Enhancing multiple implant programming workflow

Abstract

An example system includes communication circuitry configured to: initiate communication with a plurality of medical devices via respective communication channels and receive signals from the plurality of devices via the respective communication channels. The example system further includes processing circuitry configured to generate, for display, a user interface comprising information associated with each medical device of the plurality of medical devices of an active session, control the communication circuitry to maintain the respective communication channels during the active session of the user interface, control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session, receive an input from the user, and responsive to receiving the input, control the communication circuitry to transmit a command.

Description

ENHANCING MULTIPLE IMPLANT PROGRAMMING WORKFLOWCROSS RELATED APPLICATIONS

[0001] This application claims the benefit of priority to U.S. Provisional Application No. 63 / 676,191 filed July 26, 2024, which is incorporated herein by reference in its entirety.TECHNICAL FIELD

[0002] The disclosure relates to medical device management, and more specifically to managing the use of a plurality of medical devices in a patient.BACKGROUND

[0003] Medical devices may be external or implanted and may be used to monitor patient signals such as cardiac activity, biological impedance, and to deliver electrical stimulation therapy to patients via various tissue sites to treat a variety of symptoms or conditions such as chronic pain, tremor, Parkinson’s disease, diabetes, epilepsy, urinary or fecal incontinence, sexual dysfunction, obesity, or gastroparesis and other conditions. In some examples, a medical device may communicate with one or more external computing devices. The medical device may receive instructions that control programming the device to operate and / or transmit data relation to the patient status. The external computing device may be a patient programmer or clinician programmer configured to be used by a clinician caring for the patient. In some examples, the external computing device may be a hand-held programmer, a networked server, or another computing device.SUMMARY

[0004] In general, the disclosure describes systems, devices, and techniques to facilitate management of a plurality of medical devices associated with a patient. The plurality of medical devices may include one or more wearable medical devices or implantable medical devices, and the external computing device may be a device configured as a programmer that can control one or more of the medical devices. The external computing device may be configured to receive data from and / or control medical devices via a single user interface. In this manner, the single user interface may enable a user, such as a clinician, to view some or all of the medical devices associated with the patient. The external computing device may be configured to control those medicaldevices that are enabled to be controlled by the external computing device and view some information regarding those medical devices that may not be directly controllable.

[0005] In some examples, the external computing device may receive information from each medical device via respective communication channels. The communication circuitry of the external computing device may be configured to communicate with multiple medical devices of the patient via respective different communication channels. The external medical device may be configured to initiate communication channels during an active session, which may be maintained until the external computing device terminates the active session. The external computing device may thus be configured to maintain multiple communication channels with respective medical devices even during programming of one of the medical devices. In this manner, the external computing device may be configured to quickly switch between programming each medical device of the plurality of medical devices.

[0006] In some examples, the user interface presented to the user by the external computing device may include a first field providing a first set of one or more parameters of the first medical device and a second field on the same screen as the first field, wherein the second field provides a second set of one or more parameters of the second medical device. In some examples, the user interface may enable the user to switch or transition between different screens that respectively provide the first set of one or more parameters of the first device and the second screen providing a second set of one or more parameters of the second device. The user interface may include a transition input element that, when selected, enables transition between the first screen and the second screen. This transition input element may be a swipe element that, in response to receiving a swipe at the user interface, the user interface transitions to a different screen presenting information for a different medical device. In other examples, the transition input element may be a selectable icon. In any event, the external computing device may maintain communication channels for multiple medical devices during an active session to enable the user to quickly switch programming between different medical devices using the user interface without needing to reestablish communication. In some examples, the user interface can be configured to present information (e.g., operational parameters, identifying information, graphical visualizations with respect to anatomy, etc.) relating to a set of all the nearby medical devices associated with a single patient, whether or not the external computing device is configured to change operational parameters of one or more of the medical devices associated with the single patient.

[0007] In one example, this disclosure describes a system that includes communication circuitry configured to initiate communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key and receive signals from the plurality of devices via the respective communication channels. The system further includes processing circuitry configured to generate, for display, a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session and control the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface. The processing circuitry can also control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session, receive, via the user interface, an input from the user associated with one medical device of the plurality of medical devices, and responsive to receiving the input, control the communication circuitry to transmit a command to the one medical device via the respective communication channel during the active session.

[0008] In another example, this disclosure describes a method that includes initiating, via communication circuity, communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key, receiving, via the communication circuity, signals from the plurality of devices via the respective communication channels, and generating for display, via processing circuitry, a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session. The method further includes controlling, via the processing circuitry, the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface, controlling, via the processing circuitry, a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session, receiving, via the processing circuitry, an input from the user at the user interface associated with one medical device of the plurality of medical devices; controlling, via the processing circuitry and responsive to receiving the input, the communicationcircuitry to transmit a command to the one medical device via the respective communication channel during the active session.

[0009] In another example, this disclosure describes a non-transitory computer- readable storage medium that, when executed by processing circuitry, cause the processing circuitry to control communication circuity to initiate communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key. The non- transitory computer-readable storage medium further includes instructions that cause the processing circuitry to control communication circuity to receive signals from the plurality of devices via the respective communication channels and generate for display a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session, control the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface, control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session, receive an input from the user at the user interface associated with one medical device of the plurality of medical devices, and control the communication circuitry, responsive to receiving the input, to transmit a command to the one medical device via the respective communication channel during the active session.

[0010] The details of one or more examples of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the disclosure will be apparent from the description and drawings, and from the claims.BRIEF DESCRIPTION OF DRAWINGS

[0011] FIG. l is a conceptual diagram illustrating a medical system of this disclosure that includes an implantable medical device located both near a pelvis of a patient and in a pectoral region of the patient.

[0012] FIG. 2 is a block diagram illustrating an example communication configuration for a system according to one or more techniques of this disclosure.

[0013] FIG. 3 is a block diagram illustrating components of an example implantable medical device.

[0014] FIG. 4 is a block diagram of an example an external computing device.

[0015] FIG. 5 is a conceptual illustration of an example user interface presenting a first field for a first device and a second field a second device.

[0016] FIGS. 6 A and 6B are conceptual illustrations of different screens for respective medical devices of an example user interface.

[0017] FIG. 7 is a conceptual illustration of an example user interface configured to present a list of all connected medical devices for the patient.

[0018] FIG. 8A is a conceptual illustration of an example of the user interface for an external computing device that can present information from different medical devices implanted to treat different hemispheres of a brain of a patient.

[0019] FIG. 8B is a conceptual illustration of a user interface indicating a transition element for switching control between different medical devices.

[0020] FIG. 8C a conceptual illustration of an example of the user interface for an external computing device that can present information from different medical devices implanted to treat different hemispheres of a brain of a patient.

[0021] FIG. 9 is a flow chart illustrating an example mode of operation of processing circuitry controlling the communication circuitry and a user interface of one or more systems of this disclosure.

[0022] FIG. 10 is a conceptual illustration of an example user interface that is configured to present multiple medical devices for a patient and a field that accepts user input to adjust one or more parameters of a selected medical device.DETAILED DESCRIPTION

[0023] The disclosure describes systems, devices, and techniques to facilitate user control of a plurality of devices such as stationary, wearable, or implantable medical devices using an external computing device, such as a programmer. A medical device may be controlled by an external computing device (e.g., a clinician programmer, a patient programmer, a recharger, a mobile device application, a cell phone application, or similar external device). The external computing device may be configured to communicate with only one medical device or one medical device at a time (e.g., an external device, an implantable medical device (IMD), an implantable neurostimulator (IMS), etc.). For example, patients and physicians typically require multiple external computing devices to program each medical device. Each external computing devicemay be configured to only communicate with that one medical device. In some examples, the external computing device, such as an external programmer, may be configured to communicate with different medical devices, but the programmer must establish an encrypted communication session with a single device each time communication with the medical device is to occur. That communication session must be terminated before the programmer can be used with any other medical devices. It is no longer uncommon for a single patient to have more than one medical device. With multiple medical devices, programmer or other interrogation of medical devices for that single patient may require multiple programmers or cumbersome initiation and termination of different encrypted communication sessions for all of the medical devices. Furthermore, the requirement of different programmers and / or serial communication sessions may prevent a user from reviewing the overall situation for the patient regarding some or all of the medical devices associated with the patient.

[0024] As described herein, systems, devices, and techniques may enable an external computing device to control a single user interface and communicate with more than one medical device of the patient at during the same active session which can eliminate the need to separately interrogate each medical device each time the user desires to update a parameter or other information for that medical device. Moreover, the user interface can be configured to present an illustration including some or all of the medical devices of the patient, and highlight the medical device current selected by user input to view information and / or adjustable parameters associated with the selected medical device. The user interface may be configured to receive information from controllable medical devices and non-controllable medical devices in some examples.

[0025] The system of this disclosure may enable two or more secure communication channels to be initiated and maintained during an active session of the user interface. In some examples, each communication channel of the two or more communication channels has a unique encryption key (e.g., a respective unique encryption key for each medical device). In some examples, each of the two or more secure communication channels is initiated between one device of the plurality of medical devices and the external computing device. The external computing device can be configured to receive data from any of the two or more communication channels simultaneously. The external computing device can maintain each of the two or more communication channels during use of the user interface during an active session and until the active session terminates. In this manner, the user can switch between different medical devices that have respectivecommunication channels during the active session without needing to re-establish communication for each switch. However, the external computing device can be configured to only send commands over one communication channel of the active channels at once while maintaining each of the two or more communication channels. This limitation of sending commands may be connected to the user interface such that the selected medical device in the user interface is the only medical device that receives commands from the external computing device. The external computing device may employ checks to ensure that commands via the user interface are only transmitted to the selected medical device when multiple medical devices are connected during the active session.

[0026] In some examples, the external computing device presents a user interface which represents the data received from any of the two or more communication channels. In some examples, the external computing device receives input from a user (e.g. clinician, doctor, operator, or patient) at the user interface which may be transmitted over one communication channel of the two or more communication channels. In some examples, the external computing device prevents the input from being transmitted over the other communication channels of the two or more communication channels, which may be based on user input. For example, the external computing device may employ one more safety mechanisms to ensure that commands or other information is only sent to the selected medical device during the active session over the associated communication channel. The user can request a change to the selected medical device which receives the input through input of a switch signal that controls the external computing device to switch to the appropriate communication channel of the two or more communication channels before the data is transmitted to the selected medical device. In some examples, the user interface can require a confirmation input in addition to the switch signal from the user to confirm to the external computing device that the user is requesting a change of the medical device, and the associated communication channel, through which the data is to be sent to the selected medical device.

[0027] The external computing device may be a proprietary device configured to interface with certain medical devices or an external computing device (e.g., mobile computing device, smart phone, tablet computer, etc.) that can execute an application or other software that can perform the functions described herein. The application can include software configured to be executed on a mobile device, for example, where the application configures the mobile device to act as a patient programmer. The applicationmay be configurable to program different types of medical devices that may be from the same manufacturer (e.g., an electrical stimulation device and a drug pump) or different manufacturers. The external computing device may transfer data to and from one or more digital health platforms that may be supported by networked servers. In some examples, the external computing device is configured to upload a first set of data to a first health platform, a second set of data to a second health platform, and a third set of data to a third health platform. The first health platform may be a deep brain stimulation health platform, the second health platform may be a cardiac pacing health platform, and the third health platform may be a pain relief health platform. These different platforms may be operated by the same manufacturer or different manufacturers. In any case, a clinician may monitor data from medical devices and / or transmit commands to the medical devices via these one or more digital platforms. In other examples, there may additionally or alternatively be other applications or health platforms, where the number and type of applications or health platforms that a programmer may be configured to connect with may be based on the number of devices configured to communicate with the programmer, the types of devices configured to communicate with the programmer, and any other factor which influences the number and types of health platforms.

[0028] In some examples, each of the plurality of medical devices are implantable medical device configured to be implanted into a single patient. In other examples, each of the plurality of medical devices is implanted into or carried on a single patient. Example medical devices may include an implantable neural stimulator configured to deliver deep brain stimulation to a left hemisphere of a brain of a patient and an implantable neural stimulator configured to deliver deep brain stimulation to a left hemisphere of a brain of a patient. Medical devices can also or alternatively include another electrical stimulation device, an implantable medical device configured to receive neural signals indicative of a heart rate (e.g., a LINQ monitor manufactured by Medtronic, Inc.), and / or an implantable medical device configured to deliver electrical stimulation to a heart. Medical devices may also or alternatively include an implantable neural stimulator configured to deliver electrical stimulation to a spinal cord of a patient and / or a infusion pump configured to deliver a pain relieving substance to the patient. In an example, the plurality of medical devices may include one or more implantable neural stimulators configured to deliver neural stimulation to a spinal cord of a patient to relieve pain, one or more implantable neural stimulators configured to deliver deep brain stimulation to a left and / or right hemisphere of a patient to relieve symptoms of one ormore diseases, and an infusion pump configured to deliver one or more pain relieving substances to one or more infusion sites of a patient to relieve pain sensations.

[0029] In some examples, the external computing device is configured to send an interrogation request to one or more of the plurality of devices. If any of the medical devices respond with an acceptance message of the interrogation request, the external computing device and the medical device can establish a secured communication channel. This secured communication channel may require matching of one or more encryption keys. In some examples, if the medical device does not respond or responds with a denial of the interrogation request, the communication channel may remain open for the external computing device as a read-only communication channel. If the communication channel is a read-only communication channel, the information sent by the medical device may be limited to identifiable information or other information about the device such as a manufacturer, a device class, a model number, a serial number of the two or more devices, or an operational status. The external computing device may not be able to transmit commands or any other information to the medical device via a read-only communication channel. If the communication channel is an encrypted communication channel, the communication channel may support sending data, commands, or otherwise adjust the properties of the device via the communication channel. In some examples, each communication channel is a secure communication channel, and each secure communication channel may transfer information in an encrypted manner based on the unique encryption key negotiated for the duration of a communication session.

[0030] The user interface may switch between fields associated with respective medical devices or present multiple fields associated with respective medical devices of the patient. For example, the user interface includes a first field presenting a first set of one or more parameters of the first medical device and a second field on the same screen as the first field and including a second set of one or more parameters of the second medical device. The parameters may be viewable or changeable via the user input depending on whether the external computing device can establish an encrypted communication channel or otherwise include authorization to change a parameter value of a medical device. In some examples, the user interface includes a first screen that presents a first set of one or more parameters of the first medical device and a second screen that presents a second set of one or more parameters of the second medical device. The user interface may include a transition input element that, when selected or otherwise triggered, enables transition between the first screen and the second screen. In someexamples, the transition input element includes the switch signal. The user interface format may be configured to be customizable by the user. In some examples, the user interface may be configured to receive user input that customizes which medical devices are visible at any time on the user interface, the device classes (or types) that are visible, the layout of the visible devices, an orientation of the user interface, the manufacturers of each of the plurality of devices, the statuses of the one or more devices, and / or any other aspects of one or more of the medical devices that a user would desire to appear at the user interface. In some examples, the user interface format is preset by a manufacturer based on one or more detected medical devices in the patient, a user logged into the user interface, or other factors relevant to user interface formatting. In some examples, the user interface format is set according to the patient associated with the detected medical devices.

[0031] In some examples, the external computing device that controls the user interface may communicate with one or more medical devices via an intermediate communication device. For example, the intermediate communication device can be configured to receive signals from a medical device in a first format along a first communication channel between a medical device of the plurality of medical devices, translates the signals into translated signals or another format of the external computing device, and then sends the translated signals to the external computing device in a second format along a second communication channel from the intermediate communication device to the programmer. The intermediate communication device can be a distinct additional device within the system or be a component of the external computing device. In some examples, intermediate communication device may be configured to carry out instructions from the external computing device to the medical device. In some examples, the intermediate communication device can be configured to establish communications in various formats (e.g., Tel-A, Tel-N, Tel-M, Bluetooth, or Bluetooth low energy) and transmit them in a format acceptable to the external computing device (e.g., Bluetooth or Bluetooth low energy).

[0032] The systems, devices, and techniques described herein can provide various advantages. For example, the system can improve clinician programming and patient programming efficiency by enabling a user interface to present information from multiple medical devices and to a user at the same time or with minimal interaction. In some examples, the external computing device can establish communication channels to securely connect to two or more medical devices simultaneously and maintain thosesecure connections during an active session of the user interface. Therefore, the user may be able to switch between different medical devices of the patient and quickly adjust any parameter values of interest without terminating and re-establishing communications each time another medical device is interrogated. In some examples, the systems herein improve clinician and patient experience by enabling a visualization of all of the implanted devices of a single patient at once, across vendors or manufacturers, thereby streamlining care for the provider and patient.

[0033] FIG. l is a conceptual diagram illustrating a medical system of this disclosure that includes a plurality of medical devices including an implantable medical device located both near a pelvis of a patient and in a pectoral region of the patient. System 100 includes an implantable medical device (IMD) 172 A configured to deliver deep brain stimulation to a patient 105, an IMD 172B configured to deliver spinal cord stimulation (SCS) therapy, and external computing device 150, in accordance with one or more techniques of this disclosure.

[0034] Although the techniques described in this disclosure are generally applicable to a variety of devices including medical devices, external medical devices, and IMDs, application of such techniques to IMDs and, more particularly, implantable electrical stimulators (e.g., neurostimulators) will be described for purposes of illustration. More particularly, the disclosure may refer to an implantable SCS system for purposes of illustration, but without limitation as to other types of medical devices or other therapeutic applications of medical devices. In some examples, the DBS can be closed- loop in the sense that IMD 172A, as one example, may adjust, increase, or decrease the magnitude of one or more parameters of the DBS in response to changes in patient activity or movement, a severity of one or more symptoms of a disease of the patient, a presence of one or more side effects due to the DBS, or one or more sensed signals of the patient.

[0035] For example, IMD 172A can be configured to provide bi-directional DBS with capabilities to both deliver stimulation, sense intrinsic neuronal signals, and sense neural signals that are evoked in response to delivery of stimulation. IMD 172A may be configured to treat a patient condition, such as a movement disorder (e.g., essential tremor (ET) or Parkinson’s), neurodegenerative impairment, a mood disorder, or a seizure disorder of patient 105. Patient 105 ordinarily is a human patient. In some cases, however, IMD 172 A or any other medical devices described herein may be applied to other mammalian or non-mammalian, non-human patients. While movement disorders andneurodegenerative impairment are primarily referred to herein, in other examples, IMD 172 A may provide therapy to manage symptoms of other patient conditions, such as, but not limited to, seizure disorders (e.g., epilepsy) or mood (or psychological) disorders (e.g., major depressive disorder (MDD), bipolar disorder, anxiety disorders, post- traumatic stress disorder, dysthymic disorder, and obsessive-compulsive disorder (OCD)). At least some of these disorders may be manifested in one or more patient movement behaviors. As described herein, a movement disorder or other neurodegenerative impairment may include symptoms such as, for example, muscle control impairment, motion impairment or other movement problems, such as rigidity, spasticity, bradykinesia, rhythmic hyperkinesia, nonrhythmic hyperkinesia, and akinesia. In some cases, the movement disorder may be a symptom of Parkinson’s disease or essential tremor (ET). However, the movement disorder may be attributable to other patient conditions.

[0036] As shown in the example of FIG. 1, system 100 includes IMD 172 A includes lead extension 110, and leads 130A and 130B with respective sets of electrodes. In the example shown in FIG. 1, electrodes of leads 130A, 130B are positioned to deliver electrical stimulation to a tissue site within brain 118, such as a deep brain site under the dura mater of brain 118 of patient 105. In some examples, delivery of stimulation to one or more regions of brain 118, such as the subthalamic nucleus (STN), globus pallidus or thalamus, ventralus intermediate (VIM), anterior nucleus (ANT), ventral internal capsule / ventral striatum (VC VS), cortico-basal ganglia-thalamocortical circuit, or anterior insular cortex (AIC), may be an effective treatment to manage disorders, such as Parkinson’s disease. Lead extension 110 may include one or more lead extensions which extend from IMD 172 A. Lead extension 110 may include as many lead extensions as there are sets of electrodes. In the example of FIG. 1, lead extension 110 includes a single lead extension to two sets of electrodes 130A and 130B. In other examples, lead extension 110 includes two lead extensions where a first lead extension of lead extension 110 extends to a first set of electrodes 130A and a second lead extension of lead extension 110 extends to a second set of electrodes 130B. In other examples, lead extension 110 may include any number of lead extensions. Some or all of electrodes also may be positioned to sense neurological brain signals within brain 118 of patient 105. In some examples, some of electrodes are configured to sense neurological brain signals and others of electrodes are configured to deliver electrical stimulation to brain 118. In other examples, all of the electrodes are configured to both sense neurological brain signals anddeliver electrical stimulation to brain 118. In some examples, unipolar stimulation is possible where one electrode is on the housing of IMD 172A.

[0037] As shown in FIG. 1, system 100 includes an IMD 172B, leads 130C and 130D, and external computing device 150 shown in conjunction with patient 105. In the example of FIG. 1, IMD 172B is an implantable electrical stimulator that is configured to generate and deliver electrical stimulation therapy to patient 105 using one or more electrodes of electrodes 132A and 132B, respectively on leads 130C and / or 130D (collectively including leads 130A and 130B, “leads 130”), e.g., for relief of chronic pain or other symptoms. In other examples, IMD 172B may be coupled to a single lead carrying multiple electrodes or more than two leads each carrying multiple electrodes, or leadless. IMD 172B may include an electrical connector configured to connect to the electrical leads, e.g., in the header of IMD 172B.

[0038] IMD 172B may be a chronic electrical stimulator that remains implanted within patient 105 for weeks, months, or even years. In other examples, IMD 172B may be a temporary, or trial, stimulator configured to screen or evaluate the efficacy of electrical stimulation for chronic therapy. In some examples, IMD 172B is implanted within patient 105. In some examples, IMD 172B is an external device coupled to percutaneously implanted leads.

[0039] In the example of FIG. 1, external computing device 150 may communicate and / or transfer power to IMDs 172A and / or 172B. External computing device 150 may also be referred to as programmer 150, external recharging device 150 or recharger 150. In other examples, external computing device 150 may also include a mobile phone, tablet computer, a wearable computing device or similar computing device that includes processing circuitry configured to execute programming instructions to communicate with IMDs 172A and / or 172B. Such a computing device may communicate with IMDs 172A and / or 172B to adjust therapy and / or sensing parameters, download recorded data, and the other functions described in this disclosure. In some examples, external recharging device can be held in place by a belt or straps 152 in order for the recharging device to be placed adjacent to IMD 172B. In some examples belt 152 includes a pouch that accepts an external recharge device. Any of the computing devices of system 100 may include a user interface. Examples of the user interface may include indicator lights, audio feedback, or graphics displayed on a graphical user interface (GUI) such as a tablet computer, smart phone 154, wearable computing device 156 or similar device. Each of IMDs 172, smart phone 154, and wearable computing device 156 may be referred to asmedical devices when they are configured to monitor the patient or deliver therapy to the patient. Any devices associated with the patient may be discoverable, identifiable, and / or controlled via a respective communication channel with external computing device 150 and via the user interface as described herein.

[0040] A user (e.g. clinician, doctor, operator, or patient 105), may interact with a user interface of an external computing device, such as external computing device 150, to program IMDs 172A and / or 172B, download collected patient data, and similar interactions. Communication circuitry of system 100, located on any of IMDS 172A and / or 172B and external computing device 150 of system 100 may establish one or more communication channels. Each communication channel may have an authentication scheme and be configured to transfer information based on the authentication. The authentication scheme may incorporate one or more levels of encryption (such as one or more encryption keys) or some other authentication protocol required for any medical device to establish a communication channel to external computing device 150. In some examples, the one or more communication channels are configured to identify, open, and close a secure communications channel to and from any of IMDs 172A and / or 172B. Each secure communication channel may be independent from each other in communication channel establishment, generated encryption keys, and authorization roles, as noted above. In some examples, external computing device 150 may retrieve information from one or more medical devices associated with patient 105 via one or more advertisement packets transmitted by a medical device. The advertisement packets may be configured to establish a communication channel with another device, such as with external computing device 150. However, even if external computing device 150 is not configured to perform bidirectional communication with a medical device, external computing device 150 may retrieve some set of identifiable information from the medical device via the advertisement packet(s). This identifiable information may include a device identifier, type of therapy or sensing provided, manufacturer, recently sensed data, and / or a status of therapy (e.g., therapy is on or off).

[0041] Programming of IMDs 172A and / or 172B may refer generally to the generation and transfer of commands, programs, or other information to control the operation of IMDS 172A and / or 172B. In this manner, IMDs 172A and / or 172B may receive the transferred commands and programs from external computing device 150 to control stimulation, such as electrical stimulation therapy (e.g., informed pulses), control stimulation (e.g., control pulses), haptic stimulation, sensing and other operatingparameters. When operating as a recharging device, external computing device 150 may communicate to IMDs 172A and / or 172B with a more limited information set than a patient programmer or clinician programmer. In some examples the clinician programmer is near IMDs 172A and / or 172B, e.g., in the same room. In other examples, the clinician programmer may be at a remote location, operated by a caregiver, and communicate via servers 112, or some other communication device.

[0042] Communication related to power transfer may limit a recharger device to receive and transfer information such as battery current, battery discharge level, power transfer efficiency and similar system metrics and information. A variety of system metrics may be available to external computing device 150 from computations of power and heat and from metrics communicated from IMDs 172A and / or 172B. Processing circuitry of system 100, e.g., processing circuitry of external computing device 150, processing circuitry of servers 112, and / or processing circuitry of IMDs 172A and / or 172B, may calculate any of the values described herein. These metrics may include but are not limited to: battery current, power transfer efficiency, IMD efficiency and other similar metrics. Analysis of system characterization data that the IMD efficiency, which may be measured by IMDs 172A and / or 172B and communicated to external computing device 150, may be an example indicator of when a recharger coil is concentric a secondary coil.

[0043] In the example of a rechargeable power source, the rechargeable power source of IMDs 172A and / or 172B may include one or more capacitors, batteries, or other components, e.g., chemical, or electrical energy storage devices (not shown in FIG. 1). Example batteries may include lithium-based batteries, nickel metal-hydride batteries, or other materials. The rechargeable power source may be replenished, refilled, or otherwise capable of increasing the amount of energy stored after energy has been depleted.

[0044] External computing device 150, or another recharging device, may be configured to recharge the rechargeable power source within IMDS 172A and / or 172B implanted in the patient. External computing device 150 may be a hand-held device, a portable device, or a stationary charging system. External computing device 150 may include components necessary to charge IMDS 172A and / or 172B through tissue of the patient. External computing device 150 may include an internal energy transfer coil and external energy transfer coil.

[0045] External computing device 150 and IMDs 172A and / or 172B may utilize any wireless power transfer techniques that are capable of recharging the power source ofIMDs 172A and / or 172B when IMDs 172A and / or 172B is implanted within the patient. In some examples, system 100 utilizes inductive coupling between primary coils (e.g., energy transfer coil) and secondary coils (e.g., secondary coil) of external computing device 150 and IMDs 172A and / or 172B.

[0046] IMDs 172A and / or 172B may communicate using a wireless protocol (e.g., Bluetooth™, Bluetooth Low Energy (BLE), or another protocol such as inductive communication or a protocol using the Medical Implant Communication System (MICS) band) to a number of different instruments, such as, for example, an additional medical device, a patient programmer, a clinician programmer, a programming fob, or another device.

[0047] The external computing device 150 may be configured as a clinician programmer or a patient programmer. A clinician programmer may transmit therapy stimulation programs, evoked compound action potential (ECAP) test stimulation programs, stimulation parameter adjustments, therapy stimulation program selections, ECAP test program selections, user input, or other information to control the operation of IMDs 172A and / or 172B. A patient programmer device, or wearable computing device 156 and mobile computing device 154 with processing circuitry executing an application configured to control the operation of IMDs 172A and / or 172B, may communicate with a more limited information set and still be able to view both IMDs 172A and / or 172B at the same time on the same device.

[0048] IMDs 172A and / or 172B and external computing device 150 may communicate using wireless communication using any techniques known in the art. Examples of communication techniques may include, for example, radiofrequency (RF) telemetry and inductive coupling, but other techniques are also suitable. In some examples, external computing device 150 includes a communication head, e.g., an antenna, that may be placed proximate to the patient’s body near each of IMDs 172 A and / or 172B implant site to improve the quality or security of communication between IMDs 172A and / or 172B and external computing device 150. Communication between the external computing devices of system 100 and IMDs 172A and / or 172B may occur during power transmission or separate from power transmission.

[0049] This disclosure may focus on devices used for deep brain stimulation and spinal cord stimulation, as shown in the example of FIG. 1 to simplify the description. However, the techniques of this disclosure may also apply to other devices, including wearable devices that may be located elsewhere on patient 105. Some examples mayinclude devices located near the tibial region, near the heart for cardiac therapy and / or monitoring, as well as other devices to treat other conditions in other locations.

[0050] Although in one example IMDs 172A and / or 172B take the form of an DBS device and a SCS device respectively, in other examples, IMDs 172A and / or 172B may take the form of any combination of DBS devices, implantable cardioverter defibrillators (ICDs), pacemakers, cardiac resynchronization therapy devices (CRT -Ds), left ventricular assist devices (LVADs), implantable sensors, orthopedic devices, or drug pumps, as examples. Moreover, techniques of this disclosure may be configured to ascertain parameters that affect stimulation thresholds (e.g., perception thresholds and detection thresholds) associated any one of the aforementioned IMDs and then use a stimulation threshold to inform the intensity (e.g., stimulation levels) of therapy. For example, changing stimulation parameters such as the number of pulses in a burst, the number of bursts over a duration, the pulse width of a pulse in a burst, the ON-time, the OFF-time, a pattern of pulses over a duration and other parameters may change the intensity as well as the efficacy of the therapy to relieve the symptoms.

[0051] IMDs 172A and / or 172B may be constructed of any polymer, metal, or composite material sufficient to house the components of IMDs 172A and / or 172B (e.g., components illustrated in FIG. 2) within patient 105. In this example, IMDs 172A and / or 172B may be constructed with a biocompatible housing, such as titanium or stainless steel, or a polymeric material such as silicone, polyurethane, or a liquid crystal polymer, and surgically implanted at a site in patient 105 near the pelvis, abdomen, or buttocks. In other examples, IMDs 172A and / or 172B may be implanted within other suitable sites within patient 105, which may depend, for example, on the target site within patient 105 for the delivery of electrical stimulation therapy. The outer housing of IMDs 172A and / or 172B may be configured to provide a hermetic seal for components, such as a rechargeable or non-rechargeable power source. In addition, in some examples, the outer housing of IMDS 172A and / or 172B are selected from a material that facilitates receiving energy to charge the rechargeable power source.

[0052] IMDs 172A and / or 172B may deliver electrical stimulation energy, which may be constant current or constant voltage pulses, for example, to one or more target tissue sites of patient 105 using one or more electrodes 132A and 132B (collectively electrodes 132) of implantable leads 130. Leads 130 carry electrodes that are placed adjacent to the target tissue sites. Leads 130A and 130B may have electrodes 132 (not shown) disposed at a distal tip and / or at other positions intermediate along leads 130A and I30B in a brain130C and 130D and / or at other positions at intermediate points along the lead. Leads 130A and 13 OB may be implanted and coupled to IMD 172 A while leads 130C and 130D may be implanted and coupled to IMD 172B. Electrodes 132 may transfer electrical stimulation generated by an electrical stimulation generator in IMDs 172A and / or 172B to tissue of patient 105. Electrodes 132 may also sense bioelectrical signals of patient 105.

[0053] Although leads 130 may each be a single lead, leads 130 may include a lead extension or other segments that may aid in implantation or positioning of lead 130. In some other examples, IMDs 172A and / or 172B may be a leadless stimulator with one or more arrays of electrodes arranged on a housing of the stimulator rather than leads that extend from the housing. In addition, in some other examples, system 100 may include one lead or more than two leads, each coupled to IMDs 172A and / or 172B and directed to similar or different target tissue sites.

[0054] Electrodes 132 of leads 130 may be electrode pads on a paddle lead, circular (e.g., ring) electrodes surrounding the body of the lead, conformable electrodes, cuff electrodes, segmented electrodes (e.g., electrodes disposed at different circumferential positions around the lead instead of a continuous ring electrode), any combination thereof (e.g., ring electrodes and segmented electrodes) or any other type of electrodes capable of forming unipolar, bipolar or multipolar electrode combinations for therapy. Ring electrodes arranged at different axial positions at the distal ends of lead 130 may be described for purposes of illustration.

[0055] The deployment of electrodes 132 via leads 130 is described for purposes of illustration, but arrays of electrodes may be deployed in different ways. For example, a housing associated with a leadless stimulator may carry arrays of electrodes, e.g., rows and / or columns (or other patterns), to which shifting operations may be applied. Such electrodes may be arranged as surface electrodes, ring electrodes, or protrusions. As a further alternative, electrode arrays may be formed by rows and / or columns of electrodes on one or more paddle leads. In some examples, electrode arrays include electrode segments, which are arranged at respective positions around a periphery of a lead, e.g., arranged in the form of one or more segmented rings around a circumference of a cylindrical lead. In other examples, one or more of leads 130 are linear leads including 8 ring electrodes along the axial length of the lead. In some examples, the electrodes are segmented rings arranged in a linear fashion along the axial length of the lead and at the periphery of the lead.

[0056] The stimulation parameter set of a therapy stimulation program that defines the stimulation pulses of electrical stimulation therapy by IMDs 172A and / or 172B through the electrodes of leads 130 may include information identifying which electrodes have been selected for delivery of stimulation according to a stimulation program, the polarities of the selected electrodes, i.e., the electrode combination for the program, voltage or current amplitude, pulse frequency, pulse width, pulse shape of stimulation delivered by the electrodes. These stimulation parameters values that make up the stimulation parameter set that defines pulses may be predetermined parameter values defined by a user and / or automatically determined by system 100 based on one or more factors or user input.

[0057] Similarly, sensing bioelectrical signals may use a variety of combinations of electrodes on leads 130, the housing of IMDs 172A and / or 172B, or other sensors connected directly or indirectly to IMDs 172A and / or 172B. In some examples IMDs 172A and / or 172B measure and detect other bioelectrical signals from patient 105 including cardiac activity, thoracic impedance, water retention and other signals. In some examples, leads 130 includes one or more sensors configured to enable IMDs 172A and / or 172B to monitor one or more parameters of patient 105, such as patient activity, pressure such as blood pressure, temperature, or other characteristics. The one or more sensors may be provided in addition to, or in place of, therapy delivery by leads 130.

[0058] Although FIG. 1 is directed to DBS therapy and / or SCS therapy in other examples system 100 may be configured to treat any other condition. For example, system 100 may be used to treat tremor, Parkinson’s disease, epilepsy, a pelvic floor disorder (e.g., urinary incontinence or other bladder dysfunction, fecal incontinence, pelvic pain, bowel dysfunction, or sexual dysfunction), obesity, gastroparesis, or psychiatric disorders (e.g., depression, mania, obsessive compulsive disorder, anxiety disorders, and the like). In this manner, system 100 may be configured to provide therapy taking the form of deep brain stimulation (DBS), spinal cord stimulation (SCS), peripheral nerve stimulation (PNS), peripheral nerve field stimulation (PNFS), cortical stimulation (CS), pelvic floor stimulation, gastrointestinal stimulation, or any other stimulation therapy capable of treating a condition of patient 105. In other examples, IMDs 172A and / or 172B takes the form of any combination of deep brain stimulation (DBS) devices, implantable cardioverter defibrillators (ICDs), pacemakers, cardiac resynchronization therapy devices (CRT-Ds), left ventricular assist devices (LVADs), implantable sensors, orthopedic devices, drug pumps and so on.

[0059] IMDs 172A and / or 172B are configured to deliver electrical stimulation therapy to patient 105 using selected combinations of electrodes carried by one or both of leads 130, alone or in combination with an electrode carried by or defined by an outer housing of IMDS 172A and / or 172B. The target tissue for the electrical stimulation therapy may be any tissue affected by electrical stimulation, which may be in the form of electrical stimulation pulses or continuous waveforms. In some examples, the target tissue includes nerves, smooth muscle, or skeletal muscle. In the example illustrated by FIG. 1, the target tissue is brain 118 tissue and tissue proximate spinal cord 120 of IMDS 172A and / or 172B respectively.

[0060] With regard to IMD 172A, the neurological brain signals that are configured to select a stimulation electrode combination may be sensed within the same region of brain 118 as the target tissue site for the electrical stimulation. These tissue sites may include tissue sites within anatomical structures such as the thalamus, subthalamic nucleus or globus pallidus of brain 118, as well as other target tissue sites. The specific target tissue sites and / or regions within brain 118 may be selected based on the patient condition. For example, IMD 172A may be configured to perform directional sensing to ascertain a direction and / or orientation of the LFP source (e.g., signal source that generates the LFP) including the signal component in the beta frequency band. IMD 172A may direct the electrical stimulation toward the signal source to suppress (e.g., squelch) the signal component produced by the signal source in the beta frequency band, as one example.

[0061] With regard to IMD 172B, the tissue proximate spinal cord 120 may be tissue such as within an intrathecal space or epidural space of spinal cord 120, or, in some examples, adjacent nerves that branch off spinal cord 120. Leads 130 may be introduced into spinal cord 120 in using any suitable region, such as the thoracic, cervical, or lumbar regions. Stimulation of spinal cord 120 may, for example, prevent pain signals from traveling through spinal cord 120 and to the brain of patient 105. Patient 105 may perceive the interruption of pain signals as a reduction in pain and, therefore, efficacious therapy results. In other examples, stimulation of spinal cord 120 may produce paresthesia which may be reduce the perception of pain by patient 105, and thus, provide efficacious therapy results.

[0062] IMDs 172A and / or 172B are configured to generate and deliver electrical stimulation therapy to a target stimulation site within patient 105 using the electrodes of leads 130 to patient 105 according to one or more therapy stimulation programs. Atherapy stimulation program defines values for one or more parameters (e.g., a parameter set) that define an aspect of the therapy delivered by IMDs 172A and / or 172B according to that program. For example, a therapy stimulation program that controls delivery of stimulation by IMDs 172A and / or 172B in the form of pulses may define values for voltage or current pulse amplitude, pulse width, pulse rate (e.g., pulse frequency), electrode combination, pulse shape, etc. for stimulation pulses delivered by IMDs 172A and / or 172B according to that program. In some examples, parameters include sequences of pulses, for example a “burst” of pulses with gradually increasing current magnitudes, or some other sequence. In some examples, IMDs 172A and / or 172B deliver therapy for a given duration and stop delivering therapy for a given duration. In other words, parameters of the electrical stimulation therapy may include an ON-time and an OFF- time. In some examples, an ON-time is a few seconds or minutes and the OFF-time is also a few seconds or minutes. The ON-time may be equal to the OFF-time in some examples, while in other examples the ON-time and the OFF-time are unequal durations.

[0063] Some examples of items in an information set may include: operating status, operating commands, and therapy parameters that define delivered therapy such as amplitude, pulse width, frequency, burst length, and other parameters that define therapy. An information set may also include sets of parameters to configure sense circuitry in the medical device, identifying information e.g., related to identifying the patient, the computing device, location and similar identification information, power information, firmware update commands, memory access commands, and configuration of closed loop therapy algorithms. Any of this information may be obtained and displayed by external computing device 150 in a field associated with the appropriate medical device.

[0064] In one example, each control stimulation pulse may include a balanced, biphasic square pulse that employs an active recharge phase. However, in other examples, the control stimulation pulses may include a monophasic pulse followed by a passive recharge phase. In other examples, a control pulse may include an imbalanced bi-phasic portion and a passive recharge portion. Although not necessary, a bi-phasic control pulse may include an interphase interval between the positive and negative phase to promote propagation of the nerve impulse in response to the first phase of the bi-phasic pulse.

[0065] In the example of FIG. 1, IMDs 172A and / or 172B are described as performing a plurality of processing and computing functions. However, external computing device 150, mobile computing device 154, or wearable computing device 156 instead may perform one, several, or all of these functions. IMDs 172A and / or 172B canfunction to relay sensed signals to external computing device 150 for analysis, and external computing device 150 transmits instructions to IMDs 172A and / or 172B to adjust the one or more parameters defining the electrical stimulation therapy based on analysis of the sensed signals.

[0066] In an example, IMDs 172A and / or 172B may be configured to deliver therapeutic electrical stimulation signals based on one or more parameters such as amplitude, pulse width, and frequency. In some examples, shortly after implantation or during the implantation surgery for IMDs 172A and / or 172B and / or leads 130, a clinician / surgeon may ascertain initial parameters (e.g., a first set of one or more parameters for a first set of one or more therapeutic electrical stimulation signals). However, the effectiveness of the first set of one or more therapeutic electrical stimulation signals may change overtime. For example, due to lead migration, accommodation of the neural substrate to stimulation, or worsening of patient condition, the first set of one or more therapeutic electrical stimulation signals may be insufficient to provide effective therapy. Conversely, if patient condition improves, the intensity of the first set of one or more therapeutic electrical stimulation signals may be greater than needed to provide effective therapy.

[0067] Accordingly, there may be benefit in periodically updating the first set of one or more parameters to a second set of one or more parameters for a second set of one or more therapeutic electrical stimulation signals for one or more implantable medical devices. In some examples, there may be a benefit to updating each of the sets of one or more parameters from the same interface and maintain connections to each of the one or more implantable medical devices to reduce programming time, thereby improving physician efficiency. In the above examples, there may be benefit in updating the initial parameters. However, in some cases, after the initial parameters are updated, there may be benefit in periodically, or possibly continuously, determining whether to update the parameters for therapeutic electrical stimulation signals.

[0068] One way to update the parameters for therapeutic electrical stimulation signals may be for patient 105 to periodically schedule an appointment with a clinician to update the parameters. Another way to update the parameters for therapeutic electrical stimulation signals may be for patient 105 to manually adjust the parameters himself / herself. In both such examples, a user (e.g. clinician, doctor, operator, or patient) may prefer to have more than one IMD of the IMDs 172A and / or 172B on a user interface of external computing device 150 and / or maintain the connection to each of theone or more IMDS from the external computing device 150 during the programming to reduce programming times. In addition, the user interface described herein may support review and / or updating of any or all of the medical devices of patient 105 at one time, either in a clinic or remotely via a networked connection between external computing device 150 and any or all of the medical devices.

[0069] FIG. 2 is a block diagram illustrating an example communication configuration for a system according to one or more techniques of this disclosure. System 200 of FIG. 2 may be an example of the communications within system 100 of FIG. 1. Devices 210 includes device A 210A, device N 210B, and device M 210C. Device M 210C and device N 210B (collectively “devices 210”) may by the Mthand Nthdevice, respectively, connected to the programmer (i.e., there are any N number of devices connected to the programmer). In some examples, N is 1 if there is only one device for which a user of the system desires connections thereto. In some examples, N can be equal to the number of medical devices 210 worn and implanted on a user. In some examples device 210 is an implantable or wearable device as described above in relation to FIG. 1. In some examples, device 210 is a medical device, a communication device, or any other electronic device capable of communication. In some examples, device 210 is an IMD or and IMS. In other examples, device 210 may also include medical systems that are capital equipment that may be neither body worn nor implantable. Some examples of capital equipment may include a surgical navigation system, a blood oxygen monitoring system, a robotic surgery system and other types of capital equipment. For example, a robotic surgery system may establish a communication channel with a first computing device via a network, e.g., a computing device receiving input from a surgeon in an international location, as well as with a computing device receiving input from a provider that is local and may be in the same operating room as the robotic surgery system. Additionally or alternatively, device 210 may comprise an infusion device located outside of the body and enables profusion of the body with a selected drug. In some examples, the selected drug is a pain medication, a steroid, saline, or any other fluid which may be infused into patient 105.

[0070] In some examples, programmer 212 is an example of external computing device 150 capable of making connections with more than one other device, including devices 210. The connections with more than one other devices include channel A 214A, channel N 214B, channel M 214C, channel L 214D, and server channel 214E (collectively “channels 214.”) Each of devices 210 and programmer 212 may havecommunication circuitry configured to establish communication channels 214 between programmer 212 and other communicative members of system 200. The formation of a first communication channel of communication channels 214 may establish an active session. In some examples, the active session lasts until all communication channels 214 have terminated. In some examples, the active session lasts until terminated by a user. In some examples, the active session lasts until a time out condition comprising a defined amount of time since information was sent or received over any of communication channels 214. In some examples, programmer 212 maintains all communication channels 214 formed until the active session ends. In some examples, programmer 212 maintains one or more of communication channels 214 formed until the active session ends. In some examples, programmer 212 maintains one or more of communication channels 214 and may pause one or more of communication channels 214. In some examples, maintaining one or more of communication channels 214 enables programmer 212 to quickly toggle between which device of devices 210 or server(s) 216 is receiving programming.

[0071] In some examples, programmer 212 is a clinician programmer, a patient programmer, DHP, a recharger, or similar external device. In some examples, programmer 212 is capable of forming connections to devices 210 which are from any vendor and programmer 212 is capable of communicating through a communication protocol which is universal among vendors. In some examples, programmer 212 is capable of making connections only to devices 210 which are from a specific vendor and programmer 212 is capable of communicating through a communication protocol which only programmer 212’s vendor utilizes.

[0072] In some examples, processing circuitry of programmer 212 manages opening and establishing the communication channels 214. In some examples, programmer 212 establishes communication channel A 214Abetween programmer 212 and device A 210A. In some examples, programmer 212 establishes channel N 214B between programmer 212 and device N 210B. Communication channel N may be the Nthcommunication channel whereby there are N-l number of communication channels which are likewise connected to programmer 212. N may be as low as 1 whereby there is only one device connected to programmer 212 and may be as high as required to connect all relevant devices to programmer 212. In some examples, N is equal to 2 in the example of two medical devices. In some examples, wherein N is equal to 2, the medical devices may be two implantable medical devices configured to deliver deep brain stimulation wherein afirst device is implanted in a left hemisphere of a brain of a patient and a second device is implanted in a right hemisphere of the brain of the patient. In some examples, N is equal to 3. In some examples, where N is equal to the three, a first medical device is an implantable medical device configured to measure heart (e.g., a subcutaneous sensing device such as the LINQ system manufactured by Medtronic, Inc.), a second device is an implantable medical device configured to deliver electrical stimulation to a heart of the patient (e.g., an implantable cardiac defibrillator (ICD)), and a third device is a pain management device (e.g., an INS.)

[0073] In some examples, programmer 212 establishes communication channel M 214C between programmer 212 and intermediate communication device 218, as described below. In some examples, programmer 212 establishes sever communication channel 214E between programmer 212 and server(s) 216, as described below. Each of communication channels 214 may be end-to-end encrypted with unique encryption keys (i.e., security key). Programmer 212 may be capable of storing multiple unique encryption keys. In some examples, programmer 212 may store a unique encryption key for each communication channel 214 which is formed. In some examples, programmer 212 may link each of the unique encryption keys which programmer 212 stores to a device 210, or server 216, wherein the linking is based at least in part on one of a serial number, a device location, a device name, or other tracking methodology which could provide a unique correlation between each unique encryption key and communication channel 214.

[0074] In some examples, programmer 212 does not have the decryption keys such that programmer 212 is incapable of decrypting the data and may pass any received data through programmer 212 and onto another device, such as server 216. Any of communication channels 214 may be formed through wired or wireless connections. In some examples, the wireless connection is for example Bluetooth™, Bluetooth Low Energy (BLE), or another protocol such as inductive communication or a protocol using the Medical Implant Communication System (MICS) band.

[0075] Server communication channel 214E between programmer 212 and server 216 may enable data to be sent from a remote location to any of devices 210 through programmer 212. In some examples, server 216 connects to programmer 212 remotely through server communication channel 214E, such as through the internet, to enable a remote application to send data from a remote location to programmer 212 and thereby to devices 210. In such an example, server 216 may send data to devices 210 from a remotelocation whereby programmer is used as a connective intermediary. In some examples, server 216 and server channel communication 214E enables remote programming of devices 210 from a remote location whereby a patient in which devices are implanted and a physician performing the programming need not be physically proximate for devices 210 to be programmed successfully.

[0076] Communication channel M 214C between programmer 212 and intermediate communication device 218 in conjunction with communication channel L 214D between intermediate communication device 218 and device M 210C may enable data to be sent from device 210 and translated from a first communication type to a second communication type. In some examples, device M 210C is a device which operates in a communication type that programmer 212 is not configured to operate with, such as a communication protocol that is outdated, too new, of a different manufacturer, or otherwise different such that intermediate communication device 218 may take information from device M 210C translate it from the first communication type to the second communication type and then send it to programmer 212 as well as take information from programmer 212 translate it from the second communication type to the first communication type and send it to device M 210C. Communication channel L 214D may be formed by intermediate communication device 218 to enable communication between device M 210C and intermediate communication device 218. In some examples, device M 210C does not know that intermediate communication device 218 is in-between device M 210C and programmer 212 as intermediate communication device 218 may present itself as being programmer 212. In some examples, intermediate communication device 218 is a part of programmer 212 itself. In some examples, intermediate communication device 218 is part of device M 210C itself. In some examples, intermediate communication device 218 may be carried out through computer code on either device M 210C and / or programmer 212. Channel M and Channel L, together, may be referred to as a single communication channel herein when it is used to relay communications between programmer 212 and device M.

[0077] FIG. 3 is a block diagram illustrating example components of an implantable medical device as described above in FIGS. 1-2. Implantable medical device 314 is an example of IMDs 172A OR 172B described above in relation to FIG. 1 and / or any of devices 210 described above in relation to FIG. 2 and may have the same or similar functions and characteristics to IMDS 172 or devices 210. The medical device in the example of FIG. 3 is described as an implantable medical device, but the same functions,characteristics and techniques may also apply to other type of wearable or portable medical devices.

[0078] In the example illustrated in FIG. 3, IMD 314 includes temperature sensor 339, coil 316, processing circuitry 330, therapy and sensing circuitry 334, recharge circuitry 338, memory 332, communication circuitry 336, power source 318, and one or more sensors 337, such as an accelerometer. In other examples, IMD 314 may include a greater or a fewer number of components, e.g., in some examples, IMD 314 may not include temperature sensor 339 or sensors 337. In general, IMD 314 may comprise any suitable arrangement of hardware, alone or in combination with software and / or firmware, to perform the various techniques described herein attributed to IMD 314 and processing circuitry 330, and any equivalents thereof.

[0079] Processing circuitry 330 of IMD 314 may be implemented as one or more processors, such as one or more microprocessors, digital signal processors (DSPs), application specific integrated circuits (ASICs), field programmable gate arrays (FPGAs), or any other equivalent integrated or discrete logic circuitry, as well as any combinations of such components. IMD 314 may include a memory 332, such as random access memory (RAM), read only memory (ROM), programmable read only memory (PROM), erasable programmable read only memory (EPROM), electronically erasable programmable read only memory (EEPROM), flash memory, comprising executable instructions for causing the processing circuitry 330 to perform the actions attributed to this circuitry.

[0080] Moreover, although processing circuitry 330, therapy and sensing circuitry 334, recharge circuitry 338, communication circuitry 336, and temperature sensor 339 are described as separate modules, in some examples, some combination of processing circuitry 330, therapy and sensing circuitry 334, recharge circuitry 338, communication circuitry 336 and temperature sensor 339 are functionally integrated. In some examples, processing circuitry 330, therapy and sensing circuitry 334, recharge circuitry 338, communication circuitry 336, and temperature sensor 339 correspond to individual hardware units, such as ASICs, DSPs, FPGAs, or other hardware units. For example, components of IMD 314 may be implemented as separate circuits in some examples. In other examples, two or more components of IMD 314 may be implemented on a single integrated circuit, e.g., including processing circuitry 330, communication circuitry 336, memory 332, therapy and sensing circuitry 334, and so on. In this disclosure, therapy, and sensing circuitry 334 may be referred to as therapy circuitry 334, for simplicity.

[0081] Memory 332 may store therapy programs or other instructions that specify therapy parameter values for the therapy provided by therapy circuitry 334 and IMD 314. In some examples, memory 332 also stores temperature data from temperature sensor 339, instructions for recharging rechargeable power source 318, thresholds, instructions for communication between IMD 314 and an external computing device, or any other instructions required to perform tasks attributed to IMD 314. Memory 332 may be configured to store instructions for communication with and / or controlling one or more temperature sensors of temperature sensor 339. In various examples, memory 332 stores information related to determining the temperature of housing 319 (i.e., external surface) and / or exterior surface(s) of housing 319 of IMD 314 based on temperatures sensed by one or more temperature sensors, such as temperature sensor 339, located within IMD 314.

[0082] For example, memory 332 may store programming settings such as parameters for electrical stimulation therapy output, e.g., magnitude, pulse width, and so on. Memory 332 may store parameters and other settings for the delivery of haptic stimulation. Settings may be individualized based on patient preference and / or patient physiology. For example, a stimulation intensity that is above the perception threshold for a first patient may be different than the stimulation intensity that may be above the perception threshold for a second patient. In some examples, a patient may find a particular frequency to be annoying or painful and therefore a different frequency setting may be suitable when receiving haptic stimulation as feedback.

[0083] Instructions stored at memory 332 when executed by processing circuitry 330 may ascertain whether a sensed bioelectrical signal is valid, such as and ECAP or other signal in response to an output electrical stimulation therapy event. Memory 332 may store programming instructions that when executed by processing circuitry 330 cause processing circuitry 330 to cause electrical stimulation circuitry therapy circuitry 334 to deliver electrical stimulation therapy to a target nerve of a patient. Memory 332 may also store instructions on encrypting and decrypting communications to be sent using communications circuitry 336 to an external computing device, as well as instructions for establishing a communication channel over communication channels, as described above in relation to FIGS. 1 and 2.

[0084] Therapy and sensing circuitry 334 may generate and deliver electrical stimulation under the control of processing circuitry 330. Therapy and sensing circuitry 334 may also output non-therapy stimulation, such as control pulses and hapticstimulation. In some examples, processing circuitry 330 controls therapy circuitry 334 by accessing memory 332 to selectively access and load at least one of the stimulation programs to therapy circuitry 334. For example, in operation, processing circuitry 330 may access memory 332 to load one of the stimulation programs to therapy circuitry 334. In such examples, relevant stimulation parameters may include a voltage amplitude, a current amplitude, a pulse rate, a pulse width, a duty cycle, or the combination of electrodes 317A, 317B, 317C, and 317D (collectively “electrodes 317”) that therapy circuitry 334 may use to deliver the electrical stimulation signal as well as sense biological signals. In other examples, IMD 314 may have more or fewer electrodes than the four shown in the example of FIG. 3. In some examples electrodes 317 is a part of or attached to a housing of IMD 314, e.g., a leadless electrode. In other examples, one or more of electrodes 317 may be part of a lead implanted in or attached to a patient to sense biological signals and / or deliver electrical stimulation, as described above in relation to FIG. 1.

[0085] In some examples, one or more electrodes connected to therapy circuitry 334 may connect to one or more sensing electrodes, e.g., attached to housing of IMD 314. In some examples the electrodes are configured to detect an evoked motor response caused by the electrical stimulation therapy event, or other bioelectrical signals such as ECAPs, impedance and so on.

[0086] IMD 314 also includes components to receive power to recharge rechargeable power source 318 when rechargeable power source 318 has been at least partially depleted. As shown in FIG. 3, IMD 314 includes coil 316 and recharge circuitry 338 coupled to rechargeable power source 318. Recharge circuitry 338 may be configured to charge rechargeable power source 318 with the selected power level determined by either processing circuitry 330 or an external charging device, such as external computing device 150 as described above in relation to FIG. 1 or programmer 212 as described above in relation to FIG. 2. Recharge circuitry 338 may include any of a variety of charging and / or control circuitry configured to process or convert current induced in coil 316 into charging current to charge power source 318. For example, recharge circuitry 338 may include measurement circuitry configured to ascertain a magnitude of current received by secondary coil 316, a magnitude of current delivered to power source 318, and other measurements. Recharge circuitry 338 may send such measurements to processing circuitry 330 to be used in system metrics and sent to an external computing device using communication circuitry 336.

[0087] Secondary coil 316 may include a coil of wire or other device capable of inductive coupling with a primary coil disposed external to the patient. Although secondary coil 316 is illustrated as a simple loop of in FIG. 3, secondary coil 316 may include multiple turns of conductive wire. Secondary coil 316 may include a winding of wire configured such that an electrical current may be induced within secondary coil 316 from a magnetic field. The induced electrical current may then be used to recharge rechargeable power source 318.

[0088] Recharge circuitry 338 may include one or more circuits that process, filter, convert and / or transform the electrical signal induced in the secondary coil to an electrical signal capable of recharging rechargeable power source 318. For example, in alternating current induction, recharge circuitry 338 may include a half-wave rectifier circuit and / or a full-wave rectifier circuit configured to convert alternating current from the induction to a direct current for rechargeable power source 318. The full-wave rectifier circuit may be more efficient at converting the induced energy for rechargeable power source 318. However, a half-wave rectifier circuit may be configured to store energy in rechargeable power source 318 at a slower rate. In some examples, recharge circuitry 338 includes both a full-wave rectifier circuit and a half-wave rectifier circuit such that recharge circuitry 338 may switch between each circuit to control the charging rate of rechargeable power source 318 and temperature of IMD 314.

[0089] Rechargeable power source 318 may include one or more capacitors, batteries, and / or other energy storage devices. Rechargeable power source 318 may deliver operating power to the components of IMD 314. In some examples, rechargeable power source 318 includes a power generation circuit to produce the operating power. Rechargeable power source 318 may be configured to operate through many discharge and recharge cycles. Rechargeable power source 318 may also be configured to provide operational power to IMD 314 during the recharge process. In some examples, rechargeable power source 318 is constructed with materials to reduce the amount of heat generated during charging. In other examples, IMD 314 may be constructed of materials and / or using structures that may help dissipate generated heat at rechargeable power source 318, recharge circuitry 338, and / or secondary coil 316 over a larger surface area of the housing of IMD 314.

[0090] Although rechargeable power source 318, recharge circuitry 338, and secondary coil 316 are shown as contained within the housing of IMD 314, in alternative implementations, at least one of these components may be disposed outside of thehousing. For example, in some implementations, secondary coil 316 may be disposed outside of the housing of IMD 314 to facilitate better coupling between secondary coil 316 and the primary coil of external charging device. In other examples, power source 318 may be a primary power cell and IMD 314 may not include recharge circuitry 338 and recharge coil 316.

[0091] Processing circuitry 330 may also control the exchange of information with an external computing device using communication circuitry 336. Processing circuitry 330 may transmit operational information and receive therapy programs or therapy parameter adjustments over an established communication channel using communication circuitry 336. In some examples, IMD 314 communicates with other implanted devices, such as stimulators, control devices, or sensors, via communication circuitry 336. Communication circuitry 336 may include one or more antennas 337 configured to communicate with an external computing device, e.g., for power transfer or with the other devices. In addition, communication circuitry 336 may be configured to control the exchange of information related to sensed and / or determined temperature data, for example temperatures sensed by and / or determined from temperatures sensed using temperature sensor 339. In some examples, communication circuitry 336 communicates using inductive communication, and in other examples, communication circuitry 336 may communicate using RF frequencies separate from the frequencies used for inductive charging.

[0092] In the example of FIG. 3, communication circuitry 336 includes circuitry 340 configured to manage encryption and decryption and may also execute some of the other functions related to establishing communications channels described in in this disclosure. In other examples, the encryption functions of circuitry 340 may be handled by processing circuitry 330, or by some other circuitry of IMD 314.

[0093] Communication circuitry 336 may be configured to support wireless communication. For example, communication circuitry 336 may be configured to support wireless communication using Bluetooth™ (e.g., BLE and other versions of Bluetooth™, including future versions of Bluetooth™), Wi-Fi™, Near-Field Communication (NFC), Near Field Magnetic Induction (NFMI), Long Term Evolution, 5th generation (LTE / 5G), or MedRadio (MICS: Medical Implant Communication Service, MEDS: Medical External Device Service, MB AD: Medical Body Area Network)) between IMD 314 and another computing device, e.g., a computing device of system 100 or 200 described above in relation to FIGS. 1 and 2. In some examples, communication circuitry 336 supports a communication frequency that may correspond to a high frequency or radio frequency,which may be a radio frequency established using Bluetooth, Wi-Fi, Near-Field Communication (NFC), 175KHz inductive communication, or MICS, for example. Communication circuitry 336 may be configured to receive an inductive sting. Processing circuitry 330 of IMD 314 may receive, as updates to programs (e.g., at least one program parameter), values for various stimulation parameters such as magnitude and electrode combination, from an external computing device using communication circuitry 336. In addition, communication circuitry 336 may communicate with an external medical device using proximal inductive interaction of IMD 314, e.g., during recharging. Communication circuitry 336 may send and receive information on a continuous basis, at periodic intervals, or upon request from an external computing device. Communication circuitry 336 may also be referred to as telemetry circuitry.

[0094] In some examples, processing circuitry 330 transmits additional information to external charging device related to the operation of rechargeable power source 318. For example, processing circuitry 330 may use communication circuitry 336 to transmit a manufacturer, a device class, a model number, a serial number, or an operational status of the device. In some examples, processing circuitry 330 uses communication circuitry 336 to transmit in a first communication format. In some examples, processing circuitry 330 uses communication circuitry 336 to transmit an acceptance response to an interrogation request or in response to a sensor being tripped by a magnetic field. In some examples, processing circuitry 330 uses communication circuitry 336 to transmit a status which may include that rechargeable power source 318 is completely charged, rechargeable power source 318 is fully discharged, the amount of charging current output by recharge circuitry 338 e.g., to power source 318, or any other charge status of rechargeable power source 318. In some examples, processing circuitry 330 uses communication circuitry 336 to transmit instructions to the external charging device, including instructions regarding further control of the charging session, for example instructions to alter the power level or to terminate the charging session, based on the determined temperature of the housing 319 of the IMD.

[0095] Processing circuitry 330 may also transmit information to external charging device that indicates any errors with rechargeable power source 318 that may prevent rechargeable power source 318 from providing operational power to the components of IMD 314. In various examples, processing circuitry 330 may receive, through communication circuitry 336, instructions for algorithms, including formulas and / or values for constants to be used in the formulas that may be configured to ascertain thetemperature of the housing 319 and / or exterior surface(s) of housing 319 of IMD 314 based on temperatures sensed by temperature sensor 339 located within IMD 314 during and after a recharging session performed on rechargeable power source 318.

[0096] FIG. 4 is a block diagram of an example of an external computing device of FIGS. 1 and 2. External computing device 450 in of FIG. 4 is an example of external computing device 150 or programmer 212 described above in relation to FIGS. 1 and 2 respectively and may have the same or similar functions.

[0097] As described above, in some examples, external computing device 450 is a hand-held device, while in other examples, external computing device 450 may be a larger or a non-portable device. In some examples, the hand-held device of external computing device 450 is a smartphone, a tablet, or a smartwatch. In some examples, the larger or a non-portable device of external computing device 450 is a laptop, a desktop, or a server. In addition, in other examples external computing device 450 may be included as part of an external programmer or include functionality of an external programmer. As shown in the example of FIG. 4, external computing device 450 includes two separate components. Housing 424 encloses components such as a processing circuitry 430, memory 452, user interface 454, communication circuitry 456, power button, audio output circuitry 470, and power source 460. Charging head 426, also referred to as a charging wand 426, may include charging circuitry 458, and coil 448. Housing 424 is electrically coupled to charging head 426 using a charging cable. In some examples, housing 424 also includes charging circuitry 468 and coil 428, which is an example of coil 128 described above in relation to FIG. 1. Although external computing device 450 is shown as having the capability of charging another medical device, external computing device 450 may not have that capability or components that support recharge in other examples.

[0098] In some examples, separate charging wand 426 facilitates positioning of coil 448 over coil 116 of IMDs 172 A OR 172B of FIG. 1, or coil 316 of FIG. 3. In some examples, charging circuitry 468 and / or coil 428 integrates within housing 424. In other examples, external computing device 450 may not include charging wand 426. Coil 448 and coil 428 may also be referred to as an antenna.

[0099] External computing device 450 may also include one or more temperature sensors, similar to temperature sensor 339 of FIG. 3. As shown in FIG. 4, the temperature sensor may be disposed within charging head 426. For example, charging head 426 mayinclude one or more temperature sensors positioned and configured to sense the temperature of coil 448 and / or a surface of the housing of charging head 426.

[0100] In general, external computing device 450 comprises any suitable arrangement of hardware, alone or in combination with software and / or firmware, to perform the techniques ascribed to external charging device 450, and processing circuitry 430, user interface 454, communication circuitry 456, and charging circuitry 458 of external charging device 450, and / or any equivalents thereof. In various examples, external computing device 450 may include one or more processors, such as one or more microprocessors, DSPs, ASICs, FPGAs, or any other equivalent integrated or discrete logic circuitry, as well as any combinations of such components.

[0101] Similar to IMDs 172A OR 172B and 314 described above in relation to FIGS. 1 and 3, respectively, components of external computing device 450 shown in FIG. 4 may be implemented as separate circuitry, or combined into one or more integrated circuits. In other words, although processing circuitry 430, communication circuitry 456, and charging circuitry 458 are described as separate modules, in some examples, processing circuitry 430, communication circuitry 456, and / or charging circuitry 458 are functionally integrated. In some examples, processing circuitry 430, communication circuitry 456, and / or charging circuitry 458 correspond to individual hardware units, such as ASICs, DSPs, FPGAs, or other hardware units.

[0102] External computing device 450 also, in various examples, may include a memory 452, such as RAM, ROM, PROM, EPROM, EEPROM, flash memory, a hard disk, a CD-ROM, comprising executable instructions for causing the one or more processors to perform the actions attributed to external charging device 450. Memory 452 may store instructions that, when executed by processing circuitry 430, cause processing circuitry 430 and external computing device 450 to provide the functionality ascribed to external computing device 450 throughout this disclosure, and / or any equivalents thereof, including information sets 434 for the different user interface configurations for user interface 454 as described throughout this disclosure. FIG. 1. For example, memory 452 may include instructions that cause processing circuitry 430 to control the power level used to charge IMD 314 of FIG. 3, as communicated from IMD 314 using a communication channel, e.g., communication channels 214 described above in relation to FIG. 2. Memory 452 may include a record of selected power levels, sensed temperatures, determined temperatures, or any other data related to charging rechargeable power source 318, described above in relation to FIG. 3.

[0103] User interface 454 may include buttons, a keypad, indicator lights, a microphone for voice commands, a display, such as a liquid crystal (LCD), light-emitting diode (LED), or cathode ray tube (CRT) and audio output circuitry. In some examples, the display of user interface 454 is a touch screen. As discussed in this disclosure, processing circuitry 430 may present and receive information using user interface 454. For example, user interface 454 may indicate data regarding any one of the connected devices, including device data generally, as discussed below with respect to at least 520 and 522 of FIG. 5 and stimulation parameters, as discussed below with respect to at least stimulation parameter 1 516 and stimulation parameter N 518 of FIG. 5. In some examples, processing circuitry 430 receives some of the information displayed on user interface 454, e.g., using communication circuitry such as communication circuitry 456. Such communication may further comprise information transmitted from an outside device, such as a server, or data stored on the device for future use, such as being stored in memory 452.

[0104] Processing circuitry 430 may also receive user input using user interface 454. The input may be, for example, in the form of pressing a button on a keypad or selecting an icon from a touch screen. The input may change programmed settings, start, or stop therapy, request starting or stopping a recharge session, a suitable level of charging, or one or more statistics related to charging power source 318 (e.g., the cumulative thermal dose). In this manner, user interface 454 may enable the user to view information related to the operation of IMD 314. In some examples, user interface 454 receives information from a user regarding requested modifications to stimulation parameters for devices such as IMDs 172A or 172B of FIG. 1, devices 210 of FIG. 2, and / or implantable medical device 314 of FIG. 3. In some examples, processing circuitry 430 receives the user input from the user interface 454 and communicate the user input to the communication circuitry 456.

[0105] Charging circuitry 458 may include one or more circuits that generate an electrical current within primary coil 448. Charging circuitry 458 may generate an alternating current of specified amplitude and frequency in some examples. In other examples, charging circuitry 458 may generate a direct current. In any case, charging circuitry 458 may be capable of generating electrical signals, and subsequent magnetic fields, to transmit various levels of power to IMD 314. In this manner, charging circuitry 458 may be configured to charge power source 318 of IMD 314 with the selected power level.

[0106] Power source 460 may deliver operating power to the components of external charging device 450. Power source 460 may also deliver the operating power to drive primary coil 448 or primary coil 428 during the charging process. Power source 460 may include a battery and a power generation circuit to produce the operating power. In some examples, a battery of power source 460 is rechargeable to allow extended portable operation. In other examples, power source 460 may draw power from a wired voltage source such as a consumer or commercial power outlet.

[0107] Processing circuitry 430 may, when requested, transmit any stored data in memory 452 to another computing device for review or further processing, such as to servers 216 depicted in FIG. 2. Processing circuitry 430 may be configured to access memory, such as memory 332 of IMD 314 and / or memory 452 of external charging device 450, to retrieve information comprising instructions, formulas, and determined values for one or more constants. As described above in relation to FIGS. 1 - 3, processing circuitry 430 and communication circuitry 456 may establish one or more secure communication channels between any number of devices, including medical devices, servers, intermediate communication devices, and any other device for which data may be stored, transferred, or created. In some examples, processing circuitry 430 encrypts and decrypt transferred information during a communication session, based encryption keys. In the example of FIG. 4, instructions for establishing the communication channel, handling the encryption handshaking, setting, and resetting the communication session timers, storing encryption keys and other similar functions may be stored at memory 452 (e.g., encryption 432). In other examples, (not shown in FIGS. 3 and 4) the encryption keys and / or encryption instructions may be stored in a separate encrypted memory in communication with processing circuitry 330 or 430.

[0108] In some examples, communication circuitry 456 establishes a first communication channel directly to N devices, e.g., devices 210 of FIG. 2. Communication circuitry 456 may establish a communication channel directly to an IMD or INS and may additionally or alternatively establish a communication channel through an intermediate communication device to an IMD or INS. In some examples another computing device, e.g., of systems 100 or 200 described above in relation to FIGS. 1 or 2 may transfer information with devices 210 using any of communication channels 214. Communication circuitry 456 may establish a communication channel to a server, such as server 216 of FIG. 2 to receive updates, transfer data, receive updated stimulationparameters, be controlled thereby, or otherwise enable server 216 to control, adapt, or transform the data used by device 450.

[0109] Communication circuitry 456 may support wireless communication between IMDs 172A OR 172B of FIG. 1, devices 210 of FIG. 2, and / or implantable medical device 314 of FIG. 3 and external computing device 450 under the control of processing circuitry 430. Communication circuitry 456 may also be configured to communicate with another computing device using wireless communication techniques, or direct communication through a wired connection. In some examples, communication circuitry 456 is substantially similar to communication circuitry 336 of IMD 314 described herein, providing wireless communication using an RF or proximal inductive medium. In some examples, communication circuitry 456 includes an antenna 457, which may take on a variety of forms, such as an internal or external antenna. Although communication circuitry 456 may each include dedicated antennas for communications between these devices, communication circuitry 456 and 336 may instead, or additionally, be configured to utilize inductive coupling from coils 316 and 448 to transfer data.

[0110] Examples of local wireless communication techniques that may be employed to facilitate communication between external computing device 450 and IMD 314 include radio frequency and / or inductive communication according to any of a variety of standard or proprietary communication protocols, or according to other communication protocols such as the IEEE 802.1 lx or Bluetooth specification sets. In this manner, other external devices may be capable of communicating with external computing device 450 without needing to establish a secure wireless connection.[oni] FIG. 5 is an example user interface 500 with a first field 514 for a first device and a second field 526 for a second device. User interface 500 of FIG. 5 may be an example of a user interface presented to a user at user interface 454 of external computing device 450 of FIG. 4

[0112] User interface 500 includes display area 510, which may be a single screen presented at one time. Display area 510 may take any shape including rectangular, square, circular, or any other shape which may display the information to a user. As shown in FIG. 5, display area 510 is rectangular as would be found, for example, on a smartphone, a tablet, or any other mobile computing device. A shape and size of such display area 510 may be dictated by a user interface area, such as user interface 454 of FIG. 4. In some examples, display area 510 is filled with one or more data fields. In some examples, display area 510 has blank space in display area 510 for aesthetic or interoperabilityreasons, such as seen in FIG. 5 wherein a space has been left along the edges of display area 510.

[0113] Within display area 510 is at least first field 514 and second field 526 associated with respective different medical devices of one patient. In some examples, above first field 514 is first label 512. In some examples, first label 512 is anywhere nearby first field 514 such that a user may understand that first label 512 is indicative of first field 514. In some examples, above second field 526 is second label 524. In some examples, second label 524 is anywhere nearby second field 526 such that a user may understand that second label 524 is indicative of second field 526. First label 512 provides a description of which device (among any number of devices which may be connected to an external computing device) for which the data of first field 514 is associated. Second label 524 provides a description of which device (among any number of devices which may be connected to an external computing device) for which the data of second field 526 is associated. In the example provided by FIG. 5, there are two labels and two fields. In some examples, user interface 500 comprises N number of fields with N number of labels, wherein N is the number of medical devices connected to an external computing device 450 of FIG. 4. For example, user interface 500 may comprise additional fields beyond first field 514 and second field 526. In some examples, user interface 500 comprises: 3 fields, 4 fields, or any N number of fields.

[0114] In some examples, user interface may display all of the fields for all of the medical devices of the patient on the single screen of user interface 500. However, in some examples, multiple fields may be shown on the single screen, but the user interface 500 may receive a swipe or other input that navigates to other fields not shown at the same time. In some examples, user interface 500 may be configured to zoom in or zoom out on the fields to present greater or fewer fields on the same screen, but lesser or more information for each field may be shown depending on the available screen real estate available after increasing or decreasing the number of fields shown on the single screen.

[0115] First field 514 may comprise information describing parameters, including stimulation parameter 1 516 and stimulation parameter N 518, or data, including device data 1 520 and device data N 522, of a first device among any number of devices connected to an external computing device. In some examples, the information presented to the user includes stimulation parameters including stimulation parameter 1 516 to stimulation parameter N 518. There may N stimulation parameters, which may include, for example, stimulation amplitude, pulse frequency, pulse width, the number of pulses ina burst, the number of bursts over a duration, the pulse width of a pulse in a burst, the ON-time, the OFF-time, a pattern of pulses over a duration, or any other stimulation parameters which may be adjusted for a medical device. Stimulation parameters 516 and 518 may additionally or alternatively be device parameters or therapy parameters such as fluid delivery rates, recharge schedules, maintenance schedules, or any other parameters which may be programmed into a medical device. Stimulation parameter 1 516 and stimulation parameter N 518 may be input elements such that user interface 500 may receiving user input interacting with the elements and responsively transmit a command to the respective medical device to perform that adjustment to the requested parameter. Device data 1 520 and device data N 522 of first field 514 may present to a user data from the first device which indicates a status of the device, a health of the device, or other information which would be useful to present to a user. Device data N 522 represents any N number of data points which could be useful to present to a user at user interface 500.

[0116] Second field of 526 may be similar to first field 514 comprising the same information wherein stimulation parameter 1 528 may be an example of stimulation parameter 1 516, stimulation parameter N 530 may be an example of stimulation parameter N 518, device data 1 532 may be an example of device data 1 520, and device data N 534 may be an example of device data N 522. In some examples, N number of stimulation parameters is different between device and stimulation parameter N 530. In some examples, N number of device datapoints may be different between device data N 522 and device data N 534.

[0117] FIGS. 6 A and 6B are illustrations of example user interface 600 with a first screen 614 for a first device and a second screen 626 for a second device. User interface 600 of FIG. 6 may be an example of a user interface presented to a user at user interface 454 of FIG. 4. In addition, user interface 600 may be similar to user interface 500 of FIG. 5 except for a single screen only showing information for a single medical device at one time.

[0118] User interface 600 includes display area 610 which may be switched between displaying different information through the use of switch buttons 613 or 625. Display area 610 of each screen may take any shape including rectangular, square, circular, or any other shape which may display the information to a user. As shown in FIGS. 6A and 6B, display area 610 is rectangular as would be found, for example, on a smartphone, a tablet, or any other mobile computing device. Such display area 610 may be dictated by a user interface area, such as an area of user interface 454 of external computing device 450 ofFIG. 4. In some examples, display area 610 is filled with information such that there is no empty space. In some examples, display area 610 has extra space such for aesthetic or compatibility reasons, such as seen in FIGS. 6A and 6B wherein a space has been left along the edges of display area 610. Each screen of the two or more screens, including first screen 614 and second screen 626, may fill user interface 454 or nearly fill user interface 454.

[0119] Within display area 610 may be first screen 614 (FIG. 6A) or second screen 626 (FIG. 6B). In some examples, above first screen 614 is first label 612. In some examples, first label 612 is anywhere on first screen 614. In some examples, above second screen 626 is second label 624. In some examples, second label 624 is anywhere on second screen 626. First label 612 provides a user of user interface a description of which device (among any number of devices which may be connected to an external computing device) the data of first screen 614 is describing. Second label 624 provides a user of user interface a description of which device (among any number of devices which may be connected to an external computing device) the data of second field 626 is describing. In the example provided by FIG. 6, there are two screens. In some examples, user interface 600 comprises N number of screens, wherein N maybe the number of medical devices connected and sending information. For example, user interface 600 may comprise additional screens beyond first screen 614 and second screen 626. In some examples, user interface 600 comprises: 3 screens, 4 screens, or any number of screens. Each of these screens are shown at separate times, but the external computing device may maintain the communication channels of all of the medical devices of each screen such that the user interface can switch between screens without needing to re-establish communication during an active session of user interface 600.

[0120] A user may switch between screens 614 and 626 using switch interface 613 or 625. Switch interface 613 and 625 is a transition input element of user interface 600 which upon selection or interaction therewith enables a user to view another screen of the two or more screens comprising user interface 600. In FIGS. 6A and 6B, switch interface 613 or 625 is a slider wherein a user may use a slide gesture to move the highlighted side of the slider bar to the other side of the slider bar, thereby moving from first screen 614 to second screen 626 and modulating switch interface 613 into switch interface 625. To reverse this selection, user may interact with switch interface 625 in a similar manner to reverse the selection. In some examples, switch interface 613 or 625 may be a button, a dial, a keypad, or any other transition input element to select a screen from two or morescreens. Again, switching between different screens using switch interface 613 and 625, for example, does not terminate or re-establish communication with any of the respective medical devices during the active session of user interface 600. In some examples, user interface 600 may present a confirmation input in response to receiving input requesting switching to a different screen in order to ensure the user desires to view or program a different medical device. In this manner, user interface 600 may only switch to a different screen for a different medical device and switch control to a different communication channel in response to receiving the confirmation input.

[0121] First screen 614 may comprise information describing parameters, including stimulation parameter 1 616 and stimulation parameter N 618, or data, including device data 1 620 and device data N 622, of a first device among any number of devices connected to an external computing device. In some examples, the information presented to the user includes stimulation parameters including stimulation parameter 1 616 to stimulation parameter N 618. There may N stimulation parameters, such as a stimulation amplitude, pulse width, pulse frequency, the number of pulses in a burst, the number of bursts over a duration, the pulse width of a pulse in a burst, the ON-time, the OFF-time, a pattern of pulses over a duration, or any other stimulation parameters which may be adjusted for a medical device. Stimulation parameters 616 and 618 may additionally or alternatively be device parameters or therapy parameters such as fluid delivery rates, recharge schedules, maintenance schedules, or any other parameters which may be programmed into a medical device. Stimulation parameter 1 616 and stimulation parameter N 618 may be input elements such that by interacting with the elements, the parameters themselves may be adjusted by the user. Device data 1 620 and device data N 622 of first screen 614 may present to a user data form the first device which indicates a status of the device, a health of the device, or other information which would be useful to present to a user. Device data N 622 represents any N number of data points which could be useful to present to a user at user interface 600.

[0122] Second screen of 626 may be similar to first screen 614 comprising the same information wherein stimulation parameter 1 628 may be an example of stimulation parameter 1 616, stimulation parameter N 630 may be an example of stimulation parameter N 618, device data 1 632 may be an example of device data 1 620, and device data N 634 may be an example of device data N 622. In some examples, N number of stimulation parameters is different between device and stimulation parameter N 630. Insome examples, N number of device datapoints is different between device data N 622 and device data N 634.

[0123] FIG. 7 is an example user interface with a list of all connected devices. User interface 700 of FIG. 7 may be an example of a user interface presented to a user at user interface 454 of FIG. 4. User interface 700 may be similar to user interface 500, but with showing information for each medical device instead of programmable parameters. User interface 700 includes display area 710. Display area 710 may take any shape including rectangular, square, circular, or any other shape which may display the information to a user. As shown in FIG. 7, display area 710 is rectangular as would be found, for example, on a smartphone, a tablet, or any other mobile computing device. Such display area 710 may be dictated by a user interface area, such as user interface 454 of external computing device 450 of FIG. 4. In some examples, display area 710 is filled with information such that there is no empty space. In some examples, display area 710 has extra space such for aesthetic or programmatic reasons, such as seen in FIG. 7 wherein a space has been left along the edges of display area 710.

[0124] Within display area 710 is at least label 712, first field 714, and second field 728. Within display area 710 may be label 712 which describes the data contained in first field 714 and second field 728. In some examples, label 712 is a device list label as used in FIG. 7 In some examples, label 712 is a pre-set name defined in advance by a template. In some examples, within and as a first entry of first field 714 is first label 716. In some examples, first label 716 is anywhere within first field 714 such that a user may understand that first label 716 is indicative of label of first field 714. In some examples, within and as a first entry of second field 728 is second label 730. In some examples, second label 730 may be an Nth label, wherein N is a number of devices connected to the system. In some examples, second label 730 is anywhere within second field 728 such that a user may understand that second label 730 is indicative of second field 728. First label 716 provides a user of user interface a description of which device (among any number of devices which may be connected to an external computing device) the data of first field 714 is describing. Second label 730 provides a user of user interface a description of which device (among any number of devices which may be connected to an external computing device) the data of second field 728 is describing. In the example provided by FIG. 7, there are two fields. In some examples, user interface 700 comprises N number of fields for N number of devices. For example, user interface 700 maycomprise additional fields beyond first field 714 and second field 728. In some examples, user interface 700 comprises: 3 fields, 4 fields, or any number of fields.

[0125] First field 714 may comprise information describing a first device among any number of devices. First field 714 may comprise information regarding manufacturer 718 of the device, what type of device 720 the device is (e.g., left hemisphere deep brain stimulator, spinal cord stimulator, drug infusion pump, LINQ system, etc.), model number and / or serial number 722 of the device, status 724 of the device, and further information 726. Further information 726 may comprise a name of the device, a signal strength of the device, a battery status of the device, an error of the device, or any other information one may recognize relevant to a medical device.

[0126] Second field 728 may be similar to first field 714 comprising the same information as first field 714. Manufacturer 732 may be an example of manufacturer 718, device type 734 may be an example of device type 720, model number and / or serial number 736 may be an example of model number and / or serial number 722, status 738 may be an example of status 724, and further information 740 may comprise the same, additional, or alternative information as further information 726.

[0127] User interface 700 may additionally or alternatively include scroll bar 742 enabling a user to scroll through the list of devices. In some examples, the number of devices connected enables the list of devices to fit onto a screen of a user interface without scroll bar 742. In some examples, so many devices will be connected and transmitting information that they cannot all fit onto the screen of the user interface and therefore scroll bar 742 enables a user to scroll through all of the devices until they see the devices they are looking for. In some examples, user interface 700 may include one or more fields 514 and / or 526 that provide programmable parameters in addition to one or more fields 714 and / or 728 that provides information regarding the respective medical device. In some examples, these different fields, or the information they provide or inputs they can receive, are selected based on whether or not the medical device is controllable by the external computing device. If a medical device can be controlled, or programmed, but the external computing device, user interface 700 may present a field for that medical device that enables the user to input changes to one or more parameters instead of a field that only presents identifiable information.

[0128] FIGS. 8A, 8B, and 8C are discussed together for clarity. FIG. 8A is an example of the user interface 800 for a medical device system comprising a first deep brain stimulator implanted in a right hemisphere of a brain of a patient and a second deepbrain stimulator implanted in a left hemisphere of the brain the patient wherein the first device is an active device. User interface 800 is used for all of FIGS. 8A, 8B, and 8C at various configurations based on which medical device is selected for programming and / or after a user has confirmed the change in the active device.

[0129] User interface 800 includes display area 810 which may be switched between read-only and interactable through the use of a switch button. Display area 810 may take any shape including rectangular, square, circular, or any other shape which may display the information to a user. As shown in FIG. 8 A, display area 810 is rectangular as would be found, for example, on a smartphone, a tablet, or any other mobile computing device. A shape and size of display area 810 may be dictated by a user interface area, such as user interface 454 of external computing device 450 of FIG. 4. In some examples, display area 810 is filled with information such that there is no empty space. In some examples, display area 810 has extra space such for aesthetic or programmatic reasons, such as seen in FIG. 8 A wherein a space has been left along the edges of display area 810 for aesthetic or compatibility reasons.

[0130] Within display area 810 may comprise first field 814 (or region) and / or second field 826 (or region) to display data relevant to IMDs 840A and 840B (collectively “IMDs 840”). In some examples, above first field 814 is first label 812. In some examples, first label 812 is anywhere on first field 814. In some examples, above second field 826 is second label 824. In some examples, second label 824 is anywhere on second field 826. First label 812 provides a user of user interface a description of which device (among any number of devices which may be connected to an external computing device) the data of first field 814 is describing. Second label 824 provides a user of user interface a description of which device (among any number of devices which may be connected to an external computing device) the data of second field 826 is describing. In FIG. 8A, first label 812 reads “right hemisphere control” and second label 814 reads “left hemisphere control” as these labels may be pre-programmed into the user interface through the use of a template. In some examples, the template for the user interface may be stored in memory 452 of external computing device 450 of FIG. 4. The templates stored in memory 452 may control an overall look, the images displayed at the user interface, the locations of the data displayed at the user interface, and any other features of the user interface. In the example provided by FIG. 8A, there are two regions for each of the two device which patient 836 is implanted therewith. In some examples, user interface 800 comprises N number of regions for N number of implantable medical devices, wearablemedical devices, and / or other communication devices. For example, user interface 800 may include additional regions beyond first field 814 and second field 826 for each of the N devices. In some examples, user interface 800 includes three regions such as if patient 836 had three medical devices, four regions such as if patient had four medical devices, or any number of regions based on a quantity of medical devices patient 836 wears, has implanted, interacts with, or will interact with.

[0131] IMDs 840 of FIG. 8 A are both implantable neural stimulators for exemplary purposes. IMDs 840 may be two or more devices of one or more device families / therapies. In an example, IMDs 840 may include four devices such as a first device configured to deliver neural stimulation to a left hemisphere of a brain of a patient, a second device configured to deliver neural stimulation to a right hemisphere of a brain of a patient, a third device configured to deliver neural stimulation to a spinal cord of a patient to reduce pain sensations, and a fourth device such as an intrathecal pump or an infusion pump configured to deliver pain medications to reduce pain sensations. Other examples of IMDs 840 may include any combination of any device capable of telemetry or communication. Communication between IMDs 840 and other devices may include a single type or multiple types of communication formats including Bluetooth, Bluetooth low energy, Tel M, Tel N, Tel A, or any other communication protocol which may communicate to IMDs 840. In other examples, a single IMD may be coupled to lead extensions 842 and / or multiple leads and used instead of multiple IMDs to provide electrical stimulation, but other IMDs may also be implanted or otherwise associated with the patient. In any of these examples, user interface 800 may enable the user to toggle between any of the detectable devices for programming, retrieving data, charging, or any other reason.

[0132] First field 814 may comprise information describing parameters, including stimulation parameter 1 816 and stimulation parameter N 818, or data, including device data 1 820 and device data N 822, of a first device among any number of devices connected to an external computing device. In some examples, once either of IMDs 840 have connected to an external programming device, an active session is begun. In some examples, the active session lasts until a time out condition, such as a set period of time since data was sent or received from either of IMDs 840. In some examples, the information presented to the user includes stimulation parameters including stimulation parameter 1 816 to stimulation parameter N 818. There may N stimulation parameters, for example an amplitude, multiple amplitude thresholds, pulse frequency, pulse width, thenumber of pulses in a burst, the number of bursts over a duration, the pulse width of a pulse in a burst, the ON-time, the OFF-time, a pattern of pulses over a duration, sensing parameters or thresholds, or any other stimulation parameters which may be adjusted for a medical device. Stimulation parameters 816 and 818 may additionally or alternatively be device parameters or therapy parameters such as fluid delivery rates, recharge schedules, maintenance schedules, or any other parameters which may be programmed into a medical device. Stimulation parameter 816 and stimulation parameter N 818 may be transition input elements such that by interacting with the elements (e.g., clicking them, selecting them, tapping them), the parameters themselves may be adjusted by the user (e.g., through the use of a dial, a slider, or an input). Device data 1 820 and device data N 822 of first field 814 may present to a user data from the first device which indicates a status of the device, a health of the device, or other information which would be useful to present to a user. Device data N 822 represents any N number of data points which could be useful to present to a user at user interface 800. Selecting device data 1 820 or device data N 822 may present to a user a graphic (not shown) which shows a change in the selected data attribute over time.

[0133] Second region of 826 may be similar to first field 814 comprising the same information wherein stimulation parameter 1 828 may be an example of stimulation parameter 1 816, stimulation parameter N 830 may be an example of stimulation parameter N 818, device data 1 832 may be an example of device data 1 820, and device data N 834 may be an example of device data N 822. In some examples, N number of stimulation parameters is different between device and stimulation parameter N 830. In some examples, N number of device datapoints is different between device data N 822 and device data N 834.

[0134] User interface 800 may further comprise a representation of the locations of the implants and electrodes thereof. User interface 800 of FIG. 8 A represents the relative locations of IMDs 840 which may include lead extension 842A and 842B (collectively “lead extensions 842”) and leads 846A and 846B with respective sets of electrodes 844A and 844B. In the example shown in FIG. 8 A, electrodes of leads 846 A and 846B are positioned to deliver electrical stimulation to a tissue site within brain 838, such as a deep brain site under the dura mater of brain 838 of patient 836. IMDs 840, lead extensions 842, leads 846A / 846B, patient 836, and brain 838 may be examples of IMD 172 A, lead extension 110, leads 130A / 130B, patient 105, and brain 118, respectively, of FIG. 1. As described above with respect to FIG. 1, lead extensions 842A and / or 842B may includeone or more individual lead extensions. In some examples, delivery of stimulation to one or more regions of brain 838, such as the subthalamic nucleus (STN), globus pallidus or thalamus, ventralus intermediate (VIM), anterior nucleus (ANT), ventral internal capsule / ventral striatum (VC VS), cortico-basal ganglia-thalamocortical circuit, or anterior insular cortex (AIC), may be an effective treatment to manage disorders, such as Parkinson’s disease. Some or all of electrodes 844A and 844B also may be positioned to sense neurological brain signals within brain 838 of patient 836. In some examples, some of electrodes 844A and 844B are configured to sense neurological brain signals and others of electrodes 844A and 844B may be configured to deliver electrical stimulation to brain 838. In other examples, all of electrodes 844 A and 844B are configured to both sense neurological brain signals and deliver electrical stimulation to brain 838. In some examples, user interface 800 represents which electrodes of 844A and 844B are configured to sense neurological brain signals and those that are configured to deliver electrical stimulation. In some examples, unipolar stimulation is possible where one electrode is on the housing of IMDs 840.

[0135] In some examples, user interface 800 enables a user to select any of leads 846A and 846B, electrodes 844A and 844B, or IMDs 840 to alter what information is displayed in first field 814 or second field 826. In some examples, a user selects IMDs 840 and thereby may pull up data on IMDs 840 itself, such as a battery level, a temperature of the device, an age of the device, or any other information which may be relevant to a user wishing to alter an operation of IMDs 840, such information including but not limited to device data 1 820, device data N 822, device data 1 832, or device data N 834. In some examples, a user selects electrodes 844A and 844B and thereby may pull up data on electrodes 844A and 844B such as stimulation parameters which are being delivered at on electrodes 844A and 844B, the sensed data on electrodes 844A and 844B, an age of the electrodes, a health of on electrodes 844A and 844B, or any other information which may be relevant to a user wishing to alter an operation of electrodes 844 A and 844B including but not limited to stimulation parameter 1 816, stimulation parameter N 818, stimulation parameter 1 828, or stimulation parameter N 830.

[0136] A user may switch between which region is an active region (e.g., which medical device is selected for interaction) using switch interface 813 or 825. In the state shown in FIG. 8 A, a user may only interact with first field 814 that is “selected” (as shown in the indicator of switch interface 813) while second field 826 is locked or “unselected” (as shown in the indicator or switch interface 825). Second field 826 beinglocked may be exemplified by an “X,” a lock symbol, the words “unselected”, and / or as shown in FIG. 8A in which field 826 and IMD 840B is grayed out. Second field 826 may be locked for security reasons, safety reasons, or for simplicity reasons. In some examples, second field 826 is not be locked. In some examples, stimulation parameter 1 828, and stimulation parameter N 830 of second field 826 are locked while device data 1 832 and device data N 834 of second field 826 may still be accessible and unlocked. Even if second field 826 may be locked, a connection between IMDs 840 and the user interface device may continue to transmit data and / or remain active such that upon selection to change active regions, the user is able to adjust the parameters of second field 826 shortly after selecting the second field 826. In FIG. 8A, a user may only adjust the attributes of first field 814 including stimulation parameter 1 816 and stimulation parameter N 818, or data, including device data 1 820 and device data N 822. In other words, the external medical device may only enable commands (e.g., adjustments to one or more operational parameters) to be sent to the selected, or active, medical device. The external computing device is configured such that it cannot send commands to other unselected medical devices via the open communication channel when that medical device is unselected.

[0137] A user may choose that they would like to adjust the attributes of another device besides that represented by first field 814, such as a left hemisphere deep brain stimulator device, and to do so may select switch interface 813 or 825. Switch interface 813 and 825 are transition input elements of user interface 800 which upon selection may prompt a user to confirm they want to change the region selection, as exemplified by confirmation window 848 of FIG. 8B. Upon selection of an affirmatory answer in confirmation window 848, a user may then interact with the elements of second field 826, but may then be locked out of interacting with the elements of first field 814 as illustrated by FIG. 8C. Once the medical devices have been switched, FIG. 8C shows that switch interface 825 now indicates that IMD 840B is “selected”. Such a lockout of first field 814 may be substantially similar to the lockout as described with respect to FIG. 8A for second field 826.

[0138] In FIG. 8 A, switch interface 813 is a slider wherein a user may use a slide gesture to move the highlighted side of the slider bar to the other side of the slider bar, thereby disabling first field 814 and enabling second field 826. In some examples, switch interface 813 and switch interface 825 are both active whereby the user needs only select either to alter a selection. In some examples, switch interface 813 is active only when switch interface 825 is inactive and vice versa. In some examples, switch interface 813 or825 is a button, a dial, a keypad, or any other transition input element to select a region from two or more regions. Instead of input buttons, the switch interface may instead be a “swipe” across the screen to the right or to the left or a “touch” of the desired medical device that initiates the switch to a new medical device. Confirmation window 848 may be presented after any type of switch input is received to prevent undesired or accidental switching between medical devices.

[0139] FIG. 9 is a flow chart illustrating an example mode of operation of the communication circuitry of the systems of this disclosure. The flow chart in the example of FIG. 9 may apply to any of systems 100 or 200 described above in relation to FIGS. 1 and 2, to implantable medical device 314, external computing device 550, and IMDs 840 described above in relation to FIGS. 4, 5, and 8. As discussed above, the techniques of this disclosure may also apply to a medical device, such as a wearable medical device, in addition to an implantable medical device. Any of user interfaces described herein may be used in the technique of FIG. 9.

[0140] In some examples, and as shown in FIG. 4, processing circuitry 430 may cause communication circuitry 456 initiate, via communication circuity, communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key (900). The programmer may be programmer 212 and the first device may be device A 210A, wherein the communication channel is communication channel A 214A. The programmer may be programmer 212 and the second device may be device N 210B, wherein the communication channel is communication channel N 214B. The plurality of devices may be any of devices 210. Processing circuitry 430 may cause communication circuitry 456 to receive signals from the plurality of devices via the respective communication channels (905). The programmer may be programmer 212 and the signals may be representative of parameters, including stimulation parameter 1 516 and stimulation parameter N 518, or data, including device data 1 520 and device data N 522.

[0141] Processing circuitry 430 generate for display, via processing circuitry, a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session (910) The user interface may be any of user interface 500 of FIG. 5, user interface 600 of FIG. 6, user interface 700 of FIG. 7, or user interface 800 of FIGS. 8A-8C.

[0142] Processing circuitry 430 may control communication circuitry 456 to maintain the respective communication channels for each medical device of the plurality ofmedical devices during the active session of the user interface. (915) Processing circuitry 430 may control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session. (920) Processing circuitry 430 may receive an input from the user at the user interface associated with one medical device of the plurality of medical devices. (925) Processing circuitry 430 may control, responsive to receiving the input, communication circuitry 456 to transmit a command to the one medical device via the respective communication channel during the active session. (930)

[0143] The input transmitted to the first device may be an adjustment to stimulation parameters, an adjustment to device protocols, an update to the device, or any other communications which may be transmitted to a device and the first device may be any device including IMDS 172A or 172B, device 210, IMD 314, and / or IMDs 840. The communication protocols which are maintained may comprise any of communication channel A - communication channel N, including at least 214A-214E. Maintaining formed communication channels of communication channel A - communication channel N enables a rapid switching between devices without requiring interrogation for each transmission of data. Preventing transmission may be similar to locking regions of FIGS. 8A-8C, and prevention of transmission may be for safety reasons, practicality reasons, or otherwise be preferred to enabling transmission to any or all devices at once.

[0144] In some examples, other computing devices, e.g., servers 216 of system 200, may transfer information to communication circuitry 336 and IMD 314 using communication circuitry 456. In other examples, as shown in FIGS. 1 and 2, the other computing devices of systems 100 may establish communication channels directly with the medical device.

[0145] FIG. 10 is a conceptual illustration of an example user interface 1000 that is configured to present multiple medical devices for a patient and a field that accepts user input to adjust one or more parameters of only a selected medical device. User interface 1000 may be similar to user interface 800, but may show the entire patient and any medical devices that are detectable for the patient.

[0146] As shown in user interface 1000, a single screen 1010 may show all of the medical devices at one time and in approximate relation to the anatomical region of patient body 1002 in which the medical device is located. Devices 172A, 172B, 156, and 154 are similar to those described with respect to FIG. 1, but other devices may also be detected in other examples. User interface 1000 may also show target anatomicalstructures to which therapy or sensing is directed, such as brain 118, or other not shown structures such as a spinal cord, vertebra, one or more target nerves, heart, muscles, etc.

[0147] IMD 172B is shown as being selected which is indicated by switch interface 813 and selection target 1004. Selection target 1004 may encircle, highlight, or otherwise graphically indicate the current medical device selected for viewing information or parameters in field 814. As shown, parameter 816 is the amplitude of stimulation and parameter 818 is the current pulse width. User interface 1000 may receive input adjusting either parameter via arrows, drop menu, or other input mechanism. Device data 820 and 822 may show the current stimulation status as ON and the closed-loop stimulation also as ON, but other information may be shown. In some examples, field 814 may receive input changing any information as desired by the user.

[0148] User interface 1000 can support selecting any different medical device shown with respect to patient body 1002. Selection target 1004 can be dragged by the user to a different device or the user can “tap” on a different device to move selection target 1004 to the new device. Alternatively, as shown in swipe instruction 1006, user interface 1000 can receive a “swipe” from a finger or other input mechanism that switches to a new medical device. In response to selecting a different medical device, user interface 1000 can show a field associated with the newly selected device. In any case, communication channels may all be maintained as opened between the external computing device of user interface 1000 during an active session such that the external computing device can switch control to different medical devices without re-establishing communication to each medical device. User interface 1000 can be configured to receive user input requesting termination of communication channels to any specific medical devices or a global communication termination instruction when the entire programming session is complete.

[0149] All of the user interfaces described herein may be used within a single program and operate as different versions or configurations. For example, the user may request a specific type of user interface described herein. Alternatively, the system may select a specific type of user interface depending on the available medical devices for the patient.

[0150] The techniques of this disclosure may also be described in the following examples.

[0151] Example 1 : A system includes communication circuitry configured to: initiate communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a uniqueencryption key; and receive signals from the plurality of devices via the respective communication channels; and processing circuitry configured to: generate, for display, a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session; control the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface; control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session; receive, via the user interface, an input from the user associated with one medical device of the plurality of medical devices; and responsive to receiving the input, control the communication circuitry to transmit a command to the one medical device via the respective communication channel during the active session.

[0152] Example 2: The system of example 1, wherein each medical device of the plurality of medical devices are implanted in a single patient.

[0153] Example 3: The system of any of examples 1 and 2, wherein the processing circuitry is further configured to, responsive to receiving the input, control the communication circuitry to prevent transmission of the input to one or more other medical devices of the plurality of medical devices via the respective communication channels until a switch signal is received.

[0154] Example 4: The system of example 3, wherein the processing circuitry is further configured to: responsive to receiving the switch signal, control the display device to present the user interface comprising a confirmation request; responsive to receiving the confirmation request, control the display device to present the user interface comprising an indication that further inputs will be sent to a selected medical device of the one or more other medical devices; receive, via the user interface, a second input from the user associated with the selected medical device; responsive to receiving the second input, control the communication circuitry to transmit a second command to the selected medical device via the respective communication channel during the active session and to prevent transmission of the second command to the one medical device via the respective communication channel.

[0155] Example 5: The system of any of examples 1 through 4, wherein the user interface comprises a first field comprising a first set of one or more parameters associated with the first device and a second field comprising a second set of one or more parameters associated with the second device, wherein the user interface is configured topresent both the first field and the second field at the same time on a single screen of the user interface.

[0156] Example 6: The system of any of examples 1 through 5, wherein the user interface comprises a first screen comprising a first set of one or more parameters associated with the first device and a second screen comprising a second set of one or more parameters associated with the second device, wherein the user interface is configured to receive a transition input that requests the user interface switch between the first screen and the second screen.

[0157] Example 7: The system of any of examples 1 through 6, wherein the signals comprise an indication, from a respective medical device of the plurality of medical devices, representing at least one of a manufacturer, a device class, a model number, a serial number, or an operational status.

[0158] Example 8: The system of example 7, wherein the user interface comprises a list of each of the medical devices of the plurality of devices.

[0159] Example 9: The system of example 8, wherein one or more medical devices of the plurality of medical devices are configured to transmit the indication readable by the processing circuitry instead of receiving any commands via the respective communication channel during the active session.

[0160] Example 10: The system of any of examples 1 through 9, wherein the user interface is configured to receive user input customizing at least one of device, device class, layout, orientation, manufacturer, or status of the one or more devices for display via the user interface.

[0161] Example 11 : The system of any of examples 1 through 10 further comprising an intermediate communication device configured to enable a communication channel between a medical device of the plurality of medical devices and the communication circuitry, wherein the communication channel comprises a first channel between the intermediate communication device and the medical device, and a second channel between the intermediate communication device and the communication circuitry.

[0162] Example 12: The system of example 11, wherein: the first channel is configured to transmit information in a first communication format, the second channel is configured to transmit information in a second communication format, the first communication format is different than the second communication format, the medical device is configured to transmit the signals in the first communication format, and thecommunication circuitry is configured to interpret the signals in the second communication format.

[0163] Example 13: The system of any of examples 1 through 12, wherein: a first device of the plurality of medical devices is an electrical stimulation device configured to deliver electrical stimulation to a right hemisphere of a brain of a patient, a second device of the plurality of medical devices is an electrical stimulation device configured to deliver electrical stimulation to a left hemisphere of the brain of the patient, the user interface defines a single screen presenting a first region associated with the first device and a second region associated with the second device, the first region of the single screen is configured to receive input for the first device, and the second region of the single screen is configured to receive input for the second device.

[0164] Example 14: The system of example 13, wherein the processing circuitry is configured to receive a user selection of one of the first region or the second region, wherein responsive to the user selecting either the first region or the second region, the processing circuitry prompts the user to confirm the selection if a selected region is different than a currently selected region.

[0165] Example 15: A method includes initiating, via communication circuity, communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key; receiving, via the communication circuity, signals from the plurality of devices via the respective communication channels; generating for display, via processing circuitry, a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session; controlling, via the processing circuitry, the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface; controlling, via the processing circuitry, a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session; receiving, via the processing circuitry, an input from the user at the user interface associated with one medical device of the plurality of medical devices; controlling, via the processing circuitry and responsive to receiving the input, the communication circuitry to transmit a command to the one medical device via the respective communication channel during the active session.

[0166] Example 16: The method of example 15, further includes receiving, via the processing circuitry, a switch signal from the user via the user interface; controlling, via the processing circuitry, the display device to present the user interface comprising an indication that further inputs will be sent to a second medical device of the plurality of medical devices; receiving, via the processing circuitry, an input from the user via the user interface associated with the second medical device; controlling, via the processing circuitry and responsive to receiving the input, the communication circuitry to transmit a command to the second medical device via the respective communication channel during the active session and to prevent transmission of the command to the one medical device via the respective communication channel, wherein the command is based at least in part on the input.

[0167] Example 17: The method of any of examples 15 and 16, wherein receiving, via the communication circuity, the signals from the plurality of devices further comprises: receiving, via an intermediate communication device, signals from a medical device of the plurality of medical devices via a first channel; translating, via the intermediate communication device, the signals; and transmitting, via the intermediate communication device, the translated signals to the processing circuitry via a second channel.

[0168] Example 18: The method of any of examples 15 through 17, wherein the initiating, via the communication circuity, communication with the plurality of medical devices via the respective communication channels further comprises: transmitting, via the communication circuity, an interrogation request to the one medical device; and receiving, via the communication circuity, an acceptance response from the one medical device.

[0169] Example 19: The method of example 18, wherein the one medical device is configured to transmit an indication representing at least one of a manufacturer, a device class, a model number, a serial number, or an operational status instead of the acceptance response.

[0170] Example 20: A non-transitory computer-readable storage medium includes control communication circuity to initiate communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key; control communication circuity to receive signals from the plurality of devices via the respective communication channels; generate for display a user interface comprising information associated witheach medical device of the plurality of medical devices connected via the respective communication channels during an active session; control the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface; control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session; receive an input from the user at the user interface associated with one medical device of the plurality of medical devices; and control the communication circuitry, responsive to receiving the input, to transmit a command to the one medical device via the respective communication channel during the active session.

[0171] In one or more examples, the functions described above may be implemented in hardware, software, firmware, or any combination thereof. For example, the various components of FIGS. 1 - 4, processing circuitry 430 and processing circuitry 530 may be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions may be stored on or transmitted over, as one or more instructions or code, a computer-readable medium and executed by a hardwarebased processing unit. Computer-readable media may include computer-readable storage media, which corresponds to a tangible medium such as data storage media, or communication media including any medium that facilitates transfer of a computer program from one place to another, e.g., according to a communication protocol. In this manner, computer-readable media generally may correspond to (1) tangible computer- readable storage media which is non-transitory or (2) a communication medium such as a signal or carrier wave. Data storage media may be any available media that may be accessed by one or more computers or one or more processors to retrieve instructions, code and / or data structures for implementation of the techniques described in this disclosure. A computer program product may include a computer-readable medium.

[0172] The term “non-transitory” may indicate that the storage medium is not embodied in a carrier wave or a propagated signal. In certain examples, a non-transitory storage medium may store data that may, over time, change (e.g., in RAM or cache). By way of example, and not limitation, such computer-readable storage media, may include random access memory (RAM), read only memory (ROM), programmable read only memory (PROM), erasable programmable read only memory (EPROM), electronically erasable programmable read only memory (EEPROM), flash memory, a hard disk, a compact disc ROM (CD-ROM), a floppy disk, a cassette, magnetic media, optical media,or other computer readable media. In some examples, an article of manufacture may include one or more computer-readable storage media.

[0173] Also, any connection is properly termed a computer-readable medium. For example, if instructions are transmitted from a website, server, or other remote source using a coaxial cable, fiber optic cable, twisted pair, digital subscriber line (DSL), or wireless technologies such as infrared, radio, and microwave, then the coaxial cable, fiber optic cable, twisted pair, DSL, or wireless technologies such as infrared, radio, and microwave are included in the definition of medium. It should be understood, however, that computer-readable storage media and data storage media do not include connections, carrier waves, signals, or other transient media, but are instead directed to non-transient, tangible storage media. Combinations of the above should also be included within the scope of computer-readable media.

[0174] Instructions may be executed by one or more processors, such as one or more DSPs, general purpose microprocessors, ASICs, FPGAs, or other equivalent integrated or discrete logic circuitry. Accordingly, the term “processor” and “processing circuitry,” as used herein, may refer to any of the foregoing structure or any other structure suitable for implementation of the techniques described herein. Also, the techniques could be fully implemented in one or more circuits or logic elements.

[0175] The techniques of this disclosure may be implemented in a wide variety of devices or apparatuses, including, an integrated circuit (IC) or a set of ICs (e.g., a chip set). Various components, modules, or units are described in this disclosure to emphasize functional aspects of devices configured to perform the disclosed techniques, but do not necessarily require realization by different hardware units. Rather, as described above, various units may be combined in a hardware unit or provided by a collection of interoperative hardware units, including one or more processors as described above, in conjunction with suitable software and / or firmware.

[0176] Various examples of the disclosure have been described. These and other examples are within the scope of the following claims.

Claims

WHAT IS CLAIMED IS:

1. A system comprising: communication circuitry configured to: initiate communication with a plurality of medical devices via respective communication channels, wherein each medical device of the plurality of medical devices has a unique encryption key; and receive signals from the plurality of devices via the respective communication channels; and processing circuitry configured to: generate, for display, a user interface comprising information associated with each medical device of the plurality of medical devices connected via the respective communication channels during an active session; control the communication circuitry to maintain the respective communication channels for each medical device of the plurality of medical devices during the active session of the user interface; control a display device to present the user interface comprising the information associated with each medical device of the plurality of devices during the active session; receive, via the user interface, an input from the user associated with one medical device of the plurality of medical devices; and responsive to receiving the input, control the communication circuitry to transmit a command to the one medical device via the respective communication channel during the active session.

2. The system of claim 1, wherein each medical device of the plurality of medical devices are implanted in a single patient.

3. The system of any of claims 1 or 2, wherein the processing circuitry is further configured to, responsive to receiving the input, control the communication circuitry to prevent transmission of the input to one or more other medical devices of the plurality of medical devices via the respective communication channels until a switch signal is received.

4. The system of claim 3, wherein the processing circuitry is further configured to: responsive to receiving the switch signal, control the display device to present the user interface comprising a confirmation request; responsive to receiving the confirmation request, control the display device to present the user interface comprising an indication that further inputs will be sent to a selected medical device of the one or more other medical devices; receive, via the user interface, a second input from the user associated with the selected medical device; and responsive to receiving the second input, control the communication circuitry to transmit a second command to the selected medical device via the respective communication channel during the active session and to prevent transmission of the second command to the one medical device via the respective communication channel.

5. The system of any of claims 1 through 4, wherein the user interface comprises a first field comprising a first set of one or more parameters associated with the first device and a second field comprising a second set of one or more parameters associated with the second device, wherein the user interface is configured to present both the first field and the second field at the same time on a single screen of the user interface.

6. The system of any of claims 1 through 5, wherein the user interface comprises a first screen comprising a first set of one or more parameters associated with the first device and a second screen comprising a second set of one or more parameters associated with the second device, wherein the user interface is configured to receive a transition input that requests the user interface switch between the first screen and the second screen.

7. The system of any of claims 1 through 6, wherein the signals comprise an indication, from a respective medical device of the plurality of medical devices, representing at least one of a manufacturer, a device class, a model number, a serial number, or an operational status.

8. The system of claim 7, wherein the user interface comprises a list of each of the medical devices of the plurality of devices.

9. The system of claim 8, wherein one or more medical devices of the plurality of medical devices are configured to transmit the indication readable by the processing circuitry instead of receiving any commands via the respective communication channel during the active session.

10. The system of any of claims 1 through 9, wherein the user interface is configured to receive user input customizing at least one of device, device class, layout, orientation, manufacturer, or status of the one or more devices for display via the user interface.

11. The system of any of claims 1 through 10, further comprising an intermediate communication device configured to enable a communication channel between a medical device of the plurality of medical devices and the communication circuitry, wherein the communication channel comprises a first channel between the intermediate communication device and the medical device, and a second channel between the intermediate communication device and the communication circuitry.

12. The system of claim 11, wherein: the first channel is configured to transmit information in a first communication format, the second channel is configured to transmit information in a second communication format, the first communication format is different than the second communication format, the medical device is configured to transmit the signals in the first communication format, and the communication circuitry is configured to interpret the signals in the second communication format.

13. The system of any of claims 1 through 12, wherein: a first device of the plurality of medical devices is an electrical stimulation device configured to deliver electrical stimulation to a right hemisphere of a brain of a patient, a second device of the plurality of medical devices is an electrical stimulation device configured to deliver electrical stimulation to a left hemisphere of the brain of the patient, the user interface defines a single screen presenting a first region associated with the first device and a second region associated with the second device, the first region of the single screen is configured to receive input for the first device, and the second region of the single screen is configured to receive input for the second device.

14. The system of claim 13, wherein the processing circuitry is configured to receive a user selection of one of the first region or the second region, wherein responsive to the user selecting either the first region or the second region, the processing circuitry prompts the user to confirm the selection if a selected region is different than a currently selected region.

15. A non-transitory computer-readable storage medium comprising instructions that, when executed by the processing circuitry, cause the processing circuitry to perform functions of any of claims 1 through 14.

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