Patent Publication Number: US-2004040086-A1

Title: Healthcare system with coordinated operation of sub-systems

Description:
FIELD OF THE INVENTION  
       [0001] The present invention relates generally to healthcare systems, and particularly to a healthcare system that coordinates operations of sub-systems to move and provide healthcare to a patient, e.g., invalids, handicapped persons, elderly persons and physically challenged persons.  
       BACKGROUND OF THE INVENTION  
       [0002] Many kinds of healthcare systems have been developed for providing healthcare related services to patients, such as invalids, handicapped persons, elderly persons and physically challenged persons.  
       [0003] For example, there are many kinds of patient transportation devices, including vertical lifting machines with linear and rotary motion, carrying devices for moving the patient from one place to another, and devices for lifting a patient from a sitting or lying position to a standing position and vice versa.  
       [0004] In the patent literature, U.S. Pat. No. 5,630,236 describes a lavatory assistance device for supporting and assisting persons having difficulty in sitting or standing. A cradle supports a user under the armpits. The user controls lowering, stopping or raising actions by operating a control having handles which are placed in front of the cradle.  
       [0005] British Patent GB-A-2140773 describes a device comprising a frame, a cradle comprising a backrest to which arms are connected which are engageable under the armpits to support the handicapped person by the armpits during the entire movement between the standing and seated position and the reverse movement  
       [0006] U.S. Pat. No. 4,031,576 describes patient lifting apparatus comprising a frame having a seat and two armrests linked to a motor means.  
       [0007] PCT Published Patent Application WO 84/02074 describes a device that supports a person under the armpits, under the thighs and at the back, and which lowers or raises the person who remains seated.  
       [0008] French Patents FR-A-1481626 and FR-A-2337547 describe a mobile seat to move a person from a seated position to a standing position. The described devices are purported to have the capability of lowering and raising a seated person.  
       [0009] U.S. Pat. No. 6,006,377 describes a patient carrying device that carries a patient between various locations, for example, bed, toilet and bathtub. The patient carrying device comprises a pair of mobile vehicles, each capable of freely running along rails and powered by motors.  
       [0010] U.S. Pat. No. 5,809,591 describes a transverse bar which carries a patient lift system for movement between two laterally extending bars. The transverse bar is mounted at the same vertical height as the laterally extending bars and carries a motor for lifting and lowering the patient.  
       [0011] The above examples belong to the broad family of healthcare systems that move the patient. Another family of healthcare systems includes devices that move in relation to the patient, examples of which are now described.  
       [0012] Mobile lavatory units are known. For example, vertically adjustable lavatories are disclosed in U.S. Pat. No. 1,060,106 (McGregor), U.S. Pat. No. 1,391,091 (Arbuckle), U.S. Pat. No. 2,716,757 (Erikson), U.S. Pat. No. 2,817,094 (Lessley), U.S. Pat. No. 3,011,177 (Haughhey), U.S. Pat. No. 3,118,147 (Larkin), U.S. Pat. No. 3,456,264 (Flagg), U.S. Pat. No. 3,473,173 (Maciulaitis), U.S. Pat. No. 3,486,175 (Schwartz), U.S. Pat. No. 3,502,384 (Gipson), U.S. Pat. No. 4,233,693 (Stocklow), and U.S. Pat. No. 5,628,075 (Dudnick, et al.).  
       [0013] U.S. Pat. No. 5,23,109 describes a vertically adjustable lavatory assembly, comprising an outer frame and a carrier frame positioned within the outer frame. The carrier frame is vertically moveable within the outer frame and has a lavatory connected thereto. A lavatory is positioned outside the carrier frame and outer frame, and includes a faucet and a sink basin having an outlet opening therein. A drain line is in fluid flow communication with the sink basin outlet opening and a sewer line, and is adapted to accommodate for changes in the height of the sink basin. A plurality of supply lines are provided for supplying water to the faucet. The supply lines are also adapted to accommodate for changes in the height of the basin.  
       [0014] Other lavatories have been described which are vertically adjustable by hand operated jacks, hydraulic pressure, electric motors, and/or various other types of mechanical devices, gears, and linkages. The drain lines of such systems are typically flexible or telescoping to accommodate for the vertical movement of the sink.  
       [0015] Vertically adjustable toilets are also known. For example, U.S. Pat. No. 6,199,228 describes a height adjustable toilet seat including a frame member disposed on opposing sides of a toilet. The frame member has sliding plates with a toilet seat secured therebetween, whereby the toilet seat is positioned over a toilet bowl. A water supply conduit is provided that is coupled with a standard water supply line.  
       [0016] U.S. Pat. No. 5,063,617 discloses the use of household water pressure to raise and lower a toilet seat for use by disabled people.  
       [0017] U.S. Pat. No. 4,726,079 describes a height adjustable toilet bowl, including a water actuated cylinder for moving it between a low position and a high position, and a cleaning water circuit connected to a water supply pipe.  
       [0018] U.S. Pat. No. 4,091,473 describes an adjustable toilet mounted on the wall of a bathroom. The toilet is raised and lowered by an electrically driven motor. The toilet provides electrical limit switches for stopping the motor at a desired height above the bathroom floor.  
       SUMMARY OF THE INVENTION  
       [0019] The present invention seeks to provide a novel healthcare system, which may provide a multiplicity of semi-independent, complementary capabilities and functionalities for assisting a physically challenged person. In most general terms, without limiting the scope of the invention, the present invention seeks to coordinate the operation and functionality of different sub-systems of a healthcare system, integrating moving the patient with caring for some other needs of the patient in a most user-friendly manner.  
       [0020] For example, the healthcare system of the present invention may be employed to lift and support a patient sitting or lying in bed, while performing various healthcare related activities, such as but not limited to, rearranging the patient&#39;s pillows or washing the patient&#39;s back or other body parts.  
       [0021] In another example, the healthcare system of the present invention may comprise an adjustable sink uniquely suited to the needs of a frail patient. For example, the sink of the present invention may be moved vertically to adjust to the height of the patient. The sink may be moved (e.g., horizontally) towards a patient who is in a sitting position, so as to obviate the need for the patient to rise to a standing or semi-standing position. In another example, if the patient approaches the sink while standing, the sink may automatically adjust its position so that the patient may sit down next to or in front of the sink, thereby permitting the patient to use bathroom or toilet facilities with the outmost convenience and remain in close functional proximity to the sink.  
       [0022] The healthcare system of the invention may comprise one or more support members that support the patient, such as from behind on the patient&#39;s back, whether in a sitting or standing position with respect to the sink, thereby preventing the patient from losing his/her balance while using the sink or other facilities nearby. Sensors may be provided in the system that sense the load on the support members and adjust the supportive forces applied to the patient. Interactive patient interfaces, described more in detail hereinbelow, may be provided that enable maneuvering the patient to and from the sink, in and out of the room, or into and out of a wheelchair, for example.  
       [0023] Different elements of the healthcare system may coordinate and combine their functionalities. For example, two patient transporters may cooperate to convey a patient to a wheelchair, with one transporter carrying the lower body parts, and the other transporter lifting the patient under the arms. In this example, the transporters work together, however, the transporters may work independently.  
       [0024] The healthcare system of the present invention may be operated by patient commands (e.g., manually operated or by voice commands), or may be sensitive to the current situation and operate accordingly even without a patient command. In other words, the system may learn certain situations, store them in memory, and be programmed to perform some required action in those situations. Moreover, the system may be sensitive to the permissibility of certain operations in certain situations, and “override” the patient&#39;s commands. For example, if the patient pushes a “wrong” button, or would like to perform an operation that does not match his/her physical capabilities, or issues a voice command physically inconsistent with the current situation, the system may override and not carry out the command to avoid damage to the patient or system.  
       [0025] As another example, if the healthcare system senses that the patient is too frail to do certain actions even with the help of the healthcare system, the healthcare system may inform the patient, such as by a voice message, that the requested action may require human assistance. The healthcare system may itself summon the human assistance. The human user would then decide how to proceed.  
       [0026] The system of the invention may thus comprise a multi-functional patient or patient-related transport, assistance and interface system which may execute user commands, but which may also comprise interactive constraints that require the user to consult with the system before execution of commands or which may override such commands, and an infrastructure of representative functions which may enable interaction between the user and the system, for greater sensitivity and control of the system operation.  
       [0027] The healthcare system may comprise a database of medical and personal information of users of the system. Each user may be identified by means of an identification number or code. The user may be issued an identification card, such as a smart card, which may be inserted in a card reader to gain access to the system and allow the system to identify the current user and adapt to that user&#39;s needs, limitations and preferences. The database and identification card may be updated to constantly meet the user&#39;s needs, limitations and preferences.  
       [0028] In an implementation of the healthcare system for a rest room, the system may automatically close the rest room entrance door and not allow another person in, unless the system detects a medical or life-threatening emergency. Upon the user&#39;s exit, the system may close and/or lock the door, and reset the system&#39;s components. The system may also wash and disinfect sanitary devices in the rest room, so that the rest room may appear as an ordinary rest room for standard use. In this manner, the system may avoid embarrassment and discomfort for the physically challenged patients. 
     
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
     [0029] The present invention will be understood and appreciated more fully from the following detailed description taken in conjunction with the appended drawings in which:  
     [0030]FIG. 1 is a simplified pictorial illustration of a healthcare system, constructed and operative in accordance with an embodiment of the present invention;  
     [0031]FIG. 2 is a simplified pictorial illustration of another embodiment of a healthcare system, constructed and operative in accordance with an embodiment of the present invention; and  
     [0032]FIG. 3 is a simplified block diagram of various modes of operation of the healthcare systems of the present invention. 
    
    
     DETAILED DESCRIPTION OF THE PRESENT INVENTION  
     [0033] Reference is now made to FIG. 1, which illustrates a healthcare system  10 , constructed and operative in accordance with an embodiment of the present invention.  
     [0034] Healthcare system  10  may comprise one or more patient transporters  12  adapted to move a patient  14 , such as a physically challenged patient. Patient transporter  12  may comprise, without limitation, a wheelchair  16  or other ground vehicle, wall or ceiling-mounted patient manipulator  18  or a movable bed  20  (FIG. 2), for example. System  10  may also include one or more patient assist devices  22  that may perform one or more actions that assist patient  14 . Patient assist device  22  may be a multi-purpose device capable of many different operations or a simpler device dedicated to one or two functions only. Examples of patient assist devices are described hereinbelow.  
     [0035] Healthcare system  10  may comprise a controller  24  in communication with patient transporter  12  and patient assist device  22 . Controller  24  may coordinate interaction of patient transporter  12  with patient assist device  22 . Controller  24  may comprise, without limitation, a small microprocessor, a PC (personal computer), a mainframe computer or a server accessible through the Internet, for example. Controller  24  may reside physically near the patient transporter  12  and patient assist device  22  or may be remotely located and accessed by wired or wireless communication. Patient transporter  12  and patient assist device  22  may comprise appropriate sensors that communicate and work with controller  24  in a close loop control system to provide user-friendly control over healthcare system  10 .  
     [0036] In the exemplary embodiment illustrated in FIG. 1, healthcare system  10  may comprise a rest room assembly, which includes one or more movable sanitary fixtures, such as but not limited to, a movable sink  26  and a movable toilet  28 . Alternatively, either the sink  26  or toilet  28 , or both, may be stationary. Both sink  26  and toilet  28  may be moved vertically and horizontally, for example. Both sink  26  and toilet  28  may comprise a sensor  30  which may sense the position of patient  14  relative to the particular sanitary fixture. Sensor  30  may comprise part of a closed loop control system with controller  24 , wherein sensor  30  senses the position of patient  14 , sends the sensed spatial information to controller  24  and controller  24  adjusts the position of the sanitary fixtures to match the needs of the patient  14 . For example, the closed loop control system may assist the patient to rise from a wheelchair or other patient transporter  12  and move to toilet  28 , afterwards transfer to sink  26 , and patient assist device  22  may support the patient while standing before the sink, e.g., support the sides and back of the patient while standing. Controller  24  is shown in FIG. 1 as residing locally just outside the rest room, but may alternatively be located in the rest room or in some remote location or comprise a portable controller held or carried by the patient  14 .  
     [0037] Patient assist device  22  may alternatively or further comprise personal hygienic apparatus adapted to perform an action related to patient hygiene. For example, in the exemplary embodiment illustrated in FIG. 1, patient assist device  22  may comprise a robotic cleaning machine  32 , capable of cleaning and sanitizing the sanitary fixtures after use thereof. Robotic cleaning machine  32  may comprise a brush head  33  and cleaning and sterilizing fluid stored in a vessel  31 , or any other accessory for cleaning and sanitizing the sanitary fixtures.  
     [0038] For example, sink  26  may be moved vertically to adjust to the height of the patient  14 . Sink  26  may be moved (e.g., horizontally or tilted) towards patient  14  while sitting, so that patient  14  does not need to rise. In another example, if patient  14  approaches sink  26  while standing, sensor  30  may automatically adjust the position of sink  26  so that patient  14  may sit down next to or in front of sink  26 , thereby permitting patient  14  to use other sanitary fixtures with the outmost convenience and remain in close functional proximity to sink  26 .  
     [0039] In the exemplary embodiment illustrated in FIG. 2, healthcare system  10  may alternatively or further comprise other patient assist devices  22 . For example, patient assist device  22  may comprise a robotic device  34  that has grasping devices  37  and support members  38  for performing various duties, such as but not limited to, at least partially dressing or undressing patient  14  or taking care of patient personal items  36  (e.g., changing linen, propping pillows, etc.), or a washing head  35  for cleaning or washing parts of patient  14 . The patient assist devices  22  of the invention (such as but not limited to, wheelchair  16  or robotic device  34 ) may comprise a support member  38  that supports a load force of patient  14 . Support member  38  may, for example, support the back of patient  14  when patient  14  is getting in or out of bed  20 , or is standing or sitting in front of sink  26 . A sensor  40 , such as but not limited to, a load cell, may be provided to sense the load force on support member  38 . Sensor  40  may comprise part of a closed loop control system with controller  24 , wherein sensor  40  senses the load and controller  24  adjusts the supportive force of support member  38  to match the needs of the patient  14 .  
     [0040] For example, robotic device  34  may be employed to lift and support patient  14 , while performing various healthcare related activities, such as but not limited to, rearranging pillows or washing the patient&#39;s back or other body parts. For example, robotic device  34  may comprise support apparatus  75 , which may be built-in or attached to bed  20  (or may be separate from bed  20 ), which may support the weight of the patient  14 , assist the patient  14  to a reclining, sitting or even standing position, and which may help prevent the patient  14  from losing balance. For example, the support members  38  may support patient  14 , such as from behind on the patient&#39;s back, whether in a sitting or standing position with respect to the bed  20 , sink  26  or toilet  28 , thereby preventing the patient  14  from losing his/her balance.  
     [0041] As mentioned before, one of the patient assist devices  22  that may be included in healthcare system  10  is washing head  35  for cleaning or washing parts of patient  14 . Washing head  35 , although shown simplistically, in FIG. 2, together with such elements as controller  24  and related sensors, may be part of a system for providing assistance in performing basic hygienic functions in the bathroom. Such a system may provide a broad range of operations necessary for washing and massaging persons, especially physically challenged patients. The system may shower/wash and massage the patient while he/she is in a sitting or reclining position. The system may comprise washing devices that wrap around the patient, and appropriate sub-systems, which may be required for showering and massaging the entire body and which are brought as close as possible to the appropriate places on the patient&#39;s body. Controller  24  may comprise part of a user-interface to control operation of the system, controlling various functions, such as but not limited to, the patient position (sitting, standing or lying down), washing, drying, massaging, summoning additional help from healthcare personnel, prompting commands, etc. The controller function may be important in many aspects of the invention, such as but not limited to, ensuring that the washing and massaging devices do not come too close to the patient body, and providing other safety features. Some controller features are described hereinbelow, although the invention is not limited to these features.  
     [0042] Controller  24  may comprise a database (or memory)  42  of medical and personal behavior information of users of the system  10 . A card reader  44  may be provided in communication with controller  24 , which may read an identification (ID) card  46  issued to a user of the system  10 . ID card  46  may comprise, without limitation, a smart card. The system may permit entry and use only to authorized persons, identified by their ID card  46 . For example, as seen in FIG. 2, a door actuator  48  may be provided, which may be operable by ID card  46 . Door actuator  48  may permit opening or closing a door  50  only upon authentication of ID card  46 . The database  42  may be updated by means of ID card  46 , or vice versa. (Persons who may have difficulty inserting a card may have other ID devices, such as but not limited to, pressing buttons with a personal ID code.) Instructions to operate system  10  (for example, instructions for patient transporter  12 , patient assist device  22  or controller  24 ) may be provided by a patient command, such as but not limited to, a physically activated command (e.g., inserting ID card  46  into card reader  44 , or pressing buttons of a remote control  52 ) or a voice activated command. A storage medium  54 , such as but not limited to, a floppy disk, hard disk, compact disk or memory chip, may be provided for storing the instructions that enable controller  24  to coordinate interaction of patient transporter  12  with patient assist device  22 , in the various modes of operation, examples of which are described hereinbelow with reference to FIG. 3. The interaction between the patient  14  and the system  10  (e.g., by means of ID card  46 , remote control  52  or storage medium  54 ) may enable maneuvering patient  14  to and from the rest room or bedroom or into and out of wheelchair  16 , for example.  
     [0043] Reference is now made to FIG. 3, which illustrates examples of modes of operation of controller  24  and system  10 . In one embodiment of the invention, controller  24  may have a patient activated mode  60 , wherein patient assist device  22 , patient transporter  12  and/or controller  24  are operable by a patient command, e.g., voiced or physical commands from the patient. Controller  24  may have an automatic pilot mode  62 , wherein controller  24  initiates actions without a patient command, based upon information in database  42 . In automatic pilot mode  62 , healthcare system  10  may be sensitive to the current situation and operate accordingly even without a patient command.  
     [0044] Additionally, controller  24  may comprise an adjustment mode  64 , wherein controller  24  instructs patient assist device  22  to adjust the support to the patient  14  in accordance with the sensed load force, or to adjust the position of the sanitary fixture in accordance with the patient&#39;s needs.  
     [0045] Controller  24  may comprise a learning mode  66 , wherein controller  24  learns descriptors of a situation, stores the descriptors in memory or database  42 , and may be programmed to perform an action in response to the situation. For example, system  10  may be programmed to perform a daily morning routine, comprising helping patient  14  out of bed  20 , move to the rest room, use toilet  28 , wash up at sink  26 , and return to bed  20 .  
     [0046] Controller  24  may comprise an interactive mode  68 , wherein controller  24  requires a user to consult with healthcare system  10  before execution of a command. For example, the patient  14  or a healthcare provider (not shown) may issue a command to controller  24  and controller  24  may prompt the user with a query for further information. For example, controller  24  may query the patient  14  if the pillow has been adjusted sufficiently or if the patient  14  would like a glass of water.  
     [0047] Controller  24  may comprise an override mode  70 , wherein controller  24  may override a patient command. In this mode, the system  10  may be sensitive to the permissibility of certain operations in certain situations, and override the patient&#39;s commands. For example, if the patient pushes a wrong button on remote control  52 , or would like to perform an operation that does not match his/her physical capabilities, or issues a voice command physically inconsistent with the current situation, the system  10  may override and not carry out the command to avoid damage to the patient  14  or system  10 .  
     [0048] Controller  24  may comprise a call-for-assistance mode  72 , wherein controller  24  signals if patient  14  is too frail to do an action without further human assistance. For example, the healthcare system  10  may inform the patient  14 , such as by a voice message, that the requested action may require human assistance. The healthcare system  10  may itself summon the human assistance. Human personnel would then decide how to proceed.  
     [0049] Controller  24  may comprise a privacy mode  74 , wherein controller  24  locks the door  50  after patient  14  enters therein. Controller  24  may further comprise an emergency mode  76 , wherein controller  24  unlocks door  50  upon sensing an emergency situation. For example, in an implementation of the healthcare system  10  for a rest room, the system may automatically close the rest room entrance door  50  and not allow another person in, unless healthcare system  10  detects a medical or life-threatening emergency. Upon the user&#39;s exit, system  10  may close and/or lock door  50 , and reset the system&#39;s components. Controller  24  may also comprise a sanitary mode  78 , wherein controller  24  washes and disinfects items in the room after use thereof by the patient  14 . In this mode of operation, the rest room may appear as an ordinary rest room for standard use. In this manner, the system may avoid embarrassment and discomfort for the physically challenged patients.  
     [0050] It will be appreciated by persons skilled in the art that the present invention is not limited by what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of the features described hereinabove as well as modifications and variations thereof which would occur to a person of skill in the art upon reading the foregoing description and which are not in the prior art.