Abstract:
Disclosed embodiments include a telemedicine communication system designed to make possible “virtual” patient visits by approved visitors such as the spouse, family, and friends of the hospitalized patient having the appropriate digital certificate and visitation/communication permissions. According to one embodiment, the system enables relatives to visit hospitalized patients using audiovisual communication modalities selected according to the severity and health status of the patient. Additionally, the system provides functionality to enable approved relatives to follow the health status of the patient according to their permissions.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of U.S. Provisional Application No. 61/117,240 filed on Nov. 24, 2008 by the present inventors, which is incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Field of Invention 
     This invention relates to medical systems. Specifically, it relates to telemedicine systems. 
     2. Related Art 
     Telemedicine systems are well known. Several telemedicine systems have been proposed in research journals and patents. These systems are primarily designed to solve the problem of remote medical assistance. For instance, various systems have been designed to provide home-based remote medical assistance, home monitoring, and to involve remote medical experts for the purposes of providing care. However, none of the systems found in related art has been designed specifically to facilitate communication between the clinical provider, patients, and their families wishing to “visit” them while at remote locations. A system that makes possible rich life-like audiovisual communication between patients and their virtual visitors has a lot of potential to improve the quality of life for patients, families, and friends. 
     SUMMARY 
     The remote medical visitation system comprises: (a) a plurality of client access points for patients, relatives (virtual visitors), and clinicians; and these client access points comprise one or more audio-visual systems connected by a network upon completion of a secure authentication procedure; (b) a secure computer server running an integrated web-enabled platform supporting encrypted data transfer including a relational database to store user profiles, visitation protocols, user data, videoconferencing schedules, and communication information from a plurality of patients, relatives, and clinicians; and (c) a plurality of software modules including a plurality of graphical user interfaces for control, planing, communication activation, and report creation. According to a particular embodiment, the software modules include a module to manage and program a communication protocol between patients and their virtual visitors depending on a patient&#39;s health status. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Disclosed embodiments are illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings. 
         FIG. 1  illustrates a block diagram representing the main modules of the remote visitation system according to one embodiment. 
         FIG. 2  illustrates an example of a system architecture according to one embodiment. 
         FIG. 3  illustrates a block diagram representing the access modalities to the system according to the user profile. 
     
    
    
     DETAILED DESCRIPTION 
     As shown in  FIG. 1 , according to one embodiment the remote medical visitation system comprises: (a) a plurality of client access points for patients, relatives (virtual visitors), and clinicians  102 ; and these client access points comprise one or more audio-visual systems connected by a network upon completion of a secure authentication procedure; (b) a secure computer server  100  running an integrated web-enabled platform supporting encrypted data transfer including a relational database  104  to store user profiles, visitation protocols, user data, videoconferencing schedules, and communication information from a plurality of patients, relatives, and clinicians; and (c) a plurality of software modules  106  including a plurality of graphical user interfaces  108  for control, planing, communication activation, and report creation. According to a particular embodiment, the software modules include a module to manage and program a communication protocol between patients and their virtual visitors depending on a patient&#39;s health status. 
     In one embodiment the system comprises a computer server that runs an integrated web-enabled platform designed for audio-visual web communication and a plurality of clients equipped with networked audio-visual systems. It supports encrypted data transfer through standard encryption protocols. A relational database such as MySQL is used to store user profiles, protocols, user data, videoconferencing schedules, and communication information from patients, doctors, and relatives. The multi-platform system is built to include security, backups, and redundancy. All users are authenticated and the data is carefully controlled to ensure compliance with federal regulatory requirements such as the Health Information Portability and Accountability Act (HIPAA). 
     According to one embodiment, the system includes modules for control, planning, communication activation, and report creation for the health-care providers. The system includes a comprehensive digital health information management module, and a communication plan for direct communication with family members according to their permissions through web, SMS, email, and substantially equivalent technologies. 
     According to one embodiment, the system includes a module to manage and program the communication protocol between patients and their virtual visitors depending on their health status (e.g. full video conference, partial image video conference, image only, video off, etc). Additionally, the system provides the capability for the health professionals in charge of patient care to monitor the virtual visits in order to avoid visitations during real-time health complications and other inappropriate times. 
     According to one embodiment, the system includes a client application for approved visitors that upon installation enables for secure communications with the health professionals and patient according to a pre-programmed visitation protocol established by the hospital. 
     According to one particular embodiment, and without limitation, the server accepts video conference petitions and makes them possible using asterisk and MeetMe/Confiance plug-ins. The system reports use a local MySQL database that is only accessible by the server. The communication between the client and the server is implemented using RMI technology programmed in JAVA or a substantially equivalent language. The server publishes the methods that each user can access and access the secure local database as required. The video conference system employs the SIP protocol over a PBX voice over IP central, Asterisk. Using the MeetMe and Confiance plug-ins the system is capable of establishing video conferences from the software client or any other device with VoIP capabilities. Furthermore, Asterisk enables for establishing pathways to the basic phone network and mobile networks. 
     The following descriptions explain how each type of user may use the communication platform; the system includes modules to accommodate each of these uses. In one embodiment, a clinical module is especially adapted to enable clinicians to: 1) manage the system users (patients, relatives, friends) and enable the use of the virtual visitation system during the hospitalization period; 2) generate reports of the clinical status, action plans, external communications with approved family members with access to such information and automatic transmission of these reports by SMS or email; 3) have access to the history of reports, communication to family and management of these; 4) program the virtual visitations sessions including dates, times, multimedia options (video, audio, text) and manage them according to the patient recovery; 5) perform real-time monitoring of active visits in order to provide clinical supervision when needed; and 6) access to the patient webcam in order to capture images and video to be sent to family members in situations where real-time full video conference visitations are not allowed due to patient condition or other reasons. 
     According to one embodiment, the communication system includes a relatives and friends module especially adapted to enable relatives (family visitors, friends, etc) to: 1) access the system upon downloading and installing the client application upon secured identification using a digital certificate as approved visitors with corresponding permissions; 2) access historical health reports generated by the health providers or general health status depending on the level of permissions; 3) access the visitation calendar (dates, times) programmed by the clinical staff according to the visitation schedule and patient condition; 4) video conference access in real-time during scheduled times according to the modality selected by the clinical staff (i.e. full video/audio, partial video/audio, audio, text); and 5) access to said multi-media material such as photographs, pre-recorded video and upload multimedia materials (pictures, videos, audio, etc) for the patient to the multimedia space. The patients module is especially adapted to enable patients with different conditions to access the video conference and communication system and communicate with family, relatives, and friends. 
       FIG. 2  illustrates an example of the system architecture according to one embodiment. In this embodiment, the clinicians&#39; client access point  201 , the relatives&#39; client access point  202 , and the patients&#39; client access point  203  are connected to a communication network  200  with access to a central server  204  through a secure firewall  205 . Each user goes through a user-specific authentication procedure  206  and has a user-specific interface  207 . According to this embodiment the system components comprise a central server  204 , a database to store raw data  208 , a user database  209 , an audio/video conferencing system  210 , and an automatic reports generator engine  211 . 
       FIG. 3  illustrates an example of a access to the system according to one embodiment. In this embodiment, a particular clinicians&#39; client access point  301  and patients&#39; client access point connect to the server  300  and the system components described in  FIG. 2 , through a secure firewall  304  using a Intranet network  303 . The relatives client access point  307  connects to the server  300  and the system components described in  FIG. 2  through a secure firewall  305  using the Internet  306  and the EDGE, GSM, 3G, 4G, WIMAX or substantially equivalent networks  308 . According to one embodiment the system automatically sends clinical reports by SMS and substantially equivalent technologies to the mobile phone of the approved relatives. Each client access point comprises a hardware system with one or more processors, audio capability (e.g. microphone), an optional video monitoring system (e.g. a video camera), and network connectivity. 
     According to one embodiment the proposed system is designed to comply with protocols used by the military in order to allow family members to visit and support hospitalized soldiers during their recovery period. According to a particular embodiment the secure computer server includes secure communications protocols especially adapted to comply with military security standards including protocols substantially equivalent to the Secure Communications Interoperability Protocol (SCIP). Other embodiments include additional secure communications protocols such as FNDT, STU-III, and STE. 
     While particular embodiments and example results have been described, it is understood that, after learning the teachings contained in this disclosure, modifications and generalizations will be apparent to those skilled in the art without departing from the spirit of the disclosed embodiments.