WO2015044128A1

WO2015044128A1 - Patient information system

Info

Publication number: WO2015044128A1
Application number: PCT/EP2014/070224
Authority: WO
Inventors: Murray Fulton Gillies; Guy Raoul VAN DOORN; Jozef Godefridus RAEMAEKERS; Thomas Schaper
Original assignee: Koninklijke Philips N.V.
Priority date: 2013-09-30
Filing date: 2014-09-23
Publication date: 2015-04-02

Abstract

The invention relates to a patient information system (20) and an associated medical imaging system for providing information to a patient (P) who is examined in a scanning device such as an MRI scanner (12). In one embodiment, the system comprises a display (21) for displaying live images of an external area, for example images taken by an operator camera (23) in an operator area (OA) or images taken by a family camera (24) in a waiting area (WA). Additionally or alternatively, the display (21) may show an indication of body regions that have already been scanned and/or that still need to be scanned, thus allowing the patient (P) to monitor the progress of the ongoing scanning procedure.

Description

Patient information system

FIELD OF THE INVENTION

The invention relates to a patient information system and a method for providing information to a patient who is examined in a medical scanning device such as a CT or MRI scanner. Moreover, it relates to a medical imaging system comprising such a patient information system.

BACKGROUND OF THE INVENTION

The US 5 864 331 discloses an MRI (magnetic resonance imaging) scanner with a display panel and LEDs that provide a patient undergoing an examination in the scanner with information about the remaining time of the scan and/or about states of the MRI procedure.

The US 5 412 419 A discloses an audio and video system that is particularly designed for usage in an MRI environment. In one embodiment, a camera and a microphone are mounted in a control room so that pictures and sounds from the MRI technologist can be broadcast to the patient.

The US 5 076 275 A discloses a viewing system for entertaining patients in an MRI scanner with television or VCR images.

The US 2006/074286 Al discloses medical imaging system with a patient display, wherein a computer is programmed to receive scan protocol instructions and control the patient display according to the predetermined scan protocol.

SUMMARY OF THE INVENTION

It would be advantageous to have means that allow for a reduction of discomfort of a patient who is undergoing an examination in a medical imaging apparatus.

This object is addressed by a method according to claim 1 and a medical imaging system according to claim 2. Preferred embodiments are disclosed in the dependent claims. A first aspect relates to a patient information system that is intended and designed for providing information to a patient who is examined in a medical scanning device. The patient information system comprises the following components:

A display for displaying image content.

- A control unit for providing image content to the display, wherein said content is related to live images associated to an external waiting area and/or to the indication of body regions that have already been scanned by the scanning device and/or that still need to be scanned by the scanning device.

The "medical scanning device" may be any apparatus that generates image sequences and/or composite images of a patient in a scanning procedure, i.e. in a procedure during which several sub-images of the patient are produced. Such a scanning is typically a lengthy procedure that is often inconvenient for the patient due to accompanying

circumstances (e.g. loudness in MRI scans) and the need to suppress any movements. The scanning device may for example be a CT (computed tomography) scanner or in particular an MRI scanner. Examinations in an MRI scanner are known to be troublesome for many patients due to the introduction of the patient into a narrow bore that may induce feelings of claustrophobia.

The "display" may be any device with a controllable visual appearance, for example a passive screen onto which images can be projected (e.g. with a beamer), or an active monitor that is connected to an image source such as a video recorder or a computer. The display is preferably arranged such that it can be seen by the patient during the scanning procedure, perhaps with the additional requirement that the patient needs to wear some specific equipment like prism goggles or that additional equipment such as a mirror has to be installed in the optical pathway between the display and the patient.

The "control unit" may be realized by dedicated electronic hardware, digital data processing hardware with associated software, or a mixture of both.

The term "live images" is used to denote images that have been generated for more or less immediate viewing rather than for recording and later (repeated) viewing.

Technically, there may be a short delay ranging from a few milliseconds to perhaps some minutes between the actual acquisition of the live images and their display.

The term "external area" shall in general denote any area or region that cannot readily be inspected directly by the patient in the medical scanning device. The external area may typically be located in a room adjacent to the room with the medical scanning device and at least in the same building as the scanning device. The "indication of body regions that have been scanned and/or that still need to be scanned" is preferably achieved by a graphical representation of the body in which scanned or to-be-scanned areas are indicated.

According to a second aspect, an embodiment of the invention comprises a method for providing information to a patient who is examined in a medical scanning device, said method comprising the displaying of image content that is related to live images associated to an external waiting area and/or to the indication of body regions that have already been scanned and/or that still need to be scanned by the scanning device.

The method comprises in general form steps that can be executed with a patient information system described above. Explanations provided for the patient information system are therefore analogously valid for the method, too, and vice versa.

According to a third aspect, the invention relates to a medical imaging system, particularly to a CT or MRI apparatus. The medical imaging system comprises the following components:

- A scanning device for generating images of a patient.

A patient information system with a display for displaying image content and with a control unit for providing image content to the display, said image content being related to live images associated to an external waiting area and/or to an indication of body regions that have already been scanned and/or that still need to be scanned by the scanning device.

The medical imaging system comprises a patient information system of the kind described above. Explanations provided for the patient information system are therefore analogously valid for the medical imaging system, too, and vice versa.

The patient information system, the method, and the medical imaging device have the advantage that they allow for rich information of a patient undergoing a scanning procedure due to the usage of live images from the environment and/or of information about the ongoing scanning procedure. The indication of body regions that have already been scanned and/or that still have to be scanned provides for example a patient with a positive feeling of having control of the processes taking place. Moreover, the indication of scanned body regions enables a patient to concentrate on these regions when trying to rest immovable on the patient table, thus helping to improve image quality.

In the following, various preferred embodiments of the invention will be explained in more detail that can be realized in combination with a patient information system, a method, and a medical imaging system of the kind described above. In one preferred embodiment, a (video or photo) camera is provided for supplying live images from an operator area, i.e. an area or room in which one or more persons (operators) are controlling the medical imaging procedure. For purposes of reference, this camera will in the following be called "operator camera". The operator camera may particularly be installed such that it can record the face of an operator, allowing for a more personal and relaxing way of communication between patient and staff.

In a further development of the aforementioned embodiment, the activity of the operator camera is related to the activity of an intercommunication system via which an operator can communicate with the patient (at least in one direction, i.e. from operator to patient). While in general any kind of relation between the activities of the camera and the intercommunication system is possible, it is preferred that the camera is activated to generate images each time the communication device is activated. If the operator presses for example a button to switch on a microphone for talking to the patient, this button may simultaneously turn on the camera. Hence live images of the operator can be generated and transmitted to improve the communication with the patient.

In another embodiment of the invention, a camera is provided for supplying live images from a waiting area or room in which persons accompanying a patient can wait. As these persons will often be family members of the patient, said camera will in the following for purposes of reference be called "family camera". Being able to see known persons such as family members or friends may considerably help to relax a patient during a scanning procedure. Moreover, the related persons can assist the staff in instructing the patient to behave properly during the scanning procedure, for example by showing the patient how to properly breathe. Additionally or alternatively, an audio communication may be provided between the location of the patient in the scanning device and the waiting area. Thus a patient can also speak with his/her family or friends. This considerably helps to relax the patient and also to improve communication of breathing relaxation instructions or the like.

The indication of body regions that have already been scanned and/or that still need to be scanned can be done in any way that appropriately conveys this information to the patient. The information could for example be expressed by text, such as a message "Portion of scanned chest area: 20 %" (with a dynamically changing figure of the percentage). More preferably, said body regions are represented diagrammatically, for example by showing a sketch of the human body in which scanned and to-be-scanned areas are depicted in different color, grey-shade, hatching or the like. The dynamic development of these areas will then immediately and intuitively convey information about the ongoing process.

Most preferably, the body regions that have already been scanned and/or that still need to be scanned may be represented by a personalized picture of the patient. Different degrees of personalization are possible in this context, applying for example different pictures to represent male, female, young and/or adult patients. Moreover, it is possible to integrate individual photographs of the face or of the whole body of the patient who is scanned.

According to another embodiment, the display of the image content is synchronized with a schedule of the scanning procedure, wherein the term "synchronization" shall denote any kind of dependency of the temporal course of displaying the image content on said schedule. Typically, the display of some image content will begin simultaneously to the start of particular phases of the scanning procedure. The indication of body regions which have been scanned or still need to be scanned requires for example such a one-to-one synchronization. The "schedule" of the scanning procedure may be derived in real time from the ongoing scanning procedure itself, i.e. the scanning device may provide information to the control unit indicating the presently executed steps. In a preferred embodiment, the schedule is however prepared "offline" ahead of the actual procedure and then conveyed to the control unit. This has the advantage that no further close coupling between displaying of image content and scanning procedure is necessary, which avoids the risk of any disturbances of the scanning procedure by the display.

The display of the patient information system can further be used for showing any kind of other information, too. Such information may for example comprise at least one of the following items:

- General information about the scanning procedure, for example about the technical background, the diagnostic information that can be gained etc.

The workflow of the ongoing procedure, thus giving the patient a better feeling of control and to prevent that he or she is surprised and scared by sudden events.

- The remaining time of the scan.

Breathing instructions such as "hold breath", "breath regularly" etc. As breathing induces movement of the body and thus may affect image quality, a proper communication of breathing instructions is very significant. Indications with respect to loud operating periods of the scanning device. Particularly in connection with an MRI scanner such indications can be very helpful to warn a patient and to avoid that he or she is alarmed by suddenly starting noise.

Audio and/or video content that is available (stored) in the system and can be selected by the medical staff and/or the patient.

Personal audio and/or video content that is provided by the individual patient. Patients may for example watch their preferred films in order to reduce stress during the imaging procedure.

In all described embodiments, some audio content (music, text etc.) may optionally be played parallel to the displaying of image content. Thus the effect of the image content may be supported and extended.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter.

In the drawings:

Fig. 1 schematically illustrates a medical imaging system with a patient information system according to an embodiment of the present invention;

Fig. 2 shows exemplary pictures that can be used to provide information about the progress of the scanning procedure.

Like reference numbers refer in the Figures to identical or similar components.

DETAILED DESCRIPTION OF EMBODIMENTS

One important component in an attempt to improve hospital environment as experienced by both staff and patients may be an audiovisual system created to lower the anxiety level of patients in the MR room. In an approach that is based on the "Ambient Experience" (AE), a theme video may be projected onto the wall, accompanied by audio and/or various LED lighting solutions which together create a total environment that is designed to relax the patient. Such an AE approach may also include other features such as rounded room corners to make the room appear seamlessly large, a design ethic that minimalizes clutter, and a choice of theme (which video and LED color is used) to create the feeling that the patient is in control of the environment. Besides these features of AE, the MR scanner itself may be equipped with a light ring at the entrance opening of the bore and two lights at the rear side of the scanner that illuminate the bore. The lights at the rear side of the MR scanner make the bore appear larger.

Patients that undergo MR scans are often highly stressed. The level of anxiety experienced by the patient can be rooted in the nature of the individual but is often accentuated by factors related to the scan. A factor that often increases the anxiety level of the patient is the feeling of confinement. The long, narrow tunnel, which is required to develop a sufficiently high homogeneous gradient field, can induce claustrophobia type symptoms in patients who may have no previous experience of the phobia. It is estimated that more than 10 % of MR scans have reduced quality due to motion artifacts induced by the nervous movements of the patient.

An important aspect of an AE-MR scan room design is that the patient is confronted with a video imagery as soon as he or she enters the room. The reasoning behind this is that the initial "shock" of seeing the MR-scanner is a very negative part of the total experience. The video imagery should therefore be used to distract attention from the scanner at the time of entrance into the room.

A projector is therefore preferably always aligned to project onto a wall or screen adjacent to the entrance of the MRI room. While this maximizes the distraction level upon room entry the patient is only exposed to the imagery at this point in time and not during the scan. A system is therefore preferred where the projection wall is automatically aligned with the axis of the scanner when a patient is on the MR table. In this way the projection is visible to the patient from within the MR machine, too (provided he or she is wearing a headset with mirrors).

Figure 1 schematically illustrates a medical imaging system according to an embodiment of the invention that comprises and extends the above features. The imaging system comprises a scanning device 12 for generating images of a patient P lying on a patient table 11. In the shown example, the imaging device is an MRI scanner 12 with a bore 13 into which the patient P on the patient table can be introduced.

The medical imaging system further comprises a patient information system 20 with the following components:

- A display 21 (e.g. a monitor or a projection screen) on which image content can be displayed and which can be seen by the patient even if he or she is within the bore 13 of the scanning device. To this end it may be necessary that the patient wears specific goggles (not shown) with mirrors and/or prisms and/or that one or more mirrors have to be installed, for example in the bore 13 of the scanner. A control unit 22 (e.g. a microcomputer) which controls the display of image content on the display 21.

A memory 25 for storing a schedule of the intended imaging procedure such that the control unit 22 can synchronize the display of image content with this schedule. The memory and the control unit may typically be combined in one integrated device and optionally also be coupled to the control system of the scanning device (not shown).

An "operator camera" 23 that is installed in a nurse room or operator area OA where staff is surveying and controlling the imaging procedure. The operator camera 23 allows for a visual feedback from the operator to the patient P even if there is no direct line of sight. Preferably, the operator camera 23 is activated each time the operator opens a microphone 31 for speaking to the patient.

A "family camera" 24 that is installed in a waiting area WA where friends or family members accompanying the patient may wait. The ability to see the accompanying persons may have a largely relaxing effect on the patient.

A bidirectional communication link between the patient and the waiting area WA comprising a microphone and a loudspeaker 14 at the scanner close to the patient and a microphone and loudspeakers 32 in the waiting area.

The control unit or computer 22 controlling the audio-visual presented to the patient may have access to information from the MR machine control system. In particular a copy of the examination card can be made and provided in the memory 25 that can then be accessed by the computer controlling the audio -visuals. This one way communication isolates the AE -product from the medical device. The audio-visual controller therefore has access to the examination card and can perform functions based on the programmed sequence of scans.

It has been shown in the literature that providing information to patients before an MR scan lowers the amount of motion artifacts in the MR image. It is therefore worthwhile to give the patients extensive information about the procedure before-hand.

Unfortunately many patients do not comply with reading several pages of information. It is therefore suggested to create an MR information video to disseminate the extensive information and using the in-bore projection system with the display 21 to supply this information at the moment of need.

Furthermore, the amount of time that someone has to wait is perceived more positively when the end-time is known. It is therefore further suggested to use the in-bore system to display the remaining time. The remaining time is calculated from the examination card and may be updated real-time should the operator elect to repeat a portion of the scan or pause the scanning procedure (e.g. to inject patient). The time remaining can be shown as a hard number but can also be translated to a more abstract graphic such as a flower that opens with the fully open flower representing the end point.

Additionally or alternatively to showing the time to end of scan, it is further suggested to show which areas of the body have already been scanned and the remaining fraction. This is illustrated in Figure 2. Given the access to the examination card it is also possible to personalize the body shown to represent the actual patient. Figure 2 shows for example a representation for a man (left), for a woman (middle), and for a child (right).

Moreover, a photograph of the individual patient can optionally be taken and used for the feedback representation.

Another option is to give patients direct feedback on the moment that they need to hold their breath (for triggering the image gate) or breath with a certain frequency (e.g. to help relaxation). Both of these breathing instructions are coupled to the examination card so that they can be activated automatically at the correct moment for maximal impact.

Furthermore, the in-bore projection system can be used to improve the staff patient interaction. In this case a web-cam link can be connected between the nurse station OA and the projection system. The video link connection may automatically be opened when the existing control microphone switch is pressed by the operator.

Additionally or alternatively, the in-bore projection system can be used to improve the family patient interaction. In this case a web-cam link is connected between a family waiting room WA and the projection system. Should the patient wish then a live video link can be established with waiting family or friends who can lend emotional support.

In an extension to the previous embodiment it is possible that the loved one in the family waiting area is coached in breathing and that this breathing cycle is relayed to the patient lying in the MR machine. In this way the connectedness is enhanced between patient and family.

The in-bore projection system can further be used to give the patient prior warning of an increasing acoustic level as produced by the MR scanner coils. As in previous embodiments this may be enabled by the sharing of examination card data. Such a warning of impending acoustic load will reduce the shock of the noise for the patient and help improve the experience. The impending acoustic load can be shown as a hard number or may be shown in a more abstract, graphical manner. For example the system may adapt the theme video in real time so as to increase the acoustic level at the moment of high acoustic load from the scanner.

The in-bore projection system can also be used to show content as brought by the patients themselves.

Finally, the in-bore system may be used to instruct the patient on what will be the next part of the workflow. Messages may for example be issued such as: "The next step is that the scan will commence, thereafter the operator will enter the room and replace the head coil with a chest coil.".

In summary, a new functionality has been described that can for example be applied to an MRI scanner with a display visible from within the bore. The functionality may include visualization of progress of the scan to patients during MRI examination, support for breath hold time to end of scan, which body parts are being scanned, and a video link to the operator and/or family.

While the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive; the invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from a study of the drawings, the disclosure, and the appended claims. In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality. A single processor or other unit may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. A computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid-state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless

telecommunication systems. Any reference signs in the claims should not be construed as limiting the scope.

Claims

CLAIMS:

1. A method for providing information to a patient (P) who is examined in a medical scanning device (12), said method comprising the displaying of image content in the form of live images associated to an external waiting area (WA) and/or of a graphical representation of the body in which body regions that have already been scanned (D) or that still need to be scanned (U) by the scanning device (12) are indicated.

2. A medical imaging system, particularly a CT or MRI apparatus, comprising:

a) a scanning device (12) for generating images of a patient (P);

b) a patient information system (20) with

bl) a display (21) for displaying image content,

b2) a "family camera" (24) for supplying live images from a waiting area (WA),

b3) a control unit (22) for providing image content to the display (21), said image content being in the form of said live images and/or of a graphical representation of the body in which body regions that have already been scanned (D) or that still need to be scanned (U) by the scanning device (12) are indicated.

3. The medical imaging system according to claim 2,

characterized in that an "operator camera" (23) is provided for supplying live images from an operator area (OA).

4. The medical imaging system according to claim 3,

characterized in that the activity of the operator camera (23) is related to the activity of an intercommunication system (31).

5. The medical imaging system according to claim 2,

characterized in that body regions that have already been scanned (D) or that still need to be scanned (U) are represented in a personalized picture of the patient (P).

6. The method according to claim 1,

characterized in that displaying of the image content is synchronized with a schedule of the scanning procedure.

7. The method according to claim 1,

characterized in that further information is shown as image content on the display (21), said information relating to at least one of the following items:

general information about the scanning procedure;

the workflow of the ongoing procedure;

the remaining time of the scan;

breathing instructions;

indications with respect to loud operating periods;

audio and/or video content available in the system;

personal audio and/or video content provided by the patient (P).

8. The method according to claim 1 ,

characterized in that audio content is played parallel to the displaying of imag content.