SYSTEM FOR AUTOMATED COLLECTION OF DIALYSIS DATA
20230414847 · 2023-12-28
Inventors
- Alex Anping Yu (Safety Harbor, FL)
- Robert W. Childers (New Port Richey, FL)
- Peter A. Hopping (Luiz, FL, US)
Cpc classification
G16H10/65
PHYSICS
A61M1/28
HUMAN NECESSITIES
G16H20/40
PHYSICS
A61M2205/3592
HUMAN NECESSITIES
A61M2205/3553
HUMAN NECESSITIES
A61M1/1524
HUMAN NECESSITIES
A61M2205/3569
HUMAN NECESSITIES
A61M2230/005
HUMAN NECESSITIES
A61M1/155
HUMAN NECESSITIES
A61M1/1561
HUMAN NECESSITIES
A61M2205/12
HUMAN NECESSITIES
B01D61/24
PERFORMING OPERATIONS; TRANSPORTING
B01D61/30
PERFORMING OPERATIONS; TRANSPORTING
A61M2205/52
HUMAN NECESSITIES
International classification
B01D61/30
PERFORMING OPERATIONS; TRANSPORTING
G16H20/40
PHYSICS
B01D61/24
PERFORMING OPERATIONS; TRANSPORTING
A61M1/14
HUMAN NECESSITIES
A61M1/28
HUMAN NECESSITIES
Abstract
A system is disclosed for the automated collection of dialysis and physiological data. An example system includes a dialysis machine configured to generate dialysis data and a wireless peripheral device configured to generate physiological data. The system also includes a personal digital device including an application configured to communicatively couple to the dialysis machine. The application is further configured to detect being within a wireless range of the wireless peripheral device, pair with the wireless peripheral device, receive the physiological data from the wireless peripheral device, and transmit the received physiological data to the dialysis machine. The dialysis machine is configured to store the received physiological data in conjunction with the dialysis data.
Claims
1. A system for recording dialysis data and physiological data, the system including: a dialysis machine configured to generate dialysis data; a wireless peripheral device configured to generate physiological data; and a personal digital device including an application configured to: communicatively couple to the dialysis machine, detect being within a wireless range of the wireless peripheral device, pair with the wireless peripheral device, receive the physiological data from the wireless peripheral device, and transmit the received physiological data to the dialysis machine, wherein the dialysis machine is configured to store the received physiological data in conjunction with the dialysis data.
2. The system of claim 1, wherein the wireless peripheral device includes at least one of a bioelectric impedance analysis device, a blood pressure or monitor, a weight scale, a glucometer, or a thermometer.
3. The system of claim 1, wherein the dialysis machine includes an automated peritoneal dialysis machine.
4. The system of claim 1, wherein the dialysis data includes an amount of ultrafiltration removed.
5. The system of claim 1, wherein the application is configured to use at least one of ZigBee or Bluetooth to wirelessly pair with the wireless peripheral device.
6. The system of claim 1, wherein the application is configured to simulate the dialysis machine.
7. The system of claim 1, wherein the application is configured to pair with the wireless peripheral device by: displaying on a screen of the personal digital device a prompt to enter an identifier of the wireless peripheral device; and transmitting at least one pairing message to the wireless peripheral device with the entered identifier.
8. The system of claim 7, wherein the wireless peripheral device is configured to encrypt the physiological data before transmission to the application.
9. The system of claim 8, wherein the application transmits the identifier to the dialysis machine, and wherein the dialysis machine uses the identifier to decrypt the physiological data.
10. The system of claim 9, wherein the identifier is a patient identification number.
11. A system for recording dialysis data and physiological data, the system including: a wireless peripheral device configured to generate physiological data; and a personal digital device communicatively coupled to a dialysis machine, the personal digital device including an application configured to: detect being within a wireless range of the wireless peripheral device, pair with the wireless peripheral device, receive the physiological data from the wireless peripheral device, and transmit the received physiological data to the dialysis machine, wherein the dialysis machine is configured to store the received physiological data in conjunction with dialysis data.
12. The system of claim 11, wherein the application is further configured to: receive second dialysis data that is input into the personal digital device by at least one of a patient or a clinician; and transmit the second dialysis data to the dialysis machine.
13. The system of claim 12, wherein the second dialysis data relates to a continuous ambulatory peritoneal dialysis treatment.
14. The system of claim 11, wherein the wireless peripheral device includes at least one of a bioelectric impedance analysis device, a blood pressure or monitor, a weight scale, a glucometer, or a thermometer.
15. The system of claim 11, wherein the dialysis machine includes an automated peritoneal dialysis machine.
16. The system of claim 11, wherein the application is configured to pair with the wireless peripheral device by: displaying on a screen of the personal digital device a prompt to enter an identifier of the wireless peripheral device; and transmitting at least one pairing message to the wireless peripheral device with the entered identifier.
17. The system of claim 16, wherein the wireless peripheral device is configured to encrypt the physiological data before transmission to the application.
18. The system of claim 17, wherein the application transmits the identifier to the dialysis machine, and wherein the dialysis machine uses the identifier to decrypt the physiological data.
19. The system of claim 16, wherein the identifier is a patient identification number.
20. The system of claim 11, wherein the application is configured to use at least one of ZigBee or Bluetooth to wirelessly pair with the wireless peripheral device.
Description
BRIEF DESCRIPTION OF THE FIGURES
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DETAILED DESCRIPTION
[0036] Dialysis Machine
[0037] Referring now to the drawings and in particular to
[0038] Dialysis instrument 10 is configured for whichever type of renal failure therapy system is used. Dialysis instrument 10 includes a central processing unit (CPU) and a plurality of controllers (e.g., safety, valve, heater, pump, video and audio (e.g., voice guidance) controllers) operable with the CPU. The CPU operates with a graphical user-machine interface (GUI), e.g., via the video controller. The GUI includes a video monitor 20 and one or more type of input device 22, such as a touch screen or electromechanical input device (e.g., membrane switch). The CPU also operates with a wireless communicator 15 and/or receives data from a memory device port 25, such as a USB flash drive or travel drive port, discussed in more detail below.
[0039] The CPU and video controller in cooperation with video monitor 20 provide UF and other data downloading instructions visually via characters/graphics to the patient or caregiver. For example, characters/graphics can be displayed to provide instructions regarding when to attempt to send data wirelessly to machine 10 or where on machine 10 to plug a flash drive for data downloading. Additionally or alternatively, The CPU and voice guidance controller in cooperation with speakers 24 provide audible instructions via voice guidance to the patient or caregiver. For example, voice guidance can be given to provide instructions regarding the downloading of data from a remote exchange device (RED) 50 (
[0040] As seen in
[0041] Depending on the type and structure of machine 10, one or more of the items of disposable apparatus 30 may not be needed. For example, machine 10 can pump spent fluid to a house drain, such as a bathtub, a toilet or sink, instead of to a drain bag. Machine 10 can also include an inline heater, in which case warmer bag 36 is not needed.
[0042] As mentioned, a disposable cassette (located behind door 16 of machine 10 in
[0043] Machine 10 can actuate the pump and valve chambers of the cassette pneumatically, mechanically or both. The illustrated embodiment uses pneumatic actuation. The HomeChoice APD system marketed by the assignee of the present disclosure uses a pneumatic system described in U.S. Pat. No. 5,350,357 (The '357 Patent), the entire contents of which are incorporated herein by reference. Here, machine 10 includes a membrane gasket, which creates different sealed areas with cassette sheeting at each of the pump and valve chambers of the cassette. Machine 10 in the illustrated embodiment includes a door 16, which closes against the cassette. Door 16 includes a press plate (not illustrated), which can be operated mechanically (e.g., via the closing of the door) and/or pneumatically (e.g., via an inflatable bladder located in the door behind the press plate). Pressing the plate against the cassette in turn presses the cassette against the membrane gasket that cooperates with the sheeting of the cassette to pump fluid and open and close valves.
[0044] U.S. Pat. No. 6,814,547 (the '547 patent) assigned to the assignee of the present disclosure, discloses a pumping mechanism in connection with
[0045] Remote Exchange Device (RED)
[0046] One suitable embodiment for a remote exchange device (RED) 50 is described in U.S. patent application Ser. No. 12/131,755 (the '755 Application), now U.S. Pat. No. 8,262,602, filed Jun. 2, 2008, entitled Remote Exchange Peritoneal Dialysis, the entire contents of which are incorporated herein directly by reference. The control scheme for the incorporated device is illustrated here in
[0047] The control system also accepts inputs from a load cell 76 of RED 50 and from a keypad 68, or optionally, a keyboard. The control system also includes a number of outputs. A monitor 70, such as a video screen or a digital read-out, may be used to output the temperature of the dialysate, the time elapsed, and so forth. Other outputs include signals to vacuum pump 72 or dialysate pump 74, which may be a peristaltic pump, membrane pump or other desired pump. The system also includes signal processing circuitry and a wireless communicator 80. The signal processing circuitry of control system 60 and wireless communicator 80 are small and compact and fit well within control system of RED 50.
[0048] One suitable wireless module for communicator 80 is ZigBee/IEEE 805.15.4. This is a standard for a very low power radio system with a very limited range, about 10 to 20 feet. Modules made in accordance with this standard may be purchased from Maxstream, Inc., Lindon, UT, U.S.A., Helicomm, Inc., Carlsbad, CA, U.S.A., and ANT, Cochrane, Alberta, Canada. The module is very small, and may be about 2 cm square (about 1 inch square), and about 3 mm thick ( inch). The signal processing circuitry formats the digital data and routes it to a data buffer before transmission to a remote site. Other equipment in accord with other specifications may be used instead, such as IEEE 802.15.1 (Bluetooth). Alternatively, the microprocessor may report desired therapy information via a landline, such as a wire harness connected to the appropriate site for receiving the information, such as a communications center of a hospital or clinic.
[0049] The system may sound an alarm if therapy parameters are exceeded through speaker 82 or by illuminating one or more LED on RED 50. An alarm may also be given through the monitor 70 in conjunction with stopping the therapy session. The controller may use the outputs by sending a signal to the appropriate output when the temperature of the warmed dialysate fluid is too high or too low, when the therapy session has taken too long, or when any other required parameter is exceeded.
[0050] Data Transfer from RED 50 and Other Peripherals to APD Machine 10
[0051] APD machine 100 records ultrafiltrate (UF) removed for night exchanges automatically. Until now, however, the patient had to manually weigh the day exchange fill volume and drain volume by scale and manually enter these values into the APD machine. Referring to
[0052] RED 50 provides the midday exchange and the capability of recording fill volume and drain volume to calculate UF for one or more midday exchange. The RED 50 uses wireless communicator 80 to communicate with wireless communicator 15 of APD machine 10. Wireless communicator 80 has a transmit function and alternatively additionally has receiving functionality for receiving information, e.g., from APD machine 10. Wireless communicator 15 of APD machine 10 has receive functionality and alternatively additionally has transmit functionality for send data, e.g., to RED 50.
[0053] It is contemplated with system 100a that the patient return home, e.g., from work, and place RED 50 within the communication range of wireless communicators 15 and 80. When both APD machine 10 and RED 50 are then powered, the UF data is downloaded from RED 50 to APD machine 10. The downloading can be automatic or require a user input from either input devices 22 of machine 10 or via keyboard 68 of RED 50. Appropriate information regarding the downloading of UF data, such as the fill volume amount, the drain volume amount and the resulting UF can be displayed on one or both of video monitor 20 of machine 10 and monitor 70 of RED 50. The calculation of UF removed for the midday exchange (total midday drain volume less total midday fill volume) may be performed via microcontroller 60 of RED 50 or via the CPU of machine 10. The overall daily or twenty-four hour UF removed (nightly total UF and total midday UF) is performed at the CPU of machine 10 in one embodiment. In this manner, better therapy, e.g., PD therapy is provided because critical data is recorded, transferred and manipulated automatically, removing recording and calculating errors and making the therapy easier for the patient.
[0054]
[0055] APD machine 10, in general, uses each of the various UF, BIA, WS, BP, G and T data to evaluate an ongoing or completed therapy. The machine may receive any desired one or combination of UF, BIA, WS, BP, G and T data. Moreover, the different data does not have to each come from a separate device. For example a single unit measuring BIA, T, G and possibly BP could be used with RED 50 for UF and a separate weigh scale for WS. Or, such a device could be combined with RED 50.
[0056] In an alternative embodiment, any of the RED 50, BIA, BP, WS, G and T devices can communicate via wired communication with APD machine 10. Here, machine 10 and the associated device each accept a wire, e.g., for serial or USB communication.
[0057] Referring now to
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[0060]
[0061] Bluetooth wireless technology is one preferred technology and has three range classes shown below in Table 1. Classes I and II may be more suitable for the disclosed operations.
TABLE-US-00001 Maximum Range Class Permitted Power (Approximate) Class I 100 mW ~100 meters Class II 2.5 mW ~10meters ClassIII 1.0 mW ~1meters
[0062] Bluetooth data rate are shown below in Table 2. System 100 (including all system 100a to 100d) can use either version 1.2 or 2.0.
TABLE-US-00002 BluetoothVersion DateRate Version1.2 1Mbps Version2.0 3Mbps
[0063] In any of the embodiments described herein, when wireless communication is used, a network may be formed and used. For example, if Bluetooth wireless technology is used, a star topology can be established between APD machine 10 and the peripheral device, such as RED 50. In the resulting piconet, the peripheral device operates as the master, while the APD machine 10 operates as a delegate device. When the patient wants to download data to APD machine 10, the APD machine makes itself visible to others. That is, APD machine 10 places itself in a discoverable mode in which it may be discovered or communicated to by any of the master peripheral devices, such as RED 50, BIA, BP, WS, G and T devices.
[0064] It is contemplated that any of the RED 50, BIA, BP, WS, G and T devices will de-power themselves once they have communicated their data to APD machine 10. If any of the devices are battery powered, e.g., BIA, BP, WS, G and T devices, the de-powering will save battery charge.
[0065] Referring to
[0066] At circle 152, the pairing sequence 150 begins. At block 154, APD machine 10 is powered and set in wireless discoverable mode to be visible to others. At block 156, the patient uses the BP device to take a blood-pressure measurement. At block 158, method 150 waits until a wireless or Bluetooth PIN code request appears in video monitor 20 of APD machine 10 (or on computer linked to APD machine). At block 160, the patient or caregiver enters the BP PIN into the CPU of APD machine 10 via input device 22 or a computer linked to APD machine 10. At block 162, method 150 waits for authorization for the wireless or Bluetooth service. This authentication in general, entails confirmation of a unique Bluetooth Wireless device address (e.g., a forty-eight bit address unique to the world), and user entering the security PIN. The APD device could also require verification of patient ID or name.
[0067] The patient or the caregiver then presses OK or confirms to allow further action. At block 164, the patient or caregiver selects an option to keep the APD machine 10 and the BP device paired in the future. This may entail checking always allow the device to access this service on a computer screen linked to APD machine or on video monitor 20 of APD machine 10.
[0068] Patient security is a priority for system 100. It is important that APD machine 10 receives the correct data for a particular patient. It is also important that others can not access the patient's data without authorization. Regarding this latter concern, it is contemplated to use propriety protocols for communication between the peripheral devices and APD machine 10. The protocols require that the machine maintain customized software to be able to receive and process information from the peripheral devices. The software prevents a third party who may have the PIN and Bluetooth address of the APD machine 10 from intercepting the patient's information being sent from the remote device.
[0069] The wireless technology, e.g., Bluetooth, can operate in the following security modes
TABLE-US-00003 Securitymode1 Noauthenticationorencryption Securitymode2 NosecurityinitiatedatBluetooth link,orlinkestablishment.Instead securityisenforcedatconnection level(e.g.SDP,RFCOMM) establishment. Securitymode3 Initiatesecurityproceduresbeforethe linksetupiscomplete.Twodifferent securitypoliciesarepossible:always demandauthenticationoralways demandbothauthenticationand encryption.
[0070] The inventors recommend security mode three for communication between any of RED 50, BIA, BP, WS, T and G devices and the APD machine. Authentication involves the PIN and addresses described above. The encryption involves: (i) unique wireless device number and security PIN number (built in the original purchased Bluetooth wireless blood pressure and weight scale device); (ii) 64, 128, 192 or 256 bit encryption (the original purchased Bluetooth wireless blood pressure and weight scale devices from A&D has a 128 bit encryption); and (iii) proprietary communication protocol. As shown below, prototype was successfully developed using the proprietary communication protocol and blood pressure and weight scale data were transferred to the target devices.
[0071] Generally, the prototype software to interface the wireless peripheral devices was built to interface PC (Windows XP) and HP IPAQ PDA (Model HX2795, using Windows Mobile). The inventors developed the prototype to interface with wireless weight scale and blood pressure devices provided by A & D Medical, San Jose, California. The prototype has been run in Windows XP using a laptop computer or Windows Mobile 5.0 using HP iPAQ PDA. The A & D Medical Bluetooth BP and WS use link-level security and 128 bit encryption. The prototype development tools and hardware in the example prototype software included:
[0072] Software Tools: [0073] (i) Visual Studio 2005 Professional with Compact Framework 2.0; and [0074] (ii) Windows Mobile 5.0 SDK installed on top on the Compact Framework.
[0075] Hardware Tools: [0076] (i) A&D Medical Blood Pressure Cuff; [0077] (ii) A&D Medical Weight Scale; [0078] (iii) Bluetooth enabled System (e.g., HP Compaq nc6220 with Bluetooth feature); [0079] (iv) Bluetooth Dongle (Kinsington, Bluetooth 2.0, potential linking of up to seven devices within a sixty-five foot range); and [0080] (v) HP iPAQ, Model HX2795b, Processor ARM920T PXA27x, Microsoft Windows Mobile Version 5.0.
[0081] The Bluetooth prototype application was developed on Visual Studio 2005 platform using C #(C Sharp) programming language. The A&D medical devices follow the Bluetooth Serial Port Profile, so once the connection is established, the data is sent as in the serial port emulation.
[0082] After the BP or WS reading is taken, the device looks for Bluetooth discoverable computers/PDA's (e.g., machine 10) and starts the inquiry procedure. A standard PIN is stored in the peripheral device. Once the PIN request is obtained, the user responds by inputting the correct pin number, and the wireless connection is created. After the pairing process is completed, the peripheral BP and WS devices store the address of the machine 10 access point to which it is connected for the next reading. Data in the future is then transferred to the stored machine 10 access point's address by default.
[0083] Microsoft NET Framework 2.0 has a built-in Serial Port class. The Serial port class can be used to open the Port in which the data is received. The data received is decoded and displayed. The software prototype works above the layers of Bluetooth architecture, on the high level application layer connected to the emulated serial port.
[0084] A first prototype application software was developed for the Windows XP environment. This first prototype software required the user to input the computer's or machine 10's serial port number, which is used for communication. Once a reading is taken, the peripheral device (e.g., BP cuff or the weight scale) looks for the stored access point address and transmits the data when the address is found. The computer or machine 10 port is opened at the application end and receives the data, which unpacks the data and sends an acknowledgement back to the peripheral BP or WS device.
[0085] The first prototype used the Windows Mobile 5.0 SDK software, which provides a compact operating system combined with a suite of basic applications for mobile devices based on the Microsoft Win32 application programming interface (API). The Microsoft applications programming interface provides functions, libraries, communication protocols, classes and data structures to support building custom applications. Devices that run Windows Mobile software include, for example, pocket PCs, smart phones, and portable media centers. Windows Mobile software is somewhat similar to the desktop versions of Windows.
[0086] Windows CE software, also used in the original prototype software, is Microsoft's real-time embedded operating system, which is used for a wide variety of small-footprint devices, including industrial controllers, communications hubs, point-of-sale terminal, and consumer electronics. The Windows Mobile platform is built on top of Windows CE software and concentrates on lower-level operating system (OS) specifics, such as the kernel, memory management, driver architecture, etc.
[0087] The original prototype software also used a Visual Studio 2005 platform provided with emulators, which resembles a Windows Mobile 5.0 device. The prototype Software has been tested on the Windows Mobile 5.0 Pocket PC emulator. Since serial ports are used, the serial port of the emulator is mapped to listen to the computer's or machine 10's communications port, upon which the computer or machine listens. In the Configure option of the Emulator, the Serial Port 0 was mapped to the appropriate port number.
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[0092] In an alternative embodiment, the application is run using a personal digital assistant (PDA), which in turn communicates wirelessly or via wired communication with machine 10. In the prototype, the PDA could simulate either APD machine 10 or an actual PDA that a clinician uses in a dialysis center. Many current PDA's have Bluetooth wireless communication capability allowing the custom prototype application to be loaded inside the PDA, allowing the modified PDA prototype to communicate wirelessly with the wireless peripheral devices after pairing. The peripheral devices are again paired using the PIN procedure. The application that is created for the emulator is installed on to the PDA. One process for creating PDA application software for interfacing dialysis machine 10 and one or more peripheral device wirelessly is as follows: [0093] (i) add a project and choose Smart Device CAM project in Microsoft Visual Studio; [0094] (ii) after the project is created, in the project design (in the project explorer, the user can choose design view or class view, for prototype, choose design view) view under the applications folder, right click and choose Add Primary output and choose the Application project; [0095] (iii) to create a shortcut from the Start menu, Right click on File System on Target Machine and choose Add Special Folder and under that choose Start Menu folder; [0096] (iv) right click the Start Menu folder and Add Project Output the same way, right click on the Primary Output and choose the first option Create Shortcut . . . , after which a shortcut is created and a suitable shortcut name can be defined; [0097] (v) once the Project is built, a CAB file is created under the/bin/debug folder; [0098] (vi) the mobile device is synched to the computer or machine 10, and the CAB file is stored in the Device's file system; and [0099] (vii) double click on the CAB file in PDA and the application will be installed.
[0100] The Bluetooth prototype application software for Windows XP in PC and Windows Mobile 5.0 in PDA has been successfully developed and tested. The conclusions and recommendations for the prototype are listed as follows: [0101] (i) Wireless peripheral devices, such as the A&D weight scale and blood pressure cuff, can be successfully paired with a Bluetooth enabled PDA/PC, especially if the Bluetooth environment is quiet. [0102] (ii) Data transfer has been accomplished successfully in both a quiet and noisy Bluetooth environment once paired with the target PDA/PC (machine 10). [0103] (iii) In a noisy Bluetooth environment (e.g., other Bluetooth devices such as a cell phone, GPS receiver, laptop PC, other A&D scales are on and in active range), the weight scale and BP cuff have attempted to pair with the first available device, which sometimes has not been the intended machine 10 or PDA. This effect is likely the result of the weight scale and BP cuff being the master device in the Bluetooth Piconet instead of the delegate device. If PDA/PC (machine 10) had instead been configured as the master, the machine could have searched for and picked desired, specific devices to create a Bluetooth pairing. The peripheral instruments when configured to be the master communicator are thus best paired with machine 10 in a quiet Bluetooth environment. [0104] (iv) The peripheral devices have been able to successfully transfer data over distance of approximately eighty feet. Transmission distance has been found to be dependent on the transmission medium between the two devices. Moving around a corner or placing an obstruction to wireless transmissions in the path between the peripheral devices and machine 10 have been found to hamper successful data transmission. [0105] (v) During initial pairing, the target instrument 10 can be set to be discoverable and allow all peripheral Bluetooth devices to communicate the instrument. After pairing, it may helpful to set instrument 10 to only communicate with paired devices.
[0106] It should be understood that various changes and modifications to the presently preferred embodiments described herein will be apparent to those skilled in the art. Such changes and modifications can be made without departing from the spirit and scope of the present subject matter and without diminishing its intended advantages. It is therefore intended that such changes and modifications be covered by the appended claims.