System for Generating an Alert for a Systemic Infection

Abstract

A system for generating an alert for a systemic infection of a patient comprises an implantable medical device configured to measure at least one physiological parameter, a remote monitoring system configured to receive information from the implantable medical device, and an information system configured to communicate with said remote monitoring system. At least one of the implantable medical device, the remote monitoring system and the information system is configured to analyze information relating to said at least one physiological parameter to generate an alert signal for a systemic infection of the patient based on a state of the at least one physiological parameter, wherein at least one of the implantable medical device, the remote monitoring system and the information system is further configured to generate an alert message to be provided to a specified destination based on said alert signal.

Claims

1. A system for generating an alert for a systemic infection of a patient the system comprising: an implantable medical device configured to measure at least one physiological parameter, a remote monitoring system configured to receive information from the implantable medical device, and an information system configured to communicate with said remote monitoring system, wherein at least one of the implantable medical device, the remote monitoring system and the information system is configured to analyze information relating to said at least one physiological parameter to generate an alert signal for a systemic infection of the patient based on a state of the at least one physiological parameter, wherein at least one of the implantable medical device, the remote monitoring system and the information system is further configured to generate an alert message to be provided to a specified destination based on said alert signal, wherein the information system is configured to transmit said alert message to said destination using a dedicated communication path, wherein the information system is configured to provide information not related to said alert message on a default communication path different than said dedicated communication path.

2. The system of claim 1, wherein the implantable medical device comprises a communication device for communicating with the remote monitoring system using a pre-defined communication protocol for transmitting information relating to said at least one physiological parameter to the remote monitoring system.

3. The system of claim 2, wherein the communication protocol is MICS, BLE or Zigbee.

4. The system of claim 1, wherein said at least one physiological parameter includes at least one of the body temperature, the heart rate, the heart rate at rest, the respiration rate, a body activity parameter.

5. The system of claim 1, wherein the implantable medical device is configured to generate said alert signal based on said at least one physiological parameter and to transmit information relating to said alert signal to the remote monitoring system.

6. The system of claim 1, wherein the remote monitoring system is configured to generate said alert signal based on information relating to said at least one physiological parameter and to transmit information relating to said alert signal to the information system.

7. The system of claim 1, wherein the information system is configured to generate said alert signal based on information relating to said at least one physiological parameter.

8. The system of claim 1, wherein the information system an automated information system delivering patient information to the patient.

9. The system of claim 1, wherein the specified destination is a person familiar with the patient or a specified communication terminal associated with a person familiar with the patient.

10. The system of claim 1, wherein at least one of the implantable medical device, the remote monitoring system and the information system is configured, for analyzing said at least one physiological parameter, to compare the at least one physiological parameter or a parameter value derived from the at least one physiological parameter to a threshold and to generate said alert signal based on said comparison.

11. The system of claim 1, wherein the at least one physiological parameter includes a mean value of the heart rate or the heart rate at rest.

12. The system of claim 11, wherein said mean value is compared to a threshold to generate said alert signal, wherein the threshold is pre-defined or determined based on a group of prior values of the heart rate or the heart rate at rest.

13. The system of claim 12, wherein said threshold is in a range between 90 bpm and 120 bpm.

14. The system of claim 12, wherein said threshold is in a range between 110% and 150% of an average of the heart rate or the heart rate at rest over a predefined time period.

15. A method for generating an alert for a systemic infection of a patient the method comprising: measuring, using an implantable medical device, at least one physiological parameter; receiving, by a remote monitoring system, information from the implantable medical device; communicating, by an information system, with said remote monitoring system; analyzing, by at least one of the implantable medical device the remote monitoring system and the information system, information relating to said at least one physiological parameter to generate an alert signal for a systemic infection of the patient based on a state of the at least one physiological parameter; and generating, by at least one of the implantable medical device, the remote monitoring system and the information system, an alert message to be provided to a specified destination based on said alert signal, wherein the information system transmits said alert message to said destination using a dedicated communication path, wherein the information system provides information not related to said alert message on a default communication path different than said dedicated communication path.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0055] The idea(s) behind the present invention shall subsequently be explained in more detail by referring to the embodiments shown in the figures. Herein:

[0056] FIG. 1 shows a schematic view of a system for generating an alert of a systemic infection of a patient;

[0057] FIG. 2 shows a schematic view of an implantable medical device;

[0058] FIG. 3 shows a flowchart for generating an alert signal and for transmitting an alert message based on the alert signal;

[0059] FIG. 4A shows a graph of the mean daily temperature of a patient over a period of time;

[0060] FIG. 4B shows a graph of an activity parameter of the patient during the period of time;

[0061] FIG. 4C shows a graph of the daily mean heart rate over the period of time;

[0062] FIG. 4D shows a graph of the daily resting heart rate over the period of time; and

[0063] FIG. 5 shows a graphical visualization of a percentage of alert messages depending on a threshold for generating an alert signal.

DETAILED DESCRIPTION

[0064] FIG. 1 shows a schematic illustration of a system for generating an alert for a systemic infection of a patient P.

[0065] The system comprises an implantable medical device 1 implanted in a patient P, the implantable medical device 1, for example, being a cardiac stimulation devices such as a pacemaker device or a defibrillator device, for example, an implantable pulse generator (IPG) such as an implantable cardiac pacemaker, an implantable cardioverter-defibrillator (ICD), a cardiac resynchronization therapy device (CRT) such as a cardiac resynchronization therapy pacemaker or a cardiac resynchronization therapy defibrillator, a neuro stimulator or an implantable loop recorder.

[0066] The implantable medical device 1 constitutes an active electronic implant which is configured to communicate, in an implanted state within a patient P, with a remote monitoring system 2 external to the patient P. The remote monitoring system 2 may comprise one or multiple portable devices, such as mobile telecommunication devices, which are placed in the home of the patient P and serve to communicate with the implantable medical device 1 to exchange information with the implantable medical device 1 using a communication path A1, for example, according to a communication technology using the MICS protocol, the BLE protocol or the Zigbee protocol.

[0067] The remote monitoring system 2 is in communication connection with an information system 3 by means of a communication path A2, the communication path A2 being established, for example, via a public communication network such as the Internet or a telecommunications network, for example a mobile communication network such as a 2G, 3G, 4G or 5G telecommunications network. The remote monitoring system 2 generally functions as a relay to transmit information from the implantable medical device 1 to the information system 3, or from the information system 3 to the implantable medical device 1.

[0068] The information system 3 may be configured to process data received from the implantable medical device 1 via the remote monitoring system 2. Processed data may be provided to an access device 4 of healthcare personnel, for example a physician D, via a communication path A3, for example, by means of a web interface to which the access device 4 may connect for accessing the data on the information system 3.

[0069] The implantable medical device 1 generally is configured to perform a function in a patient over a prolonged period of time, such as a measurement function or a cardiac or neuronal stimulation function for the purpose of therapy. For example, the medical device 1 shall remain in a patient for multiple years in order to record measurement data during the lifetime of the medical device 1 and to communicate with the remote monitoring system 2, so that the measurement data may be used to diagnose or monitor the condition of the patient.

[0070] Such an implantable medical device 1 generally is small in size. As schematically shown in FIG. 2, the medical device 1, for example, comprises a housing 15 encompassing an electronic functional device 10 which is formed, for example, by a processor and serves to perform a predetermined function, for example, a measuring function or a therapy function. The medical device 1 in addition comprises a memory 11, e.g., in the form of a RAM (Random Access Memory), (optionally) a wake-up device 12, an energy storage 13, for example, in the form of a battery, and a communication device 17 for communicating with remote monitoring system 2. The different functional units are encapsulated in the housing 15 in a fluid-tight manner and are interconnected, for example, by a bus system 16 for a data exchange in between the different devices.

[0071] The medical device 1 in addition, in the shown embodiment, comprises a measurement sensor 14, which is used together with the functional device 10 to perform a measurement in order to record one or multiple physiological parameters, for example, to measure the patient's body temperature, the heart rate, the heart rate at rest, respiration parameters, and/or an activity parameter. Measurements may be repeatedly performed in predetermined measurement periods, with measurement data being stored, e.g., temporarily in the memory 11 during a measurement and communicated to the remote monitoring system 2 via the communication device 17.

[0072] The measurement sensor 14 may, for example, be an electrode which is in contact with tissue in the vicinity of the implanted medical device 1, or which is placed on a lead extending from the medical device 1 towards a location of interest. By means of the measurement sensor 14, for example, an electrocardiogram signal may be recorded, the electrocardiogram signal allowing for a sensing of the heart rate and the heart rate at rest.

[0073] Because the medical device 1 has small dimensions, the size of the energy storage 13 is also necessarily limited. Because the medical device 1 is to remain in a patient and be operative for a prolonged period of time, for example several years, it is desired that the medical device 1 operates energy-efficiently, thus requiring little power, but still functions reliably to perform one or more predetermined functions. In order to reduce the energy consumption of the medical device 1, in one embodiment the functional device 10 possibly does not operate continuously and at all times, but may be switched from a switched-off state to an operational state when required in order to carry out a function in the operational state. In the switched-off state the functional device 10 is shut down and causes no or only a very limited power consumption, so that in the switched-off state of the functional device 10 the system of the medical device 1 exhibits a low overall power consumption. In order to transfer the functional device 10 from the switched-off state to the operational state, the wake-up device 12 is provided, which serves to switch on the functional device 10 based on a signal provided, e.g., from an external activator device, such as the remote monitoring system 2.

[0074] Using the implantable medical device 1 in cooperation with the remote monitoring system 2 and the information system 3, an alert signal for a systemic infection of a patient P may be generated. In particular, one or multiple physiological parameters as measured by the implantable medical device 1 may be processed in order to derive the alert signal, wherein based on the alert signal an alert message may be generated and forwarded to the patient P or a person familiar with the patient P, such as a relative of the patient P or a physician D.

[0075] In particular, based on a state of one or multiple physiological parameters, such as the body temperature or the heart rate, conclusions may be drawn with respect to a risk of a systemic infection of the patient P. If it is found that a risk for a systemic infection of the patient P exists, the alert signal may be generated, wherein based on the alert signal an alert message is transmitted to a specified destination, for example, to the patient P or a person familiar with the patient P.

[0076] Referring now again to FIG. 1, the alert signal may be generated by the implantable medical device 1, by the remote monitoring system 2 or the information system 3. The alert message, in turn, may be generated by the remote monitoring system 2 or the information system 3, wherein the entity generating the alert signal not necessarily is the same as the entity generating the alert message.

[0077] In one embodiment, the implantable medical device 1 is configured to process one or multiple physiological parameters in order to generate the alert signal based on a state of one or multiple of the physiological parameters. The alert signal is then provided to the remote monitoring system 2, which possibly forwards the alert signal to the information system 3. Alternatively or in addition, the remote monitoring system 2 or the information system 3 may process information relating to one or multiple of the physiological parameters to generate the alert signal.

[0078] The remote monitoring system 2 or the information system 3 may then generate an alert message, and may forward the alert message to the patient P or a person familiar with the patient P.

[0079] For example, as illustrated in FIG. 1, the information system 3 may generate an alert message and may forward the alert message via a communication path A4 to a communication terminal 5, for example a smart phone, of the patient P or a person familiar with the patient P. For example, the alert message may be sent to the communication terminal 5 by means of a dedicated application (app) of the communication terminal 5, for example, a so-called patient app by means of which the patient P may obtain information from the information system 3.

[0080] In addition or alternatively, the information system 3 may send the alert message to the remote monitoring system 2 via a communication path A5.

[0081] The transmission of the alert message may generally involve any communication route, such as email, SMS, a messenger app or an automated or staff-assisted phone call.

[0082] Referring now to FIG. 3 showing a flowchart of a potential message flow, information relating to a measured physiological parameter may be transmitted from the implantable medical device 1 to the remote monitoring system 2 in a data message B1, for example, using the MICS, BLE or Zigbee protocol. The remote monitoring system 2 may process the received data and may send a data message B2 to the information system 3, which may further process the data, for example, to generate the alert signal and to generate a corresponding alert message.

[0083] Information not related to an alert may be provided to an access device 4, for example, associated with a physician D, for example, by means of a web interface via a data connection B3. In turn, information related to a systemic infection alert may be sent in an alert message B4 to the communication terminal 5, and in an alert message B5 to the remote monitoring system 2, the communication routes for the alert messages B4, B5 hence being different than the data connection B3 for providing general, non-infection related information.

[0084] If an alert message is received, for example, by a physician familiar with the patient P, the physician may medically attend to the patient P and may confirm or disconfirm a systemic infection. If the systemic infection alert is confirmed, this may be entered into the system, for example at the remote monitoring system 2 or the communication 5, and may be processed by the information system 3, for example, to transmit an automatic infection notification message to an official site, for example an official healthcare office. Treatment of the patient P, for example, including a quarantine, may be initiated.

[0085] Referring now to FIGS. 4A to 4D, one or multiple physiological parameters as sensed by the implantable medical device 1 may be processed in order to derive an alert signal indicative of a possible systemic infection of a patient P, for example, a possible COVID-19 infection. Generally, a systemic infection may cause a change in one or multiple physiological parameters, such as the body temperature and the patient's heart rate, such that based on a change in the physiological parameters conclusions may be drawn with respect to a potential systemic infection of the patient P.

[0086] FIG. 4A shows the mean daily temperature of a patient P over a prolonged period of time (in the instant case multiple months). FIG. 4B shows a corresponding mean activity of the patient P per day, for example, derived from a motion sensor included in the implantable medical device 1, such as an accelerometer or the like. FIG. 4C shows the daily mean heart rate over the period of time, and FIG. 4D shows the daily heart rate at rest over the period of time. Each physiological parameter is represented by one value per day, each physiological parameter hence representing an average value of the respective physiological parameter is averaged over 1 date.

[0087] Generally, in case of a systemic infection the body temperature will rise, and in addition also the heart rate will increase. It generally has been found that an increase of 1° C. in the body temperature corresponds to an increase of roughly 10 bpm in the heart rate, in case the patient undergoes a systemic infection, in contrast to, for example, a local infection which may cause an increase in the body temperature, but no or only a limited increase in the patient's heart rate.

[0088] This is visible also in FIGS. 4A to 4D. Within the series of data points, in a time range C1 it can be observed that increased values for the body temperature can be found (FIG. 4A), corresponding to an increased activity of the patient (FIG. 4B) and a slight increase in the heart rate (FIG. 4C, 4D). In a time range C2 at the end of the data series, in turn, the body temperature is seen to substantially increase (FIG. 4A), at a low activity of the patient P (FIG. 4B), but at a substantially increased heart rate (FIG. 4C) and heart rate at rest (FIG. 4D).

[0089] As the heart rate generally increases with the body temperature in case of a systemic infection, the heart rate or the heart rate at rest may be analyzed, possibly in connection with an activity parameter, in order to derive a risk alert for a systemic infection, even without measuring the body temperature, for example, in case the implantable medical device 1 does not comprise a temperature sensor.

[0090] In particular, as illustrated in FIGS. 4C and 4D, if the heart rate (FIG. 4C) or the heart rate at rest (FIG. 4D) exceeds a threshold T1 respectively T2, an alert signal may be generated indicating a positive systemic infection alert. Based on the alert signal, then, an alert message may be generated and forwarded to the patient P or a person familiar with the patient P, as described above according to FIGS. 1 to 3.

[0091] The threshold T1 for the mean heart rate may be different than the threshold T2 for the heart rate at rest. The threshold T1, T2 in each case may be set as a fixed value, for example, within a range between 90 bpm and 120 bpm. Alternatively, the threshold T1, T2 in each case may be set as a percentage of a number of previous values, for example, to a value corresponding to a certain percentage, for example, within a range of 110% to 150%, of an average of multiple, e.g., consecutive previous values.

[0092] FIG. 5 shows an estimated percentage of alert messages in overall messages sent within a system, dependent on the threshold T1, T2 for the heart rate (MHR) respectively the heart rate at rest (MHRR). If the threshold T1, T2 is set to 70 bpm, a rather large percentage of systemic alert messages may have to be expected within the overall messages sent within the system, possibly increasing the likelihood for a false alarm. If the threshold T1, T2 is chosen larger, the likelihood for an alert message is substantially reduced, as visible from FIG. 5.

[0093] The idea underlying the present invention is not limited to the embodiments described above, but may be implemented in an entirely different manner.

[0094] A system and method as described herein allows the early medical pandemic intervention in case of a systemic infection in a high risk patient group.

[0095] The system and method, if implemented in a remote monitoring work flow, will allow a very short term solution to protect the patients and persons in close contact with the patients during the COVID-19 pandemic (early medical intervention/early quarantine).

[0096] It will be apparent to those skilled in the art that numerous modifications and variations of the described examples and embodiments are possible in light of the above teachings of the disclosure. The disclosed examples and embodiments are presented for purposes of illustration only. Other alternate embodiments may include some or all of the features disclosed herein. Therefore, it is the intent to cover all such modifications and alternate embodiments as may come within the true scope of this invention, which is to be given the full breadth thereof. Additionally, the disclosure of a range of values is a disclosure of every numerical value within that range, including the end points.

LIST OF REFERENCE NUMERALS

[0097] 1 Implantable medical device

[0098] 10 Functional device

[0099] 11 Memory device

[0100] 12 Wake-up device

[0101] 13 Energy storage

[0102] 14 Sensor device

[0103] 15 Housing

[0104] 16 Bus system

[0105] 17 Communication device

[0106] 2 Patient monitoring device

[0107] 3 Monitoring service center

[0108] 4 Access device

[0109] 5 Communication terminal

[0110] A1-A5 Communication path

[0111] B1-B5 Data messages

[0112] C1, C2 time range

[0113] D Physician

[0114] P Patient

[0115] T1, T2 Threshold