System and apparatuses for wireless link management between a medical device and wireless accessories

Abstract

Example systems, methods, and apparatuses are disclosed herein for the management of wireless link quality with a wireless accessory (130). The systems, methods, and apparatuses are configured to monitor a wireless link quality across a plurality of channels to ensure there is an acceptable link quality between a wireless accessory (130) and a medical device (102), such as a dialysis machine or an infusion pump (102c). The systems, methods, and apparatuses are configured to perform a link quality check before the medical device (102) performs a treatment. Such a check ensures that communication with the wireless accessory (130) is acceptable before a more critical time when the medical device is performing the treatment.

Description

SYSTEM AND APPARATUSES FOR WIRELESS LINK MANAGEMENT BETWEEN A MEDICAL DEVICE AND WIRELESS ACCESSORIESBACKGROUND

[0001] Renal replacement therapy (“RRT”) is a therapy that replaces the normal bloodfiltering function of the kidneys. It is used when the kidneys are not working well, which is known as kidney failure and includes acute kidney injury (“AKI”) and chronic kidney disease (“CKD”). RRT involves removal of water from the body of a patient suffering from kidney failure, as well as exchange of solutes with the body. One example of RRT is an extracorporeal blood therapy, in which blood is circulated outside of a patient and interfaced with one or more medical fluids. Modalities of extracorporeal blood therapy include hemodialysis (“HD”), hemofiltration (“HF”) and hemodiafiltration (“HDF”). Another example of RRT is peritoneal dialysis (“PD”), in which a medical fluid is infused into a peritoneal cavity of a patient to interface with the blood of the patient through a peritoneal membrane.

[0002] RRT is performed by a dialysis system which is formed by arranging one or more disposable components on a dialysis machine. Medical fluids used in HD and PD are commonly known as dialysis fluids. In HF, the medical fluid is known as replacement fluid, since it is infused into the blood of a patient to replace fluid removed during therapy. In HDF, both dialysis fluid and replacement fluid are used.

[0003] Extracorporeal blood therapy by HD, HF, or HDF is performed differently for treatment of patients with AKI compared to patients with CKD, by use of a different type of dialysis machine. Generally, compared to CKD patients, AKI patients are treated continuously over a longer period of time and at lower fluid flow rates. Such continuous treatment is commonly known as CRRT (“Continuous Renal Replacement Therapy”). To ensure precise and consistent monitoring and control of fluid removal, known as ultrafiltration, AKI machines are typically provided with scales that are used for measuring the weight of fresh treatment fluid and the weight of spent treatment fluid during therapy. CKD machines instead use flow meters or volumetric pumping to control ultrafiltration.

[0004] PD machines, also known as cyclers, may include at least one scale to measure the weight of fresh treatment fluid infused into the peritoneal cavity and the weight of spent treatmentfluid withdrawn from the peritoneal cavity. Alternatively, cyclers may use volumetric pumps to control ultrafiltration.

[0005] In any of the above modalities, an automated dialysis machine is in a medical center or a patient’s home. Oftentimes, the automated dialysis machine is wirelessly communicatively coupled to an accessory, such as a heart rate monitor, a blood pressure monitor, a urine scale, a patient monitoring system, a smart bed, a blood warmer, a dialysis solution warmer, or a dialysis solution preparation device. However, depending on room layout, dimensions, and interference sources, a wireless link quality between the automated dialysis machine and the accessory may be poor or otherwise degraded. For example, an additional device (e.g., a smartphone or another medical device) may be brought into a patient’s room and interferes with a wireless link between the medical device and the wireless accessory. In another example, an accessory is moved away from the dialysis machine or placed behind a building column, furniture, or another device, which decreases the link quality. In yet another example, a dialysis machine and an accessory are moved to a new location that experiences greater amounts of wireless interference, thereby reducing wireless link quality. In any of these examples, the automated dialysis machine may not have a reliable or robust wireless link with an accessory, which can affect treatment quality and efficiency if data cannot be transmitted between the devices.

[0006] A need accordingly exists for a dialysis machine that provides wireless link management with wireless accessories.SUMMARY

[0007] Example systems, methods, and apparatuses are disclosed herein for the management of wireless link quality with a wireless accessory. The systems, methods, and apparatuses are configured to monitor a wireless link quality across a plurality of channels to ensure there is an acceptable link quality between a wireless accessory and a medical device, such as a dialysis machine or an infusion pump. In some embodiments, the systems, methods, and apparatuses are configured to perform a link quality check before the medical device performs a treatment. Such a check ensures that communication with the wireless accessories is acceptable before a more critical time when the medical device is performing the treatment.

[0008] The systems, methods, and apparatuses may additionally or alternatively perform a link quality check when a wireless medical accessory is newly connected to a medical device. Inthese embodiments, the systems, methods, and apparatuses execute a routine or algorithm that provides user guidance regarding specified poses (e.g., position, direction, and / or orientation) of a wireless accessory relative to a medical device. The systems, methods, and apparatuses are configured to guide or instruct a user to move a wireless accessory to certain poses based on a sequence defined in the routine or algorithm until an acceptable link quality with the wireless accessory is determined.

[0009] In some instances, a user interface of the medical device may display graphical icons that represent potential acceptable poses relative to the medical device. The routine or algorithm may highlight which icon is the current pose to where the medical accessory is to be moved relative to the medical device. In other instances, a user may select an icon (or other touchscreen or button input) to indicate a current pose of a wireless accessory.

[0010] The systems, methods, and apparatuses, in some embodiments, may use voice guidance to guide a user through different poses. In these embodiments, the systems, methods, and apparatuses are configured to process voice commands to determine when a medical accessory has been moved to a specified pose. The systems, methods, and apparatuses may also use audio to communicate the desired pose. Such a configuration enables a user to pose a wireless accessory without having to move back to a medical device to interact with a touchscreen or other touch input.

[0011] In some instances, the routine and / or algorithm is specific for a medical accessory type. A medical accessory can include, for example, a heart rate monitor, a blood pressure monitor, a urine scale, a patient monitoring system, a smart bed, a blood warmer, a dialysis solution warmer, or a dialysis solution preparation device. Some medical accessories are required to be connected to a patient, such as a heart rate monitor, a blood pressure monitor, a urine scale, and a smart bed. Other wireless accessories have to be placed within a certain distance of a medical device, such as a blood warmer, a dialysis solution warmer, or a dialysis solution preparation device. The routine or algorithm is configured, in some instances, with known acceptable poses based on a type of the accessory. The sequence of poses may progress from a more optimal pose to less optimal, but still acceptable poses.

[0012] In some embodiments, the routine or algorithm modify the sequence of poses or skip certain poses based on known poses of other wireless accessories. For example, a medical device may be connected to three different wireless accessories. After placing a first wirelessaccessory in a certain pose, the routine or algorithm receives a prompt input to determine a pose for another wireless accessory. The routine or algorithm progresses through the sequence (for that accessory type). The routine or algorithm determines poses that conflict, overlap, or interfere with the first wireless accessory. Accordingly, the routine or algorithm skips or omits poses to recommend that conflict with the first wireless accessory. The routine or algorithm then considers the poses of the first two wireless accessories when a third wireless accessory is connected to the medical device.

[0013] In addition to checking link quality before a treatment and when a medical accessory is newly connected to a medical device, the systems, methods, and apparatuses may periodically monitor link quality with connected wireless accessories. The systems, methods, and apparatuses may be configured to monitor the link quality every minute, five minutes, ten minutes, fifteen minutes, thirty minutes, hour, two hours, etc. After detecting a low quality wireless link, the systems, methods, and apparatuses are configured to generate an alarm and / or an alert. In some embodiments, an alarm is generated when the poor quality link is detected during a treatment while an alert (e.g., a less sever notification) is generated between treatments. After detecting the poor link quality, the systems, methods, and apparatuses are configured to operate the routine or algorithm to provide a recommendation for a new pose for the wireless accessory.

[0014] The systems, methods, and apparatuses may further be configured to perform a link quality check after receiving an input indication that a wireless device has been moved. In some embodiments, the medical device may receive a new care area parameter, which is indicative of movement to a different care area of a medical facility. In other embodiments, the medical device detects connection to a different access point, router, or switch, which is indicative of movement. In yet other embodiments, the medical device receives an input via, for example, a touchscreen that indicates the medical device has moved and / or that a link quality check should be performed.

[0015] In some embodiments, the systems, methods, and apparatuses are configured to perform a radio frequency (“RF”) scan of channels associated with one or more wireless protocols, such as Bluetooth®, Bluetooth® Low-Energy, Zigbee™, Z-Wave, 6L0WPAN, LoRaWAN, or Wi-Fi. The systems, methods, and apparatuses are configured to use the RF scan to determine if any channels are unavailable due to high noise floors, low received signal strength, and / or signal interference. The systems, methods, and apparatuses may prevent these channels from being used for communication with connected wireless accessories. This includes preventing these channelsfrom being used during channel hopping or when a dedicated channel is assigned. The RF scan may be performed after each pose to determine link quality.

[0016] The systems, methods, and apparatuses may perform the RF scan, in some embodiments, after a medical device has been moved to a new location before any wireless accessories are connected. The RF scan is performed to evaluate a noise floor. When the detected noise floor is above a threshold for a specified number of channels, the systems, methods, and apparatuses are configured to provide an alert or otherwise recommend that the medical device be moved to a new location. Accordingly, the systems, methods, and apparatuses determine an appropriate placement of medical devices and related accessories based on a room layout and / or dimensions in addition to locations of other equipment or sources of wireless signal interference.

[0017] In light of the disclosure herein and without limiting the disclosure in any way, in a first aspect of the present disclosure, which may be combined with any other aspect listed herein, a medical device includes a memory device comprising a wireless link quality routine or algorithm specifying a sequence of poses relative to the medical device to which a user is to move a wireless accessory for provisioning a wireless connection with the medical device. The sequence of poses includes at least a first pose and a second pose. The medical device also includes a display screen including an interface, a transceiver communicatively coupled to an antenna, and a processor communicatively coupled to the memory device, the display screen, and the transceiver. The processor is configured to (i) receive an input via the display screen indicative of a request to wirelessly couple a wireless accessory to the medical device, (ii) after receiving the input, pair with the wireless accessory using the transceiver and the antenna, (iii) cause the display screen to display a first instruction that is indicative of the first pose, (iv) receive a confirmation input via the display screen indicative that the wireless accessory is located at the first pose, and (v) determine a wireless link quality with the wireless accessory using the transceiver and the antenna. When the wireless link quality is equal to or greater than a threshold classification, the processor is configured to (vi) provision the wireless connection between the medical device and the accessory at the first location. When the wireless link quality is below the threshold classification, the processor is configured to (vii) cause the display screen to display a second instruction that is indicative of the second pose, receive a second confirmation input via the display screen indicative that the wireless accessory is located at the second pose, determine a second wireless link quality with the wireless accessory at the second pose, and provision the wireless connection between themedical device and the accessory at the second pose when the second wireless link quality is equal to or greater than the threshold classification.

[0018] In a second aspect of the present disclosure, which may be combined with any other aspect listed herein, each pose of the sequence of poses includes at least one of a distance or a direction from the medical device.

[0019] In a third aspect of the present disclosure, which may be combined with any other aspect listed herein, each pose of the sequence of poses includes a distance, a direction, and an orientation relative to the medical device.

[0020] In a fourth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor in conjunction with the transceiver are configured to determine the wireless link quality by (a) transmitting one or more request packets to the wireless accessory,(b) receiving response packets from the wireless accessory that are respectively responsive to one or more request packets, and (c) determining, as the wireless link quality, at least one of an average received signal strength or a percentage of packet dropouts based on the received response packets.

[0021] In a fifth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor in conjunction with the transceiver is configured to repeat (a) to(c) for each available wireless channel.

[0022] In a sixth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor is configured to determine which of the available wireless channels have a less than good link quality corresponding to an average received signal strength that is less than - 50 dBm or a packet dropout that is greater than 10%, and prevent the wireless channels that have a less than good link quality from being used for communicating with the wireless accessory.

[0023] In a seventh aspect of the present disclosure, which may be combined with any other aspect listed herein, the response packets include received signal strength values as determined by the wireless accessory based on a signal strength corresponding to reception of the request packets.

[0024] In an eighth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor in conjunction with the transceiver are configured to determine signal strength values based on a signal strength corresponding to reception of the response packets.

[0025] In a ninth aspect of the present disclosure, which may be combined with any other aspect listed herein, the medical device includes a Continuous Renal Replacement Therapy (“CRRT”) machine, a hemodialysis machine, a peritoneal dialysis machine, a syringe pump, a linear peristaltic pump, a large volume pump (“LVP”), an ambulatory pump, multi-channel pump, a nutritional compounding machine, an oxygen sensor, a respiratory monitor, a glucose meter, a blood pressure monitor, an electrocardiogram (“ECG”) monitor, a weight scale, or a heart rate monitor.

[0026] In a tenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the sequence of poses is a first sequence of poses for a first wireless accessory type, and the processor receives information indicative that the wireless accessory is of the first wireless accessory type to apply the first sequence of poses.

[0027] In an eleventh aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor in conjunction with the transceiver are configured to repeat (i) to (vii) for a second wireless accessory that is of a second wireless accessory type that corresponds to a second sequence of poses.

[0028] In a twelfth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor in conjunction with the transceiver are configured to perform (i) to (vii) only after an initial test of the wireless link quality with the wireless accessory determines that the wireless link has a less than good link quality.

[0029] In a thirteenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the wireless accessory is placed in a user-desired pose before the initial test of the wireless link quality is performed.

[0030] In a fourteenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the threshold classification corresponds to a good or excellent wireless link quality having a signal strength of at least -50 dBm.

[0031] In a fifteenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor is configured to provision the wireless connection with the medical device by graphically displaying an image and / or text indicative of the wireless accessory at the first or second pose relative to an image and / or text indicative of the medical device.

[0032] In a sixteenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor is configured to provision the wireless connection with themedical device by storing to a data structure in the memory device, an identifier of the wireless accessory and an indication of the first or second pose.

[0033] In a seventeenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor is further configured to start a medical treatment after the wireless connection is provisioned with the accessory in (vi) or (vii).

[0034] In an eighteenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the processor is further configured to determine a during-treatment wireless link quality with the wireless accessory during the medical treatment, and provide an alert or an alarm when the during-treatment wireless link quality is below the threshold classification during the medical treatment.

[0035] In a nineteenth aspect of the present disclosure, which may be combined with any other aspect listed herein, the during-treatment wireless link quality is determined based on a detected packet dropout rate.

[0036] In a twentieth aspect of the present disclosure, which may be combined with any other aspect listed herein, a medical device includes a memory device comprising a wireless link quality routine or algorithm specifying a sequence of poses relative to the medical device to which a user is to move a wireless accessory for provisioning a wireless connection with the medical device. The sequence of poses includes at least a first pose and a second pose. The medical device also includes a transceiver communicatively coupled to an antenna and a processor communicatively coupled to the memory device and the transceiver. The processor is configured to (i) receive an input indicative of a request to wirelessly couple a wireless accessory to the medical device, (ii) after receiving the input, pair with the wireless accessory using the transceiver and the antenna, (iii) provide a first instruction that is indicative of the first pose, (iv) receive a confirmation input indicative that the wireless accessory is located at the first pose, and (v) determine a wireless link quality with the wireless accessory using the transceiver and the antenna. When the wireless link quality is equal to or greater than a threshold classification, the processor is configured to (vi) provision the wireless connection between the medical device and the accessory at the first location. When the wireless link quality is below the threshold classification, the processor is configured to (vii) provide a second instruction that is indicative of the second pose, receive a second confirmation input indicative that the wireless accessory is located at the second pose, determine a second wireless link quality with the wireless accessory at the secondpose, and provision the wireless connection between the medical device and the accessory at the second pose when the second wireless link quality is equal to or greater than the threshold classification.

[0037] In a twenty-first aspect of the present disclosure, which may be combined with any other aspect listed herein, (iii) and (vii) are performed by causing a speaker to audibly provide the first and second instructions.

[0038] In a twenty-second aspect of the present disclosure, which may be combined with any other aspect listed herein, (iii) and (vii) are performed by causing a display screen to display the first and second instructions.

[0039] In a twenty -third aspect of the present disclosure, which may be combined with any other aspect listed herein, (i), (iv), and (vii) are performed using a microphone to receive the first and second confirmation inputs.

[0040] In a twenty-fourth aspect of the present disclosure, which may be combined with any other aspect listed herein, (i), (iv), and (vii) are performed using a touch interface to receive the first and second confirmation inputs.

[0041] In a twenty-fifth aspect of the present disclosure, which may be combined with any other aspect listed herein, an accessory includes a memory device comprising a wireless link quality routine or algorithm specifying a sequence of poses relative to the accessory to which a user is to move a second accessory for provisioning a wireless connection with the accessory. The sequence of poses includes at least a first pose and a second pose. The accessory also includes a transceiver communicatively coupled to an antenna and a processor communicatively coupled to the memory device and the transceiver. The processor is configured to (i) receive an input indicative of a request to wirelessly couple a second accessory to the accessory, (ii) after receiving the input, pair with the second accessory using the transceiver and the antenna, (iii) provide a first instruction that is indicative of the first pose, (iv) receive a confirmation input indicative that the second accessory is located at the first pose, and (v) determine a wireless link quality with the second accessory using the transceiver and the antenna. When the wireless link quality is equal to or greater than a threshold classification, the processor is configured to (vi) provision the wireless connection between the accessory and the second accessory at the first location. When the wireless link quality is below the threshold classification, the processor is configured to (vii) provide a second instruction that is indicative of the second pose, receive a second confirmation inputindicative that the second accessory is located at the second pose, determine a second wireless link quality with the second accessory at the second pose, and provision the wireless connection between the accessory and the second accessory at the second pose when the second wireless link quality is equal to or greater than the threshold classification.

[0042] In a twenty-sixth aspect of the present disclosure, which may be combined with any other aspect listed herein, the accessory and the second accessory include at least one of a calcium sensor, a heart rate monitor, a blood pressure monitor, a urine scale, a patient monitoring system, a smart bed, a blood warmer, a respiratory monitor, an oxygen sensor, a glucose meter, a dialysis solution warmer, an electrocardiogram (“ECG”) monitor, or a dialysis solution preparation device.

[0043] In a twenty-seventh aspect of the present disclosure, which may be combined with any other aspect listed herein, a system includes a medical device comprising a memory device including a wireless link quality routine or algorithm specifying a sequence of poses relative to the medical device to which a user is to move a wireless accessory for provisioning a wireless connection with the medical device. The sequence of poses includes at least a first pose and a second pose. The system also includes a transceiver communicatively coupled to an antenna and a processor communicatively coupled to the memory device and the transceiver. The processor is configured to (i) receive an input indicative of a request to wirelessly couple a wireless accessory to the medical device, (ii) after receiving the input, pair with the wireless accessory using the transceiver and the antenna, (iii) provide a first instruction that is indicative of the first pose, (iv) receive a confirmation input indicative that the wireless accessory is located at the first pose, and (v) determine a wireless link quality with the wireless accessory using the transceiver and the antenna. When the wireless link quality is equal to or greater than a threshold classification, the processor is configured to (vi) provision the wireless connection between the medical device and the accessory at the first location. When the wireless link quality is below the threshold classification, the processor is configured to (vii) provide a second instruction that is indicative of the second pose, receive a second confirmation input indicative that the wireless accessory is located at the second pose, determine a second wireless link quality with the wireless accessory at the second pose, and provision the wireless connection between the medical device and the accessory at the second pose. The system also includes an accessory configured to receive at least one request packet from the medical device during wireless link quality tests of (v) and (vii),determine a received signal strength indicator (“RS SI”) value of the at least one request packet, and transmit at least one response packet to the medical device that includes the RS SI value.

[0044] In a twenty-eighth aspect of the present disclosure, which may be combined with any other aspect listed herein, the accessory and the second accessory include at least one of a heart rate monitor, a blood pressure monitor, a urine scale, a patient monitoring system, a smart bed, a blood warmer, a respiratory monitor, an oxygen sensor, a glucose meter, a dialysis solution warmer, an electrocardiogram (“ECG”) monitor, or a dialysis solution preparation device.

[0045] In a twenty-ninth aspect of the present disclosure, any of the structure and functionality disclosed in connection with Figs. 1 A to 17 may be combined with any of the other structure and functionality disclosed in connection with Figs. 1 A to 17.

[0046] In light of the present disclosure and the above aspects, it is therefore an advantage of the present disclosure to provide a medical device that manages link quality with wireless accessories.

[0047] It is another advantage of the present disclosure to guide a user through multiple poses of a wireless accessory until a wireless link to a medical device is acceptable.

[0048] It is yet another advantage of the present disclosure to check link quality between a medical device and wireless accessories before a treatment begins.

[0049] It is a further advantage of the present disclosure to monitor a percentage of packet drops (e.g., a packet dropout rate) between a medical device and connected accessories to determine when a link quality has degraded during a treatment.

[0050] It is additionally an advantage of the present disclosure to use a detected noise floor and / or a link quality between a medical device and accessories to determine the feasibility of a site for deploying the medical device.

[0051] Additional features and advantages are described in, and will be apparent from, the following Detailed Description and the Figures. The features and advantages described herein are not all-inclusive and, in particular, many additional features and advantages will be apparent to one of ordinary skill in the art in view of the figures and description. Also, any particular embodiment does not have to have all of the advantages listed herein and it is expressly contemplated to claim individual advantageous embodiments separately. Moreover, it should be noted that the language used in the specification has been selected principally for readability and instructional purposes, and not to limit the scope of the inventive subject matter.BRIEF DESCRIPTION OF THE FIGURES

[0052] Fig. 1A is a diagram of a medical device located in a medical system that includes at least one wireless accessory, according to an example embodiment of the present disclosure.

[0053] Fig. IB is a diagram of the medical system including a user device, according to an example embodiment of the present disclosure.

[0054] Figs. 1C to IE are diagrams of example medical devices and corresponding wireless accessories, according to an example embodiment of the present disclosure.

[0055] Fig. 2 is a diagram of the medical system of Fig. 1A showing other wireless accessories that may be wirelessly coupled to the medical device, according to an example embodiment of the present disclosure.

[0056] Fig. 3 is a diagram of a dialysis machine medical device, according to an example embodiment of the present disclosure.

[0057] Fig. 4 is a diagram of an accessory device, according to an example embodiment of the present disclosure.

[0058] Fig. 5 is a diagram of a user interface displayed by a display screen of the medical device with options to perform link management modalities, according to an example embodiment of the present disclosure.

[0059] Fig. 6 is a flow diagram of an example procedure for performing an RF scan using the medical device of Figs. 1 A to 3, according to an example embodiment of the present disclosure.

[0060] Fig. 7 shows a flow diagram for an RF scan procedure performed by the medical device of Figs. 1 A to 3, according to an example embodiment of the present disclosure.

[0061] Fig. 8 shows a graph of background noise determined using the RF scan for 25 channels, according to an example embodiment of the present disclosure.

[0062] Figs. 9 and 11 are flow diagrams of an example procedure 900 for conducting an RF link quality test that specifies a sequence of poses for a wireless accessory using the medical device of Figs. 1 A to 3, according to an example embodiment of the present disclosure.

[0063] Fig. 10 is a diagram of packets used to determine received signal strength for the RF quality link test, according to an example embodiment of the present disclosure.

[0064] Figs 12 is a diagram illustrative of a routine or algorithm executed to perform the RF link quality test, according to an example embodiment of the present disclosure.

[0065] Fig. 13 is a diagram of a data structure showing linked accessories and corresponding poses, according to an example embodiment of the present disclosure.

[0066] Figs. 14 and 15 are diagrams illustrative of the RF link quality test, according to an example embodiment of the present disclosure.

[0067] Fig. 16 is a flow diagram of an example procedure for performing an RF link quality test after the medical device of Figs. 1A to 3 has moved locations, according to an example embodiment of the present disclosure.

[0068] Fig. 17 shows a link quality user interface when a medical device starts up and pairs with connected accessories, according to an example embodiment of the present disclosure.DETAILED DESCRIPTION

[0069] Methods, systems, and apparatuses are disclosed for link management of wireless accessories. The methods, systems, and apparatuses use one or more algorithms or routines to sequentially guide a user through a plurality of potential poses until a link quality between a medical device and a wireless accessory is acceptable. The methods, systems, and apparatuses may also monitor link quality between a medical device and wireless accessories to determine when at least one link is degraded or otherwise unusable. In these instances, the methods, systems, and apparatuses provide an alert, alarm, and / or recommendation to move the wireless accessory to a new pose. The methods, systems, and apparatuses monitor a link quality periodically, after detecting a medical device has moved to a new location, before a treatment is performed by a medical device, and / or after a request from a user. The methods, systems, and apparatuses may also assess link quality when a wireless accessory is newly connected to a medical device.

[0070] To determine link quality, the methods, systems, and apparatuses are configured to perform an RF scan. As disclosed herein, the RF scan may include increasing a sensitivity of a radio transceiver of a medical device to determine a noise floor over one or more wireless channels of a frequency band that is associated with a wireless protocol, such as Bluetooth®, Bluetooth® Low-Energy, Zigbee™, Z-Wave, 6L0WPAN, LoRaWAN, or Wi-Fi. When a wireless accessory is connected, the RF scan may additionally or alternatively include determining an average received signal strength (e.g., a received signal strength indicator (“RSSI”)) of packets / messages that are transmitted by the wireless accessory to a medical device over a plurality of channels.Poor link quality may be determined when a threshold number of channels (e.g., at least 10% to 30% of available channels) have a RS SI that is below a specified signal strength value of, for example, -50 decibels per milliwatt (“dBm”).

[0071] Reference is made herein to medical devices and accessories. As disclosed below, a medical device is a device that provides a medical treatment to a patient. The medical device is also configured to manage wireless links. A medical device can include, for example, a dialysis machine, an infusion pump, a nutritional compounding machine, a respiratory machine, a patient monitor, a smart bed, etc.

[0072] An accessory is a device that is communicatively coupled to a medical device via a direct or indirect wireless connection and provides data to the medical device or receives data from the medical device in relation to the treatment. It should be appreciated that an accessory wireless communicates with a medical device but does not manage the wireless link. In some instances, an accessory is a sensor that transmits at least one measured physiological parameter to the medical device. In other instances, an accessory receives data from a medical device for display or integration with other data related to the treatment. An accessory can include, for example, a heart rate monitor, a blood pressure monitor, a urine scale, a patient monitoring system, a smart bed, a blood warmer, a respiratory monitor, an oxygen sensor, a glucose meter, a dialysis solution warmer, an electrocardiogram (“ECG”) monitor, or a dialysis solution preparation device.

[0073] It should be appreciated that in some circumstances, a device may be a medical device in some instances and a wireless accessory in other instances. For example, an infusion pump may be a medical device and control wireless links to physiological sensors. However, when connected to a dialysis machine, such as a CRRT machine, the infusion pump may be an accessory and the dialysis machine is the medical device using the characterizations described above.

[0074] While the disclosure refers to medical devices, it should be appreciated that the methods, systems, and apparatuses may be applied to other devices. For example, the methods, systems, and apparatuses described herein may apply to Internet-of-Things devices, wireless speaker systems, wireless lighting systems, industrial systems, manufacturing systems, warehouse systems, etc. In general, the methods, systems, and apparatuses may be used in any device that wireless communicates with one or more accessories.

[0075] Reference is also made to a pose of an accessory. As described herein, pose refers to a position and / or orientation of an accessory relative to a medical device. The position includes a distance and / or direction from a medical device. In other words, the position is a location of an accessory in relation to a location of a medical device. In an example, an accessory may be positioned two to six meters to the left of medical device. In some instances, position may also include a height of an accessory relative to a floor or the medical device. Orientation refers to an angular position, such as tilt, roll, and yaw, relative to the medical device. In an example, an accessory may be tilted toward a medical device at an angle of 45°. It should be appreciated that pose does not necessarily have to include an orientation and may only include a distance and direction from a medical device.

[0076] In addition to above, reference is also made to determining the link quality between a medical device and accessories. In some instances, the link quality and / or a detected noise floor may additionally be used to determine the feasibility of a site for deploying the medical device. For example, a noise floor for each channel of a wireless protocol being used by a medical device may be monitored after the medical device has been placed at a planned deployment site, such as a room within a clinic. When the noise floor is too high for a threshold number of channels, the deployment site may be deemed unacceptable such that the medical device has to be moved to a different location of the clinic that has a lower noise floor. In other examples, the link quality between the medical device and one or more accessories may be used to determine whether a site is suitable for the medical device.Example Medical Device Embodiment

[0077] Fig. 1 A is a diagram of the medical device 102 located in a medical system 100 that includes a server 140, according to an example embodiment of the present disclosure. The medical device 102 is configured to accept one or more parameters specifying a treatment or prescription (i.e., treatment programming information). The medical device 102 performs one or more treatment routines, such as priming patient tubing, disinfecting tubing, and providing one or more medical treatments.

[0078] In the illustrated example, the medical device 102 is a CRRT machine. However, the medical device 102 may include other types of dialysis machines or an infusion pump. Figs. 1C to IE are diagrams of additional medical devices 102, according to an example embodiment ofthe present disclosure. In some examples, the medical device 102 may include a point-of-care (“PoC”) dialysis cycler 102a shown in Fig. 1C. The PoC dialysis cycler 102a is configured to provide a peritoneal dialysis treatment. When the PoC dialysis cycler 102a is used, a wireless accessory includes a dialysis solution preparation device 130i that prepares at least one of purified water or dialysis fluid. The dialysis solution preparation device 13 Oi receives water from a source, which is then purified and provided to the PoC dialysis cycler 102a via a water line 160. To create dialysis fluid, the dialysis solution preparation device 130i mixing purified water with one or more concentrates. The dialysis solution preparation device 130i communicates with the PoC dialysis cycler 102a to control water or dialysis fluid output. The dialysis solution preparation device 13 Oi may also communicate with the PoC dialysis cycler 102a to adjust a concentration of concentrate added to the purified water. In some instances, the dialysis solution preparation device 130i transmits an alert or error to the PoC dialysis cycler 102a. The alert or error is indicative of an issue regarding water or dialysis fluid preparation. In response to the alert or error, the PoC dialysis cycler 102a is configured to pause or stop a treatment.

[0079] As shown in Fig. 1C, a wireless accessory may also include an effluent scale 130ii that is configured to weigh an effluent container or bag. The effluent scale 13 Oii is configured to transmit a measured weight to the PoC dialysis cycler 102a to determine an amount of effluent removed from a patient. The PoC dialysis cycler 102a may, in some embodiments, transmit request messages to the effluent scale 13 Oii to receive a current weight value of an effluent bag.

[0080] Fig. 1C shows that both the dialysis solution preparation device wireless accessory 130i and the effluent scale 13 Oii are fluidly coupled to the PoC dialysis cycler 102a. The fluid coupling restricts a distance that the dialysis solution preparation device wireless accessory 130i and the effluent scalel30ii can be positioned away from the PoC dialysis cycler 102a. The methods, systems, and apparatuses disclosed herein are configured to use this distance limitation when recommending locations for the dialysis solution preparation device wireless accessory 13 Oi and the effluent scale wireless accessory 13 Oii relative to the PoC dialysis cycler 102a.

[0081] Fig. ID shows a medical device as a hemodialysis machine 102b, which is configured to provide a hemodialysis treatment. When the hemodialysis machine 102b is used, a wireless accessory 130 may include a patient physiological sensor or a vital sign monitoring device 130iii. The patient physiological sensor or vital sign monitoring device 130iii is configured to measure one or more physiological parameters of a patient, such as a heart rate, a blood pressure,a body temperature, a respiratory rate, a blood oxygen level, etc. The patient physiological sensor or vital sign monitoring device 130iii transmits physiological data to the hemodialysis machine 102b wirelessly, thereby enabling the hemodialysis machine 102b to determine patient parameters relative to a treatment and / or determine if a treatment should be paused or stopped after detecting a patient’s health is declining. Since the patient physiological sensor or vital sign monitoring device 130iii is not physically coupled to the hemodialysis machine 102b, the methods, systems, and apparatuses are configured to permit greater distances between the two devices. However, since the patient physiological sensor or vital sign monitoring device 130iii and the hemodialysis machine 102b are both connected to the patient, the distances are still limited to less than entire dimensions of a room.

[0082] As shown in Fig. IE, the medical device 102 may also include an infusion pump 102c, which may include a large volume pump (“LVP”). In other embodiments, the infusion pump 102c may include a syringe pump, a linear peristaltic pump, or an ambulatory pump, multi-channel pump. Further, the infusion pump 102c may include a nutrition pump. When the infusion pump 102c is used, the wireless accessory 130 may include a pulse ox sensor 130iv, a hemodynamic monitor 130v, and / or a heartrate monitor 130vi.

[0083] The pulse ox sensor 130iv, the hemodynamic monitor 130v, and / or the heartrate monitor 130vi transmit pulse ox data, hemodynamic data / fluid balance data, and heartrate data respectively to the infusion pump 102c. Each of the pulse ox sensor 130iv, the hemodynamic monitor 130v, and / or the heartrate monitor 130vi are physically connected to a patient for measuring the physiological parameters. As such, the methods, systems, and apparatuses are configured to define a range of possible recommended locations for the wireless accessories 130iv to 130vi to encompass locations relatively close to a patient but potentially further away from the infusion pump 102c. In some instances, the hemodynamic monitor 130v and the infusion pump 102c may both be in a rack or hub. The methods, systems, and apparatuses may accordingly limit recommended locations of the hemodynamic monitor 130v to the rack or hub.

[0084] It should be appreciated that in other embodiments, the medical device 102 may include any other sensor or machine. For example, the medical device 102 may include a physiological sensor, a nutritional compounding machine, an oxygen sensor, a respiratory monitor, a glucose meter, a blood pressure monitor, an electrocardiogram (“ECG”) monitor, a weight scale, and / or a heart rate monitor. The medical device 102 may also include a hospital bed or patientbedside monitor. It should be appreciated that each type of medical device has one or more corresponding wireless accessories.

[0085] The example medical device 102 includes a display screen 106 for displaying instructions and receiving control inputs from a user. The display screen 106 may include buttons, a control panel, and / or a touchscreen. The display screen 106 may also be configured to enable a user to navigate to a certain window or graphical user interface. The display screen 106 may also display instructions for operating or controlling the medical device 102 and / or provide a status of the medical device 102.

[0086] The example medical device 102 also includes a processor 108 and a communication module 110. The example processor 108 operates according to one or more instructions or software routines for performing a treatment on a patient. The instructions or software routines may be stored on a memory device 112 of the medical device 102. The memory device 112 may also store one or more graphical user interfaces that are displayed by the display screen 106.

[0087] The inputs for operating the medical device 102 may be received by the display screen 106 via the processor 108. The example processor 108 uses the inputs in conjunction with the instructions or software routines to control operation of the medical device 102. The processor 108 also monitors device components for issues, which are documented as diagnostic information. The processor 108 creates medical device data in conjunction with operating one or more pumps or other components to administer a treatment. The processor 108 may include a microcontroller, an application specific integrated circuit, a logic controller, etc.

[0088] The communication module 110 is configured to wirelessly couple the medical device 102 with one or more accessories. The communication module 110 includes one or more antennas 114 and a transceiver that converts received data from a wireless protocol to a format for the processor 108. The wireless data may be in a format defined by a wireless protocol such as, for example, Bluetooth®, Bluetooth® Low-Energy, Zigbee™, Z-Wave, 6L0WPAN, LoRaWAN, or Wi-Fi. The processor 108 may process data in an EXCOM format or other digital data format. The transceiver also converts data received from the processor 108 into a wireless protocol format for transmission to one or more accessories.

[0089] The example processor 108 is communicatively coupled to the communication module 110, the display screen 106, and the memory device 112. To enable link management, thememory device 112 stores one or more routines or algorithms 120, which specify how an RF scan is to be performed. The one or more routines or algorithms 120 may also specify how a link quality with a wireless accessory is determined. The one or more routines or algorithms 120 may further specify a sequence of poses to which an accessory is to be moved until an acceptable link quality with the medical device 102 is achieved. The routines or algorithms 120 may be configured for different accessory types. As described in more detail below, certain accessory types may have certain pose requirements. For example, a dialysis solution preparation device may be fluidly coupled to the medical device 102 via a two meter fluid line. As such, one requirement may specify that the dialysis solution preparation device has to be within two to eight meters of the medical device 102.

[0090] The example memory device 112 may also store a data structure 122, such as a log, that documents a current setup of the medical device regarding wireless links. The data structure 122 may identify connected wireless accessories by an identifier and / or hardware address. The data structure 122 may also specify a wireless protocol and / or dedicated channel for the wireless accessory. Further, the data structure 122 may identify a current pose of the accessory relative to the medical device 102. Additionally, the data structure 122 may record an average or baseline signal strength (e.g., RS SI) with the accessory.

[0091] In some embodiments, the data structure 122 may further store information indicative as to which types of accessories can connect to the medical device 102. For instance, the data structure 122 may include hardware identifiers, password / passcodes, and / or model numbers of accessories that are permitted to pair or otherwise connect to the medical device 102. During a pairing process, the processor 108 uses the data structure 122 to determine when a requesting accessory 130 is allowed to communicatively couple to the medical device over a local wireless link. This prevents unauthorized devices from coupling with the medical device 102, which could affect a patient’s treatment or otherwise compromise the medical device.

[0092] The example memory device 112 may further store a noise record 124 that is indicative of a noise floor around the medical device 102. As discussed in more detail below, the processor 108 operates in conjunction with the communication module 110 and the antenna 114 to perform an RF scan. During this scan, the processor 108 places the communication module 110 into a listen mode with a sensitivity increased. The processor 108 determines the noise for each of the channels for the wireless protocol being used. For example, Bluetooth® may have 40 or 80different channels at the 2.4 GHz spectrum. The processor 108 compares the noise data to a noise threshold for each channel to determine whether the noise is too high for the channel to be used. For the channels identified as being unusable, the processor 108 stores an identification of those channels (e.g., channel numbers) to the noise record 124 such that those channels are skipped during channel assignment or channel hopping during communication. The processor 108 may also store the average noise data for each channel to the noise record 124.

[0093] The medical system 100 of Fig. 1A also shows a wireless accessory 130 that is wirelessly linked or coupled to the medical device 102. In this example, the wireless accessory 130 is a dialysis solution preparation device that mixes dialysis solution from water and one or more dialysis concentrates. The accessory 130 is fluidly coupled to the medical device 102 via a dialysis fluid tube 132, which may have a length between one meter and eight meters. The dialysis machine medical device 102 transmits fluid demand information and desired dialysis concentrate concentration information to the wireless accessory 130 using the wireless link. The wireless accessory 130 may transmit errors or alerts related to preparation of the dialysis fluid to the dialysis machine medical device 102 using the wireless link.

[0094] It should be appreciated that the wireless accessory 130 can include other types of devices. Fig. 2 is a diagram of the medical system 100 showing other wireless accessories that may be wirelessly coupled to the medical device 102, according to an example embodiment of the present disclosure. In addition to the dialysis fluid preparation device 130 discussed above, the wireless accessories can include a patient monitor accessory 130a, a dialysis fluid warmer accessory 130b, a urine scale accessory 130c, a blood pressure monitor accessory 130d, and a smart bed accessory 130e. In some embodiments, the accessories 130 to 130e may be wirelessly connected to the medical device 102 at the same time. In other embodiments, one or a few of the wireless accessories 130 to 130e are connected to the medical device 102 at the same time. In addition to the wireless accessories 130 to 130e shown in Fig. 2, accessories can further include a heart rate monitor, a calcium sensor, a blood warmer, a respiratory monitor, an oxygen sensor, a glucose meter, an electrocardiogram (“ECG”) monitor, or any other device that is capable of wirelessly coupling to the medical device 102. For a CRRT medical device, the accessory 130 may include a calcium sensor.

[0095] It should be appreciated that the accessories do not need to include a medical device. For example, a user device 150, 13 Of may be an accessory that is wirelessly coupled tothe medical device 102 via a Bluetooth® link. The user device 150, 130f may be configured to provide remote control of the medical device 102 and / or enable a user to enter physiological data for recording in conjunction with a treatment. The user device 150, 130f may include a smartphone, a tablet computer, a desktop computer, a workstation, a smartwatch, smarteyewear, etc.

[0096] Returning to Fig. 1A, in some embodiments, the medical device 102 is communicative coupled to a server 140 via a network 142. The example network 142 may include a local area network, a wide area network (e.g., the Internet), a cellular network, or combinations thereof. It should be appreciated that the network 142 is separate from the local wireless link that exists between the medical device 102 and the wireless accessory 130. The server 140 may include a processor, a workstation, or a distributed cloud computing system.

[0097] The example server 140 is configured to provide management and updates for link management to the processor 108. For example, the server 140 may update the routines or algorithms 120 for new wireless accessories. Further, the server 140 may update the data structure 122 with identifiers of newly compatible wireless accessories for pairing and / or authentication. The server 140 may further update noise thresholds and / or minimum channel thresholds.

[0098] In some embodiments, the server 140 is configured to transmit prescription information to the medical device 102 to perform a treatment. The prescription information specifies operational parameters of the medical device 102, such as a pump speed, a treatment duration, or a dialysis fluid concentration. Further, the server 140 receives medical device data from the medical device 102 for storage in a patient’s electronic medical record. The medical device data may include operating data related to the performance of a treatment by the medical device 102. The medical device data may also include operational data and / or patient physiological data that is transmitted from the one or more accessories 130a-f to the medical device 102.

[0099] While not shown, in some embodiments the medical system 100 of Fig. 1A may include a gateway, a firewall, or a virtual private network across the network 142. The gateway, the firewall, and / or the virtual private network are configured to ensure only authorized devices can communicate with the medical device 102 via the network 142. For instance, a gateway may authenticate a connection with the medical device 102 across the network 142. The server 140 connects to the medical device 102 through the gateway.

[0100] Fig. IB is a diagram of the medical system 100 with a user device 150. As shown, the user device 150 may be directly communicatively coupled to the medical device 102 via a wireless or a wired connection. In other embodiments, the user device 150 is communicatively coupled to the medical device 102 via the network 142. The user device 150 may include a smartphone, a tablet computer, a desktop computer, a laptop computer, a workstation, etc.

[0101] The user device 150 includes a processor 152 and a memory 154 storing instructions. Execution of the instructions by the processor 152 causes the user device 150 to operate an application 156. The example application 156 may display the same information as the display screen 106 of the medical device 102 when communicatively coupled. Such a configuration enables a user to move around a room or building to pose accessories 130 and view noise data, link quality data, and / or pose recommendations. The application 156 may also include one or more inputs that enable a user to start a noise test, a link quality test, and / or confirm an accessory 130 has been moved to a specified pose. The user device 150 may also be used when the medical device 102 and / or the accessory 130 does not have the display screen 106.

[0102] In some embodiments, the user device 150 may communicatively couple to an accessory 130 when the accessory is configured to perform an RF scan and / or link quality test. Such a configuration enables noise data and / or link quality data to be displayed even when the accessory 130 does not have a display. Further, in some instances, the wireless link between the user device 150 and the medical device 102 and / or the accessory 130 may be used to perform a link test.

[0103] As an alternative to the user device 150, the accessory 130 and / or the medical device 102 may use audio exclusively and / or an LED indicator to convey results of an RF scan and / or a link quality test. The audio may be used when the accessory 130 and / or the medical device 102 includes a speaker. When the accessory 130 and / or the medical device 102 does not include a speaker or a display screen, one or more LEDs may be used to convey the noise floor of an RF scan and / or a link quality.

[0104] Fig. 3 is a diagram of a dialysis machine medical device 102, according to an example embodiment of the present disclosure. The dialysis machine medical device 102 includes the display screen 106, the processor 108, and the memory device 112, as discussed above in connection with Fig. 1A. The processor 108 may be a control engine 302 that is configured 1with software or machine-readable instructions that specify executable operations of the dialysis machine medical device 102. The control engine 302 includes user interface software 304, which specifies user interfaces that are rendered for display on the display screen 106. The user interface software 304 specifies when each user interface is to be displayed. The user interface software 304 also defines inputs for specifying operations or changing operations of the dialysis machine medical device 102. For example, the user interface software 304 can define one or more user interfaces that enable a user to enter dialysis treatment parameters for performing a treatment. The parameters may include a dialysis fluid concentration, a treatment duration, a blood pump rate, a heparin syringe pump rate, one or more fluid pump rates, a desired ultrafiltrate clearance, etc.

[0105] The control engine 302 also includes control software 306 that transmit commands or signals to the syringe pump, the blood pump, and the one or more fluid pumps based on the specified parameters. The control software 306 is also configured to generate alarms or alerts when certain conditions are met related to operation of the pumps, detected line occlusions, or other faults are detected. In addition to pumps, the control software may control a tube loader, one or more pinch valves, and one or more clamps. Further, the control software 306 is configured to receive data from one or more pressure sensors and / or container weight scales for determining if a fault condition is present or operation of a treatment is to be modified.

[0106] The example control engine 302 may also operate with the communication module 110 to perform an RF scan. Further, the control software 302 may operate with the communication module 110 to determine wireless link quality with one or more wireless accessories 130. For RF scanning, link quality testing, and accessory pose setting, the control engine 302 is configured to execute one or more routines or algorithms 120 stored in the memory device 112. The routines or algorithms 120 may specify user interfaces are / or prompts that are to be displayed. The control software 306 operates with the user interface software 304 to display the user interfaces or prompts on the display screen 106.

[0107] In some embodiments, the control engine 302 also includes protective software 308a that manages certain operations of the dialysis machine medical device 102 when critical errors occur. The protective software 308a is configured to deactivate the pumps and close valves and clamps in a controlled manner when the control software 306 of the control engine 302 experiences an error that disrupts a treatment. The protective software 308a may also managestartup and shutdown of the control software 306 when the dialysis machine medical device 102 is powered off or on, respectively.

[0108] The dialysis machine medical device 102 may also include a protective engine 310 that includes protective software 308b for monitoring operation of the pumps, valves, clamps, and sensors. For example, the protective software 308b may monitor operation of a syringe pump 312a, a blood pump 312b, and one or more fluid pumps 312c of the medical device 102, which are controlled by the software 304 and 306 of the control engine 302. The protective software 308b may also monitor a power supply 314 of the medical device. Further, the protective software 308b may also monitor valves 316a, clamps 316b, sensors, 316c, and one or more scales 316d of the medical device 102. The software 304 and 306 of the control engine 302 receives feedback data or measurement data respectively from the valves 316a, the clamps 316b, the sensors, 316c, and the one or more scales 316d for controlling the pumps 312.

[0109] The protective engine 310 is configured to detect when a component 312, 314, and / or 316 deviates from expected performance. After a deviation is detected, the protective engine 310 is configured to instruct the control engine 302 to pause a treatment. In addition, the protective engine 310 provides for a controlled deactivation of the component that failed.

[0110] Fig. 3 also illustrates the communication module 110 of Figs. 1A and IB, according to an example embodiment of the present disclosure. The communication module 110 includes a transceiver 320 that is electrically coupled to the antenna 114. The transceiver 320 may include the Qualcomm® QCA6564AU System-on-Chip (“SoC”), for example. The transceiver 320 is configured for one or more wireless protocols including Wi-Fi (e.g., 802.11.n / ac), Bluetooth® at 2.4 GHz or 5 GHz, Bluetooth® Low-Energy, Zigbee™, Z-Wave, 6L0WPAN, or LoRaWAN.

[0111] The transceiver 320 is communicatively coupled to a microprocessor 322 using, for example, 12S, PCI, or SDIO. The microprocessor 322 is configured to convert data between a wireless protocol format received in the transceiver to a format for processing by the control engine 302, such as an EXCOM format. The microprocessor 322 is communicatively coupled to RAM 328 and / or flash memory 330 to specify protocol formatting and / or message timing. In some embodiments, the memory device 112 may be stored in the RAM of the communication module 110.

[0112] As shown in Fig. 3, the communication module 110 also includes an interface 324 with the control engine 302. The example interface 324 may handle message queue and timing transmissions with the microprocessor 322. The interface 324 may also enable the control engine 302 to update software stored in the RAM 328 or flash memory 330 to adjust operation of the microprocessor 322.

[0113] The communication module 110 may also include a speech recognition module 326. In other embodiments, the speech recognition module 326 may be located in the control engine 302. The speech recognition module 326 includes a microphone and is configured to convert voice instructions to text for processing by the control engine 302. For instance, during pose placement of an accessory 130, the control engine 302 may display a prompt on the display screen 106 to place an accessory at a specified pose. The control engine 302 may also cause a speaker on the dialysis machine medical device 102 to announce the prompt. The control engine 302 may send an instruction to the microprocessor 322 to activate the speech recognition module 326. A user may then verbalize a confirmation that the accessory is in the specified pose. The speech recognition module 326 is configured to compared text corresponding to received voice commands to a library of acceptable commands. When there is a match, for example, of an ‘ok’ or ‘confirm’ command, the speech recognition module 326 transmits a response message to the control engine 201 via the microprocessor 322 and the interface 324 that is indicative of a confirmation that the accessory 130 is in the specified pose. Additional commands can include a request to skip a pose, a request to start a new link quality test, or a request to begin an RF scan.

[0114] Fig. 4 is a diagram of an accessory device 130 (e.g., the accessories 130a-f of Fig. 3), according to an example embodiment of the present disclosure. The accessory device 130 includes an antenna 402 that is electrically coupled to a transceiver 404, which may be a same type of radio transceiver as the transceiver 320 of the medical device 102. To operate, the accessory 130 includes a microprocessor 406, a control interface 408, and hardware components 410. Software may be stored in RAM 412 and / or a flash memory 414. The microprocessor 406 operates the software to perform the operations of the accessory 130 using the hardware components 410. For a dialysis fluid preparation device, the microprocessor 406 causes the hardware components 410 to prepare a dialysis fluid from water and concentrates. For a sensor, the microprocessor 406 measures a patient physiological parameter using one or more sensors of the hardware components 410. Accordingly, the configuration of the accessory 130 is based on atype of the accessory. However, the accessory 130 is configured, regardless of function, to connect to the medical device via a local wireless link.Link Management Embodiment

[0115] As discussed above, the medical device 102 is configured to provide wireless link management with accessories 130. The link management includes an RF scan to determine a noise floor around the medical device 102. The link management also includes adding an accessory 130 and specifying / recommending its pose. The link management further comprises performing a link test.

[0116] Fig. 5 is a diagram of a user interface 500 displayed by the display screen 106 of the medical device 102 with options to perform the above-described link management modalities. The user interface 500 shows a graphical representation of the medical device in addition to current programmed parameters and a list of connected accessories (e.g., a blood warmer, a water device a urine scale, and an infusion pump). The user interface 500 also includes icons 502 to 506 that enable a user to input a request to begin the RF scan test, add an accessory, or perform a link test. It should be appreciated that the link test may also be performed automatically by the medical device 102. For example, the link test may be performed a defined periodic time periods such as every minute, five minutes, ten minutes, fifteen minutes, thirty minutes, hour, two hours, etc. The link test may also be performed after the control engine 302 detects a new programmed care area or detects a connection to a new router, switch, or access point. The link test may also be performed automatically before a treatment begins.

[0117] Selection of the icon 502 to 506 causes an instruction to be sent to the control engine 302 of the medical device 102 to access the corresponding routine or algorithm 120 from the memory device 112. The medical device 102 then performs the specified operation as defined by the routine or algorithm 120. The following sections describe how the medical device 102 performs the different modalities.RF Scan Embodiment

[0118] Fig. 6 is a flow diagram of an example procedure 600 for performing an RF scan using the medical device 102 of Figs. 1A to 3, according to an example embodiment of the present disclosure. Although the procedure 600 is described with reference to the flow diagramillustrated in Fig. 6, it should be appreciated that many other methods of performing the steps associated with the procedure 600 may be used. For example, the order of many of the blocks may be changed, certain blocks may be combined with other blocks, and many of the blocks described may be optional. For example, a wireless accessory 130 may not be connected after the RF scan is complete. The operations described in the procedure 600 are specified by one or more routines or algorithms 120 and may be performed among the control engine 302 and the communication module 110 of the medical device 102.

[0119] The example procedure 600 is performed to determine a noise floor in proximity to the medical device 102. The procedure 600 begins when the medical device 102 is newly provisioned (block 602). During provisioning, the medical device 102 is moved to a designated location, such as a room in a hospital or a clinic. Alternatively, the location may include a patient’s home. To determine if the location is suitable for wireless links with accessories, a service technician selects the icon 502 of the user interface 500 of Fig. 5 (block 604). In other embodiments, the service technician may say a verbal command such as, “Start RF Scan”.

[0120] The control engine 302 of the processor 108 operates in conjunction with the communication module 110 of the medical device 102 to determine a presence of interference sources at the designated location. Interference sources could include other devices using the same channels (e.g., wireless routers, or cell phones,) or emission from other devices like fluorescent lights and microwave ovens, or bad electric connections. During the passive RF scanning, the medical device 102 determines wireless energy levels that correspond to RF noise. The RF scan may take a few minutes to a few hours or days.

[0121] Fig. 7 shows a flow diagram for an RF scan procedure 604 performed by the medical device 102, according to an example embodiment of the present disclosure. The RF scan procedure 604 is specified by at least one routine or algorithm 120 that is stored in the memory device 112. Execution of the routine or algorithm 120 by the processor 108 of the medical device causes the below-discussed operations to be performed. The processor 108 first ensures that the medical device 102 is activated (block 702). When the medical device 102 is activated, the processor 108 initializes the medical device (block 704). The processor 108 next receives an input indicated that the RF scan should be completed (block 706). When the processor 108 does not receive a request to perform an RF scan (block 708), the processor 108 omits the RF check and instead performs a dialysis treatment when instructed (block 710).

[0122] However, when a request to perform the RF scan is received, the processor 108 accesses the routine or algorithm 120 and places the communication module 110 into a listen mode (block 712). The processor 108 also increases a sensitivity of the transceiver 320 (block 714). The processor 108 next selects a first channel and scans for RF energy or background noise by dwelling in the channel for a predefined time period (block 716). The predefined time period may be five minutes, ten minutes, twenty minutes, etc.

[0123] During the dwell period, the processor 108 determines an amount of RF energy received (blocks 718 and 720) and calculates an average RF energy over the dwell period (block 722). Between reads of RF energy, the processor 108 may delay for a period of time (block 724) and determine if the scan is complete (block 726). For example, the routine or algorithm 220 may specify that each channel is to have five delays of two minutes each. The processor 108 determines the RF energy (block 720) after the delay when the number of specified delays has not been reached or exceeded. The processor 108 continues reading RF energy for the channel until the specified number of delays has been exceeded (block 726).

[0124] The processor 108 next determines whether all of the channels have been scanned (block 728). For Bluetooth® at 2.4 GHz, this may include 40 channels of each 1 MHz. When all the channels have not been scanned, the processor 108 selects a next channel (block 730) and proceeds to determine the average RF energy for that channel, as discussed above in connection with blocks 720 to 726. When all of the channels have been scanned, the processor 108 next creates and displays a visual indication of the average RF energy determined for the channels (blocks 732 and 734). The example procedure 700 for RF scanning then ends.

[0125] Fig. 8 shows a graph 800 of background noise determined by the processor 108 for 25 channels. The graph 800 may be displayed within a user interface that is shown on the display screen 106 of the medical device 102. In this example, the background noise is shown as being about 85 -dBm for all of the channels. In other embodiments, the background noise may vary per channel. The background noise is indicative of a noise floor for each channel. Line 802 represents received signal strength of packets received from a wireless accessory 130 for each channel. While in this example an accessory was not already connected to the medical device 102, in other examples, an accessory may be connected where RS SI values have already been determined for each channel and / or are determined for each channel during or after the RF scan. In these instances, the processor 108 may display the RSSI values as line 802 relative to the noisefloor to illustrate link reliability. An unreliable link may correspond to channels where the RSSI values are at or below the noise floor or within a specified margin (e.g., -15 dBm) of the noise floor. Such channels may be designated by the processor 108 as being unavailable for communication with an accessory 130.

[0126] Returning to Fig. 6, the processor 108 uses the graph 800, for example, to determine a number of channels that have a noise floor that exceeds a noise threshold (blocks 606 and 608). In some instances, the noise threshold may be a value specified between -100 dBm and -40 dBm. When more than a threshold number of channels have a noise floor that is greater than the noise threshold, the processor 108 provides an alert and / or recommendation that the medical device 102 should be moved to a new location (block 610). The alert or recommendation may indicate the number of channels with a high noise floor and / or may include the graph 800 of Fig. 8. The alert or recommendation may also prompt the service technician to attempt to search for and reduce the RF noise sources. The example procedure 600 may then be repeated after the medical device 102 is moved.

[0127] When a number of low quality channels are below the threshold (block 608), the processor 108 may display a prompt on the display screen 106 of the medical device 102 indicative that one or more wireless accessories 130 can be connected (block 612). The processor 108 may also store the graph 800 and / or data from the graph 800 to the noise record 124 as a baseline noise floor. The processor 108 may also store, to the noise record 124, an identifier of the channels that have a noise floor that is greater than a noise threshold.

[0128] As discussed in more detail below, the procedure 600 ends after the processor 108 performs an active scan and / or link test with an accessory 130 to determine an appropriate pose relative to the medical device 102. The procedure 600 may be performed again when the processor 108 detects that the medical device 102 has moved to a new location. This may include the processor 108 receiving a new care area identifier, a new patient identifier, and / or detecting, via the communication module 110, a connection to a new network port, access point, router, switch, and / or gateway.

[0129] Reference is made above to the procedures 600 and 700 being performed by the medical device 102. In some embodiments, the procedures 600 and 700 may instead be performed by the accessory 130. The procedures 600 and 700 may only be performed by theaccessory 130 when the accessory 130 has RF scan software. The results from the RF scan may be displayed on a screen of the accessory 130 and / or a communicatively coupled user device 150.Accessory Pose Guidance Embodiment

[0130] When an accessory is newly connected to the medical device 102, the processor 108 is configured to guide a user to place the accessory at a specified pose. Fig. 9 is a flow diagram of an example procedure 900 for conducting an RF link quality test that specifies a sequence of poses for a wireless accessory using the medical device of Figs. 1 A to 3, according to an example embodiment of the present disclosure. Although the procedure 900 is described with reference to the flow diagram illustrated in Fig. 9, it should be appreciated that many other methods of performing the steps associated with the procedure 900 may be used. For example, the order of many of the blocks may be changed, certain blocks may be combined with other blocks, and many of the blocks described may be optional. For example, link quality may be determined using other methods. The operations described in the procedure 900 are specified by one or more routines or algorithms 120 and may be performed among the control engine 302 and the communication module 110 of the medical device 102.

[0131] The procedure 900 begins when the medical device 102 is powered on or otherwise activated (block 902). The medical device 102 performs an initialization procedure where the protective software 308a and 308b start the software 304 and 306 on the control engine 302 (block 904). Additionally, the communication module 110 is activated. The medical device 102 next waits for a user input (block 906). In some embodiments, a user does not select a link test or a request to add a new accessory (block 908). Instead, user requests to perform a treatment using already paired and / or authenticated accessories 130. In these instances, the medical device 102 connects to the already paired wireless accessories 130 (block 910) and performs a specified treatment or therapy (block 912). The procedure 900 then ends until a new accessory is added or a link test is requested.

[0132] Returning to block 908, when a link test is requested or a user requests to add a new accessory, the processor 108 accesses one or more routine or algorithms 120 that correspond to the selected link test or request to add a new accessory 130. The one or more routine or algorithms 120 specify that the processor 108 is to disconnect any currently connected accessories 130 (block 914). The processor 108 then selects a first wireless channel (block 916).In some instances, the processor 108 of the medical device 102 registers and / or authenticates the selected wireless accessory 130 using the data structure 122, which specifies permissible accessory types that connect to the medical device 102. Registration includes receiving in the processor 108 a device identifier of the wireless accessory 103, such as a serial number, a wireless pin or password, and / or a device type. Registration may also include pairing and / or sharing protocol information between the wireless accessory 130 and the medical device 102 when both or at least one is placed into a wireless discovery mode.

[0133] At this point in the procedure 900, the wireless accessory 130 is placed at a user-preferred pose relative to the medical device 102. Accordingly, the RF link test determines whether a good link quality exists between the accessory 130 and the medical device 102 at a pose selected by the user. In other embodiments, the routine or algorithm 120 specify that the processor 108 is to prompt a user to move the wireless accessory to a first pose. As discussed in more detail below, an indication of the first pose may be displayed on the display screen 106 of the medical device 102 and / or transmitted from a speaker of the medical device.

[0134] After registration and / or pairing, the wireless accessory 130 is configured to listen on a first channel for a request (link test) packet. The wireless accessory 130 may be placed into a listed mode by receiving a link test input from a user or the medical device 102. The processor 108 then transmits one or more request packets via the first channel to the wireless accessory 130 (block 918). The wireless accessory 130 receives the request packet and determines an RSSI of the received signal. The wireless accessory 130 next transmits a response packet to the medical device 102. The response packet may also include a serial number and / or device type of the wireless accessory 130.

[0135] The processor 108 of the medical device 102 waits to receive the response packet (block 920). If the response packet has not been received before a timeout period (blocks 922 and 924), the processor 108 re-transmits the request packet if a number of permissible retries has not been exceeded (block 926). The timeout period may be 2 seconds, 5 seconds, 10 seconds, 30 seconds, etc. Further, the number of permissible re-transmissions may be three, four, five, ten, etc. When the number of permissible retries is exceeded, the processor 108 marks the channel as being unavailable (block 928). The processor 108 may store an indication of this unavailable channel to the noise record 124 and / or the data structure 122. The processor 108 then selects a next channel for the RF link test (block 930).

[0136] Returning to block 922, when the response packet is received, the processor 108 determines an RSSI value from the response packet (block 932). The processor 108 may average the RSSI value with previously received RSSI values for the same channel. The processor 108 may further determine an RSSI value of the response packet, which is incorporated into the average. The processor 108 next transmits another request packet to the wireless accessory until a count is exceeded (block 934). The count may be two packets, three packets, five packets, ten packets, twenty packets, packets, etc.

[0137] In the illustrated example, RSSI is used as an indicator of signal strength since RSSI is indicative of an amount of power present in a radio signal. In other words, RSSI is an approximate value for signal strength received on an antenna. The processor 108 (or the wireless accessory 130) quantizes the measured signal energy to form the RSSI value. Signal strength decreases as the distance increases between a wireless accessory and the medical device 102. For RSSI, a greater negative value indicates a weaker signal.

[0138] Fig. 10 is a diagram of packets used to determine RSSI, according to an example embodiment of the present disclosure. Packet 1002 represents the general packet structure for the Bluetooth® protocol. The packet 1002 includes a preamble, an address of the transmitting device, a protocol data unit, and a cyclic redundancy check (“CRC”) value. Fig. 10 also shows a request packet 1004, which is placed within the protocol data unit of the packet 1002, in Bluetooth® embodiments. The request packet 1004 includes a header, a packet identifier, a device type, and a CRC value. The packet identifier may indicate the packet is for a link test broadcast. The header may include a timestamp. A response packet 1006 includes a header, a packet identifier, a device type, an RSSI value, and a CRC value. The RSSI value corresponds to the signal strength of the request packet 1004, as determined by the accessory 130. The packet identifier of the response packet 1006 identifies the packet as a link test response. Further, the device type specifies a type of the accessory 130.

[0139] Returning to Fig. 9, when the count is exceeded for request packets transmitted, the processor 108 calculates a percent packet drop (e.g., a packet dropout rate) (block 936). The processor 108 may determine the percent packet drop by determining how many response packets were received in relation to a number of request packets transmitted. For example, if 20 response packets were received and 30 request packets were transmitted, thepercentage of packet drop would be 66.7%. In some embodiments, the RSSI and / or packet drop calculation may be omitted.

[0140] The processor 108 next determines if all channels have been tested (block 938). When not all of the wireless channels have been tested, the processor 108 selects a next channel and returns to block 918. When all of the channels have been tested, the processor 108 displays information indicative of the link quality with the wireless accessory 130 (block 940). In an example, the processor 108 may cause the display screen 106 to display the graph 800 of Fig. 8 with the line 802, which indicates the average RSSI for each channel relative to the noise floor calculated in conjunction with the procedure 604 of Fig. 7. In the illustrated example, the RSSI is sufficiently separated by the noise floor for all channels except channel 2. This means that the medical device 102 can wirelessly communicate with the wireless accessory 130 except over channel 2.

[0141] Additionally, or alternatively, the processor 108 may cause a speaker of the medical device 102 to announce information indicative of the link quality (block 942). The link quality may be classified as either “no connection”, “poor”, “marginal”, “good”, and “excellent”. In other examples, different classifiers can be used. In this embodiment, a “good” classification may correspond to an RSSI of -50 dBm while an “excellent” classification corresponds to an RSSI of -35 dBm, a “marginal” classification corresponds to a -70 dBm, and a “poor” classification corresponds to a -85 dBm. In some instances, the classifications may be relative to a noise floor (e.g., 15 dbM above a noise floor for the “good” classification). Similar classifications may be used determined for a percentage of packet drop. Alternatively, the average RSSI value and percent of packet loss can be combined to determine one classification.

[0142] To determine the link quality, the processor 108 is configured to compare the average RSSI across the available channels to a classification threshold, such as a “good” classification or better. Additionally, the processor 108 may compare the number of unavailable channels to a channel threshold, which may be a value between 10% to 30% of the available channels. When the number of unavailable channels exceeds the channel threshold, the processor 108 is configured to determine that the link quality is one of “no connection”, “poor”, or “marginal” regardless of the RSSI values. Alternatively, the processor 108 may select one of “no connection”, “poor”, or “marginal” based on the RSSI values.

[0143] The processor 108 next determines whether the link quality with the accessory 130 is acceptable (block 944). In other words, the processor 108 determines if the link quality has at least a “good” classification. When there is a good link quality, the processor 108 is configured to display information on the display screen 106 and / or announce via a speaker of the medical device 102 that the link quality is “good” or “excellent” (block 946). The example procedure 900 then ends until another wireless accessory 130 is connected or another link test is performed.

[0144] In embodiments where the link quality with the wireless accessory is not at least classified as “good”, the processor 108 is configured to prompt a user to change a pose of the wireless accessory (block 948), as shown in Fig. 11. The processor 108 may determine the prompt from the routine or algorithm 120. In some embodiments, the processor 108 selects the routine or algorithm 120 based on a type of the accessory 130. The processor 108 then selects a prompt from the routine or algorithm 120 that is specific to the accessory 130.

[0145] Fig. 12 is a diagram illustrative of the routine or algorithm 120, according to an example embodiment of the present disclosure. The routine or algorithm 120 is stored in the memory device 112 of the medical device 102 and includes sequence of poses relative to a medical device to which a user is to move the wireless accessory 130 for provisioning a wireless connection with the medical device 102. In this example, the routine or algorithm 120 is specific for accessory type 1, which may correspond to a dialysis fluid preparation device. The memory device 112 stores other routines or algorithms 120 for other accessory types. In alternative embodiments, only a single routine or algorithm 120 is stored for all accessory types.

[0146] Different accessory types may have different acceptable poses. For example, a dialysis fluid preparation device has to stay within one to eight meters of the medical device 102 due to the length of the dialysis fluid tube 132 that connects the two devices. In other embodiments, patient physiological sensors have to be placed on a patient. Additionally, a urine scale has to be placed adjacent to a patient or adjacent to the medical device 102. The use of the routines or algorithms 120 for the different accessory types ensures that a user is not prompted to move an accessory to a pose that violates the purpose or intended use of the accessory or an already connected accessory.

[0147] As discussed above, the processor 108 may start with Pose 1 at the beginning of the procedure 900. Alternatively, the processor 108 prompts the user to move theaccessory to Pose 1 (e.g., “move the wireless accessory device to the left”) at block 948 after the user’s preferred pose is determined to have a poor link quality. The processor 108 may display a prompt to move to Pose 1 on the display screen 106 of the medical device 102. Additionally or alternatively, the processor 108 is configured to cause a speaker to transmit audio indicative of Pose 1.

[0148] The pose may identify a heading and direction relative to the medical device 102 (e.g., to the left and behind a medical device). The pose may additionally include a distance from the medical device 102. Further, the pose may include a height and / or an orientation (e.g., at least three feet off the floor and angled toward the medical device). Alternatively, the pose may be relative to a prior pose. For example, as shown in Fig. 11, the pose includes a prompt to move the accessory to the left from a current pose.

[0149] After moving the accessory 130, the user provides a confirmation of the movement. The confirmation may include pressing a button on the display screen 106 and / or speaking a confirmation, which is recorded by a microphone of the medical device 102. After receiving confirmation of moving to the prompted pose, the processor 108 performs another link test, as discussed above for the prior pose and determines an RF link quality for the new pose (block 950). When the link quality has worsened from the previous pose, the processor 108 uses the routine or algorithm 120 to select a next pose (block 952). The next pose may include movement in an opposite direction or a completely new direction. When the link quality has improved from the previous pose but is still less than a threshold classification, the processor 108 uses the routine or algorithm 120 to select a next pose (block 954). The next pose may include movement in the same direction, for example. For instance, the next pose may include moving the accessory 130 further to the left of the medical device 102.

[0150] As shown in Fig. 11, as part of the procedure 900, the processor 108 uses the accessory type to ensure the correct routine or algorithm 120 is used such that the accessory 130 is not moved to a location that is incompatible with its use (block 956). In the illustrated example, the routine or algorithm 120 may include such poses by default. In other embodiments, the routine or algorithm 120 may specify certain constraints for the different types of accessories 130. For example, when the accessory 130 is a dialysis fluid preparation device, a constraint of the routine or algorithm 120 ensures the accessory is kept within a 6 meter radius of the medical device 102 (block 958). Another constraint includes ensuring there is a clear line-of-sight betweenthe accessory 130 and the medical device 102 (block 960). Other devices may have separate constraints, such as closer or further distances from the medical device 102, distances from a patient, etc. (block 962).

[0151] The processor 108 continues prompting new poses until the link quality between the medical device and the accessory 130 meets the classification threshold. The processor 108 may prompt the user whether another accessory is to be added (block 962). When the user indicates that a new accessory 130 is to be added, the example processor 108 repeats the procedure 900. However, when another accessory is not to be added, the example procedure 900 ends.

[0152] Reference is made above to the procedure 900 being performed by the medical device 102. In some embodiments, the procedure 900 may instead be performed by the accessory 130. The procedure 900 may only be performed by the accessory 130 when the accessory 130 has link quality software. The results from the link quality test may be displayed on a screen of the accessory 130 and / or a communicatively coupled user device 150. In these embodiments, the link quality is performed between two accessories 130. One accessory 130 is configured to initiate the link quality test in the manner described above for the medical device 102. The accessory 130 that initiated the link quality test provides recommendations, for example, to pose the other accessory when a link quality is below a threshold or is otherwise unacceptable.

[0153] When an accessory 130 is linked to the medical device 102, the processor 108 may update the data structure 122, which logs poses of connected accessories. Fig. 13 is a diagram of a data structure showing linked accessories and corresponding poses, according to an example embodiment of the present disclosure. The data structure 122 identifies each connected accessory. Additionally, the data structure 122 identifies a corresponding known pose of the accessory 130. The pose may specify a distance and direction from the medical device 102. In addition, the data structure 122 may specify a link quality, as determined in a most result link quality test or an initial link quality test when the accessory 130 was first connected to the medical device 102.

[0154] In some embodiments, the processor 108 may use the data structure 122 when progressing though the routine or algorithm 120. For example, when a first accessory 130a is already posed and the processor 108 is determining a pose for a second accessory 130b, the processor 108 may use the data structure 122 to determine the pose of the first accessory 130a.Then, when the routine or algorithm 120 for the second accessory 130b lists the pose where the first accessory 130a is already placed, the processor 108 is configured to skip this pose. This prevents prompts from being displayed that cause one accessory 130b to be placed in the same location or pose as another accessory 130a.

[0155] Returning to Fig. 11, in some circumstances, the processor 108 progresses through all the poses provided in the routine or algorithm 120. In these instances, the processor 108 indicates via the display screen 106 that a wireless link of acceptable quality is not possible with the accessory 130 (block 964). Instead, the accessory 130 may be connected to the medical device 102 via a wire, such as a USB cable. Alternatively, the processor 108 may prompt the user to move the medical device 102 to a new location, when possible. The example procedure 900 then ends for this accessory 130.

[0156] Fig. 14 is a diagram that illustrates the procedure 900 of Figs. 9 and 11, according to an example embodiment of the present disclosure. In this example, a dialysis fluid preparation accessory 130 is linked to a CRRT medical device 102 at Step 1. After the dialysis fluid tube 132 is connected and the accessory 130 is paired at Step 2, the medical device 102 performs the RF link test at Step 2.5. At Step 3, the medical device 102 determines the link quality is poor and prompts the clinician to move the accessory 130 to a new pose that is within a line-of- sight of the medical device 102 and within five meters of the medical device 102. The prompt also provides instructions for avoiding metal / concrete between the connection. At Step 4, the clinician provides a verbal confirmation that the accessory 130 was moved to a next pose (e.g., moved to the right). At Step 5, the medical device 102 determines the link quality is still poor and provides an audible notification. At Step 6, the clinician provides a verbal confirmation that the accessory 130 was moved to a further pose (e.g., moved to the left). At Step 7, the medical device 102 determines the link quality meets the classification threshold and audibly indicates the link quality is good. At this point, the medical device 102 is able to communicate with the dialysis fluid preparation accessory 130 via the wireless link.

[0157] Fig. 15 is a diagram of a user interface 1500 displayed by the display screen 106 of the medical device 102 during the RF link quality test, according to an example embodiment of the present disclosure. The user interface 1400 includes a graphical representation 1502 of the medical device 102. The user interface 1500 also includes graphical icons for three different poses of an accessory 130. Each pose is spaced a different distance and direction from the medical device102. During the procedure 900 of Figs. 9 and 11 , the processor 108 may highlight the current pose or newly display the current pose. After performing the link quality test, the processor 108 displays in the user interface 1500 an indication of the link quality. The indication may include an average RSSI value across the channels, a packet loss percentage, and / or color coding.

[0158] In the illustrated example, at the first pose, the dialysis fluid preparation accessory 130 had a poor link quality of -100 dBm and a packet loss of 50%. As a result, the processor 108 prompted the clinician to move the dialysis fluid preparation accessory 130 behind and to the right of the medical device 102. At the second pose, the dialysis fluid preparation accessory 130 had a marginal link quality of -80 dBm and a packet loss of 10%. The processor 108 then prompted the clinician to move the dialysis fluid preparation accessory 130 to the right of the medical device 102. At this pose, the dialysis fluid preparation accessory 130 had an excellent link quality of - 21 dBm and a 0% packet loss. The processor 108 determined that the link with the dialysis fluid preparation accessory 130 met the classification threshold and accordingly ended the link test with the accessory 130 in place.RF Link Quality Test Scenarios

[0159] As discussed above, an RF link quality test is performed when an accessory 130 is newly connected to a medical device 102. In another embodiment, the RF link quality test is performed after the medical device 102 is moved. Fig. 16 is a flow diagram of an example procedure 1600 for performing an RF link quality test after the medical device 102 of Figs. 1 A to 3 has moved locations, according to an example embodiment of the present disclosure. Although the procedure 1600 is described with reference to the flow diagram illustrated in Fig. 16, it should be appreciated that many other methods of performing the steps associated with the procedure 1600 may be used. For example, the order of many of the blocks may be changed, certain blocks may be combined with other blocks, and many of the blocks described may be optional. The operations described in the procedure 1600 are specified by one or more routines or algorithms 120 and may be performed among the control engine 302 and the communication module 110 of the medical device 102.

[0160] The example procedure 1600 begins when the medical device 102 is moved to a new location, such as a new intensive care unit (block 1602). The medical device 102 detects movement based on receiving an input from a clinician or other user via the display screen 106.Alternatively, the medical device 102 may include one or more inertial or accelerometers that detect movement. In this instance, movement over a threshold distance triggers the RF link quality test. In yet other instances, the medical device 102 may detect a connection to a new access point, Ethernet outlet, router, switch, or network.

[0161] After being moved, the medical device 102 is activated and paired with one or more accessories 130 in the new location (block 1604). Additionally, a clinician may input a request for the medical device 102 to begin a treatment. Before the medical device performs the treatment, the medical device 102 performs an RF link quality test, as discussed in conjunction with the procedure 900 of Figs 9 and 11 (block 1606). The medical device performs the RF link quality test for each paired wireless accessory 130. When one or more of the links with the respective wireless accessory 130 is not acceptable (block 1608), the medical device 102 displays or otherwise provides an alert indicative that the treatment cannot begin because of the one or more links not meeting the classification threshold (block 1610). The medical device 102 may recommend performing an RF passive scan, as discussed in connection with Fig. 7 and / or the link quality test with pose recommendations, as discussed in connection with Figs. 9 and 11. However, when the link quality is acceptable for all of the links, the medical device 102 is permitted to perform the treatment (block 1612). The example procedure 1600 then ends until the medical device 102 is moved again.

[0162] In other example, a new source of interference may be introduced. The medical device 102 periodically performs an RF link quality test. Additionally, or alternatively, the medical device 102 performs a link quality test at startup or before a treatment. The medical device 102 compares the current link quality to a link quality stored in the data structure 122 for each accessory 130. The stored link quality may include an average of prior RSSI values and / or a baseline RSSI value. The processor 108 determines when the link quality has decreased significantly from the link quality values stored in the data structure 122. The processor 108 is configured to generate an alert when the link quality for at least one wireless link has decreased by at least -15 or -20 dBm, for example.

[0163] In an example, Fig. 17 shows a user interface 1700 when the medical device 102 starts up and pairs with connected accessories 130 (e.g., DI, D2, D3, D7, and D8). The user interface 1700 shows a graphical representation of the medical device 102 in addition to relative poses of the accessories 130. The user interface 1700 also shows the current measured link qualityvalues for each of the accessories 130. In this example, the yellow color coding may indicate the link quality has decreased. For D8, the link quality may be below the classification threshold. As a result, the medical device 102 may recommend to perform a passive scan and / or a link test with pose guidance. An alert may also be provided when the medical device cannot pair or reconnect with one of the accessories 130.

[0164] While the medical device 102 cannot perform a link test during a treatment, the medical device 102 can count packet drops or a dropout rate with the wireless accessories 130. When the number of packets dropped exceeds a threshold, such as 10 to 20% of packets, the medical device 102 is configured to generate an alarm. The medical device 102 may also pause the treatment in some embodiments. The medical device 102 alert may indicate the packet drop issue and provide a recommendation to perform a passive RF scan and / or a link test with pose guidance.

[0165] In some instances, the threshold may be based on a type of the accessory 130. For example, more critical accessories, such as a heart rate monitor, may have a lower threshold (e.g., a higher link quality requirement) compared to a weight scale. Further, an alert may be generated for some less critical accessories while an alarm is generated for more critical accessories.

[0166] The example medical device 102 may also monitor for jamming, where all available wireless channels are made unavailable due to a high-power jamming device. The jamming may be caused by a malicious actor, use of an uncertified RF device, or due to security reasons. The medical device 102 may determine through a periodic link test that all channels are blocked. During a treatment, the medical device 102 may detect almost all packets being dropped across all channels. In response to these detections, the medical device 102 is configured to generate an alarm indicative of the jamming across all channels. Further, when a treatment is being performed, the medical device 102 may also pause or stop a treatment.Conclusion

[0167] 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 presentsubject matter and without diminishing its intended advantages. It is therefore intended that such changes and modifications be covered by the appended claims.

Claims

CLAIMSThe invention is claimed as follows:Claim 1: A medical device (102) comprising: a memory device (112) including a wireless link quality routine or algorithm (120) specifying a sequence of poses relative to the medical device (102) to which a user is to move a wireless accessory (130) for provisioning a wireless connection with the medical device (102), the sequence of poses including at least a first pose and a second pose; a display screen (106) including an interface; a transceiver (320) communicatively coupled to an antenna (114); and a processor (108) communicatively coupled to the memory device (112), the display screen (106), and the transceiver (320), the processor (108) configured to:(i) receive an input via the display screen (106) indicative of a request to wirelessly couple a wireless accessory (130) to the medical device (102),(ii) after receiving the input, pair with the wireless accessory (130) using the transceiver (320) and the antenna (114),(iii) cause the display screen (106) to display a first instruction that is indicative of the first pose,(iv) receive a confirmation input via the display screen (106) indicative that the wireless accessory (130) is located at the first pose,(v) determine a wireless link quality with the wireless accessory (130) using the transceiver (320) and the antenna (114),(vi) when the wireless link quality is equal to or greater than a threshold classification, provision the wireless connection between the medical device (102) and the accessory (130) at the first pose, and(vii) when the wireless link quality is below the threshold classification, cause the display screen (106) to display a second instruction that is indicative of the second pose, receive a second confirmation input via the display screen (106) indicative that the wireless accessory (130) is located at the second pose, determine a second wireless link quality with the wireless accessory (130) at the second pose, and provision the wireless connection between themedical device (102) and the accessory (130) at the second pose when the second wireless link quality is equal to or greater than the threshold classification.Claim 2: The medical device (102) of Claim 1 , wherein each pose of the sequence of poses includes at least one of a distance or a direction from the medical device (102).Claim 3: The medical device (102) of Claim 1, wherein each pose of the sequence of poses includes a distance, a direction, and an orientation relative to the medical device (102).Claim 4: The medical device (102) of Claim 1 , wherein the processor (108) in conjunction with the transceiver (320) are configured to determine the wireless link quality by:(a) transmitting one or more request packets (1004) to the wireless accessory (130);(b) receiving response packets (1006) from the wireless accessory (130) that are respectively responsive to one or more request packets (1004); and(c) determining, as the wireless link quality, at least one of an average received signal strength or a percentage of packet dropouts based on the received response packets (1006).Claim 5: The medical device (102) of Claim 4, wherein the processor (108) in conjunction with the transceiver (320) is configured to repeat (a) to (c) for each available wireless channel.Claim 6: The medical device (102) of Claim 5, wherein the processor (108) is configured to: determine which of the available wireless channels have a less than good link quality corresponding to an average received signal strength that is less than - 50 dBm or a packet dropout that is greater than 10%; and prevent the wireless channels that have a less than good link quality from being used for communicating with the wireless accessory (130).Claim 7: The medical device (102) of Claim 4, wherein the response packets (1006) include received signal strength values as determined by the wireless accessory (130) based on a signal strength corresponding to reception of the request packets (1004).Claim 8: The medical device (102) of Claim 4, wherein the processor (108) in conjunction with the transceiver (320) are configured to determine signal strength values based on a signal strength corresponding to reception of the response packets (1006).Claim 9: The medical device (102) of Claim 1, wherein the medical device (102) includes a Continuous Renal Replacement Therapy (“CRRT”) machine, a hemodialysis machine (102b), a peritoneal dialysis machine, a syringe pump (312b), a linear peristaltic pump, a large volume pump (“LVP”), an ambulatory pump, multi-channel pump, a nutritional compounding machine, an oxygen sensor, a respiratory monitor, a glucose meter, a blood pressure monitor, an electrocardiogram (“ECG”) monitor, a weight scale, or a heart rate monitor.Claim 10: The medical device (102) of Claim 1, wherein the sequence of poses is a first sequence of poses for a first wireless accessory type, and wherein the processor (108) receives information indicative that the wireless accessory (130) is of the first wireless accessory type to apply the first sequence of poses.Claim 11: The medical device (102) of Claim 10, wherein the processor (108) in conjunction with the transceiver (320) are configured to repeat (i) to (vii) for a second wireless accessory (130) that is of a second wireless accessory type that corresponds to a second sequence of poses.Claim 12: The medical device (102) of Claim 1, wherein the processor (108) in conjunction with the transceiver (320) are configured to perform (i) to (vii) only after an initial test of the wireless link quality with the wireless accessory (130) determines that the wireless link has a less than good link quality.Claim 13: The medical device (102) of Claim 12, wherein the wireless accessory (130) is placed in a user-desired pose before the initial test of the wireless link quality is performed.Claim 14: The medical device (102) of Claim 1, wherein the threshold classification corresponds to a good or excellent wireless link quality having a signal strength of at least -50 dBm.Claim 15 : The medical device ( 102) of Claim 1 , wherein the processor ( 108) is configured to provision the wireless connection with the medical device (102) by graphically displaying an image and / or text indicative of the wireless accessory (130) at the first or second pose relative to an image and / or text indicative of the medical device (102).Claim 16: The medical device (102) of Claim 1, wherein the processor (108) is configured to provision the wireless connection with the medical device (102) by storing to a data structure (122) in the memory device (112), an identifier of the wireless accessory (130) and an indication of the first or second pose.Claim 17: The medical device (102) of Claim 1, wherein the processor (108) is further configured to start a medical treatment after the wireless connection is provisioned with the accessory (130) in (vi) or (vii).Claim 18: The medical device (102) of Claim 17, wherein the processor (108) is further configured to: determine a during-treatment wireless link quality with the wireless accessory (130) during the medical treatment; and provide an alert or an alarm when the during-treatment wireless link quality is below the threshold classification during the medical treatment.Claim 19: The medical device (102) of Claim 18, wherein the during-treatment wireless link quality is determined based on a detected packet dropout rate.Claim 20: A medical device (102) comprising: a memory device (112) including a wireless link quality routine or algorithm (120) specifying a sequence of poses relative to the medical device (102) to which a user is to move a wireless accessory (130) for provisioning a wireless connection with the medical device (102), the sequence of poses including at least a first pose and a second pose; a transceiver (320) communicatively coupled to an antenna (114); and a processor (108) communicatively coupled to the memory device (112) and the transceiver (320), the processor (108) configured to:(i) receive an input indicative of a request to wirelessly couple a wireless accessory (130) to the medical device (102),(ii) after receiving the input, pair with the wireless accessory (130) using the transceiver (320) and the antenna (114),(iii) provide a first instruction that is indicative of the first pose,(iv) receive a confirmation input indicative that the wireless accessory (130) is located at the first pose,(v) determine a wireless link quality with the wireless accessory (130) using the transceiver (320) and the antenna (114),(vi) when the wireless link quality is equal to or greater than a threshold classification, provision the wireless connection between the medical device (102) and the accessory (130) at the first pose, and(vii) when the wireless link quality is below the threshold classification, provide a second instruction that is indicative of the second pose, receive a second confirmation input indicative that the wireless accessory (130) is located at the second pose, determine a second wireless link quality with the wireless accessory (130) at the second pose, and provision the wireless connection between the medical device (102) and the accessory (130) at the second pose when the second wireless link quality is equal to or greater than the threshold classification.Claim 21 : The medical device (102) of Claim 20, wherein (iii) and (vii) are performed by causing a speaker to audibly provide the first and second instructions.Claim 22: The medical device (102) of Claim 20, wherein (iii) and (vii) are performed by causing a display screen (106) to display the first and second instructions.Claim 23: The medical device (102) of Claim 20, wherein (i), (iv), and (vii) are performed using a microphone to receive the first and second confirmation inputs.Claim 24: The medical device (102) of Claim 20, wherein (i), (iv), and (vii) are performed using a touch interface to receive the first and second confirmation inputs.Claim 25: An accessory (130) comprising: a memory device (112) including a wireless link quality routine or algorithm (120) specifying a sequence of poses relative to the accessory (130) to which a user is to move a second accessory (130) for provisioning a wireless connection with the accessory (130), the sequence of poses including at least a first pose and a second pose; a transceiver (320) communicatively coupled to an antenna (114); and a processor (108) communicatively coupled to the memory device (112) and the transceiver (320), the processor (108) configured to:(i) receive an input indicative of a request to wirelessly couple a second accessory(130) to the accessory (130),(ii) after receiving the input, pair with the second accessory (130) using the transceiver (320) and the antenna (114),(iii) provide a first instruction that is indicative of the first pose,(iv) receive a confirmation input indicative that the second accessory (130) is located at the first pose,(v) determine a wireless link quality with the second accessory (130) using the transceiver (320) and the antenna (114),(vi) when the wireless link quality is equal to or greater than a threshold classification, provision the wireless connection between the accessory (130) and the second accessory (130) at the first pose, and(vii) when the wireless link quality is below the threshold classification, provide a second instruction that is indicative of the second pose, receive a second confirmation input indicative that the second accessory (130) is located at the second pose, determine a second wireless link quality with the second accessory (130) at the second pose, and provision the wireless connection between the accessory (130) and the second accessory (130) at the second pose when the second wireless link quality is equal to or greater than the threshold classification.Claim 26: The accessory (130) of Claim 25, wherein the accessory (130) and the second accessory (130) include at least one of a calcium sensor, a heart rate monitor, a blood pressure monitor (130d), a urine scale (130c), a patient monitoring system (130a), a smart bed (130e), a blood warmer, a respiratory monitor, an oxygen sensor, a glucose meter, a dialysis solution warmer (130b), an electrocardiogram (“ECG”) monitor, or a dialysis solution preparation device (130i).Claim 27: A system comprising: a medical device (102) including: a memory device (112) including a wireless link quality routine or algorithm (120) specifying a sequence of poses relative to the medical device (102) to which a user is to move a wireless accessory (130) for provisioning a wireless connection with the medical device (102), the sequence of poses including at least a first pose and a second pose, a transceiver (320) communicatively coupled to an antenna (114), and a processor (108) communicatively coupled to the memory device (112) and the transceiver (320), the processor (108) configured to:(i) receive an input indicative of a request to wirelessly couple a wireless accessory (130) to the medical device (102),(ii) after receiving the input, pair with the wireless accessory (130) using the transceiver (320) and the antenna (114),(iii) provide a first instruction that is indicative of the first pose,(iv) receive a confirmation input indicative that the wireless accessory (130) is located at the first pose,(v) determine a wireless link quality with the wireless accessory (130) using the transceiver (320) and the antenna (114),(vi) when the wireless link quality is equal to or greater than a threshold classification, provision the wireless connection between the medical device (102) and the accessory (130) at the first pose, and(vii) when the wireless link quality is below the threshold classification, provide a second instruction that is indicative of the second pose, receive a second confirmation input indicative that the wireless accessory (130) is located at the second pose, determine a second wireless link quality with the wireless accessory (130) at the second pose, and provision the wireless connection between the medical device (102) and the accessory (130) at the second pose; and an accessory (130) configured to: receive at least one request packet (1004) from the medical device (102) during wireless link quality tests of (v) and (vii), determine a received signal strength indicator (“RS SI”) value of the at least one request packet (1004), and transmit at least one response packet (1006) to the medical device (102) that includes the RS SI value.Claim 28: The system of Claim 27, wherein the accessory (130) and the second accessory (130) include at least one of a heart rate monitor, a blood pressure monitor (130d), a urine scale (130c), a patient monitoring system (130a), a smart bed (130e), a blood warmer, a respiratory monitor, an oxygen sensor, a glucose meter, a dialysis solution warmer (130b), an electrocardiogram (“ECG”) monitor, or a dialysis solution preparation device (130i).

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