U.S. patent application number 13/554819 was filed with the patent office on 2013-05-09 for medical device with communication, measurement and data functions.
The applicant listed for this patent is Clive Smith. Invention is credited to Clive Smith.
Application Number | 20130116513 13/554819 |
Document ID | / |
Family ID | 39182274 |
Filed Date | 2013-05-09 |
United States Patent
Application |
20130116513 |
Kind Code |
A1 |
Smith; Clive |
May 9, 2013 |
MEDICAL DEVICE WITH COMMUNICATION, MEASUREMENT AND DATA
FUNCTIONS
Abstract
A medical diagnostic and communications apparatus with audio
output comprises an electronic processor for processing stethoscope
signals and secondary audio signals. An electronic stethoscope
sensor is contained within a housing for transducing body sounds to
electronic signals, and is operatively connected to the electronic
processor. One or more secondary audio signal sources operatively
connects to the electronic processor. A common audio output is
connected to electronic processor to convert electronic stethoscope
signals or secondary audio signals to acoustic output. These sounds
may be produced separately or mixed.
Inventors: |
Smith; Clive; (Englewood,
CO) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Smith; Clive |
Englewood |
CO |
US |
|
|
Family ID: |
39182274 |
Appl. No.: |
13/554819 |
Filed: |
July 20, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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12075965 |
Mar 14, 2008 |
8243940 |
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13554819 |
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09412140 |
Oct 5, 1999 |
7346174 |
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12075965 |
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60103018 |
Oct 5, 1998 |
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Current U.S.
Class: |
600/301 ;
600/586 |
Current CPC
Class: |
A61B 2560/0462 20130101;
A61B 2560/0468 20130101; A61B 5/7232 20130101; G16H 40/63 20180101;
A61B 2560/0295 20130101; A61B 5/742 20130101; A61B 2560/0406
20130101; A61B 5/02055 20130101; A61B 7/04 20130101; A61B 2560/0431
20130101; A61B 7/026 20130101 |
Class at
Publication: |
600/301 ;
600/586 |
International
Class: |
A61B 7/04 20060101
A61B007/04; A61B 5/0205 20060101 A61B005/0205 |
Claims
1. A medical diagnostic and communications apparatus with audio
output comprising: electronic processing means for processing
stethoscope signals and secondary audio signals; an electronic
stethoscope sensing means contained within a housing for
transducing body sounds to electronic signals, operatively
connected to the electronic processing means; one or more secondary
audio signal sources operatively connected to electronic processing
means; common audio output means connected to electronic processing
means to convert electronic stethoscope signals or secondary audio
signals to acoustic output, said sounds being produced separately
or mixed.
2. A medical diagnostic and communications apparatus as in claim 1,
wherein secondary audio signals are generated by one or more audio
signal sources selected from the following: microphone connected to
the electronic processing means; digital voice recorder and
playback means; speech recognition recorder and playback means;
audio signals converted from the receiver of a wireless digital
communications means; audio signals converted from cellular
telephone communications means; data-to-speech conversion means
wherein physiological measurements are converted to speech;
data-to-speech conversion means wherein diagnostic analysis results
are converted to speech; data-to-speech conversion means wherein
medical information is converted to speech; auscultation signal
reference recording memory comprising a multitude of medical
conditions and associated auscultation sounds;
3. A medical diagnostic and communications apparatus as in claim 2,
wherein secondary audio sources are contained within the same
housing as the stethoscope sensing means.
4. A medical diagnostic and communications apparatus as in claim 1,
further comprising physiological measurement means which produce
physiological measurement results, the results being converted to
speech for output via the common audio output means.
5. A medical diagnostic and communications apparatus as in claim 4
wherein the physiological measurement means perform physiological
measurements selected from one or more of the following: blood
oxygen level; blood glucose level; blood pressure; body
temperature; heart rate as derived from electronic stethoscope
sensor signal; EKG measurement; ultrasonic measurement.
6. A medical diagnostic and communications apparatus as in claim 2
further comprising means for selecting one of a multitude of
languages to be used for generated speech output.
7. A medical diagnostic and communications apparatus as in claim 2
wherein the medical information comprises pharmaceutical dosage and
drug interaction data.
8. A medical diagnostic and communications apparatus as in claim 1
further including a wireless pager means.
9. A medical diagnostic and communications apparatus as in claim 1
further including a microphone and speech recognition means.
10. A medical diagnostic and communications apparatus as in claim 1
further including radio frequency wireless digital communications
means.
11. A medical diagnostic and communications apparatus as in claim 1
further containing image sensor means.
12. A medical diagnostic and communications apparatus as in claim 1
further including display means.
13. A medical diagnostic and communications apparatus as in claim
12 further including magnifying means for magnifying the display
means
14. A medical diagnostic and communications apparatus as in claim 1
wherein the electronic processing means includes digital memory
means for storing software programs downloaded via digital
communications means.
15. A medical diagnostic and communications apparatus as in claim 1
wherein the electronic processing means comprises a handheld
digital computer.
16. A medical diagnostic and communications apparatus as in claim
15, further containing wireless digital communications means to
access remote medical information storage and retrieval means.
17. A medical diagnostic and communications apparatus comprising an
electronic stethoscope sensor physically attached via mounting
means to, and operatively connected to, electronic processing means
comprising a handheld computer containing audio driver means for
processing and producing stethoscope sounds from said sensor.
18. A medical measurement and communications apparatus comprising
an ultrasonic measurement sensor operatively connected to
electronic processing means comprising a handheld computer
containing display means for displaying images processed from said
sensor.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 12/075,965 filed Mar. 14, 2008, which is a
continuation of U.S. patent application Ser. No. 09/412,140, filed
Oct. 5, 1999 (to issue as a patent on Mar. 18, 2008), which is
based on U.S. Provisional Patent Application No. 60/103,018 filed
Oct. 5, 1998, all of which are incorporated herein by reference in
their entirety.
FIELD AND BACKGROUND OF THE INVENTION
[0002] The present invention relates to a medical communications,
information and measurement device with multiple functions built
into the same unit, to produce a portable device. The preferred
embodiment is in the form of a stethoscope-like device with
expanded, general-purpose medical measurement, information and
communications functions, beyond the basic auscultation functions.
However the invention is not restricted to such a configuration,
and may also be built in the form of an information and
communications device without sensing or measurement capability.
The invention can also be built in a form suited to other work
environments outside the medical field, where the combination of
functions is also beneficial. The invention also covers methods for
accessing medical and other information and digital data via a
portable device. The benefits of the invention relate to the
integration of digital wireless communications and information
access in the work environment, using user-friendly interface
methods, in order to make information retrieval, information
management, and communications an integral part of work
process.
[0003] A problem encountered by medical workers is that many
measurement and information means used in their work are not
portable, or are inconvenient to integrate into the work flow,
requiring the worker to divert attention from the patient or move
from the patient bedside to access the information or measurement
means. Computers are provided for patient and medical information,
but these are usually fixed in specific locations. When such means
are portable, they are embodied in discrete devices which are
single-purpose, rather than being embodied in a convenient,
combined or integrated means for use and portability. For example,
a pager is convenient to carry, but provides only a single
function. The same applies to cell phones, stethoscopes, blood
pressure cuffs, oximeters, and nonmechanical information devices
such as books, journals and reference materials. All of these
devices are discrete, and single-purpose, and require the worker to
carry multiple devices or use differing means for accessing
information, making measurements or performing communications and
recording tasks.
[0004] Stethoscopes are carried by almost every physician, nurse or
medical worker during working hours. Stethoscopes have been limited
to specific functions--primarily auscultation and blood pressure
measurement. The majority of stethoscopes are mechanical devices,
however a number of electronic versions have been reported, with
some communications capability, limited to the transmission of
auscultation sounds via infrared or telephone. Some electronic
stethoscopes have included some additional measurement capability,
such as heart rate or time interval measurements.
[0005] However, the transition from a mechanical to an electronic
stethoscope introduces the potential to expand the functionality of
the stethoscope, using it as a more general-purpose electronic
platform for other functions that are useful to the medical worker.
The form factor of the stethoscope allows it to be worn comfortably
around the neck or shoulders, and the audio input and output
functions can be used for other applications beyond auscultation.
The fact that it is carried around so extensively in the medical
setting makes it an ideal platform for many additional functions of
an electronic nature.
[0006] While the descriptions herein describe the use of the
invention in a medical setting, the invention is not limited to
medical applications. The same combination of elements described
herein may be used in various other applications. While then
preferred embodiment includes a stethoscopes function, other
embodiments of the invention may include other elements of the
invention, and omit the stethoscope function. The underlying
structure of the invention, and the methods associated therewith,
concern the advantages obtained by combining various elements to
form a system that is easier to use and provides new functions and
methods as part of the work flow, that were not previously
practical or simple.
SUMMARY OF THE INVENTION
[0007] The present invention addresses the problem of multiple
devices in the workplace, and exploits the potential for a unified
electronic platform with integrated digital functions, by embedding
different functions into a single device. The preferred embodiment
is in the form of a stethoscope to be used in the medical work
environment. A key innovation is the transformation of the
stethoscope into a multiple-use device. In a more general sense,
the benefit of the invention is to bring information, measurement
and communications technology into the work flow. This is
especially of value in medicine, where the use of computers and
other electronic equipment, especially of an informational and data
processing nature, is a diversion from the patient or the
bedside.
[0008] Stethoscopes have been reported that have infrared
communications, PC communications, and telephonic communications.
However, the purpose of these links is primarily to transfer
auscultation information i.e. for remote listening or recording of
sounds. The present invention goes beyond these limitations to
include new communications, storage and processing functionality,
for the transfer, storage and processing of data besides
auscultation sounds, and the local storage of data and information
that is of a more general nature. Examples of such information
include, but are not limited to; patient records including but not
limited to patient history, sounds and images; pharmaceutical
databases including but not limited to drug dosage and drug
interactions; medical research information including but not
limited to reference sounds, diagnoses, images, and research
results; insurance claim, policy and benefit information; and
billing information. These data can be stored locally on the
device, or communicated via the communications links embedded in
the invention. The communications capability includes, but is not
limited to, wireless, infrared, and cabled connections to
telephones, telephone systems, computer networks, and the
Internet.
[0009] Finally, the user interface of the present invention
introduces novel features and methods not previously associated
with stethoscopes or information access and communications devices
in general, including voice recognition, speech recognition,
data-to-speech, text-to-speech, and audio prompting. Such
user-friendly interfacing is a key innovation for a portable
device, where small keyboards and pen input have been the rule.
[0010] When the embodiment excludes the stethoscope function, the
invention may comprise other elements for medical and other
information communications, storage and processing. The invention
then provides the worker with convenient user interface,
communications and processing capability.
[0011] The invention comprises both a device, or physical
embodiment, and methods associated with the use of the device in a
wider system.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] FIG. 1 is a block diagram of the major functions and
sub-systems of the device of the invention;
[0013] FIG. 2 is a block diagram showing the audio mixing of
auscultation sounds and alternate audio sources;
[0014] FIG. 3 shows one physical embodiment of the device with
integration of multiple functions housed in a single device;
[0015] FIG. 4 shows a binocular virtual display means built into
the stethoscope headphone assembly; and
[0016] FIG. 5 shows communications and data access methods and
functions.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0017] The invention consists of a device comprising a number of
sub-systems, with each sub-system comprising certain elements,
which are operationally connected. The uniqueness of the invention
does not require that all sub-systems and elements exist together
in the device, since the invention may comprise a subset of the
elements described herein. Beyond an actual device, the invention
also includes methods, such methods being steps for processing
signals, data and information. Those aspects of the invention that
comprise methods, typically include the device as an integral part
of the method i.e. the device is used in conjunction with other
devices (such as computers or telecommunications systems), using a
sequence of steps, to form an original procedure or method.
[0018] The major sub-systems of the device, as shown in FIG. 1 are:
[0019] (a) A Sensor sub-system (101). [0020] (b) An Electronics
Processing sub-system (102). [0021] (c) A User Input sub-system
(103). [0022] (d) A Communications sub-system (104). [0023] (e) An
Output/Display sub-system (105).
[0024] The sub-systems and their elements are:
[0025] Sensor Sub-System 101:
[0026] The Sensor sub-system 101 comprises one or more of the
following elements: [0027] (a) Stethoscope sensor 110, to sense
body sounds. [0028] (b) Pulse Oximetry sensor 111 to sense blood
oxygen level. [0029] (c) Temperature sensor 112 to detect body
temperature. [0030] (d) One or more additional sensors (113) to
sense other measurements. All of these sensors have in common the
capability to make measurements of external phenomena of a physical
or physiological nature. Examples include electrocardiography
electrodes, glucose measurement means, an ultrasound probe, a video
camera or a barcode scanner for reading labels.
[0031] One or more of the above sensors is operationally connected
to the electronics processing sub-system 102 and sensed
measurements are transferred to the Electronics Processing
sub-system 102 for further processing. In the preferred embodiment,
the stethoscope or auscultation sensor is present, however this may
be replaced be another sensor, used in addition to other sensors,
or the sensor sub-system may be absent, making the invention an
information and/or communications device without sensing
capability.
[0032] User Input Sub-System 103:
[0033] The User Input sub-system 103 provides the operator with
control of the electronics processing subsystem 102. This may be
done via a plurality of control means. Specifically, the User Input
sub-system consists of one or more of the following elements:
[0034] (a) Microphone 130 for voice input. This microphone is
distinct from the stethoscope microphone and is used for voice
input from the user in the preferred embodiment. However, the
microphone may be the same device used for auscultation. [0035] (b)
Rotary thumbwheel 131, with optional built in push-button
mechanism. In the preferred embodiment, the rotary device is a
digital input device which produces pulses in conjunction with
additional or embedded circuitry when rotated, but an analog
potentiometer may also be used. In the case of the digital
thumbwheel, the wheel may be rotated through 360 degrees. Inputs
from the rotary device are correlated with control or menu
selections. As the rotary device is actuated, feedback may be
provided to the user via audio output or spoken voice to confirm a
selection. [0036] (c) Keypad, touchscreen or individual buttons
132.
[0037] The above input devices allow the user to enter voice
information or commands, use a rotary switch for volume, menu
selections or other entries, or push buttons, pen or touch to enter
selections. The preferred embodiment includes one or more of these
control methods.
[0038] The microphone is used for voice or speech input. Voice or
speech input is used in the following manner, and becomes an
integral part of the steps that form many of the methods of the
invention:
[0039] Voice is recorded as raw or compressed sound signals, for
later transmission, storage, or transcription, such as for medical
record-keeping. Voice recognition is performed, for the purposes of
user identification. Voice signals are processed and recognized in
the device itself, using software and data within the device, or
voice may be pre-processed, and voice recognition performed by a
remote system. A remote system is defined as a system that is not
part of the device, and with which the device communicates via the
Communications sub-system. Thus remote voice recognition comprises
the steps of recording the voice digitally, optionally
pre-processing the sounds, transmitting the signal digitally to a
remote system, the remote system containing voice recognition
means. The results are then transmitted back to the device.
[0040] To perform speech recognition, for the purposes of control
and data entry. The speech sounds are processed locally or in a
remote system, being converted to commands or data, either locally
or remotely. The method is analogous to the voice recognition
process, except that semantics (meaning, commands or data) are
derived from the speech signal.
[0041] Electronic Processing Sub-System 102:
[0042] The Electronic Processing sub-system 102, provides hardware,
firmware, software and storage functionality, and is operationally
connected to the Sensor subsystem 101, User Input sub-system 103,
Communications sub-system 104, or Output/Display sub-system 105.
The Electronic Processing sub-system consists of one or more of the
following elements: [0043] (a) Central Processor/Digital Signal
Processor 120, which controls the system and processes data,
measurement signals and information. The central processor may
optionally include means for going into a standby power-saving mode
or low clock-speed mode, although this is not required for the
invention to operate. [0044] (b) Digital Memory 121, which stores
programs (software), voice information, voice recordings, medical
data, databases, measurements, reference measurement information,
reference voice information, and other data necessary for system
operations. Specifically, the data stored may include voice
recognition data to identify the user or owner of the device;
speech recognition data to identify voice commands so that the
device may respond to voice commands; data-to-speech and
text-to-speech tables and data in order to convert data and text to
speech output; patient data including auscultation sounds, patient
history, patient image data; pharmaceutical data including dosage
data or drug interaction data; medical research statistics and
information to assist the medical worker with diagnosis and
treatment by providing such data on a realtime basis; scheduling
information for appointments and time management; insurance data
regarding reimbursement for specific insurance plans,
reimbursements and recommended or approved procedures for given
diseases; billing information and storage; and other data relevant
to the treatment of patients and management of medical information.
Algorithms may be included in the memory for various diagnostic
functions and signal analysis functions. The digital memory may be
split into discrete units so that various data types are stored in
specific memories, or the memory may be a single device. The memory
used for storage of reference information is of a nonvolatile
nature or is battery-backed. Nonvolatile technologies include but
are not limited to Flash, EEPROM, or magnetic media. The memory may
be fixed or removable. The memory may contain both data and program
code related to the access and processing of the abovementioned
data and information types. [0045] (c) Voice recognition sub-system
122, which provides security features to validate the user's
identity to avoid theft or unauthorized access to information. The
voice recognition function is implemented as a hardware, firmware
or software function. The voice recognition function may optionally
include the use of the Communications sub-system 104 of the
invention in order to access voice verification data from a remote
site. In this case, the raw voice, or a pre-processed version of
the voice data may be transmitted between the remote site and the
invention. [0046] (d) Speech Recognition sub-system 123, which
processes signals from the microphone in order to perform database
searches, respond to commands, store information, or perform
speech-to-text transcription either within the device or remotely
via the Communications sub-system 104 provided in the invention.
[0047] (e) Compression sub-system 124 which compresses signals,
voice or data to provide efficient storage in the Digital Memory
121 and/or efficient information transfer via the Communications
sub-system 104. The Compression sub-system also includes the
capability to de-compress or expand the stored or received data.
[0048] (f) Battery power supply 125, to provide power to all
sub-systems in a portable manner. The supply optionally includes
power management functions to perform power conservation functions,
including sensing of active use or idle time to determine power
states. [0049] (g) Analog Functions 126, including audio input,
filtering, amplification, and output. [0050] (h) Text-to-Speech
system 127 converts stored or received data into speech for audio
reproduction. This includes a data-to-speech function for
converting data or measurements to speech output.
[0051] Many of the above functions can be implemented in hardware,
or software residing in the memory 121, and processed by Processor
120. The invention does not need all of the above features to be
functional, but uses one or more of the above in the invention.
FIG. 1 shows the elements in schematic form. Their implementation
may be in the form of hardware, software, or firmware, and their
relationship may be of a software nature, via a central software
operating system residing in the system.
[0052] Communications Sub-System 104:
[0053] The Communications sub-system 104, provides digital
communications to like devices, to computers, to computer networks,
to the telephone system, to the Internet, or to a large external
communications network. There are 3 modes of communications provide
for, and any one of these is included in the invention: [0054] (a)
Infrared Link 140, which provides wireless communication. An
industry-standard infrared link such as IRDA is likely to be used,
however any communications protocol may be implemented. [0055] (b)
Wired connection via a connector 141, to provide wired
communications. [0056] (c) Radio communications 142 to provide
communications functions. The radio can implement any one of a
number of radio protocols and functions, including pager functions,
cellular communications, spread spectrum communications, or digital
network protocols. These protocols may include PCS, CDMA, TDMA,
IEEE 802.11, the Flex pager protocol, or digital satellite
communications. Wireless communications using satellite
communications protocols is also anticipated by this invention. In
a home environment, the wireless channel may additionally be
implemented by a 900 MHZ digital communications scheme or other
domestic wireless protocol. It is to be understood that this list
does not limit the various methods that may be used.
[0057] Software in the Electronics Processor or the Communications
sub-system itself controls the operations of the communications
channel. This includes software protocols including, but not
restricted to, TCP/IP, PPP, FTP, or other Internet protocols.
[0058] The communications function is not critical to all
operations of the device, but provides unique capability to
exchange information with other systems. The Communications
sub-system is intended to provide information exchange beyond
auscultation information, for broader medical data purposes. The
data types include, but are not limited to, any of the data stored
in the Digital Memory, and described under the Digital Memory
section. In addition, the communications links may be used for
regular voice communications of a telephonic or conversational
nature, to provide partial or complete wireless telephone
functions. The communications capability further includes the
ability to locate the device logically or physically, to aid in the
location of a medical worker, such as via the use of the Global
Positioning System (GPS) or other positioning system using wireless
radio signals.
[0059] Many of the methods described in this invention include
steps involving the Communications sub-system. The steps typically
include transmitting digital data to a remote computer or
communications device, and receiving results digitally. In some
cases, the steps include communications with or via another
portable device such as a handheld computer or cellular telephone.
In such cases, signals from the device described by this invention
are communicated to a portable device including but not limited to
a cellular telephone or handheld computer. The second device then
either processes data internally and transmits results back to the
first device, or the second device relays information to a remote
system using its own communications means. In this case, the second
device acts as a communications bridge between the device and a
remote system. It is to be understood that these steps, or
variations thereof, are steps involved in communications between
the device and remote systems.
[0060] Output/Display Sub-System 105:
[0061] The Output/Display sub-system 105 provides information
output capability to the invention. Any one of a number of methods
can be used, singly or in combination. The system includes one of
the following: [0062] (a) Loudspeaker 150 to provide audio
information output. [0063] (b) Headset or earphones 151 to provide
audio information output. [0064] (c) Miniature virtual display
device 152, which provides high-density information display by
placing the eye close to the display screen and viewing a virtual
image. [0065] (d) Small display screen 153, provides information,
and/or a user interface.
[0066] The data that is to be displayed may be from a variety of
sources, including text and graphics data. The data format may take
any form, including HTML and derivatives thereof.
[0067] In one embodiment, the audio output means is shared by the
auscultation function and other functions. This is a unique aspect
of the invention, since listening to a stethoscope is a common
practice in the medical work environment, and the invention
provides for listening to numerous other audio and information
sources via the same means, making audio a natural means of
information communications in the medical environment. The
information output is also private, allowing workers to listen
without patients overhearing.
[0068] Functional Description
[0069] The invention is used by medical workers to make
physiological patient measurements, access data, store information,
access information, make medical diagnoses and/or communicate with
computers and people. It is the purpose of the invention to provide
portable digital functions to medical workers, in order that they
may take advantage of advances in numerous digital technologies as
an integral part of their workflow. Such digital technologies
includes measurement, information, and communications
functionality. The purpose of these functions is to make
information and communications an integral part of the work flow of
medical workers, by uniquely combining the elements of the
invention in a portable form, and using user-friendly, timesaving
methods to access data and information. This promises to change the
way that medical workers use information, making information an
integral part of medical practice, available quickly and easily
when needed. The flow of information includes facilitating the
transfer of information to the patient as well, since the methods
described by the invention provide for the transmissions of digital
information to the patient.
[0070] Specifically, the invention uses one or more of the
following technologies: [0071] (a) Speech recognition and voice
recognition. [0072] (b) High-density low-power memory. [0073] (c)
Wireless analog or digital communications. [0074] (d)
Text-to-speech and data-to-speech technology. [0075] (e) Low-power
electronics using a portable power source. [0076] (f) Wide area
digital communications technology, such as the Internet and
POTS.
[0077] While the invention may be built without stethoscope or
medical measurement functionality, the preferred embodiment of the
device includes an electronic stethoscope or other physiological
measurement means, combined with one or more of the following
functions: [0078] (a) Pager. [0079] (b) Cell phone. [0080] (c)
Wired and/or Wireless Communication to transmit requests for data
and receive data from a database. [0081] (d) Built in database of
auscultation sounds, patient data, medical information, and/or
pharmaceutical information. [0082] (e) Heart Rate Monitor. [0083]
(f) Blood Oximetry monitor. [0084] (g) Korotkoff signal processor
to assist with blood pressure measurements [0085] (h) Blood
Pressure Monitor [0086] (I) Thermometer [0087] (j) Speech
recognition (SR) and/or voice recognition (VR) system [0088] (k)
Speech generation text-to-speech or data-to-speech system [0089]
(l) Database search engine [0090] (m) Internet protocol
communications [0091] (n) Internet interface for performing
internet searches [0092] (o) Automated diagnostic software to
perform signal and data analysis and guide medical diagnostics
[0093] (p) Natural Language Processing (NLP) to convert spoken
input into command, control and search functions [0094] (q) Video
input and output means, to input, record, playback and display
static/still and dynamic/moving images.
[0095] The above list is not an exhaustive list of all technologies
and functions. Specific functions, methods and applications are
described below.
[0096] Various methods are described as part of the invention, for
manipulating signals, measurements, data and information.
[0097] One method relates to access of medical information. The
medical information includes, but is not limited to, drug dosage
information, drug interaction data, patient records, medical
research information, medical protocol and treatment information,
medical insurance information, patient history, billing
information, medical procedures, and other information related to
the treatment of patients. The method of working with this
information includes the following steps: The user enters commands
or requests via the User Input sub-system, using the means
provided. Such means include keystrokes, touchscreen, rotary dial,
or speech input. The Electronic Processing sub-system processes the
commands, and searches the data stored in the Digital memory. The
results are then formatted and output via the Output sub-system. In
one embodiment, the input means is speech via the microphone, and
the output means is audio, using text-to-speech means. The audio
output means may optionally be the same means as used for
auscultation sound output in an embodiment that includes
auscultation means. In another embodiment, the output means is the
virtual display device, meaning a small screen, viewed at close
proximity to the eye, to provide an image to the viewer that is
perceived to be larger than the actual screen itself. These output
means are not mutually exclusive. The virtual screen may provide
either monocular or binocular viewing means.
[0098] A second method uses the Communications sub-system and a
remote data source. The method is as follows: The user enters
commands or requests via the User Input sub-system, using the means
provided. Such means include keystrokes, touchscreen, rotary dial,
or speech input. The Electronic Processing sub-system processes the
commands, and transmits the request to a remote computer system
containing the requested data and information. The remote system
performs the steps of searching for appropriate data. The results
are then formatted, transmitted back to the device, and output via
the Output sub-system. In one embodiment, the input means is speech
via the microphone, and the output means is audio, using
text-to-speech means. In another embodiment, the output means is
the virtual display device.
[0099] It is to be understood that alternatives which are covered
by the invention include performing some of the steps within the
remote system, such as speech processing and text-to-speech
conversion. Variations of the method and structure described above
can achieve the same result, and the above descriptions should not
be construed as limitations on the structure and method of the
invention, or of the type of data for which the invention is
useful. For example, the speech recognition functions, or the
text-to-speech functions can be performed by a remote system,
decreasing the processing burden on the portable device carried by
the user. Such a method still achieves the result of being able to
enter speech commands for searching medical information systems,
and receiving speech output. A second variation of the method
includes the use of a second portable communications device which
is used as an intermediary communications means between the first
device and a remote system. For example, the first portable device
might communicate with a cellphone or handheld computer, which in
turn might contain the requisite information, or might in turn
communicate with a remote system, acting as a bridge between said
first device and remote database system. This method has the
advantage that the first medical device uses the wireless
communications or storage capability of a more general-purpose
computing or communications device such as a handheld computer or
cellphone.
[0100] A further method included in the invention is the storage of
information related to a patient and/or user either locally in
digital memory in the portable device, or in the remote system. As
an example of such a method, the following steps would be
performed: The user enters information via the User Input
sub-system. The input is then converted to a form suitable for
storage in a database. The data is then stored locally in digital
memory, or transmitted via the Communications sub-system to a
remote database or handheld computer for storage. The data stored
may include, but is not limited to, patient name and identification
data, examination results, drug dosage, tests ordered, tests
results, physiological measurements, procedures and services
rendered, billing information, and time and duration of service. If
the data is stored locally in digital memory, the method includes
the step of later transferring the data to a computer system for
inclusion in a patient's medical and billing records. An
intermediate communications means may also be used, such as a
cellphone, telephone or handheld computer, which bridges data
communications between the device and a remote computer system. The
unique aspects of this method are the combination of speech
recognition, combined with wireless communications and the medical
data as described. The method includes software for formatting the
data into an appropriate database record or document from the
speech input, when speech input is used. The automation method
includes the steps of identifying keywords or identification
phrases which the formatting software uses to allocate information
to categories such as tests ordered, test results, measurements,
physical findings, times and dates, and other relevant data. This
allows the speaker to use a natural language input format, with
some limited structure, and using software processing to partition
the data types, and compile a report with a more uniform structure.
The method also simply allows standard transcription. In this case,
the uniqueness of the invention is the embedding of speech
recognition into the process, and in a preferred embodiment, into a
portable device.
[0101] With regard to the recording of patient record information,
it is to be understood that patient records may be transmitted both
from and to the device. Therefore, the user may make a request for
a patient record, and have a remote computer system transmit the
patient record to the unit for review and updating. Such record may
include audio recordings, images, test results, and other data
specific to the patient.
[0102] As a variation, of this function, the invention includes a
voice recording method, as follows: The user dictates into
microphone 130, the sound is stored digitally, either in raw or
compressed form, and the stored recording is then transferred via
the Communications sub-system to a speech recognition system
located on a remote computer. Alternatively, the speech recognition
function is built into the invention, and the converted text
information is stored and later transferred to a remote computer
for storage and/or printing. The recorded data record might also
include physical or physiological measurement data, and other
automatically or manually generated data such as time and date. The
inclusion of this function in an information or measurement
appliance obviates the need for a separate dictation or patient
reporting device or service. The computing device that ultimately
stores the patient records or transcribes the recording from speech
to text may be located remotely and accessed via cable, telephone,
internet, or wireless link. For example, data from the unit in the
form of voice files or data files may be transmitted or emailed
from the invention to the remote system, or transferred via a cable
or infrared link. The uniqueness of the invention with regard to
dictated data lies in the combination of measurement means used by
the medical worker with voice recording means. A further aspect of
uniqueness of the preferred embodiment is the dual use of the
stethoscope audio output means--the audio output means for playback
and feedback of voice recordings may be the same audio output means
as that used for auscultation, or it maybe a separate audio output
means. The combination of voice recording means and auscultation
means has not previously been reported, and is a unique aspect of
the invention. The benefit lies in the fact that dictation means is
no longer necessary as a discrete and separate device from the
auscultation device.
[0103] While the preferred embodiment of the voice recording system
provides for speech recognition functions either within the device
or remotely, it is to be understood that the voice recordings may
also be transferred digitally to a remote device, and manually
transcribed to text by a person listening and typing the dictated
text. In this case, the fundamental benefit of the device is that
the voice recording means is combined with the auscultation means
such that a common power source may be used, and audio components
common to voice and auscultation may be used, to lower cost, size
and weight of the invention. For example, the audio output means
used for auscultation may be the same means used to listen to
recorded voice for review or playback.
[0104] In the preferred embodiment, the speech output is provided
via the same audio output means as that used for auscultation. If a
visual display means is used, a miniature display of less than 4
inches diagonal measurement is used, or a virtual display device is
used. In the preferred embodiment, the device has the form of an
electronic stethoscope, with headphones or earphones and
auscultation sensor. The preferred embodiment also includes the
communications means, which uses wireless radio communications
means. The preferred embodiment as described does not restrict the
invention, since other means may be used to perform the same
methods of data access.
[0105] One important aspect of the invention and the methods
associated therewith, is the validation of access to patient
records and medical information.
[0106] Specifically, patient privacy is becoming an important
problem, as access to patient data becomes easier. The invention
includes a method for identifying the personnel requesting
information using voice as an identification means, recording the
request for such information, and validating the authorization for
such a request. The method includes the following steps: The user
(requestor) enters a voice or speech command or identifying voice
signal. The voice signal is used, either raw or pre-processed, to
identify the user. This identification step may be done locally
from local storage, or the identification data (voice or voice
parameters) may be sent via a communications link to a remote
system which contains voice verification or identification database
information. The identity of the user is then performed, and the
request logged for future reference. If a limited number of
authorized users may gain access to the patient data, as an
additional step, the voice identity of the user is compared to the
authorized list, and approval is either granted or denied. If
granted, the requested patient information is transmitted to the
device via the communications channel, or the information is simply
transmitted without authorization if no authorization is required.
At a later time, the identity of the requesting person can be
checked for each patient. This process allows medical workers to
access patient data in realtime, but ensures that requestors are
identified so that fraudulent or unauthorized access can be
verified and prosecuted. The same identification means may also be
applied to the storage of new information is a patient record, in
order to control and audit the authority to modify patient records.
This means of identification can be extended to include telephone
or computer access, for situations not requiring portable
access.
[0107] The voice verification method is also applicable as an
anti-theft method for the portable device. The steps are as
follows: The voice identity of the user is compared to the an
internal voice identification record in digital memory, the
identity record of which has previously been stored. If the
identity matches, the device continues to operate. If not, the
device either ceases to operate, or operates with some limitations,
such as time limit or a limited number of functions. This voice
verification method may be applied to a wide variety of portable
devices which are subject to removal or theft.
[0108] The use of speech or audio output offers broad
applicability. The invention includes the capability to make
physical or physiological measurements using the Sensors
sub-system. The measurements include, but are not limited to
auscultation sounds, temperature, blood oximetry level, blood
pressure, blood glucose level, and other physiological and physical
measurements. The invention includes means for converting such
physical measurements to medically useful data, such as numerical
results. The numerical or physiological results can then be
converted to speech output to be sent to the user via the audio
output means. This has the advantage of giving the medical worker
patient measurement and test results aurally. An alternative, of
use in a portable device, is to display the information on a
miniature or virtual display of less than 4 inches diagonal
measurement. In the preferred embodiment, physiological measurement
results are provided in speech form via the same audio output means
as that used for auscultation.
[0109] The ability to store and transmit patient history and
medical information from the device to remote medical diagnostic
computer systems facilitates further information processing
capability of value to the medical worker. The invention provides
for the remote system to perform automated diagnostic analysis,
provide suggested or standard treatment, and diagnostic or research
information. The method also allows for the inclusion of solicited
or unsolicited voice or display messages to be included in a return
transmission to the user, such as drug or medical product
information. The method is as follows: Patient condition
information or disease information, or a discrete information
request is transmitted from the device to a remote computer system
via a wired or wireless digital communications link. The patient
record or disease information is then analyzed by a software search
system which matches potentially useful products, medical research
or treatment information with the patient's condition, medical
record, or information request. The remote system then optionally
combines medical information to be sent back to the user with
product information, and the combined message is transmitted and
displayed or played back aurally to the user. An alternative reply
method is to perform the matching function as described, and then
email or otherwise transmit relevant product and medical research
and information to an email address or data reception site
associated with the user, and known to the remote computer system.
The user then receives email or data which includes product
information, medical research, or other useful information related
to the patient's condition or disease in question. The email or
data response may take the form of a discrete transmission to an
email account, or simply a search result stored in a computer
system accessible by the requestor, such information being
formatted and presented to the requester when communicating with
said computer system, such as logging into the Internet and viewing
Web customized pages or links. The user or medical practitioner
benefits by receiving medical information without having to
manually perform research tasks. The method of the invention can be
extended by further transmitting digital data, email or a report to
a computer or data site accessible to the patient, the data
response having been compiled as a result of a request entered by
the medical worker into the portable device described by this
invention. In this case, the patient benefits by receiving medical
information and advice directly, as a benefit of the medical exam.
Information therefore becomes integral to the practice of medicine,
providing the practitioner with real-time or delayed information
distilled to be directly relevant to a given case, and the patient
benefits by receiving additional information that can help to
educate the patient. In the case of using patient medical records
to derive search requests, the method provides for stripping
patient-specific information from the search request, in order to
maintain confidentiality.
[0110] A further application of the invention is for telemedical
diagnostic services. The method is as follows: The user makes a
physiological measurement such as auscultation, glucose or blood
oxygen measurement. The measurement, and optionally voice or system
identification information is transmitted via communications means
to a central medical screening center staffed by qualified medical
practitioners or nurses. The communications means in this case
might be of a consumer nature, including but not limited to wired
telephone, cellphone, or Internet access. Once received at the
remote medical center, the medical measurements and data are
analyzed by said medical practitioners or nurses (analysts). The
analyst then communicates with the user, who may be a patient or
caregiver, and recommends a course of treatment or action resulting
from the measurement analysis, and additional information. The
return communication may via telephone or email or other data
transmission means. The invention provides for the measurement and
communications functions to be combined. If voice communications
with the medical analyst is included in the method, the microphone
and audio output means used for the communications on the user end
may optionally be integrated into the portable device described by
this invention, and use the same audio output means for
auscultation, measurements and voice communications. This allows
the user, patient or caregiver to listen to auscultation sounds and
have a telephone conversation concurrently or sequentially. The
communications between the device and the remote analyst includes
data for identification and control commands to allow the analyst
to control the device operation and read results directly. The
communications may optionally include video connection to allow the
analyst to view the patient while performing measurements.
[0111] While the telemedical method is preferably performed in real
time, a method which uses email or delayed data transmission is
also part of this invention. Using this method, the measurements,
voice and data are emailed or transmitted via the Internet or other
data communications service to a remote site, where an analyst
evaluates the information and responds via data communications
means or telephone. The analysis may also be performed
automatically by signal processing and computer analysis means. An
important aspect of the invention thus used, is the ability for the
remote system to use identification means to store data and
measurements in a patient database, and use sequential
communications records to analyze the progress of the patient from
one communications to the next. This is especially valuable for an
asthma or pulmonary condition, whereby sequential records may be
listened to by the analyst, for baseline and comparison
purposes.
[0112] The invention may optionally include local measurement or
analysis capability. The steps in the method would thus include the
following: Physiological measurements are made, the signals are
analyzed within the portable device using signal processing and
data processing means, and a recommended course of action is
displayed or output via the audio output means. The recommended
courses of action include, but are not limited to--no action,
monitor situation, call medical center. In this case, the
diagnostic algorithms are included in the Digital memory of the
device.
[0113] The invention also includes capability to store reference
auscultation sounds in Digital Memory. There are two purposes for
these reference signals. In one method, the user can listen to
reference sounds in order to make a manual comparison of a
patient's sounds with references in order to manually determine
similarity. In a second method, the reference sounds are used by
built in analysis software to compare a patient recording with the
reference sounds, in order to perform a matching function to find
the most similar sound, and render a potential diagnosis.
[0114] The telemedicine applications of the invention are enhanced
by the combined functions described in the invention. Specifically,
the combination of stethoscope, oximetry, glucose and/or voice
functions, combined with the communications sub-system, allows for
measurements and annotated information to be transferred via
telephone or data transmission to a central diagnostic center,
along with patient identification data, for remote evaluation. By
including a microphone and audio mixing in the device, the analyst
at the remote site can communicate with the patient or
caregiver.
[0115] A further example of the use of the invention is for
communicating with a medical worker. By including a built in pager
device, physical locator device or cellular telephone, the medical
worker has communications functionality built into a medical
information or measurement appliance, obviating the need to carry a
separate communications device. The communications functions can be
performed via the same audio means as those used for other audio
input and output functions.
[0116] The communications means provided in the device may be of a
general-purpose nature, such as pager or cellphone. While during
working hours, the worker might find the combination of medical
measurement functions, and specifically auscultation, with
communications functions to be useful, one embodiment of the device
allows for the communications functions to be physically separated
or disconnected from the communications functions. the worker can
therefore carry the communications functions in a compact manner
without having to carry all components of the invention all the
time. In such an embodiment, the medical measurement or output
means, such as auscultation sensor, oximetry sensor, or earphones,
may be mechanically decoupled from the main body of the device to
produce a more compact device.
[0117] The productivity enhancement of the invention are enhanced
by including various additional Internet and database functions
which are easily activated by the user. One such example is a
request for a database or internet search related to a patient's
history or physiological measurements. The patient's records, or
the user's inputs via voice or keypad, are converted into an
Internet or database search, and the results provided back to the
device, or sent to another destination, such as the user's email
address. This service might include transmission of the
physiological or patient information to a diagnostic database for
automated diagnosis or peer review. The invention provides these
functions by providing a connection between the point of care and
other computing resources via its communications sub-system, either
in real time or via a stored and delayed transmission.
[0118] The recordkeeping functions are enhanced by various
automated annotations. These include time, date, personnel on duty,
and/or drug and other information entered via voice or barcode. The
information may be transferred to a billing and management system,
as well as a patient information database. This is an example of
how information and data are seamlessly integrated into the patient
care process--a central purpose of the invention.
[0119] One of the problems encountered in medical education is that
of examining medical students and nurses on their auscultation
skills. The invention provides a means to administer testing of
such skills, using the following method: An electronic stethoscope
with auscultation means is operatively connected to a personal
computer, or remote computer system via a digital communications
means. The computer contains a digital memory with various heart,
lung and other body sounds, which are transmitted via the
communications means to the stethoscope, allowing the student to
listen. Included with the auscultation sounds, is a voice message
stating a multiple-choice question. The student then listens to the
sound, and is provided with a means, either on the stethoscope or
on a connected device such as a personal computer, to enter a
selected answer, which is then transmitted to the remote computer
system for grading. The system optionally has a voice recognition
identification means to validate the identity of the student taking
the test.
[0120] This educational method can also be applied to a learning
environment. In this situation, the invention consists of an
electronic stethoscope, combined with a database of recorded heart,
lung and other body sounds, recorded on a digital medium such as,
but not limited to, compact disk, floppy disk, or digital memory.
Alternatively, the sounds may be transmitted via a communications
medium such as the Internet. The invention then provides a means to
connect the stethoscope operatively to facilitate the playback of
the sounds via the stethoscope's audio output means. Additional
controls are provided to allow the listener to replay, skip, or
otherwise control the playback of these sounds. The uniqueness of
the invention lies in the facility to reproduce the recorded sounds
through the same audio means as is used by the practitioner to
listen to perform auscultation, rather than using a headphone set
connected to an audio system. This ability makes the stethoscope
into a teaching tool. The transmission of the sounds digitally to
the stethoscope is also unique, and is an improvement over previous
methods in that sound quality is maintained. The listener is
therefore listening to digitally transmitted auscultation sounds
through a stethoscope, rather than using a general-purpose audio
system. By using the Internet or other wide area network system to
perform these tasks, distance learning and teaching is facilitated,
which has not been reported before.
[0121] All of these combinations are unique in that they combine
medical management functions into a wearable device. Previous
inventions might provide some of these functions, but do not
possess the convenience of combined functions, which allows a more
integrated functionality, ease-of-use and integration of patient
measurements and database information.
[0122] One of the unique aspects of the invention, is the
combination of audio sources for information and measurement
output. FIG. 2 shows a functional diagram of one embodiment of the
invention, whereby the auscultation sounds and measurement and
information sources are mixed and reproduced via the same audio
output mechanism. Auscultation sounds from sensor 201 are
processed. The microphone 202 provides an input source that can be
mixed with the auscultation signal. Information data from the
text-to-speech (data-to-speech) processor 203 is also accessed or
generated, and converted to speech. Any other sound source with no
auscultation content 204 is also available to the mixer. It is then
mixed or multiplexed by mixer/multiplexer 205, in order to
reproduce it through the same audio output means--speaker 206 or
headphones 207. In the preferred embodiment, measurements such as
heart rate or time intervals are computed and converted to speech
to be played through the same headset used for auscultation. The
preferred embodiment includes the stethoscope sensor, and a
data-related voice source, such as text-to-speech processor 203 or
recorded sound segments from a stored source, such as 204. The
mixing function also allows for the mixing or multiplexing of
ambient sound with auscultation sound. This may be automated,
whereby the sound source is switched to auscultation when the
system senses that the auscultation sensor is in use. Such sensing
can be done by measuring the signal amplitude and/or signal
frequency content from the auscultation sensor. When the amplitude
increases, or the sub-sonic frequency content increases, the system
switches to auscultation sensing. The mixer is thus intelligent,
and is able to determine the source of the sound to be presented to
the output means.
[0123] The digital rotary switch provides an easy-to-use user
interface. As the knob is rotated, the display or voice output
indicate modes and/or menu selections to the user. Once the user
gets to the desired option, the rotary switch is pushed to "click"
(select) the option.
[0124] The output devices 152 and 153 also provides a unique method
of displaying information on a small medical device. The virtual
display 152 allows images to appear larger than they actually are,
allowing large images to be viewed on a small device. In one
preferred embodiment, the device includes a stethoscope sensor, and
a virtual display device. Alternatively, the display device may be
a small display 153, possibly, but not limited to being less than 4
inches diagonally, which displays data, images and the user
interface.
[0125] Another output means is the conversion of digital
information to audio/speech output. This is done in the Electronics
Processing sub-system, and allows digitally-stored information to
be output via an audio means such as speaker or headphones.
Information might include heart rates that are measured from the
auscultation waveform, or intervals between events within a heart
cycle. In the preferred embodiment, the measurements are performed
automatically i.e. by a software function. An alternative is that
the waveform is reproduced, and the user pushes a button at the
time of each event being measured. The electronics processor then
finds the nearest events to the button push times, and produces a
measurement, provided in voice format via the audio output
device.
[0126] The digital memory 121 is used to store programs, data,
voice recordings and other data required for correct operation and
features. A sub-section of this memory may be placed on a removable
medium, providing an alternative method of data exchange. The
memory means may be any digital storage medium, and may be
partitioned physically and logically into RAM, ROM, NVRAM, program
memory, data memory, audio memory, or other partition that provides
for an efficient design.
[0127] Some of the benefits of the invention lie in the combination
of core functional units or sub-systems, which can be shared by
various functions. Therefore, the battery pack can be used as a
power source for communications, measurement and computing
functions. This is unlike the separate device situation, whereby
each device has its own power source. A similar benefit is derived
from using a central processing unit to manage all measurement,
input, output and communications functions through various software
modules. This provides a potential for cost saving over physically
separating these functions.
[0128] The combination of functions made possible by this invention
provide a unified, convenient platform for functions and features
useful in the medical environment, whose unification adds
significantly to the convenience and ease-of-use of these functions
compared to a situation where each is offered separately.
[0129] While the invention has been described in the medical work
environment, the same elements may be combined to form a wearable
information, measurement and communications device for other
applications. These other applications do not materially change the
combination of elements in the invention, but do change the content
of the information. Other examples include legal information and
databases, law enforcement and security situations, inventory
management, whereby the information relates to products and
materials in a warehouse, and other situations where
communications, measurement, input, and output are combined in a
unique manner.
[0130] While the invention describes various potential combinations
of elements and methods, and is intended to cover a broad range of
options, it is important to specifically describe some preferred
combinations of elements. While this brief list includes specific
combinations, it is to be understood that other combinations are
covered by this invention. The term "stethoscope" shall include
devices that use ultrasonic signals to produce audio representation
of body functions: [0131] (a) A device comprising a stethoscope
combined with a pager means. [0132] (b) A device comprising a
stethoscope combined with a cellular telephone. [0133] (c) A device
comprising a stethoscope combined with a voice recording means.
[0134] (d) A device comprising a stethoscope combined with a
wireless communications means using spread spectrum digital
communications. [0135] (e) A device comprising a stethoscope
combined with wireless communications means using 900 MHZ digital
communications. [0136] (f) A device comprising a stethoscope and
oximetry measurement means. Such combination may be housed within
the same housing, as a combined portable instrument with portable
power source, such power source potentially being separate or
shared by both stethoscope and oximeter. [0137] (g) A device
comprising physical and physiological measurements means, with
speech output of measurement results. [0138] (h) A device
comprising physical and physiological measurement means, with
speech output of measurement results, and means for modifying the
language used for output. [0139] (I) A device comprising
physiological measurement means combined with speech recognition
means. [0140] (j) A device comprising physiological measurement
means for auscultation, combined with speech recognition means.
[0141] (k) A device comprising a medical database containing
pharmaceutical information including but not limited to combined
effects of various drugs, and drug dosage requirements based on
patient physical characteristics, such database being combined in
said device with speech recognition means to access said database
using speech input. [0142] (l) A device comprising a medical
database as defined in (k), whereby the database output means is
via audio output, in one or more languages. [0143] (m) A device
comprising a medical database as defined in (k), whereby the
database output means is via a miniature virtual display placed
close to the eye which generates a virtual image. [0144] (n) A
device comprising speech recognition means, digital memory means,
and software to interpret a (primarily) medical vocabulary, whereby
speech recognition means is combined with software to generate
structured patient medical records database information from
freeform unstructured speech input. This is commonly referred to as
Natural Language Processing (NLP). [0145] (o) A device as described
in (n) whereby speech recognition means is used to access patient
medical records from a remote system via a wireless digital
communications means. [0146] (p) A device comprising physiological
measurement means, combined with voice recognition means, whereby
voice recognition means determines the level of device
functionality. This is used for securing the device. [0147] (q) A
device as described in (o) combined with voice recognition means,
local or remote, whereby voice recognition is used to determine
access to patient records. [0148] (r) A device comprising
electronic stethoscope combined with medical information database,
whereby medical information is searched via speech recognition
means, and medical information results are output via an audio
output means, said audio output means being the same audio output
means used for auscultation sounds. [0149] (s) A device comprising
a stethoscope combined with a miniature virtual display device,
said display producing a virtual image when placed close to the
eye. [0150] (t) A device comprising a portable communications
device with spread spectrum digital communications means and
miniature virtual display device. [0151] (u) A device as described
in .RTM. connected via said spread spectrum communications means to
a remote medical database system, said database system including
medical research information or patient records. [0152] (v) A
device comprising a stethoscope, communications means, and control
means operating via said communications means, whereby a remote
user can control stethoscope operations and listen to auscultation
sounds. [0153] (w) A device as described in (v) whereby
communications means carries voice and auscultation signals
simultaneously or alternately. [0154] (x) A device comprising a
stethoscope with additional microphone and multiplexing and mixing
means to multiplex or mix sounds from auscultation source and
microphone, whereby sound source is determined by auscultation
source signal amplitude and low frequency characteristics. [0155]
(y) A device as described in (v) whereby remote database system
includes software to search medical database and generate medical
research or product information reports based on patient medical
record contents. [0156] (z) A device as described in (y) whereby
patient identity is removed from search request submitted to
database, in order to protect patient privacy. [0157] (aa) A
stethoscope with voice recording means, whereby voice recordings
are transferred via a digital communications means to a personal
computer. [0158] (bb) A stethoscope with voice recording means,
whereby voice recording are transferred to a personal computer or
remote computer via digital communications means, said computer
containing speech recognition means to convert said voice
recordings to text-based reports and information records. [0159]
(cc) A stethoscope with digital memory means, said memory
containing auscultation sound recordings for various medical
conditions, combined with audio output means to listen to reference
auscultation sounds, and recorded auscultation sounds, for the
purposes of comparing patient sound to known one or more
recordings, in order to assist listener in making a diagnosis.
[0160] (dd) A stethoscope as in (cc) combined with pattern
recognition means, such that patient sounds is compared to
reference sounds, and suggested matched sounds and diagnoses are
presented to the listener via auscultation audio output means.
[0161] (ee) A stethoscope combined with infrared digital
communications means, said communications means being used for
transmission of auscultation sounds and digital voice recordings.
[0162] (ff) A portable wireless communications device with facility
to connect physiological sensing and output means using the same
power source, said connection being mechanically designed such that
the communications means can be mechanically separated and operated
independently from the physiological sensing components. [0163]
(gg) A software program whereby patient records are scanned for
disease and treatment-related keywords, and patient-specific
identification data are removed; said resulting disease and
treatment information being applied to a search request for medical
and product information; said medical and product information being
transmitted via a communications means to said patient, or
patient's caregiver or physician. [0164] (hh) A portable video
recording means combined with a wireless communications means, said
wireless communications means having capability to transmit video
images to a patient record database stored on a remote system
operatively connected to said video recording system. By video, is
meant a means for capturing both still and moving images. [0165]
(ii) A stethoscope with wireless communications means and Internet
protocol software to send and receive email and web page data over
the Internet.
[0166] Physical Embodiment
[0167] FIG. 3 shows one physical embodiment of the device, to
illustrate the integration of functions into a single unit. This is
a preferred embodiment, but is only one way that the invention may
be physically packaged. The main body shown in FIG. 3 may also take
the form of a general purpose handheld computer with medical
sensors physically attached or cabled to the handheld computer to
provide the same functionality as shown in FIG. 1. In this
embodiment, most of the electronic processing 102, user input 103,
and output/display functions 105 would be provided by the handheld
computer's built in functions.
[0168] The device consists of an enclosure with elements of the
design. Input from the user is performed via keypad 132, rotary
dial 131 and/or microphone 130. The microphone may optionally be
placed on the headset shown by microphone 130a, which has the
benefit of proximity to the user's mouth for speech input.
[0169] As an alternative or adjunct to input means 131 are shown a
joystick 131a and an internal motion sensor 131b, or 131c placed in
the headset. The joystick is used to provide 2-dimensional input,
with a possible pushbutton for affirmative selection of a control
option. The motion sensor provides 3-dimensional and rotational
sensing to allow the user to control the device by moving the main
housing through space in specific directions. Similar actions can
be done using head movements, using the headset-mounted 131c.
[0170] Output of information is provided via a number of potential
means, including display 153, virtual display 152 or 152a, and/or
headphones 151. Placing the virtual display on the headset as shown
in 152a has the benefit of providing binocular vision. The headset
may be disconnected via connector point 401.
[0171] Communications is effected via connector 141, Infrared
communications port 140, and/or wireless communications means and
antenna 142. The antenna may optionally be extended into the
headset cable assembly.
[0172] The digital memory 121a means may optionally be removable
and accessible from the outside of the enclosure, as shown.
[0173] Sensor means are provided by stethoscope or auscultation
sensor 110, oximetry sensor 111, or other sensor 113 and 113a,
which may be a barcode scanner, image sensor, video/camera input
lens and imaging sensor, or other sensing means, such as ultrasonic
probe. An ultrasonic probe may be used as the means for doing
auscultation or blood flow measurements, in place of the more
conventional acoustic sensor. By stethoscope, is thus meant any
such means for performing auscultation. Ultrasound may also be used
in this invention for imaging, such as for echocardiography or
obstetrics, using the display means for viewing images.
[0174] The various sensor means may be detachable or removable,
such that they become accessories to be added to the basic housing.
In such a case, the housing is designed such that there are
cavities for inserting the various sensor and measurement means.
The image sensor means allows for the inclusion or attachment of
close-up lenses or ear-tip probes, in order to view eardrums,
nostrils, throat, or take close-up images of skin or other body
parts, for the purposes of recording in medical records.
[0175] Sensor 113a is shown to have an orifice through the housing.
This allows for sensors which measure breath, or optical
transmission characteristics. In the case of breath, either lung
capacity or breath chemistry may be measured by the patient
breathing through a tube attached to the main housing. In the case
of an optical measurement, the patient might insert s finger into
the orifice, which may in this case be closed at one end. Sensor
111 may operate in a similar manner. In all cases, the invention
allows for the inclusion of disposable sensors and/or covers to
ensure sterility. Sensor 11 may also be a reflective optical
sensor. An alternative means of connecting additional sensors to
the device include using electrical cabling, connected to durable
or disposable sensors.
[0176] Convenient physical enclosure features are provided by a
belt clip 403, which has previously not been associated with a
stethoscope, and a movable cover 402 to protect the medical or
other sensing means. Power is provided by energy source 125, which
may be a battery or other electrical energy source. Contacts 404 or
404a are located on the surface of the enclosure, and provide a
means for clipping the device to a charger, suspended by the
earpiece or held around the case, to provide charging while not
being used. Alternatively, an inductive/magnetic connection may be
used via coil 405 placed inside the device, which can provide
inductive connection to an external charging circuit. This coil may
also be used as a communications means, using higher frequencies to
transmit data, while lower frequencies are used for power transfer.
The entire housing may be sealed to allow for sterilization, or
disposable covers may be attached to protect the device itself from
touching patients.
[0177] FIG. 4 shows further detail of a preferred embodiment of a
binocular virtual display means, built in to the stethoscope
headphone assembly. A headband 406 is attached to the headphone
assembly, such that it can be moved from a position planar to the
headset (out of the way, potentially fitting into a slot), to a
position at approximately right angles to the headset such that it
becomes a support that fits over the top of the viewer's head
aligning the eyepieces of the display 152a to the viewer's eyes,
and holding the headset/display in position. The headband 406 may
be of a solid material, or a flexible substance that adapts to the
shape of the viewer's head. FIG. 4 also shows an eyepiece distance
adjustment 407, to allow the distance between the eyepieces of a
binocular display to be adjusted to the viewer's preference. This
distance is adjustable such that it is somewhat independent of the
distance between the earpieces 151. The eyepieces 152a allow for
dioptric adjustment or insertion of prescription lenses, to further
customize viewing quality to the needs of the viewer. Such
accommodation is also provided for in a monocular eyepiece 152. Any
convenient means for attaching or positioning the display may be
used, for example, using a support which rests on the viewer's
nose.
[0178] FIG. 5 shows the functional aspects of many of the methods
in this invention. The device is shown as 601a-e. In one
embodiment, the device 601a communicates with a handheld computer
602 with built in database. The database might include many forms
of data, as discussed elsewhere in this description. The device
communicates with the computer 602 via a wireless or wired
connection. In turn, the computer 602 may have wireless
communications capability to access further computer or information
networks 607, acting as a bridge to the device 601a. Alternatively,
the device 601b communicates via a wired or wireless connection to
a cellphone or 2-way pager 603 which in turn communicates with a
data network 607. Finally, the device 601c may have a built in
communications means which directly communicates with a data
network 607. Also shown is the ability of the device 601e to
communicate via a wireless link to a printer 621. The device 601d
may also communicate via the telephone network 606, either directly
or via an interface device 604.
[0179] The purpose of the communications methods and means, is to
access a telephone or data network. The devices 601 communicate
either directly or via a Base Station 608 to a data network,
Intranet, or Internet 607. The Base Station 608 may include, or be
linked to, a security and identification system 609, which may
include encryption of data, voice identity verification and audit
trailing of accesses, and other security means, to protect access
to patient records and other information and services.
[0180] Many of the purposes and methods associated with the
invention and associated methods include communication with, and
use of various data, information and knowledge bases, available
locally on an Intranet or via the Internet or other data network.
FIG. 5 shows some of these methods and elements, as examples. Data
requests from devices 601 may be transmitted to a remote computer
system 614, which accesses such databases as pharmaceutical data
615, patient data 616, product data 617, patient care protocol or
standards of care reference material 618, medical research data
619, or medical websites 620, such as those set up by information
vendors or manufacturers. A remote patient information filtering
system 613 is an important part of the methods. The filter 613
parses the patient records or physician requests, and generates
requests to the various databases which are filtered and do not
contain information which is patient-identity-specific. This is to
protect patient identity while still being able to access
information.
[0181] The means for sending information back to professionals and
patients includes placing information in a custom web page 610,
created for the requestor, or sending email responses to
professionals or patients to their email addresses 611 and 612.
Alternatively, information can be sent directly and with little
delay to the devices 601.
[0182] In some cases, consumers or patients at home might use the
system to communicate data and measurements. Device 601d
communicates via the telephone network 606 or data network 607 with
a patient care center 605. At the patient care center, voice, data,
or measurements can be received via the telephone or data network
and analyzed by a human or machine. Responses can be given verbally
in real time using a telephone hookup, or sent to the patient via a
data network to their email access address 612. The analyst 605 can
also take control of the measurement device 601d, in order to
control the taking of data.
[0183] A proprietary aspect of the invention is the combination of
the device with these data networks and databases to form a new
method for disseminating and recording information, making a
connection between the point of care, and sources of data and
information. The uniqueness of the invention lies in the
integration of such means to provide point-of-care access to
information. The device itself provides user-friendly interfaces,
and the system as a whole, as shown in FIG. 5, provides the methods
and means for information recording and access.
* * * * *