TO REDUCE EMERGENCY AND INPATIENT CARE

CROSS REFERENCE TO RELATED APPLICATION

[0001] This disclosure claims the benefit of the earlier filing date of U.S. Provisional

Patent Application No. 62/822,713, filed on March 22, 2019, which is hereby incorporated by reference in its entirety.

FIELD

[0002] This disclosure relates to patient monitoring and, in particular, systems and methods for reducing emergency care, such as emergency care following receiving one or more treatments for cancer.

BACKGROUND

[0003] The majority of cancer patients’ receiving chemotherapy end up in the hospital or the emergency room following treatment for side effects of the chemotherapy. Side effects often include nausea, dehydration, pain, fever or fatigue. For doctors, nurses, and healthcare economists, this statistic indicates preventable suffering and unnecessary cost. For patients, it results in additional pain, suffering and expense as well as exposure to a myriad of germs, which is dangerous in an immunocompromised state. And because of the severity of the side effects, the patient may also have to delay treatment or reduce their dose of chemotherapy. Therefore, a need exists to be able to proactively identify patients before the symptoms progress to a critical point and require emergency care.

SUMMARY

[0004] Disclosed are systems and methods for monitoring patients. In some embodiments, a disclosed system comprises a system for monitoring a subject, includes a biosensor capable of detecting one or more physiological parameters of the subject; a first computing system capable of receiving one or more physiological parameters transmitted from the biosensor, wherein the first computing system is further capable of receiving input from the subject; a second computing system comprising one or more processors programed to analyze one or more parameters from the first computing system with an artificial intelligence-enabled clinical database for processing the one or more parameters and output one or more notifications regarding subject’s condition; and a third computing system capable of receiving the one or more notifications from the second computing system and transmitting a selected course of action to the subject.

[0005] In some embodiments, the first computing system is a mobile computing system.

[0006] In some embodiments, the third computing system transmitting selected course of action to the subject comprises transmitting selected course of action to the subject following review of the one or more notifications from second computing system by a healthcare professional.

[0007] In some embodiments, the one or more physiological parameters is one or more vital signs.

[0008] In some embodiments, the system is used for monitoring a subject afflicted with a disease during and/or following receiving treatment for a disease.

[0009] In some embodiments, the disease is cancer.

[0010] In some embodiments, the subject has received chemotherapy.

[0011] In some embodiments, receiving input from the subject comprises the subject inputting one or more symptoms the subject is experiencing.

[0012] In some embodiments, the one or more symptoms comprise at least one of diarrhea, vomiting, dry mouth, sweating, nausea, dry mouth and tongue, less frequent urination, irritability, fatigue, sunken eyes, confusion, dizziness, or combinations thereof.

[0013] In some embodiments, the selected course of action comprises a standard alert to contact a subject’s healthcare provider or a customized alert indicating a specific treatment.

[0014] In some embodiments, a system for monitoring a subject following cancer treatment are disclosed, comprising a biosensor capable of detecting one or more

physiological parameters of the subject, wherein the one or more physiological parameters is at least one or more vital signs; a mobile computing device capable of receiving one or more physiological parameters transmitted from the biosensor, wherein the mobile computing system is further capable of receiving input from the subject regarding one or more symptoms of the subject following cancer treatment; a second computing system comprising one or more processors programed to analyze one or more parameters and one or more symptoms from the first computing system with an artificial intelligence-enabled clinical database for processing the one or more parameters and one or more symptoms and output one or more notifications regarding subject’s condition; and a third computing system capable of receiving the one or more notifications from the second computing system and transmitting a selected course of action to the subject.

[0015] In some embodiments, the third computing system transmitting selected course of action to the subject comprises transmitting selected course of action to the subject following review of the one or more notifications from second computing system by a healthcare professional.

[0016] In some embodiments, the subject has received chemotherapy.

[0017] In some embodiments, the one or more symptoms comprise at least one of diarrhea, vomiting, dry mouth, sweating, nausea, dry mouth and tongue, less frequent urination, irritability, fatigue, sunken eyes, confusion, or dizziness.

[0018] In some embodiments, the selected course of action comprises a standard alert to contact a subject’s healthcare provider or a customized alert indicating a specific treatment.

[0019] In some embodiments, a method of monitoring a subject, comprises detecting one or more physiological parameters of a subject with a biosensor; transmitting the one or more physiological parameters to a first computing system, wherein the first computing system is further capable of receiving input from the subject; transmitting one or more physiological parameters to a second computing system; analyzing one or more parameters from the first computing system with an artificial intelligence-enabled clinical database for processing the one or more parameters; outputting one or more notifications regarding subject’s condition to a third computing system capable of receiving the one or more notifications from the second computing system; and transmitting a selected course of action to the subject.

[0020] In some embodiments of the method, the first computing system is a mobile computing system.

[0021] In some embodiments of the method, transmitting a selected course of action to the subject comprises transmitting selected course of action to the subject following review of the one or more notifications from second computing system by a healthcare professional.

[0022] In some embodiments of the method, the one or more physiological parameters is one or more vital signs.

[0023] In some embodiments, the method is used for monitoring a subject afflicted with a disease during and/or following the subject receiving treatment for a disease, such as cancer.

[0024] In some embodiments, the subject has received chemotherapy. [0025] In some embodiments of the method, receiving input from the subject comprises the subject inputting one or more symptoms the subject is experiencing, such as one or more symptoms comprise at least one of diarrhea, vomiting, dry mouth, sweating, nausea, dry mouth and tongue, less frequent urination, irritability, fatigue, sunken eyes, confusion, dizziness, or combinations thereof.

[0026] In some embodiments of the method, the selected course of action comprises a standard alert to contact a subject’s healthcare provider or a customized alert indicating a specific treatment.

[0027] Also disclosed is a non-transitory computer-readable storage medium with an executable program stored thereon for monitoring a subject, wherein the program instructs a microprocessor to perform the steps of: detecting one or more physiological parameters of a subject with a biosensor; transmitting the one or more physiological parameters and/or symptoms; analyzing the one or more parameters and/or symptoms; outputting one or more notifications regarding subject’s condition; and transmitting a selected course of action to the subject.

[0028] In some embodiments of the non-transitory computer-readable storage medium, the one or more physiological parameters is one or more vital signs.

[0029] In some embodiments of the non-transitory computer-readable storage medium, the subject is afflicted with a disease, such as cancer.

[0030] In some embodiments of the non-transitory computer-readable storage medium, the subject has received chemotherapy.

[0031] In some embodiments of the non-transitory computer-readable storage medium, receiving input from the subject comprises the subject inputting one or more symptoms the subject is experiencing.

[0032] In some embodiments of the non-transitory computer-readable storage medium, the one or more symptoms comprise at least one of diarrhea, vomiting, dry mouth, sweating, nausea, dry mouth and tongue, less frequent urination, irritability, fatigue, sunken eyes, confusion, dizziness, or combinations thereof.

[0033] In some embodiments of the non-transitory computer-readable storage medium, the selected course of action comprises a standard alert to contact a subject’s healthcare provider or a customized alert indicating a specific treatment. BRIEF DESCRIPTION OF THE DRAWINGS

[0034] Embodiments will be readily understood by the following detailed description in conjunction with the accompanying drawings and the appended claims. Embodiments are illustrated by way of example and not by way of limitation in the figures of the

accompanying drawings.

[0035] Figure l is a schematic representation of a system for patient monitoring and, in particular, a system for reducing emergency care in accordance with embodiments disclosed herein.

[0036] Figure 2 is a schematic representation of an example computing

device/system for the implementation of the methods disclosed herein, such as for proactive monitoring of patient reported outcomes to reduce emergency and inpatient care,

[0037] Figure 3 is a schematic diagram of a networked computing system for the implementation of the methods disclosed herein.

DETAILED DESCRIPTION OF SEVERAL EMBODIMENTS

[0038] I. Terms

[0039] In the following detailed description, reference is made to the accompanying drawings that form a part hereof, and in which are shown by way of illustration embodiments that may be practiced. It is to be understood that other embodiments may be utilized and structural or logical changes may be made without departing from the scope. Therefore, the following detailed description is not to be taken in a limiting sense, and the scope of embodiments is defined by the appended claims and their equivalents.

[0040] Various operations may be described as multiple discrete operations in turn, in a manner that may be helpful in understanding embodiments; however, the order of description should not be construed to imply that these operations are order dependent.

[0041] The description may use perspective-based descriptions such as up/down, back/front, and top/bottom. Such descriptions are merely used to facilitate the discussion and are not intended to restrict the scope of the disclosure.

[0042] The terms“coupled” and“connected,” along with their derivatives, may be used. These terms are not intended as synonyms for each other. Rather, aspects,“connected” may be used to indicate that two or more elements are in direct physical or electrical contact with each other.“Coupled” may mean that two or more elements are in direct physical or electrical contact. However,“coupled” may also mean that two or more elements are not in direct contact with each other, but still cooperate or interact with each other. For the purposes of the description, a phrase in the form“A/B” or in the form“A and/or B” means (A), (B), or (A and B). For the purposes of the description, a phrase in the form“at least one of A, B, and C” means (A), (B), (C), (A and B), (A and C), (B and C), or (A, B and C). For the purposes of the description, a phrase in the form“(A)B” means (B) or (AB) that is, A is an optional element.

[0043] The description may use the terms“embodiment” or“embodiments,” which may each refer to one or more of the same or different embodiments. Furthermore, the terms “comprising,”“including,”“having,” and the like, as used with respect to embodiments, are synonymous, and are generally intended as“open” terms (e.g., the term“including” should be interpreted as“including but not limited to,” the term“having” should be interpreted as “having at least,” the term“includes” should be interpreted as“includes but is not limited to,” etc.).

[0044] With respect to the use of any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations may be expressly set forth herein for sake of clarity.

[0045] Unless otherwise noted, technical terms are used according to conventional usage. Definitions of common terms in molecular biology can be found in Benjamin Lewin, Genes IX, published by Jones and Bartlet, 2008 (ISBN 0763752223); Kendrew et al. (eds.), The Encyclopedia of Molecular Biology, published by Blackwell Science Ltd., 1994 (ISBN 0632021829); and Robert A. Meyers (ed.), Molecular Biology and Biotechnology: a

Comprehensive Desk Reference, published by VCH Publishers, Inc., 1995 (ISBN

9780471185710); and other similar references.

[0046] Suitable methods and materials for the practice or testing of this disclosure are described below. Such methods and materials are illustrative only and are not intended to be limiting. Other methods and materials similar or equivalent to those described herein can be used. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.

[0047] To facilitate review of the various embodiments of the disclosure, the following explanations of specific terms are provided:

[0048] Patient or Subject: A term that includes human and non-human animals, such as those having a disorder or disease, such as cancer. In one example, the patient or subject is a mammal, such as a human.“Patient” and“subject” are used interchangeably herein. [0049] Signs or symptoms: Any subjective evidence of disease or of a subject's condition, e.g., such evidence as perceived by the subject; a noticeable change in a subject's condition indicative of some bodily or mental state. A“sign” is any abnormality indicative of disease or condition, discoverable on examination or assessment of a subject. A sign is generally an objective indication of disease or condition. Signs include, but are not limited to any measurable parameters such as vital signs or other physiological parameters. Signs of dehydration include increased pulse rate, respiration rate and/or blood pressure. Symptoms of dehydration include, but are not limited to, diarrhea, vomiting, dry mouth, sweating, nausea, dry mouth and tongue, less frequent urination, irritability, fatigue, sunken eyes, confusion, dizziness, or combinations thereof.

[0050] Treating a disease or condition: A phrase referring to a therapeutic intervention that ameliorates a sign or symptom of a disease or pathological condition after it has begun to develop.

[0051] Treatment: A method of reducing the effects of a disease or condition.

Treatment can also refer to a method of reducing the disease or condition itself rather than just the symptoms.

[0052] Vital signs: clinical measurements, specifically pulse rate, temperature, respiration rate, and blood pressure, which indicate the state of a patient's essential body functions.

[0053] II. Systems and Methods of Use

[0054] Disclosed herein are systems for patient monitoring and, in particular, systems and methods for reducing emergency care, such as emergency care following receiving one or more treatments for cancer or other disease/condition. The disclosed systems and methods assist patients’ complete treatments without going or reducing the number of visits to the emergency department (ED).

[0055] In some embodiments, the disclosed systems and methods use a cloud-based system to monitor patients’ symptoms and vital signs, such as heart rate, with wearable biosensors and by collecting information about their symptoms through an app. The information from the biosensors and application is stored in a cloud, such as Microsoft Azure, and algorithms are used to predict when a condition/situation is changing, such as when a physiological condition/situation is increasing in severity and prompting medical

intervention, so that the change can be communicated to a healthcare provider, such as in the form of an alert and in turn, the healthcare provider can contact the patient to suggest a course of action prior to the patient needing immediate, urgent care. The disclosed methods and systems transform care, such as cancer care, by facilitating pro-active, supportive care, preempting emergency department visits, improving patients’ lives by reducing their suffering and helping them complete treatment with fewer complications. The disclosed systems and methods leverage artificial intelligence technology and clinical and data science experts allowing monitoring of patients more closely and responding to side effects more quickly. As such, the provided systems and methods allow better predicting of distressing episodes and enabling clinical intervention before complications become emergencies.

[0056] In some embodiments, the systems and methods are used with a subject that has a cancer and is receiving one or more therapeutic treatments, such as chemotherapy and/or radiation. In some embodiments, the subject has a cancer and/or tumor type selected from Acanthoma, Acinic cell carcinoma, Acoustic neuroma, Acral lentiginous melanoma, Acrospiroma, Acute eosinophilic leukemia, Acute lymphoblastic leukemia, Acute

megakaryoblastic leukemia, Acute monocytic leukemia, Acute myeloblastic leukemia with maturation, Acute myeloid dendritic cell leukemia, Acute myeloid leukemia, Acute promyelocytic leukemia, Adamantinoma, Adenocarcinoma, Adenoid cystic carcinoma, Adenoma, Adenomatoid odontogenic tumor, Adrenocortical carcinoma, Adult T-cell leukemia, Aggressive NK-cell leukemia, AIDS-Related Cancers, AIDS-related lymphoma, Alveolar soft part sarcoma, Ameloblastic fibroma, Anal cancer, Anaplastic large cell lymphoma, Anaplastic thyroid cancer, Angioimmunoblastic T-cell lymphoma,

Angiomyolipoma, Angiosarcoma, Appendix cancer, Astrocytoma, Atypical teratoid rhabdoid tumor, Basal cell carcinoma, Basal-like carcinoma, B-cell leukemia, B-cell lymphoma,

Bellini duct carcinoma, Biliary tract cancer, Bladder cancer, Blastoma, Bone Cancer, Bone tumor, Brain Stem Glioma, Brain Tumor, Breast Cancer, Brenner tumor, Bronchial Tumor, Bronchioloalveolar carcinoma, Brown tumor, Burkitfs lymphoma, Cancer of Unknown Primary Site, Carcinoid Tumor, Carcinoma, Carcinoma in situ, Carcinoma of the penis, Carcinoma of Unknown Primary Site, Carcinosarcoma, Castleman's Disease, Central Nervous System Embryonal Tumor, Cerebellar Astrocytoma, Cerebral Astrocytoma, Cervical Cancer, Cholangiocarcinoma, Chondroma, Chondrosarcoma, Chordoma, Choriocarcinoma, Choroid plexus papilloma, Chronic Lymphocytic Leukemia, Chronic monocytic leukemia, Chronic myelogenous leukemia, Chronic Myeloproliferative Disorder, Chronic neutrophilic leukemia, Clear-cell tumor, Colon Cancer, Colorectal cancer, Craniopharyngioma, Cutaneous T-cell lymphoma, Degos disease, Dermatofibrosarcoma protuberans, Dermoid cyst,

Desmoplastic small round cell tumor, Diffuse large B cell lymphoma, Dysembryoplastic neuroepithelial tumor, Embryonal carcinoma, Endodermal sinus tumor, Endometrial cancer, Endometrial Uterine Cancer, Endometrioid tumor, Enteropathy-associated T-cell lymphoma, Ependymoblastoma, Ependymoma, Epithelioid sarcoma, Erythroleukemia, Esophageal cancer, Esthesioneuroblastoma, Ewing Family of Tumor, Ewing Family Sarcoma, Ewing's sarcoma, Extracranial Germ Cell Tumor, Extragonadal Germ Cell Tumor, Extrahepatic Bile Duct Cancer, Extramammary Paget's disease, Fallopian tube cancer, Fetus in fetu, Fibroma, Fibrosarcoma, Follicular lymphoma, Follicular thyroid cancer, Gallbladder Cancer,

Ganglioglioma, Ganglioneuroma, Gastric Cancer, Gastric lymphoma, Gastrointestinal cancer, Gastrointestinal Carcinoid Tumor, Gastrointestinal Stromal Tumor, Gastrointestinal stromal tumor, Germ cell tumor, Germinoma, Gestational choriocarcinoma, Gestational

Trophoblastic Tumor, Giant cell tumor of bone, Glioblastoma multiforme, Glioma,

Gliomatosis cerebri, Glomus tumor, Glucagonoma, Gonadoblastoma, Granulosa cell tumor, Hairy Cell Leukemia, Hairy cell leukemia, Head and Neck Cancer, Head and neck cancer, Heart cancer, Hemangioblastoma, Hemangiopericytoma, Hemangiosarcoma, Hematological malignancy, Hepatocellular carcinoma, Hepatosplenic T-cell lymphoma, Hereditary breast- ovarian cancer syndrome, Hodgkin Lymphoma, Hypopharyngeal Cancer, Hypothalamic Glioma, Inflammatory breast cancer, Intraocular Melanoma, Islet cell carcinoma, Islet Cell Tumor, Juvenile myelomonocytic leukemia, Kaposi Sarcoma, Kaposi's sarcoma, Kidney Cancer, Klatskin tumor, Krukenberg tumor, Laryngeal Cancer, Lentigo maligna melanoma, Leukemia, Lip and Oral Cavity Cancer, Liposarcoma, Lung cancer, Luteoma,

Lymphangioma, Lymphangiosarcoma, Lymphoepithelioma, Lymphoid leukemia,

Lymphoma, Macroglobulinemia, Malignant Fibrous Histiocytoma, Malignant Fibrous Histiocytoma of Bone, Malignant Glioma, Malignant Mesothelioma, Malignant peripheral nerve sheath tumor, Malignant rhabdoid tumor, Malignant triton tumor, MALT lymphoma, Mantle cell lymphoma, Mast cell leukemia, Mediastinal germ cell tumor, Mediastinal tumor, Medullary thyroid cancer, Medulloblastoma, Medulloepithelioma, Melanoma, Meningioma, Merkel Cell Carcinoma, Mesothelioma, Metastatic Squamous Neck Cancer with Occult Primary, Metastatic urothelial carcinoma, Mixed Mullerian tumor, Monocytic leukemia, Mouth Cancer, Mucinous tumor, Multiple Endocrine Neoplasia Syndrome, Multiple myeloma, Mycosis Fungoides, Myelodysplastic Disease, Myelodysplastic Syndromes, Myeloid leukemia, Myeloid sarcoma, Myeloproliferative Disease, Myxoma, Nasal Cavity Cancer, Nasopharyngeal Cancer, Nasopharyngeal carcinoma, Neoplasm, Neurinoma, Neuroblastoma, Neurofibroma, Neuroma, Nodular melanoma, Non-Hodgkin lymphoma, Nonmelanoma Skin Cancer, Non-Small Cell Lung Cancer, Ocular oncology,

Oligoastrocytoma, Oligodendroglioma, Oncocytoma, Optic nerve sheath meningioma, Oral cancer, Oropharyngeal Cancer, Osteosarcoma, Ovarian cancer, Ovarian Epithelial Cancer, Ovarian Germ Cell Tumor, Ovarian Low Malignant Potential Tumor, Paget's disease of the breast, Pancoast tumor, Pancreatic cancer, Papillary thyroid cancer, Papillomatosis,

Paraganglioma, Paranasal Sinus Cancer, Parathyroid Cancer, Penile Cancer, Perivascular epithelioid cell tumor, Pharyngeal Cancer, Pheochromocytoma, Pineal Parenchymal Tumor of Intermediate Differentiation, Pineoblastoma, Pituicytoma, Pituitary adenoma, Pituitary tumor, Plasma Cell Neoplasm, Pleuropulmonary blastoma, Polyembryoma, Precursor T- lymphoblastic lymphoma, Primary central nervous system lymphoma, Primary effusion lymphoma, Primary Hepatocellular Cancer, Primary Liver Cancer, Primary peritoneal cancer, Primitive neuroectodermal tumor, Prostate cancer, Pseudo yxo a peritonei, Rectal Cancer, Renal cell carcinoma, Respiratory Tract Carcinoma Involving the NUT Gene on

Chromosome 15, Retinoblastoma, Rhabdomyoma, Rhabdomyosarcoma, Richter's

transformation, Sacrococcygeal teratoma, Salivary Gland Cancer, Sarcoma,

Schwannomatosis, Sebaceous gland carcinoma, Secondary neoplasm, Seminoma, Serous tumor, Sertoli-Leydig cell tumor, Sex cord-stromal tumor, Sezary Syndrome, Signet ring cell carcinoma, Skin Cancer, Small blue round cell tumor, Small cell carcinoma, Small Cell Lung Cancer, Small cell lymphoma, Small intestine cancer, Soft tissue sarcoma, Somatostatinoma, Soot wart, Spinal Cord Tumor, Spinal tumor, Splenic marginal zone lymphoma, Squamous cell carcinoma, Stomach cancer, Superficial spreading melanoma, Supratentorial Primitive Neuroectodermal Tumor, Surface epithelial-stromal tumor, Synovial sarcoma, T-cell acute lymphoblastic leukemia, T-cell large granular lymphocyte leukemia, T-cell leukemia, T-cell lymphoma, T-cell prolymphocytic leukemia, Teratoma, Terminal lymphatic cancer,

Testicular cancer, Thecoma, Throat Cancer, Thymic Carcinoma, Thymoma, Thyroid cancer, Transitional Cell Cancer of Renal Pelvis and Ureter, Transitional cell carcinoma, Urachal cancer, Urethral cancer, Urogenital neoplasm, Uterine sarcoma, Uveal melanoma, Vaginal Cancer, Vemer Morrison syndrome, Verrucous carcinoma, Visual Pathway Glioma, Vulvar Cancer, Waldenstrom's macroglobulinemia, Warthin's tumor, or Wilms' tumor.

[0057] In some embodiments, the systems and methods are used with patients to prevent and/or monitor an infectious disease or condition, such including, but are not limited to: viruses, bacteria, mycoplasma and fungi. In a particular example, it is a disease caused by at least one type of infectious pathogen. In another example, it is a disease caused by at least two different types of infectious pathogens. Infectious diseases can affect any body system, be acute (short-acting) or chronic/persistent (long-acting), occur with or without fever, strike any age group, and overlap each other. Infectious diseases can be opportunistic infections, in that they occur more frequently in immunocompromised subjects.

[0058] Viral diseases commonly occur after immunosuppression due to re-activation of viruses already present in the recipient. Particular examples of viral infections include, but are not limited to, cytomegalovirus (CMV) pneumonia, enteritis and retinitis; Epstein-Barr virus (EBV) lymphoproliferative disease; chicken pox/shingles (caused by varicella zoster virus, VZV); HSV-1 and -2 mucositis; HSV-6 encephalitis, BK-virus hemorrhagic cystitis; viral influenza; pneumonia from respiratory syncytial virus (RSV); AIDS (caused by HIV); and hepatitis A, B or C. Opportunistic infections occur in a subject with a compromised immune system, such as a subject who has been immuno-depleted and recently received a bone marrow transplant or a hematopoietic stem cell transplant. These infections include, but are not limited to cytomegalovirus, Candida albicans, human immunodeficiency virus, Staphlococcus aureus, Steptococcus pyogenes, Pseudomas aeruginosa, Acinteobacter baumanni, Toxoplasma gondii, Pneumocystitis carinii, or Aspergillus infections.

[0059] Additional examples of infectious virus include: Retroviridae; Picornaviridae

(for example, polio viruses, hepatitis A virus; enteroviruses, human coxsackie viruses, rhinoviruses, echoviruses); Calciviridae (such as strains that cause gastroenteritis);

Togaviridae (for example, equine encephalitis viruses, rubella viruses); Flaviridae (for example, dengue viruses, encephalitis viruses, yellow fever viruses); Coronaviridae (for example, coronaviruses); Rhabdoviridae (for example, vesicular stomatitis viruses, rabies viruses); Filoviridae (for example, ebola viruses); Paramyxoviridae (for example, parainfluenza viruses, mumps virus, measles virus, respiratory syncytial virus);

Orthomyxoviridae (for example, influenza viruses); Bungaviridae (for example, Hantaan viruses, bunga viruses, phleboviruses and Nairo viruses); Arena viridae (hemorrhagic fever viruses); Reoviridae (e.g., reoviruses, orbiviurses and rotaviruses); Bimaviridae;

Hepadnaviridae (Hepatitis B virus); Parvoviridae (parvoviruses); Papovaviridae (papilloma viruses, polyoma viruses); Adenoviridae (most adenoviruses); Herpesviridae (herpes simplex virus (HSV) 1 and HSV-2, varicella zoster virus, cytomegalovirus (CMV), herpes viruses); Poxviridae (variola viruses, vaccinia viruses, pox viruses); and Iridoviridae (such as African swine fever virus); and unclassified viruses (for example, the etiological agents of

Spongiform encephalopathies, the agent of delta hepatitis (thought to be a defective satellite of hepatitis B virus), the agents of non- A, non-B hepatitis (class l=intemally transmitted; class 2=parenterally transmitted (i.e., Hepatitis C); Norwalk and related viruses, and astroviruses). [0060] Examples of fungal infections include but are not limited to: aspergillosis; thrush (caused by Candida albicans); cryptococcosis (caused by Cryptococcus); and histoplasmosis. Thus, examples of infectious fungi include, but are not limited to,

Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, Chlamydia trachomatis, Candida albicans.

[0061] Examples of infectious bacteria include: Helicobacter pyloris, Borelia burgdorferi, Legionella pneumophilia, Mycobacteria sps (such as. M. tuberculosis, M. avium, M. intracellulare, M. kansaii, M. gordonae), Staphylococcus aureus, Neisseria gonorrhoeae, Neisseria meningitidis, Listeria monocytogenes, Streptococcus pyogenes (Group A

Streptococcus), Streptococcus agalactiae (Group B Streptococcus), Streptococcus (viridans group), Streptococcus faecalis, Streptococcus bovis, Streptococcus (anaerobic sps.),

Streptococcus pneumoniae, pathogenic Campylobacter sp., Enterococcus sp., Haemophilus influenzae, Bacillus anthracis, corynebacterium diphtheriae, corynebacterium sp.,

Erysipelothrix rhusiopathiae, Clostridium perfringers, Clostridium tetani, Enterobacter aerogenes, Klebsiella pneumoniae, Pasturella multocida, Bacteroides sp., Fusobacterium nucleatum, Streptobacillus moniliformis, Treponema pallidium, Treponema pertenue, Leptospira, and Actinomyces israelii. Other infectious organisms (such as protists) include: Plasmodium falciparum and Toxoplasma gondii.

[0062] Referring to Figure 1, a system for patient monitoring and, in particular, a system for reducing emergency care in accordance with embodiments disclosed herein. A wearable biosensor 102 monitors and detects one or more physiological parameters of a subject and transmits the one or more physiological parameters to a first computing system 104, such as a mobile computing system, wherein the first computing system 104 is further capable of receiving input from the subject. In some embodiments, the first computing system 104 is a mobile computing system with an application that communicates with the wearable biosensor and allows the user to input one or more physiological parameter. A second computing system 210 comprising one or more processors is programed to analyze the one or more physiological parameters transmitted from the first computing system 104 using one or more machine learning prospective hospitalization predication algorithms for processing the one or more physiological parameters and output one or more notifications to a third computing system 300 wherein the third computing system notifies/alerts the receiver, such as a healthcare professional, including, but not limited to a doctor, nurse or medical practitioner, of the physiological parameters/condition, need for intervention and/or course of action. The receiver, such as the healthcare provider, then contacts the patient regarding the physiological parameters/condition, need for intervention and/or recommended course of action.

[0063] In embodiments, the second computing system includes an Artificial

Intelligence (Al)-enabled database that includes prospective hospitalization predication algorithms which predict when a physiological parameter/condition/situation/symptom is changing. In some embodiments, the one or more physiological parameters monitored is one or more vital signs of the patient. In some embodiments, the patients is undergoing treatment for a disease or condition. In some embodiments, the disease is cancer. In some

embodiments, the disease is an infectious pathogen. In some embodiments, the first computing system 104 is capable of receiving input from the patient such as the patient inputting one or more physiological parameters/symptoms that the patient is experiencing, such as, one or more physiological parameters/symptoms associated with the treatment for the disease or condition the patient is afflicted with. In some embodiments, the one or more physiological parameters/symptoms include diarrhea, vomiting, dry mouth, sweating, nausea, dry mouth and tongue, less frequent urination, irritability, fatigue, sunken eyes, confusion, dizziness, or combinations thereof.

[0064] Figure 2 illustrates a simplified diagram of an exemplary computing device, such as a computing device 104 (which can be any computing device, such as a smart phone or standalone computing device), for proactive monitoring of patient reported outcomes to reduce emergency and inpatient care, for example a signal based on one or more

physiological parameters, such as one or more vital signs, detected from a sensor, such as a wearable biosensor. In embodiments, computing device 104 includes several components, such as one or more processors 140 and at least one sensor communication module 142, for example that is capable of communication with a sensor, for example either via a direct connection or through a signal propagated trough a transmitter and/or receiver. In various embodiments, the one or more processors 140 each include one or more processor cores. In various embodiments, the at least one sensor communication module 142 is physically and electrically coupled to the one or more processors 140. In various embodiments, the at least one sensor communication module 142 is physically and/or electrically coupled to the one or more sensors, such as a first and/or second sensor. In further implementations, the sensor communication module 142 is part of the one or more processors 140. In various

embodiments, computing device 100 includes printed circuit board (PCB) 155. For these embodiments, the one or more processors 140 and sensor communication module 142 is disposed thereon. Depending on its applications, the computing device 104 includes other components that may or may not be physically and electrically coupled to the PCB. These other components include, but are not limited to, a memory controller (not shown), volatile memory (e.g., dynamic random access memory (DRAM) (not shown)), non-volatile memory (not shown) such as read only memory (ROM), flash memory (not shown), an I/O port (not shown), (not shown), a digital signal processor (not shown), a crypto processor (not shown), a graphics processor (not shown), one or more antenna (not shown), a touch-screen display 110, a touch-screen display controller (not shown), a battery (not shown), an audio codec (not shown), a video codec (not shown), a global positioning system (GPS) device (not shown), a compass (not shown), an accelerometer (not shown), a gyroscope (not shown) (not shown), a speaker (not shown), a camera (not shown), and a mass storage device (such as hard disk drive, a solid state drive, compact disk (CD) (not shown), digital versatile disk (DVD) (not shown), a microphone (not shown), and so forth.

[0065] In some embodiments, the one or more processors 140 is operatively coupled to system memory through one or more links (e.g., interconnects, buses, etc.). In

embodiments, system memory is capable of storing information that the one or more processors 140 utilizes to operate and execute programs and operating systems, including computer readable instructions for the method disclosed herein. In different embodiments, system memory is any usable type of readable and writeable memory such as a form of dynamic random access memory (DRAM). In embodiments, computing device 104 includes or is otherwise associated with various input and output/feedback devices to enable user interaction with the computing device 104 and/or peripheral components or devices associated with the computing device 104 by way of one or more user interfaces or peripheral component interfaces. In embodiments, the user interfaces include, but are not limited to a physical keyboard or keypad, a touchpad, a display device (touchscreen or non-touchscreen), speakers, microphones, sensors, haptic feedback devices and/or one or more actuators, and the like.

[0066] In some embodiments, the computing device can comprise a memory element

(not shown), which can exist within a removable smart chip or a secure digital ("SD") card or which can be embedded within a fixed chip. In certain example embodiments, Subscriber Identity Component ("SIM") cards may be used. In various embodiments, the memory element may allow a software application resident on the device. In embodiments, a I/O link connecting a peripheral device to a computing device is protocol-specific with a protocol- specific connector port that allows a compatible peripheral device to be attached to the protocol-specific connector port (i.e., a USB keyboard device would be plugged into a USB port, a router device would be plugged into a LAN/Ethernet port, etc.) with a protocol- specific cable. Any single connector port would be limited to peripheral devices with a compatible plug and compatible protocol. Once a compatible peripheral device is plugged into the connector port, a communication link would be established between the peripheral device and a protocol-specific controller.

[0067] In embodiments, a non-protocol-specific connector port is configured to couple the I/O interconnect with a connector port of the computing device 104, allowing multiple device types to attach to the computing device 104 through a single physical connector port. Moreover, the I/O link between the computing device 100 and the I/O complex is configured to carry multiple I/O protocols (e.g., PCI Express®, USB,

DisplayPort, HDMI, etc.) simultaneously. In various embodiments, the connector port is capable of providing the full bandwidth of the link in both directions with no sharing of bandwidth between ports or between upstream and downstream directions. In various embodiments, the connection between the EO interconnect and the computing device 104 supports electrical connections, optical connections, or both.

[0068] In some embodiments, the one or more processors 140, flash memory, and/or a storage device includes associated firmware storing programming instructions configured to enable the computing device 104, in response to execution of the programming instructions by one or more processors 140, to practice all or selected aspects of a method of monitoring a patient using a computing device, in accordance with embodiments of the present disclosure.

[0069] In embodiments, the sensor communication module 142 enables wired and/or wireless communications for the transfer of data to and from the computing device 100 for example to one or more sensors, a transmitter, and/or transmitter/receiver coupled, such as physically and/or electrically coupled to one or more sensors, such as one or more sensors for detecting a physiological parameter, such as one or more vital signs.

[0070] In various embodiments, the computing device 104 also includes a network interface configured to connect the computing device 104 to one or more networked computing devices wirelessly via a transmitter and a receiver (or optionally a transceiver) and/or via a wired connection using a communications port. In embodiments, the network interface and the transmitter/receiver and/or communications port are collectively referred to as a“communication module”. In embodiments, the wireless transmitter/receiver and/or transceiver may be configured to operate in accordance with one or more wireless communications standards. The term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communications channels, etc., that may communicate data through the use of modulated electromagnetic radiation through a non solid medium. The term does not imply that the associated devices do not contain any wires, although in some embodiments they might not. In embodiments, the computing device 104 includes a wireless communication module for transmitting to and receiving data, for example for transmitting and receiving data from a network, such as a telecommunications network. In examples, the communication module transmits data, including video data, though a cellular network or mobile network, such as a Global System for Mobile

Communications (GSM), General Packet Radio Service (GPRS), cdmaOne, CDMA2000, Evolution-Data Optimized (EV-DO), Enhanced Data Rates for GSM Evolution (EDGE), Universal Mobile Telecommunications System (UMTS), Digital Enhanced Cordless

Telecommunications (DECT), Digital AMPS (IS-136/TDMA), and Integrated Digital Enhanced Network (iDEN), Long-Term Evolution (LTE), 3rd generation mobile network (3G), 4th generation mobile network (4G), and/or 5th generation mobile network (5G) networks. In embodiments, the computing device 104 is directly connect with one or more devices via the direct wireless connection by using, for example, Bluetooth and/or BLE protocols, WiFi protocols, Infrared Data Association (IrDA) protocols, ANT and/or ANT+ protocols, LTE ProSe standards, and the like. In embodiments, the communications port is configured to operate in accordance with one or more known wired communications protocol, such as a serial communications protocol (e.g., the Universal Serial Bus (USB), FireWire, Serial Digital Interface (SDI), and/or other like serial communications protocols), a parallel communications protocol (e.g., IEEE 1284, Computer Automated Measurement And Control (CAMAC), and/or other like parallel communications protocols), and/or a network communications protocol (e.g., Ethernet, token ring, Fiber Distributed Data Interface (FDDI), and/or other like network communications protocols).

[0071] In embodiments, the computing device 104 is configured to run, execute, or otherwise operate one or more applications, such as for monitoring one or more physiological parameters, including one or more vital signs and/or conditions that a subject is experiencing. In embodiments, the applications include native applications, web applications, and hybrid applications. For example, the native applications are used for operating the computing device 104, sensor coupled to the computing device 104, and other like functions of the computing device 104. In embodiments, native applications are platform or operating system (OS) specific or non-specific. In embodiments, native applications are developed for a specific platform using platform-specific development tools, programming languages, and the like. Such platform-specific development tools and/or programming languages are provided by a platform vendor. In embodiments, native applications are pre-installed on computing device 104 during manufacturing, or provided to the computing device 104 by an application server via a network. Web applications are applications that load into a web browser of the computing device 104 in response to requesting the web application from a service provider. In embodiments, the web applications are websites that are designed or customized to run on a computing device by taking into account various computing device parameters, such as resource availability, display size, touch-screen input, and the like. In this way, web applications may provide an experience that is similar to a native application within a web browser. Web applications may be any server-side application that is developed with any server-side development tools and/or programming languages, such as PHP, Node.js, ASP.NET, and/or any other like technology that renders HTML. Hybrid applications may be a hybrid between native applications and web applications. Hybrid applications may be a standalone, skeletons, or other like application containers that may load a website within the application container. Hybrid applications may be written using website development tools and/or programming languages, such as HTML5, CSS, JavaScript, and the like.

[0072] In embodiments, hybrid applications use browser engine of the computing device 104, without using a web browser of the computing device 104, to render a website’s services locally. In some embodiments, hybrid applications also access computing device capabilities that are not accessible in web applications, such as the accelerometer, camera, local storage, and the like. Any combination of one or more computer usable or computer readable medium(s) may be utilized with the embodiments disclosed herein. The computer- usable or computer-readable medium may be, for example but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, device, or propagation medium. More specific examples (a non- exhaustive list) of the computer- readable medium would include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a random access memory (RAM), a read only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a transmission media such as those supporting the Internet or an intranet, or a magnetic storage device. Note that the computer- usable or computer-readable medium can even be paper or another suitable medium upon which the program is printed, as the program can be electronically captured, via, for instance, optical scanning of the paper or other medium, then compiled, interpreted, or otherwise processed in a suitable manner, if necessary, and then stored in a computer memory. In the context of this document, a computer-usable or computer-readable medium may be any medium that can contain, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device. The computer- usable medium may include a propagated data signal with the computer-usable program code embodied therewith, either in baseband or as part of a carrier wave. The computer usable program code may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc.

[0073] Computer program code for carrying out operations of the present disclosure may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, Smalltalk, C++ or the like and conventional procedural programming languages, such as the "C" programming language or similar programming languages. The program code may execute entirely on the user's computing device, partly on the user's computing device, as a stand-alone software package, partly on the user's computing device and partly on a remote computer or entirely on the remote computer or server. In the latter scenario, the remote computer may be connected to the user's computing device, through any type of network, including a local area network (LAN) or a wide area network (WAN), or the connection may be made to an external computing device, (for example, through the Internet using an Internet Service Provider), or wireless network, such as described above.

[0074] Furthermore, example embodiments may be implemented by hardware, software, firmware, middleware, microcode, hardware description languages, or any combination thereof. When implemented in software, firmware, middleware or microcode, the program code or code segments to perform the necessary tasks may be stored in a machine or computer readable medium. A code segment may represent a procedure, a function, a subprogram, a program, a routine, a subroutine, a module, program code, a software package, a class, or any combination of instructions, data structures, program statements, and the like.

[0075] In various embodiments, an article of manufacture may be employed to implement one or more methods as disclosed herein. The article of manufacture may include a computer-readable non-transitory storage medium and a storage medium. The storage medium may include programming instructions configured to cause an apparatus to practice some or all aspects of a disclosed method using a computing device, in accordance with embodiments of the present disclosure. The storage medium may represent a broad range of persistent storage medium known in the art, including but not limited to flash memory, optical disks or magnetic disks. The programming instructions, in particular, may enable an apparatus, in response to their execution by the apparatus, to perform various operations described herein. For example, the storage medium may include programming instructions configured to cause an apparatus to practice some or all aspects of a disclosed method, such as a method of monitoring a patient using a computing device, in accordance with

embodiments of the present disclosure.

[0076] Although various example methods, apparatus, systems, and articles of manufacture have been described herein, the scope of coverage of the present disclosure is not limited thereto. On the contrary, the present disclosure covers all methods, apparatus, and articles of manufacture fairly falling within the scope of the appended claims either literally or under the doctrine of equivalents. For example, although the above discloses example systems including, among other components, software or firmware executed on hardware, it should be noted that such systems are merely illustrative and should not be considered as limiting. In particular, it is contemplated that any or all of the disclosed hardware, software, and/or firmware components can be embodied exclusively in hardware, exclusively in software, exclusively in firmware or in some combination of hardware, software, and/or firmware.

[0077] Figure 3 illustrates an exemplary networked system 200, in accordance with embodiments disclosed herein. The networked system 200 includes the computing device 104 in wireless communication therewith. The networked system 200 also induces other networked devices 210, which may be in wired or wireless communication therewith. In some embodiments, the computing device 104 includes application software with executable instructions configured to transmit and receive information from network 205. The information can be transmitted to and/or received from another device, such as one or more networked devices 205 through a network. In certain examples, the other networked device 210 transmits one or more notifications to an additional computing device which displays the data to one or more receivers, such as a healthcare professional, such as a doctor, nurse or other medical practitioner. The receiver of information, such as the healthcare professional, contacts the patient regarding the notification and provides a recommended course of action.

It is contemplated that the patient may be contacted by the healthcare professional by telephone, email, text and/or an alert on the first computing device or wearable biosensor system or other means of communication. In some embodiments, it is contemplated that other networked device 210 transmits one or more notifications directly to the patient, such as a notification to contact one’s healthcare professional or one or more recommended courses of action.

[0078] As depicted in Figure 3, the system 200 distributes and receives information to and from one or more networked devices 210 through one or more of network 205.

According to various embodiments, network 205 may be any network that allows computers to exchange data, for example for cloud based storage of data generated (historical and current) and/or implementation of some, none or even all of the methods disclosed herein. In some embodiments, network 205 includes one or more network elements (not shown) capable of physically or logically connecting computers. The network 205 may include any appropriate network, including an intranet, the Internet, a cellular network, a local area network (LAN), a wide area network (WAN), a personal network or any other such network or combination thereof. Components used for such a system can depend at least in part upon the type of network and/or environment selected. Protocols and components for

communicating via such a network are well known and will not be discussed herein in detail. In embodiments, communication over the network 205 are enabled by wired or wireless connections, and combinations thereof. Each network 205 includes a wired or wireless telecommunication means by which network systems may communicate and exchange data. For example, each network 205 is implemented as, or may be a part of, a storage area network (SAN), personal area network (PAN), a metropolitan area network (MAN), a local area network (LAN), a wide area network (WAN), a wireless local area network (WLAN), a virtual private network (VPN), an intranet, an Internet, a mobile telephone network, such as Global System for Mobile Communications (GSM), General Packet Radio Service (GPRS), cdmaOne, CDMA2000, Evolution-Data Optimized (EV-DO), Enhanced Data Rates for GSM Evolution (EDGE), Universal Mobile Telecommunications System (UMTS), Digital Enhanced Cordless Telecommunications (DECT), Digital AMPS (IS-136/TDMA), and Integrated Digital Enhanced Network (iDEN), Long-Term Evolution (LTE), 3rd generation mobile network (3G), 4th generation mobile network (4G), and/or 5th generation mobile network (5G) networks, a card network, Bluetooth, near field communication network (NFC), any form of standardized radio frequency, or any combination thereof, or any other appropriate architecture or system that facilitates the communication of signals, data, and/or messages (generally referred to as data). Throughout this specification, it should be understood that the terms "data" and "information" are used interchangeably herein to refer to text, images, audio, video, or any other form of information that can exist in a computer- based environment. [0079] In an example embodiment, each network system (including system 100 and networked devices 210) includes a device having a communication component capable of transmitting and/or receiving data over the network 205 For example, each networked device 210 may comprise a server, personal computer, mobile device (for example, notebook computer, tablet computer, netbook computer, personal digital assistant (PDA), video game device, GPS locator device, cellular telephone, smartphone, or other mobile device), a television with one or more processors embedded therein and/or coupled thereto, or other appropriate technology that includes or is coupled to a web browser or other application for communicating via the network 205

[0080] The following example is provided to illustrate particular features of certain embodiments. However, the particular features described below should not be construed as limitations on the scope of the disclosure, but rather as examples from which equivalents will be recognized by those of ordinary skill in the art.

EXAMPLE

[0081] This example describes a system and method for reducing emergency care following receiving one or more treatments for cancer. In Washington State, over half of the cancer patients receiving chemotherapy end up in the hospital or the ED. Many of these visits are potentially avoidable. They are for side effects of the chemotherapy, such as nausea, dehydration, pain, fever or fatigue. A patient receives chemotherapy. Following receiving the infusion, the patient experiences nauseous and starts vomiting. The next day the patient is unable to keep anything down. The situation escalates causing the patient to go to the ED exposing the patient to a myriad of germs, which is not recommended for a patient with a compromised immune system and it likely results in the patient incurring costs for the treatment as well as potentially having to delay subsequent treatment or reduce the dose of chemotherapy.

[0082] The present method and system proactively identifies/monitors a patient before the symptoms progress to a critical point by using the cloud network to monitor patients’ symptoms with wearable biosensors and by collecting information about their symptoms through an application. The information from the biosensors and application is stored in a cloud, such as Microsoft Azure, and algorithms are used to predict when the situation might be getting more serious for a patient and increases the prospect of

hospitalization. [0083] A patient wears a biosensor that is capable of detecting one or more vital signs. The biosensor is in communication with the patient’s mobile phone which has an application that receives signals from the biosensor. The patient receives chemotherapy. Following treatment, the patient begins to experience nausea and vomiting. The biosensor detects a change in one or more vital signs, such as an increased heart rate. In addition to the biosensor detecting one or more vital signs, the patient inputs the symptoms being experienced into the mobile phone application. The application then transmits the information to an AI-enabled database which uses one or more prospective hospitalization prediction algorithms to analyze the information/data and then provide a notification the patient’s healthcare professional/team. The patient’s healthcare professional, in turn, reviews the information and contacts the patient with a recommended course of action, either specific, for example, what measures to take to reduce symptoms at home, or general, requesting the patient to contact the healthcare professional or to come to the office for a consultation or arrange for an in-home visit.

[0084] Although certain embodiments have been illustrated and described herein, it will be appreciated by those of ordinary skill in the art that a wide variety of alternate and/or equivalent embodiments or implementations calculated to achieve the same purposes may be substituted for the embodiments shown and described without departing from the scope.

Those with skill in the art will readily appreciate that embodiments may be implemented in a very wide variety of ways. This application is intended to cover any adaptations or variations of the embodiments discussed herein. Therefore, it is manifestly intended that embodiments be limited only by the claims and the equivalents thereof.