WO2008056033A1 - System for transmitting and managing medical and processing information in a hospital - Google Patents

System for transmitting and managing medical and processing information in a hospital Download PDF

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Publication number
WO2008056033A1
WO2008056033A1 PCT/FI2007/050594 FI2007050594W WO2008056033A1 WO 2008056033 A1 WO2008056033 A1 WO 2008056033A1 FI 2007050594 W FI2007050594 W FI 2007050594W WO 2008056033 A1 WO2008056033 A1 WO 2008056033A1
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WO
WIPO (PCT)
Prior art keywords
information
patient
medical
wireless
departmental server
Prior art date
Application number
PCT/FI2007/050594
Other languages
French (fr)
Inventor
Henri Hannuniemi
Jyrki Kurtti
Markku Tampio
Hannu Kotipalo
Harri Posti
Ilmari Haho
Tiina VETELÄINEN
Lea KÄRNÄ
Jouni Ihme
Original Assignee
Whealth Oy
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Whealth Oy filed Critical Whealth Oy
Priority to EP07823231A priority Critical patent/EP2089844A4/en
Publication of WO2008056033A1 publication Critical patent/WO2008056033A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0015—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by features of the telemetry system
    • A61B5/002—Monitoring the patient using a local or closed circuit, e.g. in a room or building
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/06—Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/10—Office automation; Time management
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation

Definitions

  • the present invention relates to a medical information management arrangement that uses wireless data transmission.
  • the invention also relates to a data trans- mission network transmitting the medical information, a base station of the transmission network, a wireless terminal used in the data transmission network, a wireless sensor belt, and a departmental server managing the medical information network.
  • Health care processes are at a turning point.
  • the effectiveness of the massive present day processing assemblies can be questioned.
  • the increasing costs of patients and treatment processes create pressures to operate cost-effectively.
  • HIS Healthcare Information System
  • process information Information about hospital activities
  • HIS systems have become awkward and difficult to modify. If a hospital department requires features that differ from the ones provided by the general system, separate department-specific information systems have at times been created to perform these features. The ability of a department-specific information system to transmit information to or receive information from a HIS information system is often quite limited.
  • the patient information is entered to these systems through a separate terminal.
  • a PC connected to the information network is often used for this purpose.
  • a traditional way to do this is to write down the patient information in patient-specific files, from which they can later be transferred to an electronic information system using, for example, a PC connected to the information system.
  • patient information can be stored by the nursing staff in a notebook computer or similar, from which the in- formation can later be transferred to the actual information system. In both cases, the transfer of information can cause long delays, which can have disadvantageous effects on treatments.
  • Medical information Information about the medical state of patients, commonly called medical information, is also received from different medical measuring devices. These measure- merits can be transmitted from the patient's location for example via cables to a centralized monitoring room, where nursing staff continuously monitors the states of several patients.
  • the operation of an intensive care unit is mostly based on this kind of an operational model.
  • the medical measuring devices each re- quire their own tracking monitor, because the data transmission and display methods can vary on a device to device basis. Consequently, the nursing staff has to be able to simultaneously use different measuring devices that are operated differently.
  • the user interfaces of the measuring devices are often manufacturer- specific. Consequently, it requires practice to effectively operate them.
  • Measuring devices attached to a patient can produce large amounts of real time electronic information about the patient. It is well advised to analyze and process this information in one way or another before storing it for the long term. In practice, this work has to be done in a patient-specific way by the nursing staff and, in the worst case, in a measuring device specific way. This arrangement takes away from the limited resources which could be used on actual treatments.
  • the patient can in some situations be surrounded by several different measuring devices measuring vital functions and display units of the devices. It is still commonly necessary to connect the measuring devices to the pa- tient and to the monitoring device with cables. The amount of measuring cables and different fluid transfusion devices required can make daily treatment of the patient more difficult.
  • Hospitals are often large and sometimes rather labyrinthine building complexes. Finding one's way inside them can often be problematic, particularly for patients.
  • the numbers and placements of the nursing staff can also vary daily. It is important, in an urgent case, to find out immediately where in the hospital certain specialized members of the nursing staff, the patient requiring urgent treatment, or a certain medical device are located at a given moment.
  • Personal tracking in a hospital has made use of the different kinds of access cards used to open doors, for example. It can be determined, where in the hospital the person we want to find is most likely located by maintaining a real time log about the usages of access cards.
  • the GPS (Global Positioning System) positioning system used outdoors cannot be used indoors such as it is because the signal received from the satellites can be blocked indoors.
  • Wirelessness has become a hot topic in discussions about operational processes for health care, and consequently its suitability for processes in different forms is constantly being discussed and developed around the world.
  • the often presented solutions are based on some pre-selected data transmission technology: WLAN 1 GSM/GPRS, Bluetooth (IEEE 802.15.1), ZigBee (IEEE 802.15.4), RFID (Radio Frequency IDentification), or in the future, UWB (Ultra Wide Band).
  • WLAN 1 GSM/GPRS Bluetooth
  • ZigBee IEEE 802.15.4
  • RFID Radio Frequency IDentification
  • UWB Ultra Wide Band
  • the object of the invention disclosed in the present application is to provide a mostly wirelessly operating, department-specific information management system that is based on wirelessly collecting department-specific information about patients and the nursing staff, and processing the information in a centralized man- ner in the department.
  • patient and nursing staff information transmitted using different data transmission techniques is processed on a single departmental server.
  • the objects of the invention are met by using a solution where patient identification information, measuring information about patient state, nursing staff identification information and location information about both are all sent using one or more wireless data transmission techniques to the closest base station of the data transmission network, which can simultaneously support several different wireless data transmission techniques.
  • the information is transmitted using a single data transmission protocol from the base station to the departmental server, which manages the data transmission network.
  • the departmental server processes, forwards or stores the information it has received as such, or processes the information into a suitable file format before storing it.
  • the departmental server sends a certain part of the stored information as needed to the HIS information system of the entire hospital.
  • An advantage of the invention is that the department-specific patient and staff information is centrally processed on a single departmental server, which makes it possible to operate a medical department independently without a connection to the actual HIS system of the hospital.
  • a further advantage of the invention is that it has a modular structure and its archi- tecture is open to support different kinds of wireless techniques, making modifying and extending the system simple.
  • a further advantage of the invention is that most of the patient and staff information can be sent wirelessly via the same base station to the departmental server using different data transmission techniques. If needed, the data transmission technique can be switched without user's knowledge.
  • a further advantage of the invention is that the patient-specific measurement data can be stored at the patient's side straight into the departmental server without manual intermediary phases.
  • a further advantage of the invention is that the user interface of the medical measuring devices is physically and logically detachable from the medical measuring devices, which makes the medical measuring devices simpler and cheaper in structure. It is possible to control different medical measuring devices with a wireless terminal used by the nursing staff by modifying the user interface of the nursing staff terminal.
  • a further advantage of the invention is that the user interface of the nursing staff information processing device can be modified when needed as the patient, the treatment situation and the medical device dictate.
  • a further advantage of the invention is that the collected patient data can be buff- ered, compressed or filtered in a predefined way before the data is stored on the departmental server.
  • a further advantage of the invention is that patient data can be transmitted from the department-specific server to the HIS information system of the entire hospital or to another similar departmental server of another department.
  • a further advantage of the invention is that the patient and the nurse can always be directly wirelessly identified in a treatment situation.
  • a further advantage of the invention is that the patient's medical tracking information can be received without wired connections, which enables the patient to move freely, and the patient does not need to be bound to a specific location to have a measurement performed.
  • an advantage of the invention is that the patients and staff members can be located using personal wireless identifiers and measurement information from the base station network.
  • the departmental server of the invention is characterized by comprising - a connection block for connecting the departmental server to a medical information network, to a hospital information system and to at least one computer,
  • the nursing staff terminal of the invention is characterized by comprising computer program means for modifying the functionality of a user interface to match the treatment status of a patient by receiving a wireless instruction from the departmental server.
  • the medical radio beacon of the invention is characterized by comprising data transmission means for wirelessly transmitting in a single message a patient identifier, a treatment terminal identifier and measuring device information to a departmental server.
  • the sensor belt according to the invention is characterized by its data transmission unit comprising data transmission means for sending wireless messages between a departmental server and a patient using a single data transmission technique which can be selected from among at least two different data transmission techniques.
  • a departmental medical information arrangement uses wired and wireless data transmission technologies to create a hospital-specific medical information system.
  • the medical information arrange- ment consists of a physical device arrangement and pieces of software that are used to collect and process data coming from medical measuring devices, and to collect wireless location data and identification data.
  • Terminals can be connected to the system that use either wired or common wireless technologies, such as RFID, WLAN, ZigBee, Bluetooth, and in the future, UWB as well.
  • the medical information arrangement comprises universal base stations located in a department, which are later also referred with the abbreviation WHUB (Wireless HUB), which can be used to set up data transfer areas that support different data transmission techniques inside the hospital rooms.
  • the WHUB base stations collect data from different de- vices/sources through different wired and wireless connections.
  • a WHUB base station can receive information for example from a personal identifier of a patient, a wireless medical measuring device, or a nursing staff terminal.
  • the base stations of the medical information network are advantageously room-specific. They can be connected to each other using, for example, Ethernet cables, which can also be used to supply power to the WHUB base stations.
  • the wirelessly operating nursing staff terminal can select a data transmission method suitable for the situation from the available data transmission options.
  • Signals received by the base station network of the medical information arrangement according to the invention can be used when necessary to locate either a patient or a specific nurse in the department.
  • the localization can for example utilize level information of the received signal, delay time of the signal, or statistical prop- erties of the signal.
  • the core of the medical information arrangement is a departmental server that acts as a platform and as a buffer between the department-specific information network structure and the medical information system of the hospital (HIS).
  • the departmental server receives information from the medical information network that can be data originating from the medical measuring devices, the nursing staff terminals, or localization devices.
  • the departmental server provides a software interface to which different device manufacturers can provide device-specific drivers. Using the device drivers, the devices operating in the information network become a part of the medical information network.
  • the data col- lected from the devices is transmitted from the departmental server to the hospital information system (HIS) via a departmental server integration module that provides a connection interface for the hospital information system.
  • the hospital information system comprises a function that can be used to associate with each other a measuring device, a patient, a nursing staff terminal, and a device con- nected to a base station.
  • Figure 1a shows, as an example, a medical information network according to the invention
  • Figure 1b shows, as an example, the logical connections inside the medical information network according to the invention
  • Figure 1c shows, as an example, a patient and a sensor belt according to the invention and a remote readable patient identifier
  • Figure 2a shows, as an example, a wireless departmental network according to the invention
  • Figure 2b shows, as an example, a physical implementation of the wireless departmental network according to Figure 2a
  • Figure 3 shows, as an example, functional parts comprised in the departmental server according to the invention
  • Figure 4 shows, as an example, a universal base station according to the invention
  • Figure 5 shows, as an example, the main functional blocks of a nursing staff terminal according to the invention
  • Figure 6 shows, as an example, a radio beacon according to the invention
  • Figure 7 shows, as an example, a sensor belt according to the invention.
  • Figure 8 shows as an example, the execution of personal localization accord- ing to the invention.
  • a medical information network 10 according to the invention is shown in Figure 1a.
  • it comprises a single medical department of the hospital.
  • the operation of the medical information network is controlled by the departmental server 100 according to the invention.
  • the departmental server 100 itself comprises a prior art processor, non-volatile and volatile memory for executing application programs to store patient and medical measurement data, and connection means for creating connections to different information networks that are not specifically shown in Figure 1 a.
  • the application programs, the device drivers of the medical measurement devices, the device drivers of the nursing staff terminals, the communications protocol used, TCP/IP protocol for example, and the nursing staff and patient identification information, which are needed to manage the departmental information system of the present invention, are loaded into the memory of the departmental server 100.
  • the memory is also used to store the created patient data.
  • the departmental server 100 can be connected to an existing hospital information system HIS 11.
  • the connection can use a fixed connection 103.
  • the connection to the hospital information system HIS 11 can for example be established using the HL7 (Health Level Seven) protocol commonly used in hospital settings.
  • the hospital information system HIS 11 can be divided into several different information sub- systems. In the example of Figure 1 , this is illustrated with two separate exemplary information systems HIS/1 , reference number 111 , and HIS/2, reference number 112.
  • the departmental server 100 according to the invention can be connected to both departmental information systems 111 and 112 or to just one.
  • a connection to the desired information sub-systems is advantageously created information subsystem specifically.
  • the arrow 113 in Figure 1a indicates that the information subsystems 111 and 112 included in the information system of the entire hospital can transmit data between each other if such a connection is built into the HIS information system.
  • the functional parts of the core network of the medical information network 10 according to the invention are shown in Figure 1a.
  • the departmental server 100 managing the medical information network is connected to a required amount of universal base stations WHUB in the department, which are referred to by 101a- 101c in Figure 1 a.
  • the WHUBs can be connected to the departmental server 100 either via wired connection, wireless connection or a combination of both. This connection is referred to by 102.
  • the communication between the departmental server 100 and the WHUBs on the connection 102 when operating the medical in- formation network of the invention, advantageously uses a single protocol on the connection 102 regardless of which available data transmission technology the WHUB base station has used to connect to the wireless device not shown in Figure 1a.
  • Advantageously data transmission uses a protocol that utilizes TCP/IP protocol.
  • Figure 1 b shows, as an example, the logical data transmission connections of the medical information network according to the invention.
  • the departmental server 100 according to the invention can have a data transmission connection that uses at least partly wireless technology with the following wireless devices: medical measuring devices 104a-104c, nursing staff terminals 105a-105b, and wireless identification devices connected to patients 106a-106b, for example.
  • a separate sensor belt can be attached to the patients, which is shown in Figure 1c, that can also establish a wireless data transmission connection to the departmental server through the WHUB base station.
  • the medical data collected by the sensor belt can either be transmitted in real time or the data can be temporarily stored in the sensor belt, from which it can be transferred as a separate event to the departmental server 100 via the WHUB base station.
  • Each patient 106a-106b advantageously has a remote readable RFID identifier.
  • the RFID identifier can be either a passive identifier or an active identifier.
  • a passive identifier does not have its own power source; so consequently, it will always have to be read using an external electromagnetic field.
  • An active RFID identifier has its own power source, which enables it to transmit by itself.
  • power consumption a good solution uses the ZigBee technique in active RFID identifiers, because ZigBee uses energy sparingly compared with alternative techniques.
  • biometric identification methods and devices are used instead of an RFID identifier or together with an RFID identifier.
  • the person can be identified based for example on a fingerprint, facial recognition or voice recognition.
  • the medical measuring devices 104a-104c advantageously only comprise the means required to acquire medical information, to perform the medical procedure, and to wirelessly transmit the medical information or the result of the medical procedure. This means that the arrangement according to the invention does not necessarily need the display and user interface components of prior art.
  • the user interface of the medical measuring device 104a- 104c is advantageously a nursing staff terminal 105a-105b.
  • the departmental server 100 sends a control message that converts the display of a certain wireless nursing staff terminal, such as 105a, that has activated a certain measuring de- vice, such as 104a, in a way that makes it suitable for managing the medical measuring device 104a that is being used.
  • FIG. 1c An exemplary patient 106 is shown in Figure 1c.
  • the patient 106 is advantageously equipped with a remote readable RFID identifier 108 that can be either a passive identifier or an active identifier.
  • the RFID identifier 108 is advantageously read during each procedure performed by the nursing staff.
  • the nursing staff uses their terminal 105a-105b to read the RFID identifier 108 of the patient 106.
  • the read information is advantageously forwarded to the departmental server 100, which responds by sending as return information the patient information of the patient to the nursing staff terminal that was used to read the RFID identifier of the patient.
  • the return information can require that a certain medical measuring device, such as 104a, is used.
  • the user interface of the nursing staff terminal is converted with a control instruction sent by the departmental server 100 to a form that is suitable for the medical measuring device.
  • the nurse can subsequently activate the medical measuring device 104a in question using his/her own terminal.
  • the procedure information can be forwarded to the de- partmental server 100 for storage purposes. Before storing the information we can ask the nurse performing the procedure to confirm whether the procedure will be stored as such or not at all, or whether it requires some further processing.
  • a nurse reads an RFID identifier of a measuring device 104a with the RFID reader of the treatment terminal 105a, for example.
  • the measuring device 104a, the measuring information received from the measuring device 104a, and the above patient identification information read from the RFID identifier of the patient 106 can advantageously be associated in the departmental server 100.
  • the patient identification information and the measuring information can be associated in the treatment terminal 105a using the RFlD identifiers that were read.
  • a sensor belt is shown as an example in Figure 1c with the reference number 109 that can comprise several different sensors measuring the state of a patient 106.
  • the measuring data collected by the sensor belt 109 is forwarded to the departmental server 100 using wireless transmission at least partly.
  • FIG 2a shows an example of the implementation of the medical information network 10 according to the invention.
  • the exemplary department 20 of the hospital comprises, from Figure 2a, the office space 201 of the nursing staff, eight pa- tient rooms 202 with thirteen patient beds 203, and a procedure room 205.
  • the department 20 has four exemplary data transmission regions 131-134.
  • the data transmission region can comprise several WHUB base stations providing identical level service that form separate data transmission cells within the data transmission region.
  • the data transmission region 134 estab- lished in the office space of the nursing staff supports both WLAN and ZigBee connections.
  • the eight patient rooms are divided into two units of four patient rooms, which both have their own data transmission regions 131 and 133. In these patient room cells, data transmission is possible using WLAN, ZigBee or Bluetooth connections.
  • the data transmission region 132 has been created in the procedure room 205, which supports WLAN and ZigBee data transmission.
  • the serving WHUB base station When a person moves from one serving WHUB data transmission cell to another within the department 20, the serving WHUB base station is switched without any action from the person himself/herself.
  • the WHUB base station that receives the identification of the person with the best signal level will perform the data transmission.
  • a nurse or a patient can be located advantageously by using signals received by the WHUB base stations.
  • the departmental server 100 can calculate the person's location.
  • the accuracy of the localization depends on the data transmission technique used: with WLAN and ZigBee techniques the location can be calculated with an accuracy of a couple of meters.
  • the UWB technique will enable localization with an accuracy of a couple of centimeters by using delay time measurements.
  • Figure 2b shows, as an example, an implementation of the medical information network 10 according to the invention.
  • the arrangement of Figure 2b can be used to implement the four data transmission regions 131-134 of Figure 2a, for exam- pie.
  • the four data transmission regions of Figure 2a are formed of radio cells formed by ten exemplary WHUB base stations 101a-101 k.
  • Reference 102 depicts to a data transmission connection that interconnects, in the department 20, the WHUB base stations 101a-101k and the departmental server 100.
  • the data transmission connection 102 can be a fixed connection, a wireless connection or a combination of both.
  • This data transmission connection 102 uses the data transmission protocol according to the invention regardless of which wireless data transmission technique is used in the data transmission cells at a given moment.
  • the WHUB base stations 101 b-101e can be used to establish the data transmission region 131 of Figure 2a to four adjoining patient rooms.
  • the WHUB base sta- tion 101f can be used to establish the data transmission region 132 of Figure 2a to the procedure room 205.
  • the WHUB base stations 101g— 101 k can be used to establish the data transmission region 133 of Figure 2a to the other set of four patient rooms.
  • a single WHUB base station 101a can be used to implement the data transmission region 134 of the staff office 201.
  • the data transmission regions 131 and 133 shown in Figure 2a are certain types of macro-cells, because the physical implementation of both of them uses four different WHUB base stations located in patient rooms.
  • the data transmission region 131 is implemented with four WHUB base stations 101 b-101e
  • the data transmission region 133 is implemented with WHUB base stations 101g— 101 k.
  • One or more computers 107 can be connected to the departmental server 100. Medical information received from a patient can be processed with a computer 107 by selecting which part of the information will be stored, or by compressing the information before storing it into the memory of the departmental server 100, for ex- ample.
  • a computer 107 can also be used to control other operations, if needed.
  • An instruction from a computer 107 can for example activate the localization of a person.
  • FIG. 3 shows, as an example, the main functional parts of the departmental server 100 according to the invention.
  • the departmental server 100 is advanta- geously connected to a medical information network 10 according to the invention, to computers 107 in the department, and to a hospital information system HIS 11.
  • the connections are advantageously established by a connection block 1001 , which comprises both mechanical and software means for establishing connections 102 and 103.
  • a processing block 1002 comprises a processor that executes instructions that control the operation of the departmental server and executes various instructions related to patient data processing.
  • the processing block 1002 receives the patient data to be processed from the connection block 1001.
  • the processing block 1002 also has connections to a medical information network management block 1003, a monitoring block 1004, a device driver block 1005, a measurement block 1006, patient files 1007, a localization block 1008, and a service block 1009 of the devices in the departmental network, comprised in the departmental server.
  • the network management block 1003 coordinates, manages and controls the overall operation of the medical information network 10.
  • the monitoring block 1004 is used to manage data transmission in the medical information network 10. It comprises prior art software means for continuously monitoring the operation of the medical information network 10 and for maintaining network performance.
  • the block 1005 comprises various device drivers that are needed to control and manage the devices connected to the medical information network 10.
  • the measurement block 1006 is used when medical measurements and treatment procedures are performed on patients. It receives procedure information relating to the patients. It advantageously also comprises various measurement information processing routines, which can be used to sort and edit the collected patient information to a desired form.
  • the actual process information relating to patients is maintained and stored in block 1007, which can be considered a form of department-specific HIS informa- tion system. It can comprise various personal identifiers and collected patient data. If patient data needs to be transmitted from the departmental server 100 to the hospital information system HIS 11 , the data to be transmitted is retrieved by the processing block 1002 from the patient file block 1007.
  • the block 1008 comprises software means for performing localization.
  • the local- ization can be performed for a patient, nursing staff members, or a certain medical device.
  • the localization is advantageously performed by receiving with two or more WHUB base stations a signal transmitted from a person or a device identifier.
  • the block 1008 calculates from the level information of the received signals where in the department 20 the localization target is located.
  • the localization can also utilize signal delay measurements or other prior art localization methods.
  • the device service block 1009 stores the identification information of all devices operating in the medical information network 10.
  • FIG 4 shows, as an example, the main functional parts of a universal base station WHUB 101 according to the invention.
  • the WHUB base station can communicate using three exemplary data transmission technologies.
  • the WHUB base station comprises a WLAN transceiver 1011 , a Bluetooth transceiver 1012, and a ZigBee transceiver that are connected to an exemplary antenna 1014. It is apparent to those skilled in the art that instead of using a single antenna, each transceiver can be connected to its own antenna. In each radio ac- cess network, WLAN, Bluetooth and ZigBee, the radio path functions according to prior art.
  • the WHUB base station 101 also comprises a power source 1010.
  • the power source 1010 can be a rechargeable battery or a supply connection unit.
  • the power source can alternatively or simultaneously also use the electric power available via the fixed cable connection 102 of the Ethernet unit 1018.
  • the operation of the WHUB base station 101 is controlled by the central unit 1015. It comprises a processing unit for executing software instructions, a memory, and means through which it performs real time data transmission with the transceivers of each WHUB base station 101.
  • the central unit also comprises means for modi- fying the data received from a transceiver into such a format that it can be forwarded through the Ethernet unit 1018 via the data transmission connection 102 to the departmental server using a single protocol.
  • the central unit 1015 converts the data received from the departmental server 100 into a format that can be used by the transceiver as such. Since there are several transceivers, the central unit 1015 also multiplexes the data received from the transceivers onto the connection 102. Similarly, the central unit 1015 demultiplexes the data stream received from the departmental server 100 for each transceiver.
  • the data transmission and processing features performed by the central unit 1015 can advantageously be implemented with one or more software programs stored in the memory of the central unit, which the processor of the central unit can use.
  • the Ethernet unit 1018 connected to the central unit 1015 advantageously comprises prior art means for maintaining two-way data transmission with the departmental server 100.
  • the WHUB base station 101 can further comprise an RS-232 unit 1016 that is in accordance with ITU-T standard V.24 and/or a USB unit 1017 (Universal Serial Bus), for example.
  • the USB connection can use either wireless or wired connection. It is possible to further include other device manufacturer specific data transmission modules to the WHUB base station 101. By using the above mentioned means, it is possible to connect devices to the WHUB base station 101 that do not have means for wireless data transmission.
  • Figure 5 shows, as an example, a wireless nursing staff terminal 105. It advantageously comprises a telecommunications unit 1051 , an RFID reader 1052, a central unit 1054, a user interface 1055, an RFID identifier 1056, and an antenna 1053.
  • the terminal 105 also comprises a power source 1050 that is advantageously a rechargeable battery.
  • the telecommunications unit 1051 advantageously comprises WLAN, Bluetooth and ZigBee transceivers.
  • the telecommunications unit 1051 is connected in Figure 5 to an exemplary antenna 1053, through which the nursing staff terminal 105 receives and transmits messages. It is apparent to a person skilled in the art that there can be several antennae instead of the antenna 1053 shown in Figure 5.
  • the terminal also advantageously comprises an RFID reader 1052.
  • the reader can also use the antenna 1053 for its operations, or it can have its own antenna (not shown in Figure 5).
  • the RFID reader 1052 can be used to read for example nursing staff identifiers, patient identifiers, drug identifiers or various device identifiers.
  • Both the telecommunications unit 1051 and the RFID reader 1052 are connected to the central unit 1054 of the terminal 105.
  • the central unit 1054 advantageously comprises a processor and some volatile and non-volatile memory connected to it.
  • the operation of the terminal 105 is controlled through the user interface 1055. It advantageously comprises buttons and a display unit, which are not shown as separate components in Figure 5.
  • the buttons can either be fixed buttons, programmable buttons, or buttons created on a suitable touch screen.
  • the user inter- face of the terminal 105 according to the invention can be modified with an instruction received from the departmental server 100.
  • the terminal 105 can be for example converted into a patient information presentation device, a control panel of a medical measuring device, or a device for performing a medical procedure. The conversion can be implemented by changing the format of the information dis- played on the display unit, or by changing the functions associated with the buttons of the terminal, for example.
  • the nursing staff terminal 105 can also include an RFID identifier 1056.
  • the RFID identifier can be used when necessary to associate with each other the terminal 105, the nurse using it, patient measuring information and a certain patient 106.
  • the RFID reader 1052 of the treatment terminal 105 can be advantageously used to read the identification information of a patient 106 and the identification information of a measuring or treatment device 104a-104d, which can be read from the RFID identifiers advantageously comprised in said devices.
  • the pieces of identification information read from the above mentioned RFID identifiers can advanta- geously be combined in the departmental server 100.
  • the identification and measuring information of a patient can already be combined in the treatment terminal 105a using the read RFID identifiers.
  • the nursing staff terminal 105 also comprises means for using biometric identification (not shown in Figure 5).
  • the biometric identification can advantageously utilize a fingerprint, facial recognition or voice recognition.
  • Figure 6 shows, as an example, a radio beacon 60 according to the invention that can be used to connect devices to the medical information network 10 that do not comprise the data transmission means used in wireless data transmission networks.
  • the radio beacon 60 according to the invention is a small device connected to the RS-232 gate of a medical measuring device that advantageously comprises a processing unit, volatile and non-volatile memory for storing device drivers and treatment status information, an RFID reader, data transmission means used in wireless data transmission, and means for establishing an RS-232 connection.
  • a nurse reads the RFID identifier 108 of a patient 106, referenced by 603, and also, when necessary, the identifier of a medical measuring device 104d, referenced by 602, with the said RFID reader.
  • the RFID reader can either be an integral part of the medical radio beacon 60 or it can be connected to it through a separate cable connection.
  • the medical radio beacon 60 forwards the information sent by the medical measuring device 104d wirelessly to a suitable WHUB base station 101 , using for example a ZigBee, Bluetooth or WLAN connection, referenced by 601.
  • the wireless nursing staff terminal 105 acts as a user interface for the medical radio beacon 60.
  • the nursing staff terminal 105 is connected to act as a user interface of the medical radio beacon 60 by reading the identification information of the terminal 105 with the RFID reader of the medical radio beacon.
  • the terminal 105 can now be used both to control the measuring device 104d and to display measuring information from the measuring device.
  • the medical radio beacon 60 can also comprise its own fixed user interface.
  • the user interface can now be used to control the medical radio beacon 60 independently, and certain patient related information can be displayed on a display unit associated with the medical radio beacon.
  • the departmental server 100 controls the execution of the handshake.
  • the information collected by the medical measuring device 104d will not be modified in the medical radio beacon 60, but a patient 106 identification and a device 104d identification will be appended to it so that the departmental server 100 knows with which patient 106 it should associate the data coming from each medi- cal measuring device 104d.
  • the medical radio beacon 60 according to the invention is advantageously connected to the RS-232 gate of the medical measuring device 104d with a cable 61 , or it is connected to a connector in the medical measuring device 104d. If the embodiment with the cable is used, the RFID identifier 108 of the patient 106 can be read without needlessly moving the patient.
  • FIG. 7 shows, as an example, a sensor belt 109 used in the medical information network according to the invention.
  • the sensor belt 109 advantageously comprises a power source 1090, a telecommunications unit 1091 , an antenna 1092, a central unit 1095, sensors 1096-1099, and an RFID identifier 1094.
  • the power source of the sensor belt 109 is advantageously a rechargeable battery or a non-rechargeable battery that can store enough power to guarantee with a single charge an operating time of several days for the sensor belt 109.
  • the power source of the sensor belt 109 can also comprise an element that can be used to create the energy needed by the sensor belt from the movements of the patient.
  • the telecommunications unit 1091 comprises data transmission means for establishing at least one wireless data transmission connection.
  • the data transmission can use WLAN, Bluetooth or ZigBee networks, for example.
  • the central unit 1095 of the sensor belt 109 comprises a suitable processor, and volatile and non-volatile memory. If needed, the central unit 1095 collects, processes and temporarily stores the measuring data received from the sensors 1095- 1099. The central unit 1095 wirelessly transmits the measurement data to the departmental server 100 via the telecommunications unit 1091.
  • a sensor 1096-1099 included in the sensor belt can for example be an EKG sen- sor, a breath frequency sensor, a positional sensor, a blood pressure sensor, an oximeter sensor, or a temperature sensor.
  • the sensors included in the sensor belt 109 are connected to the central unit 1095 with suitable fixed wiring.
  • the sensor belt 109 can comprise either a passive or an active RFID identifier 1094. With the identifier, it is possible to associate a certain sensor belt 109 and an individual patient 106 with certain measurement data. This identifier can also be used to monitor the condition of the sensor belt and the sensors it comprises.
  • Figure 8 shows, as an example, how the medical information network 10 of the invention can be used to locate a person in the area of the treatment department 20.
  • the person to be located is marked with reference number 106x.
  • the localization is launched for example with a computer 107 located in the office space. Alternatively, the localization can be launched with any nursing staff terminal 105.
  • the departmental server 100 forwards a localization instruction to all WHUB base stations 101a-101 k in the department 20. Each WHUB base station 101a- 101 k then tries to read the signal level transmitted by the remote readable, active RFID identifier carried by the person 106x. It is advantageous that the localization implementation uses the ZigBee technique.
  • WHUB base stations 101d, 101e, and 101f can receive information of the RFID identifier of the person 106x from ZigBee messages.
  • the WHUB base stations 101d-101f forward the received messages, with the level information included, to the departmental server 100, whose localization block 1008 calculates where in the department 20 the searched person is located based on the measurement results.
  • the localization can naturally also use other known locating methods, one example of which uses delay time measurements. Another possible method bases the localization on statistical processing of the received signal.
  • the location data can also be used in situations where the patient has left his/her patient bed and the nursing staff thus cannot read the person's RFID identifier to retrieve treatment information, for example.
  • the nurse can find his/her own location when standing next to the patient bed.
  • the located patient bed can advantageously be connected to the absent patient. Treatment information of the patient can then be retrieved from the departmental server, even if the patient himself/herself is absent.

Abstract

The present invention relates to a medical information management arrangement that uses wireless data transmission. The invention also relates to a wireless terminal (105) used in the data transmission network, a wireless sensor belt (109), and a departmental server (100) managing the medical information network, and a medical radio beacon (60).

Description

System for transmitting and managing medical and processing information in a hospital
The present invention relates to a medical information management arrangement that uses wireless data transmission. The invention also relates to a data trans- mission network transmitting the medical information, a base station of the transmission network, a wireless terminal used in the data transmission network, a wireless sensor belt, and a departmental server managing the medical information network.
Health care processes are at a turning point. The effectiveness of the massive present day processing assemblies can be questioned. The increasing costs of patients and treatment processes create pressures to operate cost-effectively.
Conventional hospital-specific information systems, commonly abbreviated HIS (Hospital Information System), comprise large amounts of varied information about patients and hospital activities. Information about hospital activities is commonly also called process information. Consequently, HIS systems have become awkward and difficult to modify. If a hospital department requires features that differ from the ones provided by the general system, separate department-specific information systems have at times been created to perform these features. The ability of a department-specific information system to transmit information to or receive information from a HIS information system is often quite limited.
Whether dealing with an HIS information system of an entire hospital or a department-specific information system, the patient information is entered to these systems through a separate terminal. A PC connected to the information network is often used for this purpose. Before the information is entered to the system, it has been necessary to temporarily record it somehow. A traditional way to do this is to write down the patient information in patient-specific files, from which they can later be transferred to an electronic information system using, for example, a PC connected to the information system. Alternatively, patient information can be stored by the nursing staff in a notebook computer or similar, from which the in- formation can later be transferred to the actual information system. In both cases, the transfer of information can cause long delays, which can have disadvantageous effects on treatments.
Information about the medical state of patients, commonly called medical information, is also received from different medical measuring devices. These measure- merits can be transmitted from the patient's location for example via cables to a centralized monitoring room, where nursing staff continuously monitors the states of several patients. The operation of an intensive care unit is mostly based on this kind of an operational model. In practice, the medical measuring devices each re- quire their own tracking monitor, because the data transmission and display methods can vary on a device to device basis. Consequently, the nursing staff has to be able to simultaneously use different measuring devices that are operated differently. The user interfaces of the measuring devices are often manufacturer- specific. Consequently, it requires practice to effectively operate them.
Measuring devices attached to a patient can produce large amounts of real time electronic information about the patient. It is well advised to analyze and process this information in one way or another before storing it for the long term. In practice, this work has to be done in a patient-specific way by the nursing staff and, in the worst case, in a measuring device specific way. This arrangement takes away from the limited resources which could be used on actual treatments.
If there are among the medical measuring devices monitoring devices that are located next to the patient, the patient can in some situations be surrounded by several different measuring devices measuring vital functions and display units of the devices. It is still commonly necessary to connect the measuring devices to the pa- tient and to the monitoring device with cables. The amount of measuring cables and different fluid transfusion devices required can make daily treatment of the patient more difficult.
Hospitals are often large and sometimes rather labyrinthine building complexes. Finding one's way inside them can often be problematic, particularly for patients. The numbers and placements of the nursing staff can also vary daily. It is important, in an urgent case, to find out immediately where in the hospital certain specialized members of the nursing staff, the patient requiring urgent treatment, or a certain medical device are located at a given moment. Personal tracking in a hospital has made use of the different kinds of access cards used to open doors, for example. It can be determined, where in the hospital the person we want to find is most likely located by maintaining a real time log about the usages of access cards.
There are known methods for locating individuals indoors with the use of radio devices. Published application WO 02/054813 presents a method in which the char- acteristics of a signal measured by a moving radio device are statistically com- pared with reference measurements made in the same facilities. As an example, the referenced text mentions tracking a WLAN (Wireless Local Area Network; IEEE 802.11) terminal using the said method. This kind of system requires that the individual to be located carries a WLAN terminal which measures the signal strengths of the nearest WLAN base stations. From the measured signal strengths, the presented measuring arrangement can deduce the location of the wireless terminal with an accuracy of a couple of meters. The localization result is forwarded to the tracking system of individuals. In practice, the batteries of the WLAN terminals have to be recharged daily for the WLAN terminals to operate continuously. This requires discipline from the users in order for the localization system to be reliable.
The GPS (Global Positioning System) positioning system used outdoors cannot be used indoors such as it is because the signal received from the satellites can be blocked indoors.
Wirelessness has become a hot topic in discussions about operational processes for health care, and consequently its suitability for processes in different forms is constantly being discussed and developed around the world. The often presented solutions are based on some pre-selected data transmission technology: WLAN1 GSM/GPRS, Bluetooth (IEEE 802.15.1), ZigBee (IEEE 802.15.4), RFID (Radio Frequency IDentification), or in the future, UWB (Ultra Wide Band). Using the selected network technology it is possible to create a radio network that can wire- lessly transmit patient and staff information from one place to another. However, each data transmission technique has its limitations: power consumption, coverage, etc., which is why it is difficult to solve all of the presented data transmission problems cost-effectively by using a single data transmission technology.
The object of the invention disclosed in the present application is to provide a mostly wirelessly operating, department-specific information management system that is based on wirelessly collecting department-specific information about patients and the nursing staff, and processing the information in a centralized man- ner in the department. In the hospital information management system according to the present invention, patient and nursing staff information transmitted using different data transmission techniques is processed on a single departmental server.
The objects of the invention are met by using a solution where patient identification information, measuring information about patient state, nursing staff identification information and location information about both are all sent using one or more wireless data transmission techniques to the closest base station of the data transmission network, which can simultaneously support several different wireless data transmission techniques. The information is transmitted using a single data transmission protocol from the base station to the departmental server, which manages the data transmission network. The departmental server processes, forwards or stores the information it has received as such, or processes the information into a suitable file format before storing it. The departmental server sends a certain part of the stored information as needed to the HIS information system of the entire hospital.
An advantage of the invention is that the department-specific patient and staff information is centrally processed on a single departmental server, which makes it possible to operate a medical department independently without a connection to the actual HIS system of the hospital.
A further advantage of the invention is that it has a modular structure and its archi- tecture is open to support different kinds of wireless techniques, making modifying and extending the system simple.
A further advantage of the invention is that most of the patient and staff information can be sent wirelessly via the same base station to the departmental server using different data transmission techniques. If needed, the data transmission technique can be switched without user's knowledge.
A further advantage of the invention is that the patient-specific measurement data can be stored at the patient's side straight into the departmental server without manual intermediary phases. One can find out from the patient data according to the invention who the patient is, who the nurse is, and from which measuring de- vice the data is coming from. If needed, the departmental server asks a permission to store patient data from the nurse standing next to the patient.
A further advantage of the invention is that the user interface of the medical measuring devices is physically and logically detachable from the medical measuring devices, which makes the medical measuring devices simpler and cheaper in structure. It is possible to control different medical measuring devices with a wireless terminal used by the nursing staff by modifying the user interface of the nursing staff terminal. A further advantage of the invention is that the user interface of the nursing staff information processing device can be modified when needed as the patient, the treatment situation and the medical device dictate.
A further advantage of the invention is that the collected patient data can be buff- ered, compressed or filtered in a predefined way before the data is stored on the departmental server.
A further advantage of the invention is that patient data can be transmitted from the department-specific server to the HIS information system of the entire hospital or to another similar departmental server of another department.
A further advantage of the invention is that the patient and the nurse can always be directly wirelessly identified in a treatment situation.
A further advantage of the invention is that the patient's medical tracking information can be received without wired connections, which enables the patient to move freely, and the patient does not need to be bound to a specific location to have a measurement performed.
Furthermore, an advantage of the invention is that the patients and staff members can be located using personal wireless identifiers and measurement information from the base station network.
The departmental server of the invention is characterized by comprising - a connection block for connecting the departmental server to a medical information network, to a hospital information system and to at least one computer,
- a data and instruction processing block,
- computer program means for storing nursing staff identification information,
- computer program means for storing patient identification information, - computer program means for storing patient medical information, and
- device drivers of the devices operating wirelessly in the medical information network.
The nursing staff terminal of the invention is characterized by comprising computer program means for modifying the functionality of a user interface to match the treatment status of a patient by receiving a wireless instruction from the departmental server. The medical radio beacon of the invention is characterized by comprising data transmission means for wirelessly transmitting in a single message a patient identifier, a treatment terminal identifier and measuring device information to a departmental server.
The sensor belt according to the invention is characterized by its data transmission unit comprising data transmission means for sending wireless messages between a departmental server and a patient using a single data transmission technique which can be selected from among at least two different data transmission techniques.
Some advantageous embodiments of the invention are described in the dependent claims.
The basic idea of the invention is as follows: a departmental medical information arrangement uses wired and wireless data transmission technologies to create a hospital-specific medical information system. The medical information arrange- ment consists of a physical device arrangement and pieces of software that are used to collect and process data coming from medical measuring devices, and to collect wireless location data and identification data. Terminals can be connected to the system that use either wired or common wireless technologies, such as RFID, WLAN, ZigBee, Bluetooth, and in the future, UWB as well.
The medical information arrangement according to the invention comprises universal base stations located in a department, which are later also referred with the abbreviation WHUB (Wireless HUB), which can be used to set up data transfer areas that support different data transmission techniques inside the hospital rooms. In their coverage area, the WHUB base stations collect data from different de- vices/sources through different wired and wireless connections. A WHUB base station can receive information for example from a personal identifier of a patient, a wireless medical measuring device, or a nursing staff terminal. The base stations of the medical information network are advantageously room-specific. They can be connected to each other using, for example, Ethernet cables, which can also be used to supply power to the WHUB base stations.
Various wireless or wired solutions can be used as the nursing staff terminals, such as PDAs (Personal Digital Assistant) or so-called communicators, for example. The wirelessly operating nursing staff terminal can select a data transmission method suitable for the situation from the available data transmission options. Signals received by the base station network of the medical information arrangement according to the invention can be used when necessary to locate either a patient or a specific nurse in the department. The localization can for example utilize level information of the received signal, delay time of the signal, or statistical prop- erties of the signal.
The core of the medical information arrangement according to the invention is a departmental server that acts as a platform and as a buffer between the department-specific information network structure and the medical information system of the hospital (HIS). The departmental server receives information from the medical information network that can be data originating from the medical measuring devices, the nursing staff terminals, or localization devices. The departmental server provides a software interface to which different device manufacturers can provide device-specific drivers. Using the device drivers, the devices operating in the information network become a part of the medical information network. The data col- lected from the devices is transmitted from the departmental server to the hospital information system (HIS) via a departmental server integration module that provides a connection interface for the hospital information system. The hospital information system comprises a function that can be used to associate with each other a measuring device, a patient, a nursing staff terminal, and a device con- nected to a base station.
The invention will be described in detail below. The description references accompanying figures, of which:
Figure 1a shows, as an example, a medical information network according to the invention,
Figure 1b shows, as an example, the logical connections inside the medical information network according to the invention,
Figure 1c shows, as an example, a patient and a sensor belt according to the invention and a remote readable patient identifier,
Figure 2a shows, as an example, a wireless departmental network according to the invention,
Figure 2b shows, as an example, a physical implementation of the wireless departmental network according to Figure 2a, Figure 3 shows, as an example, functional parts comprised in the departmental server according to the invention,
Figure 4 shows, as an example, a universal base station according to the invention,
Figure 5 shows, as an example, the main functional blocks of a nursing staff terminal according to the invention,
Figure 6 shows, as an example, a radio beacon according to the invention,
Figure 7 shows, as an example, a sensor belt according to the invention, and
Figure 8 shows as an example, the execution of personal localization accord- ing to the invention.
A medical information network 10 according to the invention is shown in Figure 1a. Advantageously, it comprises a single medical department of the hospital. The operation of the medical information network is controlled by the departmental server 100 according to the invention. The departmental server 100 itself comprises a prior art processor, non-volatile and volatile memory for executing application programs to store patient and medical measurement data, and connection means for creating connections to different information networks that are not specifically shown in Figure 1 a.
The application programs, the device drivers of the medical measurement devices, the device drivers of the nursing staff terminals, the communications protocol used, TCP/IP protocol for example, and the nursing staff and patient identification information, which are needed to manage the departmental information system of the present invention, are loaded into the memory of the departmental server 100. The memory is also used to store the created patient data.
The departmental server 100 can be connected to an existing hospital information system HIS 11. The connection can use a fixed connection 103. The connection to the hospital information system HIS 11 can for example be established using the HL7 (Health Level Seven) protocol commonly used in hospital settings. The hospital information system HIS 11 can be divided into several different information sub- systems. In the example of Figure 1 , this is illustrated with two separate exemplary information systems HIS/1 , reference number 111 , and HIS/2, reference number 112. The departmental server 100 according to the invention can be connected to both departmental information systems 111 and 112 or to just one. A connection to the desired information sub-systems is advantageously created information subsystem specifically. The arrow 113 in Figure 1a indicates that the information subsystems 111 and 112 included in the information system of the entire hospital can transmit data between each other if such a connection is built into the HIS information system.
The functional parts of the core network of the medical information network 10 according to the invention are shown in Figure 1a. The departmental server 100 managing the medical information network is connected to a required amount of universal base stations WHUB in the department, which are referred to by 101a- 101c in Figure 1 a. The WHUBs can be connected to the departmental server 100 either via wired connection, wireless connection or a combination of both. This connection is referred to by 102. The communication between the departmental server 100 and the WHUBs on the connection 102, when operating the medical in- formation network of the invention, advantageously uses a single protocol on the connection 102 regardless of which available data transmission technology the WHUB base station has used to connect to the wireless device not shown in Figure 1a. Advantageously data transmission uses a protocol that utilizes TCP/IP protocol.
Figure 1 b shows, as an example, the logical data transmission connections of the medical information network according to the invention. The departmental server 100 according to the invention can have a data transmission connection that uses at least partly wireless technology with the following wireless devices: medical measuring devices 104a-104c, nursing staff terminals 105a-105b, and wireless identification devices connected to patients 106a-106b, for example. Furthermore, a separate sensor belt can be attached to the patients, which is shown in Figure 1c, that can also establish a wireless data transmission connection to the departmental server through the WHUB base station. The medical data collected by the sensor belt can either be transmitted in real time or the data can be temporarily stored in the sensor belt, from which it can be transferred as a separate event to the departmental server 100 via the WHUB base station.
Each patient 106a-106b advantageously has a remote readable RFID identifier. The RFID identifier can be either a passive identifier or an active identifier. A passive identifier does not have its own power source; so consequently, it will always have to be read using an external electromagnetic field. An active RFID identifier has its own power source, which enables it to transmit by itself. Regarding power consumption, a good solution uses the ZigBee technique in active RFID identifiers, because ZigBee uses energy sparingly compared with alternative techniques.
In one advantageous embodiment biometric identification methods and devices are used instead of an RFID identifier or together with an RFID identifier. In such a case, the person can be identified based for example on a fingerprint, facial recognition or voice recognition.
Some wireless data transmission connections in the information network according to the present invention are shown in Figure 1 b with arrows.
In the example of Figure 1 b, there are three measuring devices 104a-104c. In the medical information network 10 according to the invention, the medical measuring devices 104a-104c advantageously only comprise the means required to acquire medical information, to perform the medical procedure, and to wirelessly transmit the medical information or the result of the medical procedure. This means that the arrangement according to the invention does not necessarily need the display and user interface components of prior art. In the medical information network 10 according to the invention, the user interface of the medical measuring device 104a- 104c is advantageously a nursing staff terminal 105a-105b. The departmental server 100 sends a control message that converts the display of a certain wireless nursing staff terminal, such as 105a, that has activated a certain measuring de- vice, such as 104a, in a way that makes it suitable for managing the medical measuring device 104a that is being used.
An exemplary patient 106 is shown in Figure 1c. The patient 106 is advantageously equipped with a remote readable RFID identifier 108 that can be either a passive identifier or an active identifier. The RFID identifier 108 is advantageously read during each procedure performed by the nursing staff. The nursing staff uses their terminal 105a-105b to read the RFID identifier 108 of the patient 106. The read information is advantageously forwarded to the departmental server 100, which responds by sending as return information the patient information of the patient to the nursing staff terminal that was used to read the RFID identifier of the patient. The return information can require that a certain medical measuring device, such as 104a, is used. In such a case, the user interface of the nursing staff terminal is converted with a control instruction sent by the departmental server 100 to a form that is suitable for the medical measuring device. The nurse can subsequently activate the medical measuring device 104a in question using his/her own terminal. Advantageously, the procedure information can be forwarded to the de- partmental server 100 for storage purposes. Before storing the information we can ask the nurse performing the procedure to confirm whether the procedure will be stored as such or not at all, or whether it requires some further processing.
In an advantageous embodiment of the invention, a nurse reads an RFID identifier of a measuring device 104a with the RFID reader of the treatment terminal 105a, for example. In such case, the measuring device 104a, the measuring information received from the measuring device 104a, and the above patient identification information read from the RFID identifier of the patient 106 can advantageously be associated in the departmental server 100.
In an advantageous embodiment of the invention, the patient identification information and the measuring information can be associated in the treatment terminal 105a using the RFlD identifiers that were read.
A sensor belt is shown as an example in Figure 1c with the reference number 109 that can comprise several different sensors measuring the state of a patient 106. The measuring data collected by the sensor belt 109 is forwarded to the departmental server 100 using wireless transmission at least partly.
Figure 2a shows an example of the implementation of the medical information network 10 according to the invention. The exemplary department 20 of the hospital comprises, from Figure 2a, the office space 201 of the nursing staff, eight pa- tient rooms 202 with thirteen patient beds 203, and a procedure room 205. The department 20 has four exemplary data transmission regions 131-134. In the example of Figure 2a, the data transmission region can comprise several WHUB base stations providing identical level service that form separate data transmission cells within the data transmission region. The data transmission region 134 estab- lished in the office space of the nursing staff supports both WLAN and ZigBee connections. The eight patient rooms are divided into two units of four patient rooms, which both have their own data transmission regions 131 and 133. In these patient room cells, data transmission is possible using WLAN, ZigBee or Bluetooth connections. The data transmission region 132 has been created in the procedure room 205, which supports WLAN and ZigBee data transmission.
When a person moves from one serving WHUB data transmission cell to another within the department 20, the serving WHUB base station is switched without any action from the person himself/herself. The WHUB base station that receives the identification of the person with the best signal level will perform the data transmission.
If necessary, a nurse or a patient can be located advantageously by using signals received by the WHUB base stations. When locating a person, several different WHUB base stations try to receive the person's identifier simultaneously. Using the signal levels received by the WHUB base stations, the departmental server 100 can calculate the person's location. The accuracy of the localization depends on the data transmission technique used: with WLAN and ZigBee techniques the location can be calculated with an accuracy of a couple of meters. In the future, the UWB technique will enable localization with an accuracy of a couple of centimeters by using delay time measurements.
Figure 2b shows, as an example, an implementation of the medical information network 10 according to the invention. The arrangement of Figure 2b can be used to implement the four data transmission regions 131-134 of Figure 2a, for exam- pie. The four data transmission regions of Figure 2a are formed of radio cells formed by ten exemplary WHUB base stations 101a-101 k. Reference 102 depicts to a data transmission connection that interconnects, in the department 20, the WHUB base stations 101a-101k and the departmental server 100. The data transmission connection 102 can be a fixed connection, a wireless connection or a combination of both. This data transmission connection 102 uses the data transmission protocol according to the invention regardless of which wireless data transmission technique is used in the data transmission cells at a given moment.
The WHUB base stations 101 b-101e can be used to establish the data transmission region 131 of Figure 2a to four adjoining patient rooms. The WHUB base sta- tion 101f can be used to establish the data transmission region 132 of Figure 2a to the procedure room 205. The WHUB base stations 101g— 101 k can be used to establish the data transmission region 133 of Figure 2a to the other set of four patient rooms. A single WHUB base station 101a can be used to implement the data transmission region 134 of the staff office 201.
The data transmission regions 131 and 133 shown in Figure 2a are certain types of macro-cells, because the physical implementation of both of them uses four different WHUB base stations located in patient rooms. The data transmission region 131 is implemented with four WHUB base stations 101 b-101e, and the data transmission region 133 is implemented with WHUB base stations 101g— 101 k. One or more computers 107 can be connected to the departmental server 100. Medical information received from a patient can be processed with a computer 107 by selecting which part of the information will be stored, or by compressing the information before storing it into the memory of the departmental server 100, for ex- ample. A computer 107 can also be used to control other operations, if needed. An instruction from a computer 107 can for example activate the localization of a person.
Figure 3 shows, as an example, the main functional parts of the departmental server 100 according to the invention. The departmental server 100 is advanta- geously connected to a medical information network 10 according to the invention, to computers 107 in the department, and to a hospital information system HIS 11. The connections are advantageously established by a connection block 1001 , which comprises both mechanical and software means for establishing connections 102 and 103.
A processing block 1002 comprises a processor that executes instructions that control the operation of the departmental server and executes various instructions related to patient data processing. The processing block 1002 receives the patient data to be processed from the connection block 1001. The processing block 1002 also has connections to a medical information network management block 1003, a monitoring block 1004, a device driver block 1005, a measurement block 1006, patient files 1007, a localization block 1008, and a service block 1009 of the devices in the departmental network, comprised in the departmental server.
The network management block 1003 coordinates, manages and controls the overall operation of the medical information network 10.
The monitoring block 1004 is used to manage data transmission in the medical information network 10. It comprises prior art software means for continuously monitoring the operation of the medical information network 10 and for maintaining network performance.
The block 1005 comprises various device drivers that are needed to control and manage the devices connected to the medical information network 10.
The measurement block 1006 is used when medical measurements and treatment procedures are performed on patients. It receives procedure information relating to the patients. It advantageously also comprises various measurement information processing routines, which can be used to sort and edit the collected patient information to a desired form.
The actual process information relating to patients is maintained and stored in block 1007, which can be considered a form of department-specific HIS informa- tion system. It can comprise various personal identifiers and collected patient data. If patient data needs to be transmitted from the departmental server 100 to the hospital information system HIS 11 , the data to be transmitted is retrieved by the processing block 1002 from the patient file block 1007.
The block 1008 comprises software means for performing localization. The local- ization can be performed for a patient, nursing staff members, or a certain medical device. The localization is advantageously performed by receiving with two or more WHUB base stations a signal transmitted from a person or a device identifier. The block 1008 calculates from the level information of the received signals where in the department 20 the localization target is located. The localization can also utilize signal delay measurements or other prior art localization methods.
The device service block 1009 stores the identification information of all devices operating in the medical information network 10.
Figure 4 shows, as an example, the main functional parts of a universal base station WHUB 101 according to the invention. In the example of Figure 4, the WHUB base station can communicate using three exemplary data transmission technologies. The WHUB base station comprises a WLAN transceiver 1011 , a Bluetooth transceiver 1012, and a ZigBee transceiver that are connected to an exemplary antenna 1014. It is apparent to those skilled in the art that instead of using a single antenna, each transceiver can be connected to its own antenna. In each radio ac- cess network, WLAN, Bluetooth and ZigBee, the radio path functions according to prior art.
The WHUB base station 101 also comprises a power source 1010. The power source 1010 can be a rechargeable battery or a supply connection unit. The power source can alternatively or simultaneously also use the electric power available via the fixed cable connection 102 of the Ethernet unit 1018.
The operation of the WHUB base station 101 is controlled by the central unit 1015. It comprises a processing unit for executing software instructions, a memory, and means through which it performs real time data transmission with the transceivers of each WHUB base station 101. The central unit also comprises means for modi- fying the data received from a transceiver into such a format that it can be forwarded through the Ethernet unit 1018 via the data transmission connection 102 to the departmental server using a single protocol. Similarly, the central unit 1015 converts the data received from the departmental server 100 into a format that can be used by the transceiver as such. Since there are several transceivers, the central unit 1015 also multiplexes the data received from the transceivers onto the connection 102. Similarly, the central unit 1015 demultiplexes the data stream received from the departmental server 100 for each transceiver.
The data transmission and processing features performed by the central unit 1015 can advantageously be implemented with one or more software programs stored in the memory of the central unit, which the processor of the central unit can use.
I
The Ethernet unit 1018 connected to the central unit 1015 advantageously comprises prior art means for maintaining two-way data transmission with the departmental server 100.
The WHUB base station 101 according to the invention can further comprise an RS-232 unit 1016 that is in accordance with ITU-T standard V.24 and/or a USB unit 1017 (Universal Serial Bus), for example. The USB connection can use either wireless or wired connection. It is possible to further include other device manufacturer specific data transmission modules to the WHUB base station 101. By using the above mentioned means, it is possible to connect devices to the WHUB base station 101 that do not have means for wireless data transmission.
Figure 5 shows, as an example, a wireless nursing staff terminal 105. It advantageously comprises a telecommunications unit 1051 , an RFID reader 1052, a central unit 1054, a user interface 1055, an RFID identifier 1056, and an antenna 1053. The terminal 105 also comprises a power source 1050 that is advantageously a rechargeable battery.
The telecommunications unit 1051 advantageously comprises WLAN, Bluetooth and ZigBee transceivers. The telecommunications unit 1051 is connected in Figure 5 to an exemplary antenna 1053, through which the nursing staff terminal 105 receives and transmits messages. It is apparent to a person skilled in the art that there can be several antennae instead of the antenna 1053 shown in Figure 5.
The terminal also advantageously comprises an RFID reader 1052. The reader can also use the antenna 1053 for its operations, or it can have its own antenna (not shown in Figure 5). The RFID reader 1052 can be used to read for example nursing staff identifiers, patient identifiers, drug identifiers or various device identifiers.
Both the telecommunications unit 1051 and the RFID reader 1052 are connected to the central unit 1054 of the terminal 105. The central unit 1054 advantageously comprises a processor and some volatile and non-volatile memory connected to it.
The operation of the terminal 105 is controlled through the user interface 1055. It advantageously comprises buttons and a display unit, which are not shown as separate components in Figure 5. The buttons can either be fixed buttons, programmable buttons, or buttons created on a suitable touch screen. The user inter- face of the terminal 105 according to the invention can be modified with an instruction received from the departmental server 100. The terminal 105 can be for example converted into a patient information presentation device, a control panel of a medical measuring device, or a device for performing a medical procedure. The conversion can be implemented by changing the format of the information dis- played on the display unit, or by changing the functions associated with the buttons of the terminal, for example.
The nursing staff terminal 105 can also include an RFID identifier 1056. The RFID identifier can be used when necessary to associate with each other the terminal 105, the nurse using it, patient measuring information and a certain patient 106.
The RFID reader 1052 of the treatment terminal 105 can be advantageously used to read the identification information of a patient 106 and the identification information of a measuring or treatment device 104a-104d, which can be read from the RFID identifiers advantageously comprised in said devices. The pieces of identification information read from the above mentioned RFID identifiers can advanta- geously be combined in the departmental server 100.
In an advantageous embodiment of the invention, the identification and measuring information of a patient can already be combined in the treatment terminal 105a using the read RFID identifiers.
In an advantageous embodiment, the nursing staff terminal 105 also comprises means for using biometric identification (not shown in Figure 5). In this embodiment, the biometric identification can advantageously utilize a fingerprint, facial recognition or voice recognition. Figure 6 shows, as an example, a radio beacon 60 according to the invention that can be used to connect devices to the medical information network 10 that do not comprise the data transmission means used in wireless data transmission networks. The radio beacon 60 according to the invention is a small device connected to the RS-232 gate of a medical measuring device that advantageously comprises a processing unit, volatile and non-volatile memory for storing device drivers and treatment status information, an RFID reader, data transmission means used in wireless data transmission, and means for establishing an RS-232 connection. A nurse reads the RFID identifier 108 of a patient 106, referenced by 603, and also, when necessary, the identifier of a medical measuring device 104d, referenced by 602, with the said RFID reader. The RFID reader can either be an integral part of the medical radio beacon 60 or it can be connected to it through a separate cable connection. After the patient identifier 108 and possibly the measuring device 104d identifier have been read, the medical radio beacon 60 forwards the information sent by the medical measuring device 104d wirelessly to a suitable WHUB base station 101 , using for example a ZigBee, Bluetooth or WLAN connection, referenced by 601.
In an advantageous embodiment, the wireless nursing staff terminal 105 acts as a user interface for the medical radio beacon 60. The nursing staff terminal 105 is connected to act as a user interface of the medical radio beacon 60 by reading the identification information of the terminal 105 with the RFID reader of the medical radio beacon. The terminal 105 can now be used both to control the measuring device 104d and to display measuring information from the measuring device.
In an advantageous embodiment, the medical radio beacon 60 can also comprise its own fixed user interface. The user interface can now be used to control the medical radio beacon 60 independently, and certain patient related information can be displayed on a display unit associated with the medical radio beacon.
If the medical measuring device 104d requires a communication handshake before it begins sending data, the departmental server 100 controls the execution of the handshake.
The information collected by the medical measuring device 104d will not be modified in the medical radio beacon 60, but a patient 106 identification and a device 104d identification will be appended to it so that the departmental server 100 knows with which patient 106 it should associate the data coming from each medi- cal measuring device 104d. The medical radio beacon 60 according to the invention is advantageously connected to the RS-232 gate of the medical measuring device 104d with a cable 61 , or it is connected to a connector in the medical measuring device 104d. If the embodiment with the cable is used, the RFID identifier 108 of the patient 106 can be read without needlessly moving the patient.
Figure 7 shows, as an example, a sensor belt 109 used in the medical information network according to the invention. When using the sensor belt, separate cables are not needed to connect the patient. The sensor belt 109 advantageously comprises a power source 1090, a telecommunications unit 1091 , an antenna 1092, a central unit 1095, sensors 1096-1099, and an RFID identifier 1094.
The power source of the sensor belt 109 is advantageously a rechargeable battery or a non-rechargeable battery that can store enough power to guarantee with a single charge an operating time of several days for the sensor belt 109. The power source of the sensor belt 109 can also comprise an element that can be used to create the energy needed by the sensor belt from the movements of the patient. The telecommunications unit 1091 comprises data transmission means for establishing at least one wireless data transmission connection. The data transmission can use WLAN, Bluetooth or ZigBee networks, for example.
The central unit 1095 of the sensor belt 109 comprises a suitable processor, and volatile and non-volatile memory. If needed, the central unit 1095 collects, processes and temporarily stores the measuring data received from the sensors 1095- 1099. The central unit 1095 wirelessly transmits the measurement data to the departmental server 100 via the telecommunications unit 1091.
A sensor 1096-1099 included in the sensor belt can for example be an EKG sen- sor, a breath frequency sensor, a positional sensor, a blood pressure sensor, an oximeter sensor, or a temperature sensor. The sensors included in the sensor belt 109 are connected to the central unit 1095 with suitable fixed wiring.
The sensor belt 109 can comprise either a passive or an active RFID identifier 1094. With the identifier, it is possible to associate a certain sensor belt 109 and an individual patient 106 with certain measurement data. This identifier can also be used to monitor the condition of the sensor belt and the sensors it comprises.
Figure 8 shows, as an example, how the medical information network 10 of the invention can be used to locate a person in the area of the treatment department 20. The person to be located is marked with reference number 106x. The localization is launched for example with a computer 107 located in the office space. Alternatively, the localization can be launched with any nursing staff terminal 105. In both cases, the departmental server 100 forwards a localization instruction to all WHUB base stations 101a-101 k in the department 20. Each WHUB base station 101a- 101 k then tries to read the signal level transmitted by the remote readable, active RFID identifier carried by the person 106x. It is advantageous that the localization implementation uses the ZigBee technique. In the example of Figure 8, WHUB base stations 101d, 101e, and 101f can receive information of the RFID identifier of the person 106x from ZigBee messages. The WHUB base stations 101d-101f forward the received messages, with the level information included, to the departmental server 100, whose localization block 1008 calculates where in the department 20 the searched person is located based on the measurement results.
The localization can naturally also use other known locating methods, one example of which uses delay time measurements. Another possible method bases the localization on statistical processing of the received signal.
The location data can also be used in situations where the patient has left his/her patient bed and the nursing staff thus cannot read the person's RFID identifier to retrieve treatment information, for example. In such a case, the nurse can find his/her own location when standing next to the patient bed. The located patient bed can advantageously be connected to the absent patient. Treatment information of the patient can then be retrieved from the departmental server, even if the patient himself/herself is absent.
Some advantageous embodiments of the invention are described above. The invention is not limited by the solutions described herein; rather, the inventive idea can be embodied in different ways within the scope of the claims.

Claims

Claims
1. A departmental server (100), characterized in that the departmental server comprises:
- a connection block (1001) for connecting the departmental server to a medical information network (10), to a hospital information system (11), and to at least one computer (107),
- a data and instruction processing block (1002), and
- computer program means for storing nursing staff identification information,
- computer program means for storing patient identification information, - computer program means for storing patient medical information.
2. The departmental server according to claim 1 , characterized in that it further comprises device drivers of wireless devices operating in the medical information network (10).
3. The departmental server according to claim 1 , characterized in that the con- nection block (1001 ) comprises:
- computer program means for receiving messages from and sending messages to the medical information network (10) using a TCP/IP based protocol, and
- computer program means for sending data from the departmental server (100) to the hospital information system (11) using HL7 protocol.
4. The departmental server according to claim 1 , characterized in that it further comprises:
- a management block (1003) of the medical information network (10), and
- a monitoring block (1004) of the medical information network (10).
5. The departmental server according to claim 4, characterized in that it further comprises computer program means for locating (1008) a personal identifier (108) in the department (20) by using signals received from the personal identifier (108) by universal base stations (101a-101 k) comprised in the medical information network.
6. The departmental server according to claim 1 , characterized in that it further comprises computer program means that store information about procedures performed on a patient using at least two identifiers, the identifiers are arranged to be sent to the departmental server (100) by reading said identifiers using a medical radio beacon (60) or a treatment terminal (105, 105a, 105b), for example.
7. The departmental server according to claim 6, characterized in that, based on receiving patient (106) and medical measuring device (104a, 104b, 104c, 104d) identifiers, the departmental server (100) is arranged to store procedure information in a database when the patient (106) has been measured using the medical measuring device.
8. The departmental server according to claim 7, characterized in that that the read procedure information also comprises a measurement result from the procedure.
9. The departmental server according claim 7, characterized in that before the result of said procedure is stored, a person doing the procedure is arranged to enter the result of the procedure into the treatment terminal (105).
10. The departmental server according claim 7, characterized in that during the procedure, an identifier of a person doing the procedure is arranged to be read, and information about the person doing the procedure is arranged to be stored in the database of the departmental server (100).
11. The departmental server according to claim 8, characterized in that it further comprises device drivers (1005) of devices operating wirelessly in the medical information network, and by a result of the performed measurement procedure being arranged to be available from a driver of the measuring device on the departmen- tal server (100).
12. A wireless treatment terminal (105) comprising:
- a power source (1050),
- a telecommunications unit (1051),
- a central unit (1054), and - a user interface (1055) characterized in that it further comprises computer program means for modifying a functionality of a user interface (1055) to match a treatment status of a patient (106) using an instruction received wirelessly from a departmental server (100).
13. The wireless treatment terminal according to claim 12, characterized in that it further comprises an RFIC reader (1052) and/or a biometric identification reader.
14. The wireless treatment terminal according to claim 13, characterized in that information about patients (106) and medical measuring devices (104a, 104b, 104c, 104d) is arranged to be combined in the treatment terminal (105).
15. The wireless treatment terminal according to claim 13, characterized in that the biometric information reader comprises one of the following: a fingerprint sensor, a facial recognition sensor, or a voice recognition sensor.
16. The wireless treatment terminal according to claim 12, characterized in that the telecommunications unit (1051) comprises at least two of the following data transmission means: a WLAN transceiver, a Bluetooth transceiver, a ZigBee transceiver, or a UWB transceiver.
17. The wireless treatment terminal according to claim 12, characterized in that the user interface (1055) of the treatment terminal (105) is arranged to be con- verted with an instruction (105) received by the terminal into one of the following: a patient information display unit, a medical measuring device control panel, or a medical measurement information presentation unit.
18. The wireless treatment terminal according to claim 12, characterized in that the user interface (1055) of the treatment terminal (105) is arranged to be con- verted with an identifier read by the terminal (105) into a user interface for a device or object to which the identifier refers.
19. The wireless treatment terminal according to claim 18, characterized in that the user interface is one of the following: a patient information display unit, a medical measuring device control panel, or a medical measurement information pres- entation unit.
20. A medical radio beacon (60) comprising:
- connection means (61) for connecting a measuring device (104d) to the medical radio beacon, and
- data transmission means for transmitting wireless messages between the meas- uring device (104d) and a serving base station (101 ), characterized in that it further comprises data transmission means for sending a patient identification, a treatment terminal identification and measurement device information as a single wireless message to a departmental server (100).
21. The radio beacon according to claim 20, characterized in that it further com- prises:
- means for wireless reading of a patient identifier (108), and
- means for wireless reading of a treatment terminal (105) identifier.
22. The radio beacon according to claim 20, characterized in that its data transmission means comprise one or more of the following: a WLAN transceiver, a Bluetooth transceiver, a ZigBee transceiver, or a UWB transceiver.
23. A patient sensor belt (10) comprising: - a power source (1090),
- a telecommunications unit (1091),
- a central unit (1095), and
- measurement sensors (1096-1099),
characterized in that the telecommunications unit (1091) comprises data trans- mission means for transmitting wireless messages between a departmental server (100) and a patient (106) using a data transmission technique which can be selected from among at least two different data transmission techniques.
24. The patient sensor belt according to claim 23, characterized in that the telecommunications unit (1091) comprises at least two of the following data transmis- sion means: a WLAN transceiver, a Bluetooth transceiver, a ZigBee transceiver, or a UWB transceiver.
25. The patient sensor belt according to claim 23, characterized in that the sensors (1096-1099) comprise at least one of the following: an EKG sensor, a breath frequency sensor, a positional sensor, a movement sensor, a blood pressure sen- sor, an oximeter sensor, or a temperature sensor.
PCT/FI2007/050594 2006-11-06 2007-11-06 System for transmitting and managing medical and processing information in a hospital WO2008056033A1 (en)

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