if the recognizer identifies
`a cardiovascular problem. The heart sound being transmitted
`may be compressed to save transmission bandwidth.
`In yet another aspect, a monitoring system for a person
`includes one or more Wireless nodes; and a wristwatch having
`a wireless transceiver adapted to communicate with the one or
`more wireless nodes; and an accelerometerto detect a dan-
`gerous conditionand to generate a warning when the danger-
`ous condition is detected.
`In yet another aspect, a monitoring system for a person
`includes one or more Wireless nodes forming a wireless mesh
`network; and a wearable appliance having a wireless trans-
`ceiver adapted to communicate with the one or more wireless
`nodes; and a heartbeat detector coupled to the wireless trans-
`ceiver. The system may also include an accelerometer to
`detect a dangerous condition such as a falling condition and to
`generate a warning when the dangerous condition is detected.
`Implementations of the above aspect may include one or
`more ofthe following. The wristwatch determines position
`based on triangulation. The wristwatch determines position
`based on RF signal strength and RF signal angle. A switch
`detects a confirmatory signal from the person. The confirma-
`tory signal includes a head movement, a hand movement, or
`a mouth movement. The confirmatory signal includes the
`person's voice. A processor in the system executes computer
`readable code to transmit a help requestto a remote computer.
`The code can encrypt or scramble data for privacy. The pro-
`cessor can execute voice over IP (VOIP) code to allowa user
`and a remote person to audibly communicate with eachother.
`The voice communication system can include Zigbee VOIP
`or Bluetooth VOIP or 802.XX VOIP. The remote person can
`be a doctor, a nurse, a medical assistant, or a caregiver. The
`systemincludes code to store and analyze patient informa-
`tion. The patient informationincludes medicine taking habits,
`eating and drinkinghabits, sleeping habits, or excise habits. A
`patient interface is provided on a user computerfor accessing
`information and the patient interface includes in one imple-
`mentation a touch screen; voice-activated text reading: and
`one touch telephone dialing. The processor can execute code
`to store and analyze information relating to the person’s
`ambulation. A global positioning system (GPS) receiver can
`be used to detect movement and where the personfalls. The
`system can include code to map the person’s location onto an
`area for viewing. The system can include one or more cam-
`eras positioned to capture three dimensional (3D) video ofthe
`patient; and a server coupled to the one or more cameras, the
`server executing code to detect a dangerous conditionfor the
`patient based on the 3D video and allow a remote third party
`to view images ofthe patient whenthe dangerous conditionis
`detected.
`
`In another aspect, a monitoring system for a person
`includes one or more wireless bases; and a cellular telephone
`having a wireless transceiver adapted to communicate with
`the one or more wireless bases; and an accelerometerto detect
`a dangerous condition and to generate a warning when the
`dangerous conditionis detected,
`In yet another aspect, a monitoring systemincludes one or
`more cameras to determine a three dimensional (3D) model
`of a person; means to detect a dangerous condition based on
`the 3D model: and means to generate a warning when the
`dangerous conditionis detected.
`
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`US 7,539,533 B2
`
`3
`In another aspect, a method to detect a dangerous condition
`for an infant includes placing a pad with one or more sensors
`in the infant’s diaper; collecting infant vital parameters: pro-
`cessing the vital parameter to detect SIDS onset: and gener-
`ating a warning.
`Advantages of the invention may include one or more of
`the following. The system for non-invasively and continually
`monitors a subject’s arterial blood pressure, with reduced
`susceptibility to noise and subject movement, and relative
`insensitivity to placementof the apparatus on the subject. The
`system does not need frequent recalibration of the system
`while in use on the subject.
`In particular,it allows patients to conduct a low-cost, com-
`prehensive, real-time monitoring oftheir blood pressure.
`Using the web services software interface, the invention then
`avails this information to hospitals, home-health care organi-
`zations, insurance companies, pharmaceutical agencies con-
`ducting clinical trials and other organizations. Information
`can be viewed using an Internet-based website, a personal
`computer, or simply by viewing a display on the monitor.
`Data measured several times each day providea relatively
`comprehensive data set compared to that measured during
`medical appointments separated by several weeks or even
`months. This allows both the patient and medicalprofessional
`to observe trends in the data, such as a gradual increase or
`decrease in blood pressure, which may indicate a medical
`condition. The invention also minimizes effects of white coat
`syndrome since the monitor automatically makes measure-
`ments with basically no discomfort; measurements are made
`at the patient’s homeor work, rather than in a medical office.
`The wearable applianceis small, easily worn bythe patient
`during periods of exercise or day-to-day activities, and non-
`invasively measures blood pressure can be done in a matter of
`seconds without affecting the patient. An on-board or remote
`processor can analyze the time-dependent measurements to
`generate statistics on a patient’s blood pressure (e.g.. average
`pressures, standard deviation, beat-to-beat pressure varia-
`tions) that are not available with conventional devices that
`only measure systolic and diastolic blood pressure at isolated
`times.
`
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`The wearable appliance provides an in-depth, cost-effec-
`tive mechanism to evaluate a patient's cardiac condition.
`Certain cardiac conditions can be controlled, and in some
`cases predicted, before they actually occur. Moreover, data
`from the patient can be collected and analyzed while the
`patient participates in their normal, day-to-day activities.
`In cases where the device has fall detectionin addition to
`blood pressure measurement. other advantages of the inven-
`tion mayinclude one or more of the following. The system
`provides timely assistance and enables elderly and disabled
`individuals to live relatively independent lives. The system
`monitors physical activity patterns, detects the occurrence of
`falls, and recognizes body motion patterns leading to falls.
`Continuous monitoring of patients is done in an accurate,
`convenient, unobtrusive,private and socially acceptable man-
`ner since a computer monitors the images and human involve-
`ment
`is allowed only under pre-designated events. The
`patient’s privacy is preserved since humanaccess to videos of
`the patient is restricted: the system only allows human view-
`ing under emergency or other highly controlled conditions
`designated in advance by the user. Whenthepatientis healthy,
`people cannot view the patient’s video without the patient’s
`consent. Only when the patient’s safety is threatened would
`the system provide patient informationto authorized medical
`providers to assist the patient. When an emergency occurs,
`images of the patient and related medical data can be com-
`
`5:
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`6
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`65
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`4
`piled and sent to paramedics or hospital for proper prepara-
`tion for pick up and check into emergency room.
`The system allows certain designated people such as a
`family member, a friend, ora neighbor to informally check on
`the well-being ofthe patient. The system is also effective in
`containing thespiraling cost ofhealthcare and outpatientcare
`as a treatment modality by providing remote diagnostic capa-
`bility so that a remote healthcare provider (such as a doctor,
`nurse, therapist or caregiver) can visually communicate with
`the patient
`in performing remote diagnosis. The system
`allows skilled doctors, nurses, physical therapists, and other
`scarce resourcestoassist patients in a highly efficient manner
`since they can do the majority oftheir functions remotely.
`Additionally, a sudden change ofactivity (or inactivity) can
`indicate a problem. The remote healthcare provider may
`receive alerts over the Internet or urgent notifications over the
`phonein case of such sudden accident indicating changes.
`Reports of health/activity indicators and the overall well
`being ofthe individual can be compiled for the remote health-
`care provider, Feedback reports can be sent to monitored
`subjects,their designated informal caregiver and their remote
`healthcare provider. Feedback to the individual can encour-
`age the individual to remain active. The content of the report
`maybetailored to the target recipient's needs, and canpresent
`the information in a format understandable by an elder person
`unfamiliar with computers, via an appealingpatient interface.
`The remote healthcare provider will have access to the health
`and well-being status of their patients without being intrusive,
`having to call or visit to get such informationinterrogatively.
`Additionally, remote healthcare provider can receive a report
`on the health of the monitored subjects that will help them
`evaluate these individuals better during the short routine
`check up visits. For example, the system can perform patient
`behavior analysis such as eating/drinking/smoke habits and
`medication compliance, among others.
`The patient’s home equipmentis simple to use and modu-
`lar to allow for the accommodationof the monitoring device
`to the specific needs of each patient. Moreover, the systemis
`simple to install. Regular monitoring of the basic wellness
`parameters provides significant benefits in helping to capture
`adverse events sooner,
`reduce hospital admissions, and
`improve the effectiveness of medications, hence, lowering
`patient care costs and improving the overall quality ofcare.
`Suitable usersfor such systems are disease management com-
`panies, health insurance companies, sel{-insured employers,
`medical device manufacturers and pharmaceutical firms.
`The system reduces costs by automating data collection
`and compliance monitoring, and hence reduce the cost of
`nurses for hospital and nursing home applications. At-home
`vital signs monitoring enables reduced hospital admissions
`and lower emergency room visits ofchronic patients. Opera-
`tors in the call centers or emergency response units get high
`quality information to identify patients that need urgent care
`so that they can betreated quickly, safely, and cost effectively.
`The Web based tools allow easy access to patient information
`for authorized parties such as family members, neighbors,
`physicians, nurses, pharmacists, caregivers. and other affili-
`ated parties to improved the Quality of Care for the patient.
`In an on-line pharmacy aspect. a method for providing
`patient access to medicationincludes collecting patient medi-
`cal information from a patient computer; securing the patient
`medical information and sending the secured patient medical
`information from the patient computer to a remote computer:
`remotely examining the patient and reviewing the patient
`medical information; generating a prescription for the patient
`and sending the prescription to a pharmacy: and performing a
`drug interaction analysis on the prescription.
`
`0019
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`US 7,539,533 B2
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`5
`Implementations of the on-line pharmacy aspect may
`include one or more of the following. The medical informa-
`tion can include temperature, EKG, blood pressure, weight,
`sugar level, image of the patient, or sound ofthe patient.
`Responses fromthe patient to a patient medical questionnaire
`can be captured. The doctor canlisten to the patient’s organ
`with a digital stethoscope, scanning a video of the patient,
`running a diagnostic test on the patient, verbally communi-
`cating with the patient. The digital stethoscope can be a
`microphoneor piezeoelectric transducer coupled to the Zig-
`bee networkto relay the sound. A plurality of medical rules
`can be applied to the medical information toarrive at a diag-
`nosis. Genetic tests or pharmacogenetic tests can be run on
`the patient
`to check compatibility with the prescription.
`Approval for the prescription can come from one of: a doctor,
`a physician, a physician assistant, a nurse. The system can
`monitor drug compliance, and can automatically ordering a
`medicationrefill from the pharmacy.
`For pharmacy applications, advantages of the pharmacy
`system may include one or more of the following. The system
`shares the patient’s medical history and can be updated by a
`remote physician and the remote dispensing pharmacy. As the
`doctor and the pharmacy have the sameaccess to the patient
`medical history database, patient data is updated inreal time,
`and is as current and complete as possible. The patient, doc-
`tor, pharmacy, and third party testing entities benefit from a
`uniformpricing structure that is based on the diagnosis and
`treatment. The patient only pays for standard medical treat-
`ments for his or her illness. The physicianis paid a standard
`fee which covers the average work spent with a patient with
`the specific type of medical situation. The dispensing phar-
`macy is able to provide the highest level of service, since it is
`able to double check all medications dispensed to eachpatient
`along with the optimal wayto detect anticipated negative drug
`interactions. The pricing structure is competitive as physi-
`cians do not need to be distributed physically, and those with
`specialty areas may remain centrally located and yet be able
`to interact electronically with patients. The system still pro-
`vides physical access to specialists since the patients which
`are evaluated can be directed tovisit a specialists physically,
`when remote review and contact is ineffectual. The on-line
`pharmacy tracks the specific needs and medical history of
`each patient and can provide an expert system to advise the
`patient on proper drug usage and potential drug interactions.
`The system automates the purchasing of drugs, pricing the
`prescription or submission ofthe claimsto a third party for
`pricing, entering the complete prescription in their computer
`system, and auditing from third parties which provide pay-
`ment. The on-line pharmacy provides detailed multimedia
`guidanceorassistance to the patient regarding thefilled pre-
`scription. The patient can freely search for answers regarding
`the use of the filled prescription, its possible side effects.
`possible interactions with other drugs, possible alternative
`treatments, etc. The patient can communicate using video or
`VOIP with a remote pharmacist regarding any number ofs:
`questions, and be counseled by the local pharmacist on the
`use of the filled prescription. Thus, the system minimizes the
`danger from harmful side effects o