Method and apparatus for monitoring collection of physiological patient data

A method and apparatus for monitoring collection of subject condition data is provided. The method includes receiving a value of a parameter of subject condition data and a value of a sample time, for each of a plurality of sample times. The method also includes storing the subject condition data in a data structure including a first field for holding data indicating a current sample time and a second field for holding data indicating the value of the parameter. The method also includes determining a time gap defined by a duration between the current sample time and a most recent sample time and determining whether the time gap exceeds a time gap threshold and causing an apparatus to perform remedial action. A method for presenting the subject condition data on a display is also provided.

BACKGROUND

Automated electronic patient monitoring and data collection systems are used to collect real time physiological data over a plurality of sample times from physiological data monitors associated with units in a facility. Multiple servers receive the physiological data from the physiological data monitors. In the event that one of the servers does not record physiological data at a sample time, the system assesses whether another of the servers recorded physiological data at the sample time. If none of the servers record physiological data at the sample time, the system classifies the sample time as a time gap in the collection of physiological data. Collection performance of these systems is assessed based on a collection rate defined as a percentage of the sample times where physiological data is recorded.

SUMMARY

It is here recognized that conventional automated electronic patient monitoring and data collection systems are deficient, since they merely assess whether there is a time gap in the collection of physiological data at each sample time and do not take remedial action to diagnose and resolve the time gap. Consequently, the collection rate of conventional systems is limited. Collection rates in conventional systems range between 28% and 40% when using a single server and approximately 79% when multiple servers are connected redundantly, e.g. if one server does not record data, a backup server is relied upon to provide the recorded data. An advantage of the monitoring and data collection system described herein is that, in an experimental embodiment, the collection rate significantly improved to a range between 87% and 95% when using a single server and to 99.88% when multiple servers are connected redundantly.

In a first set of embodiments, a method is provided for monitoring collection of subject condition data. The method includes receiving a value of a parameter of subject condition data and a value of a sample time at each of a plurality of sample times from one or more servers. The value of the parameter and the value of the sample time is received on the one or more servers from a plurality of subject condition data monitors associated with a respective plurality of units in a facility. The method further includes storing the subject condition data from each unit in a data structure for a current sample time. The data structure includes a first field for holding data indicating the current sample time. The data structure also includes a second field for holding data indicating a value of the parameter of subject condition data. The method further includes determining a time gap defined by a duration between the current sample time and a most recent sample time. The method further includes determining whether the time gap for each unit exceeds one or more time gap thresholds. The method further includes causing an apparatus to perform a remedial action based on the determining step.

In a second set of embodiments, non-transitory computer-readable medium is provided for storing a sequence of instructions and a data structure including two or more records, where each record includes two or more fields. Execution of the one or more sequences of instructions by one or more processors causes the one or more processors to perform one or more steps of the above method.

In a third set of embodiments, an apparatus is provided for monitoring collection of subject condition data. The apparatus includes a processor, a memory including one or more sequences of instructions and a data structure including two or more records and where each record includes two or more fields. The memory and the sequence of instructions are configured to, with the processor, cause the apparatus to perform one or more steps of the above method.

In a fourth set of embodiments, a method is provided for displaying subject condition data relating to monitoring a plurality of subjects in a respective plurality of units of a facility, where the plurality of units are divided into one or more groups of the facility. The method includes receiving a value of a parameter of subject condition data and a value of a sample time at each of a plurality of sample times from a plurality of subject condition data monitors associated with the respective plurality of units. The method further includes presenting a first indicator in each of a first plurality of active areas in a group region of a display, where each active area in the group region corresponds to a respective group of the facility. In response to a selection of a particular active area of the group region, the method further includes presenting a representation based on the value of the parameter of subject condition data in each of a second plurality of active areas in a unit region of the display, where each active area in the unit region corresponds to a respective unit within the group corresponding to the particular active area of the group region.

In a fifth set of embodiments, a method is provided for displaying subject condition data relating to monitoring a plurality of subjects in a respective plurality of units. The method includes receiving a value of a parameter of subject condition data and a value of a sample time at each of a plurality of sample times from a plurality of subject condition data monitors associated with the respective plurality of units. The method further includes presenting a first indicator in each of a first plurality of active areas in a thumbnail region of a display, where each active area in the thumbnail region corresponds to a respective unit. The method further includes presenting a trace of the value of the parameter of subject condition data over a time window encompassed by the plurality sample times in each of a second plurality of active areas of a trace region of the display. Each active area in the trace region corresponds to a respective parameter. The method further includes presenting a bar that indicates an occurrence of the value of the parameter over the time window in each of a third plurality of active areas of a bar region of the display. Each active area in the bar region corresponds to a respective parameter. The method further includes presenting points in an index plot over the time window in at least one active area in an index region of the display. Each active area in the index region corresponds to a respective index plot, where the points are based on a value of a first parameter of subject condition data and a value of a second parameter of subject condition data.

Still other aspects, features, and advantages are readily apparent from the following detailed description, simply by illustrating a number of particular embodiments and implementations, including the best mode contemplated for carrying out the invention. Other embodiments are also capable of other and different features and advantages, and its several details can be modified in various obvious respects, all without departing from the spirit and scope of the invention. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not as restrictive.

DETAILED DESCRIPTION

Notwithstanding that the numerical ranges and parameters setting forth the broad scope are approximations, the numerical values set forth in specific non-limiting examples are reported as precisely as possible. Any numerical value, however, inherently contains certain errors necessarily resulting from the standard deviation found in their respective testing measurements at the time of this writing. Furthermore, unless otherwise clear from the context, a numerical value presented herein has an implied precision given by the least significant digit. Thus a value 1.1 implies a value from 1.05 to 1.15. The term “about” is used to indicate a broader range centered on the given value, and unless otherwise clear from the context implies a broader range around the least significant digit, such as “about 1.1” implies a range from 1.0 to 1.2. If the least significant digit is unclear, then the term “about” implies a factor of two, e.g., “about X” implies a value in the range from 0.5X to 2X, for example, about 100 implies a value in a range from 50 to 200. Moreover, all ranges disclosed herein are to be understood to encompass any and all sub-ranges subsumed therein. For example, a range of “less than 10” can include any and all sub-ranges between (and including) the minimum value of zero and the maximum value of 10, that is, any and all sub-ranges having a minimum value of equal to or greater than zero and a maximum value of equal to or less than 10, e.g., 1 to 4.

Some embodiments of the invention are described below in the context of the collection of physiological data from a plurality of physiological data monitors associated with a respective plurality of bed units in a medical facility, such as a hospital with one or more vital signs monitors available for each bed. Other embodiments of the invention are described below in the context of the display of the collected physiological patient data. However, the invention is not limited to these contexts. In various embodiments, the medical facility is a hospital, a mobile medical unit, such as a helicopter, plane, boat, train, or ambulance and the monitoring equipment includes devices for generating electrocardiograms (EKGs), electroencephalograms (EEGs) and other indicators on the state or condition of a patient. In some embodiments, the monitors provide other indicators of the state of other kinds of subjects, such as various equipment. For example, in various embodiments the subject condition data indicates the voltage at multiple power generators, or the central processor unit usage of various processors, or the rotation rate of various engines. As used herein the term “subject condition” refers to the conditions or state or function of a subject, including physiological data, like vital signs, for a patient of a medical facility. Furthermore, the term “unit” refers to a known location where a monitor is connected to a subject, such as a bed in a medical facility.

1. Overview for a Medical Facility

FIG. 1Ais a block diagram that illustrates an example system100for monitoring collection of physiological data, according to an embodiment. The system100includes a plurality of subject condition data monitors104a,104bthat are assigned to a respective plurality of units102a,102bin a facility, such as physiological monitors for bed units in a medical facility, as assumed for purposes of illustration in the following. In some embodiments, the system100excludes the bed units102a,101b.AlthoughFIG. 1Adepicts two bed units102, in some embodiments the system100includes more than two bed units102that are divided into more than one group within the medical facility. For example, the groups include a trauma resuscitation unit (TRU), an operating room (OR) and a neural trauma critical care (NTCC), as further discussed below. In some embodiments, the medical facility is a hospital. In other embodiments, the medical facility is any location where healthcare is provided including clinics, doctor's offices, urgent care centers, residential treatment centers, or geriatric care facilities.

At each of a plurality of sample times, the physiological data monitors104a,104bmeasure a value of a parameter of physiological patient data and transmit the measured value and a value of the sample time to a plurality of servers105a,105b.In some embodiments, the physiological data monitors104a,104b,the servers105a,105band a controller are connected through a local network180. In some embodiments, the parameter of physiological patient data includes but is not limited to electrocardiographic (EKG), photoplethysmographic (PPG), carbon dioxide (CO2), arterial blood pressure (ABP), intracranial pressure (ICP), heart rate (HR), respiratory rate (RR), temperature, oxygen saturation (SP02) and end-tidal CO2 (EtCO2). AlthoughFIG. 1Adepicts two severs105, in some embodiments the system100includes one server105or more than two servers105. The controller106maintains a data structure for each server, such as data structure120afor data reported by server105aand data structure120bfor data reported by server105b.

At each sample time, the measured value of the parameter of physiological patient data and the value of the sample time is transmitted from each server105a,105bto a controller106.FIG. 2is a block diagram that illustrates an example of a data structure200used to store physiological patient data, according to an embodiment. The data structure200resides as one of the data structures120aor120b,described above, on a computer-readable medium, such as a memory of the controller106. In some embodiments, multiple data structures200are provided in the memory of the controller106, where a respective data structure200is used to store physiological patient data from a respective server105. The data structure200includes multiple records202, where a respective record202is used to store the physiological patient data at a respective sample time. In an example embodiment, the physiological patient data at a first sample time is stored in a first record202aand the physiological patient data at a second sample time is stored in a second record201b.

Each record202includes multiple fields including a first field204for holding data indicating a value of the sample times for each bed unit102when a recorded value of the parameter of physiological patient data was received from the server for the physiological data monitor104associated with each bed unit102. Each record202also includes a second field206for holding data indicating the value of the parameter of physiological patient data received from the server for the physiological data monitor104associated with each bed unit102. In some embodiments, each record202also includes a third field208for holding data indicating the parameter of physiological patient data received from the server for physiological data monitor104associated with each bed unit102.

Although processes, equipment, and data structures are depicted inFIG. 1AandFIG. 1BandFIG. 1Cas integral blocks in a particular arrangement for purposes of illustration, in other embodiments one or more processes or data structures, or portions thereof, are arranged in a different manner, on the same or different hosts, in one or more databases, or are omitted, or one or more different processes or data structures are included on the same or different hosts.

Although data structures, messages and fields are depicted inFIG. 2, as integral blocks in a particular order for purposes of illustration, in other embodiments, one or more data structures or messages or fields, or portions thereof, are arranged in a different order, in the same or different number of data structures or databases in one or more hosts or messages, or are omitted, or one or more additional fields are included, or the data structures and messages are changed in some combination of ways.

In other embodiments, each bed unit102has a unique identifier. At each sample time, the physiological data monitor104associated with each bed unit102transmits the unique identifier to the server105which subsequently transmits the unique identifier to the controller106. In this embodiment, each record202also includes a fourth field210for holding data indicating the identifier for each bed unit102.

In other embodiments, each bed unit102has an admission status that indicates whether a patient is admitted (A) or discharged (D) from the bed unit102. In some embodiments, the admission status is changed by medical staff (e.g. nurse) using a manual switch when the patient is admitted or discharged. At each sample time, the physiological data monitor104associated with each bed unit102transmits the admission status to the server105which subsequently transmits the admission status to the controller106. In this embodiment, each record202also includes a fifth field212for holding data indicating the admission status for each bed unit102.

As illustrated inFIG. 1A, the controller106is configured to monitor the collection of physiological data and perform remedial action to diagnose and resolve detected gaps in the collection of physiological data and is connected to a display device108, or other device, to present some or all the data in the one or more data structures, or otherwise remediate the situation detected. The controller106includes a monitor of monitor module107to perform one or more steps of a method described below with reference toFIG. 7A. In various embodiments, the controller106comprises one or more general purpose computer systems, as depicted inFIG. 8or one or more chip sets as depicted inFIG. 9or one or more mobile terminals as depicted inFIG. 10, and instructions to cause the computer or chip set or mobile terminal to perform one or more steps of a method described below with reference toFIG. 7A.

In some embodiments, for a current sample time, the module107determines a time gap defined by a duration between the current sample time and a most recent sample time. In one embodiment, the current sample time and the most recent sample time are retrieved from the first field204data of the data structure202. In other embodiments, the time gap is stored in one of the fields (e.g. first field204) of the data structure202. In these embodiments, for the current sample time, the module107determines whether the time gap is greater than one or more time gap thresholds. The module107then causes the controller106to perform remedial action based on whether the time gap exceeds the one or more time gap thresholds. In some embodiments, the remedial action includes sending a communication to a person responsible for maintenance of the system, e.g., via email or text to a technician. In some embodiments, the remedial action involves transmitting a signal to the display108to present a plurality of indicators on the display108for each of the plurality of bed units102. Each indicator provides a status of the collection of physiological data from the respective bed unit102. In some embodiments, the indicator is color-coded based on whether the time gap for each bed unit102is greater than the one or more time gap thresholds. In some embodiments, the one or more time gap thresholds include a first time gap threshold (e.g. 5 minutes) and a second time gap threshold (e.g. 4 hours) that is greater than the first time gap threshold. In an embodiment, the color-coded indicator is a first colored indicator (e.g. green), if the time gap for the bed unit102is less than the first time gap threshold. In another embodiment, the color-coded indicator is a second colored indicator (e.g. yellow), if the time gap for the bed unit102is greater than the first time gap threshold but less than the second time gap threshold. In another embodiment, the color-coded indicator is a third colored indicator (e.g. red), if the time gap for the bed unit102is greater than the second time gap threshold. In one embodiment, a value of the first time gap threshold is small enough to achieve a relatively fast response (e.g. presenting the second colored indicator on the display108) to an issue with the collection of physiological data. In another embodiment, the value of the first time gap threshold is large enough to avoid oversensitive response to insignificant network delays. In an example embodiment, the value of the first time gap threshold is in a range from about 2 minutes to about 10 minutes. In another example embodiment, the value of the second time gap threshold is in a range from about 1 hour to about 12 hours. In some embodiments, the values of the first time gap threshold and the second time gap threshold are adjustable.

FIG. 3AthroughFIG. 3CandFIG. 5AthroughFIG. 5Eare diagrams of user interfaces utilized in the processes described herein, according to various embodiments. For example,FIG. 3Ais an image that illustrates an example of a block300of active areas304on the display108ofFIG. 1A, according to an embodiment. The screen includes one or more active areas304that allow a user to input data to operate on data. As is well known, an active area is a portion of a display to which a user can point using a pointing device (such as a cursor and cursor movement device, or a touch screen) to cause an action to be initiated by the device that includes the display. Well known forms of active areas are stand alone buttons, radio buttons, check lists, pull down menus, scrolling lists, and text boxes, among others. Although areas, active areas, windows and tool bars are depicted inFIG. 3AthroughFIG. 3CandFIG. 5AthroughFIG. 5Eas integral blocks in a particular arrangement on particular screens for purposes of illustration, in other embodiments, one or more screens, windows or active areas, or portions thereof, are arranged in a different order, are of different types, or one or more are omitted, or additional areas are included or the user interfaces are changed in some combination of ways.

As depicted inFIG. 3A, in some embodiments, each active area304presents a color-coded indicator associated with a respective bed unit102. In some embodiments, the block300is specific to the physiological data provided by one server105and thus multiple blocks300can be generated based on the physiological data provided by the multiple servers105. In one embodiment, the block300is a rectangular array of active areas304. In another embodiment, the block300includes vertical columns or horizontal rows that are assigned to groups of bed units102within the medical facility.FIG. 3Bis an image that illustrates an example of a region302aof the block300ofFIG. 3A, according to an embodiment. In an embodiment, a first active area304apresents a green indicator and thus the bed unit102associated with the first active area304ahas a time gap at the current sample time that is less than the first time gap threshold. In an embodiment, a second active area304bpresents a red indicator and thus the bed unit102associated with the second active area304bhas a time gap at the current sample time that is greater than the second time gap threshold. In other embodiments, the indicators presented in the active areas304include the unique identifier of the bed unit102(e.g. TORS) indicated by the fourth field210data. In an example embodiment, the active areas304of the block300correspond to bed units102in a trauma resuscitation unit (TRU), an operating room (OR), a neurotrauma critical care unit (NTCC) and/or a multi-trauma critical care (MTCC) unit. In still other embodiments, the indicator presented in the active area304aincludes the value of the parameter of physiological patient data (e.g., 88) indicated by the second field206data. In still other embodiments, the indicator presented in the active area304aincludes the admission status (e.g., A) indicated by the fifth field212data. In still other embodiments, the indicator presented in the active area304bincludes the time gap (e.g., 6 h 51 m) calculated from the first field204data. In an example embodiment, the time gap is included in red and yellow indicators and the admission status and value of the parameter of physiological patient data are included in green indicators. In some embodiments, the block300only depicts active areas304where the time gap exceeds one of the first or second time gap thresholds (e.g. the block300only displays active areas304corresponding to bed units102with abnormal collection status based on yellow or red indicators). An advantage of this embodiment is that the block300can effectively monitor a greater number of bed units102since only those bed units102with abnormal collection statuses are displayed. In other embodiments, where the number of active areas304is less than a number of bed units102being monitored (e.g. the number of bed units102in a medical facility or a group within the medical facility), the display toggles between a first block300and a second block300(or more than two blocks300) so that all of the bed units102are displayed over the two or more blocks300and where the toggle time between the blocks300is less than an incremental time when the physiological patient data is updated.

FIG. 3Cis an image that illustrates an example of a region302bof the block300ofFIG. 3A, according to an embodiment. In this embodiment, an active area304cwithin the region302bpresents a color-coded indicator based on the parameter of physiological patient data (e.g. intracranial pressure, ICP) indicated by the third field208data. In another embodiment, the color-coded indicator is based on the value of the parameter of physiological patient data (e.g., heart rate, HR>120) indicated by the second field206data. In some embodiments, the color-coded indicator is other than a green indicator, a yellow indicator or a red indicator (e.g. pink color indicator).

In some embodiments, the user can view the values of the parameter of physiological patient data associated with a particular bed unit102. By an action of a pointing device the user selects a particular active area304associated with the particular bed unit102. In one embodiment, the display108is a touchscreen and the user touches the particular active area304. In response to this user action, the display108transmits a signal to the controller106, wherein the signal identifies the particular bed unit102. In some embodiments, a graphical user interface (GUI) module109of the controller106then transmits a signal to the display108including second field206data that indicate values of the parameter of physiological patient data from the particular bed unit102. In an example embodiment, a trace plot600(FIG. 6A) is presented on the display108including the trace608of values of the parameter of physiological patient data from the particular bed unit102. In another example embodiment, a unit view550(FIG. 5B) is presented on the display108of the particular bed unit102.

FIG. 1Bis a block diagram that illustrates an example system150for monitoring collection of physiological data, according to an embodiment. The system150ofFIG. 1Bis similar to the system100ofFIG. 1A, with the exception that the system150includes three servers105a,105b,105cand a network152of more than two physiological data monitors104. In some embodiments, messages from the servers105a,105b,105cto the controller106, represented by curved lines inFIG. 1B, travel through the same or similar network as the local network180ofFIG. 1A. Additionally, in some embodiments, the system150includes multiple screens that can be alternatively presented on a single display, or presented simultaneously on three different displays108a,108b,108c,which screens are used to perform distinct functions of the system150. In one embodiment, the display108ais used to present a screen comprising the block300of active areas304. In another embodiment, the display108bis used to present a screen comprising an interactive graphical user interface (GUI) with displayed physiological data. In another embodiment, the display108cis used present a screen configured to diagnose a gap in the collection of physiological data from one or more bed units102. In an example embodiment, the display108cscreen is used to diagnose an instance when the time gap exceeds the one or more time gap thresholds. In some embodiments, the single display108is used and thus the features of each screen described above for display108a,108b,108care presented on the single display108. Additionally, the system150includes a workstation154that can be located at the medical facility or remote from the medical facility. In one embodiment, the workstation154is a medical workstation configured for medical personnel (e.g. nurses) and is located at the medical facility. In another embodiment, the workstation154is configured for information technology (IT) personnel that are responsible for maintaining the connectivity of the system150.

FIG. 1Cis a block diagram that illustrates an example system150′ for monitoring collection of physiological data, according to an embodiment. The system150′ ofFIG. 1Cis similar to the system150ofFIG. 1Bwith the exception that the system150′ includes three waveform generators156a,156b,156cthat generate a value of a waveform parameter of physiological patient data including but not limited to electrocardiographic (EKG) or photoplethysmographic (PPG). In some embodiments, the waveform generator156aand data monitor104aare associated with the same bed unit104a,the waveform generator156band data monitor104bare associated with the same bed unit104band the waveform generator156cand data monitor104care associated with the same bed unit104c.In these embodiments, the data monitors104measure a value of a parameter of physiological patient data other than the waveform parameter of physiological patient data. In an embodiment, the system150′ features a triple modular redundancy architecture which permits fast switch over time and high system availability. In one embodiment, one server105cis selected as a principle or “backbone” server. If the selected backbone server105cfails, values from a second server105aor105bwill fill in. If the selected backbone server105cand a second server105afail, values from the third server105bfill in.

FIG. 4Ais a graph that illustrates an example of a collection gap pattern400aof physiological data at the plurality of servers105a,105b,105cfrom the plurality of physiological data monitors104ofFIG. 1B, according to an embodiment. Such a pattern can be presented on a screen for diagnosing gap patterns. The horizontal axis402represents time in arbitrary units. The vertical axis404represents distinct bed units102using the unique identifier. For each bed unit (e.g. TRU01, TRU02, etc), three data streams406,408,410represent recorded values of the parameter of physiological patient data received over time at the respective three servers105a,105b,105cand reported to the controller106. Grey bands indicate times when data is received from a server105but the physiological parameter value is absent, e.g., indicates a null value for the physiological parameter. This can occur when the monitor is in communication with the server105, but the subject is not connected to the monitor, e.g., has been taken to a radiology laboratory. The three different shades of grey indicate the three different servers ofFIG. 1B. A time gap412in the data stream410afor a first bed unit102(e.g. TRU04) indicates that no records were received by the server105cover the gap412. In some embodiments, the time gap412exceeds one or more time gap thresholds.FIG. 4Adepicts that the time gap412is present in the data stream410received at the third server105cfor every bed unit. In some embodiments, the module107automatically determines that the time gap412, e.g., indicated by the first field204data for every bed unit102received from the server105cexceeds the time gap threshold and consequently determines that the server105cis offline. In this embodiment, the module107causes the controller106to perform a remedial action to resolve the time gap412and bring the server105cback online. In one embodiment, the remedial action involves automatically transmitting an alert including an indication that the server105cis offline. In an example embodiment, the alert is a communication message (e.g. email or text or both) to the workstation154that communicates to personnel at the workstation154that the server105cis offline. In response to receiving the alert, personnel at the workstation154respond to the time gap412, such as by rebooting the server105c.In other embodiments, the remedial action involves automatically transmitting a signal to the server105cto automatically reboot the server105c.In other embodiments, a user observing the collection gap pattern400aon the display108(or display108c) visually determines that the server105cis offline and subsequently transmits a communication message (e.g. email or text or both) to the workstation154to request that personnel at the workstation154bring the server105cback online. In other embodiments, the communication message is an auditory alert message delivered to the workstation154.

In some embodiments, the determination that the server105cis offline gleaned from the collection gap pattern400aofFIG. 4Acan be similarly derived from the block300ofFIG. 3A. In some embodiments, when the server105cis offline, every active area304of the block300includes an indicator that the time gap exceeds the one or more time gap thresholds. In an example embodiment, when the server105cis offline, every active area304of the block300includes a yellow indicator (e.g. if the time gap>5 minutes but<4 hours) or a red indicator (e.g. if the time gap is>4 hours).

FIG. 4Adepicts non-null values414of the parameter of physiological patient data (e.g. HR) within each respective data stream406,408,410. In some embodiments, non-null values414over a time period indicate a presence of a patient in the bed unit over that time period. Consequently, in some embodiments, the module107classifies a risk of loss of data collection for each time gap412based on whether the time gap412coincides with non-null values414. In some embodiments, the time gap412in the data stream410bfrom the TRU03bed unit102(e.g. patient is present) may be classified as higher risk loss of data collection than the time gap412in the data stream410afrom TRU04bed unit102(e.g. patient may not be present). This visual feature of the collection gap pattern400aadvantageously provides the user with information regarding potential data collection loss of each time gaps412. For example, on unit TRU01, no patient is connected to a monitor until the last portion of the time period, while, in unit TRU02and TRU03, each patient is intermittently connected to a monitor, as agreed by all functioning servers. Similarly, no patient is connected to a monitor at unit TRU04during the entire time interval depicted.

FIG. 4Bis a graph that illustrates an example of a collection gap pattern400bof physiological data at the plurality of servers105a,105b,105cfrom the plurality of physiological data monitors104ofFIG. 1B, according to an embodiment. In some embodiments, the module107stores physiological patient data (e.g. data stream406) from the server105ain a first data structure200, stores physiological patient data (e.g. data stream408) from the server105bin a second data structure200, and stores physiological patient data (e.g. data stream410) from the server105cin a third data structure200. The horizontal axis402represents time in arbitrary units. The vertical axis404represents the distinct bed units102using the unique identifier. A time gap416in the data stream406bfrom the server105aassociated with a first bed unit102(e.g. TRU03) indicates that no record was received by the server105aover the time gap416from unit TRU03only. In some embodiments, the time gap416exceeds the one or more time gap thresholds.

As depicted inFIG. 4B, no time gap is present in the data stream406afrom the server105aassociated with a second bed unit102(e.g. TRU04). Additionally, as depicted inFIG. 4B, no time gap is present in the data stream408bfrom the server105bassociated with the first bed unit102(e.g. TRU03). Consequently, the time gap416is attributable to a disconnection between the first server105aand the physiological data monitor104associated with the first bed unit102(e.g. TRU03).

In some embodiments, the module107automatically determines that the time gap416, e.g. calculated from first field204data of the first data structure associated with the first bed unit102is greater than the at least one time gap threshold. Additionally, the module107automatically determines that time gaps calculated from the first field204data of the first data structure associated with the second bed unit102(e.g. data stream406a) do not include a time gap exceeding the time gap threshold. Additionally, the module107automatically determines that time gaps calculated from the first field204data of the second data structure associated with the first bed unit102(e.g. data stream408b) do not include a time gap exceeding the time gap threshold. Consequently, the module107automatically determines that there is a disconnection between the first server105aand the physiological data monitor104associated with the first bed unit102(e.g. TRU03).

The module107then causes the controller106to perform a remedial action to respond to the time gap416. In one embodiment, the remedial action involves automatically transmitting an alert including an indication that there is a disconnection between the first server105aand the physiological data monitor104associated with the first bed unit102. In an example embodiment, the alert is a communication message (e.g. email or text or both) to personnel at the workstation154. In response to receiving the alert, personnel at the workstation154respond to the time gap416, by reconnecting the first server105aand the physiological data monitor104associated with the first bed unit102. In other embodiments, a user observing the collection gap pattern400bon the display108(or display108c) visually determines that the time gap416is attributable to a disconnection between the first server105aand the physiological data monitor104associated with the first bed unit102(e.g. TRU03). In this embodiment, the user subsequently transmits a communication message (e.g. email or text or both) to personnel at the workstation154to respond to the time gap416and reconnect the first server105aand physiological data monitor104.

FIG. 4Bdepicts non-null values414of the parameter of physiological patient data (e.g. HR) that can be used to classify the time gap416in a similar manner as in the collection gap pattern400a.

In some embodiments, the determination of a disconnection between the first server105aand the physiological data monitor104associated with the first bed unit102gleaned from the collection gap pattern400bofFIG. 4Bcan be similarly derived from the block300ofFIG. 3A. In some embodiments, this disconnection is recognized when the block300associated with the server105aincludes a first active area304b(e.g. TRU03bed unit) indicating that the time gap exceeds the time gap threshold and a second active area304a(e.g. TRU04) that does not indicate that the time gap exceeds the time gap threshold. In an example embodiment, the disconnection is recognized when the first active area304bincludes a yellow indicator or red indicator and the second active area304aincludes a green indicator.

FIG. 4Cis a graph that illustrates an example of a collection gap pattern400cof physiological data at the plurality of servers105a,105b,105cfrom the plurality of physiological data monitors104ofFIG. 1B, according to an embodiment. The horizontal axis402represents time in arbitrary units. The vertical axis404represents the distinct bed units102using the unique identifier. A time gap418in the data streams406c,408c,410cfrom the respective servers105a,105b,105cassociated with a first bed unit102(e.g. TRU02) indicates that no records were received from the first bed unit102over the time gap418. In some embodiments, the time gap418exceeds the one or more time gap thresholds. As depicted inFIG. 4C, the time gap418is present in the data streams406c,408c,410cof each server105a,105b,105cassociated with the first bed unit102(e.g. TRU02) and no time gap is present in the data streams406b,408b,410bof each server105a,105b,105cassociated with a second bed unit102(e.g. TRU03). Consequently, the time gap418is attributable to a disconnection between every server105a,105b,105cand the physiological data monitor104associated with the first bed unit102(e.g. TRU02).

In some embodiments, the module107automatically determines that the time gap418, i.e. calculated from first field204data of the first data structure, second data structure and third data structure associated with the first bed unit102(e.g. TRU02) is greater than the at least one time gap threshold. Additionally, the module107automatically determines that time gaps calculated from the first field204data of the first data structure, second data structure and third data structure associated with the second bed unit102(e.g. TRU03) do not include a time gap exceeding the time gap threshold. Consequently, the module107automatically determines that there is a disconnection between every server105a,105b,105cand the physiological data monitor104associated with the first bed unit102(e.g. TRU02). The module107then causes the controller106to perform a remedial action to resolve the time gap418.

In one embodiment, the remedial action involves automatically transmitting an alert including an indication that there is a disconnection between each server105a,105b,105cand the physiological data monitor104associated with the first bed unit102. In an example embodiment, the alert is a communication message (e.g. email or text or both) to personnel at the workstation154. In response to receiving the alert, the personnel respond to the time gap418, by reconnecting the servers105a,105b,105cand the physiological data monitor104associated with the first bed unit102. In other embodiments, a user observing the collection gap pattern400con the display108(or display108c) visually determines that the time gap418is attributable to a disconnection between every server105a,105b,105cand the physiological data monitor104associated with the first bed unit102(e.g. TRU02). In this embodiment, the user subsequently transmits a communication message (e.g. email or text or both) to personnel at the workstation154to respond to the time gap418and reconnect each server105a,105b,105cand physiological data monitor104.FIG. 4Cdepicts non-zero values414of the parameter of physiological patient data (e.g. HR) that can be used to classify the time gap418in a similar manner as in the collection gap pattern400a.

In some embodiments, the determination of a disconnection between every server105a,105b,105cand the physiological data monitor104associated with the first bed unit102gleaned from the collection gap pattern400cofFIG. 4Ccan be similarly derived from the block300ofFIG. 3A. In some embodiments, this disconnection is recognized when the multiple blocks300associated with each of the servers105a,105b,105cincludes a first common active area304b(e.g. TRU02bed unit) indicating that the time gap exceeds the time gap threshold and a second common active area304a(e.g. TRU03) that does not indicate that the time gap exceeds the time gap threshold. In an example embodiment, the first common active area304bincludes a yellow indicator or red indicator and the second common active area304aincludes a green indicator.

In an example embodiment, Table 1 below depicts a diagnosis for various collection gap patterns, including the collection gap patterns ofFIGS. 4A-4C.

TABLE 1Failure typeMoMs indicatorBedMaster1. Individual bed unitRandom cells insoftwareconfiguration erroryellow/red2. BedMaster databaseA block of cellserrorin yellow/red; BedMasterserver is online3. BedMaster serviceA block of cells indownyellow/red; BedMasterservice stoppedBedMaster1. BedMaster serverA block of cells inhardwaredownyellow/red; BedMasterserver is offlineNetwork1. BedMaster serverRandom cells inconnection failureyellow/red
In another example embodiment, the monitor of monitor module107features software in a high level programming language (e.g. Matlab® R2014a, Mathworks, Boston Mass.) that preprocesses the physiological parameter data so that it is aligned in the time domain in the collection gap patterns depicted inFIGS. 4A-4C.

Although steps are depicted inFIGS. 7A-7C, as integral steps in a particular order for purposes of illustration, in other embodiments, one or more steps, or portions thereof, are performed in a different order, or overlapping in time, in series or in parallel, or are omitted, or one or more additional steps are added, or the method is changed in some combination of ways.

FIG. 7Ais a flow diagram that illustrates an example of a method700for monitoring collection of physiological data, according to an embodiment. In step702, the value of the parameter of physiological patient data and the value of the sample time is received at the controller106from each server105a,105b.In one embodiment, step702is performed at each sample time. In an example embodiment, the sample times occur every 1 minute. In some embodiments, two servers105a,105b(FIG. 1A) are employed during step702. In other embodiments, one server105or more than two servers (e.g.FIG. 1B) are employed during step702. In some embodiments, at each sample time, the servers105a,105beach receive the value of the parameter of physiological patient data and the value of the sample time from each of the plurality of physiological data monitors104associated with the plurality of bed units102.

In step704, data is stored in the first field204of the data structure200that indicates the value of the sample time when the value of the parameter of physiological patient data is received in step702. In some embodiments, step704is performed at a current sample time and the value of the current sample time is stored in the first field204. Additionally, in step704, data is stored in the second field206that indicates the value of the parameter of physiological patient data received in step702. Where values for more than one parameter of physiological patient data is received in step702, second field206data is stored that indicates these values in step704. In some embodiments, step704is performed at the current sample time and the value of the parameter of physiological patient data received at the current sample time is stored in the second field206. If no value is reported by the monitor for a particular physiological parameter, a null value is stored in the field. The field is recorded to indicate that a record was received from the server.

In step705a time gap is defined as the duration between the current sample time and a most recent sample time when a recorded value of the parameter of physiological patient data was received at step702. In some embodiments, in step705, the current sample time and the most recent sample time are retrieved from the first field204. In other embodiments, in step704the time gap is stored in one of the fields (e.g. first field204) of the data structure200and step705is omitted.

In step706, a determination is made at the current sample time regarding the time gap determined in step705. In one embodiment, in step706, a determination is made whether the time gap calculated by the first field204data exceeds one or more time gap thresholds stored in a memory of the controller106. In an example embodiment depicted inFIG. 3A, the time gap threshold is the first time gap threshold (e.g. 5 minutes). In another example embodiment, the time gap threshold is the second time gap threshold (e.g. 4 hours) that is longer than the first time gap threshold. In some embodiments, in step706, the determination further includes a determination of a cause of the time gap exceeding the one or more time gap thresholds. In an example embodiment, in step706, the determination is made whether the time gap exceeding the time gap threshold is attributable to one of the servers105being offline (FIG. 4A). In another example embodiment, in step706, the determination is made whether the time gap exceeding the time gap threshold is attributable to a disconnection between one of the servers105and the physiological data monitor104associated with one of the bed units102(FIG. 4B). In another example embodiment, in step706, the determination is made whether the time gap exceeding the time gap threshold is attributable to a disconnection between every server105and the physiological data monitor104associated with one of the bed units102(FIG. 4C). If the determination in step706is negative, then the method700proceeds back to step702. If the determination in step706is positive, then the method700proceeds to step708.

In step708, an alert is generated that the time gap exceeds one or more time gap thresholds. In one embodiment, the alert is generated by presenting the block300of active areas304on the display108, where the color-coded indicator within each active area304is based on the determination of step706. In other embodiments, the alert is generating by transmitting a communication message (e.g. email or text or both) to personnel at the workstation154to respond to the time gap. In an example embodiment, the communication message identifies the one or more bed units102where the time gap exceeds the time gap threshold. In another example embodiment, where the determination in step706includes a determination of the cause of the time gap exceeding the time gap threshold, the communication message identifies the determined cause (e.g. server105is offline, physiological data monitor104is disconnected from server105, etc.).

In step710, remedial action is initiated based on the generated alert of step708. In one embodiment, the remedial action includes responding to the time gap that exceeds the one or more time gap thresholds. In one embodiment, where the communication message from step708identifies one or more bed units102where the time gap exceeds the time gap threshold, the remedial action involves checking the status of the physiological data monitors104associated with the one or more bed units102to ensure the physiological data monitors104are functional. In other embodiments, the remedial action involves checking that the one or more servers105are online and rebooting any servers105that are identified as offline. In one embodiment, where the communication message from step708identifies that the cause of the time gap exceeding the time gap threshold is that one or more servers105is offline, the remedial action involves verifying that the one or more servers105are offline and rebooting the one or more servers105. In yet another embodiment, where the communication message from step708identifies that the cause of the time gap exceeding the time gap threshold is a disconnection between one or more servers105and a physiological data monitor104of one of the bed units102, the remedial action involves checking the connection between the one or more servers105and the physiological data monitor104and reconnecting the one or more servers105with the physiological data monitor104. After performing the remedial action in step710, the method700proceeds back to step702. In step706, the determination of whether the time gap exceeds the time gap threshold is repeated, in order to verify whether the remedial action in step710was effective in eliminating the time gap.

As illustrated inFIG. 1A, the controller106is connected to the display108, to present the physiological patient data. In some embodiments, the display108is the same as the display108used to present the indicators for each bed unit102(e.g. the block300of active areas304) for monitoring collection of the physiological patient data. In other embodiments, the controller generates a separate screen that is presented on the same or a separate display, e.g., display108b(FIG. 1B) to present the physiological patient data, where the separate screen is configured for viewing by medical professionals to determine the state or care, or both, of a patient in one or more of the bed units. In some embodiments, it is advantageous for the screen to be presented on the display108bthat is separate from the display108aused to present the indicators for each bed unit102to monitor the collection of physiological patient data.

In some embodiments, the controller106receives the value of the parameter of physiological patient data and the value of the sample time from the servers105a,105b.In other embodiments, the servers105a,105bare omitted and the controller106receives the value of the parameter of physiological patient data and the value of the sample time from the physiological data monitors104. The controller106includes a graphical user interface (GUI) module109to perform one or more steps of a method described below with reference toFIG. 7Bor a method described below with reference toFIG. 7C. In various embodiments, the controller106comprises one or more general purpose computer systems, as depicted inFIG. 8or one or more chip sets as depicted inFIG. 9, and instructions to cause the computer or chip set to perform one or more steps of a method described below with reference toFIG. 7BorFIG. 7C. In some embodiments a screen is generated for presentation on a display to present physiological patient data related to monitoring a plurality of patients in a respective plurality of bed units102of a medical facility. In some embodiments, the plurality of bed units102are divided into one or more groups or clinical divisions of the medical facility. In one embodiment, the groups include a trauma resuscitation unit (TRU), an operating room (OR), and a neural trauma critical care (NTCC).

FIG. 5Ais a block diagram that illustrates an example of a group view500for displaying physiological data of patients in a single group of the medical facility, according to an embodiment. In one embodiment, the group view500is a screen that includes an indicator in a plurality of active areas504a,504bin a group region502. In some embodiments, each active area504corresponds to a respective group in the medical facility. In some embodiments, the indicator in each active area504is an acronym of the name of the group (e.g. TRU for trauma resuscitation unit). In other embodiments the indicator is a thumbnail image or icon representing the group. In other embodiments, multiple active areas504correspond to a respective group in the medical facility. AlthoughFIG. 5Adepicts five active areas504, the group region502is not limited to five active areas504and can include more or less active areas504in order to match the number of groups in the medical facility.

The group view500further includes a plurality of active areas506a,506b,506c,506din a unit region505, where each active area506corresponds to a respective bed unit102in a particular group associated with a particular active area504ain the group region502. In one embodiment, in response to a selection by a single or other action of a pointing device within the particular active area504a,the value of the parameter of physiological patient data for each bed unit102in the particular group is displayed in a respective active area506. In some embodiments, in response to the selection of the particular active area504a,a representation of the value of the parameter of physiological patient data is presented in the respective active area506. In one embodiment, the representation is a trace608(FIG. 6A) of the value of the parameter of physiological patient data along a time axis. In another embodiment, the representation is a bar656(FIG. 6B) that indicates an occurrence of the value of the parameter of physiological patient data along a time axis. In an example embodiment, a first color (e.g. green) of the trace or bar indicates that the value of the parameter is below a first threshold value and a second color (e.g. yellow, red) of the trace or bar indicates that the value of the parameter is above a second threshold value. In one example embodiment, the first threshold value is the same as the second threshold value. In another example embodiment, the first threshold value is not the same as the second threshold value and a third color (e.g. yellow) of the trace or bar indicates that the value of the parameter is above the first threshold value and below the second threshold value. In an example embodiment, the display108is a touchscreen and the single action of selecting the particular active area504ais touching the particular active area504a.

In some embodiments, the unit region505includes a fixed number of active areas506. In these embodiments, where the number of bed units102in the single group exceeds the fixed number of active areas506, multiple active areas504in the group region502are used to designate a single group. In an example embodiment, the indicator in the multiple areas504include an acronym for the group and an alpha or numeric character or other indicator, such as color or hatching, to represent a subgroup within the single group (e.g. TRU-A and TRU-B). AlthoughFIG. 5Adepicts that the unit region505includes a specific fixed number (e.g., four) active areas506, the unit region505is not limited to this fixed number of active areas and can feature less or more fixed number of active areas506. Additionally, in other embodiments, the unit region505includes an automatically or manually adjustable number of active areas506, where a size of each active area506changes based on the number of active areas506(e.g., larger active area506for a smaller number of active areas506and a smaller active area506for a larger number of active areas506).

FIG. 5Eis a block diagram that illustrates an example of the active area506of the group view500ofFIG. 5A, according to an embodiment. In one embodiment, the active area506includes a trace region556where one or more traces of the values of the parameter of physiological patient data is plotted against time.FIG. 5Cis a block diagram that illustrates an example of the trace region556ofFIG. 5E, according to an embodiment. In one embodiment, the trace region556includes a plurality of active areas557a,557b,where each active area557corresponds to a respective parameter of physiological patient data. In an example embodiment, where there is a limited number of active areas557a,557b,parameters of physiological patient data with higher priority are displayed first and parameters of physiological patient data with lower priority are displayed if active areas557a,557bremain after the higher priority parameters are displayed. In an example embodiment, a trace plot of the values of a first parameter of physiological patient data against time is presented in the first active area557aand a trace plot of the values of a second parameter of physiological patient data against time is presented in the second active area557b.FIG. 6Ais an image that illustrates an example of a trace plot600of the trace region556ofFIG. 5C, according to an embodiment. The horizontal axis602indicates time in units of (hour:minutes) spanning a 24 hour range from 12:00 PM to 12:00 PM. In other embodiments, the range of the horizontal axis602can be selected. In an example embodiment, the range can be selected from a minimum value of about 1 minute to a maximum value based on the plurality of sample times for the stored physiological patient data. The vertical axis604indicates the parameter of physiological patient data in relevant units (e.g., beats per minute for heartrate). The trace plot600includes a trace608of the values of the parameter of physiological patient data over a time window606encompassing at least some of the plurality of sample times that the controller106receives the values of the parameter of physiological patient data. In an example embodiment, the time window606is about 24 hours. In some embodiments, a color of the trace608changes from a first color to a second color when the value of the parameter of physiological patient data exceeds each of one or more threshold values609. In an example embodiment, the color of the trace600changes from green to yellow at a first threshold value609aand from yellow to red when the value608of the parameter exceeds a second threshold value609b.That is the trace has one color at values below each threshold value and a different color at values above the threshold value. In an example embodiment, where the parameter of physiological patient data is heart rate, the first threshold value609ais 100 beats per minute and the second threshold value609bis approximately 120 beats per minute. In some embodiments, not only is the trace given and the color appropriate for the value, but areas below the trace and above the first threshold value609aare filled with the corresponding color, as depicted inFIG. 6A.

One notable advantage of the group view500is that a user simultaneously views the traces600of each patient in a particular group by viewing the active areas506a,506b,506c,506dand prioritizes which patients require more time and attention. In an example embodiment, if the traces600in active areas506a,506bare red colored, whereas the traces600in the active areas506c,506dare green colored, the user can decide to spend more time with the patients associated with active areas506a,506b.This improves the efficiency of physicians and medical staff in the medical facility and improves the quality of care provided to patients that require more time and attention. Because these are active areas, in some embodiments, by selecting the active area corresponding to one unit with a pointing device, an expanded view of a single unit is presented on the display; and, the presentation of other units are reduced, as described below with reference toFIG. 5B.

In some embodiments the values plotted in a trace are the values of an “index” which is an indication of a particular condition of the subject that is a function or two or more physiological parameters. In some example embodiments, the index value is a ratio of a value of a first parameter of physiological patient data to a value of a second parameter of physiological patient data. In an example embodiment, the trace608indicates an index value that is of a shock index (SI) that is a ratio of a value of heart rate (HR) to a value of systolic blood pressure (SBP). In another example embodiment, the index value is a value of a brain trauma index (BTI) that is a ratio of a value of intracranial blood pressure (ICP) to a value of cerebral perfusion pressure (CPP).

In another embodiment, the active area506ofFIG. 5Eincludes a bar region558where a one dimensional bar plot that indicates a time history of range of the value of the parameter of physiological patient data is displayed as a bar with color that can change along the time axis.FIG. 5Dis a block diagram that illustrates an example of the bar region558ofFIG. 5E, according to an embodiment. In one embodiment, the bar region558includes a plurality of active areas559a,559b,where each active area559corresponds to a respective parameter of physiological patient data. In an example embodiment, a bar plot of the value range of a first parameter of physiological patient data is displayed in the first active area559aand a bar plot of the value range of a second parameter of physiological patient data is displayed in the second active area559b.FIG. 6Bis an image that illustrates an example of a bar plot650of the bar region558ofFIG. 5D, according to an embodiment. The horizontal axis602is time in units of (hour:minutes) spanning a 24 hour range from 12:00 PM to 12:00 PM. In other embodiments, the range of the horizontal axis602can be selected. In an example embodiment, the range can be selected from a minimum value of about 1 minute to a maximum value based on the plurality of sample times for the stored physiological patient data. As a one dimensional plot, there is no vertical axis. The bar plot650includes a bar656that is colored based on the value range of the parameter of physiological patient data over the time window606. In some embodiments, a color of the bar656indicates the value range such that a first color indicates that the range of the value of the parameter of physiological patient data is in a first range (e.g. less than a first threshold value), a second color indicates that the range of the value of the parameter of physiological patient data is in a second range (e.g. greater than the first threshold value but less than a second threshold value) and a third color indicates that the range of the value of the parameter of physiological patient data is in a third range (e.g. greater than the second threshold value). In an example embodiment, the first color is green, the second color is yellow and the third color is red and the first and second thresholds correspond to those used in the trace plot600ofFIG. 6A. An advantage of the bar plot is that more different physiological parameters can be presented in the same area of the display device because there is no vertical axis. Thus more parameters can be presented per unit in the group. Only one or a few traces can be plotted or only the one or few traces that exceed a first or second threshold are plotted in the trace plot region.

In some embodiments, the value range is a range of a ratio of a value of a first parameter of physiological patient data to a value of a second parameter of physiological patient data. In an example embodiment, the value range is a range of the shock index (SI) or of the brain trauma index (BTI).

Returning toFIG. 5A, in some embodiments, a plurality of active areas510a,510bare displayed in a time interval region508of the group view500. In one embodiment, an indicator is displayed in each active area510, where the indicator is a time interval value. In some embodiments, upon selecting a particular active area510aby a single action of a pointing device, the interval of the time window606of the trace plots600in the trace region556and the bar plots650in the bar region558is adjusted based on the time interval value in the particular active area510a.In one embodiment, the time interval value of the active areas510include one or more of 1 hour, 2 hours, 4 hours, 8 hours, 12 hours, 24 hours, 48 hours and 72 hours.

In some embodiments, the group view500includes a particular arrangement where the group region502is presented on a left side of the display108, the time region508is presented in a bottom portion of the display and the unit region505is presented to a right side of the group region502and above the time region508. However, this is merely one example arrangement and other embodiments of the group view500can feature different rearrangements of the group region502, time region108and unit region505.

FIG. 7Bis a flow diagram that illustrates an example of a method720for displaying the group view500of physiological data collected from the plurality of bed units102divided into groups in a medical facility, according to an embodiment. In step722, the value of the parameter of physiological patient data and the value of the sample time is received at the controller106. In some embodiments, the value of the parameter of physiological patient data and the value of the sample time is received at the controller106from each server105. In other embodiments, the value of the parameter of physiological patient data and the value of the sample time is received from the plurality of physiological data monitors104associated with the plurality of bed units102divided into the one or more groups of the medical facility without use of the server or the controller.

In step724, indicators in the active areas504of the group region502are presented, where each active area504corresponds to a respective group within the medical facility. In some embodiments, where a fixed number of active areas506are provided in the unit region505and the number of bed units102within a particular group exceeds the fixed number, multiple active areas504correspond to the respective group within the medical facility.

In step726, data is received based on a selection of a particular active area504aof the group region502. In an embodiment, the particular active area504aof the group region502is selected by a single or other action of a pointing device. In one embodiment, the display108is a touchscreen and the single action of the pointing device involves touching the particular active area504a.In an example embodiment, the particular active area504ais selected in order to monitor the values of the parameter of physiological patient data of bed units102in the group corresponding to the particular active area504a.In an embodiment, in step726, the controller106receives a signal from the display108based on the selection of the particular active area504aof the group region502.

In step728, a representation based on the value of the parameter of physiological patient data is displayed in the active areas506of the unit region505, where each active area506corresponds to a respective bed unit102within the group that corresponds to the particular active area504aselected in step726. In some embodiments, in step728, the trace plot600of the trace608of the parameter values against time of the physiological patient data is displayed in the trace region556of the active area506. In an example embodiment, in step728, multiple trace plots600are displayed in multiple active areas557a,557bof the trace region556, where each trace plot600in each active area557corresponds to a respective parameter of physiological patient data.

In some embodiments, in step728, the bar plot650of the parameter of the physiological patient data is displayed in the bar region558of the active area506. In an example embodiment, in step728, multiple bar plots650are displayed in multiple active areas559a,559bof the bar region558, where each bar plot650in each active area559corresponds to a respective parameter of physiological patient data.

In one embodiment, in response to a selection by a single or other action of a pointing device within a particular unit active area506ain the group view500, the value of the physiological patient data for the bed unit102corresponding to the particular active area506ais displayed in a different screen called unit view550.FIG. 5Bis a block diagram that illustrates an example of the unit view550for displaying physiological patient data, according to an embodiment. In one embodiment, the unit view550includes an indicator in a plurality of active areas554a,554bin a thumbnail region552. In some embodiments, each active area554corresponds to a respective bed unit102within the group corresponding to the selected active area504ain the group view500. In some embodiments, the indicator in each active area554is a thumbnail image of the traces and bars presented in the active area506of the unit region505corresponding to the respective bed unit102.

The unit view550further includes the trace region556with the plurality of active areas557(FIG. 5C), where each active area557corresponds to a respective parameter of physiological patient data. In an embodiment, the trace plot600of the trace608of the parameter of physiological patient data is displayed in the active area557of the trace region556, where the physiological patient data corresponds to the bed unit102associated with the particular active area506aselected in the group view500.

Additionally, the unit view550includes the bar region558with the plurality of active areas559(FIG. 5D), where each active area559corresponds to a respective parameter of physiological patient data. In an embodiment, the bar plot650of the bar of colored or cross-hatched value ranges of the parameter of physiological patient data is displayed in each active area559of the bar region558, where the physiological patient data corresponds to the bed unit102associated with the particular active area506aselected in the group view500.

In other embodiments, in response to a selection by a single or other action of a pointing device within a particular active area554ain the thumbnail region552, the value of the physiological patient data for the bed unit102corresponding to the particular active area554ais displayed in the unit view550.

In one embodiment, the unit view550further includes one or more active areas562a,562bin an index region560. In one embodiment, a scatter index plot rather than a time series is presented in each active area562. In a scatter plot, data points are plotted based on a value of a first parameter of physiological patient data on one axis and a value of a second parameter of physiological patient data on the perpendicular axis. In an example embodiment, the index plot is a shock index (SI) plot where the first parameter of physiological patient data is heart rate (HR) and the second parameter of physiological patient data is systolic blood pressure (SBP). In another example embodiment, the index plot is a brain trauma index (BTI) plot, where the first parameter of physiological patient data is intracranial blood pressure (ICP) and the second parameter of physiological patient data is cerebral perfusion pressure (CPP).FIG. 6Cis an image that illustrates an example of an index plot670of the index region560ofFIG. 5B, according to an embodiment. The horizontal axis672is a first parameter of physiological patient data (e.g. heartrate) in units of the parameter (e.g. beats per minute) in a range from about 80 beats per minute to about 138 beats per minute. The vertical axis674is a second parameter of physiological patient data (e.g. systolic blood pressure, SBP) in units of the parameter (e.g. millimeters of Mercury). In some embodiments, a range of the second parameter of physiological patient data is dynamically determined by minimum and maximum values acquired over the time window606. In some embodiments, the index plot670includes data points682that have coordinates (x, y) where x is a value of the first parameter of physiological patient data along the horizontal axis672and y is a value of the second parameter of physiological patient data along the vertical axis674. In some embodiments, the index plot670includes a color coded time axis676such that a sample time of each data point682can be color coded according to the color coded time axis676. The time window606defines the range of the coded time axis676. In an example embodiment, the time window606is about 24 hours. In one embodiment, the coded time axis676is a color coded time axis and each data point682is color coded based on the respective sample time of each data point682and the color coded time axis676. In an example embodiment, the color coded time axis676is a color spectrum that extends from a red color to designate more recent sample times to a blue color to indicate earlier sample times. In this example embodiment, the data points682during recent sample times are color coded red whereas the data points682during previous sample times are color coded blue.FIG. 6Cdepicts lines that correlate color coded portions of the time axis676and respective data points682of the plot670.

As illustrated inFIG. 6C, in one embodiment the index plot670includes one or more vertical intercept lines678that intersect the horizontal axis672to indicate one or more respective threshold values of the first parameter of physiological patient data. In another embodiment, the index plot670includes one or more horizontal intercept lines680that intersect the vertical axis674to indicate one or more respective threshold values of the second parameter of physiological patient data. The vertical intercept lines678and horizontal intercept lines680advantageously allow the user to determine whether data points682are within a region of the plot670defined by the intercept lines678,680. In an example embodiment, where the index plot670is a shock index (SI) plot, the intercept lines678,680allow the user to determine whether the data points682are within a region of concern673defined by a vertical intercept line678and horizontal intercept line680. In another example embodiment, the color coded points682based on the time axis676advantageously permit the user to determine whether the points682are trending toward the region of concern673.

As illustrated inFIG. 5B, in one embodiment the unit view550further includes a plurality of active areas570a,570bin an action region568. In an embodiment, an action indicator is displayed in each active area570a,570b.In one embodiment, in response to selection of the active area570aby a single or other action of a pointing device, an image file of the unit view550is generated and stored in a memory of the controller106. In one embodiment, the image file of the unit view550represents an image of the thumbnail region552, the trace region556, the bar region558and the index region560at the time that the active area570ais selected. In an example embodiment, the action indicator in the active area570ais “snapshot”.

In one embodiment, in response to selection of the active area570bby a single or other action of a pointing device, the value of a waveform parameter of physiological patient data is displayed over a secondary time window606′ that is less than the time window606. In some embodiments, the value of the waveform parameter of physiological patient data is provided to the server105by the waveform generators156a,156b,156c.This option is useful for traces that are better viewed on a much expanded time axis, such as an EKG.FIG. 6Dis an image that illustrates an example trace plot600′ of a trace608′ of values of a waveform parameter of physiological patient data, according to an embodiment. In this embodiment, the parameter of physiological patient data is an EKG waveform parameter of physiological patient data. In an embodiment, the value of the waveform parameter of physiological patient data is displayed in one of the active areas557of the trace region556. In an example embodiment, the waveform parameter of physiological patient data is an electrocardiographic (EKG) or a photoplethysmographic (PPG). In another example embodiment, the secondary time window606′ is less than 1 hour. In another example embodiment, the secondary time window606′ is less than 10 minutes.

In some embodiments, the time window606of the traces600in the trace region556, the bars650in the bar region558and the index plot670in the index region560can be adjusted. In one embodiment, the time window606is adjusted by selecting an active area566a,566bin a time interval region564of the unit view550, where each active area566includes a time interval value. Upon selecting a particular active area566a,the time window606is adjusted based on the time interval value within the particular active area566a. In one embodiment, the time interval value of the active areas566include one or more of 1 hour, 2 hours, 4 hours, 8 hours, 12 hours, 24 hours, 48 hours and 72 hours. In another embodiment, the time window606is adjusted by manually selecting a secondary time window within the time window606by a single action of a pointing device. In response to this manual selection of the secondary window within the time window606, the trace plots600in the trace region556, bar plots650in the bar region558and index plot670in the index region560are displayed over the secondary time window.

In some embodiments, highlighting one or more areas (e.g. moving cursor to one or more areas with the pointing device816such as a mouse) along one or more of the trace600, the bar plot650and/or the index plot670, generates an output on the display of a value of the respective trace/bar plot/index plot and/or a value of the time associated with the highlighted trace/bar plot/index plot value. In one embodiment, highlighting the one or more areas further displays a vertical line along the trace/bar plot/index plot at the respective time value.

In some embodiments, the unit view550further includes a home region572with an active area574. In one embodiment, an indicator is displayed in the active area574. In an example embodiment, the indicator is a home symbol. Upon selecting the active area574by a single or other action of a pointing device, the display108switches from the unit view550ofFIG. 5Bto the group view500ofFIG. 5A.

FIG. 7Cis a flow diagram that illustrates an example of a method730for displaying the unit view550of physiological data collected from the plurality of bed units102in a medical facility, according to an embodiment. In step732, the value of the parameter of physiological patient data and the value of the sample time is received at the controller106from the plurality of physiological data monitors104. In some embodiments, in step732, the value of the parameter of physiological patient data and the value of the sample time is received at the controller106from the servers105, which in turn received the data from the plurality of physiological data monitors104.

In step734, an indicator is displayed in the active areas554of the thumbnail region552of the unit view550, where each active area554corresponds to a respective bed unit102. In some embodiments, each active area554corresponds to a respective bed unit102in the group associated with the selected active area504in the group region502of the group view500. In some embodiments, the indicator in each active area554is the active area506of the unit region505corresponding to the respective bed unit102.

In step736, the trace plot600including the trace608of the value of the parameter of the physiological patient data is displayed in the active areas557of the trace region556, where each active area557corresponds to a respective parameter of physiological patient data. In some embodiments, in step736, the trace600is a value of an index parameter based on a function, such as a ratio, of a value of a first parameter of physiological patient data and a value of a second parameter of physiological patient data.

In step738, the bar plot650including that the bar656that indicates a range of the value of the parameter of the physiological patient data is displayed in the active areas559of the bar region558, where each active area559corresponds to a respective parameter of physiological patient data. In some embodiments, in step738, the bar656color indicates a value range of an index parameter based on a ratio of a value of a first parameter of physiological patient data to a value of a second parameter of physiological patient data.

In step740, one or more scatter index plots670are displayed in the active areas562of the index region560, where each active area562corresponds to a respective index plot670of a respective index parameter of physiological patient data. In an embodiment, the index parameter is shock index (SI) or brain trauma index (BTI). Data points682of the index plot670are presented, where each data point682is based on a value of a first parameter of physiological patient data and a value of a second parameter of physiological patient data. In some embodiments, the data points682of the index plot670have (x, y) coordinates, where x is the value of the first parameter of physiological patient data and y is the value of the second parameter of physiological patient data.

In some embodiments, based on the physiological patient data received at the controller106, any predictive algorithm known in the art could be used to make a prediction regarding future physiological patient data or recommend treatment of the patient. In an example embodiment, such a prediction or recommendation could be presented on the screen view presented on any display108. An example of such a predictive algorithm is disclosed in Provisional Application No. 62/334,750 filed on May 11, 2016 and with a common assignee with the present invention.

In one embodiment, the system100,150is utilized and/or the method700,720,730is practiced in a military medical transport facility, such as a military medical transport vehicle. Conventional military medical transport vehicles routinely feature limited medical staff and thus involve limited access to patients and equipment instability (e.g. data monitors104and severs105) in a noisy and moving environment. Additionally, conventional military medical transport vehicles do not feature remote monitoring of current values of the parameter of physiological patient data from the data monitors104. The implementation of the system100,150and/or the method700,720,730in military medical transport vehicles addresses these issues by permitting the limited medical staff to monitor more patients in a shorter amount of time and/or to quickly detect and remedy any equipment instability.

In one embodiment, the controller106of the system100,150is an Intel i5 1.9 GHz CPU with 16 GB memory and running on Windows 7 operating system. In an example embodiment, 16 units102are provided at the medical facility and 16 data monitors104are provided at each unit102to provide values for 16 parameters of physiological patient data. In this example embodiment, where the data monitors104provide parameter values at each minute, the controller106receives about 0.37 million data points over a 24 hour period. In an embodiment, such daily amounts of data can be displayed in real-time or near real-time (e.g. <1 second or <0.5 seconds or <250 milliseconds) in the block300and/or the gap collection pattern400and/or the group view500and/or the unit view550. Table 2 below depicts that the update time of the block300and/or pattern400and/or group view500and/or unit view550is on the order of hundreds of milliseconds (e.g. <500 milliseconds) for physiological patient data that is updated each minute.

In an embodiment, the system and method discussed herein has the capacity to deliver a remote patient monitoring platform refined and customized for use in the medical transport setting. In one embodiment, the system and method discussed herein provides both remote and on-board clinicians with the capability to simultaneously monitor dynamic physiologic changes in multiple patients. This offers the ability to identify critically worsening patients quickly and more effectively as both current and trend data can be clearly displayed. This technology allows for integration with clinical decision support tailored to the individual patient, providing unprecedented help in the austere battlefield environment. Traumatic brain injuries are common in the military population and reliable remote monitoring allows specialists to aid in the critical early hours of treatment of these complex injuries.

In an embodiment, the system and method discussed herein is practiced in a medical facility including 94 bed units102with 94 data monitors104(e.g. GE-Marquette Solar 7000/8000®, General Electric, Fairfield Conn.). In one embodiment, the 94 data monitors104are networked to provide collection of real time physiological patient data including 13 data monitors104in a trauma resuscitation unit (TRU); 9 data monitors104in an operating room (OR); 12 data monitors104in a post-anesthesia care unit (PACU) and 60 data monitors104in an intensive care unit (ICU). In an example embodiment, each data monitor104collects real-time 240 Hz waveforms (e.g. ECG, PPG, CO2, ABP, ICP) and 0.5 Hz trend data (e.g. HR, RR, SpO2, CO2, ICP) which are broadcasted via UDP (User Datagram Protocol) through secure intranet to a dedicated server105c(e.g. Bedmaster® with Excel Medical Electronics, Jupiter Fla.). In the example embodiment, about 20 million data points per unit102are generated each day or roughly 30 terabits per year of data. During a twelve month study from February 2013 to January 2014, a total of 8719 adult patients stayed in the medical facility for an average stay of 3.8 days. In an example embodiment, collection rates from each individual server105were in a range from between 27.79% and 40.49% prior to implementing the system100,150. In an example embodiment, after implementation of the triple redundant server system (e.g. servers105connected in the triple redundant arrangement) but before the implementation of the system100,150the data collection rate improved to about 79.13%. In an example embodiment, the missing collection rate (gap) was about 20.87% and was mostly due to collection gaps of greater than 4 hours (e.g. 18.02% or 1.62 times per bed per month) and collection gaps of between 5 minutes and 4 hours (e.g. 0.13% or 0.6 times per bed per month). In an example embodiment, reasons for collection gaps included individual collection server failure, software instability, individual bed setting consistency and/or clinical engineering servicing of patient monitors. In an example embodiment, in a 6 month period after implementation of the system100,150, the single server collection rate improved to a range between 87.05% and 95.54% and the triple redundant system achieved 99.88% total collection rate. Table 3 below depicts the server collection rates for the individual and combined server arrangements before and after implementation of the system100,150(“pre-MoMs”, “post-MoMs”).

A sequence of binary digits constitutes digital data that is used to represent a number or code for a character. A bus810includes many parallel conductors of information so that information is transferred quickly among devices coupled to the bus810. One or more processors802for processing information are coupled with the bus810. A processor802performs a set of operations on information. The set of operations include bringing information in from the bus810and placing information on the bus810. The set of operations also typically include comparing two or more units of information, shifting positions of units of information, and combining two or more units of information, such as by addition or multiplication. A sequence of operations to be executed by the processor802constitutes computer instructions.

Computer system800also includes a memory804coupled to bus810. The memory804, such as a random access memory (RAM) or other dynamic storage device, stores information including computer instructions. Dynamic memory allows information stored therein to be changed by the computer system800. RAM allows a unit of information stored at a location called a memory address to be stored and retrieved independently of information at neighboring addresses. The memory804is also used by the processor802to store temporary values during execution of computer instructions. The computer system800also includes a read only memory (ROM)806or other static storage device coupled to the bus810for storing static information, including instructions, that is not changed by the computer system800. Also coupled to bus810is a non-volatile (persistent) storage device808, such as a magnetic disk or optical disk, for storing information, including instructions, that persists even when the computer system800is turned off or otherwise loses power.

Information, including instructions, is provided to the bus810for use by the processor from an external input device812, such as a keyboard containing alphanumeric keys operated by a human user, or a sensor. A sensor detects conditions in its vicinity and transforms those detections into signals compatible with the signals used to represent information in computer system800. Other external devices coupled to bus810, used primarily for interacting with humans, include a display device814, such as a cathode ray tube (CRT) or a liquid crystal display (LCD), for presenting images, and a pointing device816, such as a mouse or a trackball or cursor direction keys, for controlling a position of a small cursor image presented on the display814and issuing commands associated with graphical elements presented on the display814.

Computer system800also includes one or more instances of a communications interface870coupled to bus810. Communication interface870provides a two-way communication coupling to a variety of external devices that operate with their own processors, such as printers, scanners and external disks. In general the coupling is with a network link878that is connected to a local network880to which a variety of external devices with their own processors are connected. For example, communication interface870may be a parallel port or a serial port or a universal serial bus (USB) port on a personal computer. In some embodiments, communications interface870is an integrated services digital network (ISDN) card or a digital subscriber line (DSL) card or a telephone modem that provides an information communication connection to a corresponding type of telephone line. In some embodiments, a communication interface870is a cable modem that converts signals on bus810into signals for a communication connection over a coaxial cable or into optical signals for a communication connection over a fiber optic cable. As another example, communications interface870may be a local area network (LAN) card to provide a data communication connection to a compatible LAN, such as Ethernet. Wireless links may also be implemented. Carrier waves, such as acoustic waves and electromagnetic waves, including radio, optical and infrared waves travel through space without wires or cables. Signals include man-made variations in amplitude, frequency, phase, polarization or other physical properties of carrier waves. For wireless links, the communications interface870sends and receives electrical, acoustic or electromagnetic signals, including infrared and optical signals, that carry information streams, such as digital data.

The term computer-readable medium is used herein to refer to any medium that participates in providing information to processor802, including instructions for execution. Such a medium may take many forms, including, but not limited to, non-volatile media, volatile media and transmission media. Non-volatile media include, for example, optical or magnetic disks, such as storage device808. Volatile media include, for example, dynamic memory804. Transmission media include, for example, coaxial cables, copper wire, fiber optic cables, and waves that travel through space without wires or cables, such as acoustic waves and electromagnetic waves, including radio, optical and infrared waves. The term computer-readable storage medium is used herein to refer to any medium that participates in providing information to processor802, except for transmission media.

Common forms of computer-readable media include, for example, a floppy disk, a flexible disk, a hard disk, a magnetic tape, or any other magnetic medium, a compact disk ROM (CD-ROM), a digital video disk (DVD) or any other optical medium, punch cards, paper tape, or any other physical medium with patterns of holes, a RAM, a programmable ROM (PROM), an erasable PROM (EPROM), a FLASH-EPROM, or any other memory chip or cartridge, a carrier wave, or any other medium from which a computer can read. The term non-transitory computer-readable storage medium is used herein to refer to any medium that participates in providing information to processor802, except for carrier waves and other signals.

Network link878typically provides information communication through one or more networks to other devices that use or process the information. For example, network link878may provide a connection through local network880to a host computer882or to equipment884operated by an Internet Service Provider (ISP). ISP equipment884in turn provides data communication services through the public, world-wide packet-switching communication network of networks now commonly referred to as the Internet890. A computer called a server892connected to the Internet provides a service in response to information received over the Internet. For example, server892provides information representing video data for presentation at display814.

The invention is related to the use of computer system800for implementing the techniques described herein. According to one embodiment of the invention, those techniques are performed by computer system800in response to processor802executing one or more sequences of one or more instructions contained in memory804. Such instructions, also called software and program code, may be read into memory804from another computer-readable medium such as storage device808. Execution of the sequences of instructions contained in memory804causes processor802to perform the method steps described herein. In alternative embodiments, hardware, such as application specific integrated circuit820, may be used in place of or in combination with software to implement the invention. Thus, embodiments of the invention are not limited to any specific combination of hardware and software.

The signals transmitted over network link878and other networks through communications interface870, carry information to and from computer system800. Computer system800can send and receive information, including program code, through the networks880,890among others, through network link878and communications interface870. In an example using the Internet890, a server892transmits program code for a particular application, requested by a message sent from computer800, through Internet890, ISP equipment884, local network880and communications interface870. The received code may be executed by processor802as it is received, or may be stored in storage device808or other non-volatile storage for later execution, or both. In this manner, computer system800may obtain application program code in the form of a signal on a carrier wave.

Various forms of computer readable media may be involved in carrying one or more sequence of instructions or data or both to processor802for execution. For example, instructions and data may initially be carried on a magnetic disk of a remote computer such as host882. The remote computer loads the instructions and data into its dynamic memory and sends the instructions and data over a telephone line using a modem. A modem local to the computer system800receives the instructions and data on a telephone line and uses an infra-red transmitter to convert the instructions and data to a signal on an infra-red a carrier wave serving as the network link878. An infrared detector serving as communications interface870receives the instructions and data carried in the infrared signal and places information representing the instructions and data onto bus810. Bus810carries the information to memory804from which processor802retrieves and executes the instructions using some of the data sent with the instructions. The instructions and data received in memory804may optionally be stored on storage device808, either before or after execution by the processor802.

The processor903and accompanying components have connectivity to the memory905via the bus901. The memory905includes both dynamic memory (e.g., RAM, magnetic disk, writable optical disk, etc.) and static memory (e.g., ROM, CD-ROM, etc.) for storing executable instructions that when executed perform one or more steps of a method described herein. The memory905also stores the data associated with or generated by the execution of one or more steps of the methods described herein.

Pertinent internal components of the telephone include a Main Control Unit (MCU)1003, a Digital Signal Processor (DSP)1005, and a receiver/transmitter unit including a microphone gain control unit and a speaker gain control unit. A main display unit1007provides a display to the user in support of various applications and mobile terminal functions that perform or support the steps as described herein. The display1007includes display circuitry configured to display at least a portion of a user interface of the mobile terminal (e.g., mobile telephone). Additionally, the display1007and display circuitry are configured to facilitate user control of at least some functions of the mobile terminal. An audio function circuitry1009includes a microphone1011and microphone amplifier that amplifies the speech signal output from the microphone1011. The amplified speech signal output from the microphone1011is fed to a coder/decoder (CODEC)1013.

A radio section1015amplifies power and converts frequency in order to communicate with a base station, which is included in a mobile communication system, via antenna1017. The power amplifier (PA)1019and the transmitter/modulation circuitry are operationally responsive to the MCU1003, with an output from the PA1019coupled to the duplexer1021or circulator or antenna switch, as known in the art. The PA1019also couples to a battery interface and power control unit1020.

The encoded signals are then routed to an equalizer1025for compensation of any frequency-dependent impairments that occur during transmission though the air such as phase and amplitude distortion. After equalizing the bit stream, the modulator1027combines the signal with a RF signal generated in the RF interface1029. The modulator1027generates a sine wave by way of frequency or phase modulation. In order to prepare the signal for transmission, an up-converter1031combines the sine wave output from the modulator1027with another sine wave generated by a synthesizer1033to achieve the desired frequency of transmission. The signal is then sent through a PA1019to increase the signal to an appropriate power level. In practical systems, the PA1019acts as a variable gain amplifier whose gain is controlled by the DSP1005from information received from a network base station. The signal is then filtered within the duplexer1021and optionally sent to an antenna coupler1035to match impedances to provide maximum power transfer. Finally, the signal is transmitted via antenna1017to a local base station. An automatic gain control (AGC) can be supplied to control the gain of the final stages of the receiver. The signals may be forwarded from there to a remote telephone which may be another cellular telephone, any other mobile phone or a land-line connected to a Public Switched Telephone Network (PSTN), or other telephony networks.

Voice signals transmitted to the mobile terminal1001are received via antenna1017and immediately amplified by a low noise amplifier (LNA)1037. A down-converter1039lowers the carrier frequency while the demodulator1041strips away the RF leaving only a digital bit stream. The signal then goes through the equalizer1025and is processed by the DSP1005. A Digital to Analog Converter (DAC)1043converts the signal and the resulting output is transmitted to the user through the speaker1045, all under control of a Main Control Unit (MCU)1003which can be implemented as a Central Processing Unit (CPU) (not shown).

The MCU1003receives various signals including input signals from the keyboard1047. The keyboard1047and/or the MCU1003in combination with other user input components (e.g., the microphone1011) comprise a user interface circuitry for managing user input. The MCU1003runs a user interface software to facilitate user control of at least some functions of the mobile terminal1001as described herein. The MCU1003also delivers a display command and a switch command to the display1007and to the speech output switching controller, respectively. Further, the MCU1003exchanges information with the DSP1005and can access an optionally incorporated SIM card1049and a memory1051. In addition, the MCU1003executes various control functions required of the terminal. The DSP1005may, depending upon the implementation, perform any of a variety of conventional digital processing functions on the voice signals. Additionally, DSP1005determines the background noise level of the local environment from the signals detected by microphone1011and sets the gain of microphone1011to a level selected to compensate for the natural tendency of the user of the mobile terminal1001.

An optionally incorporated SIM card1049carries, for instance, important information, such as the cellular phone number, the carrier supplying service, subscription details, and security information. The SIM card1049serves primarily to identify the mobile terminal1001on a radio network. The card1049also contains a memory for storing a personal telephone number registry, text messages, and user specific mobile terminal settings.

In some embodiments, the mobile terminal1001includes a digital camera comprising an array of optical detectors, such as charge coupled device (CCD) array1065. The output of the array is image data that is transferred to the MCU for further processing or storage in the memory1051or both. In the illustrated embodiment, the light impinges on the optical array through a lens1063, such as a pin-hole lens or a material lens made of an optical grade glass or plastic material. In the illustrated embodiment, the mobile terminal1001includes a light source1061, such as a LED to illuminate a subject for capture by the optical array, e.g., CCD1065. The light source is powered by the battery interface and power control module1020and controlled by the MCU1003based on instructions stored or loaded into the MCU1003.

In the foregoing specification, the invention has been described with reference to specific embodiments thereof. It will, however, be evident that various modifications and changes may be made thereto without departing from the broader spirit and scope of the invention. The specification and drawings are, accordingly, to be regarded in an illustrative rather than a restrictive sense. Throughout this specification and the claims, unless the context requires otherwise, the word “comprise” and its variations, such as “comprises” and “comprising,” will be understood to imply the inclusion of a stated item, element or step or group of items, elements or steps but not the exclusion of any other item, element or step or group of items, elements or steps. Furthermore, the indefinite article “a” or “an” is meant to indicate one or more of the item, element or step modified by the article. As used herein, unless otherwise clear from the context, a value is “about” another value if it is within a factor of two (twice or half) of the other value. While example ranges are given, unless otherwise clear from the context, any contained ranges are also intended in various embodiments. Thus, a range from 0 to 10 includes the range 1 to 4 in some embodiments.