"TELEMEDICINE SYSTEM FOR REMOTE MONITORING OF PATIENTS"

The present invention refers to the technical field of digital computing system and data processing, especially adapted to medical instruments for detection, measuring or recording for diagnosis purposes.

Telemedicine embodies a plurality of remote services, such as monitoring of vital signals, measuring consultation, diagnosing diseases, medical education and integration of health networks, among others, by means of the application of developments in the technical field of telecommunications for supplying information and medical attention to remotely located patients.

ATA (American Telemedicine Association) defines telemedicine as the use of medical information sharing between two distinct places by means of electronic communication in order to improve patient's health condition. For example, a specialist can assist a resident to make a diagnosis without being physically present, since the patient's data, such as ECG, temperature, blood pressure or even images can be sent in real-time to the specialist. The telemedicine allows this specialist to access a lot of information about the patient and participate remotely in all the necessary procedures, adequately instructing the resident. Besides that, it is possible to access the medical record of the patient including, for example, exams which were realized by another doctor in a fast and reliable way. Other common example is monitoring of patient that opt by in-house medical treatment, in which patient remains at home, being monitored by medical equipments according to the disease the patient has contracted and, usually with the help of a nurse. The telemedicine embodies more practical solutions, such as the centralization of medical information and the availability of this information to the involved doctors or even for generate alarms and other warning devices to inform critical situations.

Those applications of telemedicine became more advantageous when allied with the advances in the new medical equipments, once many of these equipment supplies, besides the captured signals, a lot of information obtained from the data processing. However, most of those equipments are destined for local supplying of information, generally by means of a monitor screen. Thus, despite the most part of the equipments having conventional interfaces, such as serial, Internet or Ethernet, the obtainment of the available data is not easy due to the lack of standardization for these data, generating a great variety of encoding. In the absence of standardization, each manufacturer uses its own codification to make these information available, thus, telemedicine systems became more and more complex, not achieving the goal of assisting the medical activity. Generally a hospital or a laboratory

does not have equipments from the same manufacturer, and, for example, the doctor or the nurse shall not be worry with which equipment the available telemedicine system can be linked to. Thus, there are in the state of the art, several telemedicine systems which aim to remotely supply the data coming from different equipments. Below, are cited some systems that propose different methods of data manipulation supplied by medical equipments:

For example, patent application US 6,402,691 B1 describes a system for monitoring of patients in home medical treatment for chronic diseases, such as asthma, diabetes or chronic obstruction of the lungs. In the disclosed system, the registered data are stored, available for later consultations, allowing the doctor to analyze them when it is possible.

Patent application US 6,733,447 B2 describes a system and a method to remotely monitoring multiple medical parameters comprehending a patient monitoring equipment, a unit to send information, a control device in a monitoring central system, and a system of communication between the patient and the monitoring central system. Monitored signals can include ECG, NIBP, Spθ2, breathing, temperature, invasive lines and alarms, among others.

International application WO00/49549 A1 describes a method and equipment to process, transmit and receive medical data by means of serial buses, and a site to receive and transmit patient's information, with a central processor; which allows remote medical diagnosis by means of a net such as the Internet. In this document the system also presents compatibility with several equipments, such as arterial pressure measures, electronic thermometers, electronic stethoscopes, EEG and ECG, adapting the signal processing when the supplied signal is not a digital one. Patent application US 6,112,224 describes patient's monitoring system similar to those described above, using a single interruption supporting multiple medical equipments, such as thermometers, ECG and stethoscopes, among others. This interruption allows several medical equipments to be connected, because the signals are stored in a buffer and prioritized, besides the medical equipments can be freely changed just connecting the new medical equipment to the system.

The solutions disclosed in the above cited documents, however, do not solve in a convenient and effective way some problems in the technical field of digital computing systems and data processing, especially adapted for medical instruments of detection, measuring or record for diagnosis purposes. Patent application US 6,402,691 describes a system for remote monitoring that uses its own unit, such as pressure meters and asymmetry, among others. However, in case the patient needs a different measuring, it would be necessary to acquire specific equipment and to use another telemedicine system,

because the described system does not have the ability of self-adapting to other equipments.

Patent application US 6,112,224 describes a telemetry system that adapts to new medical equipment, however it has restricted application, once it consists in a device with several interfaces, for example, serial ones, in which the medical equipments are connected and the information processing is realized. This embodiment limits the number of medical equipments that can be connected by the quantity of available interfaces, and more, increases the cost once the quantity of devices must be elevated in order to hold all the equipments being used, practically there is one equipment for each patient.

Patent applications US 6,733,447, WO00/49549 and US 6,112,224 describe systems to remotely monitor several medical parameters, being able to automatically adapt the several medical equipment belonging to different categories such as ECG, NIBP, Spθ2, breathing, temperature and invasive lines. However the used processes do not allow the utilization of equipments that use different encoding, for example, coming from different manufacturers, unless the system is manually adapted for the new equipment.

Thus, none of the cited documents, neither another solution known from the state of art, propose a telemetry system of for remote monitoring of patients which are adequate to the situations that can be found in sites of medical service supplying. For example, in a hospital are used several medical equipments supplied by different manufacturers, and they shall be available in any situation, especially in emergencies when the doctor and his auxiliaries do not have time to select manually in the telemetry system which equipment is going to be used. The telemetry system shall be simple to operate, presenting high reliance and flexibility, besides not presenting elevated costs, once the purchase of medical equipment already represents great investments.

The goal of the present invention, therefore, is to obtain a telemedicine system for remote monitoring of patients that allows the change of medical equipment in an easy and fast way, automatically doing the identification of the equipment.

Furthermore, another goal of the present invention is to obtain a telemedicine system for remote monitoring of patients that dispenses the presence of a doctor in the local where the patient is, without jeopardizing the agility and the reliability of the assistance, turning the medical service more comfortable and functional to the patient, who can be at home or any other place; and for the doctor, who can have any information quickly, including the patient's medical records.

To reach the goals cited above and other purposes, the present patent describes a telemedicine system for remote monitoring of patients that allows an interaction between: the site of remote treatment, where the patients are being monitored by means of medical equipments connected to interface modules; the monitoring central, where the servers and the database are; and also the site of remote monitoring, including, for example, doctors in the doctor's or homes wishing to access the data of a remote patient.

The proposed telemetry system allows the automatic identification of any medical equipment which is being used by means of the identification of the respective interface module. When the interface module is turned on, it sends an identification code to one of the servers that authenticate the said interface module. That code will identify the interface module for the server and, consequently, the protocol that the medical equipment uses. Then the server verifies the set of available drivers and selects the most adequate for the identified medical equipment.

The telemedicine system for remote monitoring of patients disclosed in the present patent, thus, by adapting automatically with any encoding used by medical equipments, makes easier its utilization in several environments, ranging from home medical treatment to great hospital centers. Additionally, as it is a single system that can be used with any equipment, it reduces the costs once the processing is centralized and does not need a specific system for each equipment, besides propitiating greater freedom to the manager during acquisition of new equipment.

In order to make easier the understanding and execution of the present invention, the following figures are presented, for illustrative and not restrictive purposes, representing the final form of the invention. Each illustrated component, similar or identical part is identified by a corresponding number. Figure 1 represents the simplified diagram of the telemetry system for remote monitoring of patients.

Figure 2 represents the diagrams of the state of identification of the interface module in the process of telemetry for remote monitoring of patients.

Figure 3 is a diagram representing the driver selection stages of the process of telemetry for remote monitoring of patients.

Figure 4 is a diagram representing the stages of establishment the communication of the interface module in the process of telemetry for remote monitoring of patients.

Figure 5 are diagrams that represent the communication stage in the process of telemetry for remote monitoring of patients.

Figure 6 is a diagram that represents the stages of visualization in the site of remote monitoring the process of telemetry for remote monitoring of patients.

Figure 7 is a diagram that represents the stage of visualization of vital signals record in the process of telemetry for remote monitoring of patients.

Figure 8 is a diagram that represents exemplifying the telemetry system for remote monitoring of patients.

The several ways for execute the present invention are not limited to the constructive details disclosed in the description and figures, in so far as the present invention can be accomplished by other equivalent configurations. According to the referred figures the best execution mode for the present invention consists of telemedicine system (1) for remote monitoring of patients that allows an interaction between the site of remote treatment (2), where the patients are being monitored; monitoring central (3), in which are the servers (4); the database (5) and also the site of remote monitoring (6), including, for example, medicine doctors in their surgeries or homes wishing to access the data of a remote patient. The patients in the site of remote treatment (2) can be monitored using conventional medical equipments (7) such as ECG, EEG and blood pressure meters, among others, according to the medical needs and to the equipment availability.

Most of medical equipments (7) make available the data corresponding to the recorded signals by means of interfaces of short range, such as serial interfaces. In these cases, the medical equipment (7) is locally connected to the interface module (8) which acquires the data made available by the medical equipment (7), transforms the received signal in a protocol more adequate for transmissions at long distances, such as IP, TCP, UDP or another adequate protocol. Then, that signal is sent to a monitoring central (3). In case the medical equipment (7) already has an adequate interface for long distance transmission, such as Ethernet, the interface module (8) can be dispensed. The IP protocol, besides having high reliability, has the advantage of being already used in local networks in most of the establishments, thus decreasing the installation costs of the telemetry system (1). In establishments in which other network types are used, the interface module (8) converts the signal originating from the medical equipment (7), such as a serial one, to the protocol used by the net installed.

If the medical equipment (7) supplies only analogical signals, the interface module (8) converts the signal to digital before packing it for the transmission to the monitoring central (3).

In the monitoring central (3) the signal is received by one of the servers (4) and stored on the database (5). The quantity of servers (4) varies according to the application, for example, big hospital centers with two hundred hospital beds can have four servers (4) which could be linked in cluster to increase the reliability and the speed of the telemetry system (1). By the other hand, small hospitals can have only one central server, without jeopardizing the operation of the telemetry system (1). The communication among servers (4) and medical equipments (7) is accomplished by means of specific drivers (10). Once the communication is established, the medical equipment (7) sends the data to the servers (4), which then can process the data, generating alarms and reports, which are stored on the database (5) together with the recorded signals. Additionally, the information from the patient can be sent to the patient's doctor of or to a duty doctor, even though these are in remote sites, by means of the interaction between the external server (9) of monitoring central (3) and the site of remote monitoring (6). For example, if a doctor is in his surgery, which in the case is the site of remote monitoring (6), and has a hospitalized patient, he can remotely consult his patient's health condition, via Internet for example, and also could receive periodic reports or even alarm warnings in case of some emergency. Or the doctor can consult from his surgery the result of exams that he asked for a laboratory, even though the laboratory is located in another region.

As medical information requires professional secret, it is fundamental that the telemetry system (1) also keeps the necessary secret. Thus, the protocol chosen for the communication between the site of treatment (2), monitoring central (3) and site of remote monitoring (6) should allow a reliable cryptography for data transmission, such as IP protocol. The telemetry system (1) is based on the authentication between the medical equipment (7) or the interface module (8) and the server (4) and, afterwards, between server (4) and site of remote monitoring (6), besides the cryptography of the transmitted signals.

The servers (4) use preferentially parallel processors, and they can receive, process and store at the same time signals coming from several patients (7), what is fundamental to guarantee the consistency of the information from database

(5). When the interface module (8) is turned on, it sends an identification code to one of the servers (4) which authenticates said interface module (8). This code will identify the interface module (8) to the server (4) and, consequently, the protocol that the medical equipment (7) uses. The server (4) consults the set of

available drivers (10) and selects the most adequate for the medical equipment (7) which was identified. The driver is the responsible for determining the way the bytes that are received are going to be interpreted and also how to send the bytes correspondent to each information to be sent. The selected driver will be used during all the communication between interface module (8) and server (4), as much when some command is sent to the medical equipment (7), as when the data are sent to the server (4). Thus, adapting to any new medical equipment (7), poses great advantages regarding to any other system found in the state of the art. The identification of the interface module (8) is also used for identification of the patient, allowing that the data received by the server (4) could be processed and soon after stored together with another data correspondent to the identified patient.

Figures 2 to 7 schematically represent an example of this process, initiated with the sending of the identification code from the interface module (8) to the server (4). The server (4) selects the adequate driver (10) and, using this driver, establishes the communication with the interface module (8) by means of the TCP/IP net. Thus, the communication between the medical equipment (7) and the interface module (8) can be accomplished by means of the manufacturer's own encoding without jeopardizing the interpretation of the data in the server (4). The data processed in the server (4) follow two paths: they are written in cryptography, sent to the database (5) and to the external server (9). The external server (9) allows the access from sites of remote monitoring (6), for example, a doctor who is not at the same place where the patient is. The data sent to the database (5) can be rescued and made available for visualization in monitoring central (3) and in the site of remote monitoring (6), such as Internet (6 -A) or a mobile phone (6 - B).

Another possibility for accomplishment of the present invention, the communication between the site of treatment (2), monitoring central (3) and the site of remote monitoring (6) can be accomplished by means of other protocols. As shown in Figure 8, the medical equipment (7) can be directly connected to the network (11) for transmit the data directly to the server (4), for example, in cases in which the medical equipment (7) is already endowed of long distance interface such as Ethernet. The communication between the site of treatment (2) and monitoring central (3) can still be accomplished using wireless communication devices when a network (11), such as GPRS, is available in the establishment. The communication between site of remote monitoring (6) and monitoring central (3) can be accomplished by means of other protocols, for example, sending the data to a mobile phone (6 - B) from the respective doctor. Additionally, this communication can be bi-directional, allowing the doctor who is in site of remote

monitoring (6) to send commands to be run in the site of treatment (2) or to send annotations to be filed together with the exams.

The present invention finds wide industrial application in medical centers, such as hospitals and hospital complexes, for example, allowing a doctor to remotely visualize the vital signals of a patient in an ICU.

In emergency cases, a specialized assistance before arriving to hospital can contribute significantly to survival of the patient. The telemedicine system for remote monitoring of patients has also industrial application in ambulances, from where the patient information can be sent to the hospital allowing the doctor to give instructions to the paramedics in the ambulance.

The telemedicine system for remote monitoring of patients can also be applied in the residential medical treatment. In this case, the site of treatment is the patient's own residence, and the data can be sent from the interface module to the server by means of the internet. The residential medical treatment avoids the elevated costs of internment and also brings more comfort to the patient.