111111
`
`1111111111111111111111111111111111111111111111111111111111111111111111111111
`US 20070197881A l
`
`(19) United States
`(12) Patent Application Publication
`Wolf et al.
`
`{10) Pub. No.: US 2007/0197881 AI
`Aug. 23, 2007
`(43) Pub. Date:
`
`(54) WIRELESS HEALTH MONITOR DEVICE
`AND SYSTEM WITH COGNITION
`
`(76)
`
`Inventors:
`
`.James L. Wolf, Conifer, CO (US);
`Thomas P. Walket·, Morrison, CO
`(US): Franz Huber, Denver, CO
`(US); Robert N. C aruso,
`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 appl icatlon No. 60/766,963, fi led on Feb.
`22. 2006.
`
`Publication C lassification
`
`(51)
`
`Int. Cl.
`(2006.01)
`A61B 5100
`(2006.01)
`G06Q 10100
`.......................... ... 600/300: 128/920: 705/2
`(52) U.S. C l .
`
`(57)
`
`ABSTRACT
`
`A home-based remote care solution provides sensors includ(cid:173)
`ing a basic health monitor (BHM) that is a measurement and
`feedback system. The BfiM operates with low power i.nte-
`
`grated communications combined with an in-home, low
`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 Br-IM meastu·es oxygen satu(cid:173)
`ration (Sa02), temperature of the ear canal, and motion,
`iJJcludlng detection of a fall and location within a facility.
`Optionally, the BIIM measures C02, respiration, EKG,
`EEG, and blood glucose. No intervention is required to
`determine the status of the individual and to convey this
`information to care providers. The cognitive system pro(cid:173)
`vides feedback and assistance to the individual wl1ilc learn(cid:173)
`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(cid:173)
`tion. Through the abil ity to inquire. the cognitive system is
`able to qualify events such as Joss of tmconsciousness or
`lalls. Simple voice commands activate the device to report
`its measurements and to give alerts to care providers. Alerts
`from care providers can be in a familiar voice to assist with
`compliance to medication regimens and disease manage(cid:173)
`ment instructions. Simple switches allow volume control
`and manual activation. The device comnmnlcates with a
`series of low-power gateways to 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 oxygen or tall detection.
`While connected to the cognitive server, fitll cognitive
`capabilities are attained. Full alerting capability requires the
`cognitive server to be connected through an Internet gate(cid:173)
`way to the remote care provider.
`
`304
`
`341
`
`344
`
`Remote
`Computer
`
`308
`
`307
`
`001
`
`Apple Inc.
`APL1206
`U.S. Patent No. 9,289,135
`
`

`

`Patent Application Publication Aug. 23, 2007 Sheet 1 of 14
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`US 2007/0197881 A1
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`303
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`~
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`6
`
`----5
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`3
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`2
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`1
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`Fig. 1
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`002
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`

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`Patent Application Publication Aug. 23, 2007 Sheet 2 of 14
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`US 2007/0197881 A1
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`303
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`~
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`13
`
`Fig. 2
`
`003
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`

`

`Patent Application Publication Aug. 23, 2007 Sheet 3 of 14
`
`US 2007/0197881 A1
`
`Cooktop
`
`Other
`Sensors
`
`306
`
`304
`
`POC
`Terminal
`
`301
`
`Remote
`Computer
`
`315
`
`308
`
`307
`
`Cognitive
`Server
`
`j
`
`342
`
`I
`!
`'----------~--------------
`
`341
`
`340
`
`Fig. 3
`
`004
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`

`

`Patent Application Publication Aug. 23, 2007 Sheet 4 of 14
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`US 2007/0197881 A1
`
`402
`
`Buttons
`
`420
`
`Integrated
`Microprocessor
`
`Wireless
`Tranceiver
`With
`Location
`Engine
`
`430
`
`440
`
`LCD Display
`
`431
`
`Fig. 4
`
`005
`
`

`

`Paten t Application Publication Aug. 23, 2007 Sheet 5 of 14
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`US 2007/0197881 A1
`
`501 503
`-----------------------------------------,
`
`Power and
`Baysian
`Chipcon
`Switches
`Microproc Object
`t--- - - - -1 essor
`Firmware
`
`Server
`
`Zig bee
`Stack
`801 .15.4
`
`Sensory Inc.
`Voice Processor
`Firmware
`
`Wireless
`Tranceiver
`With
`Location
`Engine
`
`I
`I
`I
`_ _ ___ .,..J
`I
`
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`
`507
`
`525
`~
`
`510
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`ChipCon
`Wireless
`Trancelver
`With
`Location
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`
`511
`
`Fig. 5
`
`Zig bee
`Stack
`801.15.4
`
`Chlpoon
`Mlcroproc
`essor
`
`USB
`
`513
`
`527~
`
`520
`
`USB
`HOST
`
`Baysian
`Object
`Access
`Server
`(OAS)
`
`COGNITIVE
`SERVER
`
`006
`
`

`

`Patent Application Publication Aug. 23, 2007 Sheet 6 of 14
`
`US 2007/0197881 A1
`
`605
`r-------- ---------·--------
`1
`:
`' '
`
`606
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`607
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`601
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`602
`603
`
`609
`
`610
`
`Levell
`Multi-Parameter
`Inference
`Engine
`
`MultiOllject
`
`Probability
`Object
`Server
`
`Speech
`Input
`
`Bays ian
`Speech
`Filter
`
`612
`
`Speed! Output
`
`Speech
`
`L-------------------~~~~:~~----------------------------------------------
`
`Fig. 6
`
`007
`
`

`

`Patent Application Publication Aug. 23, 2007 Sheet 7 of 14
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`US 2007/0197881 A1
`
`702
`
`~304
`
`705
`
`707
`
`706
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`

`

`Patent i\ppUcation Publication
`
`i\Ul\· 23,2007 Sbeet 8 of 14
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`US 2007/0197881 i\l
`
`717
`
`708
`
`715
`
`721
`
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`

`

`Patent Application Publication Aug. 23, 2007 Sheet 9 of 14
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`US 2007/0197881 Al
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`304'\
`
`731
`
`Fig. 9
`
`010
`
`

`

`Patent Application Publication Aug. 23,2007 Sheet 10 of 14 US 2007/0197881 A1
`
`750
`
`752
`
`752
`
`751
`
`Fig. 10
`
`011
`
`

`

`Patent Application Publication Aug. 23, 2007 Sheet 11 of 14 US 2007/0197881 A1
`
`801
`
`800
`
`~
`
`810
`
`806
`
`Fig. 11
`
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`
`

`

`Patent Application Publication Aug. 23, 2007 Sheet 12 of 14 US 2007/0197881 A1
`
`800
`
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`
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`
`Fig. 12
`
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`

`

`Patent Application Publication Aug. 23, 2007 Sheet 13 of 14 US 2007/0197881 A1
`
`903
`
`--
`
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`
`Fig. 13
`
`902
`
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`
`906
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`
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`

`

`Patent Application Publication Aug. 23, 2007 Sheet 14 of 14 US 2007/0197881 A1
`
`920
`
`930
`
`921
`
`922
`
`927
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`925
`
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`
`926
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`

`

`US 2007/0197881 Al
`
`Aug. 23, 2007
`
`wmr.u:SS n EALTH .MONITOR DEVICE
`ASO SYSTD1 WITH COG:\ITIOS
`
`CROSS-REFERENCE TO RELATED
`APPLICATION
`
`1000 I I This application claims the benefit of U.S. Provi(cid:173)
`sional Patent Application Scr. No. 60/766.963. filed Feb. 22.
`2006, copcnding.
`
`13AC'KGROUND OF THE lNVENTION
`
`100021 2. Field of the Invention
`10003J The
`invention generally re lates to surgery as
`applied to diagnostic testing and to computer assisted medi(cid:173)
`cal diagnostics. More specifically. the invention relates to
`monitoring a plurality o f 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.
`10004) 2. D<--scription of Prior Art
`10005) A large segment of elderly 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.
`Given a trend toward greater independence and convenience
`of in-home healthcarc. this is becoming increasingly impor(cid:173)
`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. Titis has also been shown to improve healthcare
`access for disabled persons. connect socially isolated indi(cid:173)
`~iduals to their care providers. and enhance caregiver effec(cid:173)
`ti veness.
`I 00061
`I lome-based care as described here is nottclemedi(cid:173)
`cine, which has yet to fulfill tl1e promise of remote care and
`a ppro~ria tc intervention for disease management. European
`countnes seem to be more advanced with the evaluation of
`ful ly 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 tclehcalthcare needs a serious makeover.
`Even today. home telemedicine or telehealthcare is associ(cid:173)
`a ted wi th high-tech. expensive devices and overall inacces(cid:173)
`sibility for the average home care nurse. We need to get past
`these perceptions and misunderstandings."
`(0007) The term. "home telehealthcare," is defined as
`clinician-driven hcalthcarc and education services that arc
`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
`inf?rm~t. caregivers who are interested in monitoring and
`mauttammg the health and welfare of an interested party.
`Tite definition also includes forms of communication other
`than tltc telephone.
`100081 The term. "remote hcalthcare," is defined to
`include this extended form of telehcalthcare or home-based
`care. Remote healthcare is an urgently needed method of
`caring fa~ individuals who can experience a higher degree of
`self-care tndependence when effective monitoring and con(cid:173)
`tro l is provided. Much of tlle elderly population and the
`disabled population lit lllis description. Persons undergoing
`transitiona l care Jo r a treated condition fit this category as
`well. All such persons will benefit from remote bealtbcare.
`
`10009) The traditional approach to caring for such indi(cid:173)
`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 arc 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 bealth(cid:173)
`car7 can provide an adequate level of in-home monitoring of
`baste health status. a more cost-effective alternative will
`h~ve been created for a notable segment of this population
`wtthout 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.
`(00 I 0] Communication technologies, from well-known
`POTS (plain o ld telephone system) to the Internet, have been
`used for many years to monitor, diagnose and treat persons
`remotely. Transmission of information, such as pictllfes,
`measurements of blood pressure etc. for diagnosis and
`treatment is the goal. Medical literature widely reports
`elforts to provide medical care. remotely. Wireless technolo(cid:173)
`gies arc starting to be employed in telemedicine as well.
`l~o~cver. _Audrey Kinsella has identified the need for spe(cid:173)
`ctahzed !ugh-technology knowledge (e.g., rewiring bouse(cid:173)
`holds for advrutccd telecommunications capabilities. install(cid:173)
`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 tclemcdicine.
`(0011] Current wireless technologies employing standards
`known as 802.11 b.g and Bluetootb. used in a low power set
`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
`usc. Bluctooth has very limited rrutgc and also uses too much
`power to maintain a connection. The breal'throuoh in wire(cid:173)
`less technology known as the ZigBee stan~rd allows
`devices to route low dat<l rate infonnation through multiple
`paths to ensure delivery of messages.
`100 12]
`It would be desirable to provide an improved
`method a nd apparatus for delivering remote healtl1care. An
`im proved system o f care giving may be based on high
`technology. but must be easy to use for people without basic
`computer and e lectro nic experience. A desirable system
`m!ght not provide every data point to tl1c care provider, but
`w tll forward at least events or combinations of events that
`represent a problem. lltc underlying teclmology may be
`completely hidden from the patient or user.
`1001 3) Desirably. such a system may be enabled by recent
`developments in computer and telecommunications technol(cid:173)
`ogy. Most notably. these are: a) affordable computer systems
`\\ itb touch screens and voice response. b) Internet. wireless
`communications standards of Bluetooth and ZigBee. c) low
`power electronics providing for long battery life. d) reliable
`low power GPS sensors and Zigbce triangulation technol(cid:173)
`ogy. and c) 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.
`
`13RIEF SUMMARY OF TIIG INVENTION:
`
`100 151 Against the described background, it is therefore a
`generol object of the invention to provide a method and
`apparatus that arc capable o f enhancing the quality oflife for
`
`016
`
`

`

`US 2007/0197881 A1
`
`Aug. 23,2007
`
`2
`
`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 iudividuals to Jive
`in 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 ou some form of therapy such as
`oxygen or medicatiou. In this case they are at risk of failure
`to comply with prescribed therapy, thereby potentially lead(cid:173)
`ing to a traumatic event such as falling, loss of oxygen, or
`loss of consciousness.
`10016] Children and other relati ves have increasing con(cid:173)
`cerns for the welfare of parents or other family members
`with lim ited self-care capabilit·ies. 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 little or uo under(cid:173)
`standing of the operation by the individual of the monitoring
`devices and system. (2) Monitors key physiological param(cid:173)
`eters relevant to the disease or disability. These parameters
`include activity level, falls, and key measurements such as
`Sp02 and consciousness. (3) Provides a determination of
`patient location, whether in-facility or in-home. (4) Provides
`cognitive understanding of siluatious and treatments, based
`on input from multiple sensors of physiological parameters
`coupled with interactive coaching of behavior. IJtlerences
`must be made utilizing more than one sensor. (5) Provides
`natmal interactions employing speech and provides simple
`interactions with a point-of-care (POC) appliance aud a
`wearable monitor. (6) Provides ful l time monito ring capa(cid:173)
`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
`10018) The
`advances in low power measurements and plug-and-play
`wireless contmlmications components to create a miniature
`measurement and feedback system that also provides loca(cid:173)
`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
`of the BHM include an earpiece, a pendant, a wrist-moun ted
`BHM, a clip-on BHM for a belt, or pocket-carried BHM.
`The BHM has low power integrated colllll1unications 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(cid:173)
`mination and remote monitoring of the basic health of an
`individual.
`In the preterred embodiment the BHM will be
`10019]
`worn around the ear in the same manner as a conventional
`heari ng aid or the recently introduced Bluetooth wireless
`headsets or earpicces. The BIJM will be able to measure
`oxygen sat11ration (Sa02), tempera111re of the ear canal, and
`motion, including detection of 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 fe.edback and assistance to the
`individual while learning standard behavior panerns.
`[0020) With an integrated audio speaker and microphone.
`the BHM is able to deliver audio alerts, current meaSllre-
`
`menls, 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
`abi lity to inquire, tl1e cognitive system is able to qual ify
`events such as loss of consciousness or a fa ll. Anticipated
`improvements will allow other measurements to be made
`such as C02, respiration. EKG, EEG and blood glucose.
`[0021] Simple voice commands can activate the BI-IM 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 witl1 compliance to medication regimens
`and disease managemcot instructions. Simple switches will
`allow volume control and manual activation.
`[0022] The BHM communicates through a series of low(cid:173)
`power gateways io an in-home cogniti ve server and to a
`point-of-care appliance (the POC), which can be a computer.
`Acting alone, the BHM provides basic feedback and moni(cid:173)
`toring with limited cognitive capabilities, such as detecting
`low oxygen or a fall. While conn ected to the cognitive server
`or POC. the BHM atlains full cognitive capabilities. Full
`alerting capability requires the cognitive server to be con(cid:173)
`nected through an Internet gateway to the remote care
`provider. Using specialized technology within a wireless
`trausceiver of the BI-IM, the relative position of the BHM
`within a home or facility may be determined by signal
`strength tria ngulation to the gateways.
`[0023] A key characteristic is the appropriate distribution
`of intelligence to the 13£-IM tl1rough 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 available from a single device in order to make decisions.
`The BHM contains enough sensors within a sing le unit that
`some basic decisions such as fall detection may be made
`standalone. Learning and trend detection require the full
`cognjti ve system to make decisions and feedback new
`detection parameters.
`[0024] The cognitive system provides high-level qualita(cid:173)
`tive information and quantitative data to the caregiver. The
`cogniti ve 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
`requi res communication of health states and outputs as
`probability distributions. The cognitive system provides two
`levels of namral interaction with the patient: first. through a
`primary BHM by speech output and input; and secoud,
`througl1 the POC in the home or care facility. by both touch
`screen and speech interaction.
`10025] 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
`na111re aud can be placed according to individuaUy deter(cid:173)
`mined need. The sensors can measure multiple parameters
`such as ambient temperature, surface temperat11re (as of a
`cook top), motion, sow1ds, aud infrared signals. The sensors
`contain a speaker for delivering audio alerts, an LCD display
`for disp laying measurements, and appropriate buno ns for
`interaction. These sensors collllllunicate 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
`
`

`

`US 2007/0197881 A1
`
`Aug. 23,2007
`
`3
`
`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 IOBase-T base module.
`(0027) By docking a sensor module into a IOBasc-T base
`module, tile sensor becomes part of a wired network of
`sensors to be consolidated into a set of remote objects.
`(0028] The POC llas integrated conmumication capabili(cid:173)
`ties along with the cognitive engine. The POC interacts wi th
`the user for scheduling activities. medication, and coUlUlu(cid:173)
`nications with the care provider through integrated phone,
`voice messaging, email, music, and graphics such as pic(cid:173)
`tures and videos.
`(0029] The accompanying drawings, wllich are incorpo(cid:173)
`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:
`
`BRJEF DESCRIPTION OF THE DRAWINGS
`
`(0030] FIG. l is au isometric front right side view of a
`basic health monitor (BHM), showing representative loca(cid:173)
`tions of subcomponents.
`(0031] FIG. 2 is a view similar to FIG. 1, showin g a BHM
`from the left rear.
`(0032] FIG. 3 is a schematic view of an overall remote
`healthcarc system, showing a BHM 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 Bl-lM, sensor, or similar modular device,
`showing functional interactions.
`(0034] FIG. 5 is a schematic coUlUlunications level dia(cid:173)
`gram showing software components and a communications
`patl1 from a BHM through a gateway to a cognitive server.
`(0035] FIG. 6 is a schematic block diagram of the cogni(cid:173)
`tive operation software components of the BHM and cog(cid:173)
`nitive system.
`(0036] FlG. 7 is an isometric view of a modular sensor
`device, taken from bottom front.
`(0037] FIG. 8 is an exploded view of the sensor of FIG. 7,
`showing suggested component locations.
`(0038] FlG. 9 is a view similar to FJG. 8, taken from top
`rear.
`(0039] FIG. 10 is an isometric view taken from front right,
`showiJlg 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 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 BHM.
`[0042] FIG. 13 is a plan view of a remote heaJtbcare
`system installed in a home, schematically showing the
`patient and a method of detennining location.
`(0043) FIG. 14 is a front isometric view of the POC,
`showing internee components.
`
`DETAILED DESCRIPTION OF 11-IE
`PREFERRED EMBODlMENT
`
`(0044] The invention relates to a remote healthcare deliv(cid:173)
`ery system that includes a basic health monitor (hereinafter
`"BHM''). The delivery system further includes a network of
`sensor modules that enables home-based care of indepen(cid:173)
`dently living elderly and disabled persons, who wi!J some-
`
`ti mes be called the "patient" or "user." TI1e 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, and/or neigh(cid:173)
`bors. The professional caregivers are the individual's net(cid:173)
`work of doctors, nu rses, 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 telehealtbcare systems have not
`included this ability. A cognitive system can reduce the
`demands tl1at the delivery of raw data otherwise places upon
`the informal care givers, thereby avoiding a portion of false
`alam1s. A cognitive system can work together with all
`sensors within the remote heallhcare system, especially with
`the BHM sensor. "The BHM measures basic health function
`such as pulse rate, temperatme, oxygen saturation, move(cid:173)
`ment, acceleration, and location. 1l1e BHM also contains a
`speaker and microphone for speech interaction. The patient
`wears the BHM at all times. Through the speaker and
`microphone built into the BH M, the cognitive system is able
`to g ive prompts to the patient and can receive answers from
`the patient. This ability is cntcial for implementing the
`cogniti ve, learning software included in this remote health(cid:173)
`care system and for enabli ng the prompting features of the
`system.
`[0047] A remote healthcare delivery system must fulfill
`three needs: a) safety, b) security , and c) socialueeds. Safety
`issues to be monitored include basic health assessments such
`as oxygen san1ration, blood pressure, appropriate move(cid:173)
`ment, and so on. Security is defined by the stat·us of doors
`open/closed, appliances on/off. temperature in the bouse and
`so on. The importance of social interaction for the physical
`as well as emotional well being of the patients is becoming
`increasingly evident. Appointments for social a nd recre(cid:173)
`ational activities and integrated communications fom1 the
`basis of fulfilling these social needs. lnfo mJation 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.
`[0048] A network of sensors, including the BI-IM, is
`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 tl1at will
`offer a variety of assistance, ranging from reminders to take
`medications to accessing social support. The patient will
`access tllis network thro~1gh a point-of-care appliance. here(cid:173)
`inafter called "POC," by using a variety of familiar inter(cid:173)
`faces , such as integrated calendar, telephone, and simplified
`email that utilize appropriate assistive teclUJology. The
`patient will not need to !cam new teclmology to receive
`assistance. These proactive systems enable relatives to
`assess the health and wel l-being of the patiellt remotely
`through private, secure lntemet connections and will pro(cid:173)
`vide social support to on-site caregivers. Such social support
`to caregivers is necessary to avoid bumout, which is a
`common problem among caregivers.
`[0049] 1l1e remote hcalthcare delivery system is distrib(cid:173)
`uted. which in certain circumstances might risk a full or
`
`018
`
`

`

`US 2007/0197881 A1
`
`Aug. 23,2007
`
`4
`
`par6al loss of commtmications. In order to ensure that the
`system is robust, the cognitive intelligence also is distrib(cid:173)
`uted, especially to the BHM. A fusion of the data from the
`network sensors enables a feedback of the patient's health
`state. 1l1is f1.1sion enables an adaptive intell igent assistance
`to the patient even when there is a commmJ.ica6on failure.
`(0050] The remote healthcare dehvery system employs a
`mesh network. wlJ.icb 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 transnlissions. These prior networks
`arc ditlicult to install, config ure and maintain. Also, they are
`highly vulnerable to fail ure , thereby leading to dropped
`signals. In contrast, wireless mesh networks are mul ti-hop
`systems, where the components assist each oU1er in trans(cid:173)
`mitting signals. Signals may take several hops through
`different components to reach their intended des6nation.
`Mesh networks are especially well suited to adverse condi(cid:173)
`tions and are easy to install, self-configuring, and self(cid:173)
`leamin g. Devices can be added to a mesh network wi thout
`technical knowledge and by following sin1ple installation
`instructions. This makes them particularly useful for the type
`of care, specific application, and targeted users as identified
`herein.
`(0051]
`In the following detailed description, one commu(cid:173)
`nication path may be described for use by any particular
`component. Such descriptions should be tlllderstood to be
`representative. Many of the measurement components may
`follow similar communication paths. Therefore. all dis(cid:173)
`closed communication paths are applicable to each compo(cid:173)
`nent and for commtmicating each measurement. in the
`following description, the numbers from 1-99 are elements
`p rimarily shown in FIGS. 1-2, munbers of the 300, 400, 500,
`and 600 series refer to e lements primarily shown in FIGS. 3,
`4, 5, and 6, respectively. Numbers of the 700 series refer to
`elements primarily shown in FIGS. 7-JO. Numbers of the
`800 series refer to elements primarily shown in FIGS. 11-12
`and numbers in series 900 refer to elements prinlarily shown
`in FIGS. 13 and 14.
`(0052] FIGS. 1 and 2 show a basic health monitor (BHM)
`303 of a fonn factor suited to be wearable. As suggested in
`these figures, a preferred configuration of the Bl 1M 303 is as
`an earpiece. A BHM 303 contains subcomponents thai
`enable various functions. Other configurations of U1e BHM
`perform sinJ.ilar fi.mctions and contain similar subcompo(cid:173)
`nents. In a BHM of the form factor in FIGS. 1 and 2, many
`of the subcomponents are intemaL Thus, various subcom(cid:173)
`ponents are identified as representative locations on the
`earpiece 303. 1l1e subcomponents are microphone 1. ear(cid:173)
`phone and temperature sensor 2. dual light euJ.itting diodes
`(LEDs) 3, optical sensor 4. accelerometer 5, nJ.icroprocessor
`6, and antenna 7, all as shown in FlG. 1. FIG. 2 shows
`additional components including volume controls 10, indi(cid:173)
`cator LED 11, ZigBee radio transceiver 12, and on/off button
`13. The LEOs 3 and optical sensor 4 are spaced apart, and
`the configura tion oft he earpiece 303 is suitable for U1e 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 of the figure represents the home or care center
`and shows wlJ.ich 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 hinl. TIJ.is figure aJso shows
`multiple communication paths represented as ellipses. These
`are a Zigbee wireless path 320, a wired or wireless 80 1.11
`path 330, and an Jntemet path 340, which may be by wired
`line 341 or a wireless cellular network 344. Lines connecting
`each device in the figu re represent a conummication path,
`wi th 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 fi.II I touch screen and voice
`interactive capabilities and commtmicates through a local
`network 330 wiili a cognitive server 312.
`(0055] A router gateway module 300 bas a USB link to the
`cognitive server 312. The router gateway module 300 pro(cid:173)
`vides a communication bridge from the wireless Zigbee
`network 320 to the network 330 through the cognitive server
`312. This bridge allows commmJ.icatious wi th U1e patient
`302 via the wearable basic health monitor 303 through a
`Zigbee connection. Additional wireless Zigbee modular
`sen