Method for automatic association devices to a patient and concurrent creation of a patient record

A wireless patient point-of-care network (20) includes a plurality of medical devices (22, 24, 26) each with a wireless communication interface (46). Each medical device is configured to provide at least one medical service to a patient. A patient identification device (28) is associated with the patient. The patient identification device includes a wireless communication interface (46′, 70) in communication with the wireless communication interfaces (46) of the medical devices. The patient identification device (28) performs a patient identification service that wirelessly associates the medical devices (22, 24, 26) with the patient.

The following relates to the medical monitoring arts. It finds particular application in wireless patient point-of-care networks which are set up at a patient's bedside, and will be described with particular reference thereto. It finds more general application in providing wireless monitoring and therapy for a medical patient in substantially any setting, such as at the hospital, at home, or so forth.

A patient admitted to a hospital is typically connected with various types of electronic monitoring and therapy equipment, such an electrocardiograph (ECG), a blood pressure monitor, a blood oxygen saturation (SaO2) sensor, an infusion pump for delivery of fluids, and so forth. These medical devices are used to diagnose and treat the patient.

Traditionally, medical devices used in bedside monitoring and therapy have been wired devices including an electrical power cord for powering the device and a communication cable for connecting the device to a nurses' station monitor, hospital network, or other electronic network. Sensors are traditionally connected with monitoring equipment by cabling as well. In such wired arrangements, it is relatively easy to identify which devices belong with a given patient.

The medical community is migrating toward wireless patient point-of-care networks. The continuing miniaturization of electronics, improved battery technology, and the advent of standardized low-power wireless communication protocols such as Bluetooth and ZigBee have enabled partly or completely stand-alone medical devices that have on-board electrical power and engage in wireless communication with other devices, display monitors, wireless hospital networks, or so forth. The reduction of wires in patient point-of-care networks has certain advantages, such as elimination of “wire routing” problems in setting up the patient point-of-care network, easier access by medical personnel to the patient, and improved patient mobility.

However, wireless patient point-of-care networks introduce new difficulties. In the wireless arrangement, identification of which equipment belongs with which patient is no longer straightforward. Indeed, even establishing the network to begin with is complicated by difficulty in ensuring that the invisible wireless connections are properly set up. Such difficulties are enhanced in critical care situations such as emergency rooms, where the wireless patient point-of-care network is constructed rapidly in a high-stress environment. Moreover, the patient point-of-care network should be modifiable by later addition or removal of devices, and should be portable to allow the patient to be temporarily or permanently moved during the hospital stay.

Existing wireless devices are typically associated with or assigned to the patient using a manual procedure, such as using a bar code or RFID reader, by marking the patient and corresponding devices with a marker, or by maintaining a centralized list of which devices are assigned with which patient (for example, on a blackboard mounted on a wall of the emergency room). Manual techniques are prone to human error, and result in delays in setting up or modifying the wireless patient point-of-care network.

In wireless patient point-of-care networks it is also more difficult to get an overview of which medical devices and services are available and are currently used for a specific patient. It is important to be able to determine which devices and services were used for a specific patient at what time.

The following contemplates improved apparatuses and methods that overcome the aforementioned limitations and others.

According to one aspect, a wireless patient point-of-care network is disclosed. A plurality of medical devices each including a wireless communication interface are each configured to provide at least one medical service to a patient. A patient identification device is associated with the patient. The patient identification device includes a wireless communication interface in communication with the wireless communication interfaces of the medical devices. The patient identification device performs a patient identification service that wirelessly associates the medical devices with the patient.

According to another aspect, a patient point-of-care method is provided. Medical services are provided to an associated patient using a plurality of medical devices. Each medical device includes a wireless communication interface and provides at least one medical service. A patient point-of-care method is performed using a patient identification device to manage all medical services that are provided by the devices being associated to one patient. This method allows determination of which medical devices and services are available in the patient point-of-care network and are currently used for the patient.

One advantage resides in providing a robust and secure link between data produced by medical devices and the patient.

Another advantage resides in automating the setup of the patient point-of-care network, optionally including automated setup of a patient record, to reduce the likelihood of manual errors compromising patient safety or privacy.

Yet another advantage resides in providing a readily expandable or modifiable wireless patient point-of-care network for providing medical services to a medical patient.

Numerous additional advantages and benefits will become apparent to those of ordinary skill in the art upon reading the following detailed description.

With reference toFIG. 1, a medical patient10lies on a bed12. A wireless patient point-of-care network20provides medical services such as vital signs monitoring and intravenous fluid therapy to the patient10. In the illustrated example, the wireless patient point-of-care network20includes: (i) an autonomous wireless sensor network22which in the illustrated embodiment includes three sensor nodes disposed on the chest of the patient10to monitor vital signs such as electrocardiographic (ECG) data, heart rate, respiratory rate, respiratory cycle, blood pressure, or so forth; (ii) a blood oxygen saturation (SaO2) monitor24connected with an SaO2fingertip probe25; and (iii) an infusion pump26controlling intravenous delivery of fluid from a fluid bag27. The wireless point-of-care network20is an example, and those skilled in the art can readily include additional or other medical devices in the network. Moreover, the wireless point-of-care network20can be changed on an ad hoc basis by adding or removing medical devices.

It will be appreciated that wires or cabling are not necessarily completely omitted from the wireless patient point-of-care network20for example, the SaO2fingertip probe is connected with the SaO2monitor24by a cable, and fluid transfer tubing connects the fluid bag27to the infusion pump26and connects the infusion pump26to the intravenous fluid delivery point in the right arm of the patient10. Similarly, although not illustrated it is contemplated that some of the devices of the patient point-of-care network may include power cords connected to house electricity. For example, although the illustrated the SaO2monitor24is battery-powered, it could instead or additionally include a power cord plugged into a conventional electrical power outlet.

The patient point-of-care network20further includes a patient identification device28. In the illustrated embodiment, the patient identification device28is disposed on a wristband worn by the medical patient10; however, more generally the patient identification device can be worn or attached to the patient substantially anywhere. The medical devices22,24,26wirelessly communicate with the patient identification device28, and optionally also wirelessly communicate with each other and/or with a hospital network. The patient identification device28optionally also includes patient monitoring or therapy functionality, such as an ECG, SaO2, or other sensor.

With continuing reference toFIG. 1and with further reference toFIG. 2which diagrammatically shows the illustrative SaO2monitor24, typical components of the medical devices of the wireless patient point-of-care network are described. Each medical device is configured to provide one or more medical services, such as the SaO2monitoring service provided by the SaO2monitor24in conjunction with the fingertip sensor25. The example SaO2monitor24has a sensor input40that receives data from the fingertip sensor25. The monitor24further includes a power supply44and a wireless communication interface46. The power supply44can be a rechargeable battery, storage capacitor, or other rechargeable power source, or can be a disposable battery. In some rechargeable power supply embodiments, the power supply44is wirelessly recharged, for example by exposure to infrared or radio frequency radiation. In other rechargeable power supply embodiments, the power supply44is recharged by connecting it with a battery charger. The wireless communication interface46typically employs a low power, short range communication protocol such as Bluetooth or ZigBee to conserve electrical power. In some embodiments, however, the wireless communication interface may include wireless local area network (WLAN) capability. Some medical devices may include more than one communication interface, such as a Bluetooth interface and a WLAN interface.

The monitor24further includes a digital processor50and a memory52. A portion of the memory52is allocated to storing software54that is executable by the digital processor50. In some embodiments, the portion of memory storing the software54is read-only. In other embodiments the software is stored in read/write memory and can be updated by uploading new program code into the memory52, for example by wirelessly receiving software updates via the wireless communication interface46. The software54, when executed by the processor50, performs the SaO2monitoring service. Another portion56of the memory52is allocated for storing sensor data acquired via the sensor input40. The memory52also stores a device identifier60, and a patient identifier62used to associate the monitor24with the patient10. The stored device identifier60of each medical device22,24,26should be unique at least within a hospital department or floor; more preferably, the unique identifier60should be unique throughout the hospital or other medical facility to avoid the possibility of inadvertent wireless cross-talk with another nearby patient point-of-care network that includes another medical device with the same identifier.

Only the SaO2monitor24is illustrated in detail herein; however, it will be appreciated that the other medical devices24,26of the wireless patient point-of-care network20are similarly configured to perform one or more medical services. While the SaO2monitor24provides only a single medical service (SaO2monitoring), some medical devices may provide more than one medical service. For example, the autonomous sensor node network22may provide several different medical services each monitoring a different vital sign. The illustrated wireless medical devices22,24,26each include on-board electrical power; however, some medical devices of the wireless patient point-of-care network may be powered via a power cord connected with an electrical outlet. Each of the wireless medical devices22,24,26stores the patient identifier62in memory to associate the devices22,24,26with the patient10.

FIG. 3diagrammatically shows components of the patient identification device28. Similarly to the wireless medical devices22,24,26, the patient identification device28includes a power supply44′, a wireless communication interface46′ employing a Bluetooth, ZigBee, or another low power, short range communication protocol, a digital processor50′ and a memory52′. The memory52′ includes a portion allocated to storing software54′, and a portion56′ allocated for buffering data collected from the medical devices22,24,26of the patient point-of-care network20. The memory further includes a portion allocated to store a unique device identifier60′, and a portion allocated to store the patient identifier62.

In the illustrated embodiment, the patient identification device28collects sensor data from the monitoring devices22,24and stores the collected sensor data in the buffer56′. Optionally, data from the infusion pump26, such as flow rate, is also collected in the buffer56′. These data are collected via the wireless communication interfaces46,46′. In some embodiments, the patient identification device28is also configured to perform one or more medical services, such as a pulse monitoring service performed by an illustrative pulse sensor64of the patient identification device28, or ECG, SaO2, or other services. Pulse data collected by the sensor64or data generated by other medical services optionally provided by the patient identification device28are also collected and stored in the buffer memory portion56′. In other embodiments, the patient identification device28performs no medical services of its own.

The patient identification device28coordinates the wireless patient point-of-care network20. A patient network profile66is stored in an allocated portion of the memory52′. The patient network profile66includes information about each medical device22,24,26in the wireless patient point-of-care network20. Such information may include, for example, the device identifier60of each medical device and information about the services provided by that medical device. The patient identification device28further includes a wireless local area network (WLAN) interface70employing a WLAN protocol that is different from the low power, short range communication protocol employed by the wireless communication interfaces46,46′; accordingly, the WLAN interface70is not used to communicate with the wireless medical devices22,24,26. Rather, the wireless communication interface46′ is used to communicate with the medical devices22,24,26. In some embodiments, the WLAN protocol is an IEEE 802.11 WLAN protocol.

With returning reference toFIG. 1, the WLAN interface70of the patient identification device28communicates with a wireless access point80of a local area network82of the hospital or other medical facility to send data buffered in the memory portion56′ to a patient record repository84that stores patient records. In some embodiments, data is continuously transmitted to the patient record repository84rather than being buffered. This wireless data communication is diagrammatically indicated inFIG. 1by a jagged connector86. The collected data is stored at the patient record repository84, displayed on a vital signs monitoring station or surveillance center88, compared with previous sensor readings, or otherwise utilized for patient monitoring and treatment evaluation. Indeed, once collected data is sent to and stored in the patient record repository84, it can be used by any device on the network82which has the proper authorization to access it. This situation is advantageous insofar as it enables efficient distributed access to vital patient point-of-care data; however, as this data constitutes private medical records, it is important to ensure that the data be properly identified with the patient and secured against unauthorized access.

In the illustrated embodiment the patient identification device28is used as a relay station for communicating data from the wireless medical devices22,24,26to the patient record repository84. However, in some other embodiments the wireless medical devices22,24,26communicate directly with the patient record repository84, either through the illustrated wireless communication interface46or through WLAN interfaces (not illustrated) included in the wireless medical devices. A combination can also be used, in which some medical devices relay data to the patient record repository84via patient identification device28while other medical devices include a WLAN interface and thus communicate directly with the patient record repository84.

The patient identifier62is stored on the patient identification device28and on each of the medical devices22,24,26to associate the devices with the patient10. Optionally, the patient network profile66stored on the patient identification device28includes additional patient information. Such additional patient information may include, for example, a patient name, a patient number or other unique patient identifier, and optionally other information about the patient such as information about the patient's drug allergies, a list of the patient's prescribed drugs, and so forth. By storing such critical information on the patient identification device28, it can be accessed when the patient is moved to a new room or other new location and checked before the patient is medicated or otherwise treated at the new location. For example, medical personnel may use a personal data assistant (PDA), laptop computer, or other user interface to wirelessly access the patient identification device28via either the wireless communication interface46′ or the WLAN interface70and read the patient information contained in the patient network profile66. Such an access may be performed after the patient has been moved to a new room, if the patient is unconscious or uncommunicative and a question arises about the patient's identity, or so forth. Such an access may also be performed just prior to the first administration of a new medication, to determine whether the new medication is contraindicated by patient allergies, medical history, possible adverse reaction with another medication currently prescribed to the patient, or so forth.

Such additional patient information stored in the patient network profile66can be gathered and communicated to the patient identification device28in various ways. In one approach which is illustrated inFIG. 1, a medical card92belonging to the patient includes the relevant patient information electrically encoded on a magnetic strip, optical strip, or other electronically readable data store. The encoded information is read by a card reader94and wirelessly transmitted from the card reader94to the patient identification device28via the wireless communication interface46′ or via the WLAN interface70. This communication of patient information is diagrammatically indicated inFIG. 1by a jagged connector96. In one suitable procedure, a hospital admissions person98swipes the patient card92during the admissions process and wirelessly transfers the information to the patient identification device28. The patient identification device28is then attached to the patient10as a wristband. Alternatively, the patient identification device28can be attached first, and then loaded with the patient information.

If a medical card is available, the unique patient identifier is suitably derived from the medical card. However, in some cases, the patient may not have a medical card that is readable by the card reader94. In such cases, a temporary guest card can be loaded with the requisite patient information and processed in the same way as the medical card92to generate a unique patient identifier, or a unique patient identifier and optionally other information can be collected and transferred to the patient identification device28in another manner. In some embodiments, the guest card already contains a suitable unique patient identifier which can be assigned to the newly admitted patient.

The software54of the medical devices22,24,26is generally limited to implementing the medical services provided by those medical devices, and to wirelessly connecting with and sending data to the patient identification device28. Optionally, the software54is capable of performing further operations, such as detecting a low battery and sending a wireless low battery warning message out.

The software541of the patient identification device28is generally more sophisticated, including the ability to initialize and update the patient network profile66, receive and store data from the medical devices22,24,26in the buffer56′, connect with the local area network82via the WLAN interface70, transfer buffered data to the patient record repository84, and transfer information contained in the patient network profile66over the WLAN interface70upon receiving a properly authorized request for this patient information. In some embodiments, this functionality is organized as services performed by the patient identification device28. Thus, the patient identification device28provides services such as a patient identification service for associating a medical device with the patient10, a buffer transfer service for transmitting buffered data to the patient record repository84, and so forth. The patient network profile66typically includes information about all medical devices of the patient point-of-care network20and information about the services provided by each medical device.

The wireless patient point-of-care network20is established as follows. The patient identification device28is initialized with at least the patient identifier62as previously described and is placed on or attached to the patient10. A new patient record100corresponding to the patient10is created on the patient record repository84. In some embodiments, the new patient record100is created manually. In some other embodiments, the patient identification device28automatically creates a new patient record100at the patient record repository84as part of the patient point-of-care network initialization. For example, after patient information is loaded onto the patient identification device28, in these embodiments the patient identification device28connects with the local area network82via the WLAN interface70, accesses the patient record repository84, instructs the patient record repository84to create the new patient record100, and initializes the new patient record100by transferring the patient information including the patient identifier62, information about the patient identification device28, and other information stored in the patient network profile66to the new patient record100. Thereafter, when data tagged with the patient identifier62is sent to the patient record repository84, it is directed toward and stored in the new patient record100, thus enabling the collected data to be identified with the patient10.

After installing the initialized patient identification device28on the patient10, the various wireless medical devices22,24,28can be added in an ad hoc manner to construct the wireless patient point-of-care network20. As each new medical device is added to the patient point-of-care network20, it is identified with the patient10and registered with the patient identification device28using a patient identification service executed by the patient identification device28. The registration processing includes at least sending the patient identifier62to the new medical device and updating the patient network profile66at the patient identification device28with information about the new medical device including for example the device identifier and information about medical services provided by the new medical device. These registration operations can be performed in various ways.

In some embodiments, the patient identification device28periodically wirelessly polls for new medical devices using the wireless communication interface46′ and, when a new medical device is detected, executes the patient identification service to transmit the patient identifier62to the new medical device and to update the patient network profile66. The next time the patient identification device28connects with the patient record repository84, it also updates the patient record100regarding the new medical device.

To ensure that the new medical device associates with the correct patient point-of-care network, the patient identification service can be initiated by the new medical device in response to an action by a medical person. For example, a “connect” button can be provided on the medical device, which the medical person presses when the devices is installed at the point-of-care. When the connect button is pressed, the new medical device wirelessly connects with the patient identification device28and requests that the patient identification device28execute the patient identification service to initialize the new medical device with the patient identifier62and to transfer information about the new medical device to the patient network profile66. Alternatively, the medical person may use a personal data assistant (PDA) to connect with the patient identification device28and request that it execute the patient identification service to initialize the new medical device.

In another variation, the patient identifier62can be first loaded into the new medical device by a physician or other medical person using a personal data assistant (PDA), laptop computer, or other electronic user interface capable of wirelessly communicating with the new medical device. Then, when the patient identification device28detects the new medical device by polling, it first checks to see whether the new medical device has a patient identifier that matches the patient identifier62stored in the patient identification device28. If the patient identifiers match, then the patient identification device28executes the patient identification service to add the new medical device to the patient network profile66.

In yet another variation, the new medical device directly makes a connection request to the patient identification device28, which then checks whether the patient identifier is correct.

In still yet other embodiments, the patient identification device28does not automatically add the new medical device to the patient network profile66. Rather, in these embodiments the patient network profile66is manually updated by a physician or other medical person using a PDA or the like that wirelessly connects with the patient identification device28.

In a similar manner, when a medical device is removed from the patient point-of-care network20or is disabled by a malfunction of the medical device, the patient identification device28suitably updates the patient network profile66by executing a device removal service. In some embodiments, the patient identification device28periodically polls the medical devices of the patient point-of-care network20and, when communication with one of the medical devices ceases, removes information about that medical device from the patient network profile66. Alternatively, the medical device may include a “disconnect” button which, when pressed, causes the medical device to send a request to the patient identification device28asking that the medical device be removed from the patient network profile66. In still yet another approach, the medical device can be removed from the patient network profile66manually by a physician or other medical person using a PDA or other electronic user interface capable of wirelessly communicating with the patient identification device28.

In some embodiments, the wireless patient point-of-care network20operates autonomously most of the time. Occasionally, the patient identification device28polls to locate the available wireless access point80of the local area network82and, if it identifies the available wireless access point80, makes a network connection and transfers collected data to the patient record100of the patient record repository84. On the other hand, if the polling finds that no wireless access point is available (for example, if the patient is ambulatory and out of range of any wireless access points) then the wireless patient point-of-care network20continues to operate autonomously to collect and store data and to delivery therapy such as intravenous fluids. Once a network connection is reestablished, the collected data is uploaded to the patient record100of the patient record repository84. In other embodiments, vital sign data is continuously transmitted to the patient record repository84via the network connection without buffering or otherwise storing the data at the patient identification device28. In these embodiments, data collected during an interruption in the network connection is lost, or alternatively data buffering at the patient identification device28is employed only in the event of a network connection interruption to prevent such data loss.

Another advantage of providing the patient network profile66on the patient identification device28attached to the patient10is that it enables rapid assessment of the available medical services provided by the patient point-of-care network20. For example, considering the autonomous sensor node network22, not all of the vital signs sensors of this medical device may be initially active. However, all the available medical services, and their status as active or inactive, are listed in the patient network profile66. Hence, a physician or other medical person can review the patient network profile66using a PDA or other device to determine whether a vital sign sensor of interest is already available and if so whether its status is active or inactive. This provides an overview of which medical devices and services are currently available and used for a patient in his or her associated patient point-of-care network.

Moreover, in some embodiments all data stored in the patient network profile66, including the continuously updated listing of available medical services and the status of each medical service as active or inactive, is logged in the patient record100of the patient record repository84. This log of data including the continuously updated listing of active and inactive medical services provides detailed documentation of the medical care provided to the patient throughout the patient's stay at the hospital or other medical facility, including logs of which medical devices and corresponding services were used for the patient10at which time. The patient record100at the patient record repository84stores all information related to one patient and his or her patient point-of-care network (i.e. patient identifier62, patient data, medical devices22,24,26, services provided, services used, and so forth.

The patient record100can be maintained at the patient record repository84after the patient10is discharged from the hospital, providing a permanent record of services given to the patient that may be useful in resolving billing discrepancies, maintaining the patient's medical history, providing evidence in legal proceedings, or for other purposes. On the other hand, the patient identification device28can be re-initialized and used for another newly admitted patient.