WO2004071295A1

WO2004071295A1 - Transtelephonic electrocardiographic monitoring system

Info

Publication number: WO2004071295A1
Application number: PCT/ES2003/000611
Authority: WO
Inventors: José Manuel QUERO REBOUL; María del Mar ELENA PÉREZ; Sergio TORAL MARÍN; Cristina LÓPEZ TARRIDA; José Angel SEGOVIA DE LA TORRE; Leopoldo GARCÍA FRANQUELO
Original assignee: SANTANA CABEZA, Juan, Jesús
Priority date: 2003-02-14
Filing date: 2003-12-01
Publication date: 2004-08-26
Also published as: AU2003303924A1

Abstract

The invention relates to a transtelephonic electrocardiographic monitoring system of the type used remotely to check and transmit a patient's electrocardiographic data. The invention is characterised in that it comprises an integrated modem for the continuous radio telephone transmission of data using GPRS protocol and a GPS satellite positioning module, as well as intelligent software based on neuronal networks and an expert system for electrocardiographic signal analysis and processing, differentiating between different pre-defined cardiac pathologies and encrypting and compressing the data before transmission and after decoding. The invention enables captured signals to be transmitted and other signals to be recorded without the use of any external device, thereby reducing the signal transmission costs and improving the patient's quality of life.

Description

TRANSTELEFONICA ELECTROCARDIOGRAPHIC MONITORING SYSTEM

The present specification refers, as its title indicates, to a transtelephonic electrocardiographic monitoring system using GPRS (acronym for General Packet Radio Service), of the type used for the transmission and remote control of electrocardiographic data of a patient, continuously.

This type of equipment is particularly suitable for the diagnosis, control and monitoring of various types of cardiac pathologies, especially coronary syndromes and arrhythmias. They can perform these tasks at the patient's home, by sending the data to a control center in a hospital where the different electrocardiographic parameters can be remotely controlled and continuously monitor the patient's condition. They are also capable of application within the hospital environment for the transmission of data from the rooms of the patients to the control center, with the consequent saving of wiring and improvement of patient mobility. This type of equipment is particularly suitable for the diagnosis, control and monitoring of various types of cardiac pathologies, especially coronary syndromes and arrhythmias.

At present, some types of portable devices for monitoring and control are known that perform the storage of electrocardiographic data for a certain measurement time, until the filling of its internal memory. When this memory is filled, the device must be connected to a computer, or similar computer system, to dump the stored electrocardiographic data to the internal memory of the computer.

SUBSTITUTE SHEET (RULE 26) This computer must periodically connect, via a modem, to the computer in the control center or hospital to send the data through the conventional switched telephone network (via cable) or using a GSM mobile phone.

The main problem presented by this type of existing devices is that they do not allow real continuous electrocardiographic monitoring, since due to the limited memory characteristics of the devices they need to dump from time to time in a computer, which causes dead times in Those who cannot control the patient's condition. Likewise, the patient or caregiver has a dependence on the system since they must periodically carry out this process of data dump and transmission.

Another serious inconvenience of existing devices is their dependence on an external device of the type of a computer or similar computer system, which is responsible for storing the data dumped from the device and its subsequent transmission to the hospital control center. Obviously this computer must also have either a connection to the telephone line or a GSM mobile phone communication system.

An important additional problem presented by existing devices is the high economic cost of telephone data transmissions. To transmit the data to the control center, the computer must establish a communication (pick up and dial the telephone number), transmit the data and then close the communication (hang up the telephone). Whether the communication is made by conventional wired telephony or by GSM mobile telephony, the cost of the transmission will be given by a fixed part (by call establishment) and another part by the transmission time, proportional to this. Normally, and because the time required to perform data transmission is usually relatively short, the economic cost

SUBSTITUTE SHEET (RULE 26) of the fixed part is usually proportionally quite important within the total transmission cost. Obviously, and since the cost of the telephone transmission of the data is always directly proportional to the connection time, it is economically unfeasible due to its high cost, to perform electrocardiographic data monitoring and its subsequent transmission in a continuous manner over time. associated data.

To solve the current problem regarding this type of equipment for remote electrocardiographic monitoring, the transtelephonic electrocardiographic monitoring system has been devised by means of GPRS object of the present invention, which is constituted by a Mobile System (SM), ported by the patient to be monitored, which allows the acquisition of electrocardiographic signals through the appropriate sensors, their processing and conversion into digital data packets, and their subsequent long-distance transmission via a mobile radio modem class b (for voice and data) Built-in SM itself. The SM incorporates the appropriate filters, both by software and by hardware, so that there is no interference between the signal radiated by the modem and the one picked up by the electrocardiographic sensors.

The SM also has a GPS module (Global Positioning System) that allows the positioning of the Mobile System via satellite, using radioelectric triangulation procedures. In this way, when desired, you can quickly know the location coordinates, and therefore its location, of the Mobile System, and obviously of your associated patient. This module is small in size, low consumption and with an integrated antenna, independent of the main communications antenna. The Mobile System control module controls the activation of the GPS module in order to locate the patient only when necessary. Consequently, the update of the position by GPS meets a criterion of optimization of consumption, being carried out with the highest

SUBSTITUTE SHEET (RULE 26) frequency possible provided that said criterion is respected, keeping the last reliable position obtained until a new coordinate update is stored, in order to reduce in time the location of the patient in each new communication with the satellites. The functional control of the SM is carried out by means of a microprocessor system, equipped with an intelligent software system, based on an expert system and on neural networks, for the analysis and processing of the electrocardiographic signal, discriminating between a plurality of possible predefined cardiac pathologies. This system allows to detect one of these possible predefined cardiac pathologies by means of an algorithm of detection and recognition of heart disease, in this way the Mobile System only transmits to the server center when it detects a cardiac pathology. This algorithm has several levels of detection that can be configured from a Control Center, from where the different types of cardiac pathologies to be monitored particularly in each patient are also configured.

The Mobile System is also endowed with an encryption phase through appropriate keys and data compression before transmission. Encryption allows to guarantee the authentication of a patient at the remote end and the certification of the issuer, establishing a secure communication and thus guaranteeing the secrecy and privacy of the communication. The compression of the data allows to optimize the bandwidth of the transmitted signal, using less time for its transmission, with which the communication is faster and more efficient. This phase of encryption and compression of the data to be transmitted can be carried out both by a hardware module, as well as by software as another part of the software implemented in the microprocessor control system.

Also note that the SM has capacity both for the use of electrodes for human use and for the use of specific electrodes for veterinary use, recording multiple leads in the input signal, thus allowing the use of the System for the control of sick animals , in addition to

SUBSTITUTE SHEET (RULE 26) for the control and care of human patients, which is of particular interest in different branches of veterinary medicine or zoology, as well as for medical control.

Although the system is designed and designed for electrocardiographic monitoring, nothing prevents its use for monitoring other types of biomedical signals that can be picked up by sensors or transducers of different types, such as temperature, blood pressure, humidity, saturation of oxygen and glucose etc.

The transmission is done using a Communications Protocol, through the GPRS system, which allows the simultaneous transmission of information from a plurality of similar Mobile Systems carried by different patients in different physical locations through the Internet computer data network. . The Communications Protocol includes an optimized compression algorithm to allow the transmission of as much information as possible in a packet size as small as possible.

All signals sent over the Internet using the GPRS system from the different EBs are received by a Terminal Equipment (ET). This ET will basically consist of a computer or similar computer system, connected to the Internet by any of the known methods (modem, cable modem, router, GPRS terminal, etc.) where, through a software specially developed for it, the System Control and the processing and presentation of the received signals. The purpose of this software is to maintain simultaneous communication with one or several Mobile Systems, order the information packets received and make their subsequent presentation on screen, in addition to their historical file and how many complementary functions need to be implemented. In practice, this Terminal Equipment can be either the central computer or the Hospital Server, from where the information can be distributed to the rest of the Hospital terminals, or any of the Computers used by the

SUBSTITUTE SHEET (RULE 26) doctors in charge of monitoring these patients, both in their office and even from any point, using a laptop.

When using the GPRS network, the system is also capable of being able to transmit, simultaneously with the digital data packets corresponding to the electrocardiographic information, an audio communication signal to be able to carry out a spoken communication between the ET in charge and any of the different SM . This audio communication can be carried out in a bidirectional way, similar to telephone communication, allowing simultaneous communication between a doctor and the patient, if necessary, to gather complementary information or to help solve a problem.

This transtelephonic electrocardiographic monitoring system by means of GPRS presented provides multiple advantages, apart from those mentioned above, over the systems currently available, being the most important, due to the incorporation of the radio communications modem in the Mobile System, this SM You do not need to connect with any computer system or external communications system at any time, since the SM itself forms a single portable device that contains all the necessary elements for its operation at all times.

Another subsequent advantage of the present invention is that since the patient does not need any auxiliary peripheral equipment, or computer or external communications system, a telephone line is not necessary, so that the system can be used perfectly for patient monitoring during commuting, both in ambulances and other transport systems.

SUBSTITUTE SHEET (RULE 26) Another of the most important advantages of this system is that using the GPRS system for communication allows continuous and periodic monitoring of the electrocardiographic data of the patient, since in the GPRS system the transmission of information is done by packets of data, and the billing of the use of the Internet network is done by the number of packets sent (that is, by the flow of existing information), not by the time of occupation of the network. This allows it to be enough to optimize the latency time between which the data packets are transmitted so that the monitoring of the patient is carried out in a continuous way, without thereby increasing the economic cost of the system, nor for the patient Not for the health system.

Also another added advantage that occurs when using the GPRS system is the possibility, non-existent in other systems, to perform two-way voice-spoken communication simultaneously and compatible with the transmission of electroencephalographic data. This allows better monitoring by doctors and specialists of the hospital or telecare center of the state of their patients.

We will cite as another interesting advantage that the one that due to the integration of all the elements of the MS in a single module is achieved, the reduction and miniaturization thus obtained allows the SM to be of small dimensions and low weight, thus enabling the patient carry it at all times, without causing inconvenience or problems in the development of their usual activities, with the consequent improvement in their quality of life.

Another interesting advantage is that the reduced consumption of the Mobile System, together with an adequate inimization of the energy field of the electronic system and an adequate design of the system allows to achieve a great autonomy of operation of the system.

SUBSTITUTE SHEET (RULE 26) Finally, we will also cite as another important advantage the fact that, although this Electrocardiographic Monitoring System is designed in principle for use through the GPRS network, if necessary it can be easily adapted for operation with other radio networks communication, thus facilitating its concrete adaptation to places where a certain communication network is not available, or its integration into future communication networks. To make this adaptation, it is enough to replace the radio modem that the Mobile System incorporates as the communications module of the Terminal Equipment with a model adapted for the new communications network. In this way, in addition to the GPRS network, the GSM telephone and data network (Global System Mobile - Global Mobile System) can be worked on, despite being a relatively old technology, or on the future UMTS network (Universal Mobile Telecommunications System - which is currently being developed.

To better understand the object of the present invention, a preferential practical embodiment thereof has been shown in the attached drawing. In this plan, figure - 1 - shows a functional block diagram of the entire system.

Figure -2- shows a functional block diagram corresponding only to the Mobile System

The transtelephonic electrocardiographic monitoring system using GPRS presented, is basically formed, as can be seen in the attached plan, by a variable number of Mobile Systems (1) that are carried by patients in different environments and physical locations. These Mobile Systems (1) capture electrocardiographic information, process, filter and package it to optimize transmission through the GPRS system

SUBSTITUTE SHEET (RULE 26) (two). They send the data packet through the GPRS system (2) to the Internet computer data network (3), through which it reaches any of the Terminal Equipment, consisting of a computer (5) or similar computer system, connected to the Internet through a communications module (4) (which can be a modem, cable modem, router, GPRS terminal, etc.) where, through software (6) specially developed for this purpose, the System Control and the processing and presentation of the received signals.

The Mobile System (1) carried by each patient basically consists of electrodes (7), in variable numbers but preferably three, to collect differential measurements of the patient. These electrodes are connected by an adaptation circuit (8). This adaptation circuit (8) is adapted to be able to accept specific electrodes (7) for both human and animal use, thus enabling both the medical and veterinary application for the system, registering a plurality of input signal leads. The adaptation circuit (8) is followed by a part (9) of Data Acquisition that is responsible for filtering and converting the signals to be sent to the microprocessor system (10). This microprocessor system (10) is the one that will be in charge of most of the tasks of control and packaging of the data and control of the system, for this it uses an intelligent software system (18) based on an expert system and neural networks , for the analysis and processing of the electrocardiographic signal, and it has auxiliary memories (11) of the EEPROM type for the storage of constants and system data, and (12) of the RAM type for the temporary storage of the captured variable data and They are waiting to be transmitted.

The Mobile System (1) also has a GPS module (17) of reduced size, low consumption and with integrated antenna, independent of the main communications antenna. The control module (10) of the Mobile System (1) will control the activation of the module

SUBSTITUTE SHEET (RULE 26) GPS (17) in order to locate the patient only when necessary.

At the output of the microprocessor control system (10), the data encryption and compression module (19) is found before transmission. As we have said before, this phase of encryption and compression of the data to be transmitted can be performed interchangeably by an independent hardware module (19), or by software as another part of the software (18) implemented in the microprocessor system (10) of control. Below is a mobile modem radio (13) of type GPRS class B, for simultaneous use with digital data and voice. To this modem (13) you can connect a microphone (15) and a speaker (16) to perform voice communication.

The entire system is powered by a power supply unit (14), preferably of the type based on rechargeable batteries or the like. The reduced consumption of the Mobile System, together with an adequate minimization of the energy field of the system allows to achieve a great autonomy of operation of the system.

It is voluntarily omitted to make a detailed description of the rest of the particularities of the system that is presented or of the component elements that comprise it, since we believe that the rest of these particularities are not subject to any claim.

Once the nature of the present invention has been sufficiently described, as well as a way of putting it into practice, it only remains to be added that its description is not limiting, some variations being possible, as long as said variations do not alter the essentiality of the characteristics that They are claimed below.

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Claims

1 - Transtelephonic electrocardiographic monitoring system, of the type used for the transmission and remote control of the electrocardiographic data of a patient, characterized in that said patient carries a Mobile System (1) that incorporates as an integral part a mobile radio modem (13 ) Class B, which allows simultaneous transmission of voice and data.

2 - Transtelephonic electrocardiographic monitoring system, according to the preceding claim, characterized by incorporating into the Mobile System (1) a microphone (15) and a speaker (16) for voice communication with a Terminal Equipment (4,5,6 ).

3 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized in that the aforementioned Mobile System incorporates suitable filters (8), necessary to eliminate the interferences that could cause the operation of the mobile radio modem (13) on electrocardiographic sensors (7 ) that the patient carries.

4 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by the use as an integral part of the Mobile System (1) of a GPS module (17) of small size, low consumption and with integrated antenna, its activation being controlled by the Mobile System control module (10)

(one)-

5 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by the use as an integral part of the Mobile System (1) of a software

SUBSTITUTE SHEET (RULE 26) specific (18), based on an expert system and neural networks, for the microprocessor control system (10).

6 - Transtelephonic electrocardiographic monitoring system according to claim 5, characterized by the discrimination between a plurality of possible predefined cardiac pathologies performed by the specific software (18).

7 - Transtelephonic electrocardiographic monitoring system, according to claims 5 and 6, characterized in that the detection of each of the possible predefined cardiac pathologies is carried out by means of a heart disease detection and recognition algorithm implemented in the specific software (18).

8 - Transtelephonic electrocardiographic monitoring system, according to claims 5 to 7, characterized in that the algorithm for detection and recognition of heart disease implemented in the specific software (18) can be configured remotely from a Terminal Equipment (4,5,6) located in a Remote Control Center,

9 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized in that the adaptation circuit (8) placed in the Mobile System (1) is capable of being able to accept specific electrodes (7) for both human and animal use, registering a plurality of input signal leads.

10 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by using the Internet computer data network (3) through the communications system (2) called GPRS (acronym for General Packet Radio Service - General Radio Packages Service) for the transmission of the

SUBSTITUTE SHEET (RULE 26) information from the Mobile System (1) carried by the patient, to one or more Terminal Equipment (4,5,6).

11 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by performing the monitoring of the electrocardiographic signals and the transmission of said information to the Terminal Equipment by information packets with a minimum latency, thus obtaining a continuous control of the electrocardiographic state of the patient.

12 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by allowing simultaneous digital transmission of electrocardiographic data with two-way audio communication between the mobile System carried by the patient and any Terminal Equipment (4,5,6).

13 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by allowing easy adaptation for operation with other radio communication networks, such as GSM or UMTS.

14 - Transtelephonic electrocardiographic monitoring system, according to the previous claims, characterized by locating the location coordinates of the Mobile System, and obviously of its associated patient, by means of radioelectric triangulation procedures by means of the built-in GPS module, allowing to know everything moment your geographical situation.

15 - Transtelephonic electrocardiographic monitoring system, according to the preceding claims, characterized by being easily adaptable to the monitoring and transmission of other types of

SUBSTITUTE SHEET (RULE 26) Biomedical signals, captured by other sensors, such as temperature, blood pressure, oxygen saturation and glucose.

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