(12) United States Patent
`Geva
`
`USOO6366871B1
`(10) Patent No.:
`US 6,366,871 B1
`(45) Date of Patent:
`Apr. 2, 2002
`
`(54)
`
`(75)
`(73)
`
`(21)
`(22)
`(51)
`(52)
`(58)
`
`(56)
`
`PERSONAL AMBULATORY CELLULAR
`HEALTH MONITOR FOR MOBILE PATIENT
`
`Inventor: Yakov Geva, Rishon Le Zion (IL)
`Assignee: Card Guard Scientific Survival Ltd.,
`Rechovot (IL)
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 0 days.
`
`Notice:
`
`Appl. No.: 09/261,136
`Filed:
`Mar. 3, 1999
`Int. Cl................................................... H04Q 7/22
`
`Field of Search ................................. 702/188, 127,
`702/62, 122; 340/825.57, 825.58, 825.56
`
`- - - - - - 702/188; 340/825.56
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`Lepkofker
`Cherry et al. ............... 128/630
`Tavori ........................ 340/573
`Rebstock et al. ...... 340/286.07
`Van der Laan et al. ... 340/573.1
`Thompson ................... 607/30
`Gaukel .................... 340/573.4
`Lemelson et al. .......... 340/539
`
`7/1997
`* 12/1997
`3/1998
`3/1999
`7/1999
`4/2000
`6/2000
`7/2000
`
`5,652,570
`5,701,894
`5,724,025
`5,877,675
`5,929,761
`6,083.248
`6,072,396
`6,084.510
`* cited by examiner
`
`Primary Examiner Marc S. Hoff
`Assistant Examiner Edward Raymond
`(74) Attorney, Agent, or Firm-Eitan, Pearl, Latzer &
`Cohen-Zedek
`
`(57)
`
`ABSTRACT
`
`Ambulatory patient monitoring apparatus including a por
`table housing including at least one physiological data input
`device operative to gather physiological data of the patient,
`location determination circuitry operative to determine geo
`graphic location information of the patient, cellular tele
`phone communications circuitry for communicating the
`physiological data and the geographic location information
`to a central health monitoring Station, voice communications
`circuitry whereby the patient conducts Voice communica
`tions with a clinician at the central health monitoring Station,
`digital signal processing circuitry for processing Signals
`asSociated with any of the physiological data input device,
`the location determination circuitry, the cellular telephone
`communications circuitry, and the Voice communications
`circuitry, and control circuitry for controlling any of the
`digital Signal processing circuitry, the physiological data
`input device, the location determination circuitry, the cellu
`lar telephone communications circuitry, and the Voice com
`munications circuitry.
`
`26 Claims, 12 Drawing Sheets
`
`
`
`405
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`U.S. Patent
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`Apr. 2, 2002
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`Sheet 1 of 12
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`US 6,366,871 B1
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`U.S. Patent
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`Apr. 2, 2002
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`Sheet 2 of 12
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`US 6,366,871 B1
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`U.S. Patent
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`Apr. 2, 2002
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`Sheet 3 of 12
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`US 6,366,871 B1
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`U.S. Patent
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`Apr. 2, 2002
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`Sheet 4 of 12
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`US 6,366,871 B1
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`U.S. Patent
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`Apr. 2, 2002
`
`Sheet S of 12
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`US 6,366,871 B1
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`U.S. Patent
`U.S. Patent
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`Apr. 2, 2002
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`Sheet 6 of 12
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`US 6,366,871 B1
`US 6,366,871 B1
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`NVISINITO
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`U.S. Patent
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`Apr. 2, 2002
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`Sheet 7 of 12
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`US 6,366,871 B1
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`START
`
`PATIENT PERFORMS TESTS
`
`TEST RESULTS ARE RECORDED
`IN MEMORY
`
`PATIENT ESTABLISHES A
`COMMUNICATIONS LNK
`BETWEEN MONTOR AND CENTRAL
`MEDICAL MONITORING STATION
`
`CLINCAN AND PATIENT
`COMMUNICATE BY VOICE
`
`PATENT SENDS TEST DATA AND
`THE PATIENT'S CURRENT LOCATION
`
`CLINCAN ANALYZES THE
`PATIENT'S TEST DATA
`
`
`
`CLINCAN INSTRUCTS THE
`PATIENT AND/OR NOTIFIES AND
`DISPATCHES EMERGENCY
`MEDICAL PERSONNEL TO COME
`TO THE PATIENT'S AD
`
`FINISH
`
`FIG5
`
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`U.S. Patent
`
`Apr. 2, 2002
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`Sheet 8 of 12
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`US 6,366,871 B1
`
`START
`
`MONITOR IS IN STANDBY MODE,
`WAITS FOR CALL
`
`CLINCAN AT CENTRAL STATION
`CALLS MONITOR
`
`MONTOR ANSWERS CALL
`
`CLINCAN INSTRUCTS THE
`PATIENT TO PERFORM TESTS
`
`PATIENT PERFORMS TESTS AND
`SEND THE TEST DATA AND
`PATIENT'S CURRENT LOCATION
`
`CLINCAN ANALYZES THE
`PATIENT'S TEST DATA
`
`
`
`CLINCAN INSTRUCTS THE
`PATIENT AND/OR NOTIFIES AND
`DISPATCHES EMERGENCY
`MEDICAL PERSONNEL TO COME
`TO THE PATIENT'S AID
`
`FINISH
`
`FIG.6
`
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`U.S. Patent
`
`Apr. 2, 2002
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`Sheet 9 of 12
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`US 6,366,871 B1
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`START
`
`MONITOR ACTIVATES ALARM AT A
`SPECIFIC TIME/TIMED INTERVAL
`TO REMIND THE PATIENT TO
`PERFORM TESTS, DISPLAYS TEST
`NSTRUCTIONS
`
`PATIENT PERFORMS TESTS
`
`
`
`
`
`MONITOR CONTACTS THE CENTRAL
`STATION, TRANSMITS TEST DATA
`AND THE PATIENT'S CURRENT
`LOCATION
`
`CLINCAN ANALAYZES THE
`PATIENT'S TEST DATA
`
`CLINCAN INSTRUCTS THE
`PATIENT AND/OR NOTIFIES AND
`DISPATCHES EMERGENCY
`MEDICAL PERSONNEL TO COME
`TO THE PATENT'S AD
`
`FINISH
`
`FIG 7
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`U.S. Patent
`
`Apr. 2, 2002
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`Sheet 10 of 12
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`US 6,366,871 B1
`
`START
`
`MONITOR CONTINUOUSLY
`PERFORMS TESTS, RECORDS DATA
`IN FIFO FASHON
`
`PATIENT INDICATES A
`PATIENT-ACTIVATED EVENT
`
`
`
`DATA RECORDED DURING THE
`PATENT-ACTIVATED EVENT ARE
`RECORDED IN SET-ASIDE
`MEMORY
`
`MONITOR CONNECTS TO THE
`CENTRAL STATION, TRANSMITS
`EVENT/PRE-EVENT/POST-EVENT
`DATA AND THE PATIENT'S
`CURRENT LOCATION
`
`CLINCAN ANALYZES THE
`PATIENT'S
`EVENT/PRE-EVENT/POST-EVENT
`TEST DATA
`
`CLINCAN INSTRUCTS THE
`PATIENT AND/OR NOTIFIES AND
`DISPATCHES EMERGENCY
`MEDICAL PERSONNEL TO COME
`TO THE PATIENT'S AD
`
`FIG8
`
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`U.S. Patent
`
`Apr. 2, 2002
`
`Sheet 11 of 12
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`US 6,366,871 B1
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`
`
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`
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`MONITOR PERFORMS TESTS
`CONTINUOUSLY
`
`COMPARE TEST DATA TO PRESET
`PARAMETERS
`
`IS DATA WITHIN NORMAL
`PARAMETERS2
`
`NO
`
`
`
`
`
`MONITOR CONTACTS THE CENTRAL
`STATION, TRANSMITS TEST DATA
`AND THE PATIENT'S CURRENT
`LOCATION
`
`CLINCAN ANALYZES THE
`PATIENT'S TEST DATA
`
`CLINCAN INSTRUCTS THE
`PATIENT AND/OR NOTIFIES AND
`DISPATCHES EMERGENCY
`MEDICAL PERSONNEL TO COME
`TO THE PATIENT'S AD
`
`FINISH
`
`FIG.9
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`U.S. Patent
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`Apr. 2, 2002
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`Sheet 12 of 12
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`US 6,366,871 B1
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`

`1
`PERSONAL AMBULATORY CELLULAR
`HEALTH MONITOR FOR MOBILE PATIENT
`FIELD OF THE INVENTION
`The present invention relates to patient monitoring SyS
`tems in general, an in particular to apparatus and methods
`for monitoring a mobile patient's physiological condition
`and wireleSS reporting of Same.
`BACKGROUND OF THE INVENTION
`Continuously monitoring a patient's physiological condi
`tion generally requires the patient's hospitalization, usually
`at great cost, especially where long term monitoring is
`required. In Some circumstances a wide variety of out
`patient monitoring devices may be used to monitor the
`physiology of patients who are physically outside of the
`hospital. Some out-patient monitoring devices have a lim
`ited range of operation, requiring monitored patients to
`remain close to a receiving Station and thus limiting his
`mobility. Other devices are adapted for monitoring mobile or
`ambulatory patients while they move about in a vehicle or on
`foot and have a wide range of operation.
`One Such group of devices includes holter devices which
`generally record a patient's physiological data, Such as the
`patient's ECG, during predetermined period of time for
`examination at later time. Other devices include event
`recorders. These devices provide for the captured of a
`patient's physiological data during a physiological "event,”
`Such as a cardiac arrhythmia or an episode of patient
`discomfort. These devices may be patient activated or acti
`Vated automatically when physiological data are detected
`which meet predefined event criteria.
`Holter devices and event recorders typically require that
`a patient return to the hospital periodically in order to
`transfer the recorded data. Some of these devices provide for
`transmission via telephone or other communications facili
`ties to a remote location for interpretation by a clinician.
`These devices generally require additional communication
`and medical testing devices to be present at patient location.
`In the case of event recorders, unnecessary delay between
`event recording and transmission is often introduced where
`Such additional devices are not present during the event.
`The mobility of high-risk patients must be weighed
`against the need to monitor a patient's location in order to
`provide a patient with emergency medical attention should
`a dangerous event occur.
`SUMMARY OF THE INVENTION
`The present invention seeks to provide improved appa
`ratus and methods for monitoring a mobile patient's physi
`ological condition and reporting the patient's physiological
`data as well as the patient's location which overcome the
`disadvantages of the prior art.
`It is an object of the present invention to provide an
`improved ambulatory monitoring device which monitors a
`patient's physiological condition and location, contacts a
`central Station, transmits the patient's physiological data and
`the patient's location coordinates to the central Station, and
`provides voice communications between the patient and a
`clinician at the central Station. The monitoring may be
`initiated by the patient with or without a periodic reminder,
`may be initiated by the device itself, may be initiated by the
`clinician through instruction to the patient, and/or may be
`performed continuously. The communication between the
`monitoring device and the central Station may be initiated by
`the patient, by the device itself, or by the clinician at the
`central Station.
`
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`US 6,366,871 B1
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`There is thus provided in accordance with a preferred
`embodiment of the present invention ambulatory patient
`monitoring apparatus including a portable housing including
`at least one physiological data input device operative to
`gather physiological data of the patient, location determina
`tion circuitry operative to determine geographic location
`information of the patient, cellular telephone communica
`tions circuitry for communicating the physiological data and
`the geographic location information to a central health
`monitoring Station, Voice communications circuitry whereby
`the patient conducts Voice communications with a clinician
`at the central health monitoring Station, digital Signal pro
`cessing circuitry for processing Signals associated with any
`of the physiological data input device, the location determi
`nation circuitry, the cellular telephone communications
`circuitry, and the Voice communications circuitry, and con
`trol circuitry for controlling any of the digital Signal pro
`cessing circuitry, the physiological data input device, the
`location determination circuitry, the cellular telephone com
`munications circuitry, and the Voice communications cir
`cuitry.
`Further in accordance with a preferred embodiment of the
`present invention the at least one physiological data input
`device is assembled within the housing.
`Still further in accordance with a preferred embodiment of
`the present invention the at least one physiological data
`input device is at least partially external to the housing.
`Additionally in accordance with a preferred embodiment
`of the present invention the external portion of the at least
`one physiological data input device is connected to the Via
`housing via a connector.
`Moreover in accordance with a preferred embodiment of
`the invention the location determination circuitry includes
`GPS circuitry.
`Further in accordance with a preferred embodiment of the
`present invention the control circuitry operates the physi
`ological data input device continuously.
`Still further in accordance with a preferred embodiment of
`the present invention the control circuitry operates the
`physiological data input device upon initiation by the
`patient.
`Additionally in accordance with a preferred embodiment
`of the present invention the control circuitry includes a
`memory for Storing any of the physiological data.
`Moreover in accordance with a preferred embodiment of
`the present invention the control circuitry is operative to
`Simultaneously Store a first portion of the physiological data
`in the memory in FIFO fashion and a second portion of the
`physiological data in the memory that is write-protected
`with respect to the first portion.
`Further in accordance with a preferred embodiment of the
`present invention the memory includes preset parameters
`adapted for comparison with the physiological data.
`Still further in accordance with a preferred embodiment of
`the present invention the control circuitry is operative to
`determine whether the physiological data are within the
`preset parameters.
`Additionally in accordance with a preferred embodiment
`of the present invention the control circuitry is operative to
`initiate contact with the central health monitoring Station
`when the physiological data are determined to be outside of
`the preset parameters.
`Moreover in accordance with a preferred embodiment of
`the present invention the memory includes preprogrammed
`instructions for output to the patient via either of a display
`and a Speaker.
`
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`25
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`3
`There is also provided in accordance with a preferred
`embodiment of the present invention a System for monitor
`ing a patient, the System including a central health moni
`toring Station, and a portable housing for use by the patient,
`the portable housing including at least one physiological
`data input device operative to gather physiological data of
`the patient, location determination circuitry operative to
`determine geographic location information of the patient,
`cellular telephone communications circuitry for communi
`cating the physiological data and the geographic location
`information to the central health monitoring Station, Voice
`communications circuitry whereby the patient conducts
`Voice communications with a clinician at the central health
`monitoring Station, digital Signal processing circuitry for
`processing Signals associated with any of the physiological
`data input device, the location determination circuitry, the
`cellular telephone communications circuitry, and the Voice
`communications circuitry, and control circuitry for control
`ling any of the digital signal processing circuitry, the physi
`ological data input device, the location determination
`circuitry, the cellular telephone communications circuitry,
`and the Voice communications circuitry.
`There is additionally provided in accordance with a
`preferred embodiment of the present invention a method for
`monitoring a patient, the method including providing a
`portable housing for use by the patient, the portable housing
`including at least one physiological data input device opera
`tive to gather physiological data of the patient, location
`determination circuitry operative to determine geographic
`location information of the patient, cellular telephone com
`munications circuitry for communicating the physiological
`data and the geographic location information to the central
`health monitoring Station, Voice communications circuitry
`whereby the patient conducts Voice communications with a
`clinician at the central health monitoring Station, digital
`Signal processing circuitry for processing Signals associated
`with any of the physiological data input device, the location
`determination circuitry, the cellular telephone communica
`tions circuitry, and the Voice communications circuitry, and
`control circuitry for controlling any of the digital Signal
`processing circuitry, the physiological data input device, the
`location determination circuitry, the cellular telephone com
`munications circuitry, and the Voice communications
`circuitry, gathering physiological data of the patient, deter
`mining the geographic location of the patient, and commu
`45
`nicating the physiological data and the geographic location
`to the central health monitoring Station.
`Further in accordance with a preferred embodiment of the
`present invention the method further includes analyzing the
`physiological data, and providing a response based on the
`physiological data.
`Still further in accordance with a preferred embodiment of
`the present invention the gathering Step is performed in
`response to activation by the patient.
`Additionally in accordance with a preferred embodiment
`of the present invention the method further includes acti
`Vating an alarm prior to the activation by the patient.
`Moreover in accordance with a preferred embodiment of
`the present invention the gathering Step is performed inde
`pendently from activation by the patient.
`Further in accordance with a preferred embodiment of the
`present invention the gathering Step includes Storing the
`physiological data in a memory.
`Still further in accordance with a preferred embodiment of
`the present invention the communicating Step is performed
`in response to activation by the patient.
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`Additionally in accordance with a preferred embodiment
`of the present invention the communicating Step is per
`formed independently from activation by the patient upon
`the memory becoming full.
`Moreover in accordance with a preferred embodiment of
`the present invention the method further includes clearing a
`portion of the memory corresponding to the physiological
`data that has been communicated to the control health
`monitoring Station.
`Further in accordance with a preferred embodiment of the
`present invention the Storing Step includes Simultaneously
`Storing a first portion of the physiological data in the
`memory in FIFO fashion and a second portion of the
`physiological data in the memory that is write-protected
`with respect to the first portion.
`Still further in accordance with a preferred embodiment of
`the present invention the communicating Step includes
`establishing a communications link with the central health
`monitoring Station in response to activation by the patient.
`Additionally in accordance with a preferred embodiment
`of the present invention the communicating Step includes
`establishing a communications link with the central health
`monitoring Station in response to an incoming communica
`tion from the central health monitoring Station.
`Moreover in accordance with a preferred embodiment of
`the present invention the communicating Step includes deter
`mining whether the physiological data are outside of preset
`parameters, and establishing a communications link with the
`central health monitoring Station when the physiological
`data are determined to be outside of the preset parameters.
`Further in accordance with a preferred embodiment of the
`present invention the providing a response Step includes
`Voice-communicating an instruction to the patient.
`Still further in accordance with a preferred embodiment of
`the present invention the providing a response Step includes
`providing the patient's location to medical emergency per
`Sonnel and dispatching the perSonnel to the patient's loca
`tion.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`The present invention will be understood and appreciated
`more fully from the following detailed description taken in
`conjunction with the appended drawings in which:
`FIG. 1 is a simplified pictorial illustration of a personal
`ambulatory cellular health monitor, constructed and opera
`tive in accordance with a preferred embodiment of the
`present invention;
`FIG. 2 is a simplified block diagram illustration of the
`personal ambulatory cellular health monitor of FIG. 1,
`constructed and operative in accordance with a preferred
`embodiment of the present invention;
`FIG. 3 is a simplified block diagram illustration of voice
`processing subsystem 400 of FIG. 2, constructed and opera
`tive in accordance with a preferred embodiment of the
`present invention;
`FIG. 4 is a Simplified block diagram illustrating end-to
`end communications between monitor 12 and a central
`medical monitoring Station, constructed and operative in
`accordance with a preferred embodiment of the present
`invention;
`FIG. 5 is a simplified flowchart illustration of the opera
`tion of monitor 12 in event recording mode activated by
`patient, operative in accordance with a preferred embodi
`ment of the present invention;
`FIG. 6 is a simplified flowchart illustration of the opera
`tion of monitor 12 in event recording mode activated
`
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`S
`remotely by an operator at a central medical monitoring
`Station, operative in accordance with a preferred embodi
`ment of the present invention;
`FIG. 7 is a simplified flowchart illustration of the opera
`tion of monitor 12 in event recording mode activated by the
`patient pursuant to an alarm, operative in accordance with a
`preferred embodiment of the present invention;
`FIG. 8 is a simplified flowchart illustration of the opera
`tion of monitor 12 in combination continuous recording
`mode and patient-activated event recording mode, operative
`in accordance with a preferred embodiment of the present
`invention;
`FIG. 9 is a simplified flowchart illustration of the opera
`tion of monitor 12 in continuous recording mode with a
`device-activated event recorder, operative in accordance
`with a preferred embodiment of the present invention; and
`FIG. 10 is a simplified flowchart illustration of the opera
`tion of monitor 12 in continuous recording holter-mode with
`a device-activated or patient-activated data upload, opera
`tive in accordance with a preferred embodiment of the
`present invention.
`DETAILED DESCRIPTION OF THE PRESENT
`INVENTION
`Reference is now made to FIG. 1 which is a simplified
`pictorial illustration of a personal ambulatory cellular health
`monitor, constructed and operative in accordance with a
`preferred embodiment of the present invention. A patient 10
`is shown wearing a personal ambulatory cellular health
`monitor 12 which preferably monitors the physiological
`condition of patient 10, records physiological data, and
`transmits Some or all of the data, as well as patient 10's
`location, via a cellular telephone network to a central
`medical monitoring station (not shown). Monitor 12 pref
`erably includes a microphone 405, a speaker 416, a display
`606 and a keypad 607. Monitor 12 is preferably adapted to
`be connected to one or more physiological data input
`devices Such as an electrocardiograph (ECG) input device,
`generally designated 14, having one or more ECG electrodes
`105 each connected by a wire 16 to a terminus 18 which is
`connected to monitor 12. Other physiological data input
`devices known in the art may likewise be connected to
`monitor 12 or otherwise built into monitor 12, as is
`described in greater detail hereinbelow with reference to
`FIG. 2, including devices for monitoring blood oxygen
`Saturation, respiration, blood glucose, blood pressure, lung
`function, SpO Saturation, and temperature.
`Additional reference is now made to FIG. 2 which is
`Simplified block diagram illustration of the personal ambu
`latory cellular health monitor 12 of FIG. 1, constructed and
`operative in accordance with a preferred embodiment of the
`present invention. Monitor 12 typically includes a medical
`subsystem 100, a personal location subsystem (PLC) 200, a
`digital signal processing (DSP) subsystem 300, a voice
`processing Subsystem 400, a radio Subsystem 500 and a
`control Subsystem 600.
`Medical Subsystem 100 typically includes one or more
`built-in and/or external physiological Sensors and associated
`electronic signal conditioning circuits and a Set of Sensors.
`Built-in Sensors may include a finger optical Sensor 118 for
`SpO, an optical Sensor 122 for measuring blood glucose, a,
`temperature sensor 120, and ECG electrodes 105A.
`External Sensors for plug-in connection to monitor 12
`may include EEG electrodes 101, ECG electrodes 105, a
`pressure cuff 110 for measuring NIBP, and an air flow sensor
`114 for measuring spirometry. EEG electrodes 101 and ECG
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`electrodes 105 are equipped with connector plugs 102 and
`106 respectively which may be identical for connection to
`monitor 12 via a single receptacle connector 107. Connector
`107 may include an electronic circuit which automatically
`recognizes which of EEG electrodes 101 and ECG elec
`trodes 105 is plugged in a receptacle 107. Pressure cuff 110
`also typically includes a plug 111 designed to be connected
`to a receptacle 112, as does flow Sensor 114 typically include
`a plug 115 designed to be connected to a receptacle 116.
`An EEG amplifier circuit 103 connected to EEG elec
`trodes 101, typically eight EEG electrodes, capture EEG
`Signals, amplifies and normalizes the Signal, and provides
`the normalized Signal to an EEG channel multiplexer
`(MUX) 104 which in turn provides the normalized signals to
`a multiplexer and analog to digital converter circuit (MUX
`& A/D) 124.
`An ECG amplifier circuitry 108 connected to ECG elec
`trodes 105, typically two or more ECG electrodes, captures
`ECG signals, amplifies and normalizes the Signal, and
`provides the normalized signal to MUX & A/D 124.
`ECG electrodes 105 are also preferably connected to a
`respiration circuit 109 which measures the AC voltage drop
`between ECG electrodes 105, amplifies the voltage drop,
`and normalizes the signal. Circuit 109 then provides the
`normalized signal to MUX & A/D 124.
`An NIBP circuit 113 connected to pressure cuff 110
`captures a blood pressure Signal, amplifies and normalizes
`the Signal, and provides the normalized signal to MUX &
`A/D 124.
`An air flow amplifier 117 connected to air flow sensor 114
`captures an air flow Signal, amplifies and normalizes the
`Signal, and provides the normalized signal to MUX & A/D
`124.
`An SpO circuit 119 connected to finger sensor 118
`captures an oxygen Saturation signal, amplifies and normal
`izes the Signal, and provides the normalized signal to MUX
`& A/D 124.
`A temperature circuit 121 connected to temperature Sen
`Sor 120 captures a temperature Signal, amplifies and nor
`malizes the Signal, and provides the normalized signal to
`MUX & A/D 124.
`A glucose circuit 123 connected to optical Sensor 122
`captures a blood glucose Signal, amplifies and normalizes
`the Signal, and provides the normalized signal to MUX &
`A/D 124.
`Signals received at MUX & A/D 124 are digitized and
`provided to DSP subsystem 300 where they are processed
`using known techniques and stored in a RAM memory 602.
`The personal location subsystem (PLC) 200 determined
`the location of patient 10. PLC Subsystem 200 preferably
`includes known location determination circuitry Such as
`GPS components including a GPS receiver 202 and a filter
`201 which is tuned to a known GPS frequency for CPS
`satellite communication via a built-in antenna 501 typically
`shared by radio subsystem 500. PLC subsystem 200 pref
`erably receives the pseudo range (PR) and pseudo range dot
`(PRD) from GPS satellites in communication range. The
`GPS receiver preferably operates in aided mode enabling
`“snapshot” operation as is known in GPS systems. Patient
`10’s position and velocity data is preferably transmitted via
`radio subsystem 500 to a central medical monitoring station
`together with measured physiological data as is described in
`greater detail hereinbelow. PLC 200 preferably determines
`the patient's location once monitor 12 is in contact with the
`central medical monitoring Station, Such as when contact is
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`established by the patient, a clinician at the central medical
`monitoring Station, or automatically by monitor 12 during a
`patient event or otherwise as is described in greater detail
`hereinbelow with reference to FIGS. 5–7B. The location
`information determined by GPS receiver 202 may be stored
`in memory 602 or may be transmitted immediately once the
`patient's location is determined.
`Data stored in RAM memory 602 may be transmitted
`immediately upon receipt at memory 202 or at a later time
`via radio Subsystem 500 to a central medical monitoring
`Station for analysis by a physician or clinician. Radio
`Subsystem 500 typically includes cellular telephone com
`munications circuitry including a filter 502, a power ampli
`fier 504, a frequency up-converter 506, an amplifier 508, and
`a GMSK modulator 510 which generates, modulates, and
`amplifies a signal for transmission via antenna 501. Radio
`Subsystem 500 also typically includes a filter 503 and an
`amplifier 505 which filters and amplifies incoming signals
`received via antenna 501. The Signal is then processed at a
`frequency down-converter 507, an intermediate reception
`amplifier 509, and a filter 511, whereupon the processed
`incoming Signal is provided to voice processing Subsystem
`400 for output. A synthesizer 512 is also provided which, in
`conjunction with frequency up-converter 506 and frequency
`down-converter 507, performs the frequency conversions
`required for Signal transmission and reception.
`Control Subsystem 600 typically includes control circuitry
`including a data MUX/DEMUX 601 which provides simul
`taneous multiple analog data channel conversion to digital
`data and vice versa, RAM memory 602, a ROM memory
`603, a microprocessor 604, interface function circuitry 605
`via which microprocessor 604 communicates with the vari
`ous Subsystems, display 606, keypad 607, a subscriber ID
`608 for cellular telephone identification such as is known
`with GSM systems, an alarm 609, and a service request
`decoder (SRO) 610 which decodes incoming signals to
`determine if the Signal is a voice communication or a control
`signal and, if the latter, informs microprocessor 604 of the
`incoming control Signal and the nature of the control
`instructions, Such as data download, data upload, etc. Micro
`processor 604 preferably controls the operation of monitor
`12, including medical subsystem 100, PLC subsystem 200,
`DSP subsystem 300, voice processing subsystem 400, and
`radio Subsystem 500. Control Subsystem 600 also manages
`common resources such as DSP subsystem 300, Data MUX/
`DEMUX 601, RAM memory 602, and ROM memory 603
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`among the various Subsystems, and controls data flow
`between Subsystems.
`Monitor 12 is typically powered by a battery 700 and a
`power supply 701.
`Additional reference is now made to FIG. 3 which is a
`Simplified block diagram illustration of Voice processing
`Subsystem 400 or FIG. 2, constructed and operative in
`accordance with a preferred embodiment of the present
`invention. Voice processing subsystem 400 typically voice
`communications circuitry including a demodulator 401, a
`channel coder/decoder 402, a GSM voice coder (vocoder)
`403, microphone 405, speaker 406, an analog-to-digital
`converter (ADC) 404, and a digital-to-analog converter
`(DAC) 407. Signal received by radio Subsystem 400 are
`demodulated at demodulator 401, decoded at channel coder/
`decoder 402, processed at voice coder 403, converted to
`analog signals at DAC 407, and output via speaker 406.
`Voice signals input via microphone 405 are digitized at ADC
`404, processed at voice coder 403, channel encoded at
`channel coder/decoder 402, and pro