U.S. patent application number 13/929591 was filed with the patent office on 2014-03-13 for devices, methods and systems for acquiring medical diagnostic information and provision of telehealth services.
The applicant listed for this patent is Joseph Boucher, Ryan Boucher, Lionel Nelson. Invention is credited to Joseph Boucher, Ryan Boucher, Lionel Nelson.
Application Number | 20140073880 13/929591 |
Document ID | / |
Family ID | 49783872 |
Filed Date | 2014-03-13 |
United States Patent
Application |
20140073880 |
Kind Code |
A1 |
Boucher; Ryan ; et
al. |
March 13, 2014 |
Devices, Methods and Systems for Acquiring Medical Diagnostic
Information and Provision of Telehealth Services
Abstract
The invention relates generally to various systems, tools and
methods for acquiring diagnostic information, including medical
information, for a user, transmitting the information to a remote
location, assessing the information, and transmitting resulting
diagnosis and treatment information to the user and/or a third
party for subsequent action. The present invention provides
consumer and user-friendly telemedicine systems and procedures
which enable health services and/or diagnosis to be provided at a
distance remotely.
Inventors: |
Boucher; Ryan; (San
Francisco, CA) ; Boucher; Joseph; (Chelmsford,
MA) ; Nelson; Lionel; (Los Altos Hills, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Boucher; Ryan
Boucher; Joseph
Nelson; Lionel |
San Francisco
Chelmsford
Los Altos Hills |
CA
MA
CA |
US
US
US |
|
|
Family ID: |
49783872 |
Appl. No.: |
13/929591 |
Filed: |
June 27, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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61664920 |
Jun 27, 2012 |
|
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Current U.S.
Class: |
600/301 ;
600/103; 600/109; 600/476 |
Current CPC
Class: |
A61B 1/00016 20130101;
A61B 1/24 20130101; H04W 4/90 20180201; G16H 30/20 20180101; A61B
5/7282 20130101; G16H 10/60 20180101; G16H 40/67 20180101; A61B
1/04 20130101; A61B 1/00179 20130101; A61B 5/0022 20130101; A61B
7/04 20130101; A61B 1/00181 20130101; H04W 4/02 20130101; A61B
1/227 20130101; A61B 5/0084 20130101 |
Class at
Publication: |
600/301 ;
600/109; 600/103; 600/476 |
International
Class: |
A61B 1/00 20060101
A61B001/00; A61B 7/04 20060101 A61B007/04; A61B 5/00 20060101
A61B005/00; A61B 1/04 20060101 A61B001/04; A61B 1/227 20060101
A61B001/227 |
Claims
1. An imaging apparatus for obtaining images inside a patient's ear
canal, the imaging apparatus comprising a main body and an
extension having a central axis structurally configured for
insertion into the patient's ear canal, the imaging apparatus
comprising an imaging element structurally configured for obtaining
images which are angled relative to and/or offset of the central
axis of the extension into the ear canal.
2. The imaging apparatus according to claim 1, wherein the imaging
apparatus comprises an engagement member which is structurally
configured to be supported in-use by a patient's ear or head.
3. The imaging apparatus according to claim 1, wherein the imaging
apparatus comprises a wireless transmission element for wirelessly
transmitting the obtained images to a computing device.
4. The imaging apparatus according to claim 1, wherein the
extension has a soft outer surface for improved patient comfort
during insertion of the extension into the patient's ear canal.
5-7. (canceled)
8. A kit for collecting diagnostic information of a patient, the
kit comprising: a. a main body comprising a diagnostic processor
for obtaining medical diagnostic information of the patient, the
body comprising a transmission element for transmitting the
diagnostic information via a wired or wireless connection to a
computing device; and at least two attachments for the main body
selected from the group consisting of: b1. a first attachment
comprising an imaging element, accessing element, and/or capturing
element structurally configured for imaging the ear canal and/or
the ear drum of the patient; b2. a second attachment comprising an
imaging element, accessing element, and/or capturing element
structurally configured for imaging the oral cavity and/or throat
of the patient; and b3. a third attachment comprising a sound
accessing element and/or capturing element structurally configured
to obtain internal sounds of the patient's body.
9-13. (canceled)
14. A method of remotely providing medical information to a patient
by a health care professional, the method comprising the steps of:
a. providing to the patient the imaging apparatus according to
claim 1; b. providing, via a remote connection, the patient's
current medical data to the health care professional; c. optionally
providing the health care professional with the patient's medical
history; d. causing the imaging device to provide medical
diagnostic information over the remote connection to the health
care professional; e. causing the health care profession to develop
an assessment of the patient's current physical condition on the
basis of the current medical data and the medical history if
available; and f. communicating the assessment to the patient or
patient's caregiver over an electronic communications channel.
15. The method according to claim 14, further comprising: e.
providing, by the health care professional, the patient or
patient's caregiver with treatment information.
16. The method according to claim 14, wherein the treatment
instructions comprises providing the patient with a prescription
for a drug or a laboratory procedure; directions to visit a medical
care provider, pharmacy, hospital, or laboratory; and combinations
thereof.
17. (canceled)
18. A method of remotely providing medical information by a health
care provider to a patient, the method comprising the steps of: a.
providing to the patient the imaging apparatus according to claim
1; b. providing, via a remote connection, instructions to an
untrained or semi-trained consumer to perform an examination
protocol for a patient's condition using an examination device
which stores and/or transmits current patient medical data for use
in an asynchronous or telemedicine environment; c. transmitting, by
the consumer, the examination protocol data to the health care
provider; d. causing the imaging device to provide medical
diagnostic information over the remote connection to the health
care professional; e. causing the healthcare provider to develop an
assessment of the patient's current physical condition on the basis
of the data obtained by the examination device; and f.
communicating the assessment to the patient or the patient's
caregiver over the remote connection.
19. The method according to claim 18, further comprising: e.
providing, by the health care professional, the patient or
patient's caregiver with treatment information.
20. The method according to claim 18, wherein the examination
protocol data is transmitted to the health care provider in real
time or not in real time.
21. (canceled)
22. An examination device for performing an examination protocol
for a patient's condition, the examination device comprising: a. an
anatomical interface structurally configured for application to a
predetermined area of the patient's body; b. an accessing and
capturing component which obtains current medical data of the
patient after application of the anatomical interface to the
patient's body; c. a diagnostic processing component which
processes the medical data obtained by the accessing and capturing
component; and d. an transmission element for electronically
transmitting medical data for viewing and interpretation by a
medical care provider.
23. The device according to claim 22, wherein the anatomical
interface is structurally configured for application to the
patient's ear, nose, throat, eye, wrist, skin, head, skin,
extremities, torso, or a body orifice.
24. The device according to claim 22, wherein the device further
comprises a remote control component which is structurally
configured to respond to control signals sent remotely by the
medical care provider or a caregiver over the communications
link.
25. The device according to claim 22, wherein the communications
link transmits the obtained medical data in the form of still
images, a video feed, an audio feed, a data stream, or a
combination thereof, to the medical care provider.
26. The device according to claim 22, wherein the device comprises
a port or jack configured for attachment to a mobile telephone,
laptop computer, tablet computer, or desktop computer.
27. The device according to claim 22, wherein the capturing
component is a mobile telephone, laptop computer, tablet computer,
desktop computer, or is custom-designed.
28. The device according to claim 22, wherein the diagnostic
component is a mobile telephone, laptop computer, tablet computer,
desktop computer, or is custom-designed.
29. A telehealth system for remote diagnosis of a patient's medical
condition, the system comprising: A. a user subsystem configured
for receiving a patient's current medical data, the user subsystem
comprising: 1. a communication device; 2. a diagnostic processing
device; and 3. the imaging apparatus according to claim 1; B. a
provider subsystem configured for communicating with a health care
provider, the provider subsystem comprising: 1. a communication
device; and C. an infrastructure subsystem configured to process
and store medical data and diagnostic information received from the
user subsystem and the provider subsystem, the instrastructure
subsystem comprising: 1. an application server comprising computer
instruction code configured to communication with: a. a database
configured to store a patient's personal information and electronic
health record; b. diagnostic computer instruction code configured
to receive current patient medical information and to provide
diagnostic information concerning the patient's medical condition;
and c. a database configured to store archived diagnostic
information; 2. a server comprising computer instruction code
configured to communicate with one or more third-party patient
personal information or electronic health record databases; and 3.
a server comprising computer instruction code configured to
communicate with a third party telehealth system, wherein the user,
provider, and infrastructure subsystems are structurally configured
to communicate information over an electronic data network.
Description
[0001] This application claims the priority benefit of U.S.
provisional patent application Ser. No. 61/664,920, filed on 27
Jun. 2012, the contents of which are incorporated herein by
reference in their entirety.
FIELD OF THE INVENTION
[0002] The invention relates generally to various systems, tools
and methods for acquiring diagnostic information, including medical
information, for a user, transmitting the information to a remote
location, assessing the information, and transmitting resulting
diagnosis and treatment information to the user and/or a third
party for subsequent action. More specifically, the present
invention relates to consumer and user-friendly telemedicine
systems and procedures which enable health services and/or
diagnoses to be provided remotely.
BACKGROUND OF THE INVENTION
[0003] Currently, patients with an injury or undiagnosed pain are
typically forced to visit one or more physicians or medical
treatment centers to have their condition diagnosed. If the patient
is a small child, or if the condition is thought to be serious or
in need of immediate treatment, the long waiting periods for a
physician appointment may seem unreasonable or unacceptable, and
the patient often ends up going to an emergency room and/or urgent
care center on a "walk-in" basis. At the medical facility, the
patient (or his/her guardian or caregiver) fills out medical
history forms, answers questions about the condition, and has a
clinician perform a physical examination to learn about the
condition. In many cases, the waiting period at the facility can
consume many hours, depending upon facility capacity and other
patient needs (e.g., emergency cases treated as priority, etc.).
Ultimately, the patient's visit may have been unnecessary, as the
condition was not truly "urgent" or "critical," and thus treatment
could have been delayed and/or accommodated at a regularly
scheduled appointment, or the condition would have resolved itself
with little or no intervention by the physician.
[0004] In many cases, the stress and uncertainty associated with
the patient's condition can be more debilitating than the condition
itself, especially where the patient is a small child, and the
caregiver is an inexperienced parent who is anxious about his or
her child's condition. Moreover, because emergency treatment
centers such as emergency rooms and urgent care centers are
operating at or over capacity, the long wait times at such
facilities can further exacerbate stress, leading to a wide variety
of potential medical situations including hypertension, heart
attacks and/or strokes, as well as possible physical and/or mental
altercations between patients and/or caregivers. Moreover, the
unnecessary use of emergency and urgent care facilities levies a
heavy cost on the nation's health care and health care insurance
systems, as such services are generally much more expensive than
similar services provided on a scheduled or appointed basis.
SUMMARY OF THE INVENTION
[0005] The various inventions disclosed herein include the
identification of a need for consumer-and/or user-friendly devices
that can be employed by untrained or semi-trained individuals to
safely and effectively capture, store, transmit, display, download
and/or update medical or other information, including assessments,
examinations, and evaluations of a patient's condition via
electronic media for use by patients, clinicians, health care
providers, and system administrators. In accordance with one
exemplary embodiment of the present disclosure, the method
includes, without limitation, a non-medical professional (e.g., a
consumer or other patient, etc.) utilizing a device to perform an
examination protocol for a patient's condition, the device having
the capability to store and/or transmit relevant information for
use in an asynchronous or other telemedicine environment. The
performing of the examination can include storing information about
the patient's condition in a storage medium, include storage media
accessed remotely (e.g., USB accessible, LAN accessible and/or
internet accessible storage devices), as well as localized storage
associated with the device (e.g., RAM or flash memory, SD cards,
attached smartphone memory, etc.). The device can simultaneously
and/or subsequently upload stored data to a general or specialized
storage network, or remote access to the electronic storage medium
can be provided over a computer or other communication network. The
stored data can then be accessed by a competent medical
professional or other caregiver, properly assessed, and
recommendations regarding the condition and/or treatment can be
transmitted or otherwise given to the patient or guardian.
[0006] Various embodiments disclosed herein include the
manufacture, distribution and use of specialized and/or generalized
devices that can be utilized by non-medical personnel (e.g.,
consumers) to collect patient information in a home-care or
non-medical facility location. The information can then be
transmitted and/or otherwise accessed by qualified medical and
care-giving personnel, and appropriate assessment, condition and/or
treatment information can be transmitted or otherwise provided to
the patient. In various embodiments, the device can be a part of
and/or used in conjunction with electronic communications and/or
display systems such as telephones, cell phones, smart phones,
computers, wireless radios and/or other communications media known
in the art. Desirably, the disclosed systems will allow a patient
to transmit sufficient information to the medical professional to
enable assessment of the patient's condition, which may include
information relevant to immediate and/or critical treatment of the
condition that may not be readily apparent to the patient. In
various embodiments, the inventive systems allow trained personnel
to direct the patient's actions and/or use of the diagnostic tools,
such as requesting information regarding specific anatomical
features which may be imaged by the diagnostic device in the hands
of the patient as requested "real time" by the physician.
[0007] In various embodiments, the disclosed systems and methods
include the ability to collect patient information at a plurality
of times or conditions, whereby the information can be transmitted
and/or otherwise accessed by the medical professional and used in
the assessment of the patient's condition. Such information may be
stored for various periods of time, at differing locations, and
previously-stored data can be transmitted and/or made available in
conjunction with current patient information and used in the
assessment of the patient's condition. Similarly, patient
information collected via other methods, including routine
physicals and/or during doctor office visits, can be collected and
provided with current patient information in a similar manner. If
desired, the specialized and/or generalized consumer device (or
other device such as a smartphone or computer) can include memory
features that collect and store such information, such as the
identity and dosages of medicines currently being taken by the
patient or the fact that the patient has diabetes or other medical
conditions.
[0008] Various alternative embodiments include the provision of an
internet-accessible healthcare system to consumers, whereby the
consumer can provide patient information (as previously described)
to the system, and can receive assessment, condition and/or
treatment information from a healthcare professional associated
with the system. In various embodiments, the system can provide the
consumer and/or patient with status updates and/or other relevant
information during the process to: (1) confirm receipt and/or
integrity of the relevant patient information, including patient
medical data and payment information, if necessary, (2) identify
various steps of the process, and the patient information's current
status (e.g., data assigned to a physician or specialist, data
currently being reviewed, medical recommendations being prepared,
system scheduling a local physician visit on patient's behalf,
system directing patient to a local emergency room, system
dispatches an ambulance or paramedics to the patient's location,
etc.), (3) request additional information from the patient (either
using the current device and/or additional devices, some of which
may be immediately available to the patient) which may include
initiating a live-call or other communication between the medical
professional and the patient, (4) providing assessment, treatment
and/or other information to the patient, and (5) forwarding
prescription or other treatment information to the patient,
hospital, pharmacy or other care-giver as requested by the patient
and/or assigned by the system. In various embodiments, the
provision of the type of updates can significantly reduce patient
anxiety while waiting for treatment information, as well as confirm
to the patient whether the patient information has been received
and/or is being reviewed by the system. In addition, in situations
where the patient is unable or unwilling to access emergency
services directly (e.g., the patient is stuck in an accident on the
road, lost in the wildness, climbing a mountain, located in a
collapsed building, etc.), the present system and methods described
herein can provide critical care data directly to the patient, as
well as provide emergency response personnel with detailed
information about a patient's condition, that may take mere seconds
for the device to collect, allowing responders to prioritize their
response and/or equip themselves for specialized medical
responses.
[0009] In various embodiments, the present system can be associated
with various healthcare-providing organizations and/or payors,
including clinics, hospitals, insurance companies, employers and/or
governmental entities, as necessary and/or allowed by current or
future laws (e.g., privacy and health care information
accessibility statutes, etc). The use of such systems by such
entities can significantly reduce congestion of existing emergency
as well as non-emergency health services (by reducing the number
and/or frequency of unnecessary patient visits) as well as
significantly improve the provision of health care to the general
consuming population in a highly effective and cost-efficient
manner. Moreover, various embodiments of the system can
significantly reduce the need for medical professionals to be
located proximate to their patients, and can even promote and/or
encourage "time shifting" of medical care by patients and/or
medical professionals.
[0010] Various technical features of the invention generally relate
to devices, systems and methods that facilitate remote connection
and communication between two or more parties for medical, health
and/or wellness purposes, herein collectively referred to as
telehealth. In various embodiments, technical features are
disclosed that generally relate to devices, systems and methods for
capturing, displaying, recording and/or transmitting diagnostic
information, including remote control manipulation of devices
and/or diagnostic information. Other technical features of the
invention generally relate to devices, systems and methods that
provide the infrastructure, logistics and user interfaces to make
possible remote or at home diagnosis, advice and/or coaching for
medical, health and/or wellness purposes (herein collectively
referred to as health purposes). Other technical features of the
invention generally relate to devices, systems and methods
providing advanced features for a more pleasurable user experience
and/or more elaborate telehealth system.
[0011] In various embodiments, the systems and methods disclosed
herein can facilitate one or more of the following (including
various combinations thereof):
[0012] A. Reduction of health care costs for both payer and
patient/consumer;
[0013] B. Providing adequate patient access to primary care
physicians. The invention desirably accommodates reducing the
number of primary care physicians and increasing the number of
patients able to be served;
[0014] C. Early diagnosis focusing to help minimize disease
progression;
[0015] D. Accommodation of modern fast-paced life/culture. Modern
communications methods and widespread internet/wireless connections
have created consumers' expectations for more convenient and more
rapid answers and access to information, including 24-hour and/or
"real time" access to services;
[0016] E. Consumer-friendly and/or ruggedized information capture
devices: The invention provides access to telemedicine and creates
a need for the ability to capture diagnostic information remotely;
and
[0017] F. Reduction of the number of high-cost visits to an
emergency room or facility/urgent care.
[0018] In various alternative embodiments, similar systems and
methods as described herein could have varying levels of utility in
non-health care applications, including the collection of relevant
data using similar devices and/or the provision of "expert" advice
for various other purposes, including non-medical diagnostics such
as carpentry, plumbing, auto repair, etc.
[0019] It is to be understood that a reference to an individual
encompasses singular and plural instances of the individual. For
example, a medical care professional or provider may be a single
person providing medical care, or multiple individuals working in
concert to provide complementary service(s) to the patient or
caregiver. Similarly, a caregiver can be a single individual such
as a parent, or multiple individuals such as attendants at a
nursing home.
[0020] In certain instances herein, components of the invention may
alternatively be referred to as elements. These terms, as well as
other comparable terms, are to be considered as
interchangeable.
[0021] An embodiment of one aspect of the present invention is
directed to an imaging apparatus for obtaining images inside a
patient's ear canal. The imaging apparatus according to this
embodiment comprises a main body and an extension having a central
axis structurally configured for insertion into the patient's ear
canal. The imaging apparatus comprises an imaging element for
obtaining images which are angled and/or offset relative to the
central axis of the extension into the ear canal. Alternatively,
the imaging apparatus may be configured to obtain images in line
with the central axis of the extension but where the extension is
offset and/or angled relative to the ear canal central axis.
Further, the imaging apparatus may obtain images which are angled
and/or offset relative to the central axis of the extension and
angled and/or offset relative to the central axis of the ear canal.
The main body and/or extension may engage with the outer ear or ear
canal to encourage these positions
[0022] The imaging apparatus may comprise an engagement member
which is structurally configured to be supported in-use by a
patient's ear or head so that the user, provider, or caregiver does
not need to support or hold the apparatus in position.
[0023] The imaging apparatus may comprise a wireless transmission
element for wirelessly transmitting the obtained images to a
processing or computing device. Alternatively, the imaging
apparatus may communicate with a processing or computing device via
a wired connection. A non-limiting list of examples of computing
devices include mobile telephones, smartphones, laptop computers,
tablet computers, desktop computers, servers, mainframes, and
dedicated hardware computing devices. These devices can operate
using mobile operating systems such as iOS (from Apple Inc.) and
Android (from Google Inc.), desktop operating systems such as OSX
(from Apple Inc.) and Windows (from Microsoft Corp.), or any other
kind of operating system or platform. The computing device can also
be custom-designed and manufactured for use specifically with the
imaging apparatus.
[0024] The extension portion of the imaging apparatus may have a
soft outer surface for improved patient comfort during insertion of
the extension into the patient's ear canal.
[0025] An embodiment of another aspect of the present invention is
directed to an oral imaging apparatus in the shape of a pacifier.
The imaging apparatus may comprise an imaging element configured
for taking an image of the oral cavity of a patient; and a
transmission element for transmitting the image to a processing or
computing device.
[0026] An embodiment of another aspect of the present invention is
directed to a kit for collecting diagnostic information of a
patient. Although different embodiments of the kit may contain
different components, a useful combination comprises a main body
and one or more attachments. The main body comprises diagnostic
equipment, such as processing and/or computing elements, for
obtaining medical diagnostic information of the patient, and a
transmission element for transmitting the diagnostic information
via wired or wireless connection to a computing device.
[0027] A useful first attachment for the main body comprises an
imaging element structurally configured for imaging the ear canal
and/or the ear drum of the patient. A useful second attachment for
the main body comprises an imaging element structurally configured
for imaging the oral cavity and/or throat of the patient. The kit
may also comprise a third attachment having a sound accessing
element structurally configured to obtain internal sounds of the
patient's body. The kit may comprise any combination of first
and/or second and/or third attachments.
[0028] The transmission element in the kit may be configured to
transmit the diagnostic information in real time as the device is
in use, or the diagnostic information may be transmitted upon
receipt of an instruction from a user or provider. The transmission
element may have the capability of transmitting the diagnostic
information in a plurality of image resolutions, image sizes, or
transmission speeds, or combinations thereof. For example, the
transmission element can be configured to send images at VGA, SVGA,
HVGA, or another resolution, or video at 12 frames per second, 24
frames per second, or another frame rate.
[0029] Any of the components of the kit such as the main body may
be structurally configured as a hands-free unit while in-use, or as
a handheld unit while in-use.
[0030] Another aspect of the present invention provides for a
method of remotely providing medical information to a patient by a
health care professional. The method may comprise the steps of:
[0031] a. providing, via a remote connection, the patient's current
medical data to the health care professional;
[0032] b. optionally providing the health care professional with
the patient's medical history;
[0033] c. causing the health care profession to develop an
assessment of the patient's current physical condition on the basis
of the current medical data and the medical history if available;
and
[0034] d. communicating the assessment to the patient or patient's
caregiver over an electronic communications channel.
[0035] The method may also include providing, by the health care
professional, the patient or patient's caregiver with treatment
information. The treatment instructions can include any kind of
medical advice or instructions, such as providing the patient with
a prescription for a drug or a laboratory procedure; directions to
visit a medical care provider, pharmacy, hospital, or laboratory.
Multiple instructions can also be given to multiple parties. For
example, the health care professional can provide (a) the patient's
caregiver with verbal medical care instructions; (b) a pharmacy
with a prescription for filling; and (c) a laboratory with advance
notice that the patient will need a certain kind of test to be
performed.
[0036] Another aspect of the present invention is directed to a
method of remotely providing medical information by a health care
provider to a patient. The method may comprise the steps of:
[0037] a. providing, via a remote connection, instructions to an
untrained or semi-trained consumer to perform an examination
protocol for a patient's condition using an examination device
which stores and/or transmits current patient medical data for use
in an asynchronous or telemedicine environment;
[0038] b. transmitting, by the consumer, the examination protocol
data to the health care provider;
[0039] c. causing the healthcare provider to develop an assessment
of the patient's current physical condition on the basis of the
data obtained by the examination device; and
[0040] d. communicating the assessment to the patient or the
patient's caregiver over the remote connection.
[0041] The method may further comprise providing, by the health
care professional, the patient or patient's caregiver with
treatment information for the patient.
[0042] The examination protocol data can be transmitted to the
health care provider in real time, as the data is acquired, or not
in real time, for example, upon receipt of an instruction or
request from the provider or health care professional for this
data. In such embodiments, the examination protocol data can be
stored in a storage medium such as a flash drive in a device
participating in the performance of the invention.
[0043] An embodiment of another aspect of the present invention is
directed to an examination device for performing an examination
protocol for a patient's condition. The examination device can
comprise:
[0044] a. an anatomical interface structurally configured for
application to a predetermined area of the patient's body;
[0045] b. an accessing and capturing component which obtains
current medical data of the patient after application of the
anatomical interface to the patient's body;
[0046] c. a diagnostic processing component which processes the
medical data obtained by the accessing and capturing component;
and
[0047] d. a communications link over which the processed medical
data is transmitted to a communications component for viewing and
interpretation by a medical care provider.
[0048] The anatomical interface is structurally configured for
application to the patient's ear, nose, throat, eye, wrist, skin,
head, skin, extremities, torso, or into a body orifice such as the
inside of the mouth or nose. In this manner, the anatomical
interface of the device will facilitate providing accurate patient
medical status information.
[0049] Any of the disclosed devices, systems, or components may
comprises a remote control component which is structurally
configured to respond to control signals sent remotely by the
medical care provider or a caregiver over a communications link.
The communications link can transmit the obtained medical data in
the form of still images, a video feed, an audio feed, a data
stream, or a combination thereof, to the medical care provider.
[0050] Any of the disclosed devices, systems, or components may
comprises a port or jack configured for attachment to a computing
device such as a mobile telephone, laptop computer, tablet
computer, or desktop computer. The port or jack may be conventional
such as a minijack, USB port, Apple iDevice port (such as an iPhone
or iPad), or custom-designed by the manufacturer.
[0051] Examples of the accessing and capturing component of the
present invention include a mobile telephone, laptop computer,
tablet computer, desktop computer, or a custom-designed hardware
element.
[0052] Examples of the diagnostic processing component of the
present invention include a mobile telephone, laptop computer,
tablet computer, desktop computer, or a custom-designed hardware
element. In certain embodiments of the invention, the accessing and
capturing component and the diagnostic processing component can be
the same hardware element. That is, the hardware element can have
multiple functions as discussed and provided in this
specification.
[0053] An embodiment of another aspect of the present invention is
directed to a telehealth system for remote diagnosis of a patient's
medical condition. The telehealth system can comprise elements such
as: [0054] A. a user subsystem configured for receiving a patient's
current medical data, the user subsystem comprising: [0055] 1. a
communication device; [0056] 2. a diagnostic processing device; and
[0057] 3. a diagnostic capture device; [0058] B. a provider
subsystem configured for communicating with a health care provider,
the provider subsystem comprising: [0059] 1. a communication
device; and [0060] C. an infrastructure subsystem configured to
process and store medical data and diagnostic information received
from the user subsystem and the provider subsystem, the
instrastructure subsystem comprising: [0061] 1. an application
server comprising computer instruction code configured to
communication with: [0062] a. a database configured to store a
patient's personal information and electronic health record; [0063]
b. diagnostic computer instruction code configured to receive
current patient medical information and to provide diagnostic
information concerning the patient's medical condition; and [0064]
c. a database configured to store archived diagnostic information;
[0065] 2. a server comprising computer instruction code configured
to communicate with one or more third-party patient personal
information or electronic health record databases; and [0066] 3. a
server comprising computer instruction code configured to
communicate with a third party telehealth system,
[0067] wherein the user, provider, and infrastructure subsystems
are structurally configured to communicate information over an
electronic data network.
DEFINITIONS
[0068] For convenience, further information regarding the following
terms is provided below. Other and equivalent terms in this
description may be used to describe similar concepts.
[0069] Patient: One or more individuals desiring or needing health
advice. A may be a group, e.g. exercise class or sport team.
[0070] Caregiver: One or more individual(s) that assist the patient
with their health concern. This individual is usually known to the
patient, e.g. a son or daughter or parent or coach.
[0071] User: One or more patient(s) and/or caregiver(s).
[0072] Health Professional: Any individual certified or experienced
within a health related field. Examples include a physician,
surgeon, nurse, physician assistant (PA), nurse practitioner (NP),
physical therapist, nutritional expert, paramedic etc, medic,
paramedic, EMT, etc.
[0073] Nurse Hotline: A service provided by an insurance company or
health related entity that provides health advice or helps connect
an individual with the appropriate health professional.
[0074] Call Center: A service, that may be provided by a non-health
related entity, that provides health advice or helps connect an
individual with the appropriate health professional.
[0075] Provider: One or more health professional(s), nurse hotline
and/or call center.
DESCRIPTION OF VARIOUS EXEMPLARY EMBODIMENTS
[0076] Although the disclosure hereof is detailed and exact to
enable those skilled in the art to practice the invention, the
physical embodiments herein disclosed merely exemplify the
invention, which may be embodied in a manner not expressly
described. While the preferred embodiment has been described, the
details may be changed without departing from the invention, which
is defined by the various disclosures and claims provided
herein.
BRIEF DESCRIPTION OF THE FIGURES
[0077] FIGS. 1 and 2 illustrate exemplary embodiments of a
telehealth system in use.
[0078] FIG. 3 illustrates linked components of an exemplary
embodiment of a telehealth system.
[0079] FIG. 4 illustrates three components of a telehealth system
in accordance with an exemplary embodiment of the invention;
[0080] FIGS. 5-7 illustrate exemplary embodiments of user devices
structurally configured for insertion into the human ear which
communicate a patient's current medical status in accordance with
the present invention.
[0081] FIGS. 8 and 9 show a cross-section of the ear region of a
patient's head for purposes of reference.
[0082] FIGS. 10-20 illustrate exemplary embodiments of an ear
imaging device comprising an anatomical interface to facilitate
positioning and image quality and may also serve as safety
mechanisms that prevent over insertion.
[0083] FIG. 21 illustrates features of the outer human ear for
purposes of reference.
[0084] FIGS. 22-24 illustrate exemplary embodiments of an over-ear
device for obtaining a patient's current medical status.
[0085] FIGS. 25-26 illustrate exemplary embodiments of an over-ear
device and different configurations of the outer ear elements.
[0086] FIGS. 27 and 28 illustrate side and bottom views of an
exemplary ear imaging device.
[0087] FIGS. 29 and 30 illustrate exemplary embodiments of
anatomical interfaces for an medical device for insertion into a
patient's mouth or ear.
[0088] FIG. 31 illustrates an exemplary embodiment of a medical
diagnostic instrument equipped with a microphone.
[0089] FIGS. 32-35 illustrate exemplary embodiments of medical
diagnostic instruments for collection of patient medical
information.
[0090] FIGS. 36-37 illustrate exemplary embodiments of kits
comprising devices for accessing, capturing, and at least partial
processing of medical diagnostic information in accordance with the
present invention.
[0091] FIGS. 38A-38E illustrate exemplary embodiments of medical
diagnostic devices in accordance with the present invention which
are structurally configured to be placed on, in, or adjacent to a
patient's body for obtaining medical diagnostic information.
DETAILED DESCRIPTION
[0092] I. Telehealth System: An Overview
[0093] The various figures described herein depict a variety of
telehealth and/or other systems for remote diagnosis of health
concerns. It should be understood that, while these exemplary
systems include many different elements, which will be described in
the sections that follow, various other embodiments of such
system(s) may also include additional or fewer elements, as desired
by the user and contemplated by the present disclosure. Some of
these simpler or more complex systems will be discussed later.
[0094] Communication Component and Remotely Linking One or More
User(s) and/or Provider(s)
[0095] A telehealth system will preferably include a method to
remotely link one or more parties through communication devices and
enable voice, video and/or text communication. Alternatively, a
system may employ communication devices to allow a user to record
and/or upload video, voice, text, background health information
and/or diagnostic information and enable a provider to evaluate and
provide a diagnosis or advice without live communication with the
user.
[0096] The communication component(s) may take a variety of forms.
For example, the user may communicate with a computer, a tablet, a
landline phone, a standard mobile phone, a smart phone such as the
Apple iPhone, a unique communication device specialized for use
with a telehealth system, or any other device that allows
recording, transmission and/or uploading of voice, video, text,
files and/or diagnostic information. In various embodiments, the
device will desirably allow receiving of similar information and
enable the user to receive a diagnosis or advice from the provider.
The provider communication component is of similar design and
capability. Desirably, the provider communication device will be
able to receive information from the user and transmit a diagnosis
or advice to the user. The user and/or provider may use more than
one communication device concurrently or sequentially. For example,
a user may use a landline phone to communicate by voice with a
provider and use a computer to receive and transmit diagnostic
information. While the device that transmits diagnostic information
may also have (or may be) a communication device, it will also be
described as a diagnostic processor, which may be separate from the
communication device(s).
[0097] The link between the user and provider may be created using
a variety of methods. A user(s) can initiate a telehealth session
by submitting a request for care. This request may be directed to a
specific provider (for example, the patient's primary care
physician), a limited network of providers, or it may be "crowd
sourced" to any available provider, which may facilitate a more
instantaneous response. In addition, the request may be routed to a
nurse hotline or call center that may provide a preliminary
evaluation and as necessary forward the connection to an
appropriate provider.
[0098] A provider then accepts the request for care and in various
embodiments a secure link between the user(s) and the provider(s)
can be established. This link may be as simple as a phone call but
more desirably includes a video link between the user(s) and
provider(s). Also, as previously stated, the secure link may only
involve the transmission of information (e.g. video, voice and/or
diagnostic information) and not require "real time" live
communication. The diagnostic information and/or other information
such as a recorded voice and video transmission may be reviewed by
a provider and/or software analysis tool offline from the user and
a diagnosis or advice forwarded to the user.
[0099] Collecting and Transmitting Diagnostic Information and
Relevant Medical History
[0100] The provider(s) then collect and/or review the relevant
health history from the user(s) and a description of the health
issue that the user(s) requires help for. If some or all of this
information is contained in the user's account or in some
pre-loaded form in a remote location, the user may elect to
directly share this information with and/or authorize release of
this stored date to the provider(s). In addition, it may be
desirable that the user is able to share up-to-date (current)
diagnostic information with the provider. This information may have
been collected recently, over time, or during the call through the
use of various home diagnostic devices. Examples of patient
information can include blood pressure readings or blood glucose
levels. These devices may provide the data only to the user, and
the user can then share this data with the provider or allow the
data to be sent or shared directly with the provider through a
communication channel. This diagnostic information may also be
collected through the use of diagnostic devices described in this
document. Ideally, the diagnostic device is connected to a
communication channel which gives the provider one or more feeds of
the diagnostic data and when applicable the ability to control or
refine diagnostic feeds or download snapshots or segments to allow
high resolution or more precise information to be viewed. Relevant
health history information may also include information or data
stored or otherwise obtained from the diagnostic device or a linked
device, such as geographic location data from a smartphone GPS
and/or credit card or payment information from an electronic
wallet, etc.
[0101] The next step is for the provider to determine a diagnosis
or give advice to the user. This may include an e-prescription
(which may include directions to a local pharmacy identified using
GPS geographic information from the user), scheduling a follow-up
consultation and/or recommending the user proceed to a doctor's
office, urgent care or emergency room (which may include directions
to a local service provider based on the patient's location). The
user and provider then agree that a sufficient resolution has been
reached. A third party may be contacted to help reach a
satisfactory outcome if there is disagreement on the
resolution.
[0102] C. Accounts, Logistics and Infrastructure
[0103] The final step of patient care under this exemplary system
can involve termination of the consultation (e.g. provision of
patient care instructions) and completion of logistics. This may
include submission of an e-prescription for patient collection,
processing of payment, electronic links to or emails containing the
details or summary of the call, and/or creation and submission of
insurance forms or other formal documentation.
[0104] In various embodiments, it may be preferred that one or more
user accounts of some type are created prior to the initiation of
the communication. Desirably, a user account should contain
sufficient information to verify that the patient or other
responsible person is able to pay for access to a provider. This
account may be anonymous in nature, containing as little as payment
information only, or may contain detailed information on patient
history and/or a link to a patient's Electronic Health Record
(EHR). Desirably, the provider account should contain sufficient
information to ensure his/her identity and expertise in order to
provide the requested care. This account may be part of a larger
account established and maintained by a physician group, an
insurance company, or other similar responsible group.
[0105] Telehealth Systems and Additional Features
[0106] There are several types of systems and features which may be
incorporated into a telehealth system. The telehealth system may be
as simple as a phone call between a user and a provider, or include
videoconferencing and live transmission of diagnostic data such as
images being captured by the user with a device. The system may
also allow text and file sharing as well as links and updates to a
patient's electronic health record (EHR). The provider may simply
give advice or provide a formal diagnosis and submit an
e-prescription. The system may also incorporate computer analysis
of diagnostic data to give the user probabilities of certain
conditions or be used by a provider for a more thorough
analysis.
[0107] Multiple types of connections will be described, including
the ability to connect a caregiver at one location, a patient at a
second location and one or more providers on the same "call". The
user may select specific physicians based on a ranking and pay
appropriately, or offer a specific amount of money and wait for a
provider to accept the fee. There may also be
social/gaming/educational elements built into the system. For
instance, users may wish to "crowd-source" their health issues for
comments and advice from other users. Users may be offered
discounts for achieving a certain level of accuracy in their
feedback to other users. The system may include video-game type
three-dimensional tours through or around the body with examples of
health ailments and ways to prevent or treat these issues. Users
may be given points and increase their status based on correct
guesses for exemplary health ailments.
[0108] Several embodiments of devices, methods and systems which
help facilitate the described telehealth system as well as simpler
and more complex systems are described herein. It should be noted
that that diagnostic embodiments may be used without a telehealth
system, and that telehealth embodiments may be utilized without the
use of diagnostic devices.
[0109] II. Communication Devices, Systems and Methods
[0110] Communication Component
[0111] Patient/caregiver communication devices can have any kind of
structure, and can include devices which allow connection to a
distant location, ideally allowing video, text, file sharing and/or
other data connection. A plurality of communication devices can
also be used in tandem. For example, one communication device may
be used for video/voice communication, and a second communication
device may be used as a channel to display and/or transmit
diagnostic information to the medical services provider. Also,
users may be more comfortable speaking over a landline but can see
the provider on their computer (a communication device) which also
serves as the data diagnostic processing unit to transfer data to
the medical services provider. Examples of communications devices
are provided below, and they may be used alone or in combination
with other communication devices:
[0112] landline telephone, which can be used for a simple phone
call or with a diagnostic device with wireless/wifi capability or
other internet connection which connects to a conference call with,
and feeds information to, the provider. A user can also use a
landline phone with a computing device to provide video
capability;
[0113] mobile telephone;
[0114] computer and telephone;
[0115] tablet and telephone;
[0116] tablet only;
[0117] computer only (with a standalone diagnostic device as
applicable);
[0118] supplied device specifically for communicating with this
system. Such devices are ideally suited for the elderly and they
may also serve as the diagnostic computer. The device may be
connected cellularly, have RF or other wireless transmission mode
for connection to the Internet or to a base station connected to
internet or wireless; and
[0119] monitoring device or system set up in a bedroom having wide
view or zoom capabilities, which may be initiated by a caregiver
(e.g. for elderly patients). The system may comprise one or more
cameras located in one or more rooms of the house. Users may be
connected to these communication devices in a variety of ways. One
way, especially useful in case of an urgent issue, is a push button
device worn on the body (such as a watch, bracelet, or
necklace).
[0120] Examples of a provider's communication device include:
[0121] telephone only (landline);
[0122] telephone and computing device for video or other data
connection;
[0123] mobile phone only;
[0124] tablet only;
[0125] computer only;
[0126] video conference room; and
[0127] simultaneous feeds to other providers for training or
additional physician (e.g. a specialist)
[0128] A communication device preferably has software providing a
user interface to facilitate communication, user experience,
transfer of diagnostic information, recording, output/display
and/or other features to aid in the telehealth service.
[0129] A communication device may also serve as a diagnostic
processor (which will be explained in more detail later). This
device may output diagnostic information (e.g. display images) and
transfer the diagnostic information to the provider. When used in
this fashion, the device may switch from video/voice communication
to a voice call only while collecting and transmitting diagnostic
information.
[0130] B. Systems and Methods for Remote Linking of One or More
Parties
[0131] A connection between patient/caregiver and provider(s) may
include any of the following steps, which may be performed in any
order:
[0132] 1. Request connection time, for example, as soon as possible
while waiting, request first available appointment, request
appointment at specific time or within window of date or time;
[0133] 2. Select preferred provider (e.g. primary care
physician);
[0134] 3. Select preferred group (e.g. primary care and
associates). Groups of medical practitioners may be available for
selection, or a consumer may be able to select several individual
physicians;
[0135] 4. Select crowd source option, e.g., for instantaneous
access, or for first to respond;
[0136] 5. Select tier base of providers, wherein users pay more for
higher credentials or higher ranked providers;
[0137] 6. Select tiered approach for provider selection. For
example, if the primary care physician is not available, the
request for medical care will then pass to the next larger group
after a predetermined time period, then to associates, then crowd
sourced;
[0138] 7. Triage by an instant connection with a nurse hotline, and
then routed to appropriate provider (e.g., physician assistant,
nurse practitioner, primary care, pediatrician, dermatologist,
etc.);
[0139] 8. Call center to answer and route call;
[0140] 9. Emergency/distress request. This urgent request for
assistance may be initiated with a panic button or a device worn on
the body with a distress button. This button initiates a call
and/or enables video devices in the area of the user. The button
may also directly contact 911 services or other emergency response
services. Upon initiation, the system may automatically collect
data, download relevant information (e.g., GPS location
information, current medical conditions such as diabetes, or
current medication and prescription information) and/or maintain
connection/control by remote user (e.g., medical personnel or
police) throughout the entirety of the call to monitor the
emergency situation and/or provide assistance;
[0141] Any of these options may be first initiated by a caregiver,
and then the patient can be linked to the communication.
[0142] A connection between a caregiver and a patient may be
received in any number of ways. For example, there may be a request
from a patient to one or more caregivers. A request could be sent
out to a single person, a few select people, or to many caregivers.
Alternatively, there may be a request from a caregiver to a
patient. The caregiver could open a video or communication
connection without the need for the patient to "answer". For
example, the care giver can activate multi-room cameras or a camera
in the bedroom or a bedside device.
[0143] User Interface and Software
[0144] A provider or other party can be provided with the ability
to remotely select snapshots or a short segment of video feed (or
other type of diagnostic data such as sound) for high resolution
download.
[0145] The user interface of the present invention allows for a
simple and fast method of establishing a connection with a provider
in the user's preferred method (e.g. crowd-sourced or only to
primary care physician, etc., as discussed earlier). This software
may be part of a standalone system or the software may provide an
interface for the user which links with third-party telehealth
services. This option may be especially useful when the user's
insurance company already has a contract with a telehealth service
but the user (and maybe the insurance company as well) desires the
use of diagnostic devices described herein. The user interface
would establish the easiest and clearest way for the user to manage
the call and diagnostic devices while still using the third-party
telehealth system as the "backbone" of the communication.
[0146] III. Diagnostic Devices, Systems and Methods
[0147] This section focuses on the different techniques used to
gather diagnostic information, such as imaging and sound, as well
as devices that incorporate these methods and, which interface with
the human anatomy to allow reliable data capture; and connecting
these devices to diagnostic processing components to transmit,
output, record and/or upload the data and techniques used to
manipulate or remotely control the data and/or device for higher
quality and/or more efficient viewing of data which may allow a
more accurate diagnosis. Diagnostic devices may be fully or
partially composed of one or more features discussed in this
section, including: 1) accessing and capturing components, 2)
anatomical interfaces and 3) diagnostic processing components. For
example, a diagnostic device may incorporate a lens and fiber
optics (accessing) which channel images to a video chip (capturing)
which are encapsulated within a thermoplastic shape which fits into
the ear canal (anatomical interface) and attaches to a small
external ear component which records images and sends the
information via BlueTooth.RTM. (diagnostic processing) to a smart
phone for display, recording and transfer to the internet
(diagnostic processing). In this example, the smart phone may also
be used as the communication component.
[0148] Diagnostic Information
[0149] Various types of diagnostic information may be desired to
help provide a provider give a diagnosis or medical advice to a
user. For example, a user may be concerned that his or her child
has an ear infection. The provider may desire images of the ear
drum, body temperature and medical history. In this case, a light
sensor (e.g. CCD or CMOS video chip) may be used to image the ear
drum. A standard thermometer or a device with a temperature sensor
may be used to record the body temperature and transmit the data to
the provider.
[0150] Another example of an illness where telehealth systems may
be helpful is an upper respiratory infection. In this case, the
provider may wish to know how the upper airway and/or oral cavity
appears, as well as obtain lung sounds and heart rate. A device
with a light sensor may be used to collect images from the upper
airway and a device with a microphone may be used to listen to lung
sounds as well as the heart rate. This information may then be
transmitted live to a provider or uploaded for review at a separate
time by a provider. The medical test data or diagnosis information
may be stored locally by the user, by the medical practitioner, or
by the medical care facility. The data may also be transmitted to a
medical data storage location, or saved in the cloud as is known in
the art.
[0151] Various other potential ailments may be evaluated. For
example, images of the skin may be useful for diagnosing rashes,
skin cancer or poison ivy. Images of the eye may be collected for
eye problems such as red eye or foreign bodies. Images inside the
nose may be useful for evaluating potential allergies or nasal
infections. Sounds of the knee joint or other musculoskeletal areas
may be recorded to help diagnosis arthritis or other ailments.
[0152] As will be discussed, a multitude of other data types
(light, sound, electrical, temperature, strain, etc.) may be useful
to examine an individual for an untold number of potential
ailments.
[0153] Accessing and Capturing Diagnostic Data
[0154] Capturing devices can include a data capturing element such
as a microphone or light sensor (i.e. CMOS or CCD chip). Examples
of capturing devices include commercially-available and standard
off-the-shelf devices as well as specialty devices. Examples of
standard devices are those which may readily purchased from vendors
and include smart phones, tablets and computers. Specialty devices
are devices built or supplied specifically for purposes of the
invention as described herein or supplied by other vendors for
purposes similar to that described herein. Examples of specialty
devices include devices which are similar in form to a smart phone
as well devices which are incorporated into an anatomical interface
and/or processing unit, which will be described in further detail
later. Examples include speakers incorporated into a belt, similar
in form to a heart rate monitor, and a video chip incorporated into
an earphone device that is similar to an earbud or a device that
includes an over ear retaining piece.
[0155] Imaging
[0156] Accessing and capturing light for displaying images can be a
very useful diagnostic tool. Light is emitted by a light source
(for example, a light bulb, flash, ambient, or LED) and then
reflected or absorbed by the environment (for example, the
atmosphere, skin, or mucous) prior to being captured, for example,
using a film camera, CCD or CMOS chip. Lenses and similar
components are considered herein as accessing elements. Light
continues to be modified or transmitted until it hits the
capturing/sensor element, for example, a CMOS or CCD chip. The
light may be accessed, focused and transmitted prior to reaching
the capturing element by means of devices such as lenses, fibers,
mirrors and filters. The captured image may differ depending on the
light source. For example, in the morning and evening, the ambient
light from the sun is different and the scene viewed by an observer
is different. Likewise, different LEDs or filters may be used to
provide light of different wavelengths. Wavelengths outside of the
visible spectrum may also be emitted, filtered and or captured. For
example, certain wavelengths may be useful in distinguishing
whether there is biofilm present, which is indicative of an
infection, or be absorbed or reflected differently when there is
fluid behind the ear drum. Variations of these features and/or
methods may be incorporated into a diagnostic device.
[0157] Light may be captured, by any light capturing device at any
location on the device, for example, near the end of the device,
using a video chip (e.g. CMOS or CCD) or accessed at any location
on the device, for example, by means such as lenses, fibers and/or
mirrors and channeled to a light capturing element. Devices
containing light capturing elements may take many forms. For
example, light may be channeled to a light capturing element in an
existing device such as a smart phone, tablet or computer. Light
capturing elements may also be incorporated into specialty devices
such as an earphone-type device or a specialty diagnostic
instrument which may have a form factor similar to that of a smart
phone. Light may be captured/accessed directly in from the end of
the device or capturing/accessing elements may be configured at an
angle or to the side of the end of the device.
[0158] Multiple accessing and capturing elements may be
incorporated into a device. For example, two or more fiber bundles
may be configured so that their ends are at different angles or
locations. These fibers then channel the light to one or more light
capturing elements (e.g. CCD or CMOS chip). This will allow
different images to be seen. If the light is channeled to a single
capturing element, two different images may be seen in the same
display. Software may be used to alternately display the desired
portion of the image on the full screen. Alternatively, a mirror
may rotate to alternate the displayed images from the two or more
different fibers. If the fibers are positioned at left and right
positions, the two images may be combined in order to create a 3-D
image. If a single capturing element is used, software may be used
to differentiate the images and then create the 3-D image.
Alternatively, straight channels and/or channels and mirrors may be
used to transmit the light to the light capturing element without
the use of fibers. Alternatively, light capturing elements may be
located the end of the device and capture the light at that
location, at multiple locations and/or multiple angles.
[0159] Light may be supplied in a variety of ways as well. Light
may be emitted from a light source (e.g. LED) at the end of the
device or light may be transmitted to the end of the device. For
example, fibers, mirrors or straight channels may be used to
transmit the light to the desired output location. Various filters
may be used to change the emitted wavelength and/or more than one
color or wavelength light source may be incorporated into a device.
Filters may also be used just in front of the capturing element
and/or software used to modify the exposure so that certain
wavelengths, brightnesses or other types of image variables are
modified or restricted from the image. Light may be output in a
variety of geometrical manners as well. For instance, light may be
output in a ring surrounding the video accessing and/or capturing
elements, emitted from a single location adjacent to the
accessing/capturing element(s), or from more than one location
relative to the accessing/capturing elements.
[0160] Multiple accessing and capturing elements may be positioned
to image different areas. For example, one may desire to see an
image of the skin, throat or ear while also seeing a more
contextual image, such as how the device is being used and
positioned. An example of one configuration is using one of the
cameras of a smartphone to capture an image of a child, and light
is channeled using fibers from the child's ear to the second camera
on the smart phone. Imaging accessing and capturing elements may
also be positioned to capture images in different locations of a
desired target area, for example in the oral cavity and then
further away in the back of the throat. Imaging elements may also
be located close to one another but facilitate capturing images at
different locations by having different focal lengths accomplished
through lenses or other components, for example using software that
can focus an image after capturing when used with a capturing
element that identifies angles of the captured light, e.g., using
Lytro camera technology.
[0161] Various methods may be used to maintain a clear image. For
example, air or water may be channeled to the end of the device to
maintain a clean and clear end of the accessing element (such as a
lens) or circulated around or behind the lens or other accessing or
capturing element to prevent condensation or fogging. Anti-fogging
fluid may also be applied to the device prior to use.
[0162] An accessing element may also be expandable. For example, a
tube may be compressed for accessing a location and then expanded
(for example, by inflation) to expand the diameter or size and
therefore access a greater imaging area. Another example of an
expandable device is one constructed of a central expandable member
with accessing and/or capturing elements surrounding this member.
When the central member is expanded, the surrounding elements are
pushed out, accessing a larger area. Expandable members may also be
used to change the position or angle of the accessing/capturing
elements. For example, an expandable member may push the
accessing/capturing elements up into the top of the oral cavity or
to one side of an ear canal. Similar techniques may also be used
for light sources.
[0163] Accessing and/or capturing elements may be configured for
flexibility to allow conformance to a desired location (for
example, an ear canal) and/or incorporate elements that allow the
flexible elements to be manipulated. For example, a fiber bundle
may be steered by a user in a fashion similar to endoscopes, or be
remotely steered by a provider or other person. Alternatively, just
the tip elements (such as a lens, mirror and/or light sensing chip)
may be steered or manipulated. Manipulation of the elements may
include modification of the focal length.
[0164] Other imaging techniques may also be incorporated into
diagnostic devices. One example includes ultrasonic imaging.
[0165] Sound can be detected using a diagnostic device using any
number of techniques. Sound may also be accessed and captured with
a variety of methods. As opposed to light, sound may be captured
through the air and/or captured after being transmitted through
fluids or tissue or devices. Microphones may be mounted on probes
to record sounds when the probe is in contact with the body or when
placed into cavities such as the mouth. These microphones may be
placed at the tips of the probes or away from the tips and record
vibrations transmitted through the probes. Microphones may also be
mounted on or in surface mounted devices. Examples of these devices
include pads placed on, attached to, wrapped around or worn on a
body part such as a device similar to a knee brace or a belt or a
vest. These devices may be designed to capture sounds such as those
emitted by joints, the heart and/or the lungs or airway.
Microphones located at or close to the surface of the device near
tissue may capture more localized sound while microphones located
deeper in devices and further from tissue may capture sounds from a
larger area. Sound may also be accessed at a distance and channeled
through a tube(s) to a microphone in a capturing unit.
[0166] Sound accessing elements may be "open", or natural, or
constructed similar to a diaphragm. This diaphragm may be designed
to conform to the desired area for a more thorough and reliable
contact area and/or to amplify the sounds and/or to collect sound
from a broader area. The diaphragm may be similar to that of a
stethoscope. It may attach to a capturing device with a microphone,
such as a smart phone or a small unit with a microphone that
transmits the sound, preferably wirelessly, to a diagnostic
processing device (i.e. a smart phone). Alternatively, the
diaphragm and microphone may be incorporated into the same unit
which attaches to a diagnostic processor which transmits the data,
preferably wirelessly, to another diagnostic processing unit such
as a smart phone which may output and/or store and/or send the data
through the internet. This diaphragm, with or without microphone,
may attach to the same diagnostic processor as the light accessing
element.
[0167] Sound may also be filtered and/or amplified. For example,
when using a diaphragm and stethoscope type device, sounds relevant
to the heart and/or lungs may be filtered and amplified while other
sounds may be filtered and discarded. This filtering may be done by
the diagnostic processing unit or at the provider end and may be
controlled by the provider. Also, microphones with different
sensitivities may be used in order to collect a larger range of
frequency of sounds and/or larger range of amplitudes. Once again,
filters may then be used.
[0168] Movement can be detected or captured using any kind of
motion-detecting device. Examples of such devices are strain gages
and accelerometers. Pressure in tubes can also be used to detect
expansion/contraction, and pressure or sound changes in
bags/compartments can be used to detect motion, for example,
devices placed under a mattress. Such devices can also be placed
around a patient's legs, knees, or other body part for detection of
muscle or limb motion.
[0169] In certain embodiments, GPS units can be used to detect
motion. External stereotactic devices, which devices track three or
more points, can be mounted on various worn items; or wrapped on or
affixed to a patient's legs, vest, belt, or other part of the body
or clothing.
[0170] Muscle spasms or tension can be monitored to detect or
diagnose conditions such as headaches which are often
musculoskeletal.
[0171] Headband or bandage-type devices which contain strain gauges
or other mechanisms can be used to detect motion and/or strain.
Video cameras or motion sensors such as the Kinect device can also
be used. Microelectricalmechanical (MEMS) sensors and devices worn
on the body containing MEMS sensors (e.g., vest, belt, wraps,
leggings, etc.) are also useful.
[0172] Reflexes can be detected or captured, for example, by
determining a patient's quickness in pushing buttons or other
responses. The responses can be tested in a gaming environment
which can be hardware or software-based. Devices can also have a
mechanism for hitting nerves or other tissue to elicit a reflex
response. The diagnostic instrument may be integrated into a knee
or elbow wrap or mount.
[0173] Patient health can be assessed using electrical-based
diagnostic equipment to detect or diagnose conditions such as eye
movement; hydration (resistance), and fat content (resistance), via
electrooculography, electroretinograms, EEG, EKG, and/or EMG.
[0174] Temperature can be detected using various methodology, such
as infrared, e.g. ear temperature or skin surface; or conductance;
for example, using a standard thermometer. Relative temperature can
also be used between different body surfaces or regions.
[0175] Touch and pressure can be sensed using gloves with pressure
sensors to indicate how hard a patient is pressing on something.
Such sensors may give a numerical or other scale feedback or
provide a tactile output through device on the provider end. For
example, a glove with pressure compartments may be modified to
duplicate the pressures felt/recorded on the user end. Socks with
pressure sensors can be used for gait, or for podiatrist
assistance.
[0176] Other senses that can be measured include kinesthetics
(relative position of body parts--e.g., a patient is asked to touch
his or her nose with a finger with the eyes closed); or balance,
magnetic/electrical fields, and pain.
[0177] The invention can also be used to measure or monitor
standard diagnostics or vitals. That is, the invention can be used
to obtain standard diagnostic information and vital signs such as
pulse, oximetry, pulse oximetry, CO2 blood levels, cardiac output
(arterial pulse), heart rate, glucose monitoring, blood pressure,
and weight.
[0178] Other tests or diagnostics that can be used with the
invention include, for example, swabs or blood pin-pricks. Third
party diagnostic devices and tests can also be incorporated through
release of standard interfaces or programming information.
[0179] Methods and types of diagnosis can be based on any
combination of diagnostic information. There are numerous health
ailments which may be diagnosed using any one of or a combination
of the techniques discussed above. Below is a short list of
examples.
[0180] 1. Imaging of the ear drum for ear infections. Such
diagnostic tests may also take an infrared temperature reading;
[0181] 2. Listening to sounds of four quadrants or lung on the back
of a patient. Such tests may help to diagnose asthma or a
respiratory infection;
[0182] 3. Imaging of the skin to detect skin cancer, rashes, poison
ivy, or other such ailments;
[0183] 4. Images of the mouth and throat for upper respiratory
ailments/infections;
[0184] 5. Epiglottitis by listening to sounds near trachea; and
[0185] 6. Diagnosing flu and common cold, using data such as body
temperature, images of the throat and listening to lungs.
[0186] Anatomical Interfaces for Diagnostic Devices
[0187] Anatomical interfaces for diagnostic devices can have any
shape or structure. Examples of devices with anatomical interfaces
include otoscopes, rhinoscopes, and throat visualizers. While
interfaces may be discussed in reference to a specific diagnostic
technique and/or device, such as an otoscope for imaging the ear,
similar anatomic interfaces and/or devices may be used to collect
any type of diagnostic information. An example is an anatomical
interface for the ear similar used to collect temperature
information rather than imaging information. Anatomical interfaces
may include elements to collect more than one type of diagnostic
information. Examples of such devices will now be discussed in
further detail.
[0188] An otoscope may have features such as a flexible extension
for easier insertion into the ear and for alignment to the ear drum
and to conform to the ear canal. This extension may have a feature
to prevent over-insertion or to limit the amount of force that is
encountered. For example, the extension may be spring loaded and
able to fully or partially retract depending on the forces
encountered. This retraction, or force limiting mechanism, may be
incorporated into a more rigid extension as well.
[0189] There may be a soft outer material on the extension for
comfort during insertion and while imaging. These may also be more
rigid internal material to maintain a desired shape. The extension
may have a stop that interfaces with the patient to prevent over
insertion into the ear canal. In one embodiment, the stop presses
into outer ear and does not compress tissue into ear canal. There
may also be hole to allow air to escape during insertion and
imaging, or to prevent echoing or other bothersome noises.
[0190] The stop can be incorporated into a disposable sleeve, or it
can have a shape similar to an earphone bud, or a cup around the
ear. The diameter of the extension can also increase, thereby
functioning as a stop in the ear canal. There may also be
adjustable stops or different-sized sleeves to fit different
ages.
[0191] Ear buds that snugly fit in the ear such as the Doc's Ear
Plug, may have an extension into the ear canal. Over ear devices
similar to ear phones can also serve as a stop or to provide
alignment and/or to hold an imaging device in place.
[0192] A small bud or a bud with an over ear holder can have one or
more small flexible wires connecting the bud to another device, or
the bud may be self-contained and having RF, wifi, or other
wireless communication link with a diagnostic computer and/or
processor. Such devices allow significant motion and hands-free
capturing of data, and such embodiments help with freeing up a user
to manipulate the ear. There may also be an LED at the tip or
channeled from the outer ear into the tip.
[0193] Screw type or other adjustments can be used to change the
length of insertion, and a balloon or other dilation method can be
used to stop and hold the device in place.
[0194] Such devices fit into the ear and align the capturing and/or
accessing elements. Ideally, the device will be able to image the
ear drum with minimal or no manipulation of the ear. The
capturing/accessing elements may be offset from the central axis of
the ear canal and/or angled relative to the axis.
[0195] The extension into the inner ear may be formed of a polymer
or other material. A lens can be in a central position, or it can
be offset, and optionally offset posteriorly. This extension may
dilate the canal if desired.
[0196] There may also be different attachments for the left and
right ears, and such attachments may connect to a capturing device
and channel images from the tip. A tip which rotates to fit into
and align elements with left and right ear canal and ear drum is
also possible and within the scope of the present invention.
[0197] Dilation of the ear canal is also possible by means of a
balloon or other inflation device. This dilation may push imaging,
light, or other channels outward for a larger viewing field and/or
additional viewing angles.
[0198] Multiple attachments to fit different ear sizes or patient
ages are possible and encompassed by the present invention. Such
pieces may be very inexpensive and therefore disposable. There may
also be moldable attachments for patient-specific fittings.
[0199] There may also be an extendable piece or longer extension
fittings to see deeper in the ear canal for better clarity and/or
to get past ear hairs. A head band, hat or similar retaining device
can be used to help secure and hold the ear imaging device in
place.
[0200] Many of the above features will also be useful in other
anatomical interface embodiments.
[0201] For example, a rhinoscope may consist of a nose plug with
various insert lengths and shapes, and a soft tip. There may be a
soft outer material surrounding a more rigid inner material that
maintains its shape. There may also be dual tips for both nostrils,
which can be useful for imaging nasal cavities.
[0202] The invention also provides for an attachment to look into
the throat. The attachment may consist of a narrower fiberscope
when viewed from the side that more naturally conforms with the
shape of the oral cavity, optionally with a mouth piece to depress
the tongue and to open the oral cavity for better imaging. The
mouth piece may be similar in shape to a pacifier. The attachment
may also have a slight downward curve to depress the tongue and to
provide a downward angle further back in the oral cavity to image
the throat. Similar to a pacifier, the outer material of this oral
device would preferably be soft and/or semi-compressible. The oral
device may have any shape, and in one embodiment is oval in shape,
as pacifiers generally are, to more naturally conform with the oral
cavity. This oral device may be generally flexible in nature and
bend with motions in an oral cavity should a patient, such as a
child, resist to the device being used.
[0203] The invention also provides for a dermatoscope, which can
maintain a specific distance from the object to be imaged to enable
measurements over time. A dermatoscope may incorporate an object of
known size for reference in images obtained.
[0204] The invention also provides for a heart rate (HR) type belt
or similar device which can be used to detect breathing sounds and
to listen to the lungs as well as to check the heart beat. Other
devices to detect sounds are a vest with microphones, and a small
interface similar in size to the end of a stethoscope but
attachable to a smart phone or other device with a microphone or
containing a microphone and interfacing with an adapter to send the
sounds to a computer.
[0205] Certain embodiments of the invention provide for a method to
detect internal sound by external diagnostic equipment. One purpose
is to help give a sense of what the patient feels, and such
embodiments are particularly useful for orthopedics.
[0206] An example of a device having these features is a brace for
the back, knee or other area to pick up sounds (ideally internal)
that may alone provide a diagnosis or provide reassurance when
combined with other diagnostic data such as images.
[0207] The invention also provides for a small probe inserted
through the topmost layer(s) of the skin.
[0208] The invention also provides for a probe which may be
inserted into a body cavity (e.g., oral, stomach, intestines,
etc.). Examination of the oral cavity may help with GERD diagnosis.
The obtained data can be used to correlate sounds with specific
ailments or to narrow down possibilities or identify potential
issues.
[0209] The invention also provides for a device for measuring
temperature, which may consist of an IR detector built into an ear
bud or similar device. The ear device may be held in place with a
hat or head band. Alternatively, the temperature detector can be
built into a head band or hat device with skin contact probes, and
be optionally positioned on a patient's forehead area.
[0210] The invention also provides for a device for measuring
oxygen saturation, for example, in the form of a finger or toe
attachment.
[0211] The invention also provides for a device for measuring blood
pressure, for example, for placement on a patient's wrist or
arm.
[0212] The invention also provides for a device in the form of an
eye piece (e.g. a cup-type shape) to provide safe imaging of eye
and surrounding tissue.
[0213] Particular embodiments of capturing devices have a thin
sleeve and/or covering that is disposable and which maintains a
barrier as well as providing padding for comfort during a medical
examination. There may also be stops to prevent over insertion
(e.g., for an otoscope). Adhesive patches for skin mounted or
contact devices can be used. The capturing device may also have a
moldable interface.
[0214] The capturing device may also be integrated with a device to
view, hear or otherwise observe or sense the diagnostic
information. This may be a diagnostic processing unit as discussed
later, or a simpler type interface such as an optical viewport to
see the images through the diagnostic device. This device may or
may not include components allowing storage or transfer of the
diagnostic information. Such components may include software,
mechanical elements, and/or other human interface to manipulate
output.
[0215] Diagnostic Processing and Link to Diagnostic Device
[0216] The diagnostic processing components (sometimes referred to
as diagnostic processors, or processors or processing components)
allow for receiving, transmitting, outputting and/or recording
diagnostic information and/or uploading the information to the
internet. The information may be stored at a remote location if the
information is being uploaded.
[0217] The diagnostic processing components may communicate with
the diagnostic accessing and capturing components through a wired
or wireless connection. Examples of wireless communication include
RF (e.g. Bluetooth), wifi and/or wireless phone technology. An
example of such a configuration includes a small wireless
transmitter which attaches to and is wired to an image capturing
device and transmits (preferably wirelessly) the data to a smart
phone, tablet or other computer. This computer may then display the
images, record the information and/or upload the information to the
internet.
[0218] All processing components may be integrated into a single
device, for example, a tablet, smart phone or other computer. An
image accessing device with an anatomical interface is then
positioned in front of the computer camera. The computer is then
able to capture, record, display and/or upload the information.
This computer may also serve as the communication device.
[0219] The accessing and/or capturing components may also be
mechanically attached to the processing components. An example of
this is a cradle with handle and a device with an anatomical
interface housing a lens, video chip and RF transmitter, as well as
other electronics. The cradle holds a tablet, smart phone or other
computing device. The images are then sent (preferably wirelessly)
from the device to the computing device in the cradle for
displaying, recording and/or uploading. In another embodiment, a
folder, portfolio, or carry case may hold a computer tablet on one
side for communication and a smart phone or tablet on the other
side to receive, record, display and/or upload the diagnostic
information.
[0220] Diagnostic Processing Components
[0221] Part or all of the diagnostic processor may be the same as
the communication device (e.g. laptop, tablet, smart phone) or
other existing computer device (e.g. desktop, second communication
device).
[0222] The diagnostic processor engages in wired or wireless
communication to a diagnostic capturing device. The diagnostic
processor may also serve as the diagnostic capturing device, for
example, having an anatomical interface which attaches in front of
a smartphone camera.
[0223] The diagnostic processing components may be built into the
diagnostic capturing device. For example, a wireless transmitter
may be attached and wired to a capturing device. The diagnostic
information is uploaded directly to the internet and then may be
downloaded to a communication device.
[0224] Alternatively, the diagnostic processing components may be
located in another device, such as a base station. The base station
can be located anywhere in the home or other facility, and is
typically plugged in a power outlet and connected to the internet
or a wireless service. This station communicates with and receives
the information from the diagnostic capturing device. Information
may then be transferred to a communication device and/or directly
uploaded to the internet. If directly uploaded to the internet, the
information may then be downloaded for display or other output in
the communication device.
[0225] The diagnostic processing unit can also be a local "box"
that communicates/connects to the diagnostic capturing device. The
diagnostic capturing device may transmit the information wirelessly
(e.g. RF) to the local box or be connected with a wire.
[0226] The local box may optionally be configured to display
diagnostic information. This box may attach directly to the
diagnostic capturing device, be hand held and allow moving and
placing the diagnostic capturing device as desired
[0227] Other form forms include a watch or a flexible display that
may be unfolded if applicable and placed in a convenient location.
The local box or similar device is usually situated to be
mechanically and/or electronically attached or linked to a
communication device as previously discussed.
[0228] The device can also serve as a communication device,
particularly if it has a display screen.
[0229] The local box may transmit information to a smart phone,
tablet or other computer for outputting, recording and/or uploading
the information.
[0230] Multiple devices and communication methods may be combined.
For example, the diagnostic capturing device may have diagnostic
processing components built in to record the information and/or
display the information and also transfer the information to a
local computer or communication device as well as directly transmit
the information via the internet or wireless phone technology.
[0231] The local box or electronics may allow attachment to a
multitude of diagnostic devices and be able to transmit the data to
the internet, the communication device or other device as
previously described.
[0232] The diagnostic processing components may also have a
mechanical link for information transfer. The diagnostic accessing
device may have a hollow tube for transmission of sound or fiber
optics for transmission of images to a diagnostic processing
device. The diagnostic processing device may have the hardware
required to capture and process the information. Examples of
hardware include a camera and/or microphone, and may include a
cradle or other attachment to help align parts for adequate
capturing of the diagnostic information.
[0233] The diagnostic processing component(s) may be able to
communicate/connect to third party diagnostic devices as well. For
example, a local box as previously described may communicate with
heart rate monitors, pulse oximeter, scales, blood glucose
monitors, etc.
[0234] Other features of a diagnostic processor and/or capturing
device may include a conventional camera, a microphone, and/or a
recorder. These elements may include a mechanical and/or electronic
link between the anatomical interface and the camera or microphone
to provide for transfer of the diagnostic information.
[0235] Examples of Diagnostic Devices and Additional Features
[0236] Different devices which are created by combinations of
disclosed features and components discussed in above sections can
allow for accessing and capturing of data, an anatomical interface,
and diagnostic processing.
[0237] A diagnostic device may have channels for secondary uses.
For example, an otoscope for visualizing the ear drum may have a
channel to allow air to be inserted into and pressurize the ear
canal to visualize motion of the ear drum. Alternatively,
additional diagnostic techniques which are not discussed herein may
be incorporated into any diagnostic device.
[0238] A diagnostic device may have multiple diagnostic capturing
elements. The diagnostic device may be held in place on the
patient's body using any generally available or suitable means. For
example, an otoscope may have an image capturing device and a
temperature probe (such as an infrared thermometer). This ear
device may be held in place with a head band, hat or similar
retaining device. The temperature reading apparatus may also be
positioned in the hat or head band rather than in the ear piece,
and have skin contact probes which are ideally positioned near or
on the forehead. Temperature readings may be recorded both within
the ear and on the forehead to increase the likelihood of recording
an accurate temperature.
[0239] Kits containing more than one type of diagnostic device
and/or anatomical interface are provided by and encompassed by the
present invention.
[0240] Diagnostic devices may have features to make them more
comfortable and/or acceptable to the patient. Such features may
include, but are not limited to a speaker in an ear piece (e.g.
otoscope) playing soothing sounds or music that the patient finds
enjoyable or vibration in a skin interface device (e.g.
dermatoscope). An oral device or device to look into the throat
(e.g. laryngoscope) may include a video screen situated in front of
the patient to play videos for the patient and/or include a
pleasant tasting mouth insert or the ability to apply a pleasant
taste to the oral device or laryngoscope.
[0241] As illustrated and described herein, many devices are formed
to be familiar to the user and therefore make them more comfortable
and pleasant to use. For example, an ear imaging device with an
earbud or over ear engagement member are similar in feel and use to
headphones. The user may feel comfortable using such device and
requires little or no instructions on using it. Similarly, an oral
device for capturing diagnostic information, such as images, may be
shaped in an oval form. This oval shape will more naturally conform
to the mouth. The oval shape may resemble a pacifier or have
another known shape. Users may feel more comfortable and safe using
a device on themselves or their child since the device resembles a
product they have used before. Further, devices are preferably
constructed to resemble consumer products rather than medical
devices to provide a more pleasant experience and also decrease the
time and effort to learn how to use the device.
[0242] F. Remote Control and/or Manipulation of Diagnostic Device
and/or Diagnostic Information
[0243] The invention can provide live feeds with the ability to
request a snapshot or segment in higher resolution. The invention
also permits low resolution viewing of large files such as MRIs,
and the ability to request high quality images of select images or
parts of images.
[0244] In certain embodiments, the invention can pull information
from electronic health records and/or a central location of stored
information. Such data files can be reviewed in low resolution and
then selected files or portions of files can be retrieved for high
resolution download.
[0245] The invention also provides the ability to modify device
settings, such as filtering of sounds, zooming cameras, selecting
which angle view is best, changing filters of images,
increasing/decreasing electrical power, changing light source,
selecting a camera, or modification of any other option previously
discussed. There is also the ability of remote monitoring and/or
control of a user device.
[0246] There may also be controlled articulation of a device, to
change an angle or other shape to help navigate or align an
instrument, or to change a tip angle or angle of elements such as a
mirror or video chip.
[0247] IV. Accounts, Logistics and Infrastructure
[0248] Examples of User and Provider Account(s)
[0249] Several kinds of user accounts and provider accounts are
possible in accordance with the principles of the present
invention. There may be an anonymous account, in which billing and
personal information is processed by a company or service, or a
third-party service or telehealth service, or by the company
described within), but the provider does not know the patient's
identity and health records are not updated. This option allows
advice only, and no prescriptions.
[0250] There may also be a basic account with consumer
identification. Basic health information/background is collected
during call, similar to a visit to a pharmacy clinic.
[0251] There may also be a basic account with past medical history
completed for use with this system. Certain information, for
example, a simple health questionnaire, remains separate from other
patient records.
[0252] There may also be an account which provides for integration
with the patient's existing Electronic Health Records (EHRs). Such
accounts may pull out a subset of basic health information only for
purposes of use in conjunction with the current sick call to keep
the majority of the information private. The patient or caregiver
decides what kind of information or which categories of health
information is shared. This sharing could be done for each sick
call.
[0253] Shared information may optionally be linked to a third party
EHR. An EHR can be managed within this system. Health information
can also be sent as required to update the patient's record(s) and
pulled from other records as necessary.
[0254] Accounts can be created by the user, the user's health
insurance, employer, family member, or another interested
party.
[0255] An account can be created with health insurance information,
or the account can be completely private and provide for separate
billing via a self-pay model.
[0256] Patient accounts will be determined in accordance with
particular implementations of the invention. Such accounts are
envisioned to be fully HIPPA compliant, and the consumer controls
and chooses what information is shared and with whom. Permission
from the patient may be transmitted with any medical data and/or
via a separate/independent transmission method or file.
[0257] Provider account(s) may include call records maintained
(e.g. user satisfaction), and provider credentials.
[0258] Completion of Communication
[0259] Both parties may first need to agree that an acceptable
resolution has been reached prior to completing the call as well as
agree to which information may be stored prior to the uploading and
sharing of information to an EHR or updating of any other
record.
[0260] Billing and Insurance
[0261] The invention is amenable to different kinds of billing and
insurance modes. For example, there may be a self-pay mode, or the
user or provider can bill an insurance company and generate the
relevant forms.
[0262] Communication Security and Methods of Transferring
Information
[0263] The invention can use existing technology/company/software
such as Vidyo, or such technology can be created from the ground up
in-house.
[0264] E. Recording of Information
[0265] The invention can provide for multiple record storage
options. For example, the invention can record entire
communications and all imaging/collection of diagnostic
information, or the invention can record only short segments or
snapshots of diagnostic information selected by the provider and
the final diagnosis and/or advice given. Alternatively, the
invention can store only a form containing health history and a
written diagnosis by the provider, with or without images. Prior to
providing or receiving any service, the patient/consumer and health
care provider can agree on completed review and storage of
information.
[0266] F. Database Management
[0267] Database management for a particular implementation of the
invention will generally be conducted in accordance with industry
practices and regulations.
[0268] G. Interfacing with 3.sup.rd Party Software and Hardware
Including Electronic Medical Records (EMRs) and Diagnostic
Devices
[0269] The invention can also interfacing with third party software
and hardware providers, including those providing or storing
Electronic Medical Records (EMRs) and diagnostic devices
[0270] V. Telehealth Systems and Features
[0271] Telehealth systems in accordance with the present invention
permit the linking of two or more parties at remote locations to
aid with or monitor medical conditions. The connections may be in
the form of a voice call, video call and/or text communication or
any of these with the addition of sharing information such as
photos, files and/or diagnostic information, collected previously
and/or collected during communication.
[0272] Communication methods may include cellular/mobile telephone,
through the internet, via satellite, landline or any other
technology enabling communication protocol.
[0273] Telehealth systems utilize diagnostic or health information
collected with a variety of methods or available from previous
health consultations. A third party device or a diagnostic device
described herein, or other information such as xrays, MRIs, blood
tests or information contained in an electronic health record can
be utilized.
[0274] Telehealth system in accordance with the invention may
involve an official diagnosis, e-prescriptions, billing (individual
and/or insurance), creation of insurance forms and/or updating
EHRs.
[0275] Such systems also use software and/or user interfaces to
facilitate capture, output (e.g. display or sound), transfer and/or
recording of information.
[0276] Infrastructure, including servers and databases, can be
purchased commercially or custom-designed, depending on the
implementation of the invention.
[0277] Health care providers such as physicians or other
professionals may be ranked by education, experience, user
satisfaction or other means by which a user may wish to select a
provider. Users or insurance companies may pay different amounts
depending on the rank of the provider, or based upon prior
negotiation.
[0278] Certain embodiments of the invention may be desirable for
use in a gaming, social, or educational setting. For example, the
invention can provide a 3D tour through the body and participants
would guess medical solutions or diagnoses based on real data or
examples for each location/area of the body. Users may get points
and compete against others.
[0279] There may also be crowd-sourcing to other users for opinions
without provider input. Users may compete against each other and be
ranked for knowledge which may help in the probability of obtaining
correct advice from the crowd.
[0280] The invention can also use real data for educational
purposes with an interactive interface, e.g., a 3D tour through the
body. The invention can also include demonstrations and
illustrations of how a health ailment may have been caused and how
to prevent or treat that condition.
[0281] Certain embodiments of the invention can be used for auto
detection of ailments, for example, ear infections and progression
of moles, and the invention can give the probability that the
patient has the illness with or without an additional provider
consultation. Software and analysis can be done on the user device
and/or as a "cloud" service.
[0282] There may also be crowd sourcing for two or more opinions
from providers. Such embodiments may be particularly applicable to
lower income countries or those having lower provider cost (such as
India) and for easily-diagnosed ailments requiring only an image or
similarly simple sharing of diagnostic information. This would give
a potential for extremely short provider review times, potentially
in just 10 seconds.
[0283] The invention can also be used to solicit bids from
providers for consultations, surgery or other care. A user may also
offer a set amount for diagnosis and treatment, and providers may
choose to accept the user's offer or not.
[0284] The invention can also be integrated with outside
diagnostics facilities, for example, for lab tests or culture
testing; to enable users to send samples such as blood, mucous, and
skin shavings for analysis; and to schedule appointments for blood
draws/testing or imaging tests such as xray or MRI.
[0285] Contacts between patients/caregivers and medical care
providers can be in any form, such as the following:
[0286] 1. Direct peer to peer or through central server/gate or
simultaneously peer to peer and to central location;
[0287] 2. Caregiver and patient;
[0288] 3. Patient and provider (or nurse/call center for routing if
necessary);
[0289] 4. Patient, caregiver to provider(s)
[0290] 5. Caregiver to provider and separately to patient;
[0291] 6. Patient separately to caregiver and provider; and
[0292] 7. Any of the above with a facilitator such as a nurse or
other trained individual at a call center
[0293] A non-limiting list of examples of sick calls or requests
for medical services can include requests for second opinions;
treatment of acute ailments; treatment of chronic ailments;
requests for follow-up appointments; scheduling physical therapy;
monitoring, which can be initiated by caregiver and not require an
active answer by the patient; fitness or wellness visits; and
emergency and other urgent medical calls.
[0294] The invention can be provided to consumers in numerous ways,
such as by health insurance companies, employers, through
partnerships with health IT companies, or directly to
consumers.
[0295] Different kinds of systems are possible within the scope of
the present invention. For example, there may be a basic system,
which provides telemedicine with at least voice capability and
optionally video capability to enable remote diagnosis and
prescriptions as necessary. There may also be diagnostic device
services, in which the invention provides the ability to capture
and send medical data and information from a patient to a health
care provider. The systems may also have the ability to transfer a
live feed of diagnostic information from the patient to the
provider, or the ability for the provider to select snapshots or
short segment video to download in high resolution from the
diagnostic device.
[0296] There may also be a hardware or software interface to allow
connection of any diagnostic device, e.g. for example, from a third
party. These connections can be live feeds or collected over time
such as blood glucose or heart rate and input by user, for example,
by typing blood pressure readings into a diagnostic device. For
live feeds, in one embodiment, the invention allows for recordal of
information and data, and for remote transfer of high quality
images.
[0297] VI. Systems with Therapeutic Elements
[0298] The invention may also be in communications with medical
devices which provide remote therapeutic elements or services to a
patient. Examples of such devices are massage devices or muscle or
nerve stimulation devices. The medical provider can send remote
instructions to these devices so that the patient can obtain
therapeutic treatment.
[0299] As described herein, various embodiments of the disclosed
systems and methods significantly improve efficiency for patients,
clinicians, health system managers, and third party payers. The
stored patient information allows reviewing clinicians to see the
patient examination and glean valuable information that a previous
clinician might have missed during a routine examination. Moreover,
multiple clinicians and/or specialists can access the patient
information simultaneously and/or sequentially, allowing additional
reviews to review the data and reduce the chance of something being
missed or overlooked.
[0300] The system can include features that allow consultants to
review the comments and recommendations of other clinicians. In
doing so, consultants may be exposed to the thoughts of other
clinicians, which in turn can broaden or focus the clinical
impressions more accurately, and again reduce the chances of error
or misdiagnosis. Such review will normally be done within the data
sharing permissions set by the patient, as well as within the scope
of medical record sharing laws and regulations.
[0301] Various features of the disclosed system may encourage
patient participation and involvement. The patient has opportunity
to see his or her case, actively monitor the progression and
assessment of the information by medical professionals, and review
the various comments and recommendations and actively participate
in his/her case. This may result in a more informed and involved
patient, and can significantly increase patient satisfaction with
the medical care and response.
[0302] In various embodiments, the user's initial patient
information and treatment request creates a query that becomes
available to the medical professionals (e.g., consulting
clinicians) via a secure web portal or other format. The system
provides the medical professional with the relevant patient data to
be used in providing recommendations regarding the patient
condition, assessment and/or treatment. The medical professional
can review the query on-line at any time after it has been posted
and can record his/her observations and recommendations into the
query file as necessary and/or desired. Depending upon the patient
condition and/or complexity, an initial assessment can be rapidly
completed, for example, in 15 minutes or less, by properly trained
personnel such as nurses, initial assessment technicians, or first
responders. Such initial assessment may take significantly less
time than needed for a clinician to evaluate the patient in person.
For patients requiring further in-depth assessment and/or analysis,
their queries may be forwarded to a relevant specialist, while less
complex queries can be addressed and responded to by a wide variety
of less-expensive clinical specialists. This can significantly
reduce the costs incurred to evaluate the patient, which may result
in significantly lower costs for the patient and/or payor. In
addition, the patient does not need to directly meet with
clinicians individually, which may significantly increase the
convenience and accessibility of healthcare.
[0303] Various features of the disclosed systems and methods may
further facilitate the collection and recordation of patient
demographics, medical histories, complaints, illness histories,
height, weight, identification (e.g., fingerprints, facial
photographs, DNA or blood type information), patient statements,
video exam sequences, and physical characteristics such as physical
inspection results, thermal imaging, palpation, strength, sensation
and reflexes. In addition, various information relevant to the
complaint can include links to electronic medical records, links to
imaging databases, various clinical comments, and billing
information. Patients can give permission for the attending
clinician to access their stored health records. The clinician can
provide the most rapid physical examination if a patient's records
are all available electronically. Nevertheless, the invention can
also be highly effective to start developing a patient's electronic
health record.
[0304] Use of the various systems and methods disclosed herein may
be of interest to health systems administrators as it may
facilitate a hospital or clinician group's expansion of their
service area, attract patients to their treatment facilities,
promote utilization of participating providers, create multiple
revenue streams, and may be a powerful marketing tool. In various
embodiments, the systems add efficiency and increase clinical
productivity.
[0305] In various embodiments, researchers may utilize various
database information which may include data mining features,
standardization of examination methods, and an objective
documentation format. Similarly, health care professionals and/or
educators may utilize various features that provide a rich
educational format that can be accessed by students seeking to gain
knowledge regarding the evaluation and management of health issues.
The patient information files may be archived and used to provide
exposure to a wide variety of cases and demonstrate various
pathologies to students who might otherwise go years before seeing
an example of certain variant conditions. In various embodiments, a
multidisciplinary consultation feature can be provided that allows
exposure of patient information to a variety of medical
perspectives. Such data sharing will normally be used in accordance
with local privacy laws.
[0306] Various features of disclosed embodiments offer significant
direct cost savings, which may be realized when an emergency room
or full office visit consultation is avoided because the
information is available via the system. The system saves time
because the patient does not have to wait to attend a variety of
appointments and each clinician (if multiple medical professionals
are required or desired) can view the patient information remotely
on his or her own time. In addition, multiple consultations and
opinions can be collected via the system simultaneously.
[0307] Advantageously, the system can increase quality by making
multiple opinions available to the patient, which can increase
patient responsibility and autonomy and facilitate greater levels
of involvement in patients' own health care. In various
embodiments, patients may be given the option of selecting a
desired clinician or clinical specialty that they would like to
consult on their patient information. The patient can directly
review the various opinions and recommendations collected in the
system and make their own choices about how they would like to
proceed. Patients can increase their understanding and knowledge of
their condition by allowing them (or anyone else they so choose) to
view their personal examination compilation in detail. In addition,
the system allows third party payers to have a more complete and
accurate assessment of the claimant's examination compilation.
[0308] The present invention will now be described with reference
to the Figures.
[0309] FIGS. 1 and 2 illustrate exemplary embodiments of a
telehealth system in use in accordance with an aspect of the
present invention. FIG. 1 illustrates a caregiver and a health care
provider engaged in a video call, thereby interacting in two-way
video and voice communications. A diagnostic device in accordance
with the present invention has been inserted in to the patient's
ear, and the diagnostic device acquires medical status data,
including diagnostic images, and provides this information to the
provider. During the video call, the provider can request that the
caregiver or patient provide additional medical information or
adjust the settings or placement of the diagnostic device. Although
the figure shows the caregiver using a laptop computer and the
provider using a desktop computer, the caregiver and provider can
use other kinds of computer systems, such as the illustrated
smartphone or tablet computer. In certain embodiments of the
invention, caregivers and/or providers will install an application
or an app on their devices to communicate. In view of current U.S.
federal privacy laws, it is expected that all communications
between a provider and patient/caregiver will be done over a secure
electronic connection.
[0310] FIG. 2 illustrates an exemplary embodiment of the invention
which provides for a plurality of data feed options to the provider
from the diagnostic device. In the illustrated embodiment, the
provider can choose to receive one or more high-resolution images
via download, or the provider can receive a low-resolution live
feed. The provider has the ability to manipulate the diagnostic
information and/or the device by a remote control feature. In this
specific Figure, the diagnostic data can be fed live to the
provider at low resolution for seamless transfer and communication.
The provider may select segments or snapshots of the diagnostic
feed which will be downloaded to him or her at a higher resolution.
The full stream of higher resolution data can be stored on the
user's device and/or at a central location, and accessed by the
provider for high resolution snapshots/segments or for later
review. The provider may use the remote control feature for other
actions, such as but not limited to focusing the image, controlling
tip deflection or the direction of an imaging device, and filtering
sounds.
[0311] FIG. 3 illustrates linked components of an exemplary
embodiment of a telehealth system according to the present
invention. The system is comprised of three components: (a) a user
subsystem configured for receiving a patient's current medical
data; (b) a provider subsystem configured for communicating with a
health care provider; and (c) an infrastructure subsystem
configured to process and store medical data and diagnostic
information received from the user subsystem and the provider
subsystem.
[0312] In the illustrated embodiment, the user subsystem comprises
a communication device; a diagnostic processing device; and a
diagnostic capture device. The provider subsystem comprises a
communication device. The infrastructure subsystem comprises: (a)
an application server comprising computer instruction code
configured for communication with (i) a database configured to
store a patient's personal information and electronic health record
as well as information on providers; (ii) diagnostic computer
instruction code configured to receive current patient medical
information and to provide diagnostic information concerning the
patient's medical condition; and (iii) a database configured to
store archived diagnostic information; (b) a server comprising
computer instruction code configured to communicate with one or
more third-party patient personal information or electronic health
record databases; and (c) a server comprising computer instruction
code configured to communicate with a third party telehealth
system.
[0313] FIG. 4 illustrates three components of a user subsystem of a
telehealth system in accordance with an exemplary embodiment of the
invention. The user subsystem comprises a communication device,
which can be capable of participating in a video conference. For
example, the communication device can be a laptop, tablet, or
smartphone equipped with a video camera.
[0314] The user subsystem also comprises a module which processed
diagnostic information. This system transmits information, receives
diagnostic information, outputs or displays information, records
any diagnostic data, and transfers this information to the
Internet, for example, to a storage unit which may be cloud-based
or stored or warehoused on a proprietary site and/or to the
communication device.
[0315] The user subsystem also comprises a module which accesses
and captures diagnostic information. This module can comprise an
anatomical interface, such as an earbud, and can focus and access
diagnostic information via a diaphragm, lens, fiberoptics, or other
element. This module can also capture diagnostic information via
speakers or a camera.
[0316] FIGS. 5-7 illustrate exemplary embodiments of user devices
structurally configured for insertion into the human ear which
communicate a patient's current medical status in accordance with
the present invention. The user devices can include various kinds
of communications devices, which may not have any diagnostic
capabilities (as shown in FIG. 5), or which can have a diagnostic
processor (as shown in FIG. 6), or which can have a partial
diagnostic processor (as shown in FIG. 7). In these Figures, an ear
bud having a camera is used to access and capture diagnostic
information, and the ear bud communicates directly with a
smartphone (FIGS. 5 and 6), or indirectly through a small
intermediate box which has a partial diagnostic processor for
receipt and transfer of information (FIG. 7). The earbud transmits
photos of the inside of the ear canal wirelessly via BlueTooth (BT)
or radio frequency (RF), although in certain embodiments this
information can be transmitted via a wire connected to the jack or
port of the tablet, smartphone, or other device.
[0317] FIGS. 8 and 9 show a cross-section of the ear region of a
patient's head for purposes of reference.
[0318] FIGS. 10-20 illustrate exemplary embodiments of an ear
imaging device comprising an anatomical interface to facilitate
positioning and image quality and may also serve as safety
mechanisms that prevent over insertion. As discussed earlier,
diagnostic devices may contain any combination of elements
described. For example, in FIGS. 10-20, outer ear elements may
contain LEDs in the outer ear elements which emit light which is
transmitted by standard components such as fibers, channels or
light pipes.
[0319] FIG. 10 shows an ear bud which is used to position and
align, in the posterior of the ear canal, an imaging apparatus with
the ear drum to optimize the quality of the resultant images. The
ear bud and imaging apparatus are attached to a port on the
smartphone which aligns with the camera for image capturing.
[0320] FIG. 11 illustrates an ear bud attached to an outer ear
element. The ear bud contains the imaging apparatus with a video
chip at its tip. The outer ear element contains the necessary
electronics and transfers the image, via radio frequency,
BlueTooth, wire, or other protocol, to another device such as a
smartphone for output and display of the medical data to the
Internet.
[0321] FIG. 12 illustrates an ear bud and outer ear element. In
this Figure, the outer ear element contains the video chip as well
as any ancillary electronics. The ear bud has fiber optics or a
channel to allow transmission of the image to the video chip. The
entire embodiment consists of a single hardware element.
[0322] FIG. 13 illustrates another combination of an ear bud and a
detachable outer ear element. In contrast to FIG. 12 which shows a
single hardware element, FIG. 13 illustrates that the components
are detachable. This embodiment allow for different sizes of ear
buds to be supplied, as well as permitting different buds for left
and right ears when necessary.
[0323] FIG. 14 shows an embodiment of the inventive device in the
form of a standard speculum. This embodiment is configured with
extra material on the anterior (front) side in order to position
the speculum to a more posterior (backward) position for better
alignment with the ear drum.
[0324] FIG. 15 illustrates an embodiment of the inventive device in
the form of a speculum, with an anterior buildup and extension
attached to a smartphone for image capture. The speculum element
may alternatively be attached to a different diagnostic processing
device (such as the outer ear element shown in the earlier Figures)
to capture the image.
[0325] FIGS. 16-18 show alternative examples of ear buds and
imaging apparatus. FIG. 18 shows a compressible ear bud with an
imaging apparatus for conformity and secure fitting with an
individual's ear. FIGS. 19 and 20 show examples of an ear bud and
imaging apparatus that repositions itself as the ear is
manipulated.
[0326] FIG. 21 illustrates features of the outer human ear for
purposes of reference.
[0327] FIGS. 22-24 illustrate exemplary embodiments of an over-ear
device for obtaining a patient's current medical status. FIG. 22
shows an over ear device, comprised of an outer ear element on the
helix, and an ear bud inside the ear canal. FIG. 23 shows the
embodiment of FIG. 22 separately from the ear for clarity of view.
FIG. 24 shows an embodiment of an over ear device to which a video
chip, a light source, and a speaker have been affixed.
[0328] FIGS. 25-26 illustrate exemplary embodiments of an over-ear
device and different configurations of the outer ear elements. FIG.
25 shows a bottom view of an over ear device. A video chip is
illustrated within the outer ear element (the over ear piece). FIG.
26 shows a plurality of different configurations of outer ear
elements, ear buds, and video chips. An outer ear element may be
configured with one or more video chips to allow for left and right
ear buds to be attached. More than one image may also be captured,
for example, at different locations of the ear, or at different
angles.
[0329] FIGS. 27 and 28 illustrate side and bottom views of an
exemplary ear imaging device. FIG. 27 shows a side view of an ear
imaging device. The device may be configured for interface with the
patient's anatomy so that the images are captured centrally or
off-center, as shown in the lower two illustrations. FIG. 26 shows
a bottom view of an ear imaging device. The device may be
configured and interfaced with the patient's anatomy so that images
are captured centrally, off-center, and/or at an angle, as
illustrated in the five drawings at the bottom of the Figure.
[0330] FIGS. 29 and 30 illustrate exemplary embodiments of
anatomical interfaces for a medical device for insertion into a
patient's mouth (FIG. 29) or ear (FIG. 30). The anatomical
interfaces are attached to a smartphone in the illustrated
embodiment. The attachment of the anatomical interface to the
device may be rigid (FIG. 29), or flexible as shown in FIG. 30 with
a spring/coil combination.
[0331] FIG. 31 illustrates an exemplary embodiment of a medical
diagnostic instrument equipped with a microphone. In the first
image, a diaphragm, anatomical interface, and accessing device are
shown attached to a smartphone with a microphone for capturing
sound. In the second image, a diaphragm, anatomical interface, and
accessing device are attached to a specialty diagnostic capturing
unit with a microphone which transmits sounds via a wired or
wireless connection. Such an embodiment can be used to listen to
heart or lung sounds, and the device can be used to perform the
functions of a standard stethoscope.
[0332] FIGS. 32-35 illustrate exemplary embodiments of medical
diagnostic instruments for collection of patient medical
information. FIG. 32 shows a strap with microphones. This
embodiment can be used, for example, to listen to a patient's chest
or lungs when applied to a patient's chest. Similarly, FIG. 33
shows a shirt or vest which contains microphones. When the patient
dons such articles as the strap or shirt/vest, the health care
provider can listen remotely to sounds from the patient's body and
thereby provide a diagnosis of a medical condition.
[0333] FIG. 34 illustrates an oral device, in the general form of a
pacifier, which contains a lens and video chip for use in examining
a patient's mouth or oral cavity. The oral device is equipped with
digital imaging elements which communicate with a diagnostic
processor to enable remote diagnoses. Such embodiments are useful
to any patient, although they will provide particular application
to small children.
[0334] FIG. 35 shows an embodiment of a medical device comprising
an oral device and an ear bud. The oral device and the ear buds
both have fiber optics or channel to interface with a device having
a video chip and the associated ancillary electronics, and these
elements communicate with a diagnostic processor to provide medical
data of at least two separate parts of patient's body.
[0335] FIGS. 36-37 illustrate exemplary embodiments of kits
comprising devices for accessing, capturing, and at least partial
processing of medical diagnostic information in accordance with the
present invention. FIG. 36 shows a kit comprising a strap equipped
with microphones, an oral device, nose attachments, and different
sized ear buds. These elements all communicate with a processing
box which interfaces with a communication device for transmission
of data to the medical provider. Any combination of these elements
can be used in accordance with the present invention to transmit
patient medical data to a provider. FIG. 37 shows a kit comprising
a computing device, such as a smartphone, tablet, or laptop, to
provide communication and partial processing of diagnostic
information. The kit also comprises devices for accessing and
capturing diagnostic information and at least partial processing of
the medical data, including transferring the information to a
communication device such as the smartphone, tablet, or laptop just
described.
[0336] FIGS. 38A-38E illustrate exemplary embodiments of medical
diagnostic devices in accordance with the present invention which
are structurally configured to be placed on, in, or adjacent to a
patient's body for obtaining medical diagnostic information. These
devices can contain a battery in an inner compartment for powering
the device or for transmission of obtained medical data.
[0337] FIGS. 38A-38B illustrate exemplary embodiments of medical
diagnostic devices having an anatomical interface, and which are
structurally configured to be placed into a patient's ear canal.
The illustrated devices are rotatable about certain positions to
permit optimal fitting into the ear canal.
[0338] FIGS. 38C-38D illustrate exemplary embodiments of medical
diagnostic devices which are structurally configured to be placed
in a patient's oral cavity. The devices have a main body which can
be inserted into the patient's oral cavity to permit optimal data
collection. These medical diagnostic devices have an anatomical
interface component which interfaces with the user's hand.
[0339] FIG. 38E illustrates an exemplary embodiment of a medical
diagnostic device which has stethoscope capabilities, and which is
structurally configured for listening to sounds from a patient's
body. The device has an anatomical interface component which can be
applied to a patient's chest, back, joint, or other location for
listening to sounds.
[0340] The various embodiments described above can be combined to
provide further embodiments. Aspects of the embodiments can be
modified, if necessary to employ concepts of the various patents,
application and publications to provide yet further
embodiments.
[0341] Other objects, advantages and embodiments of the various
aspects of the present invention will be apparent to those who are
skilled in the field of the invention and are within the scope of
the description and the accompanying figure. For example, but
without limitation, structural or functional elements might be
rearranged, or method steps reordered, consistent with the present
invention. Similarly, a device may comprise a single instance of a
device or comprise a plurality of devices, such plurality
functioning as a single device working in tandem. For example, a
computing device may consist of a plurality of computing devices
which together provide the desired functionality. The device types
described in various embodiments are not meant to limit the
possible types of devices that may be used in embodiments of
aspects of the present invention, and other types of devices that
may accomplish similar tasks may be implemented as well. Similarly,
principles according to the present invention, and methods and
systems that embody them, could be applied to other examples,
which, even if not specifically described here in detail, would
nevertheless be within the scope of the present invention.
[0342] The following listing identifies elements illustrated in the
Figures and provides the respective figure reference numeral for
each of the identified elements.
TABLE-US-00001 Reference Numeral Element 10 Telehealth system 12
Provider 14 Caregiver 16 Patient 18 Diagnostic device 20
Communication component 22 Processing component 24 Accessing
element 26 Capturing element 28 Anatomical interface component 30
Light source 32 Speaker 34 Microphone 36 Diaphram 38 Kit 40 Oral
device 42 Light emitting 44 Battery
* * * * *