(19) United States
`(12) Patent Application Publication (10) Pub. No.: US 2007/0276270 A1
`Tran
`(43) Pub. Date:
`Nov. 29, 2007
`
`US 20070276270A1
`
`(54) MESH NETWORKSTROKE MONITORING
`APPLIANCE
`
`Bao Tran, San Jose, CA (US)
`(76) Inventor:
`Correspondence Address:
`TRAN & ASSOCATES
`6768 MEADOW VISTA CT.
`SAN JOSE, CA 95135
`
`(21) Appl. No.:
`
`11/439,631
`
`(22) Filed:
`
`May 24, 2006
`
`Publication Classification
`
`(51) Int. Cl.
`(2006.01)
`A6IB 5/02
`(52) U.S. Cl. ....................................................... 6OO/508
`(57)
`ABSTRACT
`A health care monitoring system for a person includes one
`or more wireless nodes forming a wireless mesh network; a
`wearable appliance having a sound transducer coupled to the
`wireless transceiver, and a heart attack or stroke attack
`sensor coupled to the wireless mesh network to communi
`cate patient data over the wireless mesh network to detect a
`heart attack or a stroke attack.
`
`
`
`
`
`RMOTE Server 200
`
`
`
`
`
`
`
`
`
`internet
`100
`
`
`
`
`
`AUTHORIZEd Third
`PARTY (DOCTOR,
`FAMILY, EMERGENCY
`SERVICES,
`CAREGIVER, HOSPTA,
`NURSING HOME, CALL
`CENTER, ETC.) 210
`
`
`
`BASE STATION -
`LOCAL SERVER 20
`
`Mesh Network
`Appliances 8
`
`O
`
`(6 10
`
`30
`
`-1-
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`

`Patent Application Publication Nov. 29, 2007 Sheet 1 of 18
`
`US 2007/0276270 A1
`
`
`
`
`
`
`
`RMOTE SERVER200
`
`
`
`
`
`
`
`
`
`internet
`100
`
`
`
`AUTHORIZED THRD
`PARTY (DOCTOR,
`FAMILY, EMERGENCY
`SERVICES,
`CAREGIVER, HOSPITAL,
`NURSING HOME, CALL
`CENTER, ETC) 210
`
`BASE STATION -
`LOCAL SERVER 20
`
`Mesh Network
`Appliances 8
`
`(6 10
`
`C
`
`30
`
`FIG. 1
`
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`Patent Application Publication Nov. 29, 2007 Sheet 2 of 18
`
`US 2007/0276270 A1
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`
`
`Place a calibration sheet with known dots at a known distance
`and perpendicular to a camera view
`
`Take snapshot 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 snapshot 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 Dotl (x,y,z) to Dot2 (x, y, z)
`defining a cone center where the camera can view
`
`FIG. 2A
`
`O O O O O O O O
`O
`O
`O
`O
`O. O. O. O. O. O. O. O
`O
`O
`O
`O
`O
`O O O O O O
`O
`O
`O
`O
`O O. O. O. O. O. O. O
`O
`O
`O
`O
`
`FI G. 2 B
`
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`Patent Application Publication
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`Nov. 29, 2007 Sheet 3 of 18
`
`US 2007/0276270 A1
`
`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 patient's key features
`
`Extract facial objects
`
`Detect facial orientation
`
`Detect facial expression
`
`FIG. 4
`
`-4-
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`Patent Application Publication Nov. 29, 2007 Sheet 4 of 18
`
`US 2007/0276270 A1
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`Determine if patient needs assistance based on in-door position, fall
`detection and vital parameter (1008)
`Confirm prior to calling third party (1010)
`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 (1014)
`
`
`
`1382
`
`1388
`
`FIG. 6A
`
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`Patent Application Publication Nov. 29, 2007 Sheet 5 of 18
`
`US 2007/0276270 A1
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`HEADBAND OR HEAD CAP
`1402
`
`
`
`PATCH
`1400
`
`1182
`
`
`
`MEDICINE
`CONTAINER(S)
`1391
`
`HDTV REMOTE
`CONTROL 1399
`
`LIGHTING
`CONTROL 1398
`
`ROOM
`THERMOSTAT
`CONTROL 1396
`
`HOME SECURITY
`MONTOR 1394
`
`FIRE ALARMS
`1393
`
`HOME
`APPLIANCE(S)
`1392
`
`BASE STATION
`OR PERSONAL
`SERVER 1390
`
`POTS/PSTN OR THE
`NTERNET
`
`
`
`
`
`
`
`AUTHORIZED THIRD PARTY (FRIEND, FAMILY, COMMUNITY, EMERGENCY SERVICES,
`HOSPITAL CAREGIVER, ORMONITORING CALL CENTER, AMONG OTHERS) 1194
`
`FIG. 6B
`
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`Patent Application Publication Nov. 29, 2007 Sheet 6 of 18
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`US 2007/0276270 A1
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`Star
`
`O PAN coordinator (FFD)
`O Router Node (FFD)
`2 End Device (RFD or FFD)
`
`FIG. 7
`
`
`
`32
`
`FIG. 8
`
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`Patent Application Publication Nov. 29, 2007 Sheet 7 of 18
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`US 2007/0276270 A1
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`FIG. 9
`
`
`
`149
`
`FIG. 10
`
`-8-
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`Patent Application Publication Nov. 29, 2007 Sheet 8 of 18
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`US 2007/0276270 A1
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`f72
`
`
`
`FIG. 11
`
`FIG. 12
`
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`Patent Application Publication Nov. 29, 2007 Sheet 9 of 18
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`US 2007/0276270 A1
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`
`
`FIG. 13
`
`FIG. 14B
`
`190
`NNa
`
`
`
`- 196
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`ai
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`w" t";
`
`192
`
`FIG. 14A
`
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`Patent Application Publication
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`Nov. 29, 2007 Sheet 10 of 18
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`US 2007/0276270 A1
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`
`
`
`
`
`
`
`
`(~~~
`
`A •
`
`FIG. 15A
`
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`Patent Application Publication
`
`Nov. 29, 2007 Sheet 11 of 18
`
`US 2007/0276270 A1
`
`
`
`
`
`
`
`
`
`
`
`
`
`A •
`
`FIG. 15B
`
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`Patent Application Publication
`
`Nov. 29, 2007 Sheet 12 of 18
`
`US 2007/0276270 A1
`
`ra de
`a
`is a lami
`S. vyvyt?y
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`
`igi
`is a
`
`st
`
`FIG. 15C
`
`FIG. 15D
`
`-13-
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`
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`

`Patent Application Publication Nov. 29, 2007 Sheet 13 of 18 US 2007/0276270 A1
`
`
`
`--- k" -, - a
`
`
`
`
`
`- R --ra-year-itsr
`
`
`
`is a
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`is kni:
`virth
`ead a
`at V a.
`riff. Streiteit's tries riversity irri.orr-e-
`FIG. 15F
`
`-14-
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`Patent Application Publication Nov. 29, 2007 Sheet 14 of 18 US 2007/0276270 A1
`
`
`
`
`
`
`
`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
`
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`

`Patent Application Publication
`
`Nov. 29, 2007 Sheet 15 of 18
`
`US 2007/0276270 A1
`
`
`
`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
`
`-16-
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`Patent Application Publication
`
`Nov. 29, 2007 Sheet 16 of 18 US 2007/0276270 A1
`
`Torso
`
`
`
`
`
`Right
`upper
`
`Left
`thigh
`
`Left
`calf
`
`Right
`calf
`
`FIG. 16D
`
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`Patent Application Publication Nov. 29, 2007 Sheet 17 of 18 US 2007/0276270 A1
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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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`Patent Application Publication
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`Nov. 29, 2007 Sheet 18 of 18
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`US 2007/0276270 A1
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`10 in
`
`Muscle site
`
`WFW
`
`f
`Reference
`
`1 mm
`
`FIG. 17A
`
`HISTORICAL MEASUREMENT
`
`RECENT MEASUREMENT
`
`
`
`FIG. 17B
`
`FIG. 17C
`
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`US 2007/0276270 A1
`
`Nov. 29, 2007
`
`MESH NETWORKSTROKE MONITORING
`APPLIANCE
`
`BACKGROUND
`0001. This invention relates generally to methods and
`systems for monitoring a person.
`0002 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 brain bursts or is
`blocked by a blood clot. Within minutes, the nerve cells in
`that area of the brain are damaged, and they may die within
`a few hours. As a result, the part of the body controlled by
`the damaged section of the brain cannot function properly.
`Prior to a stroke, a person may have one or more transient
`ischemic 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.
`0003. Although great strides have been made in the
`treatment of stroke, the overall incidence will continue to
`rise as our population ages. Primary and secondary preven
`tion of stroke is important to decrease its incidence and its
`associated morbidity. 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 depen
`dent on others to perform activities of daily living. 18 The
`rate of recurrent noncardioembolic stroke is 3% to 7% per
`year.
`0004 Stroke can be subdivided into two types: ischemic
`and hemorrhagic. Ischemic stroke accounts for 85% of all
`cases.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 produc
`tion. Three main mechanisms are involved in the develop
`ment of ischemic stroke, and they are associated with
`atherothrombotic, embolic, and Small-vessel diseases. Less
`common causes include coagulopathies, vasculitis, dissec
`tion, and venous thrombosis.
`0005. 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 alter
`ations 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 delivery. Embolic stroke occurs when
`
`dislodged thrombi travel distally and occlude vessels down
`stream. One-half of all embolic strokes are caused by atrial
`fibrillation; the rest are attributable to a variety of causes,
`including (1) left ventricular dysfunction secondary to acute
`myocardial infarction or severe congestive heart failure, (2)
`paradoxical emboli secondary to a patent foramen ovale, and
`(3) atheroemboli. These latter vessel-to-vessel emboli often
`arise from atherosclerotic lesions in the aortic arch, carotid
`arteries, and vertebral arteries.
`0006 Small-vessel ischemia can occur when microat
`heromata occlude the orifice of penetrating arteries. Another
`mechanism is associated with lipohyalinosis, in which
`pathologic changes in the tunica media and the adventitia of
`penetrating arteries occur in the presence of chronic hyper
`tension. Elevated blood pressure causes endothelial injury
`that disrupts 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.
`0007 Hypoperfusion can occur as a result of (1) athero
`sclerotic disease that limits distal flow or (2) systemic
`hypotension, such as seen in patients who experience acute
`cardiacarrhythmia or cardiac arrest. A reduction in cerebral
`perfusion pressure activates the autoregulatory system. As
`the Small arterioles 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.
`0008 Hemorrhagic stroke can be further subclassified as
`intracerebral and Subarachnoid. Intracerebral hemorrhage is
`the result of the rupture of a vessel within the brain paren
`chyma. The primary causes of these ruptures are hyperten
`sion and amyloid angiopathy; secondary precipitating fac
`tors 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.
`0009 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 loca
`tions of hypertensive hemorrhages include the putamen,
`caudate, thalamus, pons, and cerebellum. Amyloid angiopa
`thy 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 hemosiderin deposition in other areas of the
`brain on magnetic resonance imaging (MRI) might also be
`seen. This deposition indicates that the patient has experi
`
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`US 2007/0276270 A1
`
`Nov. 29, 2007
`
`enced previous hemorrhage and provides indirect Support
`for the presence of amyloid angiopathy; however, pathologic
`examination can make a definitive diagnosis.
`00.10
`Early detection and treatment of stroke is essential
`to recovery from a stroke.
`
`SUMMARY
`0011. 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.
`0012. In one 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.
`0013. In another aspect, a health care monitoring system
`for a person includes one or more wireless nodes forming a
`wireless mesh network; a wearable appliance having a Sound
`transducer coupled to the wireless transceiver; and a bio
`electric impedance (BI) sensor coupled to the wireless mesh
`network to communicate BI data over the wireless mesh
`network.
`0014. 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 recognizer coupled to the Sound transducer to
`determine cardiovascular 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 trans
`mission bandwidth.
`0015. In yet another aspect, a monitoring system for a
`person includes one or more wireless nodes; and a wrist
`watch having a wireless transceiver adapted to communicate
`with the one or more wireless nodes; and an accelerometer
`to detect a dangerous condition and to generate a warning
`when the dangerous condition is detected.
`0016. 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 transceiver adapted to communicate with the one or
`more wireless nodes; and a heartbeat detector coupled to the
`wireless transceiver. The system may also include an accel
`erometer to detect a dangerous condition such as a falling
`condition and to generate a warning when the dangerous
`condition is detected.
`0017 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
`confirmatory 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 processor 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.XX VOIP. The remote person can be a doctor, a nurse,
`a medical assistant, or a caregiver. The system includes code
`to store and analyze patient information. The patient infor
`
`mation includes medicine taking habits, eating and drinking
`habits, sleeping habits, or excise habits. A patient interface
`is provided on a user computer for accessing information
`and the patient interface includes in one implementation 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 cameras
`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.
`0018. 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.
`0019. 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.
`0020. 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; processing the vital parameter to detect SIDS
`onset; and generating a warning.
`0021 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 health care provider
`within 2 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.
`0022. Other advantages of the invention may include one
`or more of the following. The system for non-invasively and
`continually 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.
`0023. In particular, it allows patients to conduct a low
`cost, comprehensive, real-time monitoring of their blood
`pressure. Using the web services software interface, the
`invention then avails this information to hospitals, home
`health care organizations, insurance companies, pharmaceu
`tical agencies conducting clinical trials and other organiza
`tions. 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 mini
`mizes effects of white coat syndrome since the monitor
`automatically makes measurements with basically no dis
`
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`Masimo Ex. 1034
`IPR Petition - USP 10,942,491
`
`

`

`US 2007/0276270 A1
`
`Nov. 29, 2007
`
`comfort; measurements are made at the patient's home or
`work, rather than in a medical office.
`0024. 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 pressures, standard deviation, beat
`to-beat pressure variations) that are not available with con
`ventional devices that only measure systolic and diastolic
`blood pressure at isolated times.
`0025. The wearable appliance provides an in-depth, cost
`effective mechanism to evaluate a patient’s cardiac condi
`tion. 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.
`0026. In cases where the device has fall detection in
`addition to blood pressure measurement, other advantages of
`the invention 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 manner since a computer monitors the images
`and human involvement is allowed only under pre-desig
`nated events. The patient’s privacy is preserved since human
`access to videos of the patient is restricted: the system only
`allows human viewing under emergency or other highly
`controlled conditions designated in advance by the user.
`When the patient is healthy, people cannot view the patients
`video without the patient’s consent. Only when the patients
`safety is threatened would the system provide patient infor
`mation to authorized medical providers to assist the patient.
`When an emergency occurs, images of the patient and
`related medical data can be compiled and sent to paramedics
`or hospital for proper preparation for pick up and check into
`emergency room.
`0027. 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 capability so that a remote healthcare provider
`(such as a doctor, nurse, therapist or caregiver) can visually
`communicate with the patient in performing remote diag
`nosis. 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.
`0028. Additionally, a sudden change of activity (or inac
`tivity) can indicate a problem. The remote healthcare pro
`vider may receive alerts over the Internet or urgent notifi
`cations 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 healthcare provider. Feedback reports can be sent
`to monitored Subjects, their designated informal caregiver
`and their remote healthcare provider. Feedback to the indi
`vidual can encourage the individual to remain active. The
`content of the report may be tailored to the target recipients
`
`needs, and can present the information in a format under
`standable by an elder person unfamiliar with computers, via
`an appealing patient interface. The remote healthcare pro
`vider 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 indi
`viduals 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 com
`pliance, among others.
`0029. The patient’s home equipment is simple to use and
`modular to allow for the accommodation of the monitoring
`device 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 admis
`sions, 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 man
`agement companies, health insurance companies, self-in
`Sured employers, medical device manufacturers and phar
`maceutical firms.
`0030 The system reduces costs by automating data col
`lection 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. Operators 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, car
`egivers, and other affiliated parties to improved the Quality
`of Care for the patient.
`0031. In an on-line pharmacy aspect, a method for pro
`viding patient access to medication includes collecting
`patient medical information from a patient computer; secur
`ing 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.
`0032. Implementations of the on-line pharmacy aspect
`may include one or more of the following. The medical
`information 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 communicating with the patient. The digital stetho
`Scope can be a microphone or piezeoelectric transducer
`coupled to the Zigbee network to relay the sound. A plurality
`of medical rules can be applied to the medical information
`to arrive at a diagnosis. 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
`
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`Masimo Ex. 1034
`IPR Petition - USP 10,942,491
`
`

`

`US 2007/0276270 A1
`
`Nov. 29, 2007
`
`nurse. The system can monitor drug compliance, and can
`automatically ordering a medication refill from the phar
`macy.
`0033 For pharmacy applications, advantages of the phar
`macy 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, doctor, pharmacy, and third party
`testing entities benefit from a uniform pricing structure that
`is based on the diagnosis and treatment. The patient only
`pays for standard medical treatments for his or her illness.
`The physician is paid a standard fee which covers the
`average work spent with a patient with the specific type of
`medical situation. The dispensing pharmacy is able to pro
`vide the highest level of service, since it is able to double
`check all medications dispensed to each patient along with
`the optimal way to detect anticipated negative drug interac
`tions. The pricing structure is competitive as physicians do
`not need to be distributed physically, and those with spe
`cialty areas may remain centrally located and yet be able to
`interact electronically with patients. The system still pro
`vides physical access to specialists since the patients which
`are evaluated can be directed to visit a specialists physically,
`when remote review and contact is ineffectual. The on-line
`pharmacy tracks the specific needs and medical