Abstract:
A method and system that allows healthcare providers, hospitals, skilled nursing facilities and other persons to monitor disabled, elderly or other high-risk individuals to prevent or reduce falls and/or mitigate the impact of a fall by delivering automated notification of “at risk” behavior and falls by such an individual being monitored where assistance is required.

Description:
This application is a continuation-in-part of U.S. application Ser. No. 14/084,588, filed Nov. 19, 2013, which is a continuation-in-part of U.S. application Ser. No. 13/543,816, filed Jul. 7, 2012, which claimed priority to and the benefit of U.S. Application Ser. No. 61/507,088, filed Jul. 12, 2011 and this application also claims priority to and the benefit of U.S. Application Ser. No. 61/798,964, filed Mar. 15, 2013, all of the above applications are incorporated by reference in their entireties for all intended purposes. 
    
    
     1. FIELD OF THE DISCLOSURE 
     The present disclosure is generally directed to patient monitoring systems and particularly to a system and method for monitoring patients in a manner which prevents or reduces patient falls. 
     2. BACKGROUND 
     According to recent studies, falls are a leading cause of death among people over the age of 65 years and 10% of the fatal falls for patients over 65 years of age occur in a hospital setting. For the general population, studies estimate that patient falls occur in 1.9 to 3% of all acute care hospitalizations. Of these hospital-based falls, approximately 30% will result in a serious in jury with the cost to care for these injuries estimated to reach $54.9 billion per year by 2020. Current technologies that exist to assist in the prevention of falls are limited in their capabilities. These include pressure pads on the bed that trigger an alert when no pressure is detected on the pad, pressure pads on the floor and light beams that create a perimeter with alarms going off upon interruption of the beam. The pressure pads are ineffective as they do not prevent the fall but rather alert after the fact when it is too late. Additionally they are prone to false positive alerts. The light beams are also prone to false alerts when the patient or visitor simply reaches through it or the caregiver breaks the beam while delivering medication, food, drink or conducting a procedure on the patient. 
     SUMMARY OF THE DISCLOSURE 
     The present disclosure is directed to addressing these above-described shortcomings with current technology. Generally disclosed is a novel method and system that allows healthcare providers, hospitals, skilled nursing facilities and other persons to monitor disabled, elderly or other high-risk individuals and utilize the described technology to prevent or reduce falls and/or mitigate the impact of a fall by delivering automated notification of “at risk” behavior and falls by such an individual being monitored where assistance is required. 
     The following non-limiting definitions are provided as aid in understanding the disclosed novel method and system: 
     
       
         
               
               
             
           
               
                   
               
             
             
               
                 3D Camera,  
                 An electronic device that contains one or more  
               
               
                 Motion 
                 cameras capable of identifying individual objects,  
               
               
                 and Sound  
                 people and motion regardless of lighting conditions  
               
               
                 Sensor 
                 as well as one or more microphones to detect audio.  
               
               
                   
                 The cameras can utilize technologies including but  
               
               
                   
                 not limited to color RGB, CMOS sensors, infrared  
               
               
                   
                 projectors and RF-modulated light. They may also  
               
               
                   
                 contain microprocessors and image sensors to  
               
               
                   
                 detect and process information both sent out and  
               
               
                   
                 received by the various cameras. 
               
               
                   
                 The electronic device calculates if there has been  
               
               
                   
                 a change in location of the person or object of  
               
               
                   
                 interest over a period of time. As a non-limiting  
               
               
                   
                 example, a person&#39;s right knee can be at time T1  
               
               
                   
                 located at coordinates (x1, y1, z1) in a picture  
               
               
                   
                 frame taken by the camera. At time T2 the right  
               
               
                   
                 knee is capture by the picture frame taken by the 
               
               
                   
                 camera at coordinates (x2, y2, z2). Based on this  
               
               
                   
                 information, motion, speed and direction can be  
               
               
                   
                 derived utilizing the elapsed time and comparing  
               
               
                   
                 the two 3D coordinates over the elapsed time. As  
               
               
                   
                 opposed to conventional motion sensors, which  
               
               
                   
                 use captured motion to control a camera, the 3D  
               
               
                   
                 Motion and Sound Sensor used with the method  
               
               
                   
                 and system, uses the camera in order to compute  
               
               
                   
                 the motion. The camera/sensors are preferably  
               
               
                   
                 continuously on at all times during while the  
               
               
                   
                 monitoring is occurring, regardless of whether  
               
               
                   
                 the person or object of interest is moving or not. 
               
               
                   
                 The 3D Camera, Motion and Sound sensor can  
               
               
                   
                 additionally be programmed to lock on a person  
               
               
                   
                 and can send back to the computerized  
               
               
                   
                 monitoring system the 3D coordinates of the  
               
               
                   
                 joints in the person&#39;s body and a skeletal  
               
               
                   
                 outline of the person. As a non-limiting  
               
               
                   
                 example, a person&#39;s right arm can be at time  
               
               
                   
                 T1 located at coordinates (x1, y1, z1) in a  
               
               
                   
                 picture frame taken by the camera. At time T2  
               
               
                   
                 the right arm is captured by the picture frame  
               
               
                   
                 taken by the camera at coordinates (x2, y2, z2).  
               
               
                   
                 Based on this information, motion, speed and  
               
               
                   
                 direction can be derived utilizing, the elapsed  
               
               
                   
                 time and comparing the two 3D coordinates  
               
               
                   
                 over the elapsed time. 
               
               
                   
                 The camera preferably views the entire bed  
               
               
                   
                 or a large portion of the bed or other area that  
               
               
                   
                 the patient is resting, at (i.e. chair, couch, etc.) 
               
               
                   
                 simply by its placement in a manner sufficient  
               
               
                   
                 for the monitored area to be visible to the camera.  
               
               
                   
                 Thus, the camera does not require any triggering  
               
               
                   
                 event to cause the camera to begin recording  
               
               
                   
                 video and/or 3D depth data or transmitting video  
               
               
                   
                 and/or 3D depth data to the other components  
               
               
                   
                 of the system for analysis. As the video camera is 
               
               
                   
                 recording or otherwise transmitting video and/or  
               
               
                   
                 3D depth data to the other system components  
               
               
                   
                 at all times during monitoring, the electronic 
               
               
                   
                 device is able to immediately track, capture  
               
               
                   
                 and/or record the monitored individual&#39;s  
               
               
                   
                 movements at all times within the room or 
               
               
                   
                 monitored area and will be able to provide  
               
               
                   
                 information as to whether and when the  
               
               
                   
                 individual begins to move or begins to get up  
               
               
                   
                 to move. 
               
               
                   
                 Preferably the 3D Camera, Motion and Sound  
               
               
                   
                 Sensor records, captures and/or streams video  
               
               
                   
                 and/or 3D depth data. As video is technically  
               
               
                   
                 made up of individual picture frames (i.e.  
               
               
                   
                 30 frames per second of video), the above  
               
               
                   
                 reference to picture frames is referring to 
               
               
                   
                 frames of video. 
               
               
                   
                 Depth sensitivity can come into play with  
               
               
                   
                 skeletal tracking in order to minimize false  
               
               
                   
                 alarms, as objects behind and in front of the  
               
               
                   
                 patient can be effectively ignored. The preferred  
               
               
                   
                 use of depth as a factor also differentiates the  
               
               
                   
                 current monitoring system from motion/object 
               
               
                   
                 detection systems that rely on 2D images. 
               
               
                   
                 The 3D Motion and Sound Sensor is located  
               
               
                   
                 within the room of the patient being monitored  
               
               
                   
                 and potentially just outside of the patient&#39;s 
               
               
                   
                 room. It is connected to the computerized  
               
               
                   
                 communication and computerized monitoring  
               
               
                   
                 systems via a data connection (TCP/IP or 
               
               
                   
                 comparable technology). 
               
               
                 Computerized  
                 A computer system specifically designed and  
               
               
                 Virtual 
                 programmed to create virtual safety rails around  
               
               
                 Safety Rail  
                 a specific object such as a hospital bed and which  
               
               
                 Monitoring 
                 monitors activity based on information received  
               
               
                 System 
                 from the 3D Camera, Motion and Sound sensor(s).  
               
               
                   
                 The computerized monitoring system will  
               
               
                   
                 preferably be located within the patient&#39;s room  
               
               
                   
                 and can be connected to the centralized monitoring  
               
               
                   
                 station at the facility but can also be located at any  
               
               
                   
                 physical location so long as a data connection 
               
               
                   
                 (TCP/IP or comparable technology) exists  
               
               
                   
                 between the computerized monitoring system, the  
               
               
                   
                 computerized communication system, centralized  
               
               
                   
                 monitoring station and/or 3D motion and sound  
               
               
                   
                 sensor. 
               
               
                   
                 The computerized virtual safety rail monitoring  
               
               
                   
                 system preferably makes its determinations based  
               
               
                   
                 on the data received by the 3D Camera, Motion  
               
               
                   
                 and Sound sensor(s). 
               
               
                 Computerized 
                 A computer system specifically designed and  
               
               
                 Communication  
                 programmed to facilitate communication between  
               
               
                 System 
                 the monitored patient and computerized monitoring  
               
               
                   
                 system in the event the virtual safety rails are  
               
               
                   
                 crossed. This system may include but is not limited  
               
               
                   
                 to amplified speakers, microphones, lights,  
               
               
                   
                 monitors, computer terminals, mobile phones and 
               
               
                   
                 or other technologies to allow for the electronic  
               
               
                   
                 communication to take place. The computerized  
               
               
                   
                 communication system will preferably be  
               
               
                   
                 located within the patients room being monitored  
               
               
                   
                 but certain components of the system are mobile  
               
               
                   
                 by their nature (i.e. mobile phones, pagers,  
               
               
                   
                 computers) and can also be located at any  
               
               
                   
                 location so long as a data connection 
               
               
                   
                 (TCP/IP or comparable technology) exists 
               
               
                   
                 between the computerized monitoring system,  
               
               
                   
                 the computerized communication system,  
               
               
                   
                 centralized monitoring station and 3D Camera,  
               
               
                   
                 Motion and Sound sensor. 
               
               
                 System  
                 A computer database that stores records of all  
               
               
                 Database 
                 alerts generated, notifications, confirmation  
               
               
                   
                 requests, responses, and reconfirmation requests  
               
               
                   
                 and any other desired information concerning a  
               
               
                   
                 triggering event or lack of triggering event(s). 
               
               
                 Centralized  
                 A computer display connected to the centralized  
               
               
                 Monitoring 
                 monitoring station, showing video and audio  
               
               
                 Primary  
                 of all patient rooms connected to the centralized  
               
               
                 Display 
                 monitoring station. 
               
               
                 Centralized  
                 A computer display connected to the centralized  
               
               
                 Monitoring 
                 monitoring station, showing video and audio of  
               
               
                 Alert Display 
                 any patient room where an individual is deemed  
               
               
                   
                 to have crossed a virtual safety rail at the moment  
               
               
                   
                 such determination is made. 
               
               
                 Caregiver 
                 A relative, friend, individual, company of facility  
               
               
                   
                 whose purpose is to provide assistance in daily living  
               
               
                   
                 activities for individuals who are disabled, elderly  
               
               
                   
                 or otherwise in needs of assistance. 
               
               
                   
               
             
          
         
       
     
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a block diagram of a virtual safety rails configuration, monitoring and alerting system and method in accordance with the present invention; and 
         FIG. 2  is a block diagram of the centralizing monitoring and alerting system in accordance with the disclosure; and 
         FIGS. 3  though  15  illustrate various screen shots for configuring the system for operation including defining bed zone, virtual safety rails and alert types; and 
         FIG. 16  is a non-limiting example of a centralized video monitoring system that can be used with the system and method shown in  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       FIG. 1  illustrates a block diagram for the virtual safety rails configuration, monitoring and alerting system and method of the present invention. Specifically,  FIG. 1  shows the workflow for monitoring an individual&#39;s status through the use of one or more 3D Camera, Motion and Sound sensors. 
     At step F 1   a , one or more 3D Camera, Motion and/or Sound sensors can be installed in the patient&#39;s or individual&#39;s room. At step F 1   b , the one or more 3D Motion and Sound sensors can be configured to recognize the individual using biometric identifiers such as height, distance between points on the body, etc. Virtual safety rails can also be calibrated at this time. At step F 1   c , data from the 3D Motion and Sound sensors can be sent to a. Computerized Virtual Safety Rail Monitoring System. At step F 1   d , a continuous video feed can be sent to the central Video Monitoring System. 
     At step F 1   e , if the computerized virtual safety rail monitoring system detects that the patient or any part of the patient has crossed outside of the designated perimeter (beyond the virtual safety rail), the monitoring system will alert the computerized communication system. A record can also be entered in a database to record the incident. If other individuals such as a caregiver are also detected at the time the virtual safety rail threshold is crossed, the system, can be designed or programmed such that no alert is generated and it will continue to monitor the data being sent from the 3D camera, motion and sound sensor. Additionally, the system can be programmed to be capable of detecting pre-programmed hand, arm, leg and body gestures from the patient/individual and/or another person in the room to initiate an alert to the computerized communication system. As a non-limiting example, a particular hand gesture could be used as a signal to send medical assistance or that the individual needs to use the restroom. Further examples are numerous. 
     At step F 1   f , the computerized communication system preferably can first issue a verbal warning to the patient that they have crossed the virtual safety rail threshold. This verbal warning can be a pre-recorded message, including, but not limited to, a pre-recorded message from any caregiver, and will advise the patient to return to within the perimeter of the virtual safety rails. At step F 1   g , should the patient fail to return to within the perimeter of the virtual safety rails in a timely manner, an alert can be generated on the central Video Monitoring System (see  FIG. 2 ). The system database can also be updated to reflect actions taken. The system can be designed to provide visual and/or audio alerts. 
     At step F 1   h , the computerized communication system can notify caregivers or other designated persons that the individual requires assistance. Notification of caregivers can be made through phone call, text messaging, speakerphone systems, pagers, email, or other electronic means of communication if so desired and configured. At step F 1   i , if the individual returns within the perimeter of the virtual safety rails, the system database can be updated to reflect such. Additionally, the system will continue to monitor the patient and store all data in the system database. 
     Preferably, based on information received from the sensor(s), the computerized monitoring system can track skeletal points on a body of the specific individual being monitored in real time. The 3D Camera, Motion and Sound sensors continually capture data concerning the one or more rooms regardless of whether (and independent of) any movements or sounds have occurred in the one or more rooms. Thus, during monitoring, the 3D Camera, Motion and Sound sensors continually capture or receive data at all times and continually feed or send the data to the computerized monitoring system for processing and analysis involved in making the relevant determinations. 
     The monitored individual or a person/caregiver with the monitored individual can received a message from the computerized communication system which is in communication with the computerized monitoring system to determine whether or not the individual needs assistance. In one embodiment, the computerized monitoring system detects or determines that the individual may have fallen or is about to fall or crossed over a virtual safety rail, solely from the video feed forwarded from the one or more 3D Camera, Motion and Sound sensors that shows that the individual has fallen or gestured that he or she needs assistance or moved over or through the electronically defined virtual safety rail. 
       FIG. 2  illustrates a block diagram for centralized monitoring and alerting and shows the workflow for centralized monitoring and alerting of the central monitoring regarding whether an individual has crossed a virtual safety rail threshold through the use of 3D Motion and Sound sensors. At step F 2   a , one or more 3D Motion and Sound sensors are installed in and/or just outside an individual&#39;s room, home, hospital room, or other place of temporary or permanent residence and connected to the computerized monitoring and communication systems as described in  FIG. 1 . The video, audio and alert data can be sent to a centralized monitoring station where the data is aggregated. Preferably, the centralized monitoring station receives data at all times from the sensors to allow the various individuals to be constantly monitored at the centralized station regardless of whether or not a fall has been detected. 
     At step F 2   b , all video, audio and alert feeds received by the centralized monitoring station can be displayed on the centralized monitoring primary display. Alternatively, multiple centralized monitoring primary displays can be utilized based on the quantity of rooms to be monitored at a given time. At step F 2   c , when the centralized monitoring system receives an alert from any of the computerized monitoring and communication systems indicating that an individual in any of the monitored rooms or other locations has fallen, the video, audio and alert information is displayed on the Centralized Monitoring Alert Display. Should the centralized monitoring station receive alerts from more then one of the computerized monitoring and communication systems indicating that an individual in a monitored room or location has crossed a virtual safety rail threshold, the centralized monitoring alert display will display the video, audio and alerting information from all such instances at the same time. If no alert is received by the centralized monitoring station, nothing is displayed on the Centralized Monitoring Alert Display. At step F 2   d , an electronic record of any alerts received by the Centralized Monitoring Station can be stored in an electronic database, which is in communication with the Centralized Monitoring Station. 
       FIGS. 3 through 15  illustrate several set up screen shots for configuring the bed zone, virtual safety rails and alert types. In  FIG. 3 , the bed zone and virtual safety rails can be configured for a given or specific 3D Motion and Sound Sensor. To begin configuration, the user can hover over the 3D Motion and Sound Sensor video window with the cursor, right-click, select plugin and then select configure plug-in. A window will popup showing the 3D Motion and Sound Sensors&#39; feed. The user selects the icon for the type of zone or rail they wish to draw, which as a non-limiting example and illustrative purposes, can be a bed zone and virtual safety rail(s) (See  FIG. 4 ). 
     As non-limiting examples, the icons that appear on the screen for selection can include the following symbols shown in  FIG. 5 . In this non-limiting example, in no particular order, some of the icons include, Bed Zone, Auto Bed Zone (Select Patient), Auto Bed Zone (Auto-select), Saved Zones, Virtual Safety Rail and Clear All. 
     As seen in  FIG. 6 , to place a zone, the user clicks on the screen where he or she would like to start the zone. Then, the cursor is moved to the corner point for zone and clicked again. The user continues to select additional points until the zone is drawn to the user&#39;s satisfaction. Preferably, the user clicks on the round end point of the beginning of the zone to complete the zone (See  FIG. 6 ). When the zone has been completed, the zone can appear and a depth range box (i.e. square, rectangle, etc. disposed over the patient on the screen) can be provided on the screen, such as, but not limited to, in the middle of the screen or zone (see  FIG. 8 ), though any location on the screen is considered within the scope of the invention. Placing a virtual rail is done with a similar process wherein the user clicks on the screen where he or she would like to start the rail. Then the cursor is moved to the end point for the rail and the user clicks on the screen again to place the rail. As seen in  FIG. 8 , upon completion the zone and or rail(s) appear and has a depth range box preferably in the middle. 
     As seen in  FIG. 7 , the user can adjust the depth range for any given zone or rail. By preferably double clicking on the depth range box or by other conventional selection methods an Edit Depth window can appear. The user can enter in the depth ranges (preferably in millimeters (mm) though not considered limiting) and then the user can click Save button or icon when done to store the entered values. 
     If there are any other types of zones or rails to draw for the particular sensor, the above steps are repeated to place the next zone or rail and the depth setting can be adjusted for each if necessary. Additionally, all zones and rails can be cleared by clicking on or otherwise selecting the Clear All icon in the toolbar. Once all of the zones/rails are configured, you can close the window to finish or you have the option to save the zone/rail configuration for later use. 
     As seen in  FIG. 9 , to access the main settings window, the user can click or otherwise select the Settings menu and the select Main Settings from the drop-down list. As one non-limiting alternative, the user can click on the Gear icon (           ) or other designated icon in the toolbar to access the main settings window.
     As seen in  FIG. 10 , for one non-limiting way to configure a new Alert, the user can select the Alerts tabs and then click on or otherwise select the Add button, which can result in the Configure Alert box appearing on the screen (See  FIG. 11 ). As seen in  FIG. 11 , under the Event field, the user can then select the event from the drop down list that they wish the user wishes to send an alert on. 
     As seen in  FIG. 12 , once the Event type is selected, under the Action field, the user can select the Action he or she wishes to have the system perform when the selected Event is detected. Once the Event and Action have be selected the OK button (See  FIG. 13 ) is can be selected to save the selected entries. 
     For certain Actions an additional field may need to be completed to finish the Action. If the field is required, it can appear below the Action dropdown (See  FIG. 14 ). If no further fields are required, the Configure Alert box can display N/A (See  FIG. 13 ) or just be blank. As mentioned above, once all settings are selected, the user clicks or otherwise selects the OK button, which causes the new Alert to be listed in the Alerts tab window. To edit an existing Alert, the user first clicks on or otherwise selects the Alert and then selects the Edit button (See  FIG. 15 ). To delete an Alert, first highlight it can then click on the Delete button (See  FIG. 15 ). 
     To add more Alerts, the user clicks or selects the Add button and repeats the above described steps. Once finished, the user clicks on or otherwise selects the bottom corner OK button to save and close the window. 
       FIG. 16  shows a non-limiting example of a centralized video monitoring system that can be used with the system and method. The window highlighted in red is a non-limiting example of an alert that can be generated when the patient fails to return to within the perimeter of the virtual safety rails. 
     The above described system uses several components, including, but not limited to:
         1. One or more 3D Camera, Motion and/or Sound Sensors. However, it also within the scope of the invention to eliminate the sound sensor and have the functions of the invention be performed with only motion/camera functions;   2. A Computerized Virtual Safety Rail Monitoring System in electronic communication with the one or more 3D Camera, Motion and Sound sensors;   3. A Computerized Communication System in electronic communication with the Computerized Virtual Safety Rail Monitoring System;   4. A Centralized Monitoring Station in electronic communication with the one or more 3D Camera, Motion and Sound sensors, Computerized Virtual Safety Rail Monitoring System and/or Computerized Communication System;   5. A Centralized Monitoring Primary Display in electronic communication with one or more Centralized Monitoring Stations;   6. A Centralized Monitoring Alert Display in electronic communication with one or more Centralized Monitoring Stations; and/or   7. Database       

     The various components can be in electrical, wired and/or wireless communication with each other. 
     The automatic detection of an individual leaving a prescribed virtual perimeter will provide significant administrative and clinical benefits to caregivers and individuals alike, including the following non-limiting public benefits:
     1. Automation of determination of perimeter violation and automated notification of caregivers or other designated entities.   2. Ability to alert patients and caregivers in time to prevent patient from getting out of bed   3. Reduction in response time for individuals who have fallen and require assistance.   4. Increased survival rate for individuals who have experienced a fall   5. Reduction in costs for hospitalization and medical care related to complications from a fall   6. Ability to distinguish multiple individuals and prevent false positives   7. Ability to distinguish direction of motion of prevent false positives   8. Ability to provide video feed of patient under all lighting conditions to the central video monitoring system   9. Audio and gesture based recognition to allow multiple forms of communication with patient.   

     Any computer/server/electronic database system (collectively “Computer System”) capable of being programmed with the specific steps of the present invention can be used and is considered within the scope of the disclosure. Once programmed such Computer System can preferably be considered a special purpose computer limited to the use of two or more of the above particularly described combination of steps (programmed instructions) performing two or more of the above particularly described combination of functions. 
     All components of the described system and their locations, electronic communication methods between the system components, electronic storage mechanisms, electronic notification technologies, etc. discussed above or shown in the drawings, if any, are merely by way of example and are not considered limiting and other component(s) and their locations, electronic communication methods, electronic storage mechanisms, electronic notification technologies, etc. can be chosen and used and all are considered within the scope of the disclosure. 
     Unless feature(s), part(s), component(s), characteristic(s) or function(s) described in the specification or shown in the drawings for a claim element, claim step or claim term specifically appear in the claim with the claim element, claim step or claim term, then the inventor does not consider such feature(s), part(s), component(s), characteristic(s) or function(s) to be included for the claim element, claim step or claim term in the claim when and if the claim element, claim step or claim term is interpreted or construed. Similarly, with respect to any “means for” elements in the claims, the inventor considers such language to require only the minimal amount of features, components, steps, or parts from the specification to achieve the function of the “means for” language and not all of the features, components, steps or parts describe in the specification that are related to the function of the “means for” language. 
     While the system and method have been described and disclosed in certain terms and has disclosed certain embodiments or modifications, persons skilled in the art who have acquainted themselves with the disclosure, will appreciate that it is not necessarily limited by such terms, nor to the specific embodiments and modification disclosed herein. Thus, a wide variety of alternatives, suggested by the teachings herein, can be practiced without departing from the spirit of the disclosure, and rights to such alternatives are particularly reserved and considered within the scope of the disclosure.