Medical monitoring analysis and playback including markers responsive to light attenuated by body tissue

Abstract

The present disclosure includes a medical monitoring hub as a monitoring center for monitored patients. The hub is configured to receive and process multiple physiological parameters associated with the patient. The hub includes advanced analytical presentation views configured to provide timely, clinically relevant, actionable information to care providers. In certain embodiments, the monitoring hub stores and can replay previously presented data reflecting the patient's condition.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Application No. 62 / 203,792, filed on August 11, 2015, the entire contents of which are hereby incorporated by reference herein. Any and all applications for foreign or domestic priority claims specified in the Application Data Sheet as filed with this application are hereby incorporated by reference under 37 CFR 1.57. Technical Field

[0003] The present disclosure relates generally to patient monitors and medical data communication hubs, and in particular to patient monitors including display elements for presenting measurement information, often over a period of time, to a caregiver. Background Art

[0004] Today's patient monitoring environment is crowded with complex and usually electronic medical devices that try to provide a variety of monitoring and treatment for a given patient. Typically, many (if not all) devices come from different manufacturers, and many devices may be portable devices. Devices may not communicate with each other and each device may include its own controls, displays, alarms, configurations, etc. Complicating matters is that caregivers often want to associate all types of measurements and data from these devices with a specific patient. Patient information input usually occurs at each device. Sometimes, the differences in devices result in the need to simply print and store reports from each device in the patient's file for caregivers to review.

[0005] Thus, while the electronic collection of physiological data associated with a patient's condition has increased, the ability to synthesize the collected patient data into timely, clinically relevant, actionable information remains a challenge. Summary of the invention

[0006] Based at least on the foregoing, there is a need for a solution for coordinating various medical devices that process or monitor a patient and the measurement data generated by such devices. An implementation of such a solution may include a medical hub that presents various analytical presentation views via a graphical display that convey to the caregiver an easily visible, intuitive, visual indication of the status and condition of the monitored patient. In an implementation, the analytical graphical views may be advantageously replayed to analyze key events in the care of a patient or to simply examine the patient's physiological activity over a period of time. In an implementation, the replay of several physiological parameters may be played synchronously, providing a broad perspective of the patient's historical activity.

[0007] According to an embodiment of the present disclosure, a medical monitoring hub is configured to monitor physiological parameters of a patient. The hub includes a first communication port configured to receive a first signal indicating a first physiological parameter associated with the patient. The monitor also includes a display configured to present an analysis presentation view to a user. The monitor includes at least one processor configured to process the received first signal and present a first view on at least a portion of the display. The first view is suitable for presenting first data indicating a first physiological parameter collected within a first time period. The hub includes a storage device configured to store the presented first data, and the processor is also configured to replay the stored first data on the display.

[0008] In certain embodiments of the present disclosure, various analysis presentation views are disclosed to help clinicians easily and intuitively interpret patient data received by a monitoring hub. A heat map is disclosed that provides a two-dimensional graphical representation of the relationship between two measured physiological parameters over a specified time period. Advantageously, the heat map uses color to identify areas in the graph where data is concentrated. For example, areas where data is highly concentrated can be presented in a first color (e.g., red), while areas where data is less highly concentrated can be presented in a second color (e.g., blue).

[0009] A box-and-whisker plot is also disclosed, which visually presents the range of physiological parameter measurements received within a specified or predetermined time period. In addition, the boundaries of the quartiles in which the data lies are presented by the box-and-whisker plot. Advantageously, the box-and-whisker plot easily presents to the user the spread or dispersion of the measured data, including abnormal measurements, and the skewness of the data.

[0010] An index chart is also disclosed. The index chart presents the current measured state of a physiological parameter relative to ranges identified as, for example, acceptable, alert, and emergency, using color and other visual cues to easily indicate the patient's measured state.

[0011] The present disclosure also describes a distribution analysis presentation view that presents a statistical distribution (e.g., a Gaussian distribution) of physiological parameter measurements over a specified or predetermined time period. Similarly, the present disclosure describes a histogram analysis presentation view that also provides another graphical representation of the measured physiological parameter data. A histogram represents an estimate of the statistical (or probability) distribution of a continuous variable such as a continuously measured physiological parameter. Therefore, the histogram reflects the actual measured data collected, rather than providing a statistical distribution (i.e., a probability model) that best fits or corresponds to the measured data.

[0012] The present disclosure also includes a meter-histogram analysis presentation view that provides a combination of analog, digital, and histogram display indicia. Advantageously, the meter-histogram analysis presentation view provides a large amount of information related to the measured physiological parameters to the clinician in an intuitive and visually accessible format.

[0013] In use, clinicians are provided with great flexibility in arranging and configuring the disclosed analysis presentation views of the present disclosure. Therefore, clinicians are provided with a monitoring environment that can be customized according to the specific needs of the clinician and / or the patient.

[0014] For the purpose of summarizing the present disclosure, certain aspects, advantages and novel features are discussed herein. It should be understood that not all of such aspects, advantages or features will be embodied in any specific embodiment of the present invention, and the skilled person will recognize countless combinations of such aspects, advantages or features based on the disclosure herein. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Various embodiments will be described below with reference to the accompanying drawings. The accompanying drawings and the associated descriptions are provided to illustrate embodiments of the present disclosure and not to limit the scope of the claims. In the accompanying drawings, similar elements have similar reference numerals.

[0016] Figures 1A to 1C A perspective view of an exemplary medical monitoring hub according to an embodiment of the present disclosure is shown. For example, Figure 1A A hub with an exemplary docked portable patient monitor is shown; Figure 1B A hub is shown with a set of medical ports and a non-invasive blood pressure input; and Figure 1C Hubs with various exemplary temperature sensors attached thereto are shown, all in accordance with various embodiments of the present disclosure.

[0017] Figure 2 A simplified block diagram of an exemplary monitoring environment including the hub of FIG. 1 is shown in accordance with an embodiment of the present disclosure.

[0018] Figure 3 A simplified exemplary hardware block diagram of the hub of FIG. 1 is shown according to an embodiment of the present disclosure.

[0019] Figure 4 is an illustration of finger control gestures for a touch screen interface according to an embodiment of the present disclosure.

[0020] Figure 5 is a diagram showing a view according to an embodiment of the present disclosure.

[0021] Fig. 6AExemplary display screens showing various analytical presentation views for presenting received and processed data are shown in accordance with an embodiment of the present disclosure.

[0022] Figure 6B A heat map analysis presentation view according to an embodiment of the present disclosure is shown.

[0023] Figure 6C A box-and-whisker plot analysis presentation view according to an embodiment of the present disclosure is shown.

[0024] Fig.6D An index analysis presentation view according to an embodiment of the present disclosure is shown.

[0025] Fig. 6E A distribution analysis presentation view according to an embodiment of the present disclosure is shown.

[0026] Fig. 6F A histogram analysis presentation view according to an embodiment of the present disclosure is shown.

[0027] Figure 6G A meter-histogram analysis presentation view is shown according to an embodiment of the present disclosure.

[0028] Figure 7 An exemplary display screen showing a playback feature according to an implementation of the present disclosure is shown.

[0029] Figure 8 is a flowchart illustrating a playback process according to an embodiment of the present disclosure.

[0030] Although the aforementioned "Description of the Drawings" generally cites various embodiments of the present disclosure, the skilled person will recognize from the disclosure herein that these embodiments are not mutually exclusive. On the contrary, the skilled person will recognize numerous combinations of some or all of these embodiments. DETAILED DESCRIPTION

[0031] The present disclosure relates to a medical monitoring hub configured to be the center of monitoring activities for a given patient. In an embodiment, the hub includes a large, easily readable display, such as a display of about ten (10) inches that occupies most of the substrate real estate on the front of the hub. Depending on design constraints, the display can be larger or smaller. However, for portability and current design goals, the preferred size of the display is roughly proportional to the vertical footprint of one of the pluggable portable patient monitors. Those skilled in the art will recognize other considerations based on the disclosure herein.

[0032] Configurable playback display

[0033] In an embodiment, the display can be configured by drag-and-drop gestures to populate the display with elements that the caregiver tends to view for a particular user. The elements can include some or all of heat maps, box and whisker plots, distribution graphs, histograms, analog meters, and analog meters combined with histograms. Once configured, the hub processor can allow selected measurement data, data responsive to measurement data, or a combination of measurement data within a selected or default time period to be replayed at a selected or default display rate. Advantageously, such configuration and replay provide a powerful tool for the caregiver to examine the patient's condition within almost any desired time period.

[0034] Monitoring Hub

[0035] The display provides measurement data for various monitored parameters of the observed patient in digital or graphical form, and in various embodiments, the display is automatically configured based on the type of data and information received at the hub. In an embodiment, the hub is movable, portable, and mountable so that it can be located to a convenient area within the caregiver's environment. For example, the hub is collected within a single housing.

[0036] In embodiments, the hub may advantageously receive data from a portable patient monitor while being plugged into or removed from the hub. Typical portable patient monitors such as oximeters or co-oximeters may provide measurement data for a number of physiological parameters derived from signals output from optical and / or acoustic sensors, electrodes, and the like. Physiological parameters include, but are not limited to, oxygen saturation, carboxyhemoglobin, methemoglobin, total hemoglobin, glucose, pH, bilirubin, natural saturation, pulse rate, respiratory rate, components of the respiratory cycle, perfusion indications including perfusion indexes, signal quality and / or confidence, plethysmographic data, indications of health or wellness indexes or other combinations of measurement data, audio information on respiratory response, disease identification or diagnosis, blood pressure, patient and / or measurement site temperature, depth of sedation, organ or brain oxygenation, hydration, measurements of metabolic response, combinations of the same, and the like, to name a few. In other embodiments, the hub may output data sufficient to enable closed-loop drug administration in conjunction with an infusion pump or the like.

[0037] In an embodiment, the hub communicates with other devices in a monitoring environment that interacts with the patient in a variety of ways. For example, the hub advantageously receives serial data from other devices without requiring other devices to be reprogrammed or the hub to be reprogrammed. Such other devices include pumps, ventilators, monitors of all modes of any combination of the aforementioned parameters, ECG / EEG / EKG devices, electronic beds, etc. In addition, the hub advantageously receives channel data from other medical devices without requiring other medical devices to be reprogrammed or the hub to be reprogrammed. When the device communicates via channel data, the hub can advantageously change a large display to include measurement information from the device. In addition, the hub accesses the nurse call system to ensure that the nurse call situation from the device is passed to the appropriate nurse call system.

[0038] The hub also communicates with hospital systems to advantageously associate incoming patient measurement and treatment data with the patient being monitored. For example, the hub may wirelessly or otherwise communicate with a multi-patient monitoring system such as a server or a group of servers, which in turn may communicate with a caregiver's data management system such as an admission, discharge, transfer ("ADT") system and / or an electronic medical record ("EMR") system. The hub advantageously associates the data flowing through it with the patient being monitored, thereby providing electronic measurement and treatment information to be passed to the caregiver's data management system, rather than associating each device in the environment with a patient.

[0039] In an embodiment, the hub advantageously includes a reconfigurable and removable docking station. The docking station can dock additional layered docking stations to accommodate different patient monitoring devices. In addition, the docking station itself is modular so that it can be removed if the primary dockable portable patient monitor changes its form factor. Therefore, how the hub configures the docking station is flexible.

[0040] In an embodiment, the hub includes a large memory for storing some or all of the data it receives, processes and / or associates with the patient, and / or communicates this data with other devices and systems. Some or all of the memory may advantageously include removable SD memory.

[0041] The hub communicates with other devices via at least: (1) a docking station to acquire data from a portable monitor, (2) an innovative universal medical connector to acquire channel data, (3) a serial data connector such as an RJ port to acquire output data, (4) Ethernet, USB, and nurse call ports, (5) a wireless device to acquire data from a portable monitor, (6) other wired or wireless communication mechanisms known to the skilled person. The universal medical connector advantageously provides optional electrically isolated power and communications that are designed to be smaller in cross-section than the isolation requirements. The connector and hub communicate to advantageously convert or configure data from other devices to be usable and displayable by the hub. In an embodiment, a software development kit ("SDK") is provided to device manufacturers to establish or define the behavior and meaning of data output from their devices. When outputs are defined, the definitions are programmed into memory resident on the cable side of the universal medical connector and provided to the device provider as an original equipment manufacturer ("OEM"). When the cable is connected between the device and the hub, the hub understands the data and can use it for display and processing purposes without the need to upgrade software to the device or the hub. In an embodiment, the hub can negotiate the mode and even add additional compression and / or encryption. By using a universal medical connector, the hub effectively organizes measurement and treatment data into a single display and alarm system, effectively commanding the monitoring environment.

[0042] When the hub receives and tracks data from other devices according to the channel paradigm, the hub can advantageously provide processing to create a virtual channel of patient measurement or treatment data. In an embodiment, a virtual channel can include non-measured parameters, i.e., the result of processing data from various measured or other parameters, for example. Examples of such parameters include health indicators derived from various measured parameters that give an overall indication of the health of the monitored patient. Examples of health parameters are disclosed by the assignee of the present disclosure in U.S. Patent Application Serial Nos. 13 / 269,296, 13 / 371,767, and 12 / 904,925 and are incorporated herein by reference. By organizing data into channels and virtual channels, the hub can advantageously synchronize input data with virtual channel data in time.

[0043] The hub also receives serial data through a serial communication port such as an RJ connector. The serial data is associated with the patient being monitored and is passed to the multi-patient server system and / or the caregiver back-end system discussed above. By receiving serial data, the caregiver advantageously associates the devices in the caregiver environment (usually from different manufacturers) with a specific patient, thereby avoiding the need to associate each individual device with the patient and possibly communicate with the hospital system. Such association is crucial because it reduces the time it takes for the caregiver to input biometric information and demographic information into each device about the patient. Moreover, in an embodiment, through the SDK, the device manufacturer can advantageously provide information associated with any measurement delays of its device, thereby further enabling the hub to advantageously synchronize the serial input data and other data associated with the patient in time.

[0044] In an embodiment, when a portable patient monitor is docked and includes its own display, the hub effectively increases its display real estate. For example, in an embodiment, the portable patient monitor may simply continue to display the measurement and / or treatment data that it may now replicate on the hub display or the docked display, and may change its display to provide additional information. In an embodiment, the docked display presents anatomical graphical data of, for example, the heart, lungs, organs, brain, or other body parts being measured and / or treated when docked. The graphical data may advantageously be animated similarly and consistently with the measurement data. For example, the lungs may expand approximately in relation to the measured respiratory rate and / or the determined inhalation / expiration portion of the respiratory cycle, the heart may beat according to the pulse rate, may beat roughly along the understood actual cardiac contraction pattern, the brain may change color or activity based on different sedation depths, etc. In an embodiment, when the measured parameters indicate that a caregiver needs to be alerted, the severity of the color change may be associated with one or more displayed graphics, such as the heart, lungs, brain, organs, circulatory system or part thereof, respiratory system or part thereof, other body parts, etc. In other embodiments, the body part may include animations regarding where, when, or how to attach the measurement device.

[0045] The hub may also advantageously overlay the parameter display to provide additional visual information to the caregiver. Such an overlay may be user-definable and configurable. The display may also include icons or graphic markers that simulate the appearance of the display.

[0046] For the sake of clarity, not all features of an actual implementation are described in this specification. Of course, the skilled person will appreciate that in the development of any such actual implementation (as in any development project), many implementation-specific decisions must be made to achieve the developer's specific goals and sub-goals, such as compliance with system and business-related constraints that vary from implementation to implementation. Moreover, it should be understood that such development work may be complex and time-consuming, but is a routine task of device engineering for a skilled person having the benefit of this disclosure.

[0047] To facilitate a complete understanding of the present disclosure, the remainder of the detailed description describes the present disclosure with reference to the accompanying drawings, wherein like reference numerals are represented by like numerals throughout.

[0048] Monitoring Hub Implementation

[0049] Figure 1A A perspective view of an exemplary medical monitoring hub 100 and an exemplary docked portable patient monitor 102 according to an embodiment of the present disclosure is shown, the medical monitoring hub 100 may also be referred to herein as monitor 100. The hub 100 includes a display 104 and a docking station 106, which in an embodiment is configured to mechanically and electrically mate with the portable patient monitor 102, and the display 104 and the docking station 106 are both housed in a removable, mountable, portable housing 108. The housing 108 includes a generally upright, inclined shape configured to rest on a horizontal, flat surface, although the housing 108 may be secured in a variety of locations and mounts and include a variety of shapes and sizes.

[0050] In embodiments, the display 104 may present various measurements and / or treatment data in the form of numbers, graphs, waveforms, or other display indicia 110. In embodiments, the display 104 occupies a majority of the front face of the housing 108, although a skilled artisan will appreciate that the display 104 may include a tablet or desktop level configuration, a laptop configuration, etc. Other embodiments may include transmitting the display information and data to a desktop computer, a smart phone, a television, or any display system recognizable to a skilled artisan. Figure 1A The upright tilted configuration presents display information to the caregiver in an easily viewable manner.

[0051] Figure 1B A perspective side view of an embodiment of the hub 100 including the housing 108, the display 104, and the docking station 106 without a docked portable monitor is shown. A connector 113 for non-invasive blood pressure is also shown.

[0052] In an embodiment, the housing 108 may also include a Figure 1C A cutout or recess for an additional medical device such as a blood pressure monitor or temperature sensor 112 is shown in FIG.

[0053] The monitor 102 may communicate with various non-invasive and / or minimally invasive devices, such as optical sensors with light emission and detection circuitry, acoustic sensors, devices that measure blood parameters from a pierced finger, a cuff, a ventilator, etc. The monitor 102 may include its own display 114 that presents its own display indicia 116. The display indicia may advantageously change based on the docking state of the monitor 102. When undocked, the display indicia may include parameter information and may change orientation based on, for example, a gravity sensor or accelerometer.

[0054] In an embodiment, the docking station 106 of the hub 100 includes a mechanical latch 118 or a mechanically releasable catch to ensure that movement of the hub 100 does not mechanically disengage the monitor 102 in a manner that could damage the monitor 102 .

[0055] Although disclosed with reference to a particular portable patient monitor 102, a skilled artisan will recognize from the disclosure herein a wide variety of medical devices that may be advantageously docked with the hub 100. Additionally, the docking station 106 may advantageously be electrically, rather than mechanically, connected to the monitor 102, and / or wirelessly communicate with the monitor 102.

[0056] Figure 2 1 shows a simplified block diagram of an exemplary monitoring environment 200 including the hub 100 of FIG. 1 according to an embodiment of the present disclosure. Figure 2 As shown in , the environment may include a portable patient monitor 102 in communication with one or more patient sensors 202, such as a blood oxygen optical sensor, an acoustic sensor, a blood pressure sensor, a respiration sensor, etc. In embodiments, additional sensors such as a NIBP sensor or system 211 and a temperature sensor or sensor system 213 may communicate directly with the hub 100. The sensors 202, 211, and 213 are typically in close proximity to the patient being monitored in use if not physically attached to the patient at the measurement site.

[0057] As disclosed, in embodiments, the portable patient monitor 102 communicates with the hub 100 through the docking station 106 when docked, and in embodiments, wirelessly communicates with the hub 100 when undocking, however, such undocking communication is not required. The hub 100 communicates with one or more multi-patient monitoring servers 204 or server systems, such as disclosed in U.S. Patent Publication Nos. 2011 / 0105854, 2011 / 0169644, and 2007 / 0180140. Typically, the server 204 communicates with a caregiver backend system 206, such as an EMR and / or ADT system. The server 204 can advantageously obtain patient information entered at the time of patient admission, such as demographic information, billing information, etc., through push, pull, or a combination of techniques. The hub 100 accesses this information to seamlessly associate the monitored patient with the caregiver backend system 206. The communication between the server 204 and the monitoring hub 100 can be any communication that a skilled person can recognize from the disclosure herein, including wireless, wired, through mobile or other computing networks, etc.

[0058] Figure 2 The hub 100 is also shown communicating via its serial data port 210 and channel data port 212. As disclosed in the foregoing, the serial data port 210 can provide data from a variety of patient medical devices, including an electronic bed system 214, an infusion pump system 216 including a closed-loop control system, a ventilator system 218, a blood pressure or other vital sign measurement system 220, and the like. Similarly, the channel data port 212 can provide data from a wide variety of patient medical devices including any of the foregoing devices and other medical devices. For example, the channel data port 212 can receive data from a depth of consciousness monitor 222, a brain or other organ oximeter device 224, a non-invasive blood pressure or acoustic device 226, and the like, such as those commercially available from SEDLine. In an embodiment, the channel device may include a panel-in-cable ("BIC") solution, in which the processing algorithms and signal processing devices that implement these algorithms are mounted to a panel housed in a cable or cable connector, which in some embodiments does not have additional display technology. The BIC solution outputs its measured parameter data to the channel port 212 for display on the display 104 of the hub 100. In embodiments, the hub 100 may advantageously be formed in whole or in part as a BIC solution that communicates with other systems such as tablets, smart phones or other computing systems.

[0059] Although disclosed with reference to a single docking station 106, environment 200 may include stacked docking stations where subsequent docking stations mechanically and electrically dock to a first docking station to change the form factor for different portable patent monitors, as described with reference to FIG. Figure 5 Such a stack may include more than two docking stations, which may reduce or increase the form factor for mechanical compliance to mate with mechanical structures on the portable device.

[0060] Figure 3 1 shows a simplified exemplary hardware block diagram of the hub 100 of FIG. 1 according to an embodiment of the present disclosure. Figure 3 As shown in , the housing 108 of the hub 100 positions and / or contains an instrument board 302, a display 104, a memory 304, and various communication connections including a serial port 210, a channel port 212, an Ethernet port 305, a nurse call port 306, other communication ports 308 including standard USB, etc., and a docking station interface 310. The instrument board 302 includes one or more substrates including communication interconnects, wiring, ports, etc. to enable the communications and functions described herein, including inter-board communications. The core board 312 includes the main parameters, signals, and other processors and memories, the portable monitor board ("RIB") 314 includes patient electrical isolation for the monitor 102 and one or more processors, the channel board ("MID") 316 controls communication with the channel port 212 including optional patient electrical isolation and power supply 318, and the radio board 320 includes components configured for wireless communication. In addition, the instrument panel 302 may advantageously include one or more processors and controllers, buses, all manner of communication connectivity and electronics, memory, memory readers including EPROM readers, and other electronics that a skilled person would recognize from the disclosure herein. Each panel includes a substrate for positioning and support, interconnections for communication, electronic components including controllers, logic devices, hardware / software combinations, etc. to accomplish the above-specified tasks and other tasks.

[0061] A skilled artisan will recognize from the disclosure herein that the instrument panel 302 may include a large number of electronic components organized in many ways. Using different panels such as those disclosed above advantageously provides organization and partitioning of complex systems.

[0062] Implementation of touch screen controls including certain gestures

[0063] Figure 4An illustration of a finger control gesture 400 for use with a touch screen display 104 according to an embodiment is shown. Finger control gestures 400 include touch 402, touch and hold 404, touch and move 406, flick 408, drag 410, and pinch 412. Touch 402 is a finger control gesture that performs a desired action once the user's finger is released from the screen. Touch and hold 404 is a finger control gesture that performs a desired action once the user has held his or her finger on the screen for a predetermined duration (e.g., a few seconds), received a "hold complete" notification, and has released his or her finger from the screen. Touch and move 406 is a finger control gesture that manipulates and / or shifts an object across the display 104 in a desired and allowed direction to an intended stopping point. To perform the touch and move finger control gesture 406, the user touches an object, moves the object (left, right, up, down, diagonally, etc.), and releases the object. Flick 408 is a finger control gesture that includes contact with an object on the display 104 along with rapid finger movement in a particular direction, typically along a single vector. To perform the flick 408 finger control gesture, the user touches the object on the display 104, moves the object (typically but not necessarily in a single direction) in a manner such that the contact point has velocity over the entire path of motion and quickly releases the finger from the display 104. Drag and drop 410 is a finger control gesture by which the user moves an object to another location or another object (e.g., a folder) and positions the object there by releasing the object. To perform the drag and drop 410 finger control gesture, the user touches, holds, drags, and drops an object. Pinch 412 is a finger control gesture that expands or reduces the field of view on the display 104. To perform the pinch 412 finger control gesture, the user touches the display 104 at two touch points using two fingers, such as the thumb and index finger of the user's hand. Moving the touch points apart from each other brings the field of view closer, expanding the field of view, while moving the touch points together brings the field of view further away, reducing the field of view.

[0064] In an embodiment, the user interface includes a plurality of controls. For example, a switch control enables a user to slide a knob to switch between switch states. The switch control also enables a user to press the left or right side of the switch to quickly move the switch left or right. If the switch control is labeled, the user can press the label to quickly move the knob left or right.

[0065] The following paragraphs include descriptions of additional touch screen controls that can be used with the system of the present disclosure. The system can include any combination of the following controls and the present disclosure is not intended to be limited by the following descriptions of the various controls.

[0066] In some embodiments, a drop-down list control enables a user to press the center (focused) tile to expand the drop-down list when the drop-down list is closed, and collapse the drop-down list when the drop-down list is opened. A drop-down list control enables a user to swipe up or down to scroll the drop-down list tiles when the drop-down list is opened. A drop-down list control enables a user to press a non-focus tile and then scroll the non-focus tile to the center focus position. A drop-down list control enables a user to collapse an open drop-down list by pressing anywhere outside the drop-down list.

[0067] Slider controls allow users to move a knob by sliding it. Slider controls also allow users to quickly move the knob to a specific position by pressing anywhere along the path of the slider.

[0068] The Slider Drop-Down List control combines the control functions of the Drop-Down List control and the Slider control.

[0069] A button control enables a user to perform an action defined by a button description by pressing a button.

[0070] The Icon Menu control enables the user to open a specified menu by pressing a tile. The Icon Menu control enables the user to scroll left or right through the icons by swiping left or right anywhere on the display. The Icon Menu control enables the user to quickly center the puzzle piece corresponding to the indicator icon by pressing the indicator button.

[0071] When there is no parameter or measurement alarm, the window control enables the user to open the parameter or measurement window by pressing the parameter or measurement. When there is a parameter or measurement alarm, the window control enables the user to silence the parameter or measurement alarm by pressing the parameter or measurement. The window control enables the parameter or measurement to be moved to a different location on the display 104 by using a drag and drop 410 finger control gesture.

[0072] When there is no parameter or measurement alarm, the Well control enables the user to open the parameter or measurement menu by pressing Parameter or Measurement. When there is a parameter or measurement alarm, the Well control enables the user to silence the parameter or measurement alarm by pressing Parameter or Measurement.

[0073] Live waveform controls allow users to separate waveforms by swiping down. Live waveform controls allow users to merge waveforms by swiping up.

[0074] The trendline control enables the user to zoom in by pulling out, zoom out by pinching in, change the time frame by panning, and open a menu of parameters or measured trends by pressing on the y-axis.

[0075] The Alarm Mute Icon control enables the user to mute all alarms by pressing the Alarm Mute Icon.

[0076] The audio pause icon control enables the user to pause the audio for a predetermined period of time by pressing the audio pause icon.

[0077] Other status bar icon controls enable the user to open a related menu by pressing the related status bar icon.

[0078] The back arrow control enables the user to exit a menu or discard any changes made by pressing the back arrow icon.

[0079] The "Confirm or Cancel" control enables the user to confirm changes to settings by pressing the OK button. The "Confirm or Cancel" control enables the user to cancel changes to settings by pressing the Cancel button.

[0080] The home control enables the user to navigate to the home screen at any time by pressing the home button. Configurable playback display Implementation of the display

[0081] Figure 5 An embodiment of a user interface 500 displayed on a display 104 of a hub 100 is shown. In an embodiment, the display 104 includes a color modular touch screen integrated into the hub 100. Horizontally positioned along the top of the display 104 is a top status line 501 that displays system status and provides shortcuts to menu items or actions. In an embodiment, the icons presented on the top status line 501 include alarm mute 501A, audio pause 501B, profile 501C, Bluetooth 501D, Wi-Fi 501E, Ethernet 501F, connection gateway 501G, portable patient monitor battery status 501H, monitoring hub battery status 501I, sound 501J, and current time 501K.

[0082] The alarm mute icon 501A displays the alarm status and silences all audible alarms for monitoring devices connected to the hub 100. The audio pause icon 501B displays the audio pause status and temporarily silences the alarm event. The profile icon 501C provides access to the profile screen; the example shown illustrates setting the profile to "Adult" for an adult patient. The Bluetooth icon 501D provides access to the Bluetooth screen. If the icon is visible on the status line 501, the Bluetooth connection is enabled. The Wi-Fi icon 501E provides access to the Wi-Fi screen. If the icon is visible on the status line 501, the Wi-Fi connection is enabled. The icon itself also indicates the strength of the wireless signal. The Ethernet icon 501F provides access to the Ethernet screen. If the icon is visible on the status line 501, the Ethernet connection is enabled.

[0083] The connection gateway icon 501G provides access to the connection gateway screen. The example shown indicates that the stand-alone device is connected to three of the available four ports. The color of the icon matches the status color of the connected stand-alone device. The portable patient monitoring battery status icon 501H displays the charging status of the portable patient monitor 102 and provides access to the portable patient monitor battery screen. The example shows that the battery is being charged. The monitoring hub battery status icon 501I displays the charging status of the monitoring hub 100 and provides access to the monitoring hub battery screen. The example shows that the battery is being charged. The sound icon 501J provides access to the sound screen to adjust the volume of the alarm and pulse sounds. In an embodiment, the sound icon 501J does not indicate the actual volume level of the alarm and pulse sounds. The current time icon 501K displays the current time and provides access to the positioning screen containing settings related to local time, language, and geography.

[0084] Positioned horizontally along the bottom of the display 104 is a bottom status line 502 that displays additional icons and information including a main menu icon, a gender icon, and a patient identifier that includes patient-specific information, such as the patient's name and room location. Although the disclosed embodiments employ status lines 501, 502 that are oriented horizontally along the top and bottom of the display 104, those skilled in the art will readily recognize that the types of information presented in the top status line 501 and the bottom status line 502 may be presented in a variety of different formats, combinations, and configurations, including but not limited to one or more status bars positioned vertically on the display 104. Moreover, those skilled in the art will recognize that other useful information may be displayed in the status bars 501, 502.

[0085] In an embodiment, the user interface can create a window for each monitoring device connected to the hub 100. Parameters or measurements can be expanded within the window to customize the view. In this example, the central portion 504 of the display 104 presents patient measurement data in two windows 506, 530. Illustratively, as a non-limiting example, the upper window 506 presents a Pulse CO-Oximetry system such as that of Masimo Corporation of Irvine, California. TMThe non-invasive monitoring platform of the monitoring platform can evaluate multiple blood components and physiological parameters including blood oxygen saturation (SpO2) 508, pulse rate (PR) 510, respiratory rate (RRp) 512, natural arterial oxygen saturation (SpfO2) 514, total hemoglobin (SpHb) 516, plethysmograph variability index (PVI) 518, methemoglobin (SpMet) 520, carboxyhemoglobin (SpCO) 522, perfusion index (PI) 524, blood oxygen content (SpOC) 526 or others. In the example shown, the lower window 530 of the display 104 presents O3 saturation (SpO2) 508, pulse rate (PR) 510, respiratory rate (RRp) 512, natural arterial oxygen saturation (SpfO2) 514, total hemoglobin (SpHb) 516, plethysmograph variability index (PVI) 518, methemoglobin (SpMet) 520, carboxyhemoglobin (SpCO) 522, perfusion index (PI) 524, blood oxygen content (SpOC) 526 or others. TM The regional oximetry module measures patient data from a regional oximetry platform that can continuously assess tissue oxygen parameters under one or more sensors placed on the patient's skin to help clinicians detect local hypoxemia.

[0086] Advantageously, the display 104 may be configured to allow the user to adjust the manner in which physiological parameters are presented on the display 104. In particular, physiological measurements that are of greater interest or importance to the clinician may be displayed in a larger format and may also be displayed in both numerical and graphical form to convey current measurements as well as historical trends of measurements over a period of time, such as the last hour. In an embodiment, the blood oxygen saturation 508, pulse rate 510, and respiratory rate 512 measurements that occupy a larger portion of the upper portion 506 of the display 104 are displayed in such a manner, while the native arterial blood oxygen saturation 514, total hemoglobin 516, plethysmographic variability index 518, methemoglobin 520, carboxyhemoglobin 522, perfusion index 524, and blood oxygen content 526 measurements that occupy a smaller portion of the upper portion 506 of the display 104 are displayed as numbers.

[0087] In an embodiment, the presentation of measurement information can be easily adjusted by using finger control gestures 400. For example, the touch and move 406 finger control gesture can be used to move an object representing a measurement result on the display 104 from one location of the display 104 to another location of the display 104. Advantageously, when the object is moved, the display 104 automatically scales the presentation of its information based on the activated parameters. For example, fewer parameters will result in displaying larger numbers, trend lines, and waveform cycles. In an embodiment, the location to which the object is moved at least partially determines the manner in which the object will be presented on the display 104.

[0088] Attention is now directed to the multiple analysis presentation views that may be presented on the disclosed monitoring hub 100. Advantageously, the disclosed monitoring hub 100 provides a number of analysis formats by which measured physiological parameters and other data may be displayed to a user. Furthermore, the size, format, color, and position of the display may be easily set and modified by a clinician user to easily customize the manner in which monitored physiological parameter data and information derived therefrom may be displayed.

[0089] Fig. 6A It is a diagram of an exemplary display screen 600 showing various formats of analysis presentation views for illustrating received physiological parameter data according to an embodiment of the present disclosure. The exemplary display screen 600 includes a heat map analysis presentation view 602, a box and whisker plot analysis presentation view 604, an index analysis presentation view 606, a distribution analysis presentation view 608, a histogram analysis presentation view 610, and a meter-histogram analysis presentation view 612. The position of each analysis presentation view can be adjusted and the format of each analysis presentation view can be replaced with other formats, which advantageously leads to a high degree of customization for the user. For example, the meter-histogram presentation view 612 is vertically located in the right panel portion of the screen 600, but it can also be replaced in any form and any position on the screen 600.

[0090] Heatmap

[0091] The heat map 602 analysis presentation view provides a two-dimensional graphical representation of the relationship between two measured parameters over a specific time period, using color to identify areas in the graph where the data is concentrated. Figure 6B As shown in , heat map 602 presents the relationship between the measured blood oxygen saturation (SpO2) and the pulse rate (PR) at a specific time point. Illustratively, as a non-limiting example, the area on the graph corresponding to the highest concentration of correlation values ​​between the measured blood oxygen saturation and the pulse rate is colored with a first color (e.g., red). Figure 6B A heat map centered around an SpO2 value of about 98% and a PR value of about 61 bpm is shown. In addition, Figure 6B It is shown that as the concentration of the correlation measurements decreases, the color changes on the heat map (eg, from red to orange, then to yellow, then to green, and finally to blue) indicate a gradual decrease in the concentration of the correlation values ​​between the two measured parameters.

[0092] The heat map 602 advantageously provides trends of multiple monitored values ​​or physiological parameters at just a moment in time. For example, Figure 6BThe caregiver is shown that while the patient's PR may be slightly lower depending on age, health status, activity level during monitoring, etc., the patient is nearly, if not saturated with oxygen. Thus, since the body appears to be oxygenated, additional PR may not be needed during the presented time period. Accordingly, and advantageously, heat map 602 delivers a visual overview of the data that enables a user to intuitively understand and analyze complex relationships between data sets.

[0093] Box and Whisker Plot

[0094] In descriptive statistics, a box plot or box graph is a convenient way to graphically depict groups of numerical data by their quartiles. A box plot may also have lines (whiskers) extending vertically from the box that indicate variability above and below the quartiles, and these are often referred to as box and whisker plots or graphs. The spacing between the different parts of the box indicates the dispersion (scatter) and skewness of the data, and displays outliers.

[0095] like Figure 6C As shown in , the box and whisker analysis presentation view 604 visually presents the range of measurements received within a specified or predetermined time period and the boundaries of the quartiles in which the data lies. Advantageously, the box and whisker plot view 604 easily presents to the user the spread or dispersion of the measured data, as well as the skewness of the data, including abnormal measurements. The whiskers 620 and 622 identify the low and high ends of the displayed measurement range, respectively.

[0096] like Figure 6C As shown in , as an illustrative example, the range of measured SpO2 data for a given patient may extend from 82% to 100%. The skilled person will recognize that other patients may have many other ranges. Box 624 identifies the centerline 626 of the measured SpO2 parameter data. Thus, half of the measured SpO2 data represented by view 604 falls above the centerline 626, and half of the measured SpO2 data falls below the centerline. The lower edge 628 and upper edge 630 of box 624 identify the median values ​​of the lower and upper halves of the measured SpO2 data, respectively. Thus, as shown in FIG. Figure 6C As shown in , the first quartile of the measured SpO2 data is located between the endpoint of the bottom whisker 620 and the lower edge 628 of the box 624; the second quartile of the measured SpO2 data is located between the lower edge 628 of the box 624 and the centerline 626; the third quartile of the measured SpO2 data is located between the centerline 626 and the upper edge 630 of the box 624; and the fourth quartile of the measured SpO2 data is located between the upper edge 630 of the box 624 and the endpoint of the top whisker 622.

[0097] The box-and-whisker plot 604 also advantageously provides trends of monitored values ​​or physiological parameters at just a moment in time. Figure 6C The caregiver is shown that while SpO2 varies, at least half of the time SpO2 is above about 94% and a quarter of the monitored window SpO2 is between about 94% and about 98%. About half of the time, though, SpO2 is lower than expected.

[0098] Index View

[0099] Such as Fig.6D The index analysis presentation view 606 of the continuous non-invasive measurement of arterial hemoglobin concentration, which may also be referred to as the "total hemoglobin" (SpHb) index 606, exemplarily shown in FIG. 6 , presents the current measured status of a physiological parameter (SpHb in this example) relative to ranges identified as acceptable, alarming, and urgent. Fig.6D As shown in , indicator 632 shows the current measured parameter level associated with vertical bar 634. Vertical bar 634 is colored in different colors such as green, yellow and red. The colors can be used to identify different zones or ranges corresponding to, for example, acceptable, warning and emergency values ​​of the measured parameter. Threshold line 636 can be set to visually identify one area from another. Illustratively, as a non-limiting example, threshold line 636 can identify the boundary between a range of acceptable values ​​and a range of warning values ​​of the measured parameter. In an embodiment, a user can set ranges and boundary conditions for such a range. In other embodiments, the ranges and boundary conditions for a given physiological parameter are set to default values ​​corresponding to clinically accepted values ​​typically used for such a range. The units of the measured parameters can be presented in the well 638 at the bottom of the index analysis presentation view 606. For example, as shown in Fig.6D As shown in , the physiological parameter being measured (total hemoglobin, SpHb) is in units of grams per deciliter (g / dL) at the ninety percent confidence interval (CI). Advantageously, the index analysis display provides the user with an easily interpretable presentation of the measured physiological parameter.

[0100] Distribution View

[0101] Such as Fig. 6E The distribution analysis presentation view 608 of the SpO2 distribution display 608 shown in FIG. presents the statistical distribution of a set of physiological parameter measurements over a specified or predetermined time period. The distribution analysis presentation view 608 provides the user with a visual representation of the range of the collected physiological parameter measurements and the statistical distribution associated with such measurements. Illustratively, as a non-limiting example, Fig. 6EThe distribution analysis presentation view 608 shown in FIG. 6 presents a distribution 640 of blood oxygen saturation (SpO2) parameter measurement results over a period of time. Fig. 6E , the distribution 640 is also substantially normal (or Gaussian), and its mean (or expected value) 642 is also shown. The current measurement value indicator 644 informs the user of the patient's current state, and the standard deviation indicator 646 indicates the degree of variation or dispersion of the measured data within the value range. A well 648 toward the bottom of the distribution analysis display 608 provides a numeric unit for the measured physiological parameter, such as a percentage for a blood oxygen saturation measurement.

[0102] Histogram View

[0103] like Fig. 6F As shown in , the histogram analysis presentation view 610 provides another graphical representation of the set of measured physiological parameter data. The histogram represents an estimate of the statistical (or probability) distribution of a continuous variable, such as a continuously measured physiological parameter. Therefore, the histogram reflects the actual measured data collected, rather than providing a statistical distribution (i.e., a probability model) that best fits or corresponds to the measured data. In order to form a histogram, the entire range of values ​​to be measured is divided into a series of generally equally spaced, generally continuous, and generally non-overlapping intervals, called "blocks". Each physiological parameter measurement result is then assigned to one of the blocks. A bar is drawn for each block, wherein the height of the bar corresponds to the number of discrete physiological parameter measurements that fall within a specific range of the block. In an embodiment, the width of each bar is constant, and the width corresponds to a range that is equally spaced. The histogram can also be normalized to display the relative frequency or proportion of the measurements that fall into each of several blocks. Advantageously, the histogram analysis presentation view 610 provides the user with a visual representation of the actual frequency of physiological parameter measurements observed in a specific range of values.

[0104] Analog meter including histogram view

[0105] like Figure 6GAs shown in , the meter-histogram analysis presentation view 612 provides a combination of analog, digital and histogram display marks in a presentation format view. Advantageously, the meter-histogram analysis presentation view 612 provides a large amount of information related to the measured physiological parameters to the user in an intuitive and visually accessible format. The meter-histogram 612 includes an analog indicator that forms, for example, a semicircular arc 650. The parts of the arc 650 can be distinguished by using various colors or shadows to indicate different areas of the measured parameter value, such as the acceptable, warning and emergency areas of the meter. Illustratively, as a non-limiting example, the acceptable range of values ​​can be colored green and can usually be located in the center of the arc 650, while the warning range of values ​​can be colored yellow and located outside the acceptable range of values, and the emergency range of values ​​can be colored red and located outside the warning value range towards both ends of the arc 650. Of course, those skilled in the art will recognize that many other colors and range forms can be used without departing from the scope of the present disclosure.

[0106] The meter-histogram analysis presentation view 612 may include a dial mark 652, and the arc 650 around which the dial mark 652 moves to reflect the currently measured level of the monitored physiological parameter. Illustratively, as a non-limiting example, the dial may move clockwise as the measured physiological parameter level increases, and the dial may move counterclockwise as the measured physiological parameter level decreases, and vice versa, the dial may move counterclockwise as the measured physiological parameter level increases, and the dial may move clockwise as the measured physiological parameter level decreases. In this way, the user can quickly determine the patient's status by viewing the analog indicator. For example, if the dial mark 652 is located at the center of the arc 650, the observer can ensure that the current physiological parameter measurement results fall within an acceptable range. If the dial mark 652 deviates too much to the left or right, the observer can quickly assess the severity of the physiological parameter level and take appropriate action. In other embodiments, an acceptable parameter measurement may be indicated when the dial marking 652 is to the right or to the left, etc.

[0107] In some embodiments, the dial mark 652 can be implemented as a dot, a dash, an arrow, etc., and the arc 650 can be implemented as a circle, a spiral, a pyramid, or any other shape as desired. In addition, the entire arc 650 or only a portion of the arc 650 can be illuminated, for example, based on the current physiological parameter being measured. In addition, the color of the arc 650 can be transformed or the arc 650 can be highlighted based on the current measured physiological parameter level. For example, as the dial mark 652 approaches a threshold level, the arc 650 and / or the dial mark 652 can change from green to yellow, red, glow brighter, flash, enlarge, move to the center of the display, sound an alarm, etc.

[0108] Different physiological parameters may have different thresholds that indicate an abnormal condition. For example, some physiological parameters may have both higher and lower threshold levels, while other physiological parameters may have only a higher threshold or a lower threshold level. Thus, each meter-histogram analysis presentation view 612 may be adjusted based on the specific physiological parameter being monitored. Illustratively, as a non-limiting example, the SpO2 meter-histogram presentation view 612 may have a lower threshold at which an alarm is activated, while the respiration rate meter-histogram presentation view 612 may have both a lower threshold and a higher threshold, and an alarm may be activated when either threshold is reached. The threshold for each physiological parameter may be based on a typical, expected threshold, or the threshold may be set to a threshold level specific to the user.

[0109] In certain embodiments, Figure 6G In the embodiment shown in , the meter-histogram analysis presentation view 612 includes a digital indicator 654. The analog arc 650 and the digital indicator 654 can be positioned relative to each other in any number of formats, such as side by side, above, below, transposed, etc. In the embodiment shown, the analog arc 650 is located above the digital indicator 654. As described above, the analog arc 650 and the dial mark 652 can include a colored warning portion indicating the current position on the graph. The digital information specifies quantitative information from the graph. In Figure 6G For example, the meter-histogram analysis presentation view 612 displays pulse rate information. Arc 650 shows that the measured pulse rate physiological parameter is within an acceptable range or begins to enter a warning range from about 50 to about 140 beats per minute, but in the area outside these numbers, the arc 650 is colored to indicate an urgent or serious condition. Therefore, as the dial mark 652 moves along the arc 650, the caregiver can easily see where the current measurement falls within the acceptable, warning and urgent pulse rate value range. The digital indicator 654 provides a digital representation of the current measurement value of the physiological parameter being displayed. The digital indicator 654 can indicate the actual measurement value or the normalized value, and can also be used to quickly assess the severity of the patient's condition.

[0110] like Figure 6G As shown in FIG. 6 , a histogram arc 656 is located above and around the arc 650, and the histogram arc 656 has a histogram bin area corresponding to the measured physiological parameter (as described above with reference to FIG. 6 ). Fig. 6F The blocks of the histogram arc 656 may be illuminated to reflect the distribution of the measured parameter values ​​in the manner described above with respect to the histogram analysis presentation view 610. Figure 6GIn the embodiment shown in , the blocks are illuminated in a color corresponding to the range along which they fall in the arc 650. Thus, the disclosed instrument histogram analysis presentation view 612 provides analog and digital indicators of currently measured physiological parameters associated with range information indicating the urgency required for the measured parameters, as well as a visual display of the actual distribution of the patient's parameter measurements over a period of time.

[0111] Advantageously, the hub 100 stores over time the measured data that it has presented on the display screen 600. In some embodiments, the data is stored in the memory 304 of the instrument board 302. In some embodiments, the data is stored externally and accessed by the monitoring hub 100 via a network connection such as an Ethernet connection. In other embodiments, the data is stored in both the on-board memory 304 and an external storage device.

[0112] Drag and Drop

[0113] Return to reference Fig. 6A , each of the aforementioned display elements 6B, 6C, 6D, 6E, 6F, and 6G can be dragged onto the screen and dropped to create a customized view to match the caregiver's preferences for a particular monitored patient. In an embodiment, the display elements and their specific displayed parameters are displayed as icons along a horizontally scrollable menu at the bottom. When the caregiver wishes to place, for example, a perfusion variability index (PVI) distribution view on the screen, the caregiver can select the PVI distribution icon from the bottom button well, scroll and drag the PVI distribution icon to the screen, for example, replacing any existing display element. In another embodiment, the caregiver can select a display element and then select one or more parameters to be provided to the element.

[0114] Replay

[0115] Fig. 6A Also shown is that display screen 600 provides a replay feature, which allows the clinician to check the historical records of patient data collected and processed by monitor 100. The user can select a time frame 662 for the replay time period. For example, the user can choose to replay a previous ten-minute time period, a four-hour time period, or an eight-hour time period. Any amount of time can be a suitable replay time period. In an embodiment, screen 600 can provide a default time frame 662, such as eight hours. After selecting the replay time period or determining the default time period, the user can select the replay icon 660 to start replaying.

[0116] In some embodiments, the stored data can be replayed on a different monitor hub or on a different display (e.g., a display connected to the multi-patient monitoring server 204) to allow clinicians remote from the patient's care environment to access and review the monitoring data.

[0117] During the playback period, the stored data can be displayed on the screen 600 at different rates. For example, the replayed data can be displayed at the same time rate as the original presentation data. Therefore, replaying the data recorded for one hour will take one hour to fully replay. Alternatively, the replayed data can be displayed in slow motion (slower than real time) or in a time-lapse (faster than real time) format. For example, in order to replay in slow motion, the screen 600 can present each data frame for a longer period of time than the original presentation. Illustratively, as a non-limiting example, slow motion playback can be used to check and analyze the part of the recorded physiological parameter data that has undergone a sudden change. Time-lapse playback allows clinicians to check the period of the recorded data in a shorter period of time than the original presentation data. In an embodiment, in order to replay in a time-lapse mode, the screen 600 can speed up the speed of displaying frames. In another embodiment, in order to replay in a time-lapse mode, the screen 600 can only display a sampling of frames from a set of data. For example, the screen 600 can be displayed once every fifteen frames, so that data can be presented in a shorter time, while still providing a useful illustration of the stored data. In an embodiment, the user can select the rate at which the time-lapse replay will occur. For example, as an illustration, the user can choose to view one minute's worth of real-time data in one second or ten seconds. This information is particularly useful, for example, for a care provider who wishes to quickly check a patient's physiological condition from a previous time period when the care provider is not present and therefore cannot observe the data as originally presented.

[0118] In some embodiments, multiple parameter displays presented on the screen 600 can synchronously replay stored data during the playback period, while other parameter displays can present real-time data. This enables the clinician to simultaneously monitor the patient's current condition and check (i.e., replay) past measurement data. Illustratively, as a non-limiting example, a series of analysis displays in the center portion of the screen 600 can replay stored data, while a series of gauges-histogram analysis displays 612 located in the side panel can present real-time data. In another embodiment, each feature on the screen 600 can replay stored data during the playback period. Figure 7Such an example is shown, and the display 700 provides a message 702 indicating that the displayed data is being replayed. In yet another embodiment, any single analysis display or combination of analysis displays on the screen 600 can present real-time data during the replay period. In some embodiments, a separate analysis display can have a separate icon or indicator (not shown) associated with it to indicate whether the analysis presentation view is presenting real-time data or stored and replayed data. In some embodiments, a separate display element can include both replay data and real-time data.

[0119] Figure 8 800 is a flow chart illustrating a playback process 800 according to an embodiment of the present disclosure. At optional block 802, a user configures a display 600 using display elements that a caregiver desires for a monitored patient. A drag-and-drop function enables a user to drag a display element directly to a desired portion of a display. In an embodiment, a default display layout may be implemented. Alternatively or additionally, a display may be set to a recent playback configuration, a playback configuration that matches a known user, a known caregiver or patient, or some or all of the foregoing.

[0120] In optional frame 804, the user sets the time period for playback. As discussed above, any amount of time can be a suitable playback time period. For example, the user can select between a playback time period of two hours, four hours, eight hours, or ten minutes. In an embodiment, the user can select a time frame icon 662 to set the time period. In other embodiments, the user can scroll back on a timeline (not shown) to select a starting point and an ending point for playback. In other embodiments, the user can input a start time and an ending time for playback.

[0121] At optional box 806, the user can select a playback interval that limits the rate at which the playback display is displayed. In some embodiments, the playback interval includes real-time, slow motion, and time-lapse intervals. Illustratively, when the time-lapse mode of playback is selected, the playback interval can indicate the number of frames of the stored data to be displayed. For example, the user can choose to display every fifteen frames or every ten frames in the recorded data in order to shorten the time required to replay the stored data. In other embodiments, a timeline of the width of an optionally selected time period can be presented to the user, and the user can pinch the timeline larger or smaller to automatically adjust the time interval.

[0122] At block 808, the time is set to the start of the time period. At block 810, the measurement data is accessed. In embodiments, the processor accesses only the data used in the active display elements; in other embodiments, all data associated with a particular time is accessed. In embodiments, the processor synchronizes the data to the display time, even though such data may not be from the same measurement device. In other embodiments, the synchronization data may be stored with the original measurement data for use when accessed during the replay process 800.

[0123] At block 812, the data is displayed to the user via the configured display elements. At optional block 814, the user may interrupt playback to pause, speed up or slow down playback, zoom in or out within a time period, switch to another time period, end playback, change display elements, or otherwise manipulate the data being played back. At optional block 816, such interruptions are processed and appropriate actions are taken, such as restarting playback with new configuration or time parameters.

[0124] At block 818, process 800 determines whether playback has reached the end of the selected playback time period. If playback has reached the end of the selected playback time period, process 800 ends; if playback has not reached the end of the selected playback time period, the display rate is added to the current display time and process 800 returns to block 810 to access additional data.

[0125] Advantageously, process 800 enables a caregiver to directly monitor various measurements and combinations of measurements for a particular time period. For example, a caregiver can see fluctuations, pulsations, or otherwise display during playback the color and / or position of heat map 602 to show how the patient's body is oxygenated and what pulse rate it uses for such oxygenation. Similarly, box-and-whisker plot 604 can have portions that grow, shrink, and move rhythmically, for example, with heat map 602. Distribution 608 can vary, and the histogram, along with its analog meter, can provide an indication of how the body reacts over a preselected time.

[0126] As described above, the user can run the replay process by selecting the replay icon 660. Once the replay process is complete, the user can choose whether to repeat the process at block 808. If the user chooses to repeat the process, the process 800 will run again at step 806. If the user chooses not to repeat the process, the process will end at block 810.

[0127] Therefore, a patient monitoring hub is disclosed as a center for patient monitoring and treatment activities for a given patient. An embodiment of the patient monitoring hub includes a large visual display that dynamically provides information about various physiological measurements or otherwise determined parameters to a caregiver. Advantageously, the display can be customized by a clinician user to present the desired physiological parameters (and other related information) in a format desired by the clinician and at a location on the display. Many analytical presentation views are provided to present the monitored physiological parameters (and other information) to the care provider in a visual form that provides timely, clinically relevant and feasible information. In addition, the disclosed monitoring hub enables all or part of the monitoring data to be replayed in a synchronized manner. The embodiments disclosed herein are presented only by way of example, rather than by way of limiting the scope of the appended claims. A person of ordinary skill in the art will recognize from the disclosure herein that many variations and modifications can be achieved without departing from the scope of the present disclosure.

[0128] The term "and / or" herein has its broadest least restrictive meaning, i.e., the disclosure includes A alone, B alone, A and B together, or A or B, but does not require both A and B or require one of A or one of B. As used herein, the phrase "at least one of A, B, and C" should be construed to mean a logical A or B or C, using a non-exclusive logical "or."

[0129] The term "plethysmography" includes its ordinary broad meaning as known in the art to include data responsive to changes in volume within an organ or the body as a whole, typically caused by fluctuations in the amount of blood or air it contains.

[0130] The following description is merely illustrative in nature and is in no way intended to limit the present disclosure, its application or use. For clarity, the same reference numerals will be used to identify similar elements in the accompanying drawings. It should be understood that the steps in the method can be performed in different orders without changing the principles of the present disclosure.

[0131] As used herein, the term module may refer to, be part of, or include an application specific integrated circuit (ASIC); an electronic circuit; a combinational logic circuit; a field programmable gate array (FPGA); a processor (shared, dedicated, or group) that executes code; other suitable components that provide the described functionality; or a combination of some or all of the above, such as in a system on a chip. The term module may include a memory (shared, dedicated, or group) that stores code executed by a processor.

[0132] The term code used above may include software, firmware and / or microcode, and may refer to a program, a routine, a function, a class and / or an object. The shared term used above means that some or all of the code from multiple modules can be executed using a single (shared) processor. In addition, some or all of the code from multiple modules can be stored by a single (shared) memory. The term group used above means that some or all of the code from a single module can be executed using a group of processors. In addition, some or all of the code from a single module can be stored using a group of memories.

[0133] The apparatus and methods described herein may be implemented by one or more computer programs executed by one or more processors. The computer program includes processor executable instructions stored on a non-transitory tangible computer-readable medium. The computer program may also include stored data. Non-limiting examples of non-transitory tangible computer-readable media are non-volatile memory, magnetic storage, and optical storage. Although the foregoing invention has been described according to certain preferred embodiments, other embodiments will be obvious to those of ordinary skill in the art based on the disclosure herein. In addition, in view of the disclosure herein, other combinations, omissions, substitutions, and modifications are obvious to those of ordinary skill in the art. Therefore, the present invention is not intended to be limited by the reaction of the preferred embodiments, but is defined by reference to the claims.

[0134] Furthermore, all publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.

Claims

1. A medical monitor configured to analyze and present an indicator reflecting a physiological parameter of a patient, the parameter including blood oxygen saturation, the monitor comprising: a first communication port configured to receive a first signal indicative of a first physiological parameter associated with the patient, the first signal responsive to light attenuated by body tissue; A second communication port; Touch screen display; Storage devices; as well as A processing system comprising a plurality of processors, one or more of the plurality of processors being configured to: processing the first received signal and determining first data indicative of a first physiological parameter in response to the first received signal, receiving second data related to the patient from another device at the second communication port, wherein the touch screen display is responsive to one or more processors among the plurality of processors to cause a first view to be presented on at least a portion of a display area of ​​the touch screen display, the first view being adapted to present the first data within a first time period; Even if the first data and the second data are not from the same measuring device, synchronizing the first data and the second data in time to a display time so as to generate synchronized data; storing the rendered first data, the second data, and the synchronization data in the storage device for use during a playback process; receiving a user selection to initiate the playback process and playback interval; determining a subset of frames to be replayed from the presented first data according to the replay interval; and replaying the subset of frames in the touch screen display, wherein the touch screen display is responsive to multiple finger control gestures when in contact with the touch screen display to also replay the subset of frames in the first view on the touch screen display, the multiple finger control gestures comprising scrolling backward on a timeline to select a start point and an end point, and wherein the touch screen display is configured to present a second view of the display area, the second view being suitable for synchronously replaying the first data and the second data in a plurality of analysis presentation views, and Wherein, the position and format of each analysis presentation view can be customized by the user by dragging and dropping each analysis presentation view as an icon from a scrollable menu onto the display area of ​​the touch screen display, and the multiple analysis presentation views dragged and dropped onto the display area have different formats.

2. The monitor according to claim 1, wherein: The touch screen display is configured to replay the first data and the second data for a duration shorter than the first time period.

3. The monitor according to claim 1, wherein: The touch screen display is configured to replay the first data and the second data for a duration longer than the first time period.

4. The monitor according to claim 1, wherein: The touch screen display is configured to replay the first data and the second data for a duration equal to the first time period.

5. The monitor according to claim 1, further comprising: a third communication port configured to receive a second signal indicative of a second physiological parameter associated with the patient; wherein one or more of the plurality of processors is configured to process the received second signal and determine third data indicative of the second physiological parameter, and the touch screen display is responsive to one or more of the plurality of processors to cause a third view to be presented on at least a portion of the touch screen display, the third view being adapted to present the third data within a first time period; wherein the storage device is further configured to store the rendered third data for use during the playback process; and The touch screen display is further configured to synchronously replay the frame subset and the stored third data.

6. The monitor according to claim 1, wherein: The second data indicates a relationship between the first physiological parameter and a second physiological parameter.

7. The monitor according to claim 1, wherein: The plurality of analysis presentation views includes a heat map view configured to present a relationship between the first physiological parameter and a second physiological parameter and to identify a region in the heat map view where second data indicative of the second physiological parameter is concentrated.

8. The monitor according to claim 7, wherein: The heat map view uses color to identify the area where the second data is concentrated.

9. The monitor according to claim 7, wherein: The heat map view is configured to identify a first region in the heat map view associated with a first set of the second data and a second region in the heat map view associated with a second set of the second data, wherein the first region is presented in a first color and the second region is presented in a second color.

10. The monitor according to claim 7, wherein: The first physiological parameter is blood oxygen saturation and the second physiological parameter is pulse rate.

11. The monitor according to claim 7, wherein: The first physiological parameter is total hemoglobin and the second physiological parameter is plethysmographic variability index.

12. The monitor according to claim 1, wherein: The plurality of analysis presentation views includes a box-and-whisker plot analysis presentation view.

13. The monitor according to claim 1, wherein: The plurality of analysis presentation views include an index analysis presentation view.

14. The monitor according to claim 1, wherein: The plurality of analysis presentation views includes a distribution analysis presentation view.

15. The monitor according to claim 1, wherein: The plurality of analysis presentation views include a histogram analysis presentation view.

16. The monitor according to claim 1, wherein: The plurality of analysis presentation views include a gauge-histogram analysis presentation view.

17. The monitor according to claim 1, wherein: The plurality of analysis presentation views includes a gauge-histogram analysis presentation view, the gauge-histogram analysis presentation view further including a numerical indicator.

18. The monitor according to claim 1, wherein: The plurality of analytical presentation views include an analog gauge showing measurement data, the analog gauge including arc and dial indicia.

19. The monitor according to claim 1, wherein: The first communication port comprises a serial port.

20. The monitor according to claim 1, wherein: The monitor is in communication with one or more medical sensors.

21. A method of monitoring a physiological parameter of a patient, the method comprising: receiving, at a first communication port, from a first physiological sensor, a first signal indicative of a first physiological parameter associated with the patient, the first signal being responsive to light attenuated by body tissue; processing the received first signal using one or more processors in a processing system including a plurality of processors to generate first data indicative of the first physiological parameter over a first time period; receiving second data related to the patient from another device at a second communication port; causing the first data to be presented on at least a portion of the touch screen display using a touch screen display responsive to one or more of the plurality of processors; Even if the first data and the second data are not from the same measuring device, synchronizing the first data and the second data in time to a display time so as to generate synchronized data; storing the rendered first data, the second data, and the synchronization data in a data storage device for use during a playback process; receiving a user selection to initiate the playback process and playback interval; determining a subset of frames to be replayed from the rendered first data according to the replay interval; as well as replaying the subset of frames on the touch screen display, wherein the touch screen display is responsive to a plurality of finger control gestures when in contact with the touch screen display to also replay the subset of frames in a first view of a display area of ​​the touch screen display, the plurality of finger control gestures comprising scrolling backward on a timeline to select a start point and an end point, and wherein the touch screen display is configured to present a second view of the display area, the second view being adapted to synchronously replay the first data and the second data in a plurality of analysis presentation views, and Wherein, the position and format of each analysis presentation view can be customized by the user by dragging and dropping each analysis presentation view as an icon from a scrollable menu onto the display area of ​​the touch screen display, and the multiple analysis presentation views dragged and dropped onto the display area have different formats.

22. The method according to claim 21, further comprising: receiving, at a third communication port, a second signal from a second physiological sensor indicative of a second physiological parameter associated with the patient; processing the received second signal using one or more of the plurality of processors to generate third data indicative of the second physiological parameter during the first time period; causing the third data to be presented on at least a portion of the touch screen display using the touch screen display; storing the rendered third data in the data storage device for use during a playback process; as well as The subset of frames and the stored third data are synchronously replayed on the touch screen display.

23. The method according to claim 21, comprising: The first data and the second data are caused to be played back for a duration shorter than the first time period.

24. The method according to claim 21, comprising: The first data and the second data are caused to be played back for a duration longer than the first period of time.

25. The method according to claim 21, comprising: The first data and the second data are caused to be replayed for a duration equal to the first time period.

26. The method of claim 22, wherein: Causing the third data presentation further comprises: processing the received first and second signals using one or more of the plurality of processors to generate the third data indicative of a relationship between the first physiological parameter and the second physiological parameter; presenting a graphic indicative of the third data; and An area in which the third data is concentrated is identified on the graph.

27. The method of claim 21, wherein: The multiple analysis presentation views include a heat map view configured to identify a first region in the heat map view associated with a first set of the second data and a second region in the heat map view associated with a second set of the second data, wherein the first region is presented in a first color and the second region is presented in a second color.

28. The method of claim 21, wherein: Causing the subset of frames to be replayed further comprises: presenting on the touch screen display a first whisker having an upper end and an opposite end, the upper end indicating an upper point of a data range of the frame subset; presenting on the touch screen display a second whisker having a lower end and an opposite end, the lower end indicating a lower point of the data range; and A box having an upper edge, a center line, and a lower edge is presented on the touch screen display between the first whisker and the second whisker, the upper edge being connected to the opposite ends of the first whisker and indicating a first dividing line between a first quartile and a second quartile of the data range, the lower edge being connected to the opposite ends of the second whisker and indicating a second dividing line between a third quartile and a fourth quartile of the data range, and the center line indicating a third dividing line between the second quartile and the third quartile of the data range.

29. The method according to claim 21, wherein: Causing the subset of frames to replay includes presenting a measurement mark, a value bar, and a threshold line on the touch screen display, wherein the value bar is divided into a plurality of zones, and wherein the threshold line is associated with a boundary between two adjacent zones.

30. The method of claim 21, wherein: Causing the subset of frames to be replayed further includes presenting a distribution graphic on the touch screen display that indicates the subset of frames.

31. The method of claim 21, wherein: Causing the subset of frames to be replayed further includes presenting a histogram indicative of the subset of frames on the touch screen display.

32. The method of claim 21, wherein: Causing the subset of frames to replay further includes presenting a meter-histogram indicative of the subset of frames on the touch screen display.

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