Sleep Diagnostic System and Method
20220338797 · 2022-10-27
Assignee
Inventors
Cpc classification
A61B5/7221
HUMAN NECESSITIES
G16H50/20
PHYSICS
G16H40/20
PHYSICS
A61B5/273
HUMAN NECESSITIES
G16H15/00
PHYSICS
A61B5/6898
HUMAN NECESSITIES
A61B2562/0219
HUMAN NECESSITIES
International classification
A61B5/00
HUMAN NECESSITIES
A61B5/273
HUMAN NECESSITIES
Abstract
A system and method for conducting a test includes initiating a test script, and providing the script to a patient. Testing hardware is shipped hardware from a provider to the patient, and instructions are provided to the patient for connecting the testing hardware to a mobile computing device. A mobile application is downloaded and installed onto the mobile computing device. The testing hardware is connected to the testing hardware and to the mobile computing device, and the test is conducted using the mobile application operating on the mobile computing device.
Claims
1. A method for conducting a test, comprising: initiating a test script, and providing the script to a patient; shipping testing hardware from a provider to the patient, and providing instructions to the patient for connecting the testing hardware to a mobile computing device; downloading and installing a mobile application onto the mobile computing device; fitting the testing hardware onto a body of the patient, the testing hardware including an adjustable belt that is affixed around a torso of the patient; connecting the testing hardware to a sensor interface device, connecting the sensor interface device to the mobile computing device, and mounting the sensor interface device onto the adjustable belt; conducting the test using the mobile application operating on the mobile computing device; collecting a data set during the test in a memory of the mobile computing device; validating, using the mobile application, whether the data set collected in the memory of the mobile computing device was collected consistently during a session; encrypting the data set in the mobile computing device and uploading the data set to a cloud server; validating with the cloud server the data set against the test script and identifying information for the patient; automatically sorting, normalizing, and scoring the data set using a scoring algorithm that is stored and operates in the cloud server; generating a clinical report based on the data set using the scoring algorithm, the clinical report containing health condition diagnosis and recommendations that is automatically generated in the cloud server using the scoring algorithm based on the data set; and transmitting the clinical report from the cloud server directly to the mobile computing device such that the patient is permitted to access and review the clinical report.
2. The method of claim 1, wherein the testing hardware includes a plurality of external sensors, and wherein the method further comprises connecting the plurality of external sensors to the sensor interface device, and wherein connecting the sensor interface device to the mobile computing device is carried out such that signals or information provided from the plurality of external sensors is conveyed to the mobile computing device and is input into the mobile sleep application.
3. The method of claim 1, further comprising using at least one onboard sensor integrated with the mobile computing device during the test.
4. The method of claim 1, wherein the testing hardware includes a breathing sensor, a nasal airflow sensor and a blood oxygen sensor.
5. The method of claim 3, wherein the at least one onboard sensor includes a microphone and an inertial sensor.
6. The method of claim 5, wherein the microphone is used to provide information relative to coughing, snoring, and/or wheezing during the test, and wherein the inertial sensor is used to provide a patient position and motion during the test.
7. A diagnostic system, comprising: a set of testing hardware, the testing hardware comprising: a plurality of sensors adapted for mounting onto a patient's body, the plurality of sensors configured to provide signals indicative of patient parameters, and a sensor interface device, the sensor interface device being connectable via mechanical and electrical connections to the plurality of sensors, the sensor interface device being adapted to communicatively couple to a mobile computing device, wherein the sensor interface device is mountable onto an adjustable belt that is adapted to be affixed around a torso of the patient; a sleep application stored on non-transient computer media, the mobile application including computer executable instructions that are executable by a processor of the mobile computing device; a cloud environment operating on at least one cloud server, the at least one cloud server being communicatively connected with the mobile computing device for data transfer therebetween; wherein, during a test, information acquired form the plurality of sensors is stored as a data set on a memory device of the mobile computing device and transmitted to the cloud environment upon test completion for processing, automatic scoring, and automatic generation of a clinical report.
8. The diagnostic system of claim 7, wherein the plurality of sensors includes a breathing sensor, the breathing sensor associated with the adjustable belt.
9. The diagnostic system of claim 8, further comprising a holster adapted to connect the mobile computing device to the adjustable belt.
10. The diagnostic system of claim 9, wherein the mobile application further includes instructions for accessing and acquiring data from onboard sensors of the mobile computing device during the test.
11. The diagnostic system of claim 7, wherein each of the plurality of sensors includes a wired connection that mates with a corresponding plug disposed on a chassis of the sensor interface device.
12. The diagnostic system of claim 11, wherein the sensor interface device includes a wired connection that is adapted to mate with a corresponding plug disposed on the mobile computing device.
13. A method for conducting a test for a patient at home, the method comprising: receiving at a provider a prescription from a physician relative to a patient for conducting the test; collecting patient information at the provider relative to the patient; providing information to the patient from the provider relative to downloading and installing onto a mobile computing device of the patient a monitoring mobile application; sending to the patient from the provider a set of testing hardware, the set of testing hardware including a plurality of external sensors; sending to the patient a sensor interface device, the plurality of external sensors being connectable to the sensor interface device; wherein the patient is instructed to connect the set of testing hardware to the sensor interface device, informationally connect the sensor interface device to the mobile computing device, conduct the test, and acquire a set of data that is stored in encrypted form within the sleep monitoring mobile application; validating, using the mobile application, whether the set of data acquired within the monitoring mobile application was collected consistently during a test session; transmitting the set of data to a cloud server, validating with the cloud server the set of data against patient information and the prescription, and using an algorithm operating in the cloud server to automatically sort, normalize and score the set of data to automatically generate a clinical report, wherein the clinical report is based on the set of data and is compiled using the algorithm operating in the cloud server to contain health condition diagnoses and recommendations; providing the report to physician for review and approval; and transmit the report from the physician to the patient using the monitoring mobile application.
14. The method of claim 13, wherein the set of data further includes data acquired by at least one onboard sensor of the mobile computing device.
15. The method of claim 13, wherein the at least one onboard sensor includes a microphone and an inertial sensor.
16. The method of claim 15, wherein the microphone is used to provide information relative to coughing, wheezing or snoring during the test, and wherein the inertial sensor is used to provide a patient position and motion during the test.
Description
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)
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DETAILED DESCRIPTION OF THE INVENTION
[0030] With the proliferation of smart phone use globally, there is a consensus that introducing medical based testing through the smart phone would be able to screen and reach a larger section of the population more cost effectively. The current estimate of smart phone users globally by the end of 2018 is expected to be 2.5-3 billion people.
[0031] The present disclosure describes a system and method for conducting a home test model to diagnose patients utilizing a patient's smart phone to conduct the test at home by collecting, preprocessing and communicating sleep data and conclusions between the patient and the doctor or data center that processes the data.
[0032] A method for conducting the test in accordance with the disclosure is shown in the flowchart of
[0033] If applicable, the provider may obtain authorization from the insurance company of the patient, or patient may pay for the test themselves at 106. The provider may then ship to the patient hardware in the form of a sensor interface device, the sensors themselves, and other supplies needed for the patient to use the sensors at 108. Before conducting the test, the patient can download the provider's mobile phone application at 110, which can include a single-use license from the provider. The patient can then carry out the test at 112, which will result in a body of data from the various sensors being acquired and saved in the mobile phone via the mobile application at 114. The body of data, or data set, is then uploaded from the patient's mobile phone to a secure cloud at 116, where a scoring algorithm that is stored in the cloud can sort, normalize and score the data automatically. A summary report is generated at 118 that is made available for a physician to view and authorize. It is contemplated that the physician's review and authorization is optional and may be replaced, for certain tests and in certain countries, with an automated processing and report from the biometric data analysis system server operating in the cloud. The results are then transmitted to the patient via the mobile app at 120.
[0034] It is noted that, globally, in markets outside the U.S., a physician sign off may not be required, which may also be the case or an option for patients that pay for their service without contribution from an insurance company. The current home test units and sensors are shipped to a patients home and typically weigh 3 lbs or more with the unit, sensors and packaging, or are smaller units installed at doctors' offices. The new system and method in accordance with the disclosure leverages the computing and communication capabilities of a mobile computing device such as a mobile phone, which also include internal sensors, and augments those capabilities with other sensors that are sent to the patient and that are connectable to the mobile phone. In this way, shipping costs and complexity for conducting the test is reduced to the point where the patient can administer the test on themselves at home.
[0035] A schematic for a diagnosis system 200 in accordance with the disclosure is shown in
[0036] In order to provide home testing to a larger percentage of the population, a mobile app based testing solution installed and operating on the mobile computer 214 provides effective testing, scoring, and clinical results to patients in a cost effective manner than existing portable testing units.
[0037] In one embodiment, the testing hardware 210 can include sensors and appropriate wiring to connect the sensors to the mobile computer 214. These sensors can include both external sensors mounted onto the patient's body, and also internal sensors of the mobile computer. In the illustrated embodiment, external sensors can include a blood oxygen level sensor, a breath rate sensor, a heartbeat sensor, and a nasal air flow sensor, all with adapters that allow connection of the sensors to clothing or around a patients face. These sensors, as well as onboard sensors of the mobile device, can provide sufficient information for a diagnosis based on the results of a test. Various examples of external sensors that are contemplated for use in a system in accordance with the disclosure are described in the paragraphs that follow.
[0038] Before turning to the sensors, various system diagrams on the connections and operation of the mobile computer will be described. A block diagram for a sleep diagnosis system 300 is shown in
[0039] For example, the respiratory sensor 304 may include an adjustable belt 502 word around the torso of the patient. The belt 502, shown in
[0040] The nasal cannula 302 shown in
[0041] Finally, the blood oxygen sensor 306, shown in
[0042] These and other sensors are connected via wiring to a sensor interface device 308, an example of which is shown in
[0043] More specifically, the interface device 308 includes a chassis 314 onto which the micro-controller 310 is mounted and operates. Power now can be utilized with AA batteries or another size depending on power consumption of overall sensors and type. Power may also alternatively or in addition be provided from the smartphone 508 through the USB interface 312 to power the sensors and the controller. In the case of a wireless interface 312 power may be provided from batteries. The mechanical interfaces or plugs 310 are attached to the chassis 314, and signals from the sensors are provided through electrical interfaces 316 directly to the micro-controller 310. Onboard power management devices 318 for conditioning and controlling electrical power operating the various components, and headers 320 for managing the transfer of digital information to the smartphone 508 can also be used on the chassis 314.
[0044] The smartphone 508 may include an application environment 322 that includes a USB interface or driver 324 operating to convey information containing sensor readings from the micro-controller 310 into the environment for processing and storage. Specifically, a host controller 326 may receive, categorize and store information from the various sensors into dedicated memory locations for each sensor, for example, a nasal air flow data location 328, the breathing sensor data location 330, and the blood oxygen data location 332 while the test is underway. The host controller 326 may also monitor and record information during a test from onboard sensors of the smartphone 508, and store information from those onboard sensors as well in dedicated memory locations.
[0045] It should be appreciated that the sleep mobile application, and also any other modules discussed herein, in certain embodiments, may be embodied as a computer application or program. The computer program may exist in a variety of forms both active and inactive. For example, the computer program can exist as software program(s) comprised of program instructions in source code, object code, executable code or other formats; firmware program(s); or hardware description language (HDL) files. Any of the above can be embodied on a computer readable medium, which includes computer readable storage devices and media, and signals, in compressed or uncompressed form. Exemplary computer readable storage devices and media include conventional computer system RAM (random access memory), ROM (read-only memory), EPROM (erasable, programmable ROM), EEPROM (electrically erasable, programmable ROM), and magnetic or optical disks or tapes. Exemplary computer readable signals, whether modulated using a carrier or not, are signals that a computer system hosting or running the present teachings can be configured to access, including signals downloaded through the Internet or other networks. Concrete examples of the foregoing include distribution of executable software program(s) of the computer program on a CD-ROM or via Internet download. In a sense, the Internet itself, as an abstract entity, is a computer readable medium. The same is true of computer networks in general.
[0046] With respect to onboard sensors, for example, the mobile application may further utilize the phone gyroscope to track and determine the body's position and level of activity during the test. This is handled through a holding plate 510 (
[0047] The various external sensors may be integrated into one single connector for an iPhone lightning jack or micro usb connector or separate batteries capable of providing power to all four sensors through the phone. These two connector types would support all standard smart phone jacks. It is also a further development to isolate the individual sensors into a separate battery based Bluetooth module to enable communications between the sensors and the app utilizing wireless communications. The phone circuit power will also provide any necessary voltage for the individual sensors. There will be a separate pigtail connectors coming off the base unit with iPhone lightning jack, micro usb, or other so that this single connector can be used with multiple phone types.
[0048] It is a further embodiment of the present disclosure to have a licensing key server which will allow the sleep service providers to upload information on a patient including name, address, date of birth, contact info, email, Insurance info etc. After a patient profile has been created, the sleep lab personnel can then create a unique security key which will be valid for a single or two night usage depending on selection which will then be texted/emailed to the patient directly. This unique key will have to be entered into the app before further functions are enabled and the sleep diagnostic test can begin.
[0049] An exemplary embodiment of a system that can accomplish having all data within the app to remain encrypted for security HIPPA compliance of patient specific medical data is shown in
[0050] A further aspect of the present disclosure is a mobile application that provides screens or user interfaces to allow the user to ensure security by utilizing a secret key, provide instructional details on how to connect the sensors to their body and phone, to provide tools to determine whether or not the sensors are functioning and/or are connected properly, to validate whether the phone collected sleep data properly and consistently during a sleep session or over a predefined period, for example, overnight, provide diagnostic tools and messages to provide feedback to the user while either collecting, processing, or uploading data, to provide a report formatted with the test results through the app once scored, and other features. Exemplary views of such user interfaces are provided in
[0051] More specifically, an initial screen 702 is shown in
[0052] The patient information screen 708 presents to the patient the demographic and identifying information 710 that the provider has on file for the particular patient, for verification, and prompts the user to contact the provider using a banner 712 to contact the provider in the event information at 710 is in any way inaccurate. Upon confirmation of the patient's information by the patient, an initiation screen 714 is presented. At the initiation screen, the application may first diagnose the connective state and operation of the various external sensors that will be used during the test, and provide a list or dashboard 716 that lists the various sensors that are required and indicate an online state or condition of each sensor. In the illustrated example, a “Y” or “N” is used to qualitatively characterize the condition of each sensor, but any other method can be used that includes visible and/or audible prompts generated by the application. In the event one sensor is not reporting a condition that is suitable to initiate the test, a warning 718 is displayed. The warning may be selectable to launch a tutorial to aid the user in properly connecting the sensors to their smartphone using the testing hardware that was supplied to the patient by the provider.
[0053] When all the sensor warnings have been cleared, for example, by ensuring that all sensors are connected properly, the test may be initiated. During the test, a progress screen 720 as shown in
[0054] While the data is uploading at the status screen 724, also shown in
[0055] In this respect, in one aspect, the present disclosure describes transmitting the collected data securely and in an encrypted format to a cloud based FDA approved algorithmic software in order to analyze and mark specific sleep events within the patient's home sleep test. In addition, other algorithmic software that is FDS approved may be used to analyze various biometric signals and diagnose or mark other ailments outside of sleep. Examples include cardiac arrhythmia, depression, anxiety, and the like. This algorithm will analyze events such as apnea hypopnea index, snoring, cardiac events, and other identifiable conditions. The data from the scoring algorithm will then be transferred to a data report processing server. The server will compile the event data and automatically generate a template report showing patients clinic assessment from the sleep test. In certain alternative embodiments, which may include additional sensor types such as EKG pickups, heartrate monitors, motion sensors, temperature sensors, perspiration sensors and the like, the algorithmic software may be used to additionally diagnose or provide conclusions related to seizure and brain activity during sleep, intensity of dreams, cardiac-related issues, and others.
[0056] It is another object of the present disclosure to utilize the data report processing server to automatically assess data as calculated by the scoring server and determine a patient's level of condition severity. The typical categories will be light moderate or acute depression, anxiety, apnea, mild apnea, moderate apnea, and severe apnea, and others. The server will automatically format a sample clinical report as shown below, which includes information and represents an exemplary report that can either be generated automatically by the system and approved by an attending physician or provided for reference directly to the patient.
[0057] SomnoMed App is a smart application that will be used to diagnose various conditions. A sample report and the information it can contain is provided below:
[0058] PATIENT NAME: Smith, John
[0059] PATIENT #: fad-JS-54
[0060] DATE OF BIRTH: 1955-08-19
[0061] REFERRER: Bob Jones MD
[0062] DATE OF STUDY: 2018-05-25
[0063] DATE OF INTERPRETATION: 2018-05-30 18:14:43
[0064] INTERPRETING PHYSICIAN: William Smith MD
[0065] TECH: Adam Warrant
[0066] HOME STUDY INTERPRETATION Physician Interpretation: Impressions
[0067] 1. Severe obstructive sleep apnea syndrome
[0068] 2. Snoring was recorded.
[0069] Recommendations
[0070] 1. The patient should be scheduled for a therapeutic sleep study with CPAP/Bilevel titration.
[0071] 2. Begin a medically supervised program to achieve and maintain ideal body weight.
[0072] 3. Sleep in a non-supine position
[0073] 4. Avoid bedtime alcohol and sedatives
[0074] 5. Avoid operating heavy equipment
[0075] 6. Avoid driving while feeling drowsy
[0076] Signed Electronically 2018-05-30 18:14:43
[0077] William Smith, M.D.
[0078] Pulmonary Disease/Sleep Medicine
[0079] Recommendation of this report should be communicated to the patient by the referring physician. The interpreting physician is available for questions regarding this report.
[0080] TECHNICAL REPORT:
[0081] Patient History:
[0082] Laura Smith is a 62 year old male who is 68 inches tall and weighs 185 pounds. The patient has a neck circumference of N/A inches, and a BMI of 27.8. The patient complaints include snoring and fatigue. The patient has an Epworth Sleepiness Scale score of 5/24, and is not a user of tobacco products.
[0083] Medications: None listed
[0084] Allergies: NKDA
[0085] Day of Study: Medications: None listed Nap: No
[0086] Alcohol: No
[0087] Caffeine: Yes
[0088] Protocol:
[0089] The study was performed using the SomnoMed system. The channels recorded were: Airflow acquired with a nasal pressure cannula. Oxygen saturation (SpO2) was monitored using a pulse oximeter. Thoracic respiratory movements were recorded by respiratory inductive plethysmography. The tracing was scored using 30 second epochs. Hypopneas were scored per AASM definition.
[0090] Position:
[0091] The patient slept in the supine, right side position(s).
[0092] Sleep Latency:
[0093] The patient's sleep onset latency after lights out was 0.0 minutes. The Stage R sleep latency from sleep onset was N/A minutes.
[0094] Total Sleep Time:
[0095] Because of the nature of a home sleep test, a 100% of the data is scored as Stage 2 sleep.
[0096] Respiratory:
[0097] The patient was observed to have had a total number of 74 apneas and hypopneas with an AHI index of 34.7 per hour during total sleep time. The normal AHI index is less than 5 per hour. There were 24 obstructive apneas, 0 mixed apneas, 9 central apneas, and 41 hypopneas.
[0098] Oxygenation:
[0099] The patient had an average oxygen saturation of 93%. The minimum oxygen level was 75%. Pulse Oximeters are accurate to a low SpO2 of 70% (+,−3).
[0100] All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
[0101] The use of the terms “a” and “an” and “the” and “at least one” and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The use of the term “at least one” followed by a list of one or more items (for example, “at least one of A and B”) is to be construed to mean one item selected from the listed items (A or B) or any combination of two or more of the listed items (A and B), unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
[0102] Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.