CA2423690A1

CA2423690A1 - Medical home medical service terminal

Info

Publication number: CA2423690A1
Application number: CA002423690A
Authority: CA
Inventors: Marc Berenguer
Original assignee: Individual
Current assignee: Orange SA
Priority date: 2000-09-25
Filing date: 2001-09-20
Publication date: 2002-03-28
Also published as: WO2002025947A1; JP2004508914A; FR2814629B1; FR2814629A1; US20040019503A1; AU2001293911A1; EP1325631A1; IL155075A0

Abstract

The invention concerns a terminal comprising a base module (100), installed at a patient's home, equipped with a telephone link (1) with a remote medical home-service centre, said base module (100) being adapted to receive at least a complementary module (200, 300, 400) dedicated to at least one utility of the medical home-service centre, and to exchange data with said remote centre via the telephone link (1). The invention is applicable to medical home-service.

Description

MODULAR HOME MEDICAL SERVICE TERMINAL
The present invention concerns a modular home medical service terminal.
s The invention can be advantageously applied in all fields concerning home medical services, whether it concerns home support, nurse aid at home or home hospitalisation, and more generally all means enabling patients living in their normal way of life to benefit from medical services. This is particularly the case when a person has decided to stay at home or return there after to having undergone medical intervention but needing to keep contact with a medical or paramedical service. This need is generally temporary in terms of frequency and its duration.
The unpublished French patent n°00 03367 concerns a home medical tele-assistance system for a patient, said system including a patient station or is terminal including a certain number of equipment items making it possible to provide the medical assistance functions at the home of the patient. This terminal is in touch with a nursing station or distant home medical service centre installed in a hospital or independent service and able to receive information from the terminal of the patient and for sending order instructions 2o to the equipment items installed at the home of the patient.
However, the home medical service terminal known in the prior art does have two types of drawbacks. Firstly, when a given terminal centralises a large number of varied functionalities, it is rare that all its possibilities are fully used, thus generating a high service/investment ratio. Secondly, if it desired to follow 2s up evolutions concerning the items of equipment installed at the home of the patient, adaptation frequently requires cumbersome structural modifications and involves significant costs and immobilisations.
Also, the technical problem to be resolved by the object of the present invention is to offer a terminal which could be still adapted to the requested 3o home medical service performances and which could also evolve according to the needs of the service, all the above being provided at a minimum cost.
According to the present invention, the solution to the technical problem put forward consists of a modular home medical service terminal, said terminal being that it includes a basic module installed at the home of a patient and 3s equipped with a telephone link with a distant home medical service centre, said basic module being able to receive at least one additional module for providing at least one home medical service functionality and for exchanging information with said distant centre via the telephone link.
Thus, the modularity principle, which is the basis of the design of the s terminal of the present invention, enables the basic module, by adding suitably selected additional modules, to be still adapted to the required services.
Moreover, each additional module can be developed and modified according to the evolution of techniques independently of the basic module, thus providing the modular terminal of the invention with large flexibility io concerning adaptation.
To sum up, the modularity of the service terminal of the invention has the following advantages - Adaptability of the functionalities of the terminal with respect to the request for the service, is - Design of the additional modules independent of one another and of the basic module, - Technical modifications and evolutions without adversely affecting the entire terminal, - Optimisation of the functions to be used, 20 - Maintenance of exploitation facilitated via the interchangeability of the modules, - Good price of the terminal for the best possible service.
According to one embodiment of the modular terminal of the invention, said basic module is a tele-assistance module including means for receiving zs images and sound originating from said centre via the telephone line, and means for transmitting to the distant centre images and sound originating from the home of the patient via the telephone line.
In this minimum version of the terminal of the invention, the basic module provides at the least possible cost an exclusively visiophonic tele 3o assistance service enabling the doctor located at the distant centre to verbally communicate with the patient and receive visual information concerning said patient and his environment. To this effect, said transmission means are constituted by a camera remote-controlled from the distant centre and a microphone.

It is also possible to have a simplified and more commercial version of the basic module in which said receiving means are constituted by a television receiver. The offset of these functions is made possible due to the fact that almost all patients have a television set at home. The simplified tele-s assistance basic module is then used as an interface between the telephone network and the television receiver, the reception of images and sound being made on the television set of the patient by means of the "peritel" connector.
The module no longer only manages the transmission means as a real function, namely the image and sound pick-up.
io A more advanced version of the terminal of the invention consists in that it further comprises an additional tele-monitoring module connected to said tele-assistance module, said tele-monitoring module including means for controlling assistance devices and/or bio-medical sensor.
When equipped as above, the modular terminal of the invention is enables nursing personnel of the distant centre to monitor a patient at his/her home by managing the assistance devices or the bio-medical sensors or both.
Of course, the type of equipment used is adapted to the pathology of the patient and shall be prescribed by the doctor. It is this doctor who shall also prescribe the programmes for managing the devices and sensors.
2o The modular nature of the terminal of the invention can generally speaking be again more easily obtained via the automatic identification of an element of the terminal from the element to which it is connected situated immediately upstream in the modular chain. This automatic identification is preferably effected continuously at any time and not merely on charging of the 2s upstream element. In other words, the element in question is charged by simply connected to the upstream element, it then being automatically identified with the latter so as to install the reserves required for functioning of the first element. However, it ought to be pointed out that in the case of elements communicating with the upstream element via a radio-frequency link, 3o charging is directly carried out by the mains supply, automatic identification from the upstream element taking place next.
According to the invention, said assistance devices and/or said bio-medical sensors also comprise continuous automatic identification means at the tele-monitoring module and the tele-monitoring module also comprises 3s continuous automatic identification means at the tele-assistance module with installing in the tele-assistance module of functional reserves required for the functioning of the tele-monitoring module.
Another particularly advantageous characteristic of the invention resides in the fact that the tele-monitoring module also comprises means for triggering s alarms at the distant centre. This arrangement enables the nursing personnel of the distant centre to be alerted of cases of, for example, the malfunctioning of one of the controlled elements, namely device or sensor, or the movement of data with respect to a control point or programme.
Having regard to the importance of this alarm triggering function, the io invention provides in particular that the tele-assistance module continuously controls the presence of a line available on the telephone link and that the transmission of alarms is overriding on the telephone link. In this respect, it is preferable that the telephone link has a line continuously available for the transmission of alarms at the distant centre.
is Finally, another advanced version of the terminal of the invention consists in that it comprises an additional tele-consultation module able to receive medical diagnostic tools and means to record data provided by said tools.
According to one embodiment, the tele-consultation module is 2o connected to the tele-assistance module and comprises automatic identification means with the tele-assistance module with installing of functional reserves required for the functioning of the tele-consultation module.
As a variant, the tele-consultation module is connected to the tele monitoring module and comprises continuous automatic identification means 2s with the tele-monitoring module with the installing in the tele-assistance module of functional reserves required for the functioning of the tele consultation module.
It should also be mentioned that an improvement made to the modular terminal of the invention consist in that the tele-assistance module comprises 3o means for assisting the nursing personnel at the home of the patient. In particular, said assistance means include a scanner head, an electronic messaging device and photo pick-up means.
The following description with reference to the accompanying drawing, given by way of non-restrictive example, shall clearly give details of the 3s invention and on how it can be embodied.

Figure 1 is a diagram of a home medical service modular terminal conforming to the invention.
Figure 1 shows a modular terminal installed at the home of a patient wishing to benefit from the services of a home medical service, such as nurse s care or any other medical aid function. This terminal is connected to a distant centre (not shown on figure 1 ) situated in for example a hospital environment and allowing a doctor to remote-monitor the patient at home for exchanging information or data with various equipment items equipping said terminal.
More specifically, the modular terminal of figure 1 includes a basic io module 100 equipped with a telephone link 1 and which generally speaking is able to receive at least one additional module for providing a home medical service functionality and for exchanging information with the distant centre via the telephone link 1.
As shall be seen in detail subsequently, said additional module can be a is tele-monitoring module 200, a tele-consultation module 300 or even an assistance module 400 for nursing personnel at the home of the patient.
In the embodiment example shown on figure 1, the basic module 100 is a tele-assistance module whose main function is to offer an audio-visual communication service between the doctor situated at the distant centre and 2o the patient at home. To this effect, the tele-monitoring module 100 includes means for receiving images and sound originating from the distant centre via the telephone link 1, these means possibly being the monitor 111 and a loud-speaker 112 of a personal computer 110 connected to the telephone link 1 and whose central unit comprises the memories and programmes required for 2s the functioning of the module 100. Similarly, the doctor receives images and sound originating from the home of the patient by means of transmission means which in particular are a remote-controlled camera 121 and a microphone 122.
It shall be observed that the tele-assistance function is provided at a 3o minimum cost since this occurs on account of using a basic module 100 strictly provided for this function without the presence of other equipment used for other functions which would be not used in the description.
On account of the fact that most patients have a television set at their home, it is possible to have a simpler version of the tele-assistance module 3s 100 in which said receiving means are constituted by a television receiver 113.

The images and sound are received from the central unit 110 of the module 100 via the peritel socket of the television set. The central unit 110 is no longer able to control the camera 121 and the microphone 122.
A certain number of improvements can be made, such as a signalling s device, for example by keying on the receiving means, a call originating from the distant centre, or even the presence of a radiofrequency device so as to initialise or accept a telephone communication originating from the distant centre and end it..
As shown on figure 1, the basic module 100 can receive an additional to module 200 known as a tele-monitoring module able to remote-monitor a patient by managing means for controlling medical devices 210 or biomedical sensors 220. This control is effected for example by a radiofrequency link with the tele-monitoring module 200, namely a wireless link..
Examples of medical devices 210 include oxygen concentrators for is oxygen therapy and parenteral nutrition, and examples of biomedical sensors 220 are electrocardiogram recorders, spirometers, scales for heart-cases, tensimeters, etc.
The installation of the tele-monitoring module 200 is effected by simply connecting it to the basic module. Once the connection is made, the module 20 200 is automatically fed and at the same time is automatically identified at the basic module 100 with the installing of functional reserves required for the functioning of the module 200. Similarly, the device 210 and the biomedical sensors 220 are automatically identified at the telemonitoring module on being charged. This can be carried out automatically via connection to the tele-2s monitoring module 200 or directly on the mains supply if the link with the module 200 is of the radiofrequency type. Generally speaking, automatic identification is effected via the transmission of a specific identification message recognised by the identifying entity. Of course, any modification occurring on the terminal of figure 1 is transmitted to the distant centre so that 3o the latter is still informed of the current configuration of the terminal.
These automatic identification and referencing actions are naturally carried out without the intervention of the operator which puts the terminal into service.
The loading of the programme for managing the tele-assistance module 200 is made either by the operator responsible for the installation with the aid 3s of floppy disks or a CD-ROM prepared by authorised personnel, or by downloading from the distant centre. Once the whole terminal is operational, the module 200 autonomously.
The management programme is able to remote-modify the operating points of the assistance devices, remotely-read and download data to the s distant centre through the basic module, retrieve data, manage said data and compare it with reference points, manage alarms, the programme verifying the state of the tele-monitoring module, the devices and sensors by visible means, and in cases of malfunctioning is able to trigger an alarm to the distant centre.
The alarm criteria are as follows : an excessive variation of a value with io respect to a reference point, the detection of the malfunctioning of an assistance device or a sensor, a malfunctioning of the tele-monitoring module itself, in this case it is the basic module which transmits the alarm to the distant centre. Finally, to the extent that an alarm needs to be able to reach the centre at all times, it is vital that the telephone link has available a channel is continuously for transmitting alarms to the distant centre, and moreover the alarm transmission is overriding on the telephone link. Also the programme continuously checks that a line is available and if this is not the case, an alarm is generated to the distant centre.
Practically speaking, in the case of a link via the RNIS network for 2o example, it is possible to use as a line reserved for the transmission of alarms the channel D, normally used for signals.
So as to enable the doctor at the distant centre to eliminate doubts in alarm cases, an alarm is provided to automatically unlock the means 121, 122 for transmitting images and sound originating from the home of the patient.
2s The doctor then has access to all the information and data he needs to make a diagnosis.
As a means of security, the tele-assistance module 200 comprises a buffer memory able to record the data after triggering of an alarm.
Figure 1 also shows the presence in the terminal of an additional tele 3o consultation module 300 for receiving medical diagnostic tools 310, stethoscope or thermometer for example, and for recording data provided by these tools. By implementing various functionalities, the aim of this module 300 is to give a doctor the possibility of making a proper diagnosis. The list of functionalities is not exhaustive as it mainly depends on the pathology of the patient, the doctor and the availability of integrated tools able to provide a diagnostic function.
As already mentioned earlier, the link between the various diagnostic tools 310 and the tele-consultation module 300 is embodied by radio s frequency, except for the taking of photos function.
The tele-consultation module 300 can be installed according to several configurations in the modular terminal of figure 1.
In a first configuration, the tele-consultation module 300 is connected to the tele-assistance module 100 and is automatically identified at the tele io assistance module with the installing in the tele-assistance module 100 of the functional reserves required for the functioning of the tele-consultation module 300.
In a second configuration, the tele-consultation module 300 is connected to the tele-monitoring module 200 and is automatically identified at is the tele-monitoring module with the placing in the tele-assistance module of functional reserves required for the functioning of the tele-consultation module 300.
Finally, in a third configuration, said tele-consultation module 300 is autonomous with the recording of the data provided by the medical diagnostic 2o tool 310.
Having regard to the fact that this tele-consultation module 300 is not intended to necessarily remain continuously at the home of the patient but rather by being installed there immediately by the nursing personnel when asked for by the doctor, it is an advantage to ensure that the tele-consultation 2s module 300 provided with diagnostic tools 310 is portable, for example contained in a case..
Several operating modes can be used for the tele-consultation module 300, namely - the transmission of the data provided by the medical diagnostic tools 310 is 3o carried out in direct read mode via the taking of images and transfer to the distant centre, - the transmission of the data provided by the medical diagnostic tools 310 is carried out in indirect read mode by the taking of images, displaying on the tele-assistance module 100 and transfer to the distant centre - the transmission of data is carried out in indirect capturing of data via input and transfer to the distant centre, - the transmission of data is carried out in indirect capturing of data via recording on a consultation terminal 320 for reading at the distant centre.
This s consultation terminal is for example a portable personal assistance device.
Finally, figure 1 shows the presence of a module 400 for aiding the nursing personnel at the home of the patient. This module is able to modify the basic module 100 so as to integrate it with functions useful for the activity of the nursing personnel and more particularly for nurses who travel to the home io of said patient.
These functions include electronic messaging for writing messages for other persons visiting the patient, namely home medical service personnel or the doctor treating said patient, or for writing a message to be transferred to the distant centre or to another home service modular terminal. Electronic is messaging is also able to read messages coming from the distant centre and intended for nursing personnel visiting the patient, the doctor treating said patient or the patient himJherself.
Another function concerns the taking of photos. In this case, the nursing personnel located at the home of the patient disengage the remote-control of 2o the camera 121, centre the sight on the patient or any other object, record the photo and send it to the distant centre.
The module 400 is also used for the entering of written data to be sent to the distant centre, either information to be entered on the file of the patient, or information (memo) to prepare the next home visit.
2s As indicated on figure 1, the assistance module 400 includes a scanner head 410 for copying documents (prescriptions, analysis results, etc) with display prior to being sent to the distant centre. Similarly, the taking of photos can be controlled from the basic module 100 with display of the photo on the screen 111 before being transmitted to the distant centre together with the 3o patent file.

Claims

1. Modular home medical service terminal, characterised in that it includes a basic module (100) installed at the home of a patient and equipped with a telephone link (1) with a home medical service distant centre, said basic module (100) being able to receive at least one additional (200, 300, 400) for using at least one home medical service functionality and for exchanging information with said distant centre via the telephone link (1).

2. Terminal according to claim 1, characterised in that said basic module is a tele-assistance module (100) including means (111, 112) for receiving images and sound originating from said centre via the telephone link (1) and means (121, 122) for transmitting to the distant centre images and sound originating from the home of the patient via the telephone link (1).

3. Terminal according to claim 2, characterised in that said transmission means are constituted by a camera (121) remote-controlled from the distant centre, and a microphone (122).

4. Terminal according to claim 2 or 3, characterised in that said receiving means are constituted by a television receiver (113).

5. Terminal according to one of claims 2 to 4, characterised in that the image and sound receiving means comprise a device indicating a call originating from the distant centre.

6. Terminal according to one of claims 2 to 5, characterised in that it comprises a radiofrequency device able to initialise or accept a telephone communication originating from the distant centre and terminating it.

7. Terminal according to one of claims 2 to 6, characterised in that it further comprises an additional tele-monitoring module (200) connected to said tele-assistance module (100), said tele-monitoring module (200) including assistance control means (210) and/or biomedical sensors (220).

8. Terminal according to claim 7, characterised in that said control is effected by a radiofrequency link between tele-monitoring module (200) and the assistance devices (210) and/or the biomedical sensors (220).

9. Terminal according to claim 7 or 8, characterised in that the tele-monitoring module (200) also comprises means for triggering alarms intended for the distant centre.

10. Terminal according to claim 9, characterised in that the tele-assistance module (100) continuously controls the presence of a line available on the telephone link (1).

11. Terminal according to claim 10, characterised in that the telephone link (1) has a line continuously available for the transmission of alarms to the distant centre.

12. Terminal according to one of claims 9 to 11, characterised in that the transmission of alarms is overriding on the telephone link (1).

13. Terminal according to one of claims 9 to 12, characterised in that an alarm automatically unlocks said means (121, 122) for transmitting images and sound originating from the home of the patient.

14. Terminal according to one of claims 9 to 13, characterised in that the tele-assistance module (200) comprises a buffer memory able to record data after triggering of an alarm.

15. Terminal according to one of claims 7 to 14, characterised in that said assistance devices (210) and/or said biomedical sensors (220) comprise continuous automatic identification means at the tele-monitoring module (200).

16. Terminal according to claim 15, characterised in that the tele-monitoring module (200) autonomously manages and continuously checks the condition of the assistance devices (210) and biomedical sensors (220).

17. Terminal according to one of claims 7 to 16, characterised in that the tele-monitoring module (200) comprises continuously automatic identification means at the tele-assistance module (100) with the placing in the tele-assistance module (100) of functional reserves required for functioning of the tele-monitoring module (200).

18. Terminal according to claim 17, characterised in that the tele-assistance (100) autonomously manages and continuously checks the condition of the tele-monitoring module (200).

19. Terminal according to one of claims 1 to 18, characterised in that it comprises an additional tele-consultation module (300) able to receive medical diagnostic tools (310) and record data provided by said tools (310).

20. Terminal according to claim 19, characterised in that the tele-consultation module (300) is connected to the tele-assistance module (100) and comprises continuous automatic identification means at the tele-assistance module with the placing in the tele-assistance module (100) of functional reserves required for the functioning of the tele-consultation module (300).

21. Terminal according to claim 19, characterised in that the tele-consultation module (300) is connected to the tele-monitoring module (200) and comprises continuous automatic identification means at the tele-monitoring module with the placing in the tele-assistance module (100) of functional reserves required for the functioning of the tele-consultation module (300).

22. Terminal according to one of claims 19 to 21, characterised in that the transmission of data provided by the medical diagnostic tools (310) is carried out in direct reading mode via the taking of images and transfer to the distant centre.

23. Terminal according to one of claims 19 to 21, characterised in that the transmission of the data provided by the medical diagnostic tools (310) is carried out in indirect reading mode via the taking of images and being displayed on the tele-assistance module (100) before being transferred to the distant centre.

24. Terminal according to one of claims 19 to 21, characterised in that the transmission of said data is effected in direct capturing of data mode by input and transfer to the distant centre.

25. Terminal according to one of claims 19 to 21, characterised in that the transmission of said data is effected in indirect capturing of data mode by recording said data on a consultation terminal (320) so as to be read at the distant centre.

26. Terminal according to claim 25, characterised in that said tele-consultation module (300) is autonomous with recording of the data provided by the medical diagnostic tools (310).

27. Terminal according to one of claims 18 to 26, characterised in that the tele-consultation module (300) fitted with the medical diagnostic tools (310) is portable.

28. Terminal according to one of claims 2 to 27, characterised in that tele-assistance module comprises an assistance module (400) for aiding the nursing personnel at the home of the patient.

29. Terminal according to claim 28, characterised in that said assistance module (400) includes a scanner head (410), electronic messaging, data input means and means for taking photos.