USOO8108036B2
`
`(12) United States Patent
`Tran
`
`(10) Patent No.:
`(45) Date of Patent:
`
`US 8,108,036 B2
`Jan. 31, 2012
`
`(54)
`
`(76)
`(*)
`
`(21)
`(22)
`(65)
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`(63)
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`(51)
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`(52)
`(58)
`
`MESH NETWORKSTROKE MONITORING
`APPLIANCE
`Inventor: Bao Tran, San Jose, CA (US)
`Notice:
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 478 days.
`Appl. No.: 12/486,810
`Filed:
`Jun. 18, 2009
`Prior Publication Data
`US 2009/0318779 A1
`Dec. 24, 2009
`Related U.S. Application Data
`Continuation of application No. 1 1/439,631, filed on
`May 24, 2006, now Pat. No. 7,558,622.
`Int. C.
`(2006.01)
`A6IN 5/04
`U.S. Cl. ........................................ 600/509; 600/513
`Field of Classification Search .................. 600/485,
`600/509, 513,528: 128/903
`See application file for complete search history.
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`6,206,829 B1* 3/2001 Iliff ............................... 600/300
`6,475,161 B2 * 1 1/2002 Teicher et al. .
`... 600,558
`7,126,467 B2 * 10/2006 Albert et al. .................. 340,521
`* cited by examiner
`
`
`
`Primary Examiner — Brian T Gedeon
`(74) Attorney, Agent, or Firm — Tran & Associates
`
`ABSTRACT
`(57)
`A heart monitoring system for a patient includes one or more
`wireless nodes forming a wireless mesh network; a wearable
`appliance having a wireless transceiver adapted to communi
`cate with the one or more wireless nodes; and a statistical
`analyzer to determine heart attack or stroke attack, the statis
`tical analyzer coupled to the wireless transceiver to commu
`nicate patient data over the wireless mesh network.
`
`20 Claims, 22 Drawing Sheets
`
`-------------
`
`REMOTE SERWER200
`
`AUTHORIZ. Third
`PARTY (OCTOR,
`FAMY, EMERGENCY
`SERVICES,
`CAREGIVER, OSPITAL,
`NurSINGHOME, CALL
`CENTER, ETC. 20
`
`BASE STATION
`LOCAL SERVER2O
`
`, also
`
`-------------------------------------
`
`A/ A/
`
`Mesh Network
`Appliances 8
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`Petitioner Apple Inc. – Ex. 1064, p. 1
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`

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`U.S. Patent
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`Jan. 31, 2012
`
`Sheet 1 of 22
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`US 8,108,036 B2
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`
`
`
`
`Internet
`1OO
`
`AUTHORIZED THIRD
`1 RARYSSES
`FAMILY, EMERGENCY
`1
`SERVICES,
`CAREGIVER, HOSPITAL,
`NURSING HOME, CALL
`CENTER, ETC) 210
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`50
`
`BASE STATION-
`LOCAL SERVER 20
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`Mesh Network
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`Appliances B
`
`-A
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`
`FIG. 1
`
`Petitioner Apple Inc. – Ex. 1064, p. 2
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 2 of 22
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`US 8,108,036 B2
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`Place a calibration sheet with known dots at a known distance
`and perpendicular to a camera view
`
`Take snap shot of 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.
`
`Take snap shot of 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 Dot 1(x,y,z) to Dot2 (x, y, z)
`defining a cone center where the camera can view
`
`FIG. 2A
`
`O
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`O
`O
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`O
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`O
`O
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`FIG. 2B
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`Petitioner Apple Inc. – Ex. 1064, p. 3
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 3 of 22
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`US 8,108,036 B2
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`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
`
`Calculate patients key features
`
`Extract facial objects
`
`Detect facial orientation
`
`Detect facial expression
`
`FIG. 4
`
`Petitioner Apple Inc. – Ex. 1064, p. 4
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 4 of 22
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`US 8,108,036 B2
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`Set up mesh network appliances (1000)
`Determine patient position using in-door positioning system (1002)
`Determine patient movement using accelerometer output (1004)
`Determine vital parameter including patient heart rate (1006)
`Determine if patient needs assistance based on in-door position, fall
`detection and vital parameter (1008)
`Confirm prior to calling third party (100)
`If confirmed or non-responsive, make connection with third party and
`send voice over mesh network to appliance worn by the patient (1012)
`If needed, call emergency personnel to get medical care (014)
`FIG. 5
`
`Petitioner Apple Inc. – Ex. 1064, p. 5
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`U.S. Patent
`US. Patent
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`Jan. 31, 2012
`Jan. 31, 2012
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`Sheet 5 of 22
`Sheet 5 0f 22
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`US 8,108,036 B2
`US 8,108,036 B2
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`
`
`1332
`
`382
`
`FIG. 6A
`FIG. 6A
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`Petitioner Apple Inc. — Ex. 1064, p. 6
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`Petitioner Apple Inc. – Ex. 1064, p. 6
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 6 of 22
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`US 8,108,036 B2
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`
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`FIG, 6B
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`Petitioner Apple Inc. – Ex. 1064, p. 7
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`Jan. 31, 2012
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`Sheet 7 of 22
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`US 8,108,036 B2
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`O PAP Coordinate FF
`f O Router Node (FFD)
`% End device (RFD or FFD)
`
`Cister ree
`& b
`
`FIG. 7
`
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`13
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`13.
`
`FIG. 8
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`136
`
`38
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`Petitioner Apple Inc. – Ex. 1064, p. 8
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`Jan. 31, 2012
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`Sheet 8 of 22
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`US 8,108,036 B2
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`FIG. 9
`
`
`
`FIG 10
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`Petitioner Apple Inc. – Ex. 1064, p. 9
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`U.S. Patent
`US. Patent
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`Jan. 31, 2012
`Jan. 31, 2012
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`Sheet 9 of 22
`Sheet 9 0f 22
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`US 8,108,036 B2
`US 8,108,036 B2
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`
`
`
`
`FIG. 2
`FIG. 12
`
`Petitioner Apple Inc. — Ex. 1064, p. 10
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`Petitioner Apple Inc. – Ex. 1064, p. 10
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 10 of 22
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`US 8,108,036 B2
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`184
`
`
`
`182
`
`185
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`FIG. 13
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`FIG. 4B
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`FIG. 14A
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`Petitioner Apple Inc. – Ex. 1064, p. 11
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 11 of 22
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`US 8,108,036 B2
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`****
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`Petitioner Apple Inc. – Ex. 1064, p. 12
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`U.S. Patent
`U.S. Patent
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`Jan. 31, 2012
`Jan. 31, 2012
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`Sheet 12 of 22
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`US 8,108,036 B2
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`Petitioner Apple Inc. — Ex. 1064, p. 13
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`Petitioner Apple Inc. – Ex. 1064, p. 13
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`
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`
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 13 of 22
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`US 8,108,036 B2
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`Patient A
`
`PatietB
`
`Patient C
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`PatientM
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`FIG. SC
`
`Petitioner Apple Inc. – Ex. 1064, p. 14
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 14 of 22
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`US 8,108,036 B2
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`
`
`FIG. 15D
`
`Petitioner Apple Inc. – Ex. 1064, p. 15
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 15 of 22
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`US 8,108,036 B2
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`
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`
`
`FIG 15E
`
`FIG. 15F
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`Petitioner Apple Inc. – Ex. 1064, p. 16
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 16 of 22
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`US 8,108,036 B2
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`Generate a blood pressure model of a patient (2002)
`
`Determine a blood flow velocity using a piezoelectric transducer (2004)
`
`Provide the blood flow velocity to the blood pressure model to
`continuously estimate blood pressure (2006)
`
`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)
`
`Remove calibration device (2016)
`
`Determine blood flow velocity (2018)
`
`Provide blood flow velocity to the blood pressure model to estimate blood
`pressure (2020)
`
`FIG. 16B
`
`Petitioner Apple Inc. – Ex. 1064, p. 17
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 17 of 22
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`US 8,108,036 B2
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`
`
`Detect weakness in left half and right half of patient body - arms, legs,
`face (3000)
`
`Detect walking pattern for loss of balance or coordination (3002)
`
`Ask user to move hands/feet in a predetermined pattern (3004)
`
`Read accelerometer output in accordance with predetermined pattern
`movement (3006)
`
`Provide accelerometer output to a pattern classifier (3008)
`
`Check whether patient is experiencing dizziness or Sudden, severe
`headache with no known cause (3010)
`
`Display a text image and ask the patient to read back the text image,
`one eye at a time (3012)
`
`Use Speech recognizer to detect confusion, trouble speaking or
`understanding (3014)
`
`Ask patient if they feel numbness in the body-arms, legs, face (3016)
`
`Ask patient to Squeeze gauge/force sensor to determine force applied
`during Squeeze (3018)
`
`FIG. 16C
`
`Petitioner Apple Inc. – Ex. 1064, p. 18
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 18 of 22
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`US 8,108,036 B2
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`
`
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`FIG. 6D
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`Petitioner Apple Inc. – Ex. 1064, p. 19
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`

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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 19 of 22
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`US 8,108,036 B2
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`Compare historical left shoulder (LS) strength against current LS
`strength (3200)
`
`Compare historical right shoulder (RS) strength against current
`RS strength (3202)
`
`
`
`Compare historical left hip (LH) strength against current LH
`strength (3204)
`
`Compare historical right hip (RH) strength against current RH
`strength (3206)
`
`If variance between historical and current strength exceeds
`threshold, generate warning (3208)
`
`FIG. 16E
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`Petitioner Apple Inc. – Ex. 1064, p. 20
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 20 of 22
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`US 8,108,036 B2
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`
`
`Reference
`
`FIG. 7A
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`Petitioner Apple Inc. – Ex. 1064, p. 21
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 21 of 22
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`US 8,108,036 B2
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`HISTORICAL MEASUREMENT
`
`3.
`
`
`
`FE
`
`FIG. 7B
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`Petitioner Apple Inc. – Ex. 1064, p. 22
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`U.S. Patent
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`Jan. 31, 2012
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`Sheet 22 of 22
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`US 8,108,036 B2
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`RECENT MEASUREMENT
`
`
`
`r
`
`FIG. 17C
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`Petitioner Apple Inc. – Ex. 1064, p. 23
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`

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`US 8,108,036 B2
`
`1.
`MESH NETWORKSTROKE MONITORING
`APPLIANCE
`
`This application is a continuation of application Ser. No.
`11/439,631, now U.S. Pat. No. 7,558,622, filed May 24, 2006,
`the content of which is incorporated by reference.
`
`5
`
`BACKGROUND
`
`2
`distally and occlude vessels downstream. One-half of all
`embolic strokes are caused by atrial fibrillation; the rest are
`attributable to a variety of causes, including (1) left ventricu
`lar dysfunction secondary to acute myocardial infarction or
`severe congestive heart failure, (2) paradoxical emboli sec
`ondary to a patent foramen ovale, and (3) atheroemboli.
`These latter vessel-to-vessel emboli often arise from athero
`Sclerotic lesions in the aortic arch, carotid arteries, and Ver
`tebral arteries.
`Small-vessel ischemia can occur when microatheromata
`occlude the orifice of penetrating arteries. Another mecha
`nism is associated with lipohyalinosis, in which pathologic
`changes in the tunica media and the adventitia of penetrating
`arteries occur in the presence of chronic hypertension.
`Elevated blood pressure causes endothelial injury that dis
`rupts the blood-brain barrier. This in turn leads to a deposition
`of plasma proteins and eventually degeneration of the tunica
`media Smooth muscle. The Smooth muscle is replaced with
`collagenous fibers, which inhibit the elasticity of the blood
`vessel. This causes the vessel lumen to narrow and eventually
`activates the clotting cascade, leading to thrombosis. Small
`vessel ischemic disease typically results in lacunar infarcts,
`which were named for the small “lakes' (lacunae) that are
`found at autopsy in affected patients.
`Hypoperfusion can occur as a result of (1) atherosclerotic
`disease that limits distal flow or (2) systemic hypotension,
`Such as seen in patients who experience acute cardiacarrhyth
`mia or cardiac arrest. A reduction in cerebral perfusion pres
`Sure activates the autoregulatory system. As the Small arteri
`oles constrict in an attempt to maintain pressure, ischemia can
`develop in the distal branches of the vascular tree. Areas of the
`brain that lies between two major vascular supplies (eg, the
`middle and anterior cerebral arteries) is known as a watershed
`area. These areas are especially prone to ischemia during
`episodes of systemic hypotension.
`Hemorrhagic stroke can be further subclassified as intrac
`erebral and subarachnoid. Intracerebral hemorrhage is the
`result of the rupture of a vessel within the brain parenchyma.
`The primary causes of these ruptures are hypertension and
`amyloid angiopathy; secondary precipitating factors are
`listed in Table 1. As with ischemic stroke, the location of an
`intracerebral hemorrhage determines the type of symptoms
`and the patients overall outcome. For example, a small lobar
`hemorrhage might cause only a mild headache and Subtle
`motor deficits, while a hemorrhage of the same size in the
`pons might result in a coma. Outcomes are also correlated
`with the volume of blood; hemorrhages greater than 60 ml are
`almost always fatal, regardless of their location.
`Hypertension is a major cause of hemorrhages of the basal
`ganglia and brainstem. Chronic hypertension can lead to the
`formation of Charcot-Bouchard aneurysms in lipohyalinotic
`vessels, which can rupture. Common locations of hyperten
`sive hemorrhages include the putamen, caudate, thalamus,
`pons, and cerebellum. Amyloid angiopathy is a common
`cause of lobar hemorrhage (FIG. 5). This disease process
`occurs in the elderly and is caused by a deposition of beta
`amyloid sheets in the tunica media of the vessel wall. The
`deposition of amyloid protein causes the vessels to become
`more rigid, fragile, and prone to rupture. Evidence of hemo
`siderin deposition in other areas of the brain on magnetic
`resonance imaging (MRI) might also be seen. This deposition
`indicates that the patient has experienced previous hemor
`rhage and provides indirect Support for the presence of amy
`loid angiopathy; however, pathologic examination can make
`a definitive diagnosis.
`Early detection and treatment of stroke is essential to
`recovery from a stroke.
`
`This invention relates generally to methods and systems for
`monitoring a person.
`Stroke is the third-leading cause of death in the United
`States. A stroke is defined as a sudden loss of brain function
`caused by a blockage or rupture of a blood vessel to the brain.
`Approximately 150,000 deaths per year are attributed to
`stroke. It is also the most common neurologic reason for
`hospitalization. A stroke occurs when a blood vessel (artery)
`that supplies blood to the brainbursts 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. Prior to a stroke, a person may
`have one or more transientischemic attacks (TIAS), which are
`a warning signal that a stroke may soon occur. TIAS are often
`called mini strokes because their symptoms are similar to
`those of a stroke. However, unlike stroke symptoms, TIA
`symptoms usually disappear within 10 to 20 minutes,
`although they may last up to 24 hours.
`Although great Strides have been made in the treatment of
`stroke, the overall incidence will continue to rise as our popu
`lation ages. Primary and secondary prevention of stroke is
`important to decrease its incidence and its associated morbid
`ity. The 30-day mortality rate is 7.6% for patients with
`ischemic stroke and 37.5% for those with hemorrhagic
`stroke. 17 Most deaths within the first week are attributable to
`the severe nature of a stroke, while deaths that occur later are
`usually the result of complications of the stroke itself or of
`other comorbid conditions. Patients with stroke often have
`systemic vascular disease; the annual risk of vascular death in
`stroke patients is greater than 3%. Most stroke survivors are
`left with some disability. For example, 48% are hemiparetic at
`6 months and 22% cannot walk. As many as one-half of all
`stroke Survivors are partially dependent on others to perform
`activities of daily living. 18 The rate of recurrent noncardi
`oembolic stroke is 3% to 7% per year.
`Stroke can be subdivided into two types: ischemic and
`hemorrhagic. Ischemic stroke accounts for 85% of all cas
`es. In ischemic stroke, interruption of the blood supply to the
`brain results in tissue hypoperfusion, hypoxia, and eventual
`cell death secondary to a failure of energy production. Three
`main mechanisms are involved in the development of
`ischemic stroke, and they are associated with atherothrom
`botic, embolic, and Small-vessel diseases. Less common
`causes include coagulopathies, vasculitis, dissection, and
`venous thrombosis.
`In atherothrombotic disease, lipid deposition leads to the
`formation of plaque, which narrows the vessel lumen and
`results in turbulent blood flow through the area of stenosis.
`The turbulence of the flow and the resultant alterations in flow
`Velocities lead to intimal disruption or plaque rupture, both of
`which activate the clotting cascade. This causes platelets to
`become activated and adhere to the plaque Surface, where
`they eventually form a fibrin clot. As the lumen of the vessel
`becomes more occluded, ischemia develops distal to the
`obstruction and can eventually lead to an infarction of the
`tissue that is dependent on the parent vessel for oxygen deliv
`ery. Embolic stroke occurs when dislodged thrombi travel
`
`10
`
`15
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`25
`
`30
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`35
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`40
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`45
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`50
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`55
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`60
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`65
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`Petitioner Apple Inc. – Ex. 1064, p. 24
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`US 8,108,036 B2
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`3
`SUMMARY
`
`4
`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 person falls. 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 of the
`patient; and a server coupled to the one or more cameras, the
`server executing code to detect a dangerous condition for the
`patient based on the 3D video and allow a remote third party
`to view images of the patient when the dangerous condition is
`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 accelerometer to detect
`a dangerous condition and to generate a warning when the
`dangerous condition is detected.
`In yet another aspect, a monitoring system includes 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 condition is detected.
`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 system may include one or more of the
`following. The system detects the warning signs of stroke and
`prompts the user to reach a healthcare provider within2 hours
`of symptom onset. The system enables patent to properly
`manage acute stroke, and the resulting early treatment might
`reduce the degree of morbidity that is associated with first
`ever strokes.
`Other advantages of the invention may include one or more
`of the following. The system for non-invasively and continu
`ally monitors a subjects arterial blood pressure, with reduced
`Susceptibility to noise and Subject movement, and relative
`insensitivity to placement of 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 of their 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 provide a relatively
`comprehensive data set compared to that measured during
`medical appointments separated by several weeks or even
`months. This allows both the patient and medical professional
`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 home or work, rather than in a medical office.
`The wearable appliance is Small, easily worn by the 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
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`In one aspect, a monitoring system for a person includes
`one or more wireless nodes and a stroke sensor coupled to the
`person and the wireless nodes to determine a stroke attack.
`In another aspect, heart monitoring system for a patient
`includes one or more wireless nodes forming a wireless mesh
`network; a wearable appliance having a wireless transceiver
`adapted to communicate with the one or more wireless nodes;
`and a statistical analyzer to determine heart attack or stroke
`attack, the statistical analyzer coupled to the wireless trans
`ceiver to communicate patient data over the wireless mesh
`network.
`In yet another aspect, a monitoring system for a person
`includes one or more wireless nodes and an electromyogra
`phy (EMG) sensor coupled to the person and the wireless
`nodes to determine a stroke attack.
`In another aspect, a health care monitoring system for a
`person includes one or more wireless nodes forming a wire
`less mesh network; a wearable appliance having a Sound
`transducer coupled to the wireless transceiver, and a bioelec
`tric impedance (BI) sensor coupled to the wireless mesh
`network to communicate BI data over the wireless mesh
`network.
`In a further 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 transducer to 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 accelerometer to detect a dan
`gerous condition and 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 of the 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 request to a remote computer.
`The code can encrypt or scramble data for privacy. The pro
`cessor can execute voice over IP (VOIP) code to allow a user
`and a remote person to audibly communicate with each other.
`The voice communication system can include Zigbee VOIP
`or Bluetooth VOIP or 802.XXVOIP. The remote person can
`be a doctor, a nurse, a medical assistant, or a caregiver. The
`system includes code to store and analyze patient informa
`tion. The patient information includes medicine taking habits,
`eating and drinking habits, sleeping habits, or excise habits. A
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`patient interface is provided on a user computer for accessing
`information and the patient interface includes in one imple
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`Petitioner Apple Inc. – Ex. 1064, p. 25
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`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.
`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 detection in addition to
`blood pressure measurement, other advantages of the inven
`tion may include 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 human access 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. When the patient is healthy,
`people cannot view the patient’s video without the patients
`consent. Only when the patient’s safety is threatened would
`the system provide patient information to authorized medical
`providers to assist the patient. When an emergency occurs,
`images of the patient and related medical data can be com
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`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, or a neighbor to informally check on
`the well-being of the patient. The system is also effective in
`containing the spiraling cost of healthcare and outpatient care
`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 resources to assist patients in a highly efficient manner
`since they can do the majority of their functions remotely.
`Additionally, a Sudden change of activity (orinactivity) can
`indicate a problem. The remote healthcare provider may
`45
`receive alerts over the Internet or urgent notifications over the
`phone in case of Such Sudden accident indicating changes.
`Reports of health/activity indicators and the overall well
`being of the 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
`may be tailored to the target recipient's needs, and can present
`the information in a format understandable by an elder person
`unfamiliar with computers, via an appealing patient 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 information interrogatively.
`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 equipment is simple to use and modu
`lar to allow for the accommodation of the monitoring device
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`US 8,108,036 B2
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`to the specific needs of each patient. Moreover, the system is
`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 of care.
`Suitable users for Such systems are disease management com
`panies, health insurance companies, self-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 of chronic 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 be treated 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 medication includes 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.
`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 of the patient.
`Responses from the patient to a patient medical questionnaire
`can be captured. The doctor can listen 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
`microphone or piezeoelectric transducer coupled to the Zig
`bee network to relay the sound. A plurality of medical rules
`can be applied to the medical information to arrive 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
`medication refill 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 same access to the patient
`medical history database, patient data is updated in real time,
`and is as current and complete as possible. The patient, doc
`tor, pharmacy, and third party testing