System and method for determining edema through remote patient monitoring
A system and method for determining edema through remote patient monitoring is presented. Device measures regularly recorded by a medical device are accumulated as raw physiometry for a patient. Derived measures are determined at least in part from the device measures. A clinical indication of one of an absence, onset, progression, regression, and status quo of edema is evaluated based on the device and derived measures.
1 . A programmer for use in determining edema through remote patient monitoring, comprising:
an interface through which to interrogate and program a medical device for a patient; and
storage to accumulate device measures regularly recorded by the medical device pending upload,
wherein derived measures are determined at least in part from the device measures and a clinical indication of one of an absence, onset, progression, regression, and status quo of edema is evaluated based on the device and derived measures.
2 . A programmer according to claim 1 , further comprising:
programming parameters for download by the programmer to effect the therapy modification for the medical device selected from the group comprising device parameters, drug infusion parameters, and neural stimulation parameters.
3 . A programmer according to claim 2 , wherein the programming parameters further comprise at least one of:
monitoring parameters to monitor the patient while asleep; and
exclusion parameters to exclude one or more of the device and derived measures when the patient exhibits an increased respiratory rate due to exercise or activity level.
4 . A programmer according to claim 1 , wherein the device and derived measures are obtained at least in part through one or more of transthoracic impedance and respiration rate.
5 . A system for determining edema through remote patient monitoring, comprising:
storage to accumulate device measures regularly recorded by a medical device as raw physiometry for a patient; and
a processor, comprising:
an analysis module to determine derived measures at least in part from the device measures; and
an evaluation module to evaluate a clinical indication of one of an absence, onset, progression, regression, and status quo of edema based on the device and derived measures.
6 . A system according to claim 5 , further comprising:
a programmer to periodically monitor the device and derived measures; and
a diagnostic module to evaluate therapy modification for managing the patient.
7 . A system according to claim 6 , further comprising:
programming parameters to effect the therapy modification for the medical device selected from the group comprising device parameters, drug infusion parameters, and neural stimulation parameters.
8 . A system according to claim 7 , wherein the programming parameters further comprise at least one of:
monitoring parameters to monitor the patient while asleep; and
exclusion parameters to exclude one or more of the device and derived measures when the patient exhibits an increased respiratory rate due to exercise or activity level.
9 . A system according to claim 5 , wherein the device and derived measures are obtained at least in part through one or more of transthoracic impedance and respiration rate.
10 . A system according to claim 5 , further comprising:
a monitoring module to monitor well being of the patient in conjunction with conditions selected from the group comprising congestive heart failure, myocardial ischemia, bronchitis, emphysema, pneumonia, pulmonary emboli, tumor infiltration of the lungs, abnormalities of the interstitium of the lungs potentially infectious in origin, immunological abnormalities, exposure to environmental pathogens, and high blood pressure.
11 . A system according to claim 5 , wherein the evaluation module processes the device and derived measures, comprising at least one of:
a recordation module to record, determine, and store the device and derived measures for edema evaluation;
an alert module to generate alerts in response to significant events characterized by the device and derived measures selected from the group comprising absolute measures, long term average measures, and short term average measures; and
an execution module to execute actions in response to indications selected from the group comprising the significant events, ECG signals, activity level, temperature, pressure, and oxygen saturation.
12 . A system according to claim 5 , further comprising:
trigger conditions characterized by the device and derived measures selected from the group comprising absolute measures, pattern matching, absolute differences between averaged measures, and comparisons of a current measure to another current measure or a previous measure; and
an execution monitor to executed the trigger conditions to cause activation of one or more of a therapy readout, alarm, or change in raw physiometry measured.
13 . A method for determining edema through remote patient monitoring, comprising:
accumulating device measures regularly recorded by a medical device as raw physiometry for a patient and determining derived measures at least in part from the device measures; and
evaluating a clinical indication of one of an absence, onset, progression, regression, and status quo of edema based on the device and derived measures.
14 . A method according to claim 13 , further comprising:
periodically monitoring the device and derived measures; and
evaluating therapy modification for managing the patient.
15 . A method according to claim 14 , further comprising:
effecting the therapy modification through programming parameters for the medical device selected from the group comprising device parameters, drug infusion parameters, and neural stimulation parameters.
16 . A method according to claim 15 , further comprising:
generating the programming parameters, further comprising at least one of:
defining monitoring parameters to monitor the patient while asleep; and
defining exclusion parameters to exclude one or more of the device and derived measures when the patient exhibits an increased respiratory rate due to exercise or activity level.
17 . A method according to claim 13 , further comprising:
obtaining the device and derived measures at least in part through one or more of transthoracic impedance and respiration rate.
18 . A method according to claim 13 , further comprising:
monitoring well being of the patient in conjunction with conditions selected from the group comprising congestive heart failure, myocardial ischemia, bronchitis, emphysema, pneumonia, pulmonary emboli, tumor infiltration of the lungs, abnormalities of the interstitium of the lungs potentially infectious in origin, immunological abnormalities, exposure to environmental pathogens, and high blood pressure.
19 . A method according to claim 13 , further comprising:
processing the device and derived measures, comprising at least one of:
recording, determining, and storing the device and derived measures for edema evaluation;
generating alerts in response to significant events characterized by the device and derived measures selected from the group comprising absolute measures, long term average measures, and short term average measures; and
executing actions in response to indications selected from the group comprising the significant events, ECG signals, activity level, temperature, pressure, and oxygen saturation.
20 . A method according to claim 13 , further comprising:
defining trigger conditions characterized by the device and derived measures selected from the group comprising absolute measures, pattern matching, absolute differences between averaged measures, and comparisons of a current measure to another current measure or a previous measure; and
executing the trigger conditions to cause activation of one or more of a therapy readout, alarm, or change in raw physiometry measured.
21 . A computer-readable storage medium holding code for performing the method according to claim 13.