Method and apparatus for health and disease management
Contents
1. 1 9 914 y 5 NOILVOI1ddV SANAS UOSNAS yez Q3AQOT1dW3a WBUSAS IV 922 9 3SNOdS3Y YILIWYYYd aaa S3LVINITVI zz i a YIAYIS YHOSN3IS NOILVINIddV 324005 VIVO TWNUaLXa 4 Patent Application Publication Nov 10 2005 Sheet 7 of 8 US 2005 0250995 1 o gt gt gt o o 2 SS 52 FIG 7 op L lt Patent Application Publication Nov 10 2005 Sheet 8 of 8 NN RN SEEN SSSIS lt ES 52 an A eae gt 1 lt US 2005 0250995 1 FIG 8 US 2005 0250995 1 METHOD AND APPARATUS FOR HEALTH AND DISEASE MANAGEMENT COMBINING PATIENT DATA MONITORING WITH WIRELESS INTERNET CONNECTIVITY CROSS REFERENCE TO RELATED APPLICATIONS 0001 This application is a continuation of co pending U S patent application Ser No 09 738 270 filed on Dec 15 2000 entitled Method and Apparatus for Health and Disease Management combining Patient Data Monitoring with Wireless Internet Connectivity which claims priority benefit of U S Provisional Patent Application Ser No 60 172 486 filed Dec 17 1999 enti2. 802 16 and Bluetooth communication schemes
3. United States Quy US 20050250995A1 Patent Application Publication Pub No US 2005 0250995 1 43 Pub Date Nov 10 2005 54 METHOD AND APPARATUS FOR HEALTH AND DISEASE MANAGEMENT COMBINING PATIENT DATA MONITORING WITH WIRELESS INTERNET CONNECTIVITY 76 21 22 63 60 51 Inventor Roger J Quy Mill Valley CA US Correspondence Address MAYER FORTKORT amp WILLIAMS PC 251 NORTH AVENUE WEST 2ND FLOOR WESTFIELD NJ 07090 US Appl No Filed 55 11 184 274 Jul 18 2005 Related U S Application Data Continuation of application No 10 418 845 filed on Apr 18 2003 now Pat No 6 936 007 which is a continuation of application No 09 738 270 filed on Dec 15 2000 now Pat No 6 602 191 Provisional application No 60 172 486 filed on Dec 17 1999 Publication Classification A61B 5 00 GO6K 9 62 A61B 10 00 o nas o mme lt 8 mean i mee 52 0 8 600 300 128 903 128 904 128 923 57 ABSTRACT Embodiments of the invention provide a method and appa ratus for a wireless health monitoring system for interac tively monitoring a disease or health condition of a patient by connecting an internet enabled wireless web device WWD to a health monitoring device which may be a medical device or other health related device such as an exercise machine The WWD may be connected
4. a respiratory monitor a tem perature or heart rate monitor and so on 0044 Ina healthy lifestyle management embodiment an HMD may be an exercise machine including treadmills rowers steppers exercise cycles or other aerobic or anaero bic exercisers or a monitor include monitors for tempera ture heart rate blood pressure amount of work or rate of work performed etc 0045 The term subject as used herein primarily indi cates a human subject The same may be a medical patient under physician care a person interested in maintaining health via accurate recording of nutrition and exercise and so on The term user is generally used to refer to the user of the device which may be synonymous with the subject or may alternatively be a caregiver of the subject etc The term patient is used in addition to a person under the care of a physician to also refer to a normal or healthy individual who is interested in maintaining a healthy physiologic balance 0046 The term signal communication is used to mean any type of connection between components where the connection is e g electromagnetic and where the connec tion allows information to be passed from one component to another This term may be used in a similar fashion as coupled connected information communication data communication etc The following are examples of signal communication schemes As for wired techni
5. application from an implantable medical device via a wireless RF connection transmitting data corresponding to the health parameter or measurement to a server via the internet 10 The method of claim 9 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 11 The method of claim 9 wherein the implantable medical device is selected from the group consisting of cardiac monitors heart rate monitors blood pressure moni tors respiratory monitors temperature monitors blood glu cose monitors and combinations thereof 12 The method of claim 9 further comprising connecting an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable medical device 13 A method of using a device to monitor health com prising running an application on an mobile or satellite phone or wireless PDA Nov 10 2005 accepting a health parameter or measurement into the application from an implantable medical device via a wireless RF connection transmitting data corresponding to the health parameter or measurement to a server via the mobile phone or wireless PDA via a mobile or satellite phone network 14 The method of claim 13 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 15 The method of claim 13 where
6. it is generally too expensive for a consumer physi ological monitoring system and there are many people who find it too complicated to set up and use for that purpose High risk chronically ill patients responsible for more than half of health care costs in the United States and forming the fastest growing segment of those requiring health care are indeed the most likely not to be able to afford or use a system built around a personal computer In addition such systems are limited in their interactivity to the information stored on the CD 0007 Previous patents by the Inventor addressed both of these disadvantages as well as the need to reduce health care costs through providing educational health care information Nov 10 2005 and interactive physiological monitoring in the home envi ronment by means of a user friendly interactive system see e g U S Pat Nos 5 601 435 6 144 837 and continuations thereof 0008 These previous patents were based on a video game console or a multimedia player using a conventional tele vision screen as the display device to achieve a system which is simpler to use than systems based on a personal computer An initial embodiment of the previous patents utilized a compact disc to provide interactive information for disease management 0009 Even with the advantages provided these systems limited the user to location in which the device was located Even where devices are portable as i
7. such that the application functions to accept a health parameter or measurement from the implantable infu sion pump via the wireless RF connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via the internet or via a mobile or satellite network to a server 47 The device of claim 46 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 48 The device of claim 46 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable infusion pump 49 A device for monitoring health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone having a port for communications with an implantable medical device via a wireless RF connection such that the application functions to accept health param eters or measurements corresponding to temperature cardiac pressure and heart rate from the implantable medical device via the wireless connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via the internet to a server 50 The device of claim 49 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable medical device 51 A device for monitorin
8. The method of claim 40 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 42 The method of claim 40 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable blood glucose monitor 43 A method of using a device to monitor health com prising running an application on an internet enabled mobile or satellite phone or wireless PDA accepting a health parameter or measurement into the application from an implantable infusion pump via a wireless connection transmitting data corresponding to the health parameter or measurement to a server via the internet or via a mobile or satellite network US 2005 0250995 1 10 44 The method of claim 43 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 45 The method of claim 43 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable infusion pump 46 A device for monitoring health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone or wireless PDA having a port for communications with an implantable infusion pump via a wireless RF connec tion
9. may vary For example the connection may be wired or wireless For wired systems the connection may be direct or an adaptor may be employed either on one or both ends of the direct wired connection to adapt the signal appropriately In the same way for wireless systems the connection may be direct if both HMD and WWD employ the same wireless protocol or an adaptor may be involved to modify the signal of one or both devices These connections all of which are encompassed by the present invention are discussed in more detail below 0090 Referring to FIG 7 an embodiment of the con nection is shown In this figure a hardware or wired connection is shown 1 an adaptor 168 disposed between a HMD 160 and a WWD 162 In most circumstances it is assumed that the varieties of HMDs will vary more widely than the varieties of WWDs Accordingly HMD 160 will likely have one of a variety of types of connectors for input output purposes here shown as a connector 164 Connector 164 mates with a connector 172 of adaptor 168 At another point on adaptor 168 is a connector 172 for connecting to a generic input output port 164 on WWD 162 A cable 170 is disposed between the two connectors cable 170 capable of including adaptor circuitry if desired 0091 Of course the use and structure of adaptor 168 between HMD 160 and WWD 162 depends on factors such as the prevalence of an industry standard for such commu nications In othe
10. pesceoscedzonsssees 145 OL Y3LINVAVd 95 SI 3SNOdS3 3 SONAS 29130 ANAND NO 3SNOdS3Y ugaas L i 821 aoaaa OL 3SNO4SIY IVAN SONAS YIAYIS OL YILINVYUVA NOILVOIddV SGN3S YOSNAS G3AO134W3 WALSAS IV lt 5 3SNOdSIY YILINVEVA lt 5 6 saunsv3w ze YIAYIS YOSN3S NOILVOI1ddV 3ounos IWNYALX3 5 bh assa90ud YIAYIS 5 SON3S Yasn DIA US 2005 0250995 1 Patent Application Publication Nov 10 2005 Sheet 6 of 8 eT ON 1 325 7 2 722 YILIMNVUVd 334435 535529099 OLV ivd lt WALN3SW31ddNS NOLLVOMIddV SON3S Y3SN 1474 OLYILIAVUVA SALVOINNWWOS 852 A1SS3138LA I asnoasau dO N3uVd ove SHIXLLON ONM ASHVIO3dS SLOVUALNI o wasn 4 H 922 052 qaAv1dsia oruarawyvuvd gez SI 3SNOdS3Y SANAS INIHOVIN yaindwoo 3SION3X3 Nano NO SAWIASIO 20 5 822 8 INIHIVIA 01 3SNOJSIY 3SIOYIXI SONAS Y3AYIS OL
11. 6 The method of claim 34 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable respiratory monitor 37 A method of using a device to monitor health com prising running an application on an internet enabled mobile or satellite phone or wireless PDA accepting a health parameter or measurement into the application from an implantable temperature monitor via a wireless connection transmitting data corresponding to the health parameter or measurement to a server via the internet or via a mobile or satellite network 38 The method of claim 37 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 39 The method of claim 37 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable temperature monitor 40 A method of using a device to monitor health com prising running an application on an internet enabled mobile or satellite phone or wireless PDA accepting a health parameter or measurement into the application from an implantable blood glucose monitor via a wireless connection transmitting data corresponding to the health parameter or measurement to a server via the internet or via a mobile or satellite network 41
12. 96 82 usasosisn Ag 90 SNOW Sesa PA nananman Patent Application Publication Nov 10 2005 Sheet 3 of 8 US 2005 0250995 1 APPLICATION 62 BASE STATION FIG 3 US 2005 0250995 1 q zs _ Patent Application Publication Nov 10 2005 Sheet 4 of 8 5 2 0 NOI LVOI1ddV 3 1 1 t by 2 y t 8 t a a 1 3 1 4 1 1 1 4 K TL i iii ii ta 89 NOILVLINASSY d a g l a YN ae A viva WALSAS WWNY3 LX3 al 22274 A tes bi eb us canal Wa aaa a a OF zz SNIVUVAdY 3 ONIYO LINOW 559373 US 2005 0250995 1 Patent Application Publication Nov 10 2005 Sheet 5 of 8 E 52 l 9 NOILY NddY Zeb udAuas OL YU3LINVYVd SALVIINNANOD AISSITIYIM 3SNOJS3IY dHOLNALLVd Orb SHIJILON GMM _NVIOISAHd IM SLOWYSLNI wasn ozh OMM
13. D 11 which may include an optional monitor screen 40 coupled via an optional adaptor 42 to a WWD 12 WWD 12 connects wirelessly via an antenna 60 to base station 15 see FIG 1 One function of WWD 12 is to provide the user interface other functions are described below 0051 As noted above HMD 11 may include physi ologic sensor 24 or may include a manual system 36 for input of physiologic data via a connection 34 Manual system 36 may also be used to input data directly into WWD 12 via a connection 32 Manual system 36 may include e g a keyboard 30 a mouse 26 a pen type device 28 and may also employ a separate monitor not shown Of course the user may also view information on monitor 40 or on a screen 41 of WWD 12 In many embodiments the stylus based system employed by many current PDA s such as the Palm may be preferred for such manual data input 0052 Data may also be input via entry on a computer 37 This data may then be synchronized to WWD 12 in known fashion Alternatively computer 37 or another computer see computer 37 in FIG 4 may be used to connect to a server using the wired internet This use may be particularly advantageous when entering a large amount of data such as a patient s medical history As noted above in this way the patient may be afforded a more convenient environment in which to manipulate data to supplement the data input to the WWD 0053 It will be clear to one of skill in the
14. D 160 connector 164 may vary more widely It is noted that certain exercise machines are equipped with DB9 or DB25 RS232 serial connectors In this case the pin outs are for a DB25 Pin Name Function 1 Protective shielded ground 2 TD Transmit Data a k a TxD Tx 3 RD Receive Data a k a RxD Rx 4 RTS Request To Send 5 CTS Clear To Send 6 DSR Data Set Ready 7 SGND Signal Ground 8 CD Carrier Detect a k a DCD 9 Reserved for data set testing 10 Reserved for data set testing 11 Unassigned 12 SDCD Secondary Carrier Detect 13 5 5 Secondary Clear to send 14 STD Secondary Transmit Data 15 DB Transmit Clock a k a TCLK TxCLK 16 SRD Secondary Receive Data 17 DD Receive Clock a k a RCLK 18 LL Local Loopback 19 SRTS Secondary Request to Send 20 DTR Data Terminal Ready 21 RL SQ Signal Quality Detector Remote loopback 22 RI Ring Indicator DCE raises when incoming call detected used for auto answer applications 23 CH CI Signal Rate selector 24 DA Auxiliary Clock a k a ACLK 25 Unassigned 0094 A connection may simply be made by providing optional adaptor 168 with adaptor circuitry such as within cable 170 or within a circuit box therein so as to match up the appropriate or complementary pins 0095 In other embodiments such as for devices con nected to proprietary connectors a less standard and perhaps proprietary pin out may be required 0096 Referring to FIG 8 an embodiment of a wireless implemen
15. art given this teaching that cable 32 as well as cables 34 and 44 may be replaced with wireless circuitry to communicate signals wirelessly 0054 For medical devices and applications physiologic sensor 24 may include e g a sensor appropriate for mea suring blood glucose levels blood pressure heart rate or any other desired parameter as required by the physician Sensor 24 may connect via an optional cable 44 to subject 38 Alternatively sensor 24 may be distal of HMD 11 1 at or within subject 38 In other words if cable 44 is employed sensor 24 may be proximal or distal of cable 44 If a wireless communications capability is added sensor 24 need not physically connect with HMD 11 or WWD 12 at all That is the same may measure a health parameter and may communicate the same to wireless health monitoring apparatus 10 wirelessly The short range wireless commu nications schemes which may be employed include infrared radio frequency including Bluetooth or 802 11 or other such schemes 0055 As examples of sensor types to measure blood glucose levels sensor 24 may be a sensor that accepts a drop Nov 10 2005 of blood e g via a finger prick To measure heart rate sensor 24 may be placed via an adhesive sensor disposed on the chest Other health monitors may also be employed so long as the measured data may either be transferred to WWD 12 e g via optional adaptor 42 described in further detail below or by bei
16. atient or subject may also input data manually such as by a stylus keypad synchro nization from a PC or by various other techniques discussed below 0025 A major advantage of the invention is that by use of an optional adaptor the system is compatible with current and prior HMDs as well as maintaining a capability of adapting to future such systems 0026 Other advantages of the invention may include or more of the following An embodiment of the invention may be used when a patient is traveling or otherwise away from their wired means of communication The invention allows wireless health monitoring to the level of accuracy previously achieved only by desktop so called wired computer systems The invention is protocol independent 0027 The interaction between a WWD and a back end server may provide a major additional advantage in certain embodiments of the invention In particular the relatively small amount of memory currently provided on a WWD as compared to a back end server severely limits the function ality of applications running on the WWD especially in terms of computing capacity processing power and user interface By providing significant application functionality on the back end less memory and processing capabilities become necessary on the WWD 1 on the front end Thus memory may be used in the WWD for an enhanced user interface or for other purposes according to the user requirem
17. cise machine or into the WWD This parameter may correspond to an amount of exercise performed an amount of food con sumed etc 0083 Calculations by the application server may also take into account supplemental data sent by the user to the server e g in a wired fashion directly over the internet step 241 0084 The application server processes the parameter step 224 and optionally step 225 and calculates a response step 226 based at least in part on the parameter The application server may optionally employ external data step 232 or an Al system step 234 in the calculation The application server then sends the response to the WWD step 228 where the response is displayed 0085 The same definitional statements regarding the terms response calculate sensor etc as given before apply in this embodiment as well 0086 As an optional step a health specialist may notify the patient or subject of the response step 238 after having the same displayed on their client computer step 236 The health specialist may be replaced in this example by an application that may also include an algorithm Nov 10 2005 0087 Adaptor Hardware 0088 description is given below of a particular type of adaptor hardware As noted above the adaptor may option ally be used to connect a HMD to a WWD 0089 In general a connection is necessary between a HMD 11 and a WWD The nature of this connection
18. cols for data communication are known However they currently vary amongst known tech niques The present invention is not limited to any particular protocols and may be implemented in any languages sup ported by the WWD and server Of course as computing capabilities continue to increase it is expected that the capabilities of WHMA 10 servers 18 and 22 as well as application 62 and client 44 and other components will correspondingly increase 0059 Application 62 running on server 22 may interact with WHMA 10 in a number of ways Referring to FIG 4 WHMA 10 is shown in signal communication with server 22 via a connection 72 Connection 72 schematically represents the wireless Internet connection and intervening pathways WHMA 10 includes an application that may be viewed as having two components a base wireless or device applica tion 70 and an application presentation layer or user inter face 68 User interface 68 is employed to e g present a menu of options to the user to allow the user to choose inputs and to generally operate the device User interface 68 may vary widely in sophistication e g from a simple data entry field to a full graphical user interface These applica tions may accept as inputs data from a sensor 24 as well as from a manual input 36 0060 Server 22 has base server application 62 with which the same calculates or provides a response based at least in part on data from WHMA 10 Application 62 ma
19. device to monitor health com prising running an application on an mobile or satellite phone or wireless PDA accepting health parameters or measurements correspond ing to temperature cardiac pressure and heart rate into the application from an implantable medical device via a wireless RF connection transmitting data corresponding to the health parameters or measurements to a server via the mobile phone via a mobile or satellite phone network 56 The method of claim 55 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable medical device 57 A device for monitoring health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone or wireless PDA having a port for communications with an implantable blood glucose monitor and an implantable infusion pump via a wireless RF connection such that the application functions to accept a health parameter or measurement from the implantable blood glucose monitor via the wireless RF connection such that the application functions to transmit data cor responding to the accepted health parameter or mea surement to a server and such that the application functions to control the implant able infusion pump based at least in part on the accepted health parameter or measurement 58 The device of claim 57 wherein the wi
20. e cardiac monitor 21 A device for monitoring respiratory health compris ing an internet enabled mobile or satellite phone or wireless PDA running an application the phone having a port for communications with an implantable respiratory monitor via a wireless RF connection such that the application functions to accept a health parameter or measurement from the implantable respi ratory monitor via the wireless RF connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via the internet or via a mobile or satellite network to a server 22 The device of claim 21 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 23 The device of claim 21 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable respiratory monitor 24 A device for monitoring health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone or wireless US 2005 0250995 1 PDA having a port for communications with an implantable temperature monitor via a wireless RF connection such that the application functions to accept a health parameter or measurement from the implantable tem perature monitor via the wireless RF connection and such that the application functions to transmit data co
21. ents 0028 In a method according to an embodiment of the invention the patient connects to a specific Internet site and a software program resident on a remote server located on the Internet downloads an interactive user interface for that patient and an application for the measurement of the physiological data The software may also be downloaded to the WWD from a personal computer via a synchronization operation in known fashion The software provides a per US 2005 0250995 1 sonalized display for the user and configures the WWD to control and monitor devices connected via a generic input output port to the WWD The software may be designed to suit the constraints of the small display screens of WWDs The software as well as inputs from the patient or other inputs can control the manner content and display of information presented to the patient and measured or input data can be stored for review by a health care provider or by a software algorithm or application The algorithm may be of varying complexity from a simple program that merely acknowledges receipt of information to an artificial intelli gence algorithm such as an expert system collaborative filtering system rules based system case based reasoning system or other such artificial intelligence application 0029 Further information may be provided to or from the patient including information entered manually The patient may input this information via a perso
22. g health comprising A mobile or satellite phone or wireless PDA running an application the phone having a port for communica tions with an implantable medical device via a wireless RF connection such that the application functions to accept health param eters or measurements corresponding to temperature cardiac pressure and heart rate from the implantable medical device via the wireless connection and such that the application functions to transmit data cor responding to the accepted health parameters or mea surements via a mobile or satellite network to a server 52 The device of claim 51 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable medical device 53 A method of using a device to monitor health com prising Nov 10 2005 running an application on an internet enabled mobile or satellite phone or wireless PDA accepting health parameters or measurements correspond ing to temperature cardiac pressure and heart rate into the application from an implantable medical device via a wireless RF connection transmitting data corresponding to the health parameters or measurements to a server via the internet 54 The method of claim 53 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable medical device 55 A method of using a
23. health monitoring system according to the present inven tion 0036 FIG 4 illustrates a data flow diagram according to an embodiment of the present invention 0037 FIG 5 illustrates an embodiment of a method of use for a wireless application and a server application according to the present invention in which the same is implemented for disease and patient management 0038 FIG 6 illustrates an embodiment of a method of use for a wireless application and a server application according to the present invention in which the same is implemented for health management Nov 10 2005 0039 FIG 7 illustrates an embodiment of a wired con nection between a HMD and a WWD also showing an optional adaptor and 0040 FIG 8 illustrates an embodiment of a wireless connection between a HMD and a WWD also showing an optional adaptor DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 0041 Various acronyms are used for clarity herein Defi nitions are given below 0042 The term HMD may encompass not only devices with physiologic sensors but also devices with a keypad keyboard mouse pointer pressure sensor or other such inputs that the patient or user may employ to perform data entry of the desired parameters In general HMDs include some means for determining a health parameter 0043 In a disease management embodiment an HMD may be a blood glucose monitor a blood pressure monitor an ambulatory ECG recorder
24. in the implantable medical device is selected from the group consisting of cardiac monitors heart rate monitors blood pressure moni tors respiratory monitors temperature monitors blood glu cose monitors and combinations thereof 16 The method of claim 13 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable medical device 17 A device for monitoring cardiac health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone having a port for communications with an implantable cardiac moni tor via a wireless RF connection such that the application functions to accept a health parameter or measurement from the implantable car diac monitor via the wireless RF connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via the internet or via a mobile or satellite network to a server 18 The device of claim 17 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 19 The device of claim 17 wherein the implantable cardiac monitor monitors heart rate or blood pressure 20 The device of claim 17 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantabl
25. n from the same AI system 76 may employ e g case based reasoning rules based systems collaborative filtering neural networks expert systems or other such systems as are known 0064 It should also be noted that each of application 62 algorithm 63 external data source 74 or AI system 76 may physically reside on more than one server e g on an array of servers for e g storage or multiple processing purposes Each of application 62 algorithm 63 external data source 74 or AI system 76 or combinations of each may also respectively reside on different servers 0065 The extent to which server application 62 interacts with wireless application 70 depends on the use to which the system is put For example in a less interactive embodiment device application 70 may act to measure a diabetic patient s blood glucose level and report the same to server application 62 In this case a physician may simply review the measured value and send the patient an email reporting that the value is acceptable or not In a highly interactive embodiment a patient may have numerous HMDs 11 connected via optional adaptors to a WWD 12 and wireless application 70 may correspondingly send a large amount of health data to server application 62 The physician accessing server appli cation 62 may in turn send detailed care plans to a caregiver via connection 72 The received data may be analyzed using algorithm 63 external data source 74 and AI s
26. n the case of a laptop computer with a modem an ordinary POTS phone line must be found and used Where the user s computer employs a broadband connection such as DSL or satellite the choices of location are even more limited 0010 Attempts have been made to remedy this defi ciency For example many telemetry systems allow a wire less distance to be placed between a health measuring unit and a remote monitoring system However such systems are limited in their range 0011 Other systems have used cellular telephone tech nology to increase the wireless health monitoring range However these systems have several deficiencies such as requiring significant modification of the mobile phone For example U S Pat No 5 772 586 issued Jun 30 1998 to Heinonon et al discloses a method for monitoring the health of a patient This system uses a specialized connec tion between the patient health measuring unit and the cellular phone however The patient health measuring unit is located in the battery space of the mobile phone and is connected to a communication bus of the mobile phone Other systems have been proposed but these suffer from similar deficiencies in that they are not designed to be used with off the shelf wireless devices or health measuring equipment 0012 The deployment of the above systems also cur rently lacks employment of full back end server function ality with which to provide a wide range of in
27. nal computer which then may download the input information to the WWD via a synchronization operation using standard protocols such as those for Palm PDA devices 0030 The user may also input supplemental information via a PC connected independently to the server via the internet Such supplemental information may include data that is difficult or inconvenient to input on the WWD In this way the patient may be afforded a more convenient envi ronment in which to manipulate data to supplement the data input to the WWD The deployment of voice processing technology may be used to enable an even more convenient user interface 1 one to which patients can talk 0031 In all of these respects the portable aspect of the WWD is important to wit the user may conveniently carry the WWD on their person wherever they may go allowing data entry at the time needed 0032 Other aspects features and advantages will be apparent from the summary above as well as from the description that follows including the figures and the claims BRIEF DESCRIPTION OF THE DRAWINGS 0033 FIG 1 illustrates a general embodiment of a wire less health monitoring system according to the present invention 0034 FIG 2 illustrates an embodiment of a wireless health monitoring apparatus according to the present inven tion showing the system of FIG 1 up to a point of a wireless antenna 0035 FIG 3 illustrates an embodiment of a back end of a
28. ng read by a user e g from a display and manually input to WWD 12 Alternatively the measured data may be transferred to WWD 12 via wireless commu nication schemes such as RF includes Bluetooth or 802 11 infrared optical microwaves etc directly from sensor 24 or from HMD 11 as described in greater detail below 0056 The user who may or may not be the same person as subject 38 may input data to WWD 12 from history or experience For example in a health or exercise device if subject 38 consumes a known number of calories this information may be entered via manual system 36 directly into WWD 12 or into HMD 11 Further the user the subject and the sensor are not necessarily the sole sources of information Data stored on the server or on a separate server operated for health management may also be employed to result in a health benefit to subject 38 0057 Referring to FIG 3 WHMA 10 is shown commu nicating wirelessly with the Internet In doing so WHMA 10 generally sends a wireless signal to a base station 14 in known fashion that is connected to a server 18 that is in signal communication in known fashion with the internet Server 18 communicates via a protocol in known fashion to Internet 20 which also communicates via a protocol in known fashion to a server 22 running an application 62 Server 22 may be accessed in known fashion by a client computer 44 through a connection 64 0058 As noted the proto
29. nto a WWD transmitting the same wirelessly to the server and receiving a recom mendation from the server The recommendation may be based on the food and also on data or information that had previously been transmitted wirelessly including data from a blood glucose monitor data input manually if any as well as data from algorithm 63 external data source 74 and AI system 76 0078 Example Employing System for Health Manage ment Using a General Exercise Machine 0079 Referring to FIG 6 an example is given for a system of health nutrition and or exercise management In this example the HMD is an exercise machine as that termed has been defined above 0080 The program is started step 242 and a sensor measures a health parameter step 216 where the health parameter corresponds to health fitness nutrition exercise etc The sensor may send the parameter to the exercise machine step 218 It is understood here that the sensor may be e g a blood pressure monitor but may also be a simple device connected to an aerobic exerciser that tracks miles ran work performed etc 0081 The exercise machine then sends the parameter to the WWD step 220 The WWD wirelessly communicates the parameter to the application server step 222 e g via the wireless web 0082 An alternative and complementary way of entering the parameter is by user input step 248 For example the user may enter the parameter into the exer
30. omprising running an application on an internet enabled mobile or satellite phone or wireless PDA accepting a health parameter or measurement into the application from an implantable cardiac monitor via a wireless RF connection transmitting data corresponding to the health parameter or measurement to a server via the internet or via a mobile or satellite network 31 The method of claim 30 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 32 The method of claim 30 wherein the implantable cardiac monitor monitors heart rate or blood pressure 33 The method of claim 30 further comprising connect ing an adaptor to the internet enabled mobile or satellite phone or wireless PDA to enable communication with the RF signal from the implantable cardiac monitor 34 A method of using a device to monitor health com prising running an application on an internet enabled mobile or satellite phone or wireless PDA Nov 10 2005 accepting a health parameter or measurement into the application from an implantable respiratory monitor via a wireless connection transmitting data corresponding to the health parameter or measurement to a server via the internet or via a mobile or satellite network 35 The method of claim 34 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 3
31. ques a standard bus or serial cable may be used if the input output ports are compatible and an optional adaptor may be employed if they are not As for wireless techniques IR microwaves RF e g Bluetooth or 802 11 protocols opti cal techniques including lasers and other such techniques may be used The patient or subject may even input data manually such as by a stylus or keypad or by various other techniques discussed above and below 0047 The term generic input output port is used to mean any type of convention standard universal stock consumer or off the shelf type of port for data input and output These may include both wired and wireless ports A further description is given below US 2005 0250995 1 0048 Various embodiments of the invention are now described in more detail 0049 Referring to FIG 1 a system of the present invention is shown for monitoring health data from a patient or subject 38 The system includes a wireless health moni toring apparatus WHMA 10 described in further detail below WHMA 10 is linked in a wireless fashion to a wireless connection point of presence POP 19 the same including at least a base station antenna 15 coupled to a server 17 Server 17 is in turn connected to the wired or even a wireless not shown Internet 21 which may include the World Wide Web 0050 Referring to FIG 2 an first embodiment of WHMA 10 is shown WHMA 10 includes an HM
32. r responding to the accepted health parameter or mea surement via the internet or via a mobile or satellite network to a server 25 The device of claim 24 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 26 The device of claim 24 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable temperature monitor 27 A device for monitoring health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone or wireless PDA having a port for communications with an implantable blood glucose monitor via a wireless RF connection such that the application functions to accept a health parameter or measurement from the implantable blood glucose monitor via the wireless RF connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via the internet or via a mobile or satellite network to a server 28 The device of claim 27 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 29 The device of claim 27 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable blood glucose monitor 30 A method of using a device to monitor cardiac health c
33. r that of wired computer television or even wireless telemetry systems Nov 10 2005 0021 Ina first embodiment of the present invention the WWD is a web enabled cellular phone Here it is noted that the term web or internet are used interchangeably to refer to the internet in general In a second embodiment the WWD is a palm handheld or laptop computer or a PDA equipped with a wireless modem In a third embodiment the WWD may be a hybrid device that combines the functions of a computer PDA and telephone 0022 An adaptor is used if necessary to convert the output signal of the medical monitoring device to a suitable input signal for the WWD The adaptor allows connection of the WWD to a medical device exercise machine or other variety of health care equipment and the connection may be made via several techniques As for wired techniques a standard parallel bus or serial cable may be used if the input output ports between the HMD and the WWD are appropriate Otherwise a suitable separate adaptor may be employed 0023 connection may also be an input such as a disk drive or other media input for input of data a USB port or phone jack or other such wired input again employing an adaptor if required 0024 As for wireless techniques infrared IR micro waves radio frequency RF e g Bluetooth or 802 11 protocols optical techniques including lasers and other such techniques may be used The p
34. r words if the output of HMD 160 is readily acceptable to WWD 162 then the same may be directly connected or may be connected via a simple cable the same basically extending from pin to pin For example a standard parallel bus or serial cable may be used if the input output ports between the HMD and the WWD which may be e g RS232 are compatible Otherwise a suitable adaptor circuit as noted above may be employed The connection may also be an input such as a disk drive or other media input for input of data a USB port or phone jack or other such wired input again employing an adaptor circuit if required 0092 It is noted as exemplary that several of the most prevalent PDA s currently employs the Palm operating system The same may be connected to the Internet in a wireless fashion using one of several available networks In one version of a Palm device a 10 pin RS 232 serial port is provided In this version of the Palm port 164 can be used to communicate with HMD 160 and connector 164 via the optional adaptor 168 according to the following pin out Pin Name Function 2 DTR Data Terminal Ready signal 2 VCC 3 3 Volts 3 RD in Receive data 4 RTS out Request to send 5 TD out Transmit data US 2005 0250995 1 continued Pin Name Function 6 CTS in Clear to send 7 GP1 in Interrupt line 8 GP2 in modem sync 9 unused unused 10 GND signal ground 0093 On the other side of optional adaptor 168 i e HM
35. rally be considered optional 0071 In FIG 5 a medical device may determine health parameters and an optional physician review is provided Health parameters may also be determined by user manual input 0072 The program is started step 142 and a sensor measures a health parameter step 116 The sensor may send the parameter to a medical device step 118 The medical device then sends the parameter to the WWD step 120 The WWD then wirelessly communicates the param eter to the application server step 122 e g via the wireless web The application server processes the parameter step 124 and calculates or provides a response step 126 based at least in part on the parameter The application server may optionally employ algorithm 63 step 125 external data step 132 or an AI system step 134 in the calculation The application server then sends the response to the WWD step 128 where the response is displayed step 130 0073 It should be noted that the term response here is used generally may simply be an acknowledgement that the parameter was received by the application server The term calculate is also used generally and may entail a simple calculation as well as a complex one A result may e g be the result of a calculation 0074 As noted above the sensor may connect to any type of medical device or other such device in which information pertaining to a patient s disease or condition may be a
36. re expending more calories in the form of exercise than the same individual is consuming in the form of food 0018 In general in the health management embodiment the system may be employed to monitor the physiologic status of a healthy subject while eating exercising or performing other activities For clarity such devices are termed herein exercise machines These may include an electronic body weight scale a body fat gauge biofeedback devices physiotherapy or chiropractic equipment blood pressure recorders or the like or any type of exercise machine or monitor including a heart rate monitor tread mill rowing machine stepper or the like 0019 In more detail the present invention provides a method and system for assisting patients to manage a disease or maintain healthy lifestyle by collecting health related data and providing information in response to those data by means of a WWD designed to display interactive informa tion through a connection to the Internet The present invention may be connected to various HMDs both medical and exercise related in nature and may communicate infor mation via a wireless connection such as a wireless Internet connection 0020 A major advantage of embodiments of the inven tion is that the same frees the patient from the constraints of wired systems The same allows users with consumer off the shelf wireless devices to significantly extend the range of connectivity ove
37. reless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 59 The device of claim 57 wherein the application further functions to accept data corresponding to food intake via a manual input 60 The device of claim 57 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable blood glucose monitor or implantable infusion pump 61 A method of using a device to monitor health com prising running an application on an internet enabled mobile or satellite phone or wireless PDA accepting a health parameter or measurement into the application from an implantable blood glucose monitor via a wireless connection US 2005 0250995 Al Nov 10 2005 11 transmitting data corresponding to the health parameter or 63 The method of claim 61 further comprising accepting measurement to a server via the internet data corresponding to food intake via a manual input 64 The method of claim 61 further comprising connect controlling an implantable infusion pump based at least in ing an adaptor to the internet enabled mobile or satellite part on the accepted health parameter or measurement phone or wireless PDA to enable communication with the 62 The method of claim 61 wherein the wireless RF RF signal from the implantable blood glucose monitor and connection is selected from the group consisting of 802 11 implantable infusion pump
38. scer tained The parameter may be any value corresponding to such information 0075 The method may also use a manual input as shown In this case after the start step 142 of the application the user may interact with the WWD step 140 The interact may be a data input a command to read data from a medical device a response to a physician question or statement an acknowledgement of physician notification etc Calcula tions by the application server may further take into account supplemental data sent by the user to the server e g in a wired fashion directly over the internet step 141 0076 FIG 5 also shows a physician review and notifi cation In this option the responses are displayed on a client computer step 136 in signal communication with the application server A physician may then review the response on the client computer and notify the patient of the responses step 138 For example the physician may notify the patient of positive or negative responses Of course it should be noted that the client computer may simply be a US 2005 0250995 1 pager PDA WWD or other such device as well as a more typical desktop or laptop computer 0077 In one implementation a diabetic may keep a database on a server of a dietary history and a blood glucose history With this data at hand wirelessly the diabetic may choose whether to eat a particular food by entering nutri tional information about the food i
39. tation of the WHMA 10 is shown In FIG 8 a wireless connection is shown between HMD 160 and WWD 162 HMD 160 may have an integral wireless modulator demodulator disposed within not shown More likely however is that HMD 160 has an adaptor 154 connectable thereto which performs these functions Adaptor 154 may plug into a connector 165 on HMD 160 WWD 162 may have an integral wireless modulator demodulator not shown although an adaptor can also be used in this context If an adaptor is used the same may plug into generic input output port 164 Nov 10 2005 0097 While the device shown in FIG 8 is described in the context of general wireless communications various protocols may be employed For radio frequency commu nications protocols such as Bluetooth or 802 11 may be advantageously employed Other techniques employing a similar configuration include those employing IR micro waves optical techniques including lasers and so on 0098 It should be understood that the above is merely exemplary and that the form of the adaptor may vary widely between HMDs and WWDs 0099 It will be understood that the above description of a Method and Apparatus for Health and Disease Manage ment Combining Patient Data Monitoring with Wireless Internet Connectivity has been with respect to particular embodiments of the invention While this description is fully capable of attaining the objects of the invention it is understood
40. teractive communication with the patient Instead such systems if internet enabled are often limited to mere one way non interactive data transfer via a modem While some systems are more enhanced including that disclosed in U S Pat No 5 357 427 issued Oct 18 1994 to Langen et al and entitled Remote Monitoring of High Risk Patients using Artificial Intelligence these systems are limited by the wired telecommunications infrastructure SUMMARY OF THE INVENTION 0013 Embodiments of the present invention overcome one or more of the disadvantages of the prior art by providing a full feature health monitoring system that may wirelessly connect to a back end server application via the internet The invention allows wireless access to and from a wide variety of present medical or health related instruments and devices while maintaining the capability of connecting to future such devices 0014 In particular the invention may be embodied in several systems Two complementary such systems are US 2005 0250995 1 described herein although extensions to other such systems can be envisioned First an embodiment of the invention may be employed to manage the disease state or condition of a patient In this embodiment the patient may employ a health monitoring device in particular a medical device and a wireless connection provides data from the medical device for processing via the internet including a revie
41. that the same is merely representative of the broad scope of the invention envisioned and that numerous variations of the above embodiments may be known or may become known or are obvious or may become obvious to one of ordinary skill in the art and these variations are fully within the broad scope of the invention For example while certain wireless technologies have been described herein other such wireless technologies may also be employed Furthermore while various types of medical devices have been mentioned numerous other types may also be used in the embodiments of the invention including pulse oxime ters syringe drivers infusion pumps spirometers ventila tors anesthesia monitors and so on Accordingly the scope of the invention is to be limited only by the claims appended hereto and equivalents thereof In these claims a reference to an element in the singular is not intended to mean one and only one unless explicitly stated Rather the same is intended to mean one or more All structural and func tional equivalents to the elements of the above described preferred embodiment that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be encompassed by the present claims Moreover it is not necessary for a device or method to address each and every problem sought to be solved by the present invention for it to be encompassed b
42. tled Method and Appa ratus for Health and Disease Management Combining Patient Data Monitoring with Wireless Internet Connectiv ity REFERENCE TO GOVERNMENTAL SUPPORT 0002 none REFERENCE TO MICROFICHE APPENDIX 0003 none FIELD OF THE INVENTION 0004 The present invention relates to monitoring of living subjects and more particularly to health monitoring of persons where measured or input health data is commu nicated by a wireless device to and from a software appli cation running on an internet connected server and where the same may be studied and processed by the software application a health professional or the subject BACKGROUND OF THE INVENTION 0005 Several attempts have been made in the past to achieve efficient interactive communication of medical or health information between a subject or patient and a reviewer or provider of that information In particular communication of consumer physiological information has been a subject of such attempts It is noted that in this regard the reviewer or provider of medical or health information is understood to include not only a physician but also a software application or algorithm that may analyze the information 0006 Medical or health information has been made avail able on a CD ROM accessible by a home computer system This passive approach had certain disadvantages First although the personal computer is prevalent is the United States
43. to the health monitoring device directly by a wired connection to a generic input output port of the WWD using an optional adaptor if necessary Alternatively the WWD may be wire lessly connected to the health monitoring device such as via an infrared or radio frequency connection including using protocols such as Bluetooth or 802 11 The wireless con nection may also employ an adaptor if necessary The user may also input data to the WWD manually such as by a keypad keyboard stylus or optionally by voice command The health related data is transmitted from the WWD to a server using standard internet protocols The server calcu lates a response using a software program which may include an algorithm or artificial intelligence system and may further provide for review by a physician or health specialist The user may interact with the server For example the server transmits a response to the WWD and the user may answer the response or provide other informa tion N Mouse 26 Stylus Screen 28 Keyboard 30 A Aa Computer 37 _ US 2005 0250995 1 Patent Application Publication Nov 10 2005 Sheet 1 of 8 o 1 L 914 US 2005 0250995 1 Patent Application Publication Nov 10 2005 Sheet 2 of 8 Old Le 1 nduuoo
44. tor for connection to the port to enable communication with the RF signal from the implantable medical device 5 A device for monitoring health comprising A mobile or satellite phone or wireless PDA running an application the phone or wireless PDA having a port for communications with an implantable medical device via a wireless RF connection such that the application functions to accept a health parameter or measurement from the implantable medi cal device via the wireless connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via a mobile or satellite network to a server 6 The device of claim 5 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 7 The device of claim 5 wherein the implantable medical device is selected from the group consisting of cardiac monitors hear rate monitors blood pressure monitors res piratory monitors temperature monitors blood glucose monitors and combinations thereof 8 The device of claim 5 further comprising an adaptor for connection to the port to enable communication with the RF signal from the implantable medical device 9 A method of using a device to monitor health com prising running an application on an internet enabled mobile or satellite phone or wireless PDA accepting a health parameter or measurement into the
45. w by a physician or other health care professional if required 0015 In the second embodiment a health or lifestyle management plan may be implemented Various health parameters such as those relating to nutrition or exercise may be entered into a health monitoring device in this instance termed an exercise machine and the same may be wireless communicated to a server An application may process and store the health parameters and a health spe cialist may optionally review the same 0016 Wireless internet connectivity has many advan tages For example in the first embodiment a diabetic could connect a blood glucose meter to an internet enabled wire less web device WWD away from home and download data to a Diabetes Management Company s server and in response receive guidance displayed on the screen or by voice about choices for the next meal 0017 Alternatively in the second embodiment a person interested in tracking an exercise program may take the WWD to the local health club and attach the same to an exercise machine send data output from various exercise machines over the Internet and receive a personalized response from the server of a company specializing in Health amp Lifestyle Management The individual may input caloric content of foods eaten and may further input caloric content of exercise performed In this way e g a person in a weight loss program may see in great detail whether they a
46. y include an algorithm 63 for analyzing data from the HMD and either application 62 or algorithm 63 may optionally access data from an external data source 74 and may further consult an artificial intelligence system 76 US 2005 0250995 1 0061 External data source 74 may be a memory or disk or other such storage that stores health data such as healthy and unhealthy weight height ranges healthy and unhealthy cholesterol counts the patient s or subject s prior medical or health history healthy and unhealthy blood pressure values information corresponding to the caloric and other nutri tional content of foods information corresponding to the caloric expenditure values of various exercises algorithms for calculating various health parameters etc In general any data that may benefit the health of a subject or patient may be stored in external data source 74 External data source 74 may also include online access of health infor mation from external web sites ftp servers or other sources 0062 Due to the current relatively small amount of memory and storage available on current WWDs such external application processing as by application 62 and external data storage as by external data 74 may be particu larly important 0063 As noted application 62 or algorithm 63 may also consult AI system 76 for suggestions as to health benefits AI system 76 may even interact with external data source 74 to extract useful informatio
47. y the present claims Furthermore no element component or method step in the present invention is intended to be dedicated to the public regardless of whether the element component or method step is explic itly recited in the claims No claim element herein is to be construed under the provisions of 35 U S C 112 16 unless the element is expressly recited using the phrase means for 1 A device for monitoring health comprising an internet enabled mobile or satellite phone or wireless PDA running an application the phone or wireless PDA having a port for communications with an implantable medical device via a wireless RF connec tion such that the application functions to accept a health parameter or measurement from the implantable medi cal device via the wireless connection and such that the application functions to transmit data cor responding to the accepted health parameter or mea surement via the internet to a server US 2005 0250995 1 2 The device of claim 1 wherein the wireless RF connection is selected from the group consisting of 802 11 802 16 and Bluetooth communication schemes 3 The device of claim 1 wherein the implantable medical device is selected from the group consisting of cardiac monitors hear rate monitors blood pressure monitors res piratory monitors temperature monitors blood glucose monitors and combinations thereof 4 The device of claim 1 further comprising an adap
48. ystem 76 In this sense the two applications may be highly interactive 0066 It is noted that an Application Service Provider ASP may operate application 62 That is application 62 may be leased by an ASP to the health care provider and the ASP may perform all necessary upgrades and maintenance to application 62 and its associated components 0067 To initialize the system the program starts and a wireless application is loaded into the WWD The loading of the wireless application may occur via synchronization from a desktop or via downloading from a server over the internet The server application may be loaded into an appropriate internet connected server Subject data may be loaded into the WWD or into the server In the latter case the subject information may later be transferred to the WWD or trans Nov 10 2005 ferred to the server from the WWD as called for by the application The initialization scheme then ends 0068 The wireless application may access the server and server application or vice versa as determined by the respective program instructions Examples are now given for 1 a system of disease and patient management and 2 a system for health management employing an exercise machine 0069 Example Employing System for Disease Manage ment 0070 Referring to FIG 5 an example is given for a system of disease and patient management In this figure as well as in FIG 6 boxes in dotted lines may gene
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