Local area communication of emergency alerts

Abstract

An example system includes an implantable medical device (IMD) configured to: sense physiological data; detect an acute health event based on the physiological data; and transmit a universal unique identifier (UUID) advertisement, according to a short-range wireless protocol, in response to the acute health event; a computing device configured to: in response to receipt of the UUID advertisement, transmit a protocol message to a central controller; and receive a request from the central controller to generate a communication path between the central controller and the IMD via the computing device. The computing device is configured to connect to the central controller via a network connection and configured to connect to the IMD via the short-range wireless protocol. In response to generation of the communication path, the IMD is configured to transmit an indication of the acute health event or the physiological data to the central controller via the communication path.

Description

LOCAL AREA COMMUNICATION OF EMERGENCY ALERTS

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 610,270, filed December 14, 2023, the entire content of which is incorporated herein by reference.FIELD

[0002] This disclosure generally relates to systems including medical devices and, more particularly, to monitoring of patient health using such systems.BACKGROUND

[0003] A variety of devices are configured to monitor physiological signals of a patient. Such devices include implantable medical devices (IMD). The physiological signals sensed by such devices include as examples, electrocardiogram (ECG) signals, respiration signals, perfusion signals, activity and / or posture signals, pressure signals, blood oxygen saturation signals, body composition, and blood glucose or other blood constituent signals. In general, using these signals, such devices facilitate monitoring and evaluating patient health over a number of months or years, outside of a clinic setting.

[0004] In some cases, such devices are configured to detect acute health events based on the physiological signals, such as episodes of cardiac arrhythmia, myocardial infarction, stroke, or seizure. Example arrhythmia types include cardiac arrest (e.g., asystole), ventricular tachycardia (VT), and ventricular fibrillation (VF). The devices may store ECG and other physiological signal data collected during a time period including an episode as episode data. Such acute health events are associated with significant rates of death, particularly if not treated quickly.

[0005] For example, VF and other malignant tachyarrhythmias are the most commonly identified arrhythmia in sudden cardiac arrest (SCA) patients. If this arrhythmia continues for more than a few seconds, it may result in cardiogenic shock and cessation of effective blood circulation. The survival rate from SCA decreases between 7 and 10 percent for every minute that the patient waits for defibrillation. Consequently, sudden cardiac death (SCD) may result in a matter of minutes.SUMMARY

[0006] In general, the disclosure describes techniques for establishing a communication path between an IMD and a central controller via a computing device when the IMD detects an acute health event. For example, a patient computing device intended for communicating with the IMD may not be able to receive communications from the IMD and / or send communications to central controller leaving the IMD unable to communicate with the central controller. Generating a communication path between an IMD and a central controller via another computing device (other than the intended patient computing device) may provide necessary communication between an IMD and central controller during the direst moments, such as when a patient has an acute health event and when the patient computing device is unable to receive communications from IMD and / or send communications to a central controller. The generation of the communication path in accordance with techniques described herein may help an IMD communicate with a central controller to send outputs for emergency services and / or emergency treatment of patients suffering from an acute health event when the intended patient computing device is unable to receive communications from the IMD and / or send communications to central controller. Furthermore, computing devices may be able to generate communication path(s) as described herein in response to receipt of advertisement signals and a request from the central controller, providing effective emergency communication between the IMD and central controller via the computing device without requiring significant specialized configuration of the computing device or use of specialized messaging between the IMD and computing device.

[0007] In one example, this disclosure describes a system comprising: an implantable medical device (IMD) configured to: sense physiological data of a patient; detect an acute health event of the patient based on the sensed physiological data; and transmit a universal unique identifier (UUID) advertisement, according to a short-range wireless protocol, in response to detection of the acute health event; a computing device configured to: receive the UUID advertisement; in response to receipt of the UUID advertisement, transmit a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; and receive a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the computing device is configured to connectto the central controller via a network connection and the computing device is configured to connect to the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; wherein, in response to generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0008] In another example, this disclosure describes a method for operating a system comprising an implantable medical device (IMD) to responds an acute health event, the method comprising: sensing, by the IMD, physiological data of a patient; detecting, by the IMD, the acute health event of the patient based on the sensed physiological data; transmitting, by the IMD, a universal unique identifier (UUID) advertisement, according to a short-range wireless protocol, in response to detection of the acute health event; receiving, by a computing device, the UUID advertisement; in response to receipt of the UUID advertisement, transmitting, by the computing device, a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; receiving, by the computing device, a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the computing device is configured to connect to the central controller via a network connection and the computing device is configured to connect to the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; and in response to generation of the communication path, transmitting, by the IMD, one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0009] In another example, this disclosure describes a computing device comprising: communication circuitry; and processing circuitry configured to: receive, via the communication circuitry, a UUID advertisement transmitted by an implantable medical device (IMD) according to a short-range wireless protocol, the UUID advertisement transmitted by the IMD in response to detection of an acute health event of a patient based on physiological data of the patient sensed by the IMD; in response to receipt of the UUID advertisement, control the communication circuitry to transmit a protocol message to a central controller, the protocol message comprising an indication that the computingdevice received the UUID advertisement; receive, via the communication circuitry, a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the processing circuitry is configured to control the communication circuitry to connect the to the central controller via a network connection and the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; and in response to receipt of the request, generate the communication path between the central controller and the IMD via the computing device, wherein, in response to generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0010] The summary is intended to provide an overview of the subject matter described in this disclosure. It is not intended to provide an exclusive or exhaustive explanation of the systems, device, and methods described in detail within the accompanying drawings and description below. Further details of one or more examples of this disclosure are set forth in the accompanying drawings and in the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims.BRIEF DESCRIPTION OF DRAWINGS

[0011] FIGS. 1A-1B are block diagrams illustrating an example system configured detect acute health events of a patient, and to respond to such detections, in accordance with one or more techniques of this disclosure.

[0012] FIG. 2 is a block diagram illustrating an example configuration of an implantable medical device that operates in accordance with one or more techniques of the present disclosure.

[0013] FIG. 3 is block diagram illustrating an example configuration of a computing device that operates in accordance with one or more techniques of the present disclosure.

[0014] FIG. 4 is a block diagram illustrating an example configuration of a health monitoring system that operates in accordance with one or more techniques of the present disclosure.

[0015] FIG. 5 is a flowchart illustrating examples of the techniques of the present disclosure.

[0016] Like reference characters refer to like elements throughout the figures and description.DETAILED DESCRIPTION

[0017] A patient with an IMD may have an acute health event, such as sudden cardiac arrest, stroke, acute myocardial infarction, or anaphylactic shock, and become incapacitated. In some systems, an IMD may detect the acute health event in the patient and send a notification of the acute health event to a computing device of the patient, such as a phone or smart watch, that has been configured, e.g., with a software application, for communication with the IMD. The patient computing device may then contact a first responder via a network connection through WiFi or a cellular network.

[0018] An acute health event could, however, occur while a patient computing device does not have network access, such as the power is off, the patient computing device is out of range of the IMD, the network access has been disabled, or the patient computing device is in a structure and / or location where network access is unavailable. Without the ability to communicate with the IMD or access a network, the patient computing device may not be able to convey that an acute health event occurred, such as contacting an emergency service, such as 911, to obtain medical help.

[0019] This disclosure describes techniques for configuring an IMD of the patient to transmit a universal unique identifier (UUID) advertisement in response to detecting an acute health event to ultimately generate an authenticated communication path between a central controller and the IMD via computing device(s) nearby the IMD, which may be different than the patient computing device generally used to communicate with the IMD. In some examples, the UUID advertisement may be received by one or more nearby computing device(s). The UUID advertisement may comprise (e.g., act as) an indication that the IMD detected an acute health event. In some examples, the UUID advertisement may be defined with a particular communication protocol such that any device that is compatible with that particular communication protocol is able to understand the UUID advertisement. The computing device(s) is configured to transmit a protocol message to a central controller in response to receiving the UUID advertisement. The protocol messagecomprises an indication that the computing device(s) received the UUID advertisement. In some examples, the protocol message may be defined with a particular communication protocol such that any device that is compatible with that particular communication protocol is able to understand the protocol message. In response to receipt of the protocol message, the central controller is configured to send a request to computing device(s) to generate a communication path between the central controller and the IMD via the computing device(s), such as a two-way communication path between the IMD and the central controller via the computing device(s). In response to the generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0020] The generated communication path between the central controller and the IMD via computing device(s) provides an improved authenticated communication path between the IMD and central controller when a patient computing device is unable to communicate as intended in response to acute event detection, such as when the patient computing device is unable to communicate with one or more of the IMD or the central controller.For example, the patient computing device being powered off, being out of range of the IMD or the patient computing device not having network access to communicate with the central controller. The generated communication path provides necessary secure communication between an IMD and a central controller in times of emergency when an IMD may not be able to communicate with a central controller securely because a patient computing device is not able to communicate via a network. The generation of the communication path between the central controller and the IMD via computing device(s) may enable the IMD to communicate with central controller expeditiously to enable emergency assistance to be provided to the patient having the acute health event as soon as possible. The emergency assistance may include treatment of the acute health event. Treating the acute health event as soon as possible may lead to improved treatment results and potentially decrease significant consequences of the acute health event on the patient, such as, but not limited to, death.

[0021] A variety of types of IMDs or wearable devices may be configured to detect arrhythmia episodes and other acute health events based on sensed ECGs and, in some cases, other physiological signals. Such IMDs may facilitate relatively longer-termmonitoring of patient health during normal daily activities. IMDs may also sense and monitor ECGs and other physiological signals, and detect acute health events such as episodes of arrhythmia, cardiac arrest, myocardial infarction, stroke, and seizure.Example IMDs include pacemakers and implantable cardioverter-defibrillators, which may be coupled to intravascular or extravascular leads, as well as pacemakers with housings configured for implantation within the heart, which may be leadless. Some IMDs do not provide therapy, such as implantable patient monitors. One example of such an IMD is the Reveal LINQ™ Insertable Cardiac Monitor (ICM) or the LINQ II™ ICM, available from Medtronic, Inc., which may be inserted subcutaneously. Such IMDs may facilitate relatively longer-term monitoring of patients during normal daily activities, and may periodically transmit collected data, e.g., episode data for detected arrhythmia episodes, to a remote patient monitoring system, such as the Medtronic Carelink™ Network. In some examples, a system may include a plurality of IMDs in which a first IMD of the plurality of IMDs is configured to sense physiological data and / or detect an acute health event based on the sensed physiological data. In some examples, in response to the detection of an acute health event, the first IMD of the plurality of IMDs may send an alert to a second IMD of the plurality of IMDs, such as via, but not limited to, intrabody communication and / or tissue conductive communication, to cause the second IMD to transmit an UUID advertisement, such as described in examples below. The second IMD being different than the first IMD.

[0022] FIGS. 1A-1B are block diagrams illustrating an example system 2 configured detect acute health events of a patient 4, and to respond to such detection, in accordance with one or more techniques of this disclosure. As used herein, the terms “detect,” “detection,” and the like may refer to detection of an acute health event presently (at the time the data is collected) being experienced by patient 4, as well as detection based on the data that the condition of patient 4 is such that they have a suprathreshold likelihood of experiencing the event within a particular timeframe, e.g., prediction of the acute health event. In some examples, the acute health event may be referred to as an emergency health event. In some examples, the IMD 10 may be in wireless communication with a patient computing device 12 when the patient computing device 12 is powered on and has network access. Although not illustrated in FIGS. 1A-1B, IMD 10 may include electrodesand other sensors to sense physiological signals of patient 4, and may collect and store sensed physiological data based on the signals and detect episodes based on the data.

[0023] IMD 10 may be configured to transmit a UUID advertisement 11, according to a short-range wireless protocol, in response to detecting an acute health event. In some examples, the short-range wireless protocol may include Bluetooth®, Bluetooth® Low Energy (BLE), or other wireless communication protocols. In some examples, UUID advertisement 11 may not be a proprietary, patient-specific message but rather would be a signal that another smart computing device that is not directly associated with the IMD 10 may be capable of understanding as an emergency condition. In some examples, the UUID advertisement 11 may include one or more of an indication that an acute health event has occurred, an indication of the time of the event, and / or an indication or identifier that the IMD 10 is a device that is to be monitored by a remote patient monitoring system, such as the Medtronic Carelink™ Network. In some examples, the UUID advertisement 11 includes an emergency identifier that indicates the IMD 10 sensed an acute health event that necessitates an emergency response. In some examples, the UUID advertisement 11 may not include information of the detected acute health event. In some examples, the UUID advertisement 11 includes identifying information of central controller 20 to indicate to the computing device(s) 14 to transmit protocol message 15 to the central controller 20, such as an identifiers and / or an address of the central controller 20.

[0024] In various implementations of the techniques described herein, IMD 10 may be configured to broadcast the UUID advertisement 11 at least within a variety of different ranges, such as within a range of at least 150 meters of IMD 10, within a range of at least 40 meters of IMD 10, within a range of at least 275 meters of IMD 10, within a range of at least 125 meters of IMD 10, within a range of at least 15 meters of IMD 10, or at least within a range of 1-100 meters of IMD 10. In some examples, IMD 10 may be configured to broadcast the UUID advertisement 11 up to a range limited by a particular wireless communication protocol used to broadcast the UUID advertisement 11.

[0025] In some examples, IMD 10 may be implanted outside of a thoracic cavity of patient 4 (e.g., subcutaneously in the pectoral location illustrated in FIGS. 1A-1B). IMD 10 may be positioned near the sternum near or just below the level of the heart of patient 4, e.g., at least partially within the cardiac silhouette. In some examples, IMD 10 takes the form of the LINQ™ ICM. Although described primarily in the context of examples inwhich IMD 10 takes the form of an ICM, the techniques of this disclosure may be implemented in systems including any one or more implantable or external medical devices, including monitors, pacemakers, defibrillators, wearable external defibrillators, neurostimulators, drug pumps, wearable devices, or other such devices. Furthermore, although described primarily in the context of examples including a single implanted patient sensing device, in some examples a system includes one or more patient sensing devices, which may be implanted within patient 4 or external to (e.g., worn by) patient 4.

[0026] Patient computing device 12 may be configured for wireless communication with IMD 10. Patient computing device 12 retrieve or receive event data and other sensed physiological data from IMD 10 that was collected and stored by the IMD 10. In some examples, computing device 12 may take the form of personal computing devices of patient 4. For example, patient computing device 12 may take the form of a smartphone of patient 4. In some examples, patient computing device 12 may be any computing device configured for wireless communication with IMD 10, such as a desktop, laptop, smart watch, or tablet computer. Patient computing devices 12 may communicate with IMD 10 according to the Bluetooth®, Bluetooth® Low Energy (BLE), or other wireless communication protocols, as examples. In some examples, patient computing device 12 may be configured to receive an indication of an acute health event of patient 4 from IMD 10.

[0027] One or more computing devices, such as 14A, 14B, 14C, 14D, 14E, 14F, (collectively computing device(s) 14) the form of personal computing devices of bystanders other than the patient 4. For example, each of the computing device(s) 14 may take the form of a smartphone of respective bystander. In some examples, computing devices 14 may be any computing device configured for wireless communication, such as a desktop, laptop, tablet computer, smart watch, smart home device, other smart devices, or internet of things. IMD 10 may be configured to communicate with computing device(s) 14 according to short-range wireless protocols, such as Bluetooth®, Bluetooth® Low Energy (BLE), or other short-range wireless communication protocols, as examples. Central controller 20 may be configured to communicate with computing device(s) 14 via a network 16 connection.

[0028] In some examples, such as shown in FIG. 1A, computing device(s) 14 may be configured to receive the UUID advertisement 11 and transmit a protocol message 15 tocentral controller 20 via network 16. In some examples, the protocol message 15 may include an indication that the respective computing device 14 received a UUID advertisement 11. In some examples, the protocol message 15 does not include the UUID advertisement 11 and / or does not include any of the information in the UUID advertisement 11. In some examples, the protocol message 15 may include an identifier of the respective computing device 14 with information on the type of service, such as a genetic service identifier. In some examples, the protocol message 15 may include registration information, such as credential or tokens, of the respective computing device 14 with the central controller 20 to establish a trust relationship between the central controller 20 and the respective computing device 14 to enable a communication path between the IMD 10 and the central controller 20 via the respective computing device 14 be established. In some examples, the protocol message 15 may include an indication of a geolocation. For example, the indication of geolocation may include one or more of a geolocation of the respective computing device 14 that sent the protocol message 15, a geolocation of the IMD 10, and / or a geolocation of the computing device 14 when it receives the UUID advertisement 11. In some examples, the protocol message 15 may not include contents of the UUID advertisement 11. In some examples, computing device(s) 14 may have a prior knowledge that the UUID advertisement 11 is intended for emergency communication sessions for the purpose of generating a communication between an IMD and central controller to relay medical information. In some examples, UUID advertisement 11 may be a universal, standard message, such that any smart device, such as computing device(s) 14, may be configured to aide in an acute health event, either as a transmitter and / or receiver of information related to the acute health event.

[0029] One or more of computing devices 14 may be configured to communicate with a variety of other devices or systems via a network 16. For example, one or more of computing devices 14 may be configured to communicate with central controller 20 via network 16. Central controller 20 may be respectively managed by manufacturers of IMD 10 to, for example, provide cloud storage and analysis of collected data, maintenance and software services, or other networked functionality for their respective devices and users thereof. Central controller 20 may comprise, or may be implemented by, the Medtronic Carelink™ Network, in some examples. In the example illustrated by FIGS. 1A-1B, central controller 20 may implement a health monitoring system (HMS) 22.

[0030] Central controller 20 may be configured to receive protocol message 15 from computing device(s) 14 via network 16. In response to receiving protocol message 15, central controller 20 may be configured to send a request 17 to computing device(s) 14, such as, but not limited to, the computing device 14 that sent the protocol message 15, to generate a communication path between the central controller 20 and the IMD 10 via computing device(s) 14. In some examples, the generated communication path is a two- way communication path between the IMD 10 and the central controller 20 via the computing device(s) 14. In some examples, central controller 20 may determine which computing device(s) 14 to send a request to generate a communication path with IMD 10 based on a particular distance the computing device 14 that sent the protocol message is from the other computing device(s) 14. For example, such as the other computing device(s) being within 150 meters of the computing device 14 that sent the protocol message. For example, as shown in FIG 1A, computing devices 14B and 14C each received the UUID advertisement 11 from IMD 10 and each of computing devices 14B and 14C sent a protocol message 15 to central controller 20 via network 16. As shown in FIG. IB, central controller 20 sends a request 17 via network 16 to computing devices 14B and 14C, that sent the protocol message 15, and also determines to send a request to computing devices 14A, 14E, and 14F based on computing device 14A being within a distance threshold XI of computing device 14B and computing devices 14E, 14F being within a distance threshold X2 of computing device 14C. In some examples, a distance threshold may be up 100 meters. In some examples, a distance threshold may be up to 150 meters. In some examples, a distance threshold may be up to 200 meters. In some examples, request 17 may not be sent to computing device(s) 14 that are not within a distance threshold of a computing device 14 that sent the protocol message 15. In some examples, central controller 20 may include hardware components such as those of a server and / or computing device 14, embodied in one or more physical devices.

[0031] In response to the generation of the communication path between the central controller 20 and the IMD 10 via computing device(s) 14, IMD 10 may be configured to transmit one or more of an indication of the detected acute health event and / or the sensed physiological data to the central controller 20 via the generated communication path between the central controller 20 and the IMD 10 via computing device(s) 14. The generated communication path between the central controller 20 and the IMD 10 viacomputing device(s) 14 provides an improved authenticated communication path between the IMD 10 and central controller 20 when a patient computing device 12 is not able to access the network 16 in times of emergency. The techniques to provide the improved authenticated communication path provides improved security of sensitive data, such as patient 4 medical data and / or patient 4 personal data, that is being sent between the IMD 10 and central controller 20 through computing device(s) 14 while also generating the authenticated communication path quick enough to enable emergency assistance be provided to patient 4 to help treat the acute health event as soon as possible, which may lead to improved treatment results and potentially decrease significant consequences of the acute health event, such as death. The generation of the authenticated communication path may enable sensitive patient data to be sent from the IMD 10 to the central controller 20 via the computing device 14 while keeping the patient data secure from users of the computing device(s) 14.

[0032] In response to the generation of the communication path between the central controller 20 and the IMD 10 via computing device(s) 14, IMD 10 may transmit data to central controller 20. The data may include sensed data, e.g., values of physiological parameters measured by IMD 10 and, in some cases previously sensed by patient computing device 12, data regarding episodes of arrhythmia or other acute health events detected by IMD 10, and other physiological signals or data recorded by IMD 10. HMS 22 may also retrieve data regarding patient 4 from one or more sources of electronic health records (EHR) 24 via network. EHR 24 may include data regarding historical (e.g., baseline) physiological parameter values, previous health events and treatments, disease states, comorbidities, demographics, height, weight, and body mass index (BMI), as examples, of patients including patient 4. HMS 22 may use data from EHR 24 to configure algorithms implemented by IMD 10 to detect acute health events for patient 4.

[0033] Network 16 may include one or more computing devices, such as one or more non-edge switches, routers, hubs, gateways, security devices such as firewalls, intrusion detection, and / or intrusion prevention devices, servers, cellular base stations and nodes, wireless access points, bridges, cable modems, application accelerators, or other network devices. Network 16 may include one or more networks administered by service providers, and may thus form part of a large-scale public network infrastructure, e.g., the Internet. Network 16 may provide computing devices and systems, such as thoseillustrated in FIGS. 1A-1B, access to the Internet, and may provide a communication framework that allows the computing devices and systems to communicate with one another. In some examples, network 16 may include a private network that provides a communication framework that allows the computing devices and systems illustrated in FIGS. 1A-1B to communicate with each other, but isolates some of the data flows from devices external to the private network for security purposes. In some examples, the communications between the computing devices and systems illustrated in FIGS. 1A-1B are encrypted.

[0034] As will be described herein, IMD 10 may be configured to detect acute health events of patient 4 based on data sensed by IMD 10 and, in some cases, other data, such as data sensed by patient computing device 12, and data from EHR 24. In response to detection of an acute health event, IMD 10 may attempt to wirelessly transmit an indication of the acute health event, such as a message, to patient computing device 12. The message may indicate that IMD 10 detected an acute health event of patient 4 and may include a request for an indication from patient computing device 12 that the message including the acute health event has been received and that the patient computing device 12 has network 16 access. In some examples, if the IMD 10 does not receive an indication for a period of time (e.g., examples of the period of time being up to 5 seconds, up to 10 seconds, up to 15 seconds, up to 30 seconds, or up to 1 minute) from computing device 12 that the message indicating the acute health event has been received and that the patient computing device 12 has network 16 access, IMD 10 may transmit UUID advertisement(s) 11. In some examples, IMD 10 may transmit UUID advertisement(s) 11 in response to IMD 10 detecting an acute health event.

[0035] In response to the generation of the communication path between central controller 20 and IMD 10 via computing device(s) 14, IMD 10 may send one or more of an indication of the detected acute health event and / or the sensed physiological data of patient 4 to central controller 20 via the generated communication path. The sensed physiological data may include physiological data collected by IMD 10, e.g., data which lead to detection of the acute health event, data prior to detection of the acute health event, and / or real-time or more recent data collected after detection of the acute health event.The sensed physiological data may include values of one or more physiological parameters and / or digitized physiological signals. Some examples of acute health eventsare cardiac arrest, ventricular fibrillation, ventricular tachycardia, myocardial infarction, pause in heat rhythm (asystole), pulseless electrical activity (PEA), acute respiratory distress syndrome (ARDS), stroke, seizure, fall, anaphylactic shock, or respiratory failure.

[0036] In some examples, in response to receiving the UUID advertisement 11 from IMD 10, computing device(s) 14 may also output an alarm that may be visual and / or audible, and configured to immediately attract the attention of patient 4 or any person nearby patient 4 within environment 28. In some examples, after the communication path between the central controller 20 and the IMD 10 via the computing device 14 is generated and IMD 10 sends one or more of an indication of the detected acute health event and / or the sensed physiological data of patient 4 to central controller 20 via the generated communication path, computing device(s) 14 may receive a trigger signal from central controller 20 to output an alarm that may be visual and / or audible, and configured to immediately attract the attention of patient 4 or any person nearby patient 4.

[0037] Environment 28 includes computing facilities, e.g., a local network 32, by which IMD 10, patient computing device 12, computing device(s) 14, and / or other devices within environment 28 may communicate via network 16, e.g., with central controller 20, HMS 22 or with other devices on local network 32. For example, environment 28 may be configured with wireless technology, such as 802.11 wireless networks, 802.15 ZigBee networks, an ultrawideband protocol, near- filed communication, or the like. Environment 28 may include one or more wireless access points, e.g., wireless access points 34A and 34B (collectively, “wireless access points 34”) that provide support for wireless communications throughout environment 28. Additionally or alternatively, e.g., when local network is unavailable, computing device(s) 14 within environment 28 may be configured to communicate with network 16, e.g., with central controller 20 and / or HMS 22, via a cellular base station 36 and a cellular network.

[0038] In some examples, in response to determining and / or confirming an acute health event of patient 4, central controller 20 may transmit the alert to a care provider, an emergency medical technician, or other designated persons in environment 28 or near environment 28. For example, the alert may be a communication to the emergency medical technician, or local neighborhood alert system with an automated emergency defibrillator service, to a care provider, etc. In some examples, the alert includes collected data from IMD 10, such that medical personnel may be prepared to take quick action onarrival in environment 28. In some examples, the alert includes at least one of a telephone call, a short message service message, an email, a internet message, a security system alert, a social media alert, an audible alert, or a visual alert. In some examples, the central controller 20 may send an alarm or warning to everyone and every device around the environment 28.

[0039] For example, central controller 20 may be configured to transmit alert messages to one or more computing devices 38 associated with one or more care providers 40 via network 16. Care providers may include emergency medical systems (EMS) and hospitals, and may include particular departments within a hospital, such as an emergency department, catheterization lab, or a stroke response department. Computing devices 38 may include smartphones, desktop, laptop, or tablet computers, or workstations associated with such systems or entities, or employees of such systems or entities. The alert messages may include any of the data collected by IMD 10, including sensed physiological parameters, time of the acute health event, location of patient 4, and results of the analysis by IMD 10 and / or HMS 22. The information transmitted from HMS 22 to care providers 40 may improve the timeliness and effectiveness of treatment of the acute health event of patient 4 by care providers 40. In some examples, instead of or in addition to HMS 22 providing an alert message to one or more computing devices 38 associated with an EMS care provider 40, central controller 20 may be configured to automatically contact EMS, e.g., autodial 911 (e.g., in the United States or North America to use the telephone system to contact a 911 call center), in response to receiving the detected acute health event and / or the sensed physiological data from IMD 10 via the communication path. Such operations may be cancelled by computing device(s) 14 of bystanders.

[0040] Similarly, central controller 20 may be configured to transmit an alert message to computing device(s) 14 of bystanders, which may improve the timeliness and effectiveness of treatment of the acute health event of patient 4 by bystanders. In some examples, central controller 20 may determine that computing device(s) 14 of bystanders are proximate to patient 4 based on a location of patient 4, e.g., received from IMD 10 or from computing device(s) 14 that send the protocol message, and locations of computing device(s) 14, e.g., reported to central controller 20 by an application implemented on computing device(s) 14. In some examples, central controller 20 may transmit the alert message to any of computing device(s) 14 in an alert area determined based on thelocation of patient 4, e.g., by transmitting the alert message to all computing devices in communication with base station 36.

[0041] In some examples, the alert message to bystanders may be configured to assist a layperson in treating patient. For example, the alert message to bystanders may include a location (and in some cases a description) of patient 4, the general nature of the acute health event, directions for providing care to patient 4, such as directions for providing cardio-pulmonary resuscitation (CPR), a location of nearby medical equipment for treatment of patient 4, such as an automated external defibrillator (AED) or life vest, and instructions for use of the equipment.

[0042] FIG. 2 is a block diagram illustrating an example configuration of IMD 10 of FIGS. 1A-1B. As shown in FIG. 2, IMD 10 includes processing circuitry 50, memory 52, sensing circuitry 54 coupled to electrodes 56A and 56B (hereinafter, “electrodes 56”) and one or more sensor(s) 58, and communication circuitry 60.

[0043] Processing circuitry 50 may include fixed function circuitry and / or programmable processing circuitry. Processing circuitry 50 may include any one or more of a microprocessor, a controller, a graphics processing unit (GPU), a tensor processing unit (TPU), a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field-programmable gate array (FPGA), or equivalent discrete or analog logic circuitry. In some examples, processing circuitry 50 may include multiple components, such as any combination of one or more microprocessors, one or more controllers, one or more GPUs, one or more TPUs, one or more DSPs, one or more ASICs, or one or more FPGAs, as well as other discrete or integrated logic circuitry. The functions attributed to processing circuitry 50 herein may be embodied as software, firmware, hardware, or any combination thereof. In some examples, memory 53 includes computer-readable instructions that, when executed by processing circuitry 50, cause IMD 10 and processing circuitry 50 to perform various functions attributed herein to IMD 10 and processing circuitry 50. Memory 53 may include any volatile, non-volatile, magnetic, optical, or electrical media, such as a random-access memory (RAM), read-only memory (ROM), non-volatile RAM (NVRAM), electrically-erasable programmable ROM (EEPROM), flash memory, or any other digital media.

[0044] Sensing circuitry 54 may monitor signals from electrodes 56 in order to, for example, monitor electrical activity of a heart of patient 4 and produce ECG data forpatient 4. In some examples, processing circuitry 50 may identify features of the sensed ECG, such as heart rate, heart rate variability, intra-beat intervals, and / or ECG morphologic features, to detect an episode of cardiac arrhythmia of patient 4. Processing circuitry 50 may store the digitized ECG and features of the ECG used to detect the arrhythmia episode in memory 52 as episode data for the detected arrhythmia episode.

[0045] In some examples, sensing circuitry 54 measures impedance, e.g., of tissue proximate to IMD 10, via electrodes 56. The measured impedance may vary based on respiration and a degree of perfusion or edema. Processing circuitry 50 may determine physiological data relating to respiration, perfusion, and / or edema based on the measured impedance.

[0046] In some examples, IMD 10 includes sensing circuitry 58, such as one or more accelerometers, microphones, optical sensors, temperature sensors, and / or pressure sensors. In some examples, sensing circuitry 54 may include one or more filters and amplifiers for filtering and amplifying signals received from one or more of electrodes 56 and / or sensors 58. In some examples, sensing circuitry 54 and / or processing circuitry 50 may include a rectifier, filter and / or amplifier, a sense amplifier, comparator, and / or analog-to-digital converter. Processing circuitry 50 may determine physiological data, e.g., values of physiological parameters of patient 4, based on signals from sensors 58, which may be stored in memory 52.

[0047] Memory 52 may store applications 70 executable by processing circuitry 50, and data 80. Applications 70 may include an acute health event surveillance application 72. Processing circuitry 50 may execute event surveillance application 72 to detect an acute health event of patient 4 based on combination of one or more of the types of physiological data described herein, which may be stored as sensed data 82. In some examples, sensed data 82 may additionally include data sensed by other devices, e.g., patient computing device 12, and received via communication circuitry 60. Event surveillance application 72 may be configured with a rules engine 74. Rules engine 74 may apply rules 84 to sensed data 82. Rules 84 may include one or more models, algorithms, decision trees, and / or thresholds. In some cases, rules 84 may be developed based on machine learning.

[0048] As examples, event surveillance application 72 may detect a cardiac arrest, a ventricular fibrillation, a ventricular tachycardia, a cardiac pause of asystole, pulselesselectrical activity (PEA), or a myocardial infarction based on an ECG and / or other physiological data indicating the electrical or mechanical activity of heart of patient 4 (FIGS. 1A-1B). In some examples, event surveillance application 72 may detect stroke based on such cardiac activity data. In some examples, sensing circuitry 54 may detect brain activity data, e.g., an electroencephalogram (EEG) via electrodes 56, and event surveillance application 72 may detect stroke or a seizure based on the brain activity alone, or in combination with cardiac activity data or other physiological data. In some examples, event surveillance application 72 detects whether the patient has fallen based on data from an accelerometer alone, or in combination with other physiological data. When event surveillance application 72 detects an acute health event, event surveillance application 72 may store the sensed data 82 that lead to the detection (and in some cases a window of data preceding and / or following the detection) as event data 86.

[0049] In some examples, in response to detection of an acute health event, processing circuitry 50 may attempt to transmit, via communication circuitry 60, event data 86 for the event to computing device 12. This transmission may be included in a message indicating the acute health event and may include a request for an indication from computing device 12 that the message including the acute health event has been received and that the computing device 12 has network 16 access. In some examples, if the IMD 10 does not receive an indication from computing device 12 that the message indicating the acute health event has been received and that the computing device 12 has network 16 access, IMD 10 may transmit UUID advertisement(s) 11, as shown in FIGS. 1A-1B. In some examples, IMD 10 may transmit UUID advertisement(s) 11 in response to IMD 10 detecting an acute health event.

[0050] Central controller 20 may send a request to computing device(s) 14 to generate a communication path between central controller 20 and IMD 10 via computing device(s) 14, as shown above in FIGS. 1A-1B. In response to the generation of the communication path between central controller 20 and IMD 10 via computing device(s) 14, IMD 10 may send one or more of an indication of the detected acute health event and / or the sensed physiological data of patient 4. In response to the generation of the communication path between central controller 20 and IMD 10 via computing device(s) 14, the central controller 20 may authenticate the validity of the IMD 10, such as requesting a unique authentication tokens from IMD 10.

[0051] Communication circuitry 60 may include any suitable hardware, firmware, software, or any combination thereof for wirelessly communicating with another device, such as patient computing device 12 and / or computing device(s) 14 and / or devices 30.

[0052] FIG. 3 is a block diagram illustrating an example configuration of a computing device 14, which may correspond to either (or both operating in coordination) of computing devices 14A, 14B, 14C, 14D, 14E, and / or 14F illustrated in FIGS. 1A-1B. In some examples, computing device(s) 14 takes the form of a smartphone, a smart speaker or other smart home or loT device, a laptop, a tablet computer, a personal digital assistant (PDA), a smartwatch or other wearable computing device.

[0053] As shown in FIG. 3, computing device 14 includes processing circuitry 130, memory 132, one or more input devices 134, one or more output devices 136, sensing circuitry 138, and communication circuitry 140. Although shown in FIG. 3 as a standalone device for purposes of example, computing device 14 may be any component or system that includes processing circuitry or other suitable computing environment for executing software instructions and, for example, need not necessarily include one or more elements shown in FIG. 3.

[0054] Processing circuitry 130 is configured to implement functionality and / or process instructions for execution within computing device 14. Examples of processing circuitry 130 may include, any one or more microprocessors, controllers, GPUs, TPUs, DSPs, ASICs, FPGAs, or equivalent discrete or integrated logic circuitry.

[0055] Memory 132 may be configured to store information within computing device 14, for processing during operation of computing device 14. In some examples, memory 132 may store data or software configured to recognize that an UUID advertisement(s) 11 is a unique command signifying an acute health emergency. Memory 132, in some examples, is described as a computer-readable storage medium. In some examples, memory 132 includes a temporary memory or a volatile memory. Examples of volatile memories include random access memories (RAM), dynamic random access memories (DRAM), static random access memories (SRAM), and other forms of volatile memories known in the art. Memory 132, in some examples, also includes one or more memories configured for long-term storage of information, e.g. including non-volatile storage elements. Examples of such non-volatile storage elements include magnetic hard discs,optical discs, floppy discs, flash memories, or forms of electrically programmable memories (EPROM) or electrically erasable and programmable (EEPROM) memories.

[0056] One or more input devices 134 of computing device 14 may receive input, e.g., from a user. Examples of input are tactile, audio, kinetic, and optical input. Input devices 134 may include, as examples, a mouse, keyboard, voice responsive system, camera, buttons, control pad, microphone, presence- sensitive or touch-sensitive component (e.g., screen), or any other device for detecting input from a user or a machine. In some examples, input devices 134 may additionally or alternatively include physiologic sensors, such as PPG sensors, ECG sensors, temperature sensors, impedance sensors, etc., that may augment and / or aid in the diagnosis of an acute health event and / or help guide emergency responders in their care of patient 4.

[0057] One or more output devices 136 of computing device 14 may generate output, e.g., to patient 4 or another user. Examples of output are tactile, audio, and visual output. Output devices 136 of computing device 14 may include a presence- sensitive screen, sound card, video graphics adapter card, speaker, cathode ray tube (CRT) monitor, liquid crystal display (LCD), light emitting diodes (LEDs), or any type of device for generating tactile, audio, and / or visual output.

[0058] Communication circuitry 140 of computing device 14 may communicate with other devices by transmitting and receiving data. For example, communication circuitry 140 may be configured to communicate with IMD 10 and central controller 20. Communication circuitry 140 may include a network interface card, such as an Ethernet card, an optical transceiver, a radio frequency transceiver, or any other type of device that can send and receive information. For example, communication circuitry 140 may include a radio transceiver configured for communication according to standards or protocols, such as 3G, 4G, 5G, WiFi (e.g., 802.11 or 802.15 ZigBee), Bluetooth®, Bluetooth® Low Energy (BLE), or forms of satellite communication.

[0059] FIG. 4 is a block diagram illustrating an operating perspective of HMS 22. HMS 22 may be implemented in central controller 20, which may include hardware components such as those of computing device 14 and / or a server, embodied in one or more physical devices. FIG. 4 provides an operating perspective of HMS 22 when hosted as a cloud-based platform. In the example of FIG. 4, components of HMS 22 are arranged according to multiple logical layers that implement the techniques of this disclosure. Eachlayer may be implemented by one or more modules comprised of hardware, software, or a combination of hardware and software.

[0060] Computing devices, such as IMD 10 and / or computing device 12 may operate as clients that communicate with HMS 22 via interface layer 200. Upon the central controller 20 sending a request to generate a communication path between the central controller 20 and the IMD 10 via computing device(s) 14 and the communication path being generated, IMD 10 may operate as a client that communicates with HMS 22 via computing device(s) 14. In some examples, IMD 10 may communicate with HMS 22 via computing device(s) 14 and interface layer 200. Interface layer 200 represents a set of application programming interfaces (API) or protocol interfaces presented and supported by HMS 22 for the client software applications. Interface layer 200 may be implemented with one or more web servers.

[0061] As shown in FIG. 4, HMS 22 also includes an application layer 202 that represents a collection of services 210 for implementing the functionality ascribed to HMS herein. After generating a communication path between the central controller 20 and the IMD 10 via computing device(s) 14, application layer 202 may receive information, e.g., an alert of an acute health event and / or sensed physiological data, from IMD 10 via computing device(s) 14 using the generated communication path, and further processes the information according to one or more of the services 210 to respond to the information. Application layer 202 may be implemented as one or more discrete software services 210 executing on one or more application servers, e.g., physical or virtual machines. That is, the application servers provide runtime environments for execution of services 210. In some examples, the functionality interface layer 200 as described above and the functionality of application layer 202 may be implemented at the same server. Services 210 may communicate via a logical service bus 212. Service bus 212 generally represents a logical interconnections or set of interfaces that allows different services 210 to send messages to other services, such as by a publish / subscription communication model.

[0062] Data layer 204 of HMS 22 may provide information in using one or more data repositories 220. A data repository 220, generally, may be any data structure or software that stores and / or manages data. Examples of data repositories 220 include but are not limited to relational databases, multi-dimensional databases, maps, and hash tables, to name only a few examples.

[0063] As shown in FIG. 4, each of services 230-238 is implemented in a modular form within HMS 22. Although shown as separate modules for each service, in some examples the functionality of two or more services may be combined into a single module or component. Each of services 230-238 may be implemented in software, hardware, or a combination of hardware and software. Moreover, services 230-238 may be implemented as standalone devices, separate virtual machines or containers, processes, threads or software instructions generally for execution on one or more physical processors.

[0064] In some examples, in response to receiving protocol message 15 from computing device(s) 14 indicating that the respective computing device 14 received a UUID advertisement 11, central controller 20 may send a request to computing device(s) 14 to generate a communication path between the central controller 20 and the IMD 10 via computing device(s) 14. In response to the generation of the communication path, event processor 230 may be responsive to receipt of the detected acute health event of patient 4 and / or sensed physiological data sensed by IMD 10 via the generated communication path.

[0065] Event processor 230 may initiate performance of any of the operations in response to detection of an acute health event ascribed herein to HMS 22, such as communicating with computing device(s) 14 of bystanders and care providers 40, activating a verification device or system and, in some cases, analyzing data to confirm or override the detection of the acute health event by IMD 10.

[0066] Record management service 238 may store the patient data included in a received alert message within event records 252. Alert service 232 may package the some or all of the data from the event record, in some cases with additional information as described herein, into one more alert messages for transmission to computing device(s) 14 of bystanders and / or care providers 40.

[0067] Care provider data 256 may store data used by alert service 232 to identify to whom to send alerts based on locations of computing device(s) 14 of bystanders and care providers 40 relative to a location of patient 4 and / or applicability of the care provided by care providers 40 to the acute health event experienced by patient 4.

[0068] In examples in which HMS 22 performs an analysis to confirm, verify, or override the detection of the acute health event by IMD 10, event processor 230 may apply one or more rules 250 to the data received in the alert message, e.g., to feature vectors derived by event processor 230 from the data. Rules 250 may include one or moremodels, algorithms, decision trees, and / or thresholds, which may be developed by rules configuration service 234 based on machine learning. Example machine learning techniques that may be employed to generate rules 250 can include various learning styles, such as supervised learning, unsupervised learning, and semi- supervised learning.Example types of algorithms include Bayesian algorithms, Clustering algorithms, decision-tree algorithms, regularization algorithms, regression algorithms, instance-based algorithms, artificial neural network algorithms, deep learning algorithms, dimensionality reduction algorithms and the like. Various examples of specific algorithms include Bayesian Linear Regression, Boosted Decision Tree Regression, and Neural Network Regression, Back Propagation Neural Networks, Convolution Neural Networks (CNN), Long Short Term Networks (LSTM), the Apriori algorithm, K-Means Clustering, k- Nearest Neighbour (kNN), Learning Vector Quantization (LVQ), Self-Organizing Map (SOM), Locally Weighted Learning (LWL), Ridge Regression, Least Absolute Shrinkage and Selection Operator (LASSO), Elastic Net, and Least- Angle Regression (LARS), Principal Component Analysis (PCA) and Principal Component Regression (PCR).

[0069] In some examples, in addition to rules used by HMS 22 to confirm acute health event detection, rules 250 maintained by HMS 22 may include rules 84 used by IMD 10. In such examples, rules configuration service 234 may be configured to develop and maintain rules 84. Rules configuration service 234 may be configured to modify these rules based on event feedback data 254 that indicates whether the detections and confirmations of acute health events by IMD 10 and / or HMS 22 were accurate. In some examples, rules configuration service 234 may utilize event records from true and false detections (as indicated by event feedback data 254) and confirmations for supervised machine learning to further train models included as part of rules 250. As illustrated in the example of FIG. 4, services 210 may also include an assistant configuration service 236 for configuring and interacting with computing devices.

[0070] FIG. 5 is a flowchart illustrating examples of the techniques of the present disclosure. In the example of FIG. 5, an IMD 10 senses physiological data of patient 4 (502), and detects an acute health event of patient 4 based on the sensed physiological data (504). In response to detection of the acute health event, IMD 10 transmits a UUID advertisement 11(506). The IMD 10 may transmit the UUID advertisement 11 according to a short-range wireless protocol. A computing device 14 receives the UUIDadvertisement 11 (508), and in response to receiving the UUID advertisement 11, transmits a protocol message 15 to a central controller 20 (510). The central controller 20 receives the protocol message 15 (512), and in response to receiving the protocol message 15, sends a request 17 to the computing device 14 to generate a communication path 518 between the central controller 20 and the IMD 10 via the computing device 14 (514). The IMD 10, in response to the generation of the communication path 518, transmits one or more of an indication of the detected acute health event or the sensed physiological data to the central controller 20 via the communication path 518 (516). In some examples, the generated communication path 518 is a two-way communication path between IMD 10 and central controller 20 via computing device 14. In some examples, the central controller 20, in response to receiving one or more of an indication of the detected acute health event or the sensed physiological data via the communication path 518, may be configured to send an emergency message to one or more computing device 14 (520). In some examples, the emergency message may include an alert to a care provider, an emergency medical technician, or other designated persons in environment 28 or near environment 28. In some examples, UUID advertisement 11 may not be a proprietary, patient-specific message but rather would be a signal that another smart computing device that is not directly associated with the IMD 10 may be capable of understanding as an emergency condition. In some examples, the UUID advertisement 11 may include one or more of an indication that an acute health event has occurred, an indication of the time of the event, and / or an indication or identifier that the IMD 10 is a device that is to be monitored by a remote patient monitoring system. In some examples, the protocol message 15 may include an indication that the computing device 14 received the UUID advertisement 11. In some examples, the protocol message 15 may include an indication of a geolocation. For example, the indication of geolocation may include one or more of a geolocation of the e computing device 14 that sent the protocol message 15, a geolocation of the IMD 10, and / or a geolocation of the computing device 14 when it receives the UUID advertisement 11.

[0071] It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may beperformed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques). In addition, while certain aspects of this disclosure are described as being performed by a single module, unit, or circuit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units, modules, or circuitry associated with, for example, a medical device.

[0072] In one or more examples, the described techniques may be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions may be stored as one or more instructions or code on a computer-readable medium and executed by a hardware -based processing unit. Computer-readable media may include non-transitory computer-readable media, which corresponds to a tangible medium such as data storage media (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer).

[0073] Instructions may be executed by one or more processors, such as one or more digital signal processors (DSPs), general purpose microprocessors, application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry. Accordingly, the term “processor” or “processing circuitry” as used herein may refer to any of the foregoing structure or any other physical structure suitable for implementation of the described techniques. Also, the techniques could be fully implemented in one or more circuits or logic elements.

[0074] The following examples are illustrative of the techniques described herein.

[0075] Example 1: A system includes an implantable medical device (IMD) configured to: sense physiological data of a patient; detect an acute health event of the patient based on the sensed physiological data; and transmit a universal unique identifier (UUID) advertisement, according to a short-range wireless protocol, in response to detection of the acute health event; a computing device configured to: receive the UUID advertisement; in response to receipt of the UUID advertisement, transmit a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; and receive a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the computing device is configured to connect tothe central controller via a network connection and the computing device is configured to connect to the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; wherein, in response to generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0076] Example 2: The system of example 1, wherein the generated communication path is a two-way communication path between the IMD and the central controller via the computing device.

[0077] Example 3: The system of any of examples 1-2, wherein the computing device is a second computing device, and the IMD is further configured to: determine that a first computing device of the patient is unable to communicate with one or more of the IMD or the central controller; and in response to the detection of the acute health event and determination that the first computing device is unable to communicate with one or more of the IMD or the central controller, transmit the UUID advertisement.

[0078] Example 4: The system of any of examples 1-3, wherein the protocol message comprises an indication of a geolocation.

[0079] Example 5: The system of example 4, wherein the indication of a geolocation includes one or more of a geolocation of the computing device, a geolocation of the IMD, or a geolocation of the computing device when it receives the UUID advertisement.

[0080] Example 6: The system of any of examples 1-5, wherein the UUID advertisement includes an emergency identifier.

[0081] Example 7: The system of any of examples 1-6, wherein the UUID advertisement includes identifying information of the central controller.

[0082] Example 8: The system of any of examples 1-7, wherein the UUID advertisement does not include information of the detected acute health event.

[0083] Example 9: The system of any of examples 1-7, wherein the UUID advertisement does not include the physiological data of the patient.

[0084] Example 10: The system of any of examples 1-9, wherein the protocol message does not include contents of the UUID advertisement.

[0085] Example 11: The system of any of examples 1-10, further includes in response to receipt of the protocol message, send a request to other computing devices within apredetermined distance to the computing device to generate a communication path between the central controller and the IMD via the other computing devices.

[0086] Example 12: A method for operating a system includes sensing, by the IMD, physiological data of a patient; detecting, by the IMD, the acute health event of the patient based on the sensed physiological data; transmitting, by the IMD, a universal unique identifier (UUID) advertisement, according to a short-range wireless protocol, in response to detection of the acute health event; receiving, by a computing device, the UUID advertisement; in response to receipt of the UUID advertisement, transmitting, by the computing device, a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; receiving, by the computing device, a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the computing device is configured to connect to the central controller via a network connection and the computing device is configured to connect to the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; and in response to generation of the communication path, transmitting, by the IMD, one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0087] Example 13: The method of example 12, wherein the computing device is a second computing device, and the method further includes determining, by the IMD, that a first computing device is unable to communicate with one or more of the IMD or the central controller; and in response to the detection of the acute health event and determination that the first computing device is unable to communicate with one or more of the IMD or the central controller, transmitting the UUID advertisement.

[0088] Example 14: The method of any of examples 12-13, the method further includes in response to receipt of the protocol message, sending, by the central controller, a request to other computing devices within a predetermined distance to the computing device to generate a communication path between the central controller and the IMD via the other computing devices.

[0089] Example 15: The method of any of examples 12-14, wherein the generated communication path is a two-way communication path between the IMD and the central controller via the computing device.

[0090] Example 16: The method of any of examples 12-15, wherein the protocol message comprises an indication of a geolocation.

[0091] Example 17: The method of example 16, wherein the indication of a geolocation includes one or more of a geolocation of the computing device, a geolocation of the IMD, or a geolocation of the computing device when it receives the UUID advertisement.

[0092] Example 18: The method of any of examples 12-17, wherein the UUID advertisement includes an emergency identifier.

[0093] Example 19: The method of any of examples 12-18, wherein the UUID advertisement includes identifying information of the central controller.

[0094] Example 20: The method of any of examples 12-19, wherein the UUID advertisement does not include information of the detected acute health event.

[0095] Example 21: The system of any of examples 12-19, wherein the UUID advertisement does not include the physiological data of the patient.

[0096] Example 22: The method of any of examples 12-21, wherein the protocol message does not include contents of the UUID advertisement.

[0097] Example 23: A computer readable medium storing instructions that when executed by one or more processors cause the one or more process to perform the method of any of examples 12-22.

[0098] Example 24: A computing device includes communication circuitry; and processing circuitry configured to: receive, via the communication circuitry, a UUID advertisement transmitted by an implantable medical device (IMD) according to a short- range wireless protocol, the UUID advertisement transmitted by the IMD in response to detection of an acute health event of a patient based on physiological data of the patient sensed by the IMD; in response to receipt of the UUID advertisement, control the communication circuitry to transmit a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; receive, via the communication circuitry, a request from the central controller to generate a communication path between the central controller and the IMDvia the computing device, wherein the processing circuitry is configured to control the communication circuitry to connect the to the central controller via a network connection and the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; and in response to receipt of the request, generate the communication path between the central controller and the IMD via the computing device, wherein, in response to generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

[0099] Example 25: The computing device of example 24, wherein the generated communication path is a two-way communication path between the IMD and the central controller via the computing device.

[0100] Example 26: The computing device of any of examples 24-25, wherein the protocol message comprises an indication of a geolocation.

[0101] Example 27: The computing device of example 26, wherein the indication of a geolocation includes one or more of a geolocation of the computing device, a geolocation of the IMD, or a geolocation of the computing device when it receives the UUID advertisement.

[0102] Example 28: The computing device of any of examples 24-27, wherein the UUID advertisement includes an emergency identifier.

[0103] Example 29: The computing device of any of examples 24-28, wherein the UUID advertisement includes identifying information of the central controller.

[0104] Example 30: The computing device of any of examples 24-28, wherein the UUID advertisement does not include information of the detected acute health event.

[0105] Example 31: The computing device of any of examples 24-30, wherein the protocol message does not include contents of the UUID advertisement.

[0106] Various examples have been described. These and other examples are within the scope of the following claims.

Claims

WHAT IS CLAIMED IS:

1. A system comprising: an implantable medical device (IMD) configured to: sense physiological data of a patient; detect an acute health event of the patient based on the sensed physiological data; and transmit a universal unique identifier (UUID) advertisement, according to a short-range wireless protocol, in response to detection of the acute health event; a computing device configured to: receive the UUID advertisement; in response to receipt of the UUID advertisement, transmit a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; and receive a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the computing device is configured to connect to the central controller via a network connection and the computing device is configured to connect to the IMD via the short- range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; wherein, in response to generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

2. The system of claim 1, wherein the generated communication path is a two-way communication path between the IMD and the central controller via the computing device.

3. The system of any of claims 1-2, wherein the computing device is a second computing device, and the IMD is further configured to: determine that a first computing device of the patient is unable to communicate with one or more of the IMD or the central controller; andin response to the detection of the acute health event and determination that the first computing device is unable to communicate with one or more of the IMD or the central controller, transmit the UUID advertisement.

4. The system of any of claims 1-3, wherein the protocol message comprises an indication of a geolocation, wherein the indication of a geolocation includes one or more of a geolocation of the computing device, a geolocation of the IMD, or a geolocation of the computing device when it receives the UUID advertisement.

5. The system of any of claims 1-4, wherein the UUID advertisement includes an emergency identifier.

6. The system of any of claims 1-5, wherein the UUID advertisement includes identifying information of the central controller.

7. The system of any of claims 1-6, wherein the UUID advertisement does not include information of the detected acute health event.

8. The system of any of claims 1-7, wherein the UUID advertisement does not include the physiological data of the patient.

9. The system of any of claims 1-8, wherein the protocol message does not include contents of the UUID advertisement.

10. The system of any of claims 1-9, further comprising the central controller, wherein the central controller is further configured to: in response to receipt of the protocol message, send a request to other computing devices within a predetermined distance to the computing device to generate a communication path between the central controller and the IMD via the other computing devices.

11. A computing device comprising:communication circuitry; and processing circuitry configured to: receive, via the communication circuitry, a UUID advertisement transmitted by an implantable medical device (IMD) according to a short-range wireless protocol, the UUID advertisement transmitted by the IMD in response to detection of an acute health event of a patient based on physiological data of the patient sensed by the IMD; in response to receipt of the UUID advertisement, control the communication circuitry to transmit a protocol message to a central controller, the protocol message comprising an indication that the computing device received the UUID advertisement; receive, via the communication circuitry, a request from the central controller to generate a communication path between the central controller and the IMD via the computing device, wherein the processing circuitry is configured to control the communication circuitry to connect the to the central controller via a network connection and the IMD via the short-range wireless protocol, the request sent by the central controller in response to receipt of the protocol message from the computing device; and in response to receipt of the request, generate the communication path between the central controller and the IMD via the computing device, wherein, in response to generation of the communication path, the IMD is configured to transmit one or more of an indication of the detected acute health event or the sensed physiological data to the central controller via the communication path.

12. The computing device of claim 11, wherein the generated communication path is a two-way communication path between the IMD and the central controller via the computing device.

13. The computing device of any of claims 11-12, wherein the protocol message comprises an indication of a geolocation, wherein the indication of a geolocation includes one or more of a geolocation of the computing device, a geolocation of the IMD, or a geolocation of the computing device when it receives the UUID advertisement.

14. The computing device of any of claims 11-13, wherein the UUID advertisement includes at least one of an emergency identifier or identifying information of the central controller, and wherein the protocol message does not include contents of the UUID advertisement.

15. The computing device of any of claims 11-14, wherein the UUID advertisement does not include information of the detected acute health event.

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