WO2012146750A1

WO2012146750A1 - Briefcase for remote medical care

Info

Publication number: WO2012146750A1
Application number: PCT/EP2012/057844
Authority: WO
Inventors: Loic ETIENNE; Eric Thibaut; David FERRARA; Sauveur Ferrara
Original assignee: Sante Actions Innovations
Priority date: 2011-04-27
Filing date: 2012-04-27
Publication date: 2012-11-01
Also published as: FR2974495A1

Abstract

The invention relates to a briefcase for remote medical care (3), which is to be used by a first person (200) near a patient (100) and which includes a computer (5), a first communication means (6) suitable for enabling an exchange of information between the first person (200) and the computer (5), and sensors (7) connected to the computer (5) and suitable for capturing biological data of the patient (100). According to the invention, the computer (5) comprises an expert system (9) which includes a database of diseases and the symptoms thereof and which is suitable for preparing an observation report containing at least a preliminary probable diagnosis on the basis of the biological data transmitted by the sensors (7), the information transmitted by the first person (200), and the content of the database.

Description

TELEMEDICINE BRIEFCASE

The invention relates to a telemedicine case and a telemedicine system comprising such a case.

A telemedicine briefcase is a briefcase comprising a suitcase forming a protective enclosure and different objects arranged in the bag and making it possible to establish the diagnosis of a patient, either by the person carrying the briefcase if it is a doctor or by a remote physician if the person wearing the briefcase does not have this quality.

For this purpose, the objects arranged in the case include a computer, first communication means adapted to allow the exchange of information between the computer and the person close to the patient, and sensors connected to the computer and adapted to take biological data of the patient.

The first means of communication may conventionally comprise a screen, a keyboard, a mouse, a webcam, a printer, a headset, a microphone ..., and the sensors may comprise a temperature probe, a blood pressure monitor, an oximeter of pulse, a glucometer, a peak flow meter, a spirometer, a pulmotest, an electrocardiogram, a carbon monoxide sensor in the ambient air, a defibrillator, a slit lamp ... The number and the choice of means of Communication and sensors depend on the maximum weight and volume of the briefcase set by its designer.

Such a kit does not make it possible to remedy the problem of lack of a doctor, whether in developing countries or in rural areas of other countries. In fact, either the briefcase is worn by the doctor in which case it takes a doctor per briefcase, or the doctor is distant from the patient, in which case the holder of the briefcase can not perform the auscultation or establish the diagnosis, which requires the remote doctor, by means of communication integrated to the briefcase, to order the holder of briefcase, to observe the patient and to communicate with them during all the auscultation, and makes practically obligatory to have a doctor by briefcase.

The aim of the invention is to solve one or more of these disadvantages, and in particular to allow a remote physician to be able to examine several patients located in different places.

A first aspect of the invention thus relates to a telemedicine briefcase adapted to be used by a first person close to a patient, including a computer, the first means of communication adapted to allow the exchange of information between the first person close and the computer, and sensors connected to the computer and adapted to take biological data from the patient, characterized in that the computer includes an expert system that includes a database of diseases and their symptoms and is suitable for establishing a record of observation containing at least a probable pre-diagnosis based on the biological data transmitted by the sensors, information transmitted by the first person and the contents of the database.

Thus, because of the presence of an expert system, it is possible to guide the actions of the close person and to have a prediagnosis, without the intervention of a doctor. Such an intervention can then intervene later.

According to a first particular embodiment, the expert system is adapted, based on the biological data transmitted by the sensors, the information transmitted by the first person and the contents of the database, to ask the first person close additional information and additional biological data collection to establish the observation report. Therefore, it is possible to refine the prediagnosis before bringing in a doctor.

According to a second particular embodiment, the case includes means for identifying the first person close and means for limiting the access rights of the latter according to his identity. As a result, access to computer content can be controlled, particularly with respect to patient health data if the computer has it.

According to a third embodiment, the case comprises second communication means for exchanging data between the computer and a remote server. It is thus possible to record on a high-performance and high-capacity computer system the data relating to the patient, and thus to limit the power of the computer of the case. According to one variant, the second communication means are configured to allow the remote server to receive the various data contained in the computer in real time.

According to a fourth embodiment, the computer comprises means for identifying the patient and search means adapted to search for the presence of a computerized medical file assigned to the patient in the computer. According to a first variant, the search means can be adapted to search for the presence of a computerized medical file assigned to the patient in the remote server. According to a second variant, the computer comprises means for creating a computerized medical file assigned to the patient.

According to a fifth embodiment, the case comprises third communication means adapted to allow the exchange of information between the computer and a second person remote from the patient. As a result, the case makes it possible to establish a diagnosis of the patient by a distant physician. According to a first variant of the fifth embodiment, the case comprises means for identifying the second remote person and means for limiting the access rights of the latter according to his identity.

According to a second variant of the fifth embodiment, the case comprises means for accepting control of the computer by the second remote person. Preferably, the means for accepting control of the computer by the second remote person are shaped so that the acceptance is possible only after the establishment of the pre-diagnosis by the expert system. Even more preferably, the means allowing to accept the control of the computer by the second remote person are shaped so that the acceptance is possible only after the sending of the pre-diagnosis to that second person by the third means of communication.

According to a third variant of the fifth embodiment, the computer comprises means allowing the second remote person to modify the information transmitted to the computer by the first person close.

According to a fourth variant of the fifth embodiment, the case comprises fourth communication means allowing an exchange between the first person close and the second person remote. Preferably, the fourth communication means also allow an exchange between the patient and the second remote person.

A second aspect of the invention relates to a telemedicine system characterized in that it comprises, on the one hand, at least one telemedicine case according to the fifth embodiment, and, on the other hand, a remote center comprising complementary communication means adapted to establish a data exchange with the case.

Other characteristics and advantages of the invention will emerge clearly from the description which is given hereinafter, by way of indication and in no way limiting, with reference to the appended drawings, in which:

FIG. 1 illustrates a telemedicine system according to the present invention, and

Figure 2 illustrates an architecture of the computer system of the computer of the case.

The invention proposes a telemedicine system 1 which comprises on the one hand a telemedicine center 2 and on the other hand at least one telemedicine briefcase 3.

Each telemedicine case 3 according to the present invention comprises a bag 4 which forms a protective enclosure and different objects arranged in the bag 4. These objects allow the establishment of the diagnosis of a patient 100, either by the person wearing the 200 case 3 if it is a doctor, or by a remote doctor 300 if the case carrier 200 is not a doctor.

Preferably, in order to be easily used even in rough terrain, the case 3 reaches a maximum of 7 kg or 8 kg, since a weight of 6 kg would be ideal.

Suitcase 4 is preferably rectangular in order to optimize its internal space, at least it preferably comprises a flat surface to ensure its stability during use. It is also preferable that its edges are rounded or flexible to avoid hurting the wearer of briefcase 200. Advantageously, the suitcase 4 is solid to prevent deterioration during travel

Preferably, the bag comprises a body and a cover movable between an open position and a closed position, and a seal provided between the body and the lid. This makes it possible to protect the objects contained in the bag from bad weather (rain, snow, sand, etc.) when the lid is in the closed position. For the same reasons, the electrical plugs for powering the various electrical objects are sealed.

To facilitate the storage of objects in the bag, the latter preferably includes internal housings, such as boxes (padded or not), air cushions. Preferably, in order to protect objects that are not in use from bad weather when the lid of the bag is in the open position, each housing comprises a sealed sealing system (such as a lid).

The objects contained in the bag 4 include a computer 5. Preferably, this computer is a tablet. Advantageously, the computer 5 has a flash memory instead of a hard disk in order to save weight and avoid mechanical problems. Preferably, the computer 5 has an autonomy of 3 hours in the monitoring condition of an electrocardiogram and can be recharged as soon as it is rested on a charging base. The bag 4 also includes batteries 1 10 to ensure sufficient autonomy of all objects.

The objects contained in the bag 4 also comprise first communication means 6 which are adapted to allow the exchange of information between the computer 4 and the holder of the case 200 and which is thus close to the patient 100. Such first means 6 may include a screen, a keyboard, a mouse, a webcam, a printer, a headset, a microphone ..., their number and the choice of means 6 used depending on the maximum weight and volume set of the briefcase 3. The objects contained in the bag 4 also comprise sensors 7 which are connected to the computer 5 and which are adapted to take biological data from the patient 100. Such sensors 7 may comprise a temperature probe, a blood pressure monitor, a blood pressure oximeter pulse, a glucometer, a peak flow meter, a spirometer, a pulmotest, an electrocardiogram, a carbon monoxide sensor in the ambient air, a defibrillator, a slit lamp ... their number and the choice of sensors 7 used depending on the fixed maximum weight and volume of the case 3. Preferably, the sensors 7 are connected to the computer 5 by a wireless system, such as bluetooth, which facilitates their handling.

Furthermore, the telemedicine case advantageously comprises a geolocation device 8 which is connected to the computer 5 and which, preferably, is mechanically connected to the bag 4.

According to the present invention, the computer 5 comprises an expert system 9. This expert system 9 includes a database of diseases and their symptoms and is adapted to establish an observation report containing at least one probable pre-diagnosis. based on the biological data transmitted by the sensors 7, information transmitted by the briefcase holder 200 and the contents of the database. Preferably, this observation report comprises a simple text that summarizes the interrogation data produced by the briefcase wearer 200, the results of the sensors 7, the interpretation performed by the expert system 9, its recommendations and its Probable prediagnostics with their probability. This report advantageously comprises a degree of urgency for treating the patient.

Preferably, the expert system 9 is adapted, according to the biological data transmitted by the sensors 7, information transmitted by the briefcase holder 200 and the content of the database, to ask the carrier 200 for information and / or additional biological data to establish the observation report.

For reasons of confidentiality and integrity of the system, the case 3

(In this case, the computer 5) comprises identification means 10 for identifying the holder of briefcase 200 and means for limiting access rights 1 1 to limit access to the content of the computer system depending on the identity and quality (doctor or not) of the wearer 200.

Preferably, the case 3 comprises second communication means 12 which allow a data exchange between the computer 5 and a remote server 13, this remote server 13 can be in the center of telemedicine 2. In this way it is possible to record on a high-performance computer system and large capacity patient data, and thus to limit the power of the computer 5 of the briefcase 3. Advantageously, these second communication means 12 are configured to allow the remote server to receive the various data contained in the computer 5 in real time.

The case 3 (in this case, the computer 5) also comprises patient identification means 100 (the same means as those used for the identification of the case carrier 200) and search means 14 adapted to search in the computer 5 the presence of a computerized medical file assigned to the patient 100 in the computer 5, and when the case 3 comprises second communication means 12, in the remote server 13. The computer 5 also includes means 15 for creating a computerized medical file assigned to the patient 100 if necessary.

Finally, the case 3 comprises third communication means 16 which are adapted to allow the exchange of information between the computer 5 and a second person 300 (typically a doctor) distant from the patient, this distant person 300 being in the center of telemedicine 2. Reciprocally, the center 2 comprises third complementary communication means 17 which are adapted to establish the connection with the third connection means 16 and to allow the concrete connection with the distant physician 300.

The briefcase 3 (in this case, the computer 5) also comprises identification means 10 of the remote physician 300 (the same means as those used for the identification of the briefcase holder 200 and the patient 100) and means for limiting access rights 1 1 (the same means as those used to limit access to the briefcase holder 200) making it possible to limit access to the content of the computer system according to the identity and the quality (doctor or not) of the remote person 300.

The computer 5 comprises means 18 for accepting the control of the computer 5 by the remote physician 300 (via the third complementary communication means 17 and the third communication means 16). Preferably, these control acceptance means 18 are shaped so that the acceptance is possible only after establishing the pre-diagnosis by the expert system 9, and, in a particularly preferential manner, after the sending of the pre-diagnosis. to this distant physician 300 (by the third means of communication 16). As a result, the intervention time of the remote physician 300 can be reduced, the observation report presenting the patient's condition. In addition, the information of the degree of urgency makes it possible to classify the patients if several reports arrive at the center of telemedicine 2 in a very short time.

The case 3 also includes fourth communication means 19 allowing an exchange between the briefcase holder 200 and the doctor 300, these fourth means of communication 19 may be independent of the computer (mobile phone) or not (webcam, screen, speakers, microphone ...). Advantageously, these fourth communication means 19 also allow an exchange between the patient 100 and the remote physician 300 (and can thus include a second webcam of high quality in addition to that integrated in the computer 5). As a result, the physician can examine the patient to confirm or modify the pre-diagnosis. He can also ask the holder of the briefcase 200 and the patient 100 to perform different gestures.

Preferably, the control acceptance means 18 allow the remote physician 300 to modify, if necessary, the information transmitted to the computer 5 by the briefcase holder 200 and / or the observation record.

The remote physician 300 can thus perform a complete diagnosis and prescription that is recorded in the computer 5.

Finally, all the data contained in the computer 5 is advantageously recorded in the remote server 13.

As illustrated in FIG. 2, the architecture of the computer system contained in the computer 5 comprises a core 51 (the expert system 9) and software layers 52 (the communication means with sensors 7, the man-machine interfaces formed by the first communication means 6, and the telecommunication means formed by the second, third and fourth communication means 12, 16, 18) which are intercommunicating. This architecture allows easy evolution of the computer system and modular development in parallel and simpler integration. In the present embodiment, the database consists of tables (each having its contents) and relationships between these tables. The database manages a set of fifteen modules (encyclopedia, expert system, directories, travel database, tests, online doctors, biological exams, personal file ...).

Such a case 3 is particularly suitable for emergency medicine because of the presence of an expert system 9 making it possible to establish an observation report with at least one pre-diagnosis without the holder of case 200 necessarily having to doctor, and allowing a distant physician 300 to make the final diagnosis. Moreover, preferably, the computer 5 and the sensors 7 are not specific to the case 3. The open architecture of the computer system makes it possible to integrate any type of sensor with easy parameterization.

Claims

1. Telemedicine bag (3) adapted to be used by a first person (200) close to a patient (100), comprising a computer (5), first communication means (6) adapted to allow the exchange of information between the first person (200) and the computer (5), and sensors (7) connected to the computer (5) and adapted to take biological data from the patient (100), the computer (5) comprising a system expert

(9), characterized in that the case (3) is a briefcase configured for performing diagnostics, the expert system (9) comprising a database of diseases and their symptoms and being adapted to establish a report of observation containing at least one probable pre-diagnosis based on the biological data transmitted by the sensors (7), information transmitted by the first person (200) and the contents of the database.

Telemedicine bag (3) according to claim 1, characterized in that the expert system (9) is adapted, according to the biological data transmitted by the sensors (7), information transmitted by the first person (200) and the content of the database, to ask that person (200) for additional biological information and data collection to establish the observation record.

3. telemedicine case (3) according to one of claims 1 and 2, characterized in that it comprises second communication means for a data exchange between the computer (5) and a remote server (13).

4. telemedicine case (3) according to claim 3, characterized in that the second communication means are shaped to allow the remote server (13) to receive the various data contained in the computer (5) in real time .

5. telemedicine case (3) according to one of claims 1 to 4, characterized in that the computer (5) comprises means of identification

(10) the patient (100) and search means (14) adapted to search for the presence of a computerized medical record assigned to the patient (10).

6. telemedicine case (3) according to one of claims 1 to 5, characterized in that it comprises third communication means (16) adapted to allow the exchange of information between the computer (5) and a second person (300) distant from the patient.

7. telemedicine case (3) according to claim 6, characterized in that it comprises means (18) for accepting control of the computer by the second person (300).

8. telemedicine bag (3) according to claim 7, characterized in that the control acceptance means (18) are shaped so that the acceptance is possible only after the establishment of the pre-diagnosis by the system expert (9).

9. telemedicine bag (3) according to claim 8, characterized in that the control acceptance means (8) are shaped so that the acceptance is possible only after the sending of the pre-diagnosis to this second person (300).

10. telemedicine bag (3) according to one of claims 6 to 9, characterized in that it comprises fourth communication means (19) for an exchange between the first person (200) and the second person (300) .

1 1. Telemedicine system (1) characterized in that it comprises, on the one hand, at least one telemedicine case (3) according to one of claims 6 to 10, and, on the other hand, a telemedicine center ( 2) remote comprising third complementary communication means (17) adapted to establish communication with the third communication means (16).