WO1998032374A1

WO1998032374A1 - Apparatus for medical measurements and interactive expert processes

Info

Publication number: WO1998032374A1
Application number: PCT/FR1998/000131
Authority: WO
Inventors: Didier Rincourt
Original assignee: Didier Rincourt
Priority date: 1997-01-24
Filing date: 1998-01-26
Publication date: 1998-07-30
Also published as: FR2758709B1; FR2758709A1

Abstract

The invention concerns an apparatus for medical measurements and interactive expert processes, designed for the public for the self-monitoring of physio-pathological measurements, analysing the signals, displaying, recording, remote transmitting of the data collected by the patients and for informing the public in an interactive manner about their health without requiring the intervention of a health professional. The apparatus consists of a housing in which are found user-friendly sensors, connected to an internal multimedia computer system. The latter interprets the acquired data, tenders advice using sounds and images, and autonomously gives accurate warning. The apparatus is as represented in figure 1 with: automatic appliance for taking blood pressure connected to a cardiac rate sensor (1), sublingual temperature probe (2), breathed-out air analyser (3), electrocardiograph probe (4), miniaturised camera, microphone and amplifier (5), biological substance analyser (6), stress evaluator, (7), Doppler return ultrasound probe (8), alphanumeric keyboard (9), liquid crystal screen (10), printer (11), diskette or coded chip card reader-recorder (12), modem (13), multimedia CD-ROM reader (14). The apparatus designed for household use reduces health expenses and avoids the frequent intervention of a professional, stores and transmits in the networks data for providing appropriate health care.

Description

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MEDICAL MEASUREMENT APPARATUS AND INTERACTIVE EXPERT METHODS

The invention relates to a medical measurement device and interactive expert procedures.

The device is intended for the public for self-monitoring of pathophysiological measurements. analyze signals, display, record, transmit patient data remotely and inform the public about their health interactively

According to the state of the art, medical measuring devices are separate and the physiological and pathological data must be collected one by one by a doctor

To collect data, patients must go to or be visited by their doctor. These trips and consultations are the source of time and financial resources lost to patients and the community (Social Security) Mutuals and Private Insurance)

Only exist for self-monitoring the manual or automatic blood pressure monitor which also reads the heart rate, and the mercury or electronic thermometer often broken, lost or out of battery

The commissioning of these separate medical measuring instruments is long and impractical because it is necessary to leave the field of action to group them, to know the instructions for use of each measuring instrument and to operate the controls of different type

The reading and transcription of the results of the measurements by the patient are a source of errors whereas these results must be reliable in order to be interpreted by the attending physician. In addition to the results, the patient must write down on a notebook his useful telephone numbers, his memos and keep his medical file up to date with a significant risk of losing documents and forgetting

Other more complex pathophysiological parameters are traditionally collected by doctors and it is often useful to repeat the measurement of these parameters, which leads to new consultations, thus the loss of time and financial means.

Thus, the electrocardiogram performed by the doctor in his office is only an instantaneous reflection of cardiac activity at the time when the tracing is performed and anomalies can go unnoticed leading to a delay in diagnosis and the need to perform additional examinations Until now, only heart sounds were transmitted by telephone in the form of electrical signals to the doctor's computer.

The disposable balloon ethvlometer has a colored reagent tip which determines the blood alcohol level qualitatively and not quantitatively, and does not perform calculations

Finally, medical information is contained in the books and is provided by doctors who do not have enough time to complete it. o.

To solve all of these problems, a device for family use of self-monitoring of medical measures has been designed which analyzes the signals, stores, displays the measurements and calculations, records, transmits remotely in real time. the data collected by the patients themselves

At the same time, the data collected command direct and interactive access to the CD-ROM which is automatically opened for comments on medical measures taken.

The public, without technical knowledge, by simple gestures which they carry out themselves, without the intervention of a competent person in medicine and without taking their eyes off the field of action, implements the integrated medical measurement instruments in a single transportable device, reads and hears the information provided interactively by the CD-ROM in the form of texts, video sequences and sounds

The invention is described below using the accompanying drawings, in which

- Figure 1 shows the device illustrated from the front and from above

- Figure 2 shows the block diagram of the interactive operation of the device

- Figure 3 shows the data acquisition system of medical measuring instruments

- Figure 4 shows the mode of implementation of the blood pressure measuring device

The following medical measuring instruments and their related elements are presented in Figure 1

1 - automatic blood pressure device coupled to the heart rate sensor

2 - sublingual thermal probe

3 - exhaled air analyzer

4 - electrocardiographic probe

5 - miniature camera, microphone and its amplifier

6 - biological substance analyzer

7 - stress assessor.

8 - ultrasound Doppler probe

9 - alphanumeric keyboard

10 - liquid crystal display

1 1 - printer

12 - floppy or coded smart card reader-writer

13 - modem

14 - multimedia CD-ROM drive

The basic functions of the device presented in Figure 2 are as follows The operator commands entered by the keyboard and the buttons request the microprocessor which selects the sensor and sends a command signal to direct the operation of the medical measuring instruments.

In return, the medical measuring instruments supply their data to the sensors, then the 8-bit analog-digital converter converts the analog signals into digital signals for processing by the microprocessor.

For the blood pressure device, the air compressor control signal is generated by the microprocessor (Figure 4). This controls an interface composed of a switch located between the power supply and the air compressor which inflates the cuff in a sequence ordered by the microprocessor.

The software which directs the calculations carried out by the microprocessor is in the ROM read-only memory, stored in interchangeable cartridges or in multimedia CD-ROMs

The RAM memory linked to the microprocessor makes it possible to store and restore the data in memory.

The internal clock which provides information to the microprocessor is used to date the recordings and to manage a programmable alarm.

The microphone makes it possible to bring sounds and words to the microprocessor via the acquisition system, in particular for voice recognition.

The loudspeaker is connected to the microprocessor via a power amplifier in order to reproduce the beeps at the start and end of the measurement and the sounds of the CD-ROM. ROM read-only memory. modem, clock, text-to-speech and microphone

The data are sent by the microprocessor first to the mass memory consisting of a floppy disk reader or coded smart card, then to the modem for transmission to the doctor's computer, to the printer. roller or matrix, to an LCD screen or to a television screen via a TV interface. The data takes the form of letters, numbers, symbols and curves.

Finally, the cardinal function of the device is characterized in that the acquisitions made using the measuring instruments allow the microprocessor to control the interactive access of the CD-ROM without the intervention of the operator.

The device according to the invention implements innovative functions for unprecedented purposes, and is therefore not a simple grouping of measurement instruments nor a simple data integrator. The practical operation of the invention (FIG. 1) is described below:

In addition to taking the blood pressure and pulse by the cuff (1). the device calculates the physical form by comparing to graphs stored in memory-ROM the measurements of tension and pulse made after the effort of bending of the legs.

At the same time, the device controls interactive access to video sequences from the multimedia CD-ROM.

The washable sublingual thermal probe (2) analyzes the resistance of the metal as a function of the temperature. The thermal curves obtained are particularly useful in the event of infection and to calculate the date of ovulation. The device also measures the ambient temperature, atmospheric pressure and the humidity level of the places where people are.

Taking the temperature controls access to the chapter on what to do in the event of fever, in particular in children.

The exhaled air analyzer (3) measures the blood alcohol level quantitatively, is coupled to a plethysmograph and to a peak flow gauge.

Thus, the device determines the instant blood alcohol level and the time at which a determined blood alcohol level will be reached during its decrease, thanks to the average physiological decrease curve of the blood alcohol level stored and displayed. on the screen, and two measurements made by the patient at sufficient time.

The device determines, at the same time, the decrease in lung volumes for example after a pathology such as pneumonia or an asthma attack to determine its course and severity, or even after smoking a cigarette. The blood alcohol and respiratory capacity measurements control access to the corresponding information on the CD-ROM without the operator having to search for it.

The electrocardiographic probe (4) should be placed on the chest facing the heart. The shortest cardiac electrical waves last approximately 0.04 seconds. To be sure to take into account the signal peaks (which contain high frequencies), we take a much smaller sampling step (a thousand times smaller), i.e. a frequency of 25 kHz.

As for sensitivity, the converter must be able to handle signals of low amplitude (from -20 mV to +20 mV). Given the precision required, an 8-bit converter (values between -127 and +128) is sufficient, knowing that a "clean" signal can be restored from the samples (low-pass filters).

Physiopathological and in particular electrocardiographic data recordings are made, transmitted in real time and stored in mass memory at all times, in particular at the time of the disorders. By reading his computer, the doctor becomes aware in real time of the intrinsic electrical activity of the patient's heart and remotely establishes the precise diagnosis of the current pathology. During the next consultation, the doctor places the floppy disk or the coded smart card permanently worn by the patient, in his computer reader-recorder or analyzes the results printed on paper.

The miniaturized camera, the microphone and its amplifier (5) are placed at the end of the electrocardiographic probe to examine the patient, to examine remotely via the modem, the sounds of the heart and the lungs. Attached to the chest and connected to a sensor, the microphone makes it possible to highlight breathing pauses and set off an alarm clock.

The device according to the invention thus makes it possible to wake up an infant who is taking respiratory breaks and to eliminate the risk of my sudden. In obese patients, the device diagnoses respiratory pauses which are sources of chronic disorders such as fatigue, loss of alertness and memory.

The analyzer of substances contained in the blood, urine, saliva and secretions (6) allows home tests.

The stress evaluator (7) which captures the resistivity and the tremors of the body, is coupled to an oximeter and to an invasive or non-invasive glucometer with illumination through the skin.

The piezoelectric effect ultrasound generator connected to the ultrasound Doppler probe (8) is used to produce ultrasound images. This system is particularly useful for doctors visiting their homes.

The RAM-based electronic diary stores useful telephone numbers, memos, identity, social security number and history in place of patients. history of the disease, treatment, diabetic log book, date of vaccinations (the microprocessor also calculates the date of upcoming reminders), the date of the last period and any other information in the patient's medical record.

The programmable alarm linked to the electronic diary is intended in particular to remind the time of taking the drugs with display of their list and their dosage. A keyboard command allows the patient to delete the name of the medication he has just taken from the list.

It is indeed common for patients to no longer remember if they took their medication or not. This validation also allows the control by the entourage of the taking of the drugs.

The RAM is backed up by batteries so that its contents are not lost.

The floppy disk drive or coded smart card reader (12) writes the information from the medical record contained in the electronic agenda of the RAM. The floppy disk or coded card is permanently worn by patients. The microprocessor formats patient data into a series of compatible facsimile codes which can be transmitted by any secure means such as the telephone using a modem (13), to a remote computer. The patient transmits in real time the data concerning his state of health to the computer of his attending physician without travel.

On reception, thanks to specific software, the patient's data is automatically saved on the hard drive of his doctor's computer, without requiring keyboard input. Then, the patient receives an acknowledgment of receipt from his doctor's computer in order to validate the transmission.

The multimedia CD-ROM drive (14) informs and educates the public, in particular through expert audience management systems, interactive educational video games, newspapers and books.

The patient-operated wireless remote control switches the device on. If necessary, the patient presses the emergency button on the remote control so that the device immediately sends a predetermined telephone message to the emergency services.

The device according to the invention, used by families, does not replace the doctor but prolongs its action and helps it in its diagnosis.

The device represents the essential media for the smooth functioning of healthcare networks.

In addition, the device allows patients of all ages to stay at home while benefiting from reassuring reassurance under medical supervision, reduces the number of repeat medical procedures and allows the public to carry their complete medical file in the form of a floppy disk or coded smart card respecting medical confidentiality.

The device also allows rescuers to record physio-pathological data while waiting for the doctor's intervention and to complete their training in a fun and interactive way thanks to the CD-ROM.

In addition, thanks to the device, the treating physician retains his patients by providing a constant monitoring service. In his absence, the doctor is relayed by specialized medical service providers.

For the manufacture of the device, in the form of a molded plastic case, on the model of a video console of approximately 40 cm in length, 30 cm in width and 8 cm in thickness, a PC architecture is used. by integrating a laptop motherboard to which we add an 8-bit acquisition interface, a power interface, a CD-ROM interface, a floppy-disc, a printer, an LCD screen or a TV interface and batteries and rechargeable batteries for power supply.

Claims

1 interactive expert device intended to carry out and transmit medical measurements characterized in that it integrates in a same box a device for measuring the blood pressure (1) coupled to a pulse sensor, of a resistance analysis thermometer ( 2). a barometer, a hydrometer, an exhaled air analyzer (3) coupled to a peak flow gauge, an electrocardiographic probe (4), a miniaturized camera and a microphone (5) placed at its end, a biological substance analyzer (6), a stress analyzer (7) coupled to an oximeter and an invasive or non-invasive glucometer with illumination through skin, an ultrasonic probe (8), an alphanumeric keyboard (9), an LCD screen (10), a printer (1 1), a floppy disk drive or coded smart card (12). a telephone interface (13) and a CD-ROM drive (14)

2 Device according to claim 1 characterized in that the software is in the ROM, stored in interchangeable cartridges or in multimedia CD-ROMs

3 Device according to any one of the preceding claims, characterized in that the content of the random access memory-RAM linked to the microprocessor is stored in mass memory on a floppy disk or on an encoded smart card

4 Device according to any one of the preceding claims, characterized in that it comprises the clock which supplies its information to the microprocessor and which serves to date the recordings and to manage a programmable alarm.

5 Device according to any one of the preceding claims, characterized in that the acquisition system is implemented by voice command

6 Device according to any one of the preceding claims, characterized in that the modem (13) transmits the data by telephone or radio link to a remote computer

7 Device according to any one of the preceding claims, characterized in that it comprises an LCD screen (10) or a television screen and a TV interface. on which the data is displayed

8 Device according to any one of the preceding claims, characterized in that it comprises an ultrasound generator linked to the probe (8) which produce ultrasound images and Doppler traces.

9 Device according to any one of the preceding claims, characterized in that it comprises a wireless remote control carried by the patient which activates the device and makes it possible to send a predetermined telephone message to the emergency services.