Hospital Bed Warning Light Management

Abstract

A patient support device includes a plurality of components (including bed rails) and a control system. The ability of the patient support device to automatically determine treatment compliance may be important for preventing any potential harm to the patient. The control system includes a controller that is operable to monitor the position, angle, movement, or other attributes of each component of the patient support and communicate with a caregiver.

Description

[0001] Cross - Reference to Related Applications

[0002] This application claims priority to U.S. Provisional Application No. 63 / 403,116, filed on September 1, 2022, under 35 U.S.C. § 119(e), which is hereby incorporated by reference in its entirety. BACKGROUND OF THE INVENTION

[0003] The present invention relates to determining the hierarchy of patient care protocols, for example, using sensors of a patient support device such as a hospital bed. More specifically, the present invention relates to a system or method for communicating treatment operation protocols and determining whether a patient support device should issue an alert.

[0004] Patient support devices, including mattresses, stretchers, operating room tables, etc., are commonly used in various care environments to facilitate patient care and transportation. Patient support devices are programmed with protocols to enable users to perform various automated functions related to patient support. Examples of such automated functions include raising or lowering one or more sections of a patient support, adjusting the configuration of a bed frame or support surface or a portion thereof, and activating or deactivating selected treatments, alarms, communications, and other automated features of the patient support.

[0005] Many such patient supports include a frame, a platform supported by the frame, a mattress, bed rails configured to prevent a patient from falling out of the mattress, and a controller configured to control one or more features of the bed. A patient, caregiver, or visitor may intermittently change the position of one or more components of the patient support device during the day. In some cases, it is important to determine the position of one or more components relative to the patient support device before implementing a treatment operation protocol. Additionally, sensors can be used to determine the position of one or more components.

[0006] Monitoring various components of a patient support device can include monitoring position, angle, movement, or other attributes. A caregiver may not be able to determine whether different components are out of compliance with a treatment operation protocol. The ability of a patient support device to automatically determine compliance can prevent potential harm to a patient. Thus, characterizing the components of a patient support device according to any treatment operation protocol communicated to a caregiver can provide improved care for the patient. SUMMARY OF THE INVENTION

[0007] The present invention includes one or more features recited in the appended claims and / or the following features, which alone or in any combination may constitute patentable subject matter.

[0008] According to a first aspect of the present invention, a patient support device includes a plurality of device components; a plurality of device component sensors located on the plurality of device components; a baseline operation protocol programmed on the patient support device; a user interface operable to program using a treatment operation protocol; and a control system including a controller in communication with the plurality of device component sensors, the controller being operable to determine whether the treatment operation protocol complies with the baseline operation protocol.

[0009] In some embodiments of the patient support device, the controller can act as a protocol conflict manager.

[0010] In one embodiment of the patient support device, if the control system determines that the treatment operation protocol does not comply with the baseline operation protocol, then the treatment operation protocol replaces the baseline operation protocol, and the control system is further operable to communicate with the plurality of device component sensors to ensure compliance with the treatment operation protocol.

[0011] In one embodiment of the patient support device, the compliance status of the patient support device with respect to the treatment operation protocol is projected onto the floor. In some embodiments of the patient support device, the plurality of device components are a plurality of bed rails, and the controller is operable to receive a separate signal from each of the plurality of device component sensors to determine whether each of the plurality of bed rails is up or down, and the controller is further operable to process the signals to determine compliance with the treatment protocol.

[0012] In one embodiment of the patient support device, the treatment operation protocol is a CLR (Continuous Lateral Rotation) protocol, and the baseline operation protocol includes a baseline bed rail protocol. In some embodiments, the CLR protocol includes having four bed rails in the up position, and the baseline bed rail protocol includes having two bed rails in the up position. In some embodiments, the CLR protocol replaces the baseline bed rail protocol, and if the patient support device does not comply with the CLR protocol, the controller projects a warning sign on the floor. In some embodiments, the warning sign is an indication that the patient support device does not comply with the CLR protocol.

[0013] In one embodiment of the patient support device, the CLR protocol replaces the baseline bed rail protocol, and wherein if the controller determines that the patient support device does not have four bed rails in the up position, the user interface displays a warning sign. In some embodiments, the CLR protocol includes determining the status of other components of the patient support device.

[0014] In one embodiment of the patient support device, the user interface is operable for manual or remote programming.

[0015] According to a second aspect of the present invention, a system includes a patient support device having a head end and a foot end; a plurality of patient support components; an indicator light located at the foot end; and a controller operable to communicate with the plurality of patient support components and the indicator light. The controller is operable to receive individual signals from each of the plurality of patient support components, process the signals to determine the position of each patient support component; and a user interface operable to be programmed using a baseline operation protocol and a treatment operation protocol.

[0016] In some embodiments of the system, the controller can function as a protocol conflict manager.

[0017] In one embodiment of the system, the controller is operable to process the signals to determine whether the treatment operation protocol complies with the baseline operation protocol. In some embodiments of the system, if the control system determines that the patient support device does not comply with the treatment operation protocol, the control system is further operable to communicate with the plurality of device component sensors to ensure compliance with the treatment operation protocol.

[0018] In one embodiment of the system, the indicator light projects the compliance status of the patient support device onto the floor, and wherein the compliance status is based on the treatment operation protocol.

[0019] In one embodiment of the system, the treatment operation protocol is the CLR protocol, and the user interface is operable to be programmed using the CLR protocol. In some embodiments, the CLR protocol replaces the baseline operation protocol, and wherein the CLR protocol includes having four bed rails in the up position. In some embodiments, the baseline operation protocol includes a bed rail protocol that includes having two bed rails in the up position.

[0020] In one embodiment of the system, if the controller determines that the patient support device does not have four bed rails in the up position, the user interface is operable to display a warning sign. In some embodiments, if the controller determines that the patient support device does not have four bed rails in the up position, an indication that the patient support device does not comply with the programmed bed rail protocol is projected onto the floor. In some embodiments, the CLR protocol further includes determining the status of other components of the patient support device.

[0021] In one embodiment of the system, the user interface is operable for manual or remote programming.

[0022] According to a second aspect of the present invention, a method includes monitoring the compliance of a support device with a treatment operation protocol. The method includes the steps of: inputting a baseline operation protocol into a user interface; monitoring signals from a plurality of device component sensors; processing, using a controller, the signals from the plurality of device component sensors, the device component sensors being located on a plurality of device components; determining the positions of a plurality of bed rails based on the signals from the plurality of device component sensors; and determining whether the positions of the plurality of bed rails comply with a patient protocol.

[0023] In one embodiment of the method, if the support device does not comply with the patient protocol, the method includes the controller communicating with the plurality of device component sensors to ensure compliance with the programmed patient protocol. In another embodiment of the method, the method includes automatically moving a part of the support device based on the signals from the device component sensors to ensure compliance with the patient protocol. In one embodiment of the method, the method includes projecting a compliance status of the support device onto the floor.

[0024] In some embodiments of the method, the controller can function as a protocol conflict manager.

[0025] In one embodiment of the method, the user interface is operable to be programmed using a CLR (Continuous Lateral Rotation) protocol. In some embodiments, the method includes the CLR protocol instead of a conventional bed rail protocol, and the CLR protocol includes having four bed rails in an upward position. In some embodiments, if the controller determines that the patient support device does not have four bed rails in the upward position, the method includes the user interface displaying a warning sign.

[0026] In one embodiment of the method, if the controller determines that the patient support device does not have four bed rails in the upward position, the method includes projecting an indication that the patient support device does not comply with the programmed bed rail protocol onto the floor. In one embodiment of the method, the user interface is operable to be programmed manually or remotely.

[0027] Additional features, which alone or in combination with any other feature(s) (such as those listed above and / or those listed in the claims) may constitute patentable subject matter, and which will become apparent to those skilled in the art after considering the following detailed description of various embodiments, which illustrate the best mode of implementing the presently perceived embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] The detailed description refers specifically to the drawings, in which:

[0029] Figure 1 is a perspective view of a patient support device according to the present invention, the patient support device including a control system operable to measure signals from a plurality of sensors and process those signals;

[0030] Figure 2 is a schematic diagram of a warning sign that is inconsistent with the patient bedrail protocol;

[0031] Figure 3 is Figure 1 a block diagram of a portion of the control system of the patient support device;

[0032] Figure 4 is a decision tree executed by the control system to determine whether the user interface has been programmed with a treatment operation protocol;

[0033] Figure 5 is an illustration of an embodiment of a display screen including a home icon, a stationary icon, a sleep data icon, a motion icon, and a help icon;

[0034] Figure 6 is an illustration of an embodiment of a display screen including a bedrail protocol icon;

[0035] Figure 7 is an illustration of an embodiment of a current bedrail protocol screen displayed when the bedrail protocol icon is activated;

[0036] Figure 8 is an illustration of an embodiment of an information screen when the CLR protocol information icon is activated;

[0037] Figure 9 is an illustration of an embodiment of a current bedrail protocol screen showing the selected CLR protocol icon;

[0038] Figure 10 is a schematic diagram of a bedrail state that is consistent with the treatment operation protocol. DETAILED DESCRIPTION

[0039] In Figure 1 is shown an illustrative patient support device 10 implemented as a hospital bed. Figure 1 The bed 10 has a frame 20 including a base frame 22 supported on casters 24. The fixed base frame 22 further supports a gravity frame 30, and an adjustable-position mattress support upper frame 34 further supports a mattress 18. The bed 10 also includes a headboard 12 at the head end 46 of the bed 10, a footboard 16 at the foot end 48 of the bed 10, and movable bedrails 14A-D coupled to the upper frame 34 of the bed 10. The bed 10 also includes a user interface 54 on one of the bedrails 14A-D. Figure 1The bed 10 of an embodiment is generally configured to position the upper frame 34 adjustably relative to the base frame 22 to adjust the position of a patient supported on the mattress 18.

[0040] Conventional structures and devices can be provided to position the upper frame 34 adjustably, and such conventional structures and devices can include, for example, linkages, actuators, and other motion members and devices coupled between the base frame 22 and the gravity frame 30 and / or between the gravity frame 30 and the upper frame 34. The position of the upper frame 34 and the mattress 18 relative to the base frame 22 or the gravity frame 30 is controlled, for example, via a patient control pendant 56 or a user interface 54. For example, the upper frame 34 can be adjustably positioned to be generally inclined from the head end 46 to the foot end 48, and vice versa. Additionally, the upper frame 34 can be adjustably positioned such that the head section 44 of the mattress 18 is positioned between a minimum and a maximum tilt angle (e.g., 0 - 65 degrees) relative to horizontal or the bed deck, and the upper frame 34 can also be adjustably positioned such that the seat portion (not shown) of the mattress 18 is positioned between a minimum and a maximum bend angle (e.g., 0 - 35 degrees) relative to horizontal or the bed deck. Those skilled in the art will recognize that the upper frame 34 or portions thereof can be adjustably positioned in other orientations, and such other orientations are also contemplated by the present invention.

[0041] One or more components of the patient support device can be communicated via icons 32 projected onto the floor and / or icons 33 illuminated on the frame members of the bed 10. Examples of structures for projecting the icon 32 onto the floor or illuminating the icon 33 on the frame are disclosed in WO2016196403A1 and US20180184984A1, each of which is incorporated herein by reference to disclose structures for projecting icons onto the floor. The projected icon 32 can be used to indicate whether a component of the patient support device 10 complies with a baseline operating protocol used by the patient. In some embodiments, the bed rail status of the patient support device 10 can be communicated via the icon 32 projected onto the floor. The projected icon 32 can be used to indicate whether the bed rails 14A - D of the patient support device 10 comply with the baseline operating protocol. A treatment operating protocol can be programmed into the user interface 54 by a caregiver or a user.

[0042] For example, the treatment operating protocol can be a CLR (Continuous Lateral Rotation) protocol, which requires raising all 4 bed rails 14A - D before the start of CLR. Currently, caregivers face significant challenges in caring for patients on a patient platform with pulmonary therapies. Many of these treatments include patient rotation. Rotation treatments typically include lateral rotation of the patient support device 10 for patients in need of pulmonary therapy or pressure ulcer prevention or treatment. The rotatable support surface generally includes the mattress 18 on the hospital bed 10, which is laterally rotated by an air support system when all bed rails 14A - D are in the up position. As Figure 2As shown, even if the patient support device 10 does not comply with the treatment operation protocol but complies with the baseline operation protocol, the projected icon 32 may not indicate a warning. Although the bed rail 14A is lowered, the projected icon 32 is a green sign indicating compliance. This effect may exist due to different requirements of the two simultaneously used protocols (the baseline protocol that defines the nominal hospital bed situation and the treatment protocol that is selectively applied only during treatment). The present invention solves the management of inconsistent requirements of simultaneously active protocols.

[0043] In Figure 3 In an illustrative embodiment diagrammatically shown in, the bed 10 has a control system 26, which includes a controller 28, a scale module 50, a component module (such as a bed rail module 52), and a user interface 54. The bed 10 can communicate with the hospital information system 36 via the communication infrastructure 110. The scale module 50 of the bed 10 is used to measure the movement of a patient occupying the bed 10 by measuring signals from load sensors 66, 68, 70, 72. The bed rail module 52 of the bed 10 is used to determine the operation of the bed rails 14A-D by measuring signals from sensors 82, 84, 86, 88.

[0044] In the illustrative embodiment, each of the controller 28, the scale module 50, the component module (such as the bed rail module 52), and the user interface 54 includes a processor 62 and a storage device 64. The processor 62 and the storage device 64 are used in the controller 28, the scale module 50, the bed rail module 52, and the user interface 54. The storage device 64 includes instructions that, when executed by the processor 62, cause the processor 62 to perform functions associated with a specific one of the controller 28, the scale module 50, the bed rail module 52, and the user interface 54.

[0045] In some embodiments, the treatment operation protocol may require changing the positions of more than one component of the bed 10 (such as the bed rails 14A-D, the head end 48, etc.). For example, the treatment operation protocol may require all the bed rails 14A-D to be in a specific position, or require the head end 46 to be at a specific angle. As Figure 4As shown, in step 112, the controller 28 is operable to act as a protocol conflict manager to execute a decision tree to determine whether the user interface 54 has been programmed with a treatment operation protocol. If the user interface 54 has been programmed with a treatment operation protocol, then in step 116, the treatment operation protocol will replace the baseline operation protocol. Then, in step 118, the controller 28 is operable to identify components of the bed 10 (such as bed rails 14A-D, head end 48, etc.) that require a different orientation in the treatment operation protocol compared to the baseline operation protocol. Then, in step 120, the controller 28 is operable to communicate with sensors (such as sensors 82, 84, 86, 88) in the identified component modules of the bed 10 (such as the bed rail module 52) to determine whether they comply with the treatment operation protocol.

[0046] If it is determined in step 122 that the components of the bed 10 (such as bed rails 14A-D, head end 48, etc.) comply with the treatment operation protocol, then no warning or alert is issued in step 124. If it is determined in step 122 that the components of the bed 10 (such as bed rails 14A-D, head end 48, etc.) do not comply with the treatment operation protocol, then a warning or alert is issued in step 126. If in step 112 the controller 28 determines that the user interface 54 has not been programmed with a treatment operation protocol, then in step 114 the controller 28 is operable to determine whether the components of the bed 10 (such as bed rails 14A-D, head end 48, etc.) comply with the baseline operation protocol. If it is determined in step 114 that the components of the bed 10 (such as bed rails 14A-D, head end 48, etc.) comply with the baseline operation protocol, then no warning or alert is issued in step 124. If it is determined in step 114 that the components of the bed 10 (such as bed rails 14A-D, head end 48, etc.) do not comply with the baseline operation protocol, then a warning or alert is issued in step 126.

[0047] The components of the control system 26 communicate with each other to share information and allocate functions of the bed 10. The processors 62 of each of the controller 28, the scale module 50, the component modules (such as the bed rail module 52), and the user interface 54 are also operable based on instructions from the storage device 64 to communicate with other modules in the controller 28, the scale module 50, the component modules (such as the bed rail module 52), and the user interface 54 using a communication protocol. It should be understood that the term processor here includes any microprocessor, microcontroller, processor circuit, control circuit, pre-programmed device, or any structure capable of accessing a storage device and executing non-transitory instructions to perform the tasks, algorithms, and processes of the present invention. In an illustrative embodiment, the control system 26 employs a conventional Controller Area Network (CAN) for communication between subsystems, but it should be understood that any one of a variety of networking and communication solution protocols can be employed in the control system 26.

[0048] Return referenceFigure 3 , the bed rail module 52 is a functional controller for the bed rails 14A-D and includes a processor 62 and a storage device 64. The processor 62 communicates with the bed rails 14A-D. The sensor assembly 60 includes individual sensors for determining the position of each of the bed rails 14A-D. Signals from sensors 82, 84, 86, and 88 are used to determine the position of the bed rails 14A-D and to make inferences regarding compliance with any patient bed rail protocols that the user may have entered on the patient interface 54. Such determination will enhance patient safety and provide a more adequate and accurate analysis of the patient's condition related to the patient support device. Additionally, the bed 10 can record the presence of treatment operation protocols and send data to the electronic medical record. As Figure 2 shown, the treatment operation protocol can be indicated on the user interface 54. The display screen 94 can include a status board 98 that indicates whether the treatment has been stopped due to non-compliance with the treatment operation protocol. The status board 98 can contain additional information.

[0049] The display screen 94 of the user interface 54 can include more than one input icon. As Figure 5 shown, the main screen 132 on the display screen 94 includes a main icon 134, an up arrow icon 136, a balance icon 138, a physiology icon 140, and a settings icon 142. When any icon is activated, the controller 28 receives a user input command from the graphical display screen 94. Based on the user input command on the display 94 and the data processed by the processor 62, the controller 28 controls various functions of the bed 10, such as the pneumatic system and / or raising or lowering different parts of the bed 10. In some embodiments, based on the user input command on the display 94 and the data processed by the processor 62, the controller 28 controls the functions of one or more actuators in the bed 10. In some embodiments, based on the user input command on the display 94 and the data processed by the processor 62, the controller 28 controls the functions of the bed rails 14A-D.

[0050] As Figure 6 shown, when the caregiver activates the settings icon 142, the controller 28 prompts the caregiver to select bed features on the feature screen 146. As Figure 7 shown, the caregiver can activate the bed rail protocol icon 144 (shown in Figure 6 ) to cause the controller 28 to bring up the current bed rail protocol screen 148. The current bed rail protocol screen 148 of the user interface 54 can list different treatment operation protocols that require certain bed rail 14A-D positions, including the CLR protocol. The current bed rail protocol screen 148 includes a CLR protocol information icon 152 that the caregiver can activate to cause the controller 28 to display the information about the CLR protocol shown on the information screen 156 in Figure 8 . Selecting the "Yes" icon 158 on the information screen 156 activates the CLR protocol. Refer toFigure 9 When the caregiver activates the "Yes" icon 158 on the information screen 156, the CLR protocol icon 150 on the current bed rail protocol screen 148 is selected. The controller 28 is operable to recognize the CLR protocol as a treatment operation protocol in place of any baseline operation protocol. The caregiver can activate the "Accept" icon on the current bed rail protocol screen 148 to confirm the selection of the CLR protocol.

[0051] Figure 10 The figure shows that if the controller 28 is operable to determine that a treatment operation protocol replaces a baseline operation protocol, the projected icon 32 can indicate a bed rail status indicating that the bed 10 does not conform to the treatment operation protocol. In Figure 10 where 14A is lowered, the projected icon 32 does not indicate conformity.

[0052] Although the present invention relates to specific embodiments, those skilled in the art will understand that various changes may be made in form and detail without departing from the subject matter set forth in the appended claims.

Claims

1. A patient support device, comprising: A plurality of device components, A plurality of device component sensors located on the plurality of device components, A baseline operation protocol programmed on the patient support device, A user interface that can be operated to program using a treatment operation protocol, and A control system, the control system including a controller in communication with the plurality of device component sensors, the controller being operable to determine whether the treatment operation protocol complies with the baseline operation protocol, Wherein the treatment operation protocol is a continuous lateral rotation (CLR) protocol, and the baseline operation protocol includes a baseline bed rail protocol, and Wherein the CLR protocol includes having four bed rails in the upward position, and the baseline bed rail protocol includes having fewer than four bed rails in the upward position.

2. The patient support device according to claim 1, wherein, If the control system determines that the treatment operation protocol does not comply with the baseline operation protocol, the treatment operation protocol replaces the baseline operation protocol, and the control system is further operable to communicate with the plurality of device component sensors to ensure compliance with the treatment operation protocol.

3. The patient support device according to claim 1, wherein, The compliance status of the patient support device with respect to the treatment operation protocol is projected on the floor.

4. The patient support device according to claim 1, wherein the plurality of device components are a plurality of bed rails, and wherein the controller is operable to receive a separate signal from each of the plurality of device component sensors to determine whether each bed rail of the plurality of bed rails is up or down, and the controller is further operable to process the signals to determine compliance with the treatment protocol.

5. The patient support device according to claim 1, the CLR protocol replacing the baseline bed rail protocol, and wherein if the patient support device does not comply with the CLR protocol, the controller projects a warning sign on the floor.

6. The patient support device according to claim 5, wherein the warning sign is an indication that the patient support device does not comply with the CLR protocol.

7. The patient support device according to claim 1, the CLR protocol replacing the baseline bed rail protocol, and wherein if the controller determines that the patient support device does not have four bed rails in the upward position, the user interface displays a warning sign.

8. The patient support device according to claim 1, wherein the CLR protocol includes determining the status of other components of the patient support device.

9. The patient support device according to claim 1, wherein the user interface is operable for manual or remote programming.

10. A system, comprising: A patient support device, the patient support device including a head end and a foot end, A plurality of patient support components, An indicator light located at the foot end, and A controller, the controller being operable to communicate with the plurality of patient support components and the indicator light, the controller being operable to receive a separate signal from each of the plurality of patient support components to process the signals to determine the position of each patient support component, and A user interface, the user interface being operable to be programmed using a baseline operation protocol and a treatment operation protocol.

11. The system according to claim 10, wherein the controller is operable to process the signal to determine whether the treatment operation protocol complies with the baseline operation protocol.

12. The system according to claim 10, wherein, If the control system determines that the patient support device does not comply with the treatment operation protocol, the control system is further operable to communicate with the plurality of device component sensors to ensure compliance with the treatment operation protocol.

13. The system according to claim 10, wherein the indicator projects the compliance status of the patient support device onto the floor, and wherein the compliance status is based on the treatment operation protocol.

14. The system according to claim 10, wherein the treatment operation protocol is a Continuous Lateral Rotation (CLR) protocol, and wherein the user interface is operable to be programmed using the CLR protocol.

15. The system according to claim 14, wherein the CLR protocol replaces the baseline operation protocol, and wherein the CLR protocol includes having four bed rails in the upward position.

16. The system according to claim 15, wherein the baseline operation protocol includes a bed rail protocol, the bed rail protocol including having fewer than four bed rails in the upward position.

17. The system according to claim 16, wherein If the controller determines that the patient support device does not have four bed rails in the upward position, the user interface is operable to display a warning sign.

18. The system according to claim 16, wherein, If the controller determines that the patient support device does not have four bed rails in the upward position, an indication that the patient support device does not comply with the programmed bed rail protocol is projected onto the floor.

19. The patient support device according to claim 15, wherein the CLR protocol further includes determining the status of other components of the patient support device.

20. The system according to claim 10, wherein the user interface is operable to perform manual or remote programming.

21. A method of monitoring the compliance of a support device with a treatment operation protocol, the method comprising the steps of: Inputting a baseline operation protocol into a user interface, Monitoring signals from a plurality of device component sensors, Processing the signals from the plurality of device component sensors using a controller, wherein the device component sensors are located on a plurality of device components, Determining the positions of a plurality of bed rails based on the signals from the plurality of device component sensors, and Determining whether the positions of the plurality of bed rails comply with a patient protocol.

22. The method according to claim 21, wherein If the support device does not comply with the patient protocol, the method includes the controller communicating with the plurality of device component sensors to ensure compliance with the programmed patient protocol.

23. The method according to claim 22, wherein the method includes automatically moving a portion of the support device based on the signals from the device component sensors to ensure compliance with the patient protocol.

24. The method according to claim 21, wherein the method includes projecting the compliance status of the support device onto the floor.

25. The method according to claim 21, wherein The user interface is operable to be programmed using a Continuous Lateral Rotation (CLR) protocol.

26. The method according to claim 25, wherein, The method includes the CLR protocol instead of the conventional 27. The method according to claim 26, wherein, If the controller determines that the patient support device does not have four bed rails in the up position, the method includes the user interface displaying a warning sign.

28. The method according to claim 26, wherein If the controller determines that the patient support device does not have four bed rails in the up position, the method includes projecting an indication that the patient support device does not conform to the programmed bed rail protocol onto the floor.

29. The method according to claim 21, wherein the user interface is operable to be programmed manually or remotely.

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