Abstract:
The present invention relates to a healthcare monitoring system and method that detects and transmits data. The system can utilize a wearable monitor that detects a variety of data from its wearer. The data can then be transmitted over a network to a centralized location where the data may be analyzed and any appropriate action may be taken.

Description:
PRIORITY CLAIM UNDER 35 U.S.C. §119 
   This invention is related to and claims priority under 35 U.S.C. §119 to U.S. Provisional Patent Application No. 60/660,342, filed Mar. 11, 2005, the contents of which are hereby incorporated by reference in their entirety. 

   FIELD OF THE INVENTION 
   This invention relates to the field of health care monitoring and, more specifically, to the use of a wearable monitor to collect data on a patient and transmit the collected data to a centralized location with data storage, analysis, reporting and notification. 
   BACKGROUND 
   Nursing homes and assisted care facilities employ a number of different methods and devices to monitor their patients. These devices are capable of monitoring physiological functions, but are generally used in isolation and not integrated with other devices. Some devices include fall alert buttons that require a patient to actively push a button to alert the staff of a care facility of a fall. This type of device, however, is not effective for a patient who has a cognitive impairment (such as dementia) is knocked unconscious or otherwise rendered incapacitated by a fall or other medical condition. Care facilities also use a variety of pressure pads and other sensors to provide an audible alert to indicate that a patient has left a desired location. These types of devices have reliability problems and require a high level of vigilance to constantly monitor the sensors. Moreover, none of these devices is capable of delivering private, targeted and configurable alerts for designated caregivers, nor do they provide centralized data collection for automatic charting and close monitoring of individual patients. 
   In addition to the above, many care facilities try to perform at least some vital sign monitoring. This may be limited to checking a patient&#39;s vital signs only once a week due to the time and money needed to have staff to perform these duties. However, when a patient&#39;s vital signs are checked only once a week, the declining health of a patient may only be detected after a health condition has worsened, eliminating the opportunity for early intervention. Thus, there can be an increase in a care facility&#39;s patient morbidity and mortality rate. Additionally, staff turnover and productivity can be an issue in care facilities that may need to spend more time replacing and training staff members to monitor sensors and patients&#39; vital signs and to understand the patient&#39;s medical history and specific need for care. 
   Care facilities also have an interest in knowing the location of their patients at their facility, as well as patients that may be located remotely or living at individual homes and receiving care remotely. However, typical methods of monitoring patients and determining their locations involve the use of video cameras and closed-circuit television. Another method is the use of motion detectors to infer movement and activity level within a home. These systems typically require significant wiring or installation of equipment within a home and can be uneconomical for either home or multi-patient facility use. Additionally, this may only provide an inference, but not a direct indication, of patient&#39;s well-being. Further, video-based services require a high level of attention to the video feeds from the cameras and the identity of the people can be difficult to discern. There are additional issues in personal privacy and intrusion when using video or even motion detectors. Additionally, it is not usually practical to have cameras or a video monitoring system in the house of a remotely located patient. 
   Other facilities, such as hospitals, have also utilized patient and personnel tracking systems using radio frequency identification (RFID) badges. These devices can be worn by a person and transmit an RF signal that may be tracked from a centralized location in the facility. These devices, however, do not provide any other information besides the location of the wearer and they may not provide adequate transmission range. Also, RFID is limited in its memory so very little processing is available and there is no 2-way processing of event monitoring data. Other information that a care facility may desire to collect, such as a patient&#39;s vital signs, are not collected or transmitted by these devices. Additionally, the battery life on these devices can vary significantly depending on the type of RF signal transmitted and the amount and duration of transmissions from the device. Typically the devices only have a battery life of a few days before they require recharging or replacing the batteries. Other devices designed to transmit a signal having information about a patient may utilize cellular phone technology. These devices, however, often fail to get an appropriate cellular signal in health care facilities and again require significantly more power and have a battery life of hours thereby rendering such devices impractical for long-term monitoring. 
   Yet other devices that have been used in battery-powered sensors include those using IEEE 802.15.1 Bluetooth wireless technology to replace cables. Enabling devices with Bluetooth does not in itself being about an integration of separate monitoring devices for one patient. Indeed, there can be a limit of eight devices that may be joined together in a Bluetooth piconet raising the question about supporting hundreds of patients in a facility. The short range, typically on the order of ten meters, calls for a multimode extensive network strategy to support a healthcare facility, such as a mesh or partial mesh network, would provide for adequate coverage but also exceeds the specifications of Bluetooth. Merely replacing a cable from a monitor to a wireless Bluetooth-enabled equivalent can result in rapid battery depletion if continuous monitoring is attempted. 
   Still other devices have been used for monitoring an individual&#39;s vital signs. These devices have been wearable and typically were capable of monitoring some vital signs, such as pulse rate and body temperature. These devices, however, typically only have the ability to display the information collected on a display that is either worn on the individual or on separate display that the collected data is downloaded onto. Other devices have included the ability to transmit location information to track the movement of an individual. These devices, however, do not have the ability to transmit collected data on the individual back to a central location for analysis. Further, these devices usually require a person to wear a variety of different sensors and can be intrusive on the person and prohibit some movement. These devices also only allow a person to wear the device for a limited time, for example a few days, before the power source must be replaced or recharged. 
   Therefore, a need exists for a system that can track and monitor a patient using a wearable, form-friendly, low-power, wireless device that can be used to monitor the health and wellness of a person wearing the device over long periods of time without the constant surveillance of healthcare personnel. 
   SUMMARY 
   In one embodiment, a system for monitoring a patient is disclosed. The system may have one or more wearable monitors that a person may wear. The one or more wearable monitors may have one or more sensors that collect data about the patient. The collected data may then be transmitted to at least one repeater, which passes the signal on to at least one gateway. The at least one gateway can transmit the collected data to at least one server for further analysis. 
   In another embodiment, a method of monitoring a person receiving health care is described. The method involves having a person wear a monitor with one or more sensors for collecting data from the wearer. The monitor can also be capable of transmitting data to a repeater. The repeater can then be used for transmitting data to a gateway, which in turn can be used for transmitting data over a local area network. Processing and interpreting the data can then be performed by a server. 
   In yet another embodiment, means for monitoring a health care patient are described. This may include means for collecting physiological data and other data from a person using a wearable device, means for transmitting the data to a centralized location and means for analyzing and interpreting the data. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     Advantages of embodiments of the present invention will be apparent from the following detailed description of the preferred embodiments thereof, which description should be considered in conjunction with the accompanying drawings in which: 
       FIG. 1  shows an exemplary diagram of a health care monitoring system. 
       FIG. 1   a  shows an exemplary diagram of a health care monitoring system. 
       FIG. 2  shows an exemplary diagram of a wearable monitor. 
       FIG. 3  shows an exemplary diagram of a repeater. 
       FIG. 4  shows an exemplary diagram of a gateway. 
       FIG. 5  shows an exemplary diagram of a mobile gateway. 
       FIG. 6  shows an exemplary diagram of a server. 
   

   DETAILED DESCRIPTION 
   Aspects of the invention are disclosed in the following description and related drawings directed to specific embodiments of the invention. Alternate embodiments may be devised without departing from the spirit or the scope of the invention. Additionally, well-known elements of exemplary embodiments of the invention will not be described in detail or will be omitted so as not to obscure the relevant details of the invention. Further, to facilitate an understanding of the description discussion of several terms used herein follows. 
   The word “exemplary” is used herein to mean “serving as an example, instance, or illustration.” Any embodiment described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other embodiments. Likewise, the term “embodiments of the invention” does not require that all embodiments of the invention include the discussed feature, advantage or mode of operation. 
   Referring generally to  FIGS. 1-6 , a medical situation awareness system that can monitor the health, location or well-being of a person is shown. The system may include a user-friendly, internet-based interface and tools for analyzing data. The system may also include a scalable, customizable database for management and codification of the uncertain relational knowledge gathered. This database can include advanced analytic tools. Additionally, the system can include a Bayesian advanced analytic software tool that can take the uncertain relational knowledge gathered and develop a Bayesian relational network. This network may then be used to create a predictive model of medical condition for the monitored patient. The model may be used, for example, to filter false positives, incorrect data or inaccurate data. This autonomic process could allow for an effective wearable monitoring system because the event data from the sensors could require significant analysis time by an operator to ensure an accurate picture of the patient&#39;s overall health is provided. Further, the system may have a graphical interface that can be used for results analysis or health care suggestions. This system may be employed in any of a variety of situations, for example hospitals, extended care facilities, nursing homes, private homes, or any other situation where it is desirable to monitor and provide care for a person. 
     FIG. 1  shows an embodiment of a health care monitoring system. System  100  may have a variety of components, such as monitor  102 , gateway  106  and server  110 . Monitor  102 , gateway  106 , and server  110  may transmit data to each other and receive data from each other through any of a variety of wireless transmission protocols. Further, monitor  102  may include sensors  114  to detect physiological, locational and other data from a wearer of monitor  102 . These sensors may include, but are not limited to a temperature sensor, a pulse oximetry sensor, a variety of body sensors, a fall detection sensor, and a location sensor, as well as any of a variety of other sensors. Additionally, external sensor  112  may be disposed separately from sensors  114  to detect and transmit data from a location apart from monitor  102 . Monitor  102  may further include processing and storage capabilities  116  for processing and storing the data from the sensors as well as data received from outside sources. Also, mesh network  118  may be utilized with monitor  102 . Mesh network  118  may include a variety of repeaters so as to allow for the transmission of data over significant areas as well as for use in providing location information of a wearer of monitor  102 . 
   Gateway  106  can communicate wirelessly with monitor  102  and server  110  and may also include processing and storage capabilities  120 , which may be able to process and store data transmitted from monitor  102 , as well as data generated by gateway  106  and data received from server  110 . Gateway  106  may be part of a wireless local area network (LAN)  122  and also part of other networks  124 , allowing it to communicate with other devices, for example, over the Internet. 
   Server  110  may communicate with gateway  106  over network  130  to both send and receive data. Server  110  may include processing and storage capabilities  128 , which may be used for processing, interpreting and storing data received from gateway  106  and monitor  102 , as well as performing other analyses, such as eliminating false alarms and predicting future events. Further, server  110  can include a display  126 , such as a nurse&#39;s display, where a person may access the data stored and processed by server  110 . 
   In another embodiment shown in  FIG. 1   a , a system  100  for monitoring the health, location or well-being of a person is shown. Here, a person may use a device such as a wearable monitor  102 . The monitor  102  can be a hardware device taking the form of an arm band or a wrist band or a device that can be applied to the skin via a bandage, as a non-limiting example. In a further embodiment, the monitor  102  can be wearable and not interfere with any range of motion or actions of a person. The dimensions of the monitor  102  may also be small, for example, 1″×1″×3″ or smaller. There may be a variety of sensors, such as a pulse sensor, temperature sensor and a mobility sensor, integrated into the monitor  102 , as a few non-limiting examples. Further, a panic button may be disposed on the monitor  102 , allowing a wearer or other person to send a signal to a remotely located party, such as a caregiver or a facility&#39;s server. Additionally, the monitor  102  may incorporate “fall detection,” which can detect if a person falls down or otherwise moves in a manner that could result in an injury. The fall detection may use any of a variety of sensors, for example, piezoelectric-based, accelerometer-based and gyroscopic-based. The sensor or sensors may be incorporated in the monitor  102  whether it is worn on a wrist of a patient or anywhere else on their body. Further, the fall detection portion of the monitor  102  can send also send a signal to a caregiver or a facility&#39;s server. 
   In an additional embodiment of the monitoring system, the wearable monitor  102  can send a wireless signal to a repeater  104 . The repeater  104  can be a custom hardware device that may be battery or AC powered. The repeater  104  may also be installed in any location where additional routing nodes may be required, to provide further wireless coverage and allowing the wearable monitor to communicate with a smart gateway. 
   Further, in the system shown in  FIG. 1   a , a smart gateway  106  may be utilized to further transmit a wireless signal. In one exemplary embodiment, the smart gateway  106  may be a hardware device that integrates IEEE 802.15.4 ZigBee wireless networking components with Ethernet, 802.11 wireless routers or a modem. IEEE 802.15.4 may be used as it allows a large number of nodes to join the network, thus permitting a large number of patients to be monitored. Communication may occur over the 2.4 GHZ band, which is unlicensed and available in most locations, allowing for a single product to be utilized throughout the world. Additionally, to avoid congestion caused by other devices using this band, the IEEE 802.15.4 ZigBee standard may use 16 channels in the 2.4 GHz band, allowing the monitor  102  to utilize less crowded channels when necessary. Likewise, any spectrum, such as the 5 GHz spectrum, may be used to avoid potential interference with other devices. Also, because 802.15.4 has a relatively long range, larger scale monitoring can occur. This transmission protocol is also a very low power protocol, allowing for extended use of the monitors, and the low data rate and limited interference with other devices allow for 802.15.4 devices to work in environments where other RF devices are already operating. However, in other exemplary embodiments, any other type of wireless networking devices, components or protocols may used with the gateway  106 . The gateway  106  can collect the event data generated by the wearable monitor and may send real-time medical alerts directly to a caregiver or, alternatively, to a facility&#39;s server for further analysis and action. 
   Although the above embodiments discuss the IEEE 802.15.4 ZigBee wireless standard, any wireless communication protocol known by a person of ordinary skill in the art could be used for transmitting and receiving. In another embodiment, any wireless communication protocol known to a person having ordinary skill in the art that has economical power consumption, reasonable data rates, limited interferences, and sufficient range may be used. 
   After the wireless signal shown in  FIG. 1   a  is transmitted from the smart gateway  106 , it can pass through a local area network  108  to a server  110 . The server  110  can be a software application that allows a nursing home facility or other care giving facility to track the incidence of fall reports, medical emergencies and other transmissions of the wearable monitor at their site. The server  110  can also have the ability to send targeted real-time medical alerts to facility employees and can escalate these alerts to various members on the staff, as well as track response times, for example, to the medical alerts. The server  110  may also provide statistics on the vital signs of the residents as well as the location of the residents. Further, the server  110  may be able to perform intelligent analyses of event data to minimize false alarms and allow for predictive decision support of healthcare providers, which could lead to improved care. Data transmitted to the server  110  may be forwarded to any of a variety of devices  113 , and be viewable over the Internet or a local area network. The data may then be reviewed and analyzed by an authorized person at the remote location  115  of the device  113 . 
   In yet another embodiment, the system  100  may be used in either a health care facility or at an individual&#39;s home. Further, a monitor  102  that functions in a health-care facility may also change locations to the individual&#39;s home or another location that is compatible with the system. Additionally, if the user moves back to the original care facility, the monitor  102  can continue to work seamlessly. Further, the same equipment for system  100  that is used in a health-care facility may be used for a patient at their home, as the equipment is typically relatively inexpensive. The message protocols used in the system can provide end-to-end integrity and security in the data from each wearable monitor and each sensor as the data is transmitted over wireless networks to the Internet or public carrier networks to reach the server having patient&#39;s records. 
     FIG. 2  shows a more detailed diagram of the wearable monitor  102 . The monitor  102  may be used to monitor the health and mobility of the wearer. In one embodiment, the monitor  102  may be a low-cost, high volume device that can be replaceable if it is lost or broken. The monitor  102  may also be customized based on whether or not it is being used in a wearer&#39;s home or at a care facility. The monitor  102  can include a wristband device, which may be a physically attractive, compact device capable of being worn on the wrist, similar to a wrist watch. Alternatively, the wearable monitor  102  may be a pager-sized device that can be attached to the belt of a wearer or to an armband or leg-band on the wearer. In yet another embodiment, the wearable monitor  102  could be formed so that it is integrated in a bandage or similar adhesive device that may be securely worn anywhere on the body of a wearer. 
   Although some embodiments have been described as including a wrist watch or pager-sized device, or the same divided into two or more smaller pieces, or any configuration known to one having ordinary skill in the art that would attach to the body securely and not inhibit or intrude upon the mobility, nor limit the range of motion of a user may be used. A version of the wearable monitor called a “wand” may be carried by authorized healthcare and support personnel. The wand can function to communicate with the server or other system components to verify patient identity, verify proper operation of the patient&#39;s wearable monitor, verify that the healthcare personnel have responded to medical alerts and notifications made by the system and have attended to the needs of the patient, as well as verify or determine any other relevant information. 
   The monitor  102  may have a variety of internal components, regardless of whether the wearer has the wristband device or the pager-sized device. An 802.15.4 wireless transceiver  202  may be disposed in the monitor. Alternatively, another wireless transceiver may be used with monitor  102 . Additionally, an antenna can be disposed in the device. The antenna may be able to produce a significantly uniform signal having a significantly uniform signal strength emanating to all directions (substantially isotropic) regardless of the orientation of the monitor due to change in position of the wearer of the monitor. The antenna may further be optimized for communication in an indoor environment. A processor  204  may also be housed in the device. In an exemplary embodiment, the processor  204  can be an ultra-low power 8-bit processor. Additionally, a processor  204  may be utilized that has a hibernate mode where only micro-amps of current are used to power the hibernating device, and which only “wakes up” or activates to process events which can minimize power requirements and extend battery life. Flash memory (not pictured) may also be employed in the monitor  102 . The flash memory can contain the latest sensor data and alerts when the wearable monitor is out of the range of a network, the protocol stack as well as firmware developed to react to events generated by the sensors. 
   In addition, the monitor can include any of a variety of sensors. These sensors can include medical-grade sensors which can be employed to determine the health of the wearer. For example, the sensors may include a pulse sensor  206 , a temperature sensor  208  and accelerometers for the x-y axis  210  and z axis  212 , allowing for mobility detection and fall detection. Further the mobile device can include a battery or batteries  214 . The battery or batteries  214  may be such that they allow for the device to run off of the battery power for more than six months. Any of a variety of batteries may be used in both the wristband and pager-size applications. 
   Further embodiments of the monitor  102  not pictured in  FIG. 2  may include a blood pressure sensor, a pulse oximetry sensor (to provide more accurate blood oxygen saturation determination mechanisms), a temperature sensor, respiratory rate sensor, wireless network-based location sensor and GPS or cell-based geo-location and E911 service. Individual sensors may be utilized to monitor these events or a single sensor may be utilized to perform a one or more of the tasks. Additionally, a shock meter that may use galvanic skin resistance and skin temperature, along with event analysis software to provide an early detection of shock may be incorporated. 
   Although the above preferred embodiments discuss a blood pressure sensor, laser pulse oximetry sensor, a temperature sensor, respiratory sensor, GPS and E911 services, any other sensor or service known to one having ordinary skill in the art may be used or incorporated into the device. 
   The wearable monitor  102  can use wireless networking components in order to send vital sign data, location information and medical emergency alerts. In one exemplary embodiment, 802.15.4 ZigBee wireless networking components (e.g. transceiver  202 ) may be used. In another exemplary embodiment, any other wireless networking components may be used that may be disposed on monitor  102  and provide for transmitting and receiving data wirelessly. Additionally, the monitor  102  can incorporate GPS locating capability to provide detailed location information of the wearer. Further, a cellular modem may be incorporated onto the monitor  102 , allowing the wearer to be monitored from remote locations and, optionally, interacting with ZigBee or equivalent-enabled mobile phones. 
   The software that can be used in the wearable monitor  102  can be designed to be small, thus limiting the amount of processing power required and therefore extending battery life. Additionally, the software incorporated on the monitor  102  can be programmed into firmware. One portion of the software can include an IEEE 802.15.4/ZigBee protocol stack or any alternative wireless protocol stack. This combination can provide the ability for the wearable monitor  102  to wirelessly communicate with one or more repeaters and gateways. Additionally, in one embodiment, since the wearable monitor  102  may require very low power consumption, it can be considered an end node that does not route data, and thus may be considered a reduced function device (RFD) under the IEEE 802.15.4 standard. However, in other embodiments, the monitor  102  can have full routing functions and utilize any known wireless standard. Further, the software may also be able to respond to beacons from a gateway device that is requesting current sensor data to be sent. Also, in a further embodiment, the data transmitted from the wearable monitor  102  can be encrypted, for example, using the security capabilities of the 802.15.4 standard or any other Advanced Encryption Standard (i.e. AES 128) scheme known to one of ordinary skill in the art may be used. 
   Additional software may be used for processing sensor data and ensuring that out of range data is processed for all of the sensors that are integrated into the device. For example, in the case of fall detection, the software should be able to process the data and determine if a fall has occurred or if a typical movement has occurred. Also, sensor data may be gathered and sent to a gateway on a periodic basis for statistical tracking of norms. In a further embodiment, if there is a network failure, high-water mark sensor data can be latched and transmission can be retried until transmission is confirmed. Additionally, the wearable monitor  102  can also test battery power of battery  214  on a regular basis and may also transmit a “low battery” alert when battery life has decreased below a predetermined amount, for example, 20% of the remaining battery life. Alternatively, a “low battery” alert may be transmitted at any predetermined amount at or below 50% of the remaining battery life. 
   An exemplary repeater is shown in  FIG. 3 . A repeater  104  can ensure that adequate wireless coverage is maintained across the facility or home where the wearer of the monitor is located. In one embodiment, a repeater  104  can collect the statistics and alerts generated by the wearable monitor  102  and transmit real-time medical alerts to a caregiver or a care facility&#39;s server. Increasing the number of repeaters, for example in a mesh pattern or any other pattern known by one of ordinary skill in the art that will provide the desired coverage, in a given location, can also reduce the number of gateways that a home or facility may need. Additionally, the number of repeaters may be increased to support a virtually unlimited number of monitored patients and, additionally, determine the location of any individual patient. Repeaters can also compensate for the signal sent from an ultra-low power wearable monitor, which may have a limited transmission range. The repeater  104  can use a variety of hardware and software and may be changed or customized depending on the type of repeater that is being used. Non-limiting examples of different repeaters include an internal-use-only repeater that is A/C powered with battery backup, an internal-use-only repeater that is D/C battery powered, a weatherproof repeater that is A/C powered with battery backup, and a weatherproof repeater that is D/C battery powered. 
   A repeater  104  may also utilize a variety of internal hardware components, as shown in  FIG. 3 . With the exception of the A/C power transformer in the A/C power devices, the hardware configurations for different repeaters may all be the same. The repeater can house an 802.15.4 wireless transceiver  302  that meets both the size and power requirements of the device. The 802.15.4 transceiver  302  may be further integrated with an Ethernet connection, one or more 802.11 wireless Internet routers and one or more dial-up modems (not shown). In other embodiments, the repeater  104  may house any other type of wireless transceiver. Additionally, the repeater  104  can have an antenna, which may be customized or altered depending on whether or not the monitor is being used indoors or outdoors. Further, the repeater  104  may also have an ultra-low power 8-bit processor  304 , similar to the one described above with respect to the monitor and optionally having a hibernate mode. Additionally, the repeater  104  can utilize flash memory containing the protocol stack as well as firmware developed to react to repeater events, a battery or batteries  306 , which may power the repeater for one year or longer and an A/C power transformer  308 , which can be utilized for locations with an electrical plug. 
   The repeater  104  may also have a software component designed to be small to limit the amount of processing power and thus extending the battery  306  life in the event that the device is not A/C powered. This software may be entirely programmed into the firmware. One part of the software may be the IEEE 802.15.4/ZigBee protocol stack, or any other appropriate wireless protocol stack, which can provide the ability for the repeater to wirelessly communicate with wearable monitors and gateways in the system. The repeater  104  can be designed as a routing node, allowing it to pass data along from source nodes to destination nodes. The repeater may also be considered a full function device (FFD) in terms of the IEEE 802.15.4 standard. The repeater  104  further may utilize any of a variety of batteries, for example M batteries, to power it as it routes data or may alternatively be A/C powered. Finally, the software on the repeater  104  may also respond to beacons from a gateway device, which can request current status to be sent. The status data transmitted from the repeater  104  to a gateway device can include both status data of the repeater  104  itself as well as current status data of the wearer of the monitor  102 . If the repeater  104  is battery powered, additional processing may be performed that tests the battery power on a regular basis and sends a low battery alert when a predetermined amount of battery power in battery or batteries  306  is, for example 20%. Alternatively, a “low battery” alert may be transmitted at any predetermined amount at or below 50% of the remaining battery life. 
   An exemplary gateway device, as shown in  FIG. 1 , item  106 , is shown in greater detail in  FIG. 4 . The gateway device  106  can be a fixed-location device that bridges a 802.15.4 ZigBee wireless network, or any other alternative wireless network used by the above-described devices, with a local area network in a facility or home. A variety of wearable monitors  102  and repeaters  104  may operate through an individual gateway  106  and the gateway  106  may have similar functionality to an 802.11 wireless access point, or any other type of wireless access point. Similar to the repeater  104 , the gateway  106  may utilize a variety of hardware and software components. Additionally, the gateway  106  may have different configuration based on the local area network  108  that is configured in a facility or home. For example, a gateway  106  may be an A/C powered device with Ethernet network connectivity, an A/C powered device with 802.11b (or other) network connectivity, or an A/C powered device with modem connectivity. 
   In a further embodiment shown in  FIG. 4 , a gateway  106  may have a variety of hardware components. These components may include an 802.15.4 wireless transceiver  402 , or any other type of wireless transceiver, and an antenna, similar to those in the repeater  104 . The gateway  106  may also have a processor  404 , for example a 32-bit processor. Additionally, the gateway  106  can utilize flash memory  406 , or other memory type, which can store patient data as a temporary network buffer and contain the protocol stack as well as firmware message processing  408 . The gateway  106  can also have an amount of RAM that is needed for the application and an A/C power transformer  410  to provide power for the gateway, as well as an internal D/C battery backup. 
   The gateway  106  may also provide Internet connectivity. Connections to the Internet may be made by at least one of an 802.11 wireless connection  412 , Ethernet connection  414  or modem  416 , or any other device capable of connecting to the Internet. 
   The software used in the gateway  106  shown in  FIG. 4  can be used in processing events from the wearable monitor and may optionally be Linux-based. Additionally, all of the software incorporated into the gateway may be programmed into the firmware. One such software component is an operating system, for example a Linux or Linux-variant operating system  408 . Further, the gateway  106  can include an IEEE 802.15.4/ZigBee protocol stack, or any other type of wireless protocol stack, the combination of which can provide the ability for the gateway  106  to wirelessly communicate with wearable monitors  102  and repeaters  104  in the system  100 . The gateway  106  may further be designed as a routing node so that it can pass data along from source nodes to destination nodes. The gateway  106  may be considered a personal area network (PAN) coordinator node under the terms of the IEEE 802.15.4 or master node under IEEE 802.15.1 or other wireless standard. Additionally, if there are multiple gateways in the network for scalability, a single gateway may be chosen as the PAN coordinator and the remaining gateways can function as coordinators in a cluster tree network topology. The coordinator nodes can also generate beacons, for example status requests, that the other nodes in the network may respond to on a periodic basis. 
   Other software included in a gateway  106  can include a reliable queue, which can provide for scalability and reliability of the delivery of critical monitoring events to the server. A gateway  106  can also have the capability to process the events sent to it by the wearable monitors  102  and the repeaters  104 . In situations where there may be multiple events from the same monitor  102  or repeater  104 , the gateway  106  can have the intelligence to collapse the events and perform a root cause analysis. Finally, gateways can receive software upgrades and updates. Further, gateways may be able to upgrade the wearable monitor and repeater components when new firmware is made available for updates. 
   In another embodiment, the system may be utilized in the home of a patient. A home-based system, however, may contain a gateway  106  having additional intelligence so that it also can have the decision making capabilities based on a patient&#39;s physiological trends and statistical data for instances where a patient can be provided immediate feedback for self awareness and patient education about their ailments. The gateway device  106  may also be able to continue communication with a healthcare provider&#39;s server  110  so that a healthcare team can maintain their ability to monitor the patient. The communication between the system in the patient&#39;s home and the healthcare facility can be securely delivered through encryption to ensure patient privacy and, if necessary, to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations and, if necessary, military specific requirements. 
   In an alternative embodiment shown in  FIG. 5 , a mobile gateway  500  may be used in lieu of or with gateway  106 . The mobile gateway  500  functions similarly to gateway  106 , insofar as it can have a wireless transceiver  502  and antenna, processor  504 , operating system  506  and flash memory  508 . A mobile gateway  500  can also bridge the ZigBee wireless network, or any other wireless network used with the system, with a cellular network  512  and allow for monitoring of the wearer of a monitor  102  when the monitor  102  is away from their home or facility. A mobile gateway  500  can also contain GPS locator  510  capabilities to identify the location of the wearer in case of an emergency event. Further, mobile gateway  500  may use rechargeable battery  514  to power the device. A mobile gateway  500  may be configured in a variety of manners, such as by partnering with a mobile phone manufacturer to integrate gateway capabilities into a ZigBee-enabled, or other wireless protocol-enabled, mobile phone or by integrating gateway cellular and GPS capabilities into a wearable monitor. 
     FIG. 6  shows a more detailed view of server  110 . The server  110  can process the logic associated with the monitoring system  100  and provide the capability to configure the user information and handle the processing of events from various users using statistical analysis engine  602 . Further, the server  110  can track and store the incidence of falls and other medical emergencies at the site using storage, database or databases, or memory  603  in conjunction with statistical analysis engine  602 . It can also have the ability to send targeted real-time medical alerts to caregivers and may optionally escalate these alerts to additional members of a healthcare team as well as track response times using alert notification  604 . These alerts may include email  606 , voice transmission  608 , SMS  610  or other alert transmission  612 . The server  110  may also provide statistics on the vital signs of a patient or patients as well as their location and, through the use of complex applications software, can make intelligent decisions based on trends in patient data and statistical data using tools disposed in statistical analysis engine  602 . Server  110  may include triage sorting capabilities  614 , allowing for improved organization of patient data. A presentation user interface  616  may also be used with server  110  so as to provide an accessible and easily navigable way of viewing data in server  110 . The presentation user interface  616  further be used by operating system and networking software  622  to provide additional methods of user access. Additionally, server  110  may have security perimeter  618 , which may prevent unauthorized access to data transmitted to the server. Network configuration data, privacy information and management data  620  may also be housed on server  110 . Finally, server  110  may also include patient data manager  624 , which may house any of a variety of data associated with any number of patients. 
   The server  110  may also include one or more databases  603 . Data stored in the one or more databases  603  can include accumulated patient information and system configuration information. This information can be used for a variety of purposes, such as supporting one or more remote monitors, one or gateways, one or more repeaters, and any other device that may be used in the system. 
   In one exemplary embodiment, at least one server may be used for deployment in support of a number of gateways, repeaters and monitors. The server, e.g. server  110 , and system architecture can be flexible and scalable, however, allowing the number of servers deployed will be determined, for example, by the unique requirements presented by institutional organization, the desire by the institution for local or remote maintenance support, physical and geographic distance, network reliability, desired separation of data among multiple institutions, processing capacity desired and any other relevant needs or desires. Processing may be distributed across multiple specialized servers, which can allow, for example, certain portions of the database and complex software applications for statistics to be on one or more servers at one location, and certain portions of the database and complex software applications for communications and configuration with gateways and associated repeaters and monitors might be at another location or locations. Some deployments may include gateways, repeaters and monitors at one location but all of its supporting servers are at a different location. 
   The server  110  may include software bundles with rack-mounted server hardware included in operating system and networking software  622 . This can be, for example, a standard Intel-based processor and PC-like functionality. Further, the server  110  associated with a deployment can have a variety of application software built on top of open source software components. Other software components can include an operating system, such as Linux, a Linux variant, Windows or a Windows-based operating system. A web-based interface, such as presentation interface  616 , can also be provided via a web server, for example Apache http server. Further, an application server, such as Tomcat, can be used to dynamically monitor events and statistics and configure contact information notification services. A database may also be used to persist the configuration and data, such as patient information, contact data, and statistics. Because multiple patients, multiple monitors and multiple sensors may be included in the system, the configuration may have unique identifiers for each patient, as stored in patient data manager  624 . Additionally, a set of unique messages appropriate for each type of event and each type of data from a sensor may be used. Complex software applications, such as engine  602 , may utilize the data to create patient records, statistics, and analysis of data for reports. Complex software applications can also apply statistical techniques such as Bayesian Networks, moving averages, regression analysis, inference, probabilistic reasoning, and other analytical, machine learning, and artificial intelligence techniques known to a person having ordinary skill in the art to filter and apply data. Standard reports can be available on a per-event, per-patient, and per-facility basis, as well as any other desired basis. The ability to customize reports can be made available and the output from these reports could potentially also be used for billing or for quality control. Examples of open-source database projects that may be utilized are Apache projects such as Apache Derby, and mySQL or other databases known to a person having ordinary skill in the art. 
   The server  110  software may also include reliable queue, which can ensure scalability and reliability of the delivery of critical monitoring events to the caregiver mobile devices. Additionally, a notification service can provide the ability to communicate with mobile devices as well as the ability to send SMS text messages to pages and mobile phones as well as the sending of voice messages. The server  110  can further have the ability to process all of the events sent to it by the gateways in the facility or network and, additionally, the server  110  can have the ability to upgrade the gateway  106  as well as provide firmware to the gateway  106 , which, in turn, can upgrade the wearable monitor  102  and repeater  104  components when new firmware, if desired, is available. 
   In another exemplary embodiment, server  110  may be able to identify specific sensor values and time stamps that originate from a specific monitor, e.g. monitor  102 . This identification may be able to take place regardless of how the data from monitor  102  is transmitted or over which network path or paths the data is transmitted. For example, server  110  may identify data as being sourced from monitor  102  despite the data generated by monitor  102  having traveled over one or more of a wireless network, the Internet, a private local area network (LAN), wide area network (WAN), and a satellite or public carrier wired or wireless network. Additionally, server  110  may also account for data that may have been temporarily stored in monitor  102  when transmission was not available and later transmitted to server  110 . The data sent from an exemplary monitor may include a protocol of identification and unique or specific messages and formats for the exemplary monitor. The transmitted data may include information such as values generated by sensors disposed on the monitor, the time of a sensor value, information supportive of a message error detection and correction scheme and an encryption method to protect user privacy, which may exceed HIPAA standards. 
   In another embodiment, server  110  may provide notification or report information on the wellness or health of a wearer of monitor  102 . Server  110  may provide this information by utilizing complex application software that compares incoming data from monitor  102  with previously stored data from monitor  102  and other monitors recording similar data. The comparison of the sum of the data can be used to generate predictive probabilistic statistics, for example probabilistic statistics derived from Bayesian inference networks and probabilistic relations with a deterministic predictive capability for impending events. The data sourced from monitor  102  may be further be encrypted and server  110  may decrypt the data prior to processing and analyzing it. This data may also be correlated to generate notifications indicating changes in the health status of a wearer of monitor  102 . Additionally, server  110  may generate location data for monitor  102  based on the network interaction and signal attributes of monitor  102 , such as which devices monitor  102  is transmitting to and which network paths data generated by monitor  102  are being transmitted over. 
   The foregoing description and accompanying drawings illustrate the principles, preferred embodiments and modes of operation of the invention. However, the invention should not be construed as being limited to the particular embodiments discussed above. Additional variations of the embodiments discussed above will be appreciated by those skilled in the art. 
   Therefore, the above-described embodiments should be regarded as illustrative rather than restrictive. Accordingly, it should be appreciated that variations to those embodiments can be made by those skilled in the art without departing from the scope of the invention as defined by the following claims.