U.S. patent application number 13/401093 was filed with the patent office on 2012-12-27 for network monitoring systems for medical devices.
This patent application is currently assigned to CARDIOPULMONARY CORPORATION. Invention is credited to James W. Biondi, Aaron Fand.
Application Number | 20120331132 13/401093 |
Document ID | / |
Family ID | 25153390 |
Filed Date | 2012-12-27 |
United States Patent
Application |
20120331132 |
Kind Code |
A1 |
Biondi; James W. ; et
al. |
December 27, 2012 |
NETWORK MONITORING SYSTEMS FOR MEDICAL DEVICES
Abstract
A ventilator monitoring system is described for monitoring a
plurality of ventilators. In one embodiment, a server including a
dedicated ventilator application program for each type of
ventilator, monitors a plurality of heterogeneous ventilators over
a wireless network.
Inventors: |
Biondi; James W.; (North
Haven, CT) ; Fand; Aaron; (Cheshire, CT) |
Assignee: |
CARDIOPULMONARY CORPORATION
Milford
CT
|
Family ID: |
25153390 |
Appl. No.: |
13/401093 |
Filed: |
February 21, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10984186 |
Nov 8, 2004 |
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13401093 |
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09791334 |
Feb 23, 2001 |
6839753 |
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10984186 |
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Current U.S.
Class: |
709/224 |
Current CPC
Class: |
G16H 10/60 20180101;
G16H 40/67 20180101; A61M 16/021 20170801; A61B 5/002 20130101;
A61M 16/0051 20130101; A61M 2230/435 20130101; G08B 23/00
20130101 |
Class at
Publication: |
709/224 |
International
Class: |
G06F 15/173 20060101
G06F015/173 |
Claims
1-16. (canceled)
17. A method of polling a medical device attached to a network, the
method comprising: polling the medical device periodically across
the network to obtain a plurality of data values from a message
queue for the medical device; and looping through the plurality of
data values in the message queue, the looping comprising: obtaining
the name for each of the data values; and determining whether each
data value exists, and either creating the data value if no data
value exists or updating the data value if the data value has
changed.
18. The method of claim 1, comprising adjusting the medical device
based on the plurality of data values received.
Description
REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 10/984,186, filed on Nov. 8, 2004, which is a
continuation of U.S. patent application Ser. No. 09/791,334, filed
on Feb. 23, 2001, now U.S. Pat. No. 6,839,753, the entire
disclosures of each of which are hereby incorporated by reference
herein.
TECHNICAL FIELD OF THE INVENTION
[0002] This invention relates in general to network monitoring
systems for medical devices, more particularly, to network
monitoring systems that collect data from heterogeneous devices for
display at a central monitoring station.
BACKGROUND
[0003] Remote medical monitoring systems provide the advantage of
monitoring a plurality of medical devices connected to one or more
patients from a single site. In a health care facility, a single
monitoring system station permits simultaneous monitoring and
interaction with remote medical devices located, for example, in a
patient's hospital room. Network monitoring systems provide uniform
and continuous patient monitoring while reducing the number of
trained health care personnel needed to monitor and interact with
each medical device.
[0004] Remote monitoring systems having numerous disadvantages are
currently used in health care facilities. These prior art systems
typically require manual entry of data into a patient's record.
Waveform data or similar data is typically generated from the
network system as a hard copy and manually entered by cutting and
pasting into the patient's medical record. Manual entry of data
into a patient's medical record is likely to introduce
transcription errors in the patient's medical record.
[0005] Some prior art monitoring systems are capable of monitoring
devices of the same make and model manufactured by the same
company. Typically, health care institutions purchase medical
devices, such as ventilators, from a number of different
manufacturers. As currently known in the field of respiratory
ventilators, in order to monitor a ventilator from a remote
location, a remote monitoring system is required for each
ventilator make and model. Consequently, a monitoring station and
additional personnel are required to monitor each ventilator type.
As a result, efficiency, which would otherwise be introduced by
having a network monitoring system that monitors heterogeneous
ventilators, is diminished.
SUMMARY OF THE INVENTION
[0006] The network monitoring system for medical devices according
to the invention monitors and collects data, such as medical device
settings, measured patient values, alarm conditions, and other
data, from heterogeneous devices and displays the data at a central
monitoring station. The display of collected data uses web
technology so that the data can be displayed on any client computer
connectable to an institution's intranet. In a further embodiment
of the invention, trending data of various patient parameters is
gathered so that users can view the patient's recent history. A log
is kept of the important events that occurred on the medical device
and of important patient parameters to provide diagnostic
information to caregivers such as nurses, technicians, and
physicians.
[0007] In one embodiment of the invention, each medical device has
its own data acquisition service application on a server that
either listens for unsolicited data or actively polls data from the
medical device. These applications are optimized to collect data
and load it into the database quickly. In one embodiment of the
invention, the medical device is a ventilator.
[0008] The database, in one embodiment, is Open Database
Connectivity (ODBC) compliant so that the database is accessible to
the server side web pages. The server side web page provides tables
that store device data, configuration data, customization data and
device-specific data. Queries made to the database in one
embodiment are stored to speed up complicated query functions such
as table joining.
[0009] In one embodiment of the invention, the data obtained by the
data acquisition service application on the server is displayed by
a web browser or a client connected or connectable to a hospital
intranet. Web pages are generated by executing code on the server
using data stored in the database and outputting standard HTML.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is a block diagram of an embodiment of the
invention.
[0011] FIG. 2 is a more detailed block diagram of the embodiment of
the invention shown in FIG. 1.
[0012] FIG. 3 is a diagram of a listener application according to
one embodiment of the invention.
[0013] FIG. 4 is a flow chart of one embodiment of the operation of
the listener application of FIG. 3 according to the invention.
[0014] FIG. 5 is a flow chart of one embodiment of the operation of
the load thread application of FIG. 3 according to the
invention.
[0015] FIG. 6 is a flow chart of the operation of an embodiment of
a parser according to one embodiment of the invention.
[0016] FIG. 7 is a diagram of a pollster application according to
one embodiment of the invention.
[0017] FIG. 8 is a flow chart of the operation of one embodiment of
the pollster application of FIG. 7 according to one embodiment of
the invention.
[0018] FIG. 9 is a flow chart of one embodiment of a connection
request event according to the invention.
[0019] FIG. 10 illustrates embodiments of data tables according to
the invention.
[0020] FIG. 11 illustrates a Matrix View screen display according
to one embodiment of the invention.
[0021] FIG. 12 illustrates a List View screen display according to
one embodiment of the invention.
[0022] FIG. 13 illustrates a Detail View screen display according
to one embodiment of the invention.
DETAILED DESCRIPTION OF THE INVENTION
[0023] In brief overview and referring to FIG. 1, a system
constructed in accordance with the invention includes a medical
device 20 such as a ventilator, connected to a network access
device 26 such as a wireless transceiver. The network access device
26 communicates with a network 30 such as an 802.11 wireless
Ethernet.RTM. local area network. A server 36, such as the
Bernoulli server manufactured by the Cardiopulmonary Corporation
Milford, Conn., executing an application program 50 is also in
communication with the network 30 through a network access point
26' through a router 40 by way of the same network 30 or a
different network 30'. The server 36 communicates with a database
44 and a user accesses information on the server 36 using a browser
48 on a client computer through a network link 30'' which may or
may not be the same as the aforementioned networks 30, 30'.
[0024] In operation, the Bernoulli server 36 requests information
from the medical ventilator 20 generally through the router 40.
Data obtained from the medical ventilator 20 is stored in the
database 44. When a user wishes to access ventilator data from the
medical ventilator 20, the user uses a browser 48 to read the
ventilator files stored in the database 44.
[0025] In more detail and referring also to FIG. 2, in one
embodiment the medical ventilator 20 is connected, via an RS232
serial port, to a network access point 26. The network access point
26 converts the serial RS232 data available from the medical device
20 to a TCP/IP protocol compatible formal for transmission over the
network 30. In one embodiment, the network access device 26
converts the serial data to Ethernet.RTM. data and sends the
Ethernet.RTM. data to an Ethernet.RTM. hub for transmission to the
server 36.
[0026] In another embodiment of the invention, the network access
device 26 is a wireless Ethernet.RTM. transceiver which not only
converts the serial RS232 data to the correct protocol for a
wireless Ethernet.RTM. network but also converts the data to radio
frequency data which is then broadcast generally over a limited
area. The radio frequency data is received by a wireless network
access point 26' which converts the radio frequency data back to
TCP/IP data on a network connection and sends the data to the
appropriate data acquisition application 50 on the server 36.
Conversely, the network access point 26' also converts data from
the server 36 to a wireless TCP/IP protocol which is transmitted
via the wireless network 30 and received by the network access
device 26. The network access device 26 then converts the received
radio frequency information to serial RS232 data for use by the
medical ventilator 20.
[0027] According to the invention, a dedicated data acquisition
application 50 on the server 36 is used for each medical ventilator
type 20. That is, generally each brand of ventilator will have its
own protocol and will have a separate application program 50. Each
data acquisition application 50 is in part a listener program 50'
specifically programmed to communicate with the medical ventilator
type 20. Data acquisition applications 50 that send commands to
prompt for data include what are referred to as pollsters 50''.
Since the listener application 50' and the pollster application
50'' typically are running, in one embodiment they are written as a
service application.
[0028] In one embodiment, according to the invention, referring to
FIG. 3, a listener application 50' listens for data at a known User
datagram protocol/Internet protocol (UDP/IP) port. The UDP protocol
allows the data to go in one direction from the medical device 20
to the server 36 without the need for an established socket
connection. In another embodiment, the time spent listening by the
listener application 50' on the known UDP/IP port is maximized by
using a multithread program execution approach. Referring to FIG.
3, for this embodiment, two threads are utilized: a listen thread
100 waits for data on the network access port 104 and a load thread
108 processes the received data and stores it in the database
44.
[0029] In this embodiment, referring to FIG. 4, the listen thread
waits in STEP 300 for one of three events to occur. The three
events are the shutdown event (STEP 310), the data ready event
(listen for socket data) (STEP 320), and the minute timer event
(STEP 330). The shutdown event (STEP 310) is triggered when the
service Application Protocol Interface (API) requests to shutdown
the listener application (STEP 340). The data ready event (STEP
320) is triggered when data is available on the UDP/IP network port
so that data can be read (STEP 350) and put into a message queue
110 (STEP 360).
[0030] The minute timer event (STEP 330) is unlike the other two
events in that it is a periodic event triggered once per minute.
Each time the minute timer is triggered, the current values or the
configured parameters that are set for the ventilators 20 are
appended to a table of data (STEP 370), the trend data table,
described below, with a time stamp. Any trend data older than a
configured time (for example, a default of 72 hours) is purged from
the trend data table (STEP 380). Also any medical ventilator data
in the active device data table described below older than two
minutes is purged to prevent possible user misinterpretation of the
data. In a particular embodiment of the invention, each time the
minute timer is triggered (STEP 330), there is a check to see if it
is time for a scheduled "snapshot" (STEP 390) of the active data to
be recorded. A "snapshot" is the action of copying all of a medical
device's data from the active data table and placing it into a
snapshot table, described below, with a time stamp. Snapshots are
used to track the medical device state at the time of important
events (STEP 400) for reporting purposes.
[0031] Referring also to FIG. 5, according to the invention, once
the listen thread 100 receives data, the load thread 108 waits for
the data to arrive in the message queue (STEP 410). Once the data
has been received in the message queue, all values are analyzed
from the data (STEP 420) and the name of the value is determined
(STEP 430) If the value exists (STEP 440), and has not changed
(STEP 460), no changes are made and the loop is continued. If the
value does not exist (STEP 440), a value is created (STEP 450) and
the loop is continued. If the value has changed (STEP 460), the
value is updated for the device (STEP 470) and the loop is
continued. After all of the values are processed STEP 420
adjustments are made to the data. If a setting was changed on the
ventilator or an alarm was triggered (STEP 490), all active data is
transferred to the snapshot table with a timestamp (STEP 500). In
one embodiment, an alert is sent by Simple Mail Transport Protocol
(SMTP) or telephony (STEP 521) to a remote device such as a pager.
After all processing is finished, the Just_Changed_flags are
cleared (STEP 531).
[0032] In more detail once the message is received by the listen
thread, the individual medical ventilator values are parsed out of
the data stream by the parser 60 (FIG. 2). Referring also to FIG.
6, in one embodiment, for example, data received from the medical
ventilator 20 (STEP 415) includes a single line with four ASCII
values separated by spaces and terminated with a carriage return
("500 020 030 004"). The name of each value is determined (STEP
600; STEP 601; STEP 602; STEP 603) by using the data protocol of
the medical ventilator, for loading into the active data table of
the database 44.
[0033] The data response may contain for example, tidal volume,
oxygen setting, a high pressure limit and an inspiration time and
may be associated with the following database names: chTV, stFI02,
stPPAWhi, stITIME. The database names and the medical device
identification, for example, DevA, are used as keys in the active
data table described below. According to this embodiment of the
invention, the first row to be added to the database in the active
data table (STEP 650) in the above example is: DevA, chTV, 500. A
new row is created in the active data table for the device value if
the device value does not already exist (STEP 440). No changes are
made if the device value is the same as the one already in the
table. The device value is only updated (STEP 470) if it is
different from the value already in the table (STEP 460).
[0034] Any adjustments (STEP 480) to the device 20 that need to be
made are done once all the data has been parsed and loaded.
Examples of adjustments (STEP 480) include scaling the inspiration
time down to hundredths of seconds. If the adjustment requires
checking the values of multiple parameters, a temporary device
value name may be used when loading this data. The adjustment
process stores the value into the final device data name to avoid
flickering in the displays. For example, the adjustment process
might load the inspiration time value of 004 with the temporary
name of sxITIME during the loading process (STEP 603), check the
ventilation mode value (STEP 604), and if Mode=Pressure, save the
value of 0.04 with the stITIME name during the adjustment process
(STEP 605).
[0035] According to one embodiment of the invention, the monitoring
application 50 can request that data be sent by the ventilator 20
using a pollster application or pollster portion 50'' of the device
application 50. The pollster application 50'' sends commands 64 to
the medical device 20 over TCP/IP socket connections to elicit data
responses. The socket connections are tracked in a connection list
so that the connection can be held open from command to command.
The pollster application waits for connection request at a
predefined or well known TCP/IP port. When the medical device 20
sends a connection request to that port, the pollster application
50'' makes the connection by way of another random port using the
standard TCP/IP "accept" functionality.
[0036] In one embodiment of this application, referring to FIG. 7,
the dual thread approach is also used. A polling thread 400 and a
load thread 410 are executing in the pollster application 50''.
Referring to FIG. 8, in one embodiment of the invention, the
polling thread waits (STEP 600) for one of five events to occur.
The first three of the five events are the same as in the listen
thread described above: the shutdown event, data ready event
(listen socket data), and minute timer event.
[0037] In this embodiment, referring to FIG. 8, the polling thread
waits in STEP 609 for one of the five events to occur. The shut
down event (STEP 610) is triggered, like in the listen thread
described above, when the service Applications Protocol Interface
(API) requests to shutdown the polling application (STEP 640). The
data ready event (STEP 620) is triggered either when data to be
read is available on the UDP/IP port or when there is notification
that the socket connection has been broken (STEP 627). When data is
available to be read (STEP 651), the data is appended to the
message queue (STEP 660).
[0038] The minute timer event (STEP 630) is a periodic event
triggered once per minute. Each time the minute timer is triggered,
the current values or the configured parameters are appended to a
table of data (STEP 670), the trend data table described below,
with a time stamp. Any trend data older than a configured time (for
example, default of 72 hours) is purged from the trend data table
(STEP 680). Also any device data in the active device data table,
described below, older than two minutes is purged to prevent
possible user misinterpretation of the data. In a particular
embodiment of the invention, each time the minute timer is
triggered, there is a check to determine if it is time for a
scheduled "snapshot" of the active data to be recorded (STEP 690).
Snapshots are used to track the medical ventilator state at the
time of imported events (STEP 700) for reporting purposes.
[0039] Referring also to FIG. 9, in addition, the polling thread
400 also waits (STEP 595) for a connection request event (STEP 615)
(connect socket data) and a polling event (polling timer) (STEP
635). The connection request event (STEP 615) is triggered when a
medical ventilator 20 requests a socket connection using the well
known TCP/IP Port for this specific application 50'' (STEP 612).
The connection, once made, is stored in a connection list (STEP
625). A new entry is made in a device list table in the database 44
the first time that a response is received by the application
program 50 from a ventilator. The medical ventilator's IP address
is used to create a unique medical device identification in the
table. Commands or polls are sent to each established connection
once per second (STEP 635).
[0040] The polling event is triggered ten times a second so that
commands (polls) can be spaced apart in a random pattern to reduce
the possibility that many requests will be sent by the various
application programs at the same time thereby interfering with
access to the network. Commands are not sent if the data response
from the device (STEP 655) has not been received from the last
command sent. The connection stops waiting after three such missed
poll events and then is closed.
[0041] Referring now to FIG. 10, in more detail, there are four
different types of tables in the database: Device Data Tables 500,
Device Configuration Tables 510, Customization Tables 520, and
DeviceSpecific Tables 530. The Device Data tables 500 hold data
acquired from the medical devices 20. There are tables for holding
the latest device values 502, device snapshot information 504,
trending data 506, and a record of setting changes and alarm events
508. A Just_Changed_flag 509 is set (STEP 531) within the table row
when data is updated in the device data table. This flag 509 allows
queries to determine if either a setting has just changed or alarm
condition has just occurred. When one of these conditions is met, a
snapshot of the active data is saved into the snapshot table 504
(STEPS 400 or 700, FIGS. 4 and 8, respectively). A new entry is
appended to the log of events table 508 marking this event. Remote
alerts can be sent (STEP 521) to numeric or alphanumeric pagers
when specific alarms occur. The alarming medical ventilator 20 is
associated with a patient and the patient is associated with a
pager before a remote alert can be sent. The Just_Changed_flag 509
is cleared (STEP 531) for all the active device data after all of
the checks have been made.
[0042] The Device Configuration tables 510 store the information
about the institution like the list of beds, patients, users, etc.
The history 512 of the mappings of devices, beds, and patients is
stored in the configuration table. This table is important when
recovering patient information after changes have been made. The
Customization tables 520 hold information that controls the
appearance of most of the user interface. All customizations are
stored together to facilitate future expansion of the system.
Customizations are organized by Group 522, Subgroup 524, and
DeviceType 526. The customizations are stored in fields that have
generic names (Param1, Param2 . . . ) so the database form used to
enter the data must operate in conjunction with the web page that
runs the query in order to correctly interpret the values. The
DeviceSpecific tables 530 store information specific to a medical
device type used for data acquisition. There are tables to mark the
values that are to be trended 532 and tables to hold the
descriptions of alarms, settings, and measured values 534.
[0043] Data is extracted from the database 44 using Queries.
Queries have been developed to speed the cases where these tables
must be joined to access the data. For example, there is a query
that combines the header information in the Snapshot table with the
data in the Snapshot Data table. Queries are also used to hold
business rules like determining when to take a snapshot because an
alarm condition has just occurred. There are some stored
procedures, or action queries depending on the database technology,
used to manage the TrendData table.
[0044] Queries are made to the system through the web software 71.
In one embodiment, for example, there are three main parts of the
user interface 70: Monitoring, Reporting, and Administration. These
functions are displayed as `Monitor`, `Report`, and `Administer`
buttons, respectively, at the bottom right side of the screen. The
Monitor screen, for example, is arranged to allow the user to view
information on all patient beds, or groups of patient beds,
simultaneously, with the option to view more detailed information
on any individual patient bed. The Monitor screen provides
information such as patient settings, measured values, and alarm
values. The Report screen, for example, allows the user to choose
from Trends, Log of Events, Snapshots, etc. to view. After one of
these reports is chosen, the user is taken through a series of
screens to set up the parameters necessary to see the specified
report. The Administration screen, for example, allows the user to
add, remove, or change the status of patients and medical devices
on the network.
[0045] In more detail, three different views are available to the
user through the Monitor screen: the matrix view 750, the list view
760, and the details view 770. Referring to FIG. 11, in one
embodiment Matrix View screen 750 is primarily used at a central
monitoring station. This screen 750 is filled with a matrix
displaying the status of all configured beds 751a-751n, generally
751, including beds without assigned patients. The number of
columns in this matrix may be adjusted for optimal viewing. In one
embodiment, no more than twenty beds 751 are displayed on the
screen 750 at once. If there are more configured beds 751 than can
fit on the screen, then tabs (not shown) will appear on the screen
to select from configured groups of beds; e.g., view all of the
NICU beds, SICU beds, or Step Down beds. In one embodiment, the
user interface 70 is a web page.
[0046] Each bed 751 is displayed in its own web frame cell
752a-752n (generally 752) with a border, and parameter settings are
displayed if there is an assigned patient and medical ventilator.
In one embodiment, the displayed information as well as the border
color is medical ventilator dependent. The server side code looks
in the customization tables 520 for information about which device
data to display for the assigned medical ventilator. This
information includes for example, titles, units, and most
importantly the data name in the vent data table. The device data
is then looked up in the vent data table, combined with the title
and units, and then sent to the client web browser 48. In a
particular embodiment, if there is an alarm condition on the
device, the border will change to bright red and the text of the
alarm will be displayed. In a further embodiment, if the alarms
have not been silenced on the device, an audible alarm will sound.
The contents of each bed web frame 752 are refreshed every two
seconds.
[0047] Whereas the matrix view web page 750 with its multiple
frames and frequent refreshes requires more bandwidth than is
commonly available over dialup lines, the list view web page 760,
illustrated in FIG. 12, is optimized for slow connections. In one
embodiment, the list view page 760 has a single frame displaying
information only about the active beds 751. Much more information
is displayed for each bed 751 in the list view 760 as compared to
the matrix view 750, which reduces the need to go to the details
view 770. The user is able to display a more detailed view by
clicking on the bed title, which splits the screen in the same way
as the matrix view.
[0048] If the user clicks anywhere within a web frame cell 752 on
the matrix view web page 750, i.e. selects a patient bed 751, then
a web page 760 with two different sections will appear. In one
embodiment, the top section of the screen will display a small
version of the matrix view web page 750 while the bottom section
will display detailed information about the selected bed.
[0049] The detailed view web page 770, illustrated in FIG. 13, for
example, is divided into five different sections: title, settings,
simple settings, other measurements, and alarms. The title section
identifies the bed and patient and has the ability to send an alert
to a remote user, allow the user to view this detail section 770 as
a full screen, or to print the page.
[0050] In one embodiment of the detailed view 770, the settings
section is generally set up as a table with five rows: Primary
Setting, Secondary Setting (if supported by the medical device),
High Alarm Limit, Measurement, Low Alarm Limit. Each primary
setting is labeled with a title and units. If the medical device
has dual modes, then the secondary settings are displayed below the
primary settings. Each column shows information about one setting
with any related measured value and alarm limit. The alarms and
measurements are displayed proportionally to the maximum setting
value. If the measured value is outside the alarm limit, then the
alarm background will be highlighted in red to draw attention to
it. Three rows will be used if there is no maximum value set for
the setting and no secondary settings.
[0051] The simple settings section displays those settings that
have no related alarm limits or measured values. Also included in
this section is a summary wrap-up of the apnea settings when
displaying data from a ventilator device 20. The Other Measurements
section displays those measured values that have no related alarm
limits or settings. The Alarms section displays the current medical
device alarm conditions.
[0052] Information may be accessed as a report. The reporting
system provides the maximum amount of flexibility for adding,
modifying, and removing individual reports. Reports are web pages
that may require a number of parameters such as the patient
identification. The customization tables in the database are used
extensively to store navigational information. The starting screen
of the report navigation is the list of available reports obtained
from the database; e.g., Snapshots, Flowsheets, Trends, Log of
Events, and Log of Remote Alerts. The user is always able to get
back to this starting screen by clicking on the Begin button on the
top of the screen.
[0053] The customization table holds the order of report parameter
web pages for each report. When the user selects a report, the
server side uses the customization table to determine to display
either one of the report parameter web pages or the report web page
itself. These pages allow the user to specify the value of a
parameter such as patient, bed, or time range. So if the report is
only for an individual patient, the patient parameter page will
display only the list of patients with their assigned beds that
have data for the report. The time range parameter page sets both a
start and end time defaulting to the last twelve hours of data. All
times are to be bounded by date range in the data itself. The user
is able to directly enter dates by typing on the keyboard or click
on a set of buttons to adjust by day, hour or minute. There are
buttons to go back to the "last" twelve hours, move the range
twelve hours ahead or behind. Other parameter pages may be
developed specifically for a given report. The value of each
parameter is stored as a session variable on the server. The
session variable also stores the value of current "step" in the
order of parameters. The current step is decremented when the user
clicks on the Back button and the appropriate parameter page is
displayed.
[0054] Although the reporting system is built to be extensible,
there are a few reports considered to be standard. The Snapshot
report shows a detailed summary of the state of a medical
ventilator 20 at the time of a triggering event. The user must
first select a patient. Then a time range is used to create a
filtered list of snapshot reports for the patient. The user then
chooses from this list to display all of the measured values,
settings, and alarms at the time of the snapshot.
[0055] The Event Log report displays all of the important events
that have occurred for a patient over a specified time frame. The
user first must select a patient and time range for the report.
Then there are several specific options for snapshot reports
including different event filters, report pagination and sort
order. Finally the report is displayed detailing all of the setting
changes, alarm conditions and clinician interventions.
[0056] The Trend report is a graphical line chart showing the
movement of measured values. The user first must select a patient
and time range for the report. Then the report is displayed with a
separate line chart for each trend parameter. The user can choose
to magnify the size of individual trend parameter charts.
[0057] These reports process the raw collected data into diagnostic
information using "smart" software. A series of
institution-specific hierarchical alarms may be viewed for each
patient, in which the most critical alarm is ranked first, followed
by each alarm in order of importance. As an example, new alarms
will be created that may not be present on the medical device. Such
an example might consist of a high tidal volume alarm for a
ventilator that does not have one built-in. Clinicians often
compare parameters in the context of other parameters when making a
clinical decision. This decision making process is encapsulated
into a rules-based system with the collected clinical signs and key
respiratory data as input and suggested decisions as output. The
result is an indicator suggesting whether or not the patient is
progressing towards the need for clinical intervention. These
results will be combined together into a triage report ranking
patients by their clinical progress.
[0058] The administration pages are used to manage the assignment
of medical devices to beds with patients. This administration
starts with the display of all current associations and the list of
unassigned medical devices. The user will be able to click on a
button to admit a patient, edit a patient, move a patient and
medical device, disconnect a medical device, or swap a medical
device. These actions require a number of steps where the user will
make selections. The values of these selections are stored in
session variables until it is possible to perform the action. The
user will be able to cancel the action or move backwards by one
step.
[0059] The user can choose to admit a patient. The user must
provide the patient name along with an optional medical record
number and comment. The user then selects the bed from the list of
unassigned, available beds. The user selects the medical device
from the list of unassigned medical devices. The patient, bed, and
medical device are all assigned to each other after these
selections have been made.
[0060] The user can choose to edit the information about a patient.
The user must first select the patient to edit. Then the selected
patient's information will be presented in an editable format. When
the user finishes, the changes will be made.
[0061] The user can choose to dissociate the patient from the bed,
where the patient may remain in the bed but is no longer connected
to the medical device. Once the user selects the patient, the
patient will be unassigned from the bed and medical device. This
association is remembered in the database. The institution can
elect to purge the data tables for this association from the
database at this point or move them into an archive database.
[0062] The user can choose to move the patient to another bed. The
user first selects the patient to be moved from a list of assigned
beds. Then the destination bed is chosen from the list of
unassigned beds. The user can also choose to swap a currently
assigned medical device with an unassigned medical device. This may
be necessary when preventative maintenance is performed. The user
first selects the patient to move from a list of assigned beds.
Then an unassigned medical device is selected from the list of
unassigned medical devices.
[0063] Requiring the user to log on before sensitive data is
displayed on the web pages insures patient confidentiality. There
is an option button to increase the level of data access in the
administration section. A log on screen is displayed when the user
requests a high data access level for the current web session. The
logon screen requires certain information from the user in order to
obtain patient information.
[0064] A set of monitoring pages are available specially formatted
for viewing on web browsers of handheld mobile devices. The main
requirement is that these mobile devices have small displays with
tall aspect ratios. The user will be able to display a modified
list view.
[0065] There are cases when a clinician signature is required to
validate that the snapshot data shown on the handheld mobile device
was compared to the data displayed on the medical device 20. This
requires a clinician to be in possession of a handheld mobile
device and be physically present at a patient's bedside. There are
special screens on the handheld mobile device that may be viewed
only by logged on users. These screens on the handheld mobile
device display the device data to the user who then directly
compares this data to that on the medical device. If everything
matches, then the user can initiate a manual snapshot of the data
which includes his or her signoff signature.
[0066] All of the data from the medical devices connected to a
patient acquired by the network monitoring system and reports can
be stored electronically as part of the patient's medical record.
Alternatively, a hard-copy printout of the data can be included
with the patient's permanent medical record.
[0067] While the present invention has been described in terms of
certain exemplary preferred embodiments, it will be readily
understood and appreciated by one of ordinary skill in the art that
it is not so limited, and that many additions, deletions and
modifications to the preferred embodiments may be made within the
scope of the invention as hereafter claimed. Accordingly, the scope
of the invention is limited only by the scope of the appended
claims.
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