U.S. patent application number 11/071639 was filed with the patent office on 2005-07-28 for portable ecg device with wireless communication interface to remotely monitor patients and method of use.
Invention is credited to Brodnick, Donald Eugene, Rowlandson, Ian.
Application Number | 20050165318 11/071639 |
Document ID | / |
Family ID | 24652063 |
Filed Date | 2005-07-28 |
United States Patent
Application |
20050165318 |
Kind Code |
A1 |
Brodnick, Donald Eugene ; et
al. |
July 28, 2005 |
Portable ECG device with wireless communication interface to
remotely monitor patients and method of use
Abstract
A portable ECG monitor and an overall system for remotely
monitoring cardiac function of a patient is disclosed, together
with a method of use. The portable ECG includes a multi-lead,
multi-channel ECG monitor and a wireless communication device
connected to the ECG monitor to receive patient ECG data and
transmit the patient ECG data to a centralized facility, such as a
hospital. The wireless communication device can include a mobile
phone and/or an interactive Internet appliance. A method of
remotely monitoring ECG data is also disclosed. The method and
apparatus are particularly useful with patients experiencing
symptomatic ischemia. The method includes providing a portable ECG
device with wireless communication capabilities to such a patient,
acquiring ECG data from the patient at a location remote from a
health care facility, then transmitting the ECG data to the
centralized facility, and assessing the ECG data at the centralized
facility. The patient is then provided with instructions based on
the ECG assessment. The centralized facility and the health care
facility may be one in the same, or may be two different and
distinct facilities.
Inventors: |
Brodnick, Donald Eugene;
(Cedarburg, WI) ; Rowlandson, Ian; (Fox Point,
WI) |
Correspondence
Address: |
Ziolkowski Patent Solutions Group, SC
14135 N. Cedarburg Road
Mequon
WI
53097
US
|
Family ID: |
24652063 |
Appl. No.: |
11/071639 |
Filed: |
March 3, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
11071639 |
Mar 3, 2005 |
|
|
|
09661064 |
Sep 13, 2000 |
|
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Current U.S.
Class: |
600/509 ;
128/903 |
Current CPC
Class: |
G16H 50/20 20180101;
G16H 40/67 20180101; A61B 5/0006 20130101 |
Class at
Publication: |
600/509 ;
128/903 |
International
Class: |
A61B 005/00; A61B
005/04 |
Claims
1-35. (canceled)
36. A cardiac condition monitoring system comprising: a patient ECG
monitor; a plurality of electrodes connectable to the patient ECG
monitor and configured to acquire 12-lead ECG data from a patient
during a data acquisition stage; a patient communication interface
constructed to process the 12-lead ECG data and communicate the
processed 12-lead ECG data to a health care provider; and a health
care communication interface remote from the patient ECG monitor
and constructed to receive the processed 12-lead ECG data and
display the processed data to health care personnel.
37. The system of claim 36 wherein the data acquisition stage is
initiated by the patient upon a patient diagnosed cardiac condition
and terminated upon determination by the health care provider that
the patient diagnosed cardiac condition is a misdiagnosis of a
cardiac condition.
38. The system of claim 36 wherein the plurality of electrodes are
positionable on a patient to acquire 8 views of a patients cardiac
condition and derive 4 additional views of a patients cardiac
condition.
39. The system of claim 38 wherein the plurality of electrodes is
further defined as eight electrodes and wherein six of the
electrodes are positionable about a patient's chest, one electrode
is positionable below a patient's umbilical cord, and one electrode
is positionable about a patients arm.
40. The system of claim 36 further comprising an information
management system connectable to the patient ECG monitor and
constructed to at least one of transmit the processed 12-lead ECG
data to the health care communication interface and record the
processed 12-lead ECG data until arrival of a patient at a health
care facility and then connect to the health care communication
interface and communicate the recorded data thereto.
41. The system of claim 40 wherein the information management
system further comprises a removable storage medium constructed to
store the recorded data and be removed from the patient ECG monitor
and connected to the health care communication interface.
42. A medical information acquisition system comprising: an
individual ECG device; a plurality of electrodes connectable to the
individual ECG device, the plurality of electrodes connectable to a
patient to acquire data required to generate 12 views of a
patient's cardiac condition; an ECG device communication interface
connected to the individual ECG device and constructed to
communicate the 12 views of a patient's cardiac condition with a
health care facility upon patient actuation of the individual ECG
device; and a health care facility communication interface
constructed to communicate with the ECG device communication
interface and configured to display the 12 views of the patient
cardiac condition and communicate a diagnosis of the 12 views of
the patient cardiac condition to the individual ECG device.
43. The system of claim 42 wherein the individual ECG device is
constructed to be actuated by a patient upon the patient diagnosing
a cardiac condition and deactivated by the patient upon
confirmation by a health care provider that the cardiac condition
is non-critical.
44. The system of claim 42 wherein the individual ECG device
further comprising an information management system, the
information management system constructed to be connectable to the
health care facility communication interface when a patient is
proximate thereto and transmit the acquired data thereto when the
patient is remote from a health care facility.
45. The system of claim 42 wherein the individual ECG device
wirelessly communicates with the ECG device communication interface
and the ECG device communication interface wirelessly communicates
with the health care facility communication interface.
46. The system of claim 42 wherein the 12 views of a patients
cardiac condition are further defined as 8 views acquired from data
received from the plurality of electrodes and 4 views derived from
data received from the plurality of electrodes.
47. The system of claim 42 wherein the patient communication
interface is constructed to concurrently communicate at least two
of the ECG signals, ECG signal converted to a human discernable
form, and a moving video signal to the health care facility
communication interface.
48. The system of claim 42 wherein patient actuation of the
individual ECG device is further defined as the patient
self-attaching the plurality of electrodes of the individual ECG
device and a patient deactivation of the individual ECG device
further comprises a patient disconnecting the plurality of
electrodes and turning off the ECG monitor.
49. A patient ECG acquiring system comprising: a transportable ECG
monitor having a plurality of channels and constructed to be
intermittently worn by a patient; a plurality of electrodes
connectable to the transportable ECG monitor across the plurality
of channels such that the transportable ECG monitor acquires
12-lead ECG data from a patient having the plurality of electrodes
attached thereto; an information management system connected to the
transportable ECG monitor and constructed to receive and process
the 12-lead ECG data, the information management system further
comprising: a communication interface constructed to communicate
processed 12-lead ECG data to a health care provider when a
connection link is established therebetween; and a storage device
constructed to store at least one of acquired and processed 12-lead
ECG data when the communication link is unestablishable during
12-lead ECG data acquisition, the storage device removably
connected to the transportable ECG monitor such that it can engage
a health care provider information acquisition system and
communicate the stored 12-lead ECG data thereto.
50. The system of claim 49 wherein the transportable ECG monitor is
constructed to be turned-on by a patient who is experiencing a
self-diagnosed cardiac condition and turned-off by the patient upon
confirmation from a health care provider that the self-diagnosed
cardiac condition is approximately normal cardiac condition for the
patient.
51. The system of claim 49 wherein the transportable ECG monitor
further comprises a GPS system constructed to communicate an
approximate position of the transportable ECG monitor to the health
care provider upon remote actuation of the GPS system by the health
care provider.
52. The system of claim 49 further comprising a moving video
capture system in communication with the transportable ECG monitor
and constructed to communicate voice and video data to a health
care provider across the information management system concurrently
with the 12-lead ECG data.
53. The system of claim 49 wherein the plurality of electrodes are
self-applied by a patient such that the 12-lead ECG data includes 8
acquired views and 4 derived views from a plurality of signals
received from the plurality of electrodes.
54. The system of claim 49 wherein the transportable ECG monitor is
further configured to prompt the patient if assistance is needed
when the transportable ECG monitor is activated, and if so,
establish communication with the health care facility prior to
acquisition of 12-lead ECG data.
55. The system of claim 49 wherein the health care provider
information acquisition system is constructed to acquire and record
information received from the transportable ECG monitor for at
least one patient diagnosed event.
Description
BACKGROUND OF THE INVENTION
[0001] The invention relates generally to electrocardiograms (ECGs)
and the use thereof, and more particularly to, a method and
apparatus to remotely monitor patients using a portable ECG device
with a wireless communication interface.
[0002] ECG analysis is a well established method for studying the
function of the heart and identifying disorders of the heart. An
ECG is a graphic tracing of the variations and the electrical
potential caused by the excitation of the heart muscle as detected
at the body surface by the leads of the ECG device. A normal
electrocardiogram is a scale or representation that shows
deflections resulting from cardiac activity as changes in the
magnitude of voltage and polarity over time and includes a P-Wave,
a QRS complex, a T-Wave, and a U-Wave. These waves are then
analyzed using a set of rules and parameters to determine what is
normal and what is not. Certain deviations are used to flag
possible complications.
[0003] ECG is an important tool in diagnosing patients presented to
an emergency room with chest pain. One particular disorder that is
studied using ECG is acute cardiac syndromes (ACS), which includes,
but is not limited to, acute myocardial infarction (AMI) and acute
cardiac ischemia (ACI), the latter of which is commonly referred to
as unstable angina. Acute ischemia, or unstable angina, includes
the starvation of oxygen to a portion of the heart, commonly caused
by a partial blockage, and acute infarction is the complete
blockage of oxygen to a portion of the heart. Ischemia can lead to
or be a symptom of myocardial infarction. It is well known that
time is critical in diagnosing these conditions in a patient
experiencing chest pain.
[0004] Unstable angina, or ischemia, is sometimes difficult to
diagnose and differentiate from other causes of chest pain which
are not life threatening. However, since ischemia can lead to AMI,
and since time to treatment is critical once AMI sets in, it is
advantageous to properly diagnose an ischemic patient as soon as
possible. For example, once AMI sets in, the benefit of applying
treatment is reduced significantly when the elapsed time from the
onset of AMI chest pain to treatment exceeds six hours.
Unfortunately, patients often delay in seeking treatment when they
first experience chest pain, which compromises the opportunity that
exists for salvaging the heart muscles affected via treatment, such
as thrombolytic therapy. Further exasperating this problem, studies
have shown that patients who are under the care of a physician,
and/or have previously experienced AMI, delay the most in seeking
care. This may be due to the fact that the patients do not wish to
"bother" the physician for "mild" pain. It may also be due to the
fact that the patients may have had false alarms in the past that
resulted in a long wait at the hospital.
[0005] It would therefore be advantageous if a physician, or health
care provider, could supply a device to this type of patient that
could expedite diagnosis and treatment by alleviating the
embarrassment and time expense of showing up in an emergency
department when in fact, no cardiac problem exists. This could
eliminate not only the time involved in a patient going to the
emergency room for indigestion, but also saves hospital resources
and health insurance costs.
SUMMARY OF THE INVENTION
[0006] A method and apparatus is disclosed to remotely monitor ECG
data from a patient using a portable ECG device with a wireless
communication interface that solves the aforementioned
problems.
[0007] In general, the invention includes the use of a multi-lead,
multi-channel ECG monitor that allows 24-hour surveillance by a
qualified clinician at a central facility, or hospital, of a
patient experiencing symptomatic ischemia without requiring costly
hospitalization. The ECG monitor is coupled with a communications
device that will automatically communicate with the centralized
facility, which may be a hospital, or could be a separate facility
providing a specialized service to a hospital. To provide
simplicity of use, the system should not require the patient to
remember a phone number and require dialing the phone number when
the patient is in the middle of experiencing chest pains, and
preferably, there should be no extra device to plug into a wall
outlet which may be time-consuming and difficult for some patients
when experiencing ischemic symptoms.
[0008] Therefore, in accordance with one aspect of the invention, a
portable ECG apparatus is disclosed that includes an ECG monitor
connected to a plurality of lead wires and a plurality of
transducers, capable of receiving a plurality of ECG signals from
the patient. The ECG wireless communication device is coupled to
receive patient ECG data from the ECG monitor and transmit the
patient ECG data to a health care provider. The wireless
communication interface can include a wireless mobile phone
preconfigured to communicate directly with the health care provider
and transmit voice and ECG data concurrently over a single
connection. Audio communication will assist a clinician to
ascertain the patient's symptoms and guide the patient in use of
the device, if that is necessary. Another implementation for the
wireless communication interface includes the use of an Internet
appliance which has infrared communication capability to
communicate with the remote ECG monitor and transmit data over the
Internet. Transmission of ECG data then can also include video
signals in addition to audio signals.
[0009] In accordance with another aspect of the invention, an ECG
monitoring system is disclosed having a remote ECG monitor with
multiple leads and multiple channels to acquire ECG signals from
the patient. A remote communication and interface is coupled to the
remote ECG monitor to receive the ECG signals from the remote ECG
monitor and transmit the ECG signals over a public communication
system to a centralized facility. A local communication interface
is provided to receive the ECG signals from the public
communications system at the centralized facility. A local ECG
device is located in the centralized facility to connect to the
local communication interface and receive the ECG signals and
provide the ECG signals to a clinician or doctor in human
discernable form.
[0010] In accordance with yet another aspect of the invention, a
method of remotely monitoring ECG data from a patient includes
providing an ECG device to a patient experiencing symptomatic
ischemia for use remotely from a health care facility. The ECG
device has communication capabilities to transmit ECG signals/data
to a centralized facility. The method includes acquiring a
multi-channel ECG from the patient at a location remote from a
health care facility, transmitting the multi-channel ECG to the
centralized facility, and assessing the multi-channel ECG at the
centralized facility by a trained clinician or a doctor. The method
also includes providing instructions to the patient based on the
ECG assessment, which can include dispatching an ambulance in
critical care situations. The method can also include offering
remote interactive assistance in the use of the ECG device, if
requested by the patient. Additionally, the patient's location can
be confirmed if the patient becomes unconscious and the patient's
exact location cannot be confirmed through the remote communication
interface.
[0011] Various other features, objects and advantages of the
present invention will be made apparent from the following detailed
description and the drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] The drawings illustrate one preferred embodiment presently
contemplated for carrying out the invention.
[0013] In the drawings:
[0014] FIG. 1 is a block diagram of an electrocardiogram device
incorporating the apparatus of the present invention.
[0015] FIG. 2 is a high level flow chart depicting an algorithm at
least partially incorporated into the apparatus of FIG. 1 and
showing the method of the present invention.
[0016] FIG. 3 is a functional block diagram of one implementation
of the present invention.
[0017] FIG. 4 is a functional block diagram of another
implementation of the present invention.
[0018] FIG. 5 is a detailed flow chart of an algorithm programmed
into the electrocardiogram device of FIG. 1.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0019] Referring to FIG. 1, an electrocardiograph device 10, in
accordance with the present invention, is shown optionally
connected to an information management system 12 through a
communications link 14. A commonly used device for acquiring an ECG
is a 12-lead ECG, such as the GE Marquette MacVu or Seer-MC
equipped with 12SL.TM.. The ECG device 10 and the information
management system 12 receives power 16 from an external source.
Among other things, the information management system 12 includes a
central processing unit 18 connected to a memory unit, or database,
20 via a data link 22. The memory unit 20 may be RAM, ROM, a mass
storage unit, a floppy disk, or any other computer readable storage
medium, or a combination thereof. The CPU 18 processes data and is
connected to an output, such as printer 24 and/or display 26.
Alternatively, the electrocardiograph 10 can be connected directly
to a printer 24 or display 26 through communications link 14 if the
optional information management system 12 is not utilized.
[0020] The ECG device 10 is connected to a plurality of patient
lead wires 28, each having a transducer 30 to receive ECG signals
from a patient 32 in a known manner. The ECG device 10 has a signal
conditioner 34 that receives the ECG signals and filters noise,
sets thresholds, segregates signals, and provides the appropriate
number of ECG signals for the number of leads 28 to an A/D
converter 36 which converts the analog signals to digital signals
for processing by a microcontroller 38, or any other type of
processing unit. Microcontroller 38 is connected to a memory unit
40, similar to memory unit 20, or any other computer readable
storage medium. In a preferred embodiment, memory unit 40 is a
combination of ROM and RAM, wherein the ROM is used for static
data, such as computer programs, and the RAM is used for dynamic
data, such as the ECG signals received from patient 32.
[0021] A power supply 42 is provided to supply isolated power 44 to
the signal conditioner 34 and the A/D converter 36 and provide an
isolation barrier 46 to isolate the lead wires 28 from un-isolated
power 48 and line voltage 16. Such electrical isolation is
typically provided by a medical grade isolation transformer, an
optical device, or battery operation.
[0022] The ECG device 10 also includes a wireless communication
device, such as wireless phone 50, which may be built into the ECG
device 10, or may be an external module. The wireless phone 50
receives signals 52 from the microcontroller 38 and is capable of
transmitting voice and ECG data 54 concurrently. The wireless phone
50 is powered by the uninsulated power source 48. The wireless
phone may be, what is commonly known as, a cellular phone, a
digital phone, or a multi-mode phone. ECG device 10 can also
include an interactive Internet appliance 56 connected to a
television 58, to provide interactive audio and visual
communication with patient 32. The ECG device 10 includes an
infrared transmitter 60 to communicate with an infrared receiver 62
of the Internet appliance 56. The Internet appliance 56 is also
equipped with an infrared transmitter 64 to communicate with an
infrared receiver 66 of the ECG 10. Operation of this ECG monitor
system will be further described with reference to FIGS. 2-5.
Alternatively, the Internet appliance 56 and television 58 can
equivalently be integrated into a single unit or a personal
computer with an Internet connection could equivalently serve the
function of an "Internet appliance." Generally then, the "Internet
appliance" is any device capable of transmitting such data over an
interconnected communication system, such as the Internet.
[0023] Referring now to FIG. 2, a high level flow chart of the
process 100 and use of a system incorporating the apparatus of FIG.
1 is shown. The process 100 begins with providing an ECG device,
such as that described with reference to FIG. 1, to a patient
experiencing symptomatic ischemia for use remotely from a health
care facility 102. As will be described with further detail with
reference to FIGS. 3 and 4, the ECG device includes communication
capabilities to transmit raw ECG signals, or process ECG data to a
centralized facility. The use of the ECG device starts when the
patient experiences symptoms 104. If the patient is not familiar
with using the device and the overall process 106, 108, the patient
telephones the hospital 110 to acquire step by step instructions
once symptoms appear. It is believed that some patients will need
this service, while others will not. While all patients will
receive instructions when they acquire the ECG device, it is
understandable that once the patient begins to experience the
symptoms of ischemia, the patient may become less likely to
remember the steps and the process. Also, first time users may feel
the need to be given step by step instructions by human
interaction.
[0024] Once this call is initiated 110, a trained clinician will
instruct the patient 112 on attaching the electrodes 114 and
activating the ECG device 116. At this time the process becomes
automated. The ECG signals are then acquired 118 and transmitted to
the centralized facility 120. Alternatively, if the patient is
familiarized with the apparatus and the process 106, 122, the
patient attaches the electrodes 124 and activates the ECG device
126, which then begins to acquire the ECG signals 118 from the
patient at a location remote from the health care facility. The ECG
device then automatically transmits the ECG signals, or the
processed ECG data 120 to the centralized facility, as will be
further described with reference to FIGS. 3-5. It is noted that the
ECG device can transmit either raw ECG signals to be processed
later, or it can process the ECG signals and transmit the results
of the multi-channel ECG.
[0025] The centralized facility then receives the ECG signals or
the ECG processed data 128, and the signals/data are processed at
130. The processing can include either processing the raw ECG
signals to produce a graph of the ECG, or simply decoding the
transmitted processed ECG data. The trained clinician then analyzes
the ECG 132, and if it is clear that there is no cardiac cause for
the symptoms 134, 136, the clinician can rule out a cardiac cause
for this particular episode 138. The clinician then reassures the
patient 140, prints the ECG graph for the patient's file 142 and
instructs the patient to disconnect the electrodes 144. The ECG
device is then disabled and the process is ended at 146.
[0026] However, if the clinician suspects a cardiac cause for the
symptoms the patient is experiencing 134, 148, the clinician can
re-evaluate the ECG graph 150 and print the graph 152 for the
patient's file while simultaneously activating an automatic repeat
feature of the ECG activation and transmission at 154. The
clinician then analyzes the new ECG 156 and determines if the cause
is cardiac related and if care is needed 158. If the cause is
determined not to be cardiac after further ECG acquisitions 158,
160, the clinician can rule out a cardiac cause 138, reassure the
patient 140, print and file the ECG 142 and instruct the patient to
disconnect the electrodes 144 to end the process 146. On the other
hand, if the cause is determined to be cardiac related 158, 162,
the clinician determines whether or not critical care is needed
164. If it is not 166, the clinician instructs the patient to go to
the patient's health care facility 168. The process then concludes
with the patient going to the health care facility 170, 146.
Conversely, if it is determined that critical care is necessary
immediately 164, 172, the centralized facility dispatches an
ambulance 174 to pick up the patient and the system continues to
monitor the ECG of the patient at 176 until the patient arrives at
the hospital 178, which concludes the process 146.
[0027] FIG. 3 shows a block diagram of one embodiment of the
present invention in which a patient 180 is located at a remote
location 182. The patient 180 is shown connected to the portable
ECG device 184, of the present invention to receive multiple
channels of ECG signals from patient 180. The ECG device 184 is
coupled to automatically communicate with a wireless communication
device, in this case, a cellular or digital mobile phone 186. The
mobile phone 186 is connected to the ECG device 184 to receive
patient ECG data and to transmit the patient ECG data through
electromagnetic waves 188 to a centralized health care facility
190. In this manner, both voice 192 and ECG signals 194 can be
communicated in real time, or in very near real time, from the
remote location 182 by electromagnetic waves 188 to the centralized
health care facility 190. This transmission, occurring over a
single connection, is defined herein as being a concurrent voice
and ECG data transmission. The wireless phone 186 can be
constructed integral with the ECG device 184, or it can include
infrared transmitter and receivers to communicate therebetween.
[0028] The centralized health care facility 190 may be a hospital,
a health care provider, or a separate centralized facility
providing a service of monitoring and assessing the ECG results for
hospitals and health care providers and transmitting the results to
the hospital or health care provider 196 through a data line 197.
At the centralized facility 190, a local communication interface
198 includes a phone connection to allow voice transmissions 200
with a doctor/clinician 202, who has access to the patient's file
or chart 204. The local communication interface 198 is also
connected to an ECG and/or an ECG display 206 to process and/or
display an ECG graph. The ECG/display 206 is connected to a printer
208 so that the ECG graph can be printed and placed in the
patient's file 204. The file 204 may be an electronic chart
accessible to the centralized facility 190 and/or a separate health
care provider 196 via data line 197. Similarly, the
doctor/clinician may communicate directly with the health care
provider 196 to alert the health care provider of the results of
the ECG. In accordance with the aforementioned process, the
doctor/clinician 202 can talk with the patient 180 and observe the
patient's ECG waveforms in real time, or in near real time, to
assess the patient's condition. FIG. 3 shows one particular
embodiment for dividing the functions between a centralized
facility 190 and a health care provider 196, however, it is
contemplated that multiple different configurations can be
arranged, each of which are embodied in the appended claims.
[0029] Referring to FIG. 4, a second embodiment of the present
invention is disclosed. Again, patient 180 is connected to the ECG
device 184, of the present invention, which preferably includes a
12-channel ECG device, such as the aforementioned GE Marquette
MacVu or Seer-MC equipped with 12SL.TM.. However, in this
embodiment, the wireless communication device is an interactive
Internet appliance such as an interactive Web TV appliance 210,
capable of allowing voice, video and ECG data transmission through
an interconnected global computer system, such as the Internet 212.
The ECG device 184 and the Web TV appliance 210 transmits data
therebetween through an infrared transmission 214. Accordingly, the
ECG device 184 is equipped with an infrared transmitter and the Web
TV appliance is equipped with an infrared receiver, as described
with reference to FIG. 1. The Web TV appliance 210 can also receive
data instructions from the centralized facility or health care
provider 190 through the Web TV appliance 210. The Web TV appliance
210 is connected to a television 216 to display visual signals 218
and audio signals 220 to patient 180.
[0030] Preferably, the Web TV appliance 210 is equipped with a
video camera 222 and a microphone 224 to receive and transmit audio
and video signals from patient 180 to the centralized facility 190.
In this manner, the processor in the ECG device 184 is programmed
to allow concurrent transmission of ECG data, voice data, and video
data, wherein the video and audio transmissions may be
bi-directional. That is, since the voice, video, and ECG signals
are communicated in real time, or near real time, from the remote
location 182 to the centralized facility 190, which may be a
hospital, the centralized facility 190 is thereby equipped with a
Web computer 226 that is, in turn, connected to a television 228,
also equipped with a microphone 230 and a video camera 232 to
transmit images and audio from a doctor or clinician 240. Similar
to the embodiment of FIG. 3, the doctor or clinician at the
centralized facility 190, FIG. 4, can listen to and talk to the
patient 180 remotely while observing the patient's ECG waveforms.
Also similar to the embodiment of FIG. 3, the ECG/display 206
receives data from the local communication interface 226. If the
data has already been processed, it can go directly to the printer
208, or if the ECG of the centralized facility is processing the
data, the signals go through the ECG 206, then to the printer 208.
The patient's file is then updated 204.
[0031] Referring to FIG. 5, a detailed flow chart of the software
programmed into the portable ECG device is shown. Once the ECG is
initiated 250, the program checks to see if the patient requests
assistance with using the ECG device 252. If so 254, the auto-dial
feature of the mobile phone is initiated or the Web TV interface is
prompted 256, at which time communication is permitted between the
health care provider, or centralized facility, and the patient 258.
Once the assistance is complete 260, or the patient did not require
assistance 252, 262, the ECG signals are acquired 264, processed
266, and prepared for transmission at 268. The desired mode of
transmission is then selected at 270 to allow concurrent
transmission of ECG data and at least voice communication.
[0032] If the Web TV mode is selected 270, 272, the ECG transmits
the data to the Web TV device 274 and allows audiovisual
communication 276. Conversely, if the wireless phone transmission
mode is selected 270, 278, the auto-dial feature is enabled, if not
already connected 280, and the ECG transmits the data at 282,
thereby allowing bi-directional voice communication 284. At this
point, regardless of whether the wireless phone transmission mode
is selected 278 or the Web TV mode is selected 272, the ECG device
is enabled to receive instructions 286 from the centralized
facility. If the ECG is instructed to acquire more data 288, 290
the process is repeated. If not 288, 292, the ECG subroutine is
complete 294.
[0033] Accordingly, the present invention includes an ECG
monitoring system having a remote ECG monitor with multiple leads
and multiple channels to acquire ECG signals from a patient. A
remote communication interface is also provided to receive the ECG
signals from the remote ECG monitor and transmit the ECG signals
over a public communication system to a health care provider or
centralized facility. A local communication interface is provided
at the centralized facility to receive ECG signals from the public
communication system and is connected to a local ECG device to
receive the ECG signals and provide the ECG signals in human
discernable form. The ECG signals can be processed and digitally
analyzed in either the remote ECG monitor, the remote communication
interface, the local communication interface, or the local ECG
device. As previously discussed, the remote communication interface
can either be a wireless phone or an interactive Internet appliance
having a video camera or microphone to allow bi-directional
communication between the patient and the health care provider.
Although it may be considered redundant, an embodiment may include
both.
[0034] The device can also include an information management system
that includes a data link port connectable to maintain ECG
monitoring during patient transport to a health care facility. The
information management system can include a portable computer with
data storage that is downloadable at the health care facility for
recording the ECG data during transit. The information management
system includes a communication system to broadcast ECG data as the
patient is in transit to a health care facility.
[0035] The invention also includes a method of remotely monitoring
ECG data from a patient that includes providing an ECG device to a
patient experiencing symptomatic ischemia for use remotely from a
health care facility. The ECG device includes the aforementioned
communication capabilities to transmit ECG signals/data to a
centralized facility. The method includes acquiring a multi-channel
ECG from the patient at a location remote from a health care
facility and transmitting the multi-channel ECG data to the
centralized facility. After assessing the multi-channel ECG at the
centralized facility, the method includes providing instructions to
the patient based on the assessment. The method can also include
offering remote interactive assistance in the use of the ECG
device, if requested by the patient.
[0036] It is contemplated that the method can be conducted by a
centralized facility as a service to a health care facility. That
is, personnel at the centralized facility can coordinate the ECG
monitoring and advise the health care facility as needed.
Alternatively, the centralized facility can be integrated with the
health care facility. The method also includes repeating the
acquiring, transmitting, and assessing steps, as dictated by the
centralized facility, or health care provider, and if an ECG
assessment results in a determination that immediate medical care
is needed, the method includes dispatching emergency personnel to
the patient. The method can include continuing, acquiring,
transmitting, and assessing the ECG while the patient is in transit
to the health care facility.
[0037] With the use of a Web TV appliance, the centralized facility
can be relatively assured that the patient is located at the
patient's house during use. However, the same cannot be said for
the wireless phone transmission mode. In this instance, the method
can include confirming a location of the patient before dispatching
emergency personnel. This can be done through telephone
communication, but if the patient should experience a heart attack
and become unconscious, an alternative method must be provided. In
this instance, the confirmation step includes receiving a GPS
guidance signal from the ECG device indicative of the location of
the patient. Accordingly, the ECG device optionally includes a GPS
guidance system. The guidance system is initialized by the
centralized facility which sends the GPS initialization signal to
the ECG device, and once received, the ECG device transmits a GPS
guidance signal from the ECG device to a global satellite system,
which in turn, transmits a location of the patient to the
centralized facility.
[0038] The present invention has been described in terms of the
preferred embodiment, and it is recognized that equivalents,
alternatives, and modifications, aside from those expressly stated,
are possible and within the scope of the appending claims.
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