(19) United States
`(12) Patent Application Publication (10) Pub. No.: US 2005/0239493 A1
`Batkin et al.
`(43) Pub. Date:
`Oct. 27, 2005
`
`US 2005O239493A1
`
`(54) REMOTE MONITORING OF CARDIAC
`ELECTRICAL ACTIVITY USINGA CELL
`PHONE DEVICE
`(76) Inventors: Izmail Batkin, Ontario (CA); Riccardo
`Brun del Re, Ottawa (CA); Steven
`Carkner, Ottawa (CA); Robert
`Brookes, Ontario (CA)
`
`Correspondence Address:
`BSSh
`Station D
`Ottawa K1P5W6 (CA)
`
`(21) Appl. No.:
`
`10/513,729
`
`(22) PCT Filed:
`
`May 7, 2003
`
`(86) PCT No.:
`
`PCT/CA03/00648
`
`(30)
`
`Foreign Application Priority Data
`
`May 7, 2002 (CA)............................................. 2385232
`Publication Classification
`(51) Int. Cl." ...................................................... H04M 1/00
`(52) U.S. Cl. .......................................................... 455/550.1
`
`ABSTRACT
`(57)
`Abio-monitor is built into a telephone handset or cellphone.
`Sensors are configured to obtain bio-signals while the hand
`Set or cell phone is in the position for normal Speaking use
`of the telephonic device. This enables biosignal acquisition
`and/or bio-signal telephonic transmission to occur without
`the need for a position change to effect voice communica
`tions. The invention can also be constructed in the form of
`a case or harneSS designed to fit over a preexisting cellphone
`or a pre-existing telephone handset.
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`REMOTE MONITORING OF CARDIAC
`ELECTRICALACTIVITY USINGA CELL PHONE
`DEVICE
`
`FIELD OF THE INVENTION
`0001. This invention relates to remote health monitoring.
`In particular, it relates to a device whereby cardiac signals
`Such as human heart rate, electrocardiogram (ECG) and
`other Vital signs may be acquired by a patient and transmit
`ted to a remote location.
`
`BACKGROUND TO THE INVENTION
`0002. In the field of cardiology, devices exist that use
`telephones to transmit a patient's ECG data from the
`patient's location to a monitoring clinic or doctors office.
`Examples include So-called cardiac loop event recorders.
`These are connected via cables to ECG gel electrodes,
`quasi-permanently attached to the patient. These devices are
`able to record ECG data of the patient during arrhythmias.
`0003. Other hand-held recorder devices exist that possess
`permanent, metallic electrodes arranged in a planar configu
`ration, all on one side of the device. These must be tempo
`rarily held by the patient against the patient's chest skin in
`order to pickup the cardiac Signal.
`0004 Still other devices of the prior art require the
`patient's two thumbs to be placed on independent, co-planar
`electrodes on one face of the device.
`0005 Traditionally, all these types of devices transmit
`Stored patient ECG data to the monitoring clinic or the
`doctor's office using a conventional telephone. This is
`accomplished via an audio signal, which the device modu
`lates with the patient's ECG and which is transmitted
`through the telephone and Subsequently de-modulated by a
`modem or receiver/adapter at the clinic or doctors office.
`0006 Cardiac monitors based on the co-planar electrode
`arrangements have also been proposed on the back of a cell
`phone. One example is U.S. Pat. No. 6,485,416 (November
`2002). These require the user to hold the device against the
`bare Skin of the chest, thus not enabling Simultaneous vocal
`communication while monitoring.
`0007 U.S. Pat. No. 5,772.586 issued to Nokia Mobile
`Phones Ltd. describes the transmission of blood glucose data
`by cellphone. Sensor electronics are restricted to the battery
`case location and no special consideration is given to ECG.
`0008 U.S. Pat. No. 6,102,856 “Wearable Vital Signs
`Monitoring System” (August 2000) specifies a wireless
`transmission device to be worn on the chest with various
`Sensors affixed to the patient.
`0009 U.S. Pat. No. 5,544,661 entitled “Real-Time
`Ambulatory Patient Monitor” (August 1996) describes a
`portable device possessing ECG and photo-plethysmograph
`(blood oxygen) Sensors connected to the patient and pro
`Viding "wireless wide-area' communications.
`0010. In all the above cases, bio-signal monitoring is not
`accomplished in the posture of normal Speaking or commu
`nications over a phone handset. In most of the above cases,
`multiple devices and Sensors are required, making the
`devices more cumberSome to operate than an ordinary
`telephone or cell phone.
`
`0011 U.S. Pat. No. 6,549,756 (Apr. 15, 2003) describes
`portable palm-sized personal data communications devices
`and cellphones fitted with non-co-planar blood-flow Sensors.
`These are designed to maximize the number of Sensors in
`contact with the hand of the user holding the device. This
`allows for bio-signal monitoring while the device is in
`normal use for data communications. However the bio
`Sensors described are incapable of ECG pickup and, due to
`human body physiology, use of multiple contact points on a
`Single hand of a perSon as described does not propose
`acquisition of bio-signals while the telephone unit is posi
`tioned for voice communication.
`0012 No prior art telephonic device has been proposed
`that enables ECG or bio-signal collection from the user
`while the user is holding the device in the position for
`ordinary use for communications.
`0013. It would be desirable for a device to detect and
`transmit bio-signals. Such as ECG while being positioned for
`use essentially as an ordinary telephone. Such a System
`would offer convenience and would enable real-time or
`Simultaneous bio-signal transmission and Verbal communi
`cations with the health practitioner, thus providing the
`patient with instant feedback while saving millions of dol
`lars in healthcare costs.
`0014) A consideration in realizing this goal is that, during
`normal communications, hand-held telephonic devices typi
`cally contact the user's body at one hand and at the head.
`However, commercial cardiac pickup devices of the prior art
`do not use the head as a pickup location for ECG.
`0015. It has been known in the field of medical research
`that a person's head can be used as one locus for the pickup
`of ECG signals. In order to generate a difference potential
`due to cardiac activity, a Second pickup electrode must be
`placed on the torSo, arm or leg of the perSon. Such an
`arrangement may also provide a differential-type pickup
`with common mode noise rejection. Due to human body
`physiology, electrodes placed on the head and left arm
`produce ECG-like Signals on most people.
`0016 Other physiologic signals can also be acquired
`from the head. These include plethysmograph (blood oxy
`gen and pulse) from the ear lobe, and temperature Sensing
`from the inner ear.
`0017. The simultaneous handling of bio-signals, once
`acquired, and audio signals through a telephone or cellular
`phone can be performed by known technology in a number
`of ways. These can be classified into four broad categories:
`Analog Half-Duplex, Analog Full Duplex, Digital Half
`Duplex, and Digital Full-Duplex.
`0018. A number of present technologies and emerging
`digital data Systems and cellular phone Systems enable
`alternating, or simultaneous, real-time voice and data trans
`mission. An opportunity exists for these technologies to be
`combined to produce a new and effective System for the
`remote transmission of bio-signals with the added feature of
`providing real-time Voice telephonic communication
`between the patient and medical professionals even though
`they are located at a distance.
`0019. The invention in its general form will first be
`described, and then its implementation in terms of Specific
`embodiments will be detailed with reference to the drawings
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`following hereafter. These embodiments are intended to
`demonstrate the principle of the invention, and the manner
`of its implementation. The invention in its broadest and
`more specific forms will then be further described and
`defined in each of the individual claims, which conclude this
`Specification.
`
`SUMMARY OF THE INVENTION
`0020. The invention is directed to a hand-held, vital signs
`monitoring device incorporated with, or accompanying a
`telephone handset or cell phone.
`0021. The invention is particularly Suited to a hand-held
`Sensor System incorporating one of a variety of head-Source
`bio-Sensors, including Sensors for blood oxygen, pulse,
`body-temperature, and ECG incorporated with or accompa
`nying a telephone handset or cell phone.
`0022. The invention provides a means by which these
`Signals, including the head-to-arm ECG signal, may be
`conveniently acquired and telephonically transmitted by the
`patient via a single, hand-held device, in the form of a
`telephone handset or a cell phone, while the device is in the
`position for ordinary communications. "Telephonic commu
`nications” as used herein includes transmission of data over
`a System that will accommodate acoustic, e.g. Voice, com
`munications.
`0023 The invention therefore enables the simultaneous
`or alternate communication of bio-data and Voice without
`the need for any interruption arising from repositioning of
`the device.
`0024. According to one aspect, the invention can be
`realized as a Specially designed telephone handset or a
`Specially designed cell phone. According to another aspect,
`the invention can be realized as a harness, case, attachment,
`or glove designed to be carried by an existing telephone
`handset or an existing cell phone.
`0.025
`In both aspects, the invention addresses a specially
`designed telephone handset or cell phone, or a harneSS or
`case designed to be carried by an existing telephone handset
`or an existing cell phone, which device embodies:
`0026 a) a first sensor to be carried on the outer
`Surface of the device in order to establish a first
`contact with the user's head and receive bio-signals
`through Such first contact;
`0027 b) a pickup signal conditioning circuit carried
`by the device connected to the first Sensor to condi
`tion received signals for telephonic communication;
`and
`0028 c) a telephonic communication circuit con
`nected to the Signal conditioning circuit to provide a
`telephonic Signal corresponding to the bio-signal
`data for telephonic communication,
`0029 whereby the simultaneous or alternate communi
`cation of bio-data and Voice may occur without the need for
`any interruption arising from repositioning of the device.
`0.030. For the purpose of ECG, a second sensor is posi
`tioned on another portion of the Surface of the device to
`establish a Second contact with the user's hand to also effect
`the acquisition of bio-signals through Such Second contact.
`Both the first and second sensors may then serve as ECG
`
`pickup electrodes for delivery of bio-signals to a differential
`amplifier contained within the Signal conditioning circuit. In
`addition to the two pickup electrodes, the device of the
`invention for ECG may also carry a third electrode to serve
`as a reference electrode, preferably ohmic with a low
`coupling impedance, positioned to contact either the user's
`head or the hand when the device is in use and connected to
`the common for Such circuit. The reference electrode Serves
`to establish a reference voltage (ground) for the differential
`amplifier and improves common mode noise rejection. This
`reference electrode may be mounted proximately to either
`the first or the Second pickup electrode.
`0031) The invention is suitable for ECG but is not
`restricted to ECG. Other bio-sensors can be incorporated to
`acquire bio-signals e.g. monitoring of blood oxygen, pulse,
`and ear temperature etc. The invention therefore enables the
`pickup, and real-time assessment of the patient's Vital signs.
`Instant feedback can be provided to the patient, as can
`Simultaneous or alternate bio-signal and Voice communica
`tion during apparently normal telephonic exchange without
`the need for any interruption arising from repositioning of
`the device.
`0032. According to the invention, the sensed bio-signal is
`provided to the conditioning circuit, which conditions it to
`provide the Signal, or a Surrogate of Said Signal, for tele
`phonic transmission. Conditioning may include a differential
`amplifier, a filter, an analysis circuit based upon algorithms
`to partially analyse the bio-signal before transmission, a
`compression circuit, a digitising circuit and other known
`Signal manipulating means. Memory may also be provided
`for delayed transmission of Signals. Accordingly, variants of
`the invention can transmit either the bio-signal, in analog or
`digitised form, or Surrogates for the bio-signal, in real time
`or on a delayed basis.
`0033. A memory in the conditioning circuit may be used
`to Store Signals for delayed transmission. Conveniently, an
`archive memory may be used to Store Standard bio-data Such
`as Standard ECG trace of the user, acquired when the user is
`healthy. This archived bio-signal may then be sent to distant
`medical professions, along with contemporary Signals, when
`the user/patient is having a crisis.
`0034. When the invention is incorporated into a case,
`harness, or glove designed to be carried by an existing
`telephone or cell phone, either an acoustic coupling means
`or an electrical connection may be employed in order to
`convey the bio-signal into the telephonic transmission por
`tion of the combined device. In the case of use of a cell
`phone for ECG, the first and Second pickup electrodes, the
`reference electrode (preferentially all ohmic), and the elec
`trical circuitry of the invention may readily be carried within
`a case or attachment, coupled to the cellphone by an internal
`or external connector which extends from the circuitry of the
`invention to the microphone or data port of the cell phone to
`permit inclusion of the bio-signal into the cell phone's
`telephonic communications. A control Switch may allow
`user control to toggle the telephonic communication
`between bio-signal and Voice-only transmissions. Alter
`nately, bio-signal and Voice telephonic transmissions,
`including Simultaneous transmissions, may be effected by
`any one of known means for combining voice and data
`communication, as further elaborated below.
`0035. The electrode placement of the invention on the
`hand-held telephonic device provides for bio-signal pickup
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`during the course of normal communications. Thus the
`head-facing Sensor is on the same Side of the device as the
`customary earpiece. This enables Single-hand operation and
`Simultaneous or alternate, near-simultaneous bio-signal and
`Voice communication through the telephone or cell phone,
`thus allowing real-time data transmission and telephonic
`feedback between the patient and the health care practitio
`C.
`0036) A preferred type of pickup electrodes for ECG are
`active-type electrodes designed to minimize contact poten
`tials and motion artifact as described, for example, in PCT
`patent applications PCT/CAO0/00981 and PCT/CAO3/
`00426, the contents of Such applications being adopted
`herein by reference.
`0037. The foregoing Summarizes the principal features of
`the invention and Some of its optional aspects. The invention
`may be further understood by the description of the pre
`ferred embodiments, in conjunction with the drawings,
`which now follow.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`0038 FIG. 1 is an illustration of a cell phone of the
`invention showing locations for the pickup electrodes, the
`ground reference electrode and the analysis circuit.
`0039 FIG. 2 is an illustration of a case of the invention
`designed to fit onto a pre-existing cell phone.
`0040 FIG. 3 is a schematic depiction showing a patient
`transmitting bio-signals obtained between the hand and ear
`as in normal telephonic communications.
`0041
`FIG. 4 is a schematic showing the electrical circuit
`for an “active' ohmic electrode.
`0.042
`FIG. 5 is a schematic showing the electrical circuit
`for two “active' ohmic electrodes feeding a signal to a
`differential amplifier.
`0.043
`FIG. 6 is a functional block diagram of one version
`for the electronics of the invention.
`
`DESCRIPTION OF THE PREFERRED
`EMBODIMENT
`0044) In FIG. 1 a cell phone 1 of the invention is
`equipped as a cardiac monitoring device, possessing a
`forward facing, first, head-contacting Sensor 2 positioned to
`contact the face or ear of the user. While sensor 2 is shown
`in FIG. 1 as being below the earpiece 17 on the cell phone,
`it may otherwise Surround Such earpiece 17 or be positioned
`elsewhere on the cell phone 1 to conveniently contact the
`user's head during or between telephonic transmissions. To
`capture ECG signals, a Second, Side or rear-facing, hand
`contacting Sensor 3 is positioned to contact the left hand or
`thumb of the user. And preferably, a reference electrode 4 is
`positioned on the cell phone 1 to contact either the face or
`hand of the user. The electrodes may be ohmic or capacitive,
`the reference electrode being preferably ohmic of the active
`type.
`0.045. It is desirable in the case where ohmic electrodes
`are used for the first and Second electrodes, particularly in
`conjunction with a differential, common-mode noise rejec
`tion circuit, for the body-contacting Surface of Such elec
`trodes to have a volume resistivity in the range of 10exp5 to
`
`10exp11 ohm-cms, more preferably 10exp6 to 10exp10
`ohm-cms. With Such an electrode it is desirable to feed the
`Signal directly into a preferably on-board, high impedance
`amplifier—hence constituting an active electrode.
`0046. In FIG. 2 an already-existing cell phone 1 is
`provided with a harneSS incorporating a first, forward-facing
`Sensor 2 positioned to contact the face or ear of the user; a
`Second, Side or rear-facing Sensor 3 positioned to contact the
`left hand or thumb of the user; a reference electrode 4,
`preferably ohmic, positioned to contact either the face or
`hand of the user; and an electronic circuit 5 to condition
`and/or analyse the bio-signal and to digitise and/or modulate
`the bio-signal in preparation for transmission. A coupling
`connector 19 delivers the bio-signal to the cell phone input
`for telephonic transmission 18. Optionally, an input Switch
`10 may be provided to allow the user to select bio-signal
`data transfer A or voice transmission B, as shown in FIG. 6.
`0047 FIG. 3 illustrates a device of the invention in use
`by a user. When the device 1 is held to an ear as shown in
`FIG. 3, bio-signals are acquired from the same user posture
`as in ordinary telephonic use. Use of the left hand is
`preferred for ECG pickup as this produces a stronger Signal
`for most perSons. But this is not a universal rule.
`0048 If for any reason this posture is not convenient on
`a particular individual, then the invention can also be made
`to operate by placing the face-oriented Sensors on other body
`parts Such as the chest or opposed hand.
`0049 FIG. 6 illustrates a functional block diagram of the
`invention removed from the interior of a cell phone, or case
`for clarity. The outputs from the first sensor 1, the second
`Sensor 2, and the reference electrode 3, are connected to the
`conditioning circuit 5. Circuit 5 may include analyser means
`15 to partially analyse the bio-signal. For the purpose of
`ECG pickup, the analyser circuit 15 preferably includes a
`differential amplifier. The analyser circuit 15 may also
`include means to derive key parameters from the bio-signal,
`provide band-pass filters, interference filters and produce
`outputs based on the correlation of multiple bio-signals.
`0050. The reference electrode 3 is connected to circuit 5
`and is also connected to a recommended electrical Shield 14,
`which overlies the circuitry of the invention in order to
`maximize the rejection of unwanted electrical interference
`Signals. It has been found useful in Some cases to overly
`electric shield 14 with an additional magnetic shield 11
`constructed of mu-metal foil or sheet. This further reduces
`interference arising from transmission of the telephonic
`device.
`Bio-signals that have been analysed within the
`0051
`circuit 15 may be provided to the memory 6, and subse
`quently to the modulator 7 within the conditioning circuit 5
`which prepares the Signal for Submission to the telephonic
`device input 9. The conditioned signal may be in acoustic or
`electronic form., electronic being indicated. Before Submis
`sion to the telephonic input 9, however, the modulated
`bio-signal may be temporarily Stored in a buffer memory 6,
`which is also connected to a controller 8. Controller 8
`controls the timing of the data Submission into the tele
`phonic device and uses memory 6 to prevent loSS of bio
`data.
`0052 Buffer memory 6 can optionally be made to store or
`archive Several Seconds of the patient's normal bio-signal
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`in an archive memory 6A. Such a Signal can be recorded
`under highly controlled conditions, Such as at the doctor's
`office, during the patient's optimal health condition. This
`normal Signal can be permanently Stored and Sent to the
`doctor's office along with each real-time bio-signal trans
`mission, e.g. interspersed. Such a feature would provide the
`health practitioner with the user's 'Standard bio-signal, thus
`assisting the practitioner in assessing the patient's immedi
`ate Status.
`0053. In the embodiment described previously wherein
`the invention is in the form of a harneSS or case to be used
`with an existing cell phone, the micro-controller 8 can be
`connected to a user-activated Switch 10. In this case, the
`Switch 10 controls a sense circuit in controller 8 which
`toggles the cell phone through input 9 between of normal
`Voice mode and data transmission mode. The detailed func
`tioning of controller 8 depends on the particular model of
`cell phone utilized.
`0.054 Communications over the telephonic link can be
`effected in a number of electronic modes. Half-Duplex
`allows the health practitioner to talk to the patient, and to
`instruct the patient on when to begin and cease Sending the
`bio-signal information. When instructed, the patient
`Switches back to normal mode to regain control of the
`outgoing audio channel and can immediately converse in a
`normal fashion with the monitoring Station.
`0055. It is also anticipated that the monitoring station
`could control the bio-monitoring functions by Sending a
`Specific tone or other Signal through antenna 21 and link 16
`to instruct the device to begin or cease Sending bio-signals,
`thereby removing the need for the patient to activate the
`device.
`0056. Other envisioned voice-over-data capabilities
`include Full-Duplex, via time-division multiple-access, code
`division multiple access or frequency division multiple
`CCCSS.
`
`0057. Other systems such as GPRS (General Packet
`Radio Service), EDGE (Enhanced Data rates for GSM
`Evolution), High Speed Internet, piggy-back DSL (Digital
`Subscriber Line) or ADSL (Asynchronous DSL) continue to
`expand the possibilities for Simultaneous data and Voice.
`0.058 As high-speed digital systems continue to prolif
`erate, it is expected that more opportunities for Simultaneous
`transmission of medical data and Voice Signals will arise.
`This will not be limited to cellular phone or PSTN systems,
`but will also encompass cable-television, Satellite, micro
`cell and pico-cell communication Systems. It is also envi
`Sioned that a medical telephones could incorporate two,
`Separate Voice and data Systems that operate completely
`independently. This will allow the voice portion to connect
`to a PSTN system and the data portion to connect to any
`available digital connection including, but not limited to,
`wired connections, wireleSS connections, Ethernet, RS232,
`USB, 802.11 or blue-tooth.
`0059 FIG. 4 depicts a pictorial schematic layout for an
`electrode used to pickup signals originating inside a body 12
`for delivery to the conditioning circuit 5. The electrical
`Signal inside the body can be called the body-Source, as
`represented by a Voltage Vb. Analyzing this circuit for its
`DC characteristics, the body Source, along with the Voltage
`divider required for the pickup of the bio-signal is illustrated
`in FIG. 4 wherein:
`
`0060 Rs and R's are the skin resistance;
`0061
`F is the location of the body-to-electrode
`interface;
`0062 Rc is the contact resistance at the interface F;
`0063 Re is the electrode bulk resistance, and
`0064 Ra is the resistance across which the output
`Signal Va is measured.
`0065. The end of the voltage divider, opposite to the
`electrode, is connected to the body through resistance Rr at
`point K. An operational amplifier, IC1A, Serves as the
`Sensing electronics.
`0066. In the case of passive electrodes connected to an
`ECG machine, Ra represents the ECG machine input resis
`tance. In the case of active, ohmic pickup electrodes pos
`Sessing an on-board, internal buffer amplifier acting as an
`impedance converter, Ra represents the combined resistance
`of the Sensing circuit as bridged by the Sensing resistor.
`0067. In order to protect the sensing circuitry from over
`load voltages, Ra may be paralleled by two parallel,
`reversely oriented diodes Such as diodes exemplified by
`Panasonic MA198CT. Diodes D1, D2 are shown in FIG. 5.
`At the low Signal levels provided by the pick-up electrodes,
`Such diodes exhibit high forward resistances, having a
`resistance of on the order of 10 exp 12-13 ohms. The
`forward resistance of these diodes before conduction occurs
`at low voltages is on the order of 10 exp 13 ohms. By
`choosing diodes with a forward breakdown voltage that is
`above the level of the signal of interest, the “reset' function
`of the input resistance of the high impedance amplifies can
`be improved.
`0068 FIG. 5 shows a differential input electronic circuit
`that reduces or eliminates common mode noise. In FIG. 5
`two pick-upS using operational amplifiers IC1A, IC2A simi
`lar to that of FIG. 4 are used to drive a differential amplifier
`IC3A which further conditions the signal for transmission by
`shielded wire 20 to a further portion of the conditioning
`circuit 5, and eventually to the telephonic communication
`circuit of the phone. By use of this differential signal
`detection circuit, common mode noise arising from the
`reference electrode, the body, and external noise Sources will
`be minimized.
`0069. In Summary, using the invention a new and useful
`means for telemonitoring of patients may be provided.
`
`CONCLUSION
`0070 The foregoing has constituted a description of
`Specific embodiments showing how the invention may be
`applied and put into use. These embodiments are only
`exemplary. The invention in its broadest, and more specific
`aspects, is further described and defined in the claims, which
`now follow.
`0071. These claims, and the language used therein, are to
`be understood in terms of the variants of the invention which
`have been described. They are not to be restricted to such
`variants, but are to be read as covering the full Scope of the
`invention as is implicit within the invention and the disclo
`Sure that has been provided herein.
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`1. A telephone device for a user in the form of a telephone
`handset or cellphone, or a case, or harneSS for attachment to
`a pre-existing telephone handset or cell phone in combina
`tion with a pre-existing telephone handset or cell phone,
`comprising:
`a) a first Sensor carried on the outer Surface of the device
`in order to establish contact with the user's head and
`acquire bio-signals through Such first contact;
`b) a pickup signal conditioning circuit carried by the
`device and connected to the first Sensor to condition
`acquired bio-signals into conditioned signals for Sub
`Sequent telephonic communication;
`c) a telephonic communication circuit connected to the
`Signal conditioning circuit to provide a telephonic
`Signal corresponding to the bio-signal data for tele
`phonic communication, and
`d) voice communication means positioned on the device
`to convey Voice messages to and from the user through
`the telephonic communication circuit while the device
`is in position to receive bio-signals through Such first
`COntact,
`whereby the Simultaneous or alternate communication of
`bio-data and Voice may occur without the need for any
`interruption arising from repositioning of the device.
`2. A telephone device as in claim 1 comprising a Second
`sensor positioned on another portion of the surface of the
`device to establish contact with the user's hand to also effect
`the acquisition of Said bio-signals through Such Second
`contact, Said Second Sensor being connected to the pickup
`Signal conditioning circuit to condition acquired signals into
`conditioned signals for Subsequent telephonic communica
`tion.
`3. A telephone device as in claim 2 wherein:
`1. the first Sensor is a first cardiac pickup positioned to
`contact the user's head during normal hand-held tele
`phonic communications, and
`2. the Second Sensor is a Second cardiac pickup electrode
`positioned to contact the left hand of the user during
`normal hand-held telephonic communications.
`4. A telephone device as in claim 3 wherein the first and
`Second Sensors are ohmic electrodes combined with:
`a) a third ohmic reference electrode positioned to contact
`the user's skin at either the face or hand location;
`and wherein:
`b) the pickup signal conditioning circuit includes a dif
`ferential, common-mode noise rejection circuit with a
`circuit ground; and
`c) the third reference electrode is connected to the circuit
`ground.
`5. A telephone device as in claim 4 wherein Said first,
`Second and reference electrodes have a body-contacting
`Surface layer which has a volume resistivity in the range of
`10exp5 to 10exp11 ohm-cms.
`6. A telephone device as in claim 2 comprising a case or
`harneSS Shaped to be carried by a cell phone or phone
`handset wherein Said case or harneSS carries:
`
`a) Said first sensor array;
`b) said Second Sensor array; and
`c) said signal conditioning circuit,
`and Said Signal conditioning circuit is connected to the
`cell phone or phone handset to deliver Said conditioned
`Signals corresponding to the bio-signal data for tele
`phonic communication by the cell phone or phone
`handset.
`7. A telephone device as in claim 6 comprising acoustic
`coupling means whereby said Signal conditioning circuit is
`connected to the cell phone or phone handset to deliver Said
`conditioned Signals corresponding to the bio-signal data
`acoustically for telephonic communication by the cellphone
`or phone handset.
`8. A telephone device as in claim 7 wherein said cell
`phone or phone handset comprises an electrical input port
`and Said device comprises an input connection extending
`therefrom to Said Signal conditioning circuit to deliver Said
`conditioned signals corresponding to the bio-signal data for
`telephonic communication by the cellphone or phone hand
`Set.
`9. A device as in claim 8 comprising Switch means
`connected to the a telephonic communication circuit to
`permit Selection between data transmission and Voice com
`munications.
`10. A device as in claim 9 comprising telephonic circuit
`means operating on the basis of one of the following Systems
`namely, Analog Half-Duplex, Analog Full Duplex, Digital
`Half-Duplex, and Digital Full-Duplex, to permit transmis
`Sion of the patient bio-signal and Verbal communication by
`telephonic communication.
`11. A device as in claim 10 comprising telephonic circuit
`means whereby a monitoring Station receiving Said tele
`phonic communication controls the bio-monitoring func
`tions by Sending a specific tone or other audio Signal to
`instruct the device to begin or cease Sending bio-signals.
`12. A device as in claim 11 wherein the ohmic reference
`electrode is mounted proximately to one of the pickup
`electrodes.
`13. A device as in claim 12 wherein Said Signal condi
`tioning circuit comprises a memory in