Method and apparatus for health and disease management
Contents
1. PATIENT PRESENTS WITH MALADY 202 MEDICAL PERSONNEL ARRIVE ON SCENE AND WWD IS ENGAGED 204 PERSONNEL TAKES ACTION 206 VISUAL DATA CAPTURED OF PATIENT AND OR 4 STORED MEMORY DEVICE 208 VISUAL DATA OPTIONALLY TRANSFORMED IS SENT WIRELESSLY TO INTERNET FOR REVIEW BY PHYSICIAN WHO ADVISES PERSONNEL OF NEEDED ACTIONS 214 US 2004 0162466 1 FIG 11 HMD IS ATTACHED TO PATIENT 210 HMD DATA CAPTURED OF PATIENT AND OR STORED ON MEMORY DEVICE 212 NETWORK AVAILABLE 220 WAIT FOR AVAILABLE NETWORK 218 DROPOUT 218 STORE DATA O MEMORY DEVICE IF NOT ALREADY STORED 216 Patent Application Publication Aug 19 2004 Sheet 12 of 12 US 2004 0162466 1 FIG 12 INSERT MEMORY DEVICE IN WWD DOWNLOAD DOWNLOAD VISUAL APPLICATION DATA FROM MEMORY FROM MEMORY DEVICE AND DISPLAY DEVICE INTO ON WWD 274 WWD 272 US 2004 0162466 Al 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 in part of U S patent application Ser No 10 418 845 filed Apr 18 2003 which is a continuation of U S patent application Ser No 09 738 270 filed Dec 15 2000 now U S Pat No 6 602 191 REFERENCE TO GOVERNMENTAL SUPPORT 0002 none REFERENCE TO MICROFICHE APPENDI2. 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 interactive 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
3. sion may be accomplished via the techniques described above Such data may be in either raw form or in preformatted for video form and may be stored in the WWD or on the memory device step 212 of FIG 11 In either case it may be required to format the data in way suitable for the display screen of the WWD In some cases viewing on the WWD is not necessary and the data may be sent in its original form optionally undergoing some inter mediate processing directly on to the off site caregiver s system for viewing or analysis step 214 of FIG 11 Examples of this type of data may be ECG data such as from an ECG recorder or from the ECG output port of an emergency portable defibrillator or other sources of data Alternatively a subset of the data may be sent such as a compressed version while the remainder 1 the complete version of the patient data may be maintained on the WWD and or memory device for purposes of maintaining a com plete patient record 0116 As above the WWD may store the HMD data and transmit the same wirelessly to a point of collection or may Aug 19 2004 save the data on the memory device for contemporaneous or later transmission again either via a streamed or other transmission method 0117 In more detail in the case of a dropout or other disruption of wireless service step 218 of FIG 11 the data may be stored on the memory device or in the WWD if it has not already been as m
4. 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 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 US 2004 0162466 Al health monitoring device in particular a medical device and a wireless connection to provided data from the medical device for processing via the internet including a review 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 exer
5. 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 0047 In a disease management embodiment an HMD may be a blood glucose monitor a blood pressure monitor an ambulatory ECG recorder a respiratory monitor a tem perature or heart rate monitor and so on 0048 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 0049 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 0050 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
6. 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 techniques 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 US 2004 0162466 Al 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 0051 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 0052 Various embodiments of the invention are now described in more detail 0053 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 19 the same
7. 04 0162466 Al 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 0064 Server 22 has a 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 may 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 0065 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 inc
8. 07 In another embodiment shown in FIG 10 the memory device 246 is shown inserted in a memory device reader 258 which is in turn connected to a WWD 250 via link 251 0108 The memory device 246 then allows for enhanced functionality of the WWDs 244 or 250 In one respect they allow for increased data storage This may be particularly important for medical data as certain health monitoring apparatuses produce copious amounts of data e g cardiac monitoring equipment and thus require substantial storage capabilities 0109 Another reason such memory devices are particu larly pertinent in medical device monitoring is that they store data which can then be wirelessly transmitted in a streamed or non streamed fashion In the event of drop outs interruptions or unavailability of the wireless network no loss of data occurs as the data has been stored on the memory device and may be wirelessly transmitted at a later time when cellular or mobile service is again available The memory device thus serves as a back up storage media In the event of an extended period of unavailability of a wireless network the memory device may be replaced or overwritten to provide practically unlimited storage until such time as the network is available and the data can be uploaded 0110 Ofcourse even if the wireless network is available the memory device or on board WWD memory may store the data for various purposes This real time capability and
9. US 20040162466A1 United States a2 Patent Application Publication Pub No US 2004 0162466 1 Quy 43 Pub Date Aug 19 2004 54 76 21 22 63 METHOD AND APPARATUS FOR HEALTH AND DISEASE MANAGEMENT COMBINING PATIENT DATA MONITORING WITH WIRELESS INTERNET CONNECTIVITY Inventor Roger J Quy Mill Valley CA US Correspondence Address Mark D Wieczorek c o Mayer Fortkort amp Williams 2nd Floor 251 North Avenue West Westfield NJ 07090 US Appl No 10 773 501 Filed Feb 6 2004 Related U S Application Data Continuation in part of application No 10 418 845 filed on Apr 18 2003 which is a continuation of application No 09 738 270 filed on Dec 15 2000 now Pat No 6 602 191 li o m Publication Classification 51 Int Cl 52 A61B 5 00 FOIN 3 10 US CL amm 600 300 128 903 340 539 12 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 digital camera or other health monitoring device The WWD may accommodate a memory device for enhanced storage capabilities that may be particularly per tinent to data intensiv
10. X 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 wireless device to and from software appli cation running on an internet connected server and where the same may be studied and processed by the software application 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 subject or patient and 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 physician but also software application or algorithm that may analyze the information 0006 Medical or health information has been made avail able on CD ROM accessible by home computer system This passive approach had certain disadvantages First although the personal computer is prevalent is the United States 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
11. 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 0057 It will be clear to one of skill in the art given this teaching that cable 32 as well as cables 34 and 44 may be replaced with wireless circuitry to communicate signals wirelessly Alternatively cables 34 or 44 may be replaced by a direct plug and socket connection 0058 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 Aug 19 2004 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 0059 As examples of sensor types to measure b
12. alth parameter corresponding to a disease state or condition of a patient and determined by the health monitoring device A device application and a user interface and Aug 19 2004 A server application residing on a computer readable medium and disposed on a server in communication with the wireless network for causing the server to Receive the visual data and Display the visual data 6 The system of claim 5 wherein in the event of an interruption of a wireless connection between the internet enabled wireless web device and the wireless network the internet enabled wireless web device is configured to store the visual data from the health monitoring device in the memory or on the memory device 7 Amethod of wirelessly monitoring the disease state or condition of a patient via viewing photographic data corre sponding to the patient comprising Capturing a visual image of a patient via a camera the camera integral with or connected via a link to an internet enabled wireless web device having a memory device Wirelessly transmitting the visual image to a server via a wireless network Receiving the visual image at the server Wherein if the wireless transmitting between the internet enabled wireless web device and the wireless network is interrupted further comprising storing the photo graphic image on the memory device or in a memory of the internet enabled wireless web device 8 The method of claim 7 wh
13. 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 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 US 2004 0162466 Al 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 personal 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 supplementa
14. ay be the case for streamed data step 216 of FIG 11 The WWD may periodically test for the availability of the wireless network step 220 of FIG 11 and may wait until the network is available step 218 of FIG 11 Once the system is again available the advice from the caregiver may be sent to the WWD and the on site personnel may again take action step 206 of FIG 11 0118 Using such data an off site health care professional may give an on site caregiver valuable diagnosis and treat ment advice Moreover no wired or dedicated connection is necessary In addition the above noted difficulties with wireless or cellular systems may be overcome 0119 There are various ways in which visual data may be communicated to an off site caregiver Asimple method is to send the visual data via an email message In more advanced methods the visual data may be integrated with a data stream of other medical information Current systems may be used in combination with the present invention to facili tate the handling and transmission of visual data by a WWD For example current operating systems for WWDs include Windows Mobile Symbian current application program ming languages include Java current software libraries and development environments include MobilityWorld In all cases the visual data may be stored e g as a separate file or may be included as an embedded object in a data file on the memory device or in an email 0120 It w
15. between the internet enabled wireless web device and the wireless network the internet enabled wireless web device is configured to store the visual data from the digital camera in a memory or on the memory device 2 The system of claim 1 wherein the internet enabled wireless web device is selected from the group consisting of an internet enabled mobile phone a handheld palm or laptop computer or personal digital assistant having an optional implemented or integral wireless capability and a hybrid device of a handheld computer and mobile telephone 3 The system of claim 1 further comprising a memory device removably insertable into the internet enabled wireless web device including an application program capable of being run from the memory device or run subsequent to download into the memory of the internet enabled wireless web device 4 The system of claim 3 wherein the application program includes instructional materials or visual still or video images 5 A wireless health monitoring system for monitoring a disease state or condition of a patient using visual data from a health monitoring device comprising An internet enabled wireless web device including a generic input output port for reception of visual data from an output port of a health monitoring device a circuit for wireless communications with a network a memory device and memory configured to store Visual data corresponding to a health parameter the he
16. cise 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 are 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
17. connection is unavailable such as in a medical emergency in a rural setting or during trans portation of a patient 0103 such systems an additional security layer may be employed including industry standard encryption and Aug 19 2004 decription of the transmitted data especially as patient health information is highly sensitive and private data 0104 Despite the obvious advantages of cellular or mobile systems disadvantages also inure For example interruptions of service drop outs may occur between cells and in many locations service is not available 0105 Moreover current WWDs often lack sufficient on board memory for storage of visual data such as from cameras or data intensive HMDs 0106 Embodiments of the present invention at least in part assists in such cases Referring to FIG 9 a system is shown in which a WWD 244 is shown with a memory device 246 The memory device 246 may be a smartcard a smartmedia card a memory card memory stick compact flash card memory cubes micro drives disk on keys flash memory keys micro laser disks nano storage devices bio memories battery memory combination device USB flash drives and so on or indeed any other type of removable media that may be connected to a WWD to store informa tion Typically these memory devices are capable of storing substantial amounts of data The same may also include a memory and power source or combination device 01
18. e internet enabled wireless web device the health parameter indicative of a disease state or condition of a patient wherein in the event of an interruption of the wireless connection between the internet enabled wireless web Aug 19 2004 device and the wireless network the internet enabled wireless web device is configured to store the health parameter from the health monitoring device in a memory or on a removable memory device 17 Ainternet enabled wireless web device for monitoring health the internet enabled wireless web device connected in wireless communication with a server running an appli cation comprising An internet enabled wireless web device with a remov able memory device and running an application the application functioning to accept inputs from a first communications port and a second communications port the first communications port including a generic input output port and the second communications port including a wireless link to a network the generic input output port for receipt of a health parameter from a health monitoring device or visual data from a digital camera the health parameter or visual data correspond ing to a patient s disease state or condition wherein in the event of an interruption of the wireless connection between the internet enabled wireless web device and the server the internet enabled wireless web device is configured to store the health parameter or visual data in a mem
19. e tasks such as the handling and storage of images or other visual data The health related data is transmitted from the WWD to a server using standard internet protocols and may be integrated with various oper ating systems for handheld or wireless devices especially those with enhanced capabilities for handing images and visual data ame mas ll Computer 37 US 2004 0162466 1 Patent Application Publication Aug 19 2004 Sheet 1 of 12 A T 4 L 9i4 Se ee ee US 2004 0162466 1 Patent Application Publication Aug 19 2004 Sheet 2 of 12 Le oo EE EE al gern Patent Application Publication Aug 19 2004 Sheet 3 of 12 US 2004 0162466 1 FIG 3 US 2004 0162466 1 Patent Application Publication Aug 19 2004 Sheet 4 of 12 wen eee EG J gt Ce On a Re ewes omme namn et oad OL snivuvddv MW3AH3S ONIMOLINOW SS3T3HIM US 2004 0162466 1 Patent Application P
20. ere the image is a video image a still image a streamed image or a non streamed image 9 The method of claim 7 further comprising Attaching a memory device to the internet enabled wire less web device including an application program and running the application program from the memory device or from the memory or subsequent to download of the application program into the memory 10 The method of claim 9 whereby the application program includes instructional materials photographic still or video images 12 Amethod of wirelessly monitoring the disease state or condition of a patient using visual data from a health monitoring device comprising Transmitting visual data from a health monitoring device corresponding to a health parameter to an internet enabled wireless web device having a memory device via a port the health parameter corresponding to a disease state or condition of a patient Wirelessly transmitting the visual data to a server Receiving the visual data at the server Displaying the visual data and wherein in the event of an interruption of a wireless connection between the internet enabled wireless web device and the wireless network the internet enabled wireless web device is configured to store the visual data from the health monitoring device in a memory or on the memory device 13 The method of claim 12 further comprising Attaching a memory device to the internet enabled wire less web device t
21. es 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 pager PDA WWD or other such device as well as a more typical desktop or laptop computer 0080 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 into 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 EXAMPLE EMPLOYING SYSTEM FOR HEALTH MANAGEMENT USING A GENERAL EXERCISE MACHINE 0081 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 0082 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 unders
22. he memory device including an US 2004 0162466 Al application program and running the application pro gram from the memory device or from the memory subsequent to download of the application program into the memory 14 The method of claim 13 whereby the application program includes instructional materials or photographic still or video images 15 Acomputer program residing on a computer readable medium containing instructions for causing an internet enabled wireless web device in signal communication via a wireless network to the internet to cause an internet enabled wireless web device to receive data corresponding to a visual image of a patient from a camera connected to or integral therewith the visual data indicative of a disease state or condition of a patient wherein in the event of an interruption of the wireless connection between the internet enabled wireless web device and the wireless network the internet enabled wireless web device is configured to store the visual data from the camera in a memory or on a removable memory device 16 Acomputer program residing on a computer readable medium containing instructions for causing an internet enabled wireless web device in signal communication via a wireless network to the internet to cause an internet enabled wireless web device to receive via data corresponding to a health parameter of a patient from a health monitoring device connected to or integral with th
23. ialist 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 ADAPTOR HARDWARE 0089 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 0090 In general a connection is necessary between a HMD 11 and a WWD The nature of this connection 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 0091 Referring to FIG 7 an embodiment of the con nection is shown In this figure a hardware or wired connection is shown i e 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 fo
24. ill 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 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 implanted monitors syringe drivers infusion pumps spirometers ventilators anesthesia monitors blood glucose meters 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 element
25. 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 0054 Referring to FIG 2 an first embodiment of WHMA 10 is shown WHMA 10 includes an HMD 11 which may include an optional monitor screen 40 coupled via an optional adaptor 42 toa 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 0055 As noted above HMD 11 may include a 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 keyboard 30 mouse 26 pen type device 28 and may also employ separate monitor not shown Of course the user may also view information on monitor 40 or on 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 0056 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
26. is displayed step 130 0076 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 0077 As noted above the sensor may connect to any type of medical device or other such device in which information pertaining to patient s disease or condition may be ascer tained The parameter may be any value corresponding to such information 0078 The method may also use 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 data input command to read data from medical US 2004 0162466 Al 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 0079 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 respons
27. ization scheme then ends 0072 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 EXAMPLE EMPLOYING SYSTEM FOR DISEASE MANAGEMENT 0073 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 generally be considered optional 0074 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 0075 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
28. l information via a PC connected independent 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 i e 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 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 me
29. lood glucose levels sensor 24 may be a sensor that accepts a drop 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 being 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 The measured data may be obtained by an implant able device such as a cardiac monitor for which a wireless communication scheme would be particularly appropriate 0060 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 employed to result in a health benefit to subject 38 0061 Referring to FIG 3 WHMA 10 i
30. lude online access of health infor mation from external web sites ftp servers or other sources 0066 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 0067 As noted application 62 or algorithm 63 may also consult Al system 76 for suggestions as to health benefits AI system 76 may even interact with external data source 74 to extract useful information from the same Al 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 0068 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 0069 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
31. 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 system 76 In this sense the two applications may be highly interactive Aug 19 2004 0070 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 0071 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 ferred to the server from the WWD as called for by the application The initial
32. 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 over that of wired computer television or even wireless telemetry systems 0021 Ina first embodiment of the present invention the WWD is a web enabled mobile phone Here it is noted that the term web or internet are u
33. or the remote diagnosis and management of patients 0100 Besides the patient data transmission from HMDs other sorts of transmissions may also occur For example visual data such as photographs or videos may be trans ferred as an indication of the patient s condition and to aid remote diagnosis Alternatively other visual indications of a patient s status such as graphical or other outputs of HMDs may provide information useful for a diagnosing treating physician 0101 In these embodiments a set of visual data from a camera or from an HMD may be transmitted from the WWD to a wireless antenna that is connected to the wired tele communications infrastructure Overlaid on this is the inter net and the visual data may thus be sent via an appropriate protocol to a server for retrieval and analysis by a user such as a treating off site physician 0102 U S Pat No 5 441 047 describes a system by which images and data may be transmitted by standard telephone lines or wireless telemetry systems Systems also allow for such transfers over wireless or cellular systems e g U S Pat No 5 987 519 Moreover the advent of cellular phones and WWDs that include a digital camera or alternatively are equipped with a link to one allow the capture and transmission of photographic images using low cost consumer devices In this way transmission of information may be particularly convenient and may occur when a regular telephone
34. ory or on the removable memory device 18 The system of claim 17 wherein the internet enabled wireless web device is selected from the group consisting of an internet enabled mobile phone a handheld palm or laptop computer or personal digital assistant having an optional implemented or integral wireless capability and a hybrid device of a handheld computer and mobile telephone
35. r 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 0092 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 other 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 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 0093 Port 164 can be used to communicate with HMD 160 and connector 164 via a number of types of wired connections including USB USB2 or Firewire In some cases optional adaptor 168 may also be employed US 2004 0162466 Al 0094 connection may simply be made by providing optional adaptor 168 with adap
36. robustness is often very important in ensuring patient safety and ensuring that a high level of care is being delivered to the patient by the caregiver particularly in field or emergent situations where the wireless connection may be the only source of communications with a physician 0111 related reason why memory devices are particu larly pertinent in medical device monitoring is that they allow a greater level of buffering for real time data moni toring thus allowing more pre analysis and filtering of data US 2004 0162466 Al 0112 further benefit of the use of memory devices is that they provide for easy application downloading step 272 of FIG 12 onto WWD For example memory device may be inserted into WWD step 270 of FIG 12 large application program may be easily downloaded onto WWD from the memory device rather than through wired or wireless synchronization or downloading process via PC or the internet or both Downloading in this fashion may be particularly rapid and complete The downloaded data may include visual data step 274 of FIG 12 such as still or video photographic images that instruct user on the operation of device In an alternative embodiment the data need not be downloaded but may rather be streamed either from stored video on server or in real time via user with a webcam In downloaded or streamed by generally not live systems the user interface may be in
37. s 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 US 2004 0162466 Al 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 by 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 What is claimed is 1 A wireless health monitoring system for monitoring a disease state or condition of a patient using visual data comprising An internet enabled wireless web device including an integral digital camera a communications port having a circuit for wireless communications with a network a memory device and a user interface A server application residing on a computer readable medium and disposed on a server in communication with the wireless network for causing the server to Receive visual data from the digital camera and Display the visual data wherein in the event of an interruption of a wireless connection
38. s 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 0062 As noted the protocols 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 0063 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 US 20
39. sed interchangeably to Aug 19 2004 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 e g WWD The adaptor allows con nection 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 tech niques a standard USB USB2 Firewire 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 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 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 patient 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 tha
40. t 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 one 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 i e 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 requirements 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
41. teractive allowing the user to access knowledge database resident on the server or memory device or previously downloaded onto the main memory of the WWD 0113 Particularly important types of data about a patient that presents with malady step 202 of FIG 11 that may be wirelessly transmitted from the WWD are those corre sponding to photographic pictures both still and video and graphical or visual data output images from an HMD e g an ECG output In either case medical personnel may arrive on an emergent scene and engage the WWD step 204 of FIG 11 Some action may be taken immediately if war ranted step 206 of FIG 11 0114 To obtain the first type of data noted above pho tographic data camera may be employed which is either resident on the WWD camera 224 of FIG 9 or is otherwise available by way of a link 228 camera 226 of FIG 10 The WWD 250 may store photographic data either still or video and transmit the same wirelessly to point of collection e g server application or may save the photographic data on the memory device for contemporaneous or later trans mission again either via streamed non streamed or other transmission method step 208 of FIG 11 0115 To devise the second type of data mentioned above data port from HMD 260 that is coupled to patient step 210 of FIG 11 may be employed to send information from the same to an input port on the WWD 250 This transmis
42. 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 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 Aug 19 2004 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 in 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
43. thod 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 0039 FIG 7 illustrates an embodiment of a wired con nection between a HMD and a WWD also showing an optional adaptor and Aug 19 2004 0040 FIG 8 illustrates an embodiment of a wireless connection between a HMD and a WWD also showing an optional adaptor 0041 FIG 9 illustrates an embodiment of a wireless system for transmitting visual data to and from a user 0042 FIG 10 illustrates an alternative embodiment of a wireless system for transmitting visual data to and from a user 0043 FIG 11 illustrates an embodiment of a method for using a wireless system to transmit visual data to and from a user 0044 FIG 12 illustrates an embodiment of a method for using a memory device to load an application program onto a wireless system DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 0045 Various acronyms are used for clarity herein Defi nitions are given below 0046 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
44. tood 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 0083 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 0084 alternative and complementary way of entering the parameter is by user input step 248 For example the user may enter the parameter into the exercise machine or into the WWD This parameter may correspond to an amount of exercise performed an amount of food con sumed etc 0085 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 0086 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 Aug 19 2004 application server may optionally employ external data step 232 or an AI system step 234 in the calculation The application server then sends the response to the WWD step 228 where the response is displayed 0087 The same definitional statements regarding the terms response calculate sensor etc as given before apply in this embodiment as well 0088 As an optional step a health spec
45. tor circuitry such as within cable 170 or within 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 less standard and perhaps proprietary pin out may be required 0096 Referring to FIG 8 an embodiment of wireless implementation 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 165 connectable thereto which performs these functions WWD 162 may have an integral wireless modulator demodulator not shown although an adaptor can also be used in this context 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 above description of a remote health monitor ing system termed occasionally a telemedicine system clearly provides a valuable tool f
46. ublication Aug 19 2004 Sheet 5 of 12 i SI ISNOdSIU 5 OL yiya SONAS YISN S Old US 2004 0162466 1 Patent Application Publication Aug 19 2004 Sheet 6 of 12 YIAYIS OL VIVA TVANINAITddNS SONIS 35 1 314110N 1Snvio3ds HL1V3H 4 ot x 8 2 WaindWOO 1 NO ISNOdSJY ymas I NOLVONTddV Vw OL 354045 SONIS 35 9 Old frt 3 NOLLVINMddV vez Q3AO04N3 WALSAS IV 3 3SNOdS3Y qM SaLv1NdTVI zez lt i mov ROUN ores 30mnos viva 2 479 US 2004 0162466 1 31972 e Patent Application Publication Aug 19 2004 Sheet 7 of 12 US 2004 0162466 1 Patent Application Publication Aug 19 2004 Sheet 8 of 12 8 i e See qp p e um gt WP Patent Application Publication Aug 19 2004 Sheet 9 of 12 US 2004 0162466 1 FIG 9 244 224 Patent Application Publication Aug 19 2004 Sheet 10 of 12 US 2004 0162466 1 FIG 10 Patent Application Publication Aug 19 2004 Sheet 11 of 12
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