Abstrict
In a blood pressure monitor, time habit data representing daily
time habits of a patient and a plurality of timings for blood pressure
measurement determined by a medical doctor are inputted. The predetermined
timings are variably adjusted based on the daily time habit data,
and results of blood pressure measurements at the specified timings
are stored in a memory. A personal computer for the doctor of a
medical facility receives and outputs information read out from
the memory of the blood pressure monitor. Accordingly, blood pressure
measurements can be performed in timings adjusted in accordance
with the daily habit pattern of the patient, so that more accurate
measurement can be achieved. Because information including such
measurement data is presented to the doctor with diagnostic authority
via the personal computer, the doctor can acquire useful information
for assisting diagnosis and treatment of hypertension symptoms of
the patient.
Claims
What is claimed is:
1. An electronic blood pressure monitor, comprising: a measuring
portion configured to measure a blood pressure of a subject; a first
input interface for inputting time habit data of the subject to
the blood pressure monitor, the time habit data being indicative
of a daily habit pattern of the subject; a second input interface
for inputting measurement pattern data to the blood pressure monitor,
the measurement pattern data identifying a timing of a plurality
of blood pressure measurements on the subject; a timing adjustment
device for altering the timing of the measurements defined by the
measurement pattern data based on the time habit data of the subject;
and an output portion for outputting measurement data to an external
device or an internal detachable data storage medium, the measurement
data including results of the blood pressure measurements.
2. The blood pressure monitor of claim 1, further comprising an
alarm device notifying a time of blood pressure measurement based
on the timing altered by the timing adjustment device.
3. The blood pressure monitor of claim 1, wherein the timing of
the blood pressure measurements defined by the measurement pattern
data is configured to diagnose a type of hypertension of the subject.
4. The blood pressure monitor of claim 1, further comprising a
first input portion providing the first input interface and a second
input portion providing the second input interface, the second input
portion being accessible only to a person with the authority to
diagnose the subject.
5. The blood pressure monitor of claim 4, further comprising an
event input interface for inputting event occurrence data into the
blood pressure monitor, wherein the event input interface comprises
a first event input portion disposed on the first input portion.
6. The blood pressure monitor of claim 4, further comprising an
event input interface for inputting event occurrence data into the
blood pressure monitor, wherein the event input interface comprises
a second event input portion disposed on the second input portion.
7. The blood pressure monitor of claim 6, wherein the event occurrence
data inputted by the second event input portion is used by the blood
pressure monitor to display therapeutic instructions for the person
with authority to diagnose the subject.
8. The blood pressure monitor of claim 6, wherein the event occurrence
data inputted by the second event input portion is a record of administering
medicine to the subject.
9. The blood pressure monitor of claim 8, further comprising, a
memory portion storing data including the time habit data, the measurement
pattern data and the measurement data, the measurement data being
stored in the memory portion chronologically, and a computation
portion which selects a set of the measurement data stored in the
memory portion based on selection criteria for hypertension diagnosis,
performs a computation on the selected data based on computation
criteria for hypertension diagnosis, performs a judgment on a result
of the computation based on judging criteria for hypertension diagnosis,
and transfers a result of the judgement to the output portion, wherein
the computation includes calculating a difference of the results
of the measurements before and after a passage of a predetermined
time from a start of the administering the medicine.
10. The blood pressure monitor of claim 1, further comprising a
memory portion for storing data including the time habit data, the
measurement pattern data and the measurement data, the measurement
data being stored in the memory portion chronologically.
11. The blood pressure monitor of claim 10, further comprising
an event input interface for inputting event occurrence data into
the blood pressure monitor, the event occurrence data being stored
in the memory portion chronologically.
12. The blood pressure monitor of claim 11, wherein an event corresponding
to the event occurrence data has an influence on blood pressure
measurements.
13. The blood pressure monitor of claim 10, further comprising
a computation portion which selects a set of the measurement data
stored in the memory portion based on selection criteria for hypertension
diagnosis, performs a computation on the selected data based on
computation criteria for hypertension diagnosis, performs a judgment
on a result of the computation based on judging criteria for hypertension
diagnosis, and transfers a result of the judgement to the output
portion.
14. The blood pressure monitor of claim 13, further comprising
an event input interface inputting event occurrence data into the
blood pressure monitor, the event occurrence data being stored in
the memory portion chronologically, wherein the computation includes
calculating a difference of the results of the measurements before
and after an occurrence of an event specified by the event occurrence
data.
15. The blood pressure monitor of claim 13, wherein the result
of the judgment is stored in the memory portion.
16. The blood pressure monitor of claim 13, wherein the plurality
of the blood pressure measurements includes a first measurement
performed when the subject wakes up, a second measurement performed
when the subject completes a work day, and a third measurement performed
when the subject goes to bed, and the computation includes dividing
a result of the second measurement by a result of the third measurement
or an average of a result of the first measurement and the result
of the third measurement.
17. The blood pressure monitor of claim 13, wherein the plurality
of the blood pressure measurements includes night-time measurements
performed when the subject is asleep and day-time measurements performed
when the subject is awake, and the computation includes calculating
an average of results of the night-time measurements, calculating
an average of results of the day-time measurements, a first day-time
measurement and a last day-time measurement being excluded from
the average calculation, and dividing the average of the results
of the day-time measurements by the average of the results of the
night-time measurements.
18. The blood pressure monitor of claim 13, wherein the plurality
of the blood pressure measurements includes day-time measurements
performed when the subject is awake, and the computation includes
calculating an average of results of the day-time measurements,
a first day-time measurement and a last day-time measurement being
excluded from the average calculation, calculating an average of
results of the first and last day-time measurements, and dividing
the average of the results of the day-time measurements by the result
of the last day-time measurement or the average of the results of
the first and last day-time measurements.
19. The blood pressure monitor of claim 13, wherein the plurality
of the blood pressure measurements includes night-time measurements
performed when the subject is asleep and a day-time measurement
performed when the subject completes a work day, and the computation
includes calculating an average of results of the night-time measurements,
and dividing the day-time measurement by the average of the results
of the night-time measurements.
20. The blood pressure monitor of claim 13, wherein the plurality
of the blood pressure measurements includes a first measurement
performed when the subject wakes up and a second measurement performed
when a predetermined time passes after the first measurement, and
the computation includes dividing a result of the second measurement
by a result of the first measurement.
21. The blood pressure monitor of claim 13, wherein the plurality
of the blood pressure measurements includes day-time measurements
performed when the subject is awake, and the computation includes
calculating an average of results of the day-time measurements,
a first day-time measurement and a last day-time measurement being
excluded from the average calculation, and dividing a result of
a blood pressure measurement performed on the subject when the subject
is at a medical facility with the authority to diagnose the subject
by the average of the results of the day-time measurements, the
result of the blood pressure measurement performed at the medical
facility being stored in the memory portion.
22. The blood pressure monitor of claim 21, wherein the blood pressure
measurement at the medical facility is performed when a person with
authority to diagnose the subject is present with the subject.
23. The blood pressure monitor of claim 10, wherein a readout from
the memory portion is allowed only for the person with authority
to diagnose the subject.
24. A blood pressure data processing system comprising: an electronic
blood pressure monitor configured to measure a blood pressure of
a subject and to output measurement data including a result of a
blood pressure measurement, the electronic blood pressure monitor
including a memory portion for storing the measurement data; and
an information processing system receiving the measurement data
from the electronic blood pressure monitor, wherein the electronic
blood pressure monitor comprises a timing adjustment portion which
receives time habit data indicative of a daily habit pattern of
the subject and measurement pattern data identifying a timing of
a plurality of blood pressure measurements on the subject, and alters
the timing of the measurements defined by the measurement pattern
data based on the time habit data of the subject, and the information
processing system comprises an information reception device for
receiving the measurement data read out from the memory portion
of the electronic blood pressure monitor in response to a read request
and an output device outputting the measurement data received by
the information receiving device.
25. The blood pressure data processing system of claim 24, wherein
the electronic blood pressure monitor further comprises a computing
portion performing a predetermined computation on the measurement
data stored in the memory portion based on criteria for hypertension
diagnosis and storing a result of the computation in the memory
portion.
26. The blood pressure data processing system of claim 24, wherein
the electronic blood pressure monitor further comprises an information
sending portion sending the measurement data in response to the
read request, the information processing system comprises a request
sending portion sending the read request, and the information reception
device comprises an information receiving portion for receiving
the measurement data sent from the information sending portion.
27. The blood pressure data processing system of claim 24, wherein
the electronic blood pressure monitor is configured to be directly
connected to the information processing system by a data transmitting
cable.
28. The blood pressure data processing system of claim 24, wherein
the memory portion comprises a detachable storage medium, the electronic
blood pressure monitor comprises a first medium access portion selectively
engaging with the detachable storage medium and accessing the detachable
storage medium engaged with the first medium access portion, and
information reception device comprises a second medium access portion
selectively engaging with the detachable storage medium and accessing
the detachable storage medium engaged with the second medium access
portion when the read request is inputted.
29. The blood pressure data processing system of claim 24, wherein
the measurement data is read out only when the read request is verified.
30. The blood pressure data processing system of claim 24, further
comprising a patient record registry device registering a patient
record and a patient record management device managing the patient
record, wherein the electronic blood pressure monitor further comprises
an information sending portion for sending the measurement data
read out from the memory portion, the patient record management
device receives the measurement data sent from the information sending
portion and stores the measurement data in the patient record registry
device as a part of the patient record, and the information processing
system receives a patient record of the subject stored in the patient
record registry through the patient record management device and
performs a predetermined computation on the measurement data based
on criteria on hypertension diagnosis and the patient record of
the subject.
31. The blood pressure data processing system of claim 30, wherein
the blood pressure monitor is allowed to send the measurement data
to the patient record management device only when the patient record
management device verifies the blood pressure monitor.
32. The blood pressure data processing system of claim 30, wherein
the blood pressure monitor is connected to the patient record management
device via a communication network and a network connection device.
33. The blood pressure data processing system of claim 32, wherein
the network connection device comprises a mobile communication terminal.
Description BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to an electronic blood pressure monitor
and a blood pressure data processing system for processing results
of measurement which are obtained by electronically measuring blood
pressures, and in particular, to an electronic blood pressure monitor
and a blood pressure data processing system capable of assisting
diagnosis and treatment of hypertension in a subject.
2. Background of the Invention
Conventionally, when a person with the authority to diagnose a
patient diagnoses and treats an outpatient on the basis of blood
pressure values of the patient, the blood pressure values are not
necessarily considered to be reliable values since they are results
of a measurement performed when the patient is at a medical facility.
That is, blood pressure values are variable even within a day, as
well as influenced by additional body activity due to the visit
to the hospital. Also, the phenomenon of "white-coat hypertension"
is known, so-called because it is induced by the patient's seeing
a doctor wearing a white laboratory coat, so that diagnosing and
treating hypertension based on blood pressure values taken when
a patient is at a medical facility has been viewed with suspicion.
Hence there has been a demand for a blood pressure measurement system
which is useful for properly measuring blood pressures which are
representative of blood pressures of the patient and for diagnosing
and treating hypertension.
Conventionally, there have been a few examples of measuring blood
pressures in a daily life outside a hospital, in which a patient
herself/himself regularly measures blood pressures and records the
result of the measurement every day and at predetermined times under
the instruction of a person with the authority. In the manner as
described above, however, the patient may forget the measurements
to be performed at the predetermined times, or may be in a condition
in which measurement is impossible, or the measurement data may
not be recorded properly, and additionally, measurement of blood
pressure cannot be performed when the patient is asleep. Accordingly,
it has been impossible to properly measure blood pressure values
throughout the daily life of the patient.
In view of the above, a portable blood pressure monitor is provided.
A patient always wears a small blood pressure monitor, and by automatically
measuring blood pressures every certain time, for example, every
15 minutes, variations in blood pressures over 24 hours can be ascertained.
Also new clinical findings have been obtained based on the result
of such measurements.
In such a portable blood pressure monitor, however, blood pressure
values obtained in the measurements performed while the patient
is moving lack reliability, and the patient always wears the blood
pressure monitor including the sleeping time, so that the influence
exerted on the daily life of the patient is significant, and stress
caused by taking the measurement every 15 minutes cannot be ignored,
making it difficult to continue the measurement for a long period
of time.
As disclosed in Japanese Unexamined Patent Publication JP-A 8-275927
(1996), for example, a medical system has been proposed wherein
communication means are provided between a patient at home and a
medical facility, obtained blood pressure values and the like are
transmitted to the medical facility, and thereby the contents of
interview and instruction can be transmitted to the patient from
a person with the authority to diagnose the patient. Alternatively,
as disclosed in Japanese Unexamined Patent Publication JP-A 5-137697
(1993), a portable blood pressure monitor capable of inputting event
times for blood pressure measurement, for example, such as after
administration of medicine, after meals, just before going to bed,
just after waking up, and capable of storing these events together
with the measured blood pressure values has been proposed.
However, a data processing system for diagnosing and treating a
patient having hypertension has not been proposed yet, and a system
which is useful for both a patient having hypertension and a person
with authority to diagnose the patient has not been proposed yet.
As described above, it is the current situation that not only does
a blood pressure monitor suited for measurement at home for patients
having hypertension and prospective patients having hypertension
not exist, but also a tool capable of assisting diagnosis by sending
information such as blood pressure measurement data, measurement
time and the like to a person with the authority to diagnose the
patient from the patient having hypertension and capable of judging
the hypertension based on the obtained data does not exist. For
this reason, it has been impossible to effectively control the blood
pressure values which otherwise could be a matter of life or death,
and increases in medical fees due to wasteful administration of
medicine and unsuitable treatment have occurred.
SUMMARY OF THE INVENTION
Accordingly, this invention is directed to providing an electronic
blood pressure monitor and a blood pressure data processing system
capable of assisting diagnosis and treatment of hypertension symptoms
or the like.
An electronic blood pressure monitor according to an aspect of
this invention includes a measuring portion configured to measure
a blood pressure of a subject and an output portion outputting data
including results of the blood pressure measurement, and further
may include a first input interface inputting time habit data, a
second input interface inputting measurement pattern data and a
timing adjustment device.
As time data indicating a time habit of the subject is inputted
by the first input interface for inputting time habit data, and
pattern data specifying a certain timing of a plurality of blood
pressure measurements by the measuring portion is inputted by the
second input interface for inputting pattern data, the timing adjustment
device variably adjusts the timing of a plurality of measurements
defined by the inputted pattern data based on the inputted time
habit data of the subject.
Therefore, as a person with the authority to diagnose the subject
inputs pattern data and designates a timing of a plurality of blood
pressure measurements, the designated timing of the plurality of
blood pressure measurements is variably adjusted in accordance with
the time data indicating the daily habits of the subject, and the
measurements are performed according to a schedule that has been
so adjusted. Accordingly, blood pressure measurements can be performed
according to a schedule which has been adjusted in accordance with
the daily habits of the subject, with the result that more accurate
measurements are achieved. By presenting such data including the
results of measurements via the output portion, it is possible to
provide information which is useful for assisting diagnosis and
treatment of hypertension symptoms of the subject.
The electronic blood pressure monitor as described above further
includes an alarming device for notifying a time of blood pressure
measurement based on the timing altered by the timing adjustment
device.
Therefore, since an alarm for notifying blood pressure measurement
is issued for the subject every timing of blood pressure measurement,
it is possible to prevent the subject from missing or forgetting
the blood pressure measurement times.
In the above-described blood pressure monitor, the timing of the
blood pressure measurements defined by the measurement pattern data
is configured to diagnose hypertension of the subject.
Therefore, the predetermined timings for diagnosing hypertension
of the subject can be variably adjusted in accordance with the daily
habits of the subject, so that more correct diagnosis is realized.
The above-described blood pressure monitor further includes a first
input portion providing the first input interface and a second input
portion providing the second input interface, the second input portion
being accessible only to a person with the authority to diagnose
the subject.
Therefore, since a third party including the subject other than
a person with the authority to diagnose the subject is not allowed
to operate the second input portion, it is possible to securely
prevent the pattern data defining the predetermined timings of blood
pressure measurement inputted by external operation of the second
input portion by a person with the authority to diagnose the subject
from being changed by such a third party.
The above-described electronic blood pressure monitor further includes
an event input interface inputting an event occurrence data into
the blood pressure monitor, and the event input interface includes
a first event input portion disposed on the first input portion.
Therefore, the subject can input events which occur in his or her
daily life and have influence on the blood pressure measurement
(for example, exercise, driving cars, meals, smoking, drinking and
the like) at any time by operating the first input portion.
The above-described electronic blood pressure monitor further includes
an event input interface for inputting event occurrence data into
the blood pressure monitor, and the event input interface includes
a second event input portion disposed on the second input portion.
Therefore, a person with the authority to diagnose the subject
can input events occurring in the daily life of the subject that
are determined the influential on the blood pressure measurement
by operating the second event input portion.
The event occurrence data inputted by the second event input interface
may be used by the blood pressure monitor to display therapeutic
instructions, such as exercise, dieting or no smoking, from a person
with authority to diagnose the subject, and may provide a record
of administering medicine to the subject.
The computation of the above-described blood pressure monitor includes
calculating a difference between the results of the measurements
before and after a passage of a predetermined time from the start
of administering the medicine.
Therefore, in the case of administering medicine such as an antihypertensive,
it is possible to display assisting data for diagnosing the effect
of the administration.
The above-described blood pressure monitor further includes a memory
portion storing data including the time habit data, the measurement
pattern data and the measurement data, the measurement data being
stored in the memory portion chronologically.
Therefore, since a chronological change in measurement data can
be confirmed by reading out the measurement data stored in the memory
portion, it is possible to provide a more appropriate diagnosis.
The above-described blood pressure monitor further includes an
event input interface inputting event occurrence data into the blood
pressure monitor, the event occurrence data being stored in the
memory portion chronologically, and an event corresponding to the
event occurrence data has an influence on the blood pressure measurements.
Therefore, since a chronological change in measurement data and
chronological occurrences of events in association with daily life
that will influence on the blood pressure measurement are represented
by reading out the measurement data stored in the memory portion,
it is possible to determine a correlation between the change in
measurement data and the occurrences of the events that will influence
on the blood pressure measurement.
The above-described blood pressure monitor further includes a computation
portion which selects a set of the measurement data stored in the
memory portion based on selection criteria for hypertension diagnosis,
performs a computation on the selected data based on computation
criteria for hypertension diagnosis, performs a judgment on a result
of the computation based on judging criteria for hypertension diagnosis,
and transfers a result of the judgment to the output portion.
Therefore, in this blood pressure monitor, since a set of the measurement
data is selected based on selection criteria for hypertension diagnosis,
and the set of the measurement data is subjected to computation
and the computation result is judged, and the judgment result is
outputted, so that it is possible to provide an index for assisting
the diagnosis of hypertension.
In the above-described blood pressure monitor, a readout from the
memory portion is allowed only for a person with the authority to
diagnose the subject. Therefore, it is possible to prevent the measurement
data or the judgment data or the event data stored in the memory
portion from being read out by a third party other than a person
with the authority to diagnose the subject, which reduces the likelihood
of invasion of privacy of the subject and the illegal falsification
of stored data.
The memory portion may be detachably mounted on the blood pressure
monitor. This provides convenience for the subject since the subject
can bring just the memory portion to the medical facility and have
a diagnosis.
In the above-described blood pressure monitor, the result of the
judgment is stored in the memory portion. Therefore, by temporarily
storing the above-described index for assisting the hypertension
diagnosis in the memory portion and reading out the same index at
a medical facility or the like, it is possible to provide information
for assisting diagnosis and prescription of medication.
In the computation in the above-described electronic blood pressure
monitor, the plurality of the blood pressure measurements includes
a first measurement performed when the subject wakes up, a second
measurement performed when the subject completes a day's work, and
a third measurement performed when the subject goes to bed, and
the computation includes dividing a result of the second measurement
by a result of the third measurement or an average of a result of
the first measurement and the result of the third measurement.
In the computation in the above-described electronic blood pressure
monitor, the plurality of the blood pressure measurements includes
night-time measurements performed when the subject is asleep and
day-time measurements performed when the subject is awake, and the
computation includes calculating an average of results of the night-time
measurements, calculating an average of results of the day-time
measurements, a first day-time measurement and a last day-time measurement
being excluded from the average computation, and dividing the average
of the results of the day-time measurements by the average of the
results of the night-time measurements.
In the computation in the above-described electronic blood pressure
monitor, the plurality of the blood pressure measurements includes
day-time measurements performed when the subject is awake, and the
computation includes calculating an average of results of the day-time
measurements, a first day-time measurement and a last day-time measurement
being excluded from the average computation, calculating an average
of results of the first and last day-time measurements, and dividing
the average of the results of the day-time measurements by the result
of the last day-time measurement or the average of the results of
the first and last day-time measurements.
In the computation in the above-described electronic blood pressure
monitor, the plurality of the blood pressure measurements includes
night-time measurements performed when the subject is asleep and
a day-time measurement performed when the subject completes a work
of a day, and the computation includes calculating an average of
results of the night-time measurements, and dividing the day-time
measurement by the average of the results of the night-time measurements.
By the computation process as described above, an index for diagnosing
the inverted dipper (night-time blood pressure is higher than day-time
blood pressure or 24-hour average blood pressure), non-dipper (an
increase in day-time blood pressure is slight with respect to night-time
blood pressure), dipper (a decrease in night-time blood pressure
is normal) or extreme dipper (the decrease is excessive) can be
outputted as a result of the process.
In the computation in the above-described electronic blood pressure
monitor, the plurality of the blood pressure measurements includes
a first measurement performed when the subject wakes up and a second
measurement performed when a predetermined time passes after the
first measurement, and the computation includes dividing a result
of the second measurement by a result of the first measurement.
By this computation process, it is possible to output an index
for diagnosing the morning surge (rapid blood pressure rising in
the early morning) as a result of the process.
In the computation in the above-described electronic blood pressure
monitor, the plurality of the blood pressure measurement includes
day-time measurement performed when the subject is awake, and the
computation includes calculating an average of results of the day-time
measurements, a first day-time measurement and a last day-time measurement
being excluded from the average calculation, calculating an average
of results of the first and last day-time measurements, and dividing
a result of a blood pressure measurement performed on the subject
when the subject is at a medical facility with the authority to
diagnose the subject by the average of the results of the day-time
measurements, the result of the blood pressure measurement performed
at the medical facility being stored in the memory portion.
The blood pressure measurement at the medical facility is performed
when a person with the authority to diagnose the subject is with
the subject.
By such a computation process, it is possible to output an index
for diagnosing the presence/absence of white-coat hypertension (becoming
tense in front of a person with the authority (wearing a white coat,
for example) to diagnose the subject to cause increase in blood
pressure) as a result of the process.
The above-described electronic blood pressure monitor further includes
an event input interface inputting an event occurrence data into
the blood pressure monitor, the event occurrence data being stored
in the memory portion chronologically, and the computation includes
calculating a difference of the result of the measurements before
and after an occurrence of an event specified by the event occurrence
data. In this computation process, the result of the measurement
after an occurrence of an event specified by the event occurrence
data read out from the memory portion may be divided by the result
of the measurement before the occurrence of the event specified
by the event occurrence data read out from the memory portion. Alternatively,
averages of the result of the measurements before and after an occurrence
of an event specified by the event occurrence data read out from
the memory portion may be calculated, and the average of the measurement
after an occurrence of an event may be divided by the average of
the measurement before an occurrence of the event.
Therefore, it is possible to ascertain the relationship between
the result of the blood pressure measurement and events that influence
the blood pressure measurement in association with daily life.
A blood pressure data processing system according to another aspect
of this invention includes an electronic blood pressure monitor
configured to measure the blood pressure of a subject and to output
measurement data including a result of a blood pressure measurement
and an information processing system receiving the measurement from
the electronic blood pressure monitor.
The electronic blood pressure monitor includes a timing adjustment
portion which receives time habit data indicative of a daily habit
pattern of the subject and measurement pattern data identifying
a timing of a plurality of blood pressure measurements on the subject,
and alters the timing of the measurements defined by the measurement
pattern data based on the time habit data of the subject, and a
memory portion storing data including the measurement data.
The information processing system includes an information reception
device receiving the measurement data read out from the memory portion
of the electronic blood pressure monitor in response to a read request
and an output device outputting the measurement data received by
the information receiving device.
Therefore, at the electronic blood pressure monitor, if a person
with the authority to diagnose the subject or the like designates
and inputs a plurality of predetermined timings of blood pressure
measurement, the designated plurality of predetermined timings are
variably adjusted on the basis of the time habit data indicative
of a daily habit pattern of the subject, and the blood pressure
measurements are performed according to the adjusted timings, while
the data including the measurement data is stored in the memory
portion. Then at the information processing system of the medical
facility, the data stored in the memory portion is received and
outputted. Accordingly, since it is possible to perform the blood
pressure measurements according to timings adjusted in accordance
with the daily habit pattern of the subject, more accurate measurements
are enabled. Such information including measurement data is displayed
via the output device of the information processing system of a
medical facility, useful information for assisting the diagnosis
and treatment of the hypertension symptoms of the subject can be
acquired at a medical facility.
The electronic blood pressure monitor of the above-described blood
pressure data processing system further includes a computing portion
performing a predetermined computation on the measurement data stored
in the memory portion based on criteria of hypertension diagnosis
and storing the result of the computation in the memory portion.
Therefore, at a medical facility, since the result of the predetermined
process for assisting the diagnosis of hypertension of the subject
based on the measurement data of blood pressure of the subject is
displayed via the output device of the information processing system,
it is possible to acquire information useful for assisting the diagnosis
and treatment of the patient's hypertension symptoms.
In the above-described blood pressure data processing system, the
electronic blood pressure monitor further includes an information
sending portion sending the measurement data in response to the
read request, and the information processing system comprises an
information receiving portion receiving the measurement data sent
from the information sending portion.
Therefore, the measurement data of blood pressure stored in the
memory portion of the electronic blood pressure monitor or the result
of the predetermined process for assisting the diagnosis of hypertension
based on the measurement data of blood pressure can be given to
the information processing system of the medical facility by communication.
In the above-described blood pressure data processing system, the
electronic blood pressure monitor may be configured to be directly
connected to the information processing system by a data transmitting
cable.
Furthermore, the communication may be established by connection
via radio, public line network (including the Internet), dedicated
line network or the like.
In the above-described blood pressure data processing system, the
memory portion may include a detachable storage medium, the electronic
blood pressure monitor may include a first medium access portion
detachably engaging with the detachable storage medium and accessing
the detachable storage medium engaged with the first medium access
portion, and the information reception device may include a second
medium access portion detachable engaging with the detachable storage
medium and accessing the detachable storage medium engaged with
the second medium access portion when the read request is inputted.
Therefore, the memory portion which stores the measurement data
of blood pressure or the result of the predetermined process for
assisting a diagnosis of hypertension based on the measurement data
of blood pressure is advantageously a portable storage medium. Accordingly,
after completing the blood pressure measurements, the subject removes
the storage medium from the first medium access portion of the electronic
blood pressure monitor and brings the same storage medium to the
medical facility. At the medical facility, the storage medium provided
by the subject is accessed via the second medium access portion
of the information processing system, and the contents of the storage
medium are read out to be displayed to a person with the authority
to diagnose the subject.
In this manner, all the subject has to do is to go to the medical
facility while carrying the storage medium for presenting the information
for assisting a diagnosis of hypertension to a person with the authority
to diagnose the subject and have a diagnosis (or prescription),
which is convenient.
In the above-described blood pressure data processing system, the
measurement data is read out only when the read request is verified.
Therefore, the measurement data of blood pressure from the memory
portion or the result of the predetermined process for assisting
a diagnosis of hypertension based on the measurement data of blood
pressure may be accessed and read out only when the read request
is verified. Therefore, it is possible to prevent the measurement
data or the judgment data or the event data stored in the memory
portion from being read out by a third party other than a person
with the authority to diagnose the subject, which reduces the likelihood
of invasion of privacy of the subject and the illegal falsification
of stored data.
The above-described blood pressure data processing system further
may include a patient record registry device for registering a patient
record and a patient record management device for managing the patient
record. The electronic blood pressure monitor further may include
an information sending portion sending the measurement data read
out from the memory portion. The patient record management device
receives the measurement data sent from the information sending
portion and stores the measurement data in the patient record registry
device as a part of the patient record, and the information processing
system receives a patient record of the subject stored in the patient
record registry through the patient record management device and
performs a predetermined computation on the measurement data based
on criteria on hypertension diagnosis and patient record of the
subject.
Therefore, information including the measurement data of blood
pressure of the subject stored in the memory portion of the electronic
blood pressure monitor is sent to be received by the patient record
management device of the medical facility. The patient record management
device registers the received information as patient record data
in the patient record registry for each subject, and the information
processing system reads out the patient record of the subject registered
in the patient record registry and performs a predetermined process
for assisting a diagnosis to output a result of the process.
Therefore, the subject may have a diagnosis (prescription) even
at home by being subjected to the predetermined process by the medical
facility for assisting a diagnosis based on the information including
the measurement data of blood pressure of the subject.
In the above-described blood pressure data processing system, the
blood pressure monitor is allowed to send the measurement data to
the patient record management device only when the patient record
management device verifies the blood pressure monitor.
Therefore, since the electronic blood pressure monitor is allowed
to send the information including the measurement data of blood
pressure of the subject to the data management device from the electronic
blood pressure monitor by means of the information sending potion
only when the blood pressure monitor is verified, it is possible
to prevent the patient record data in the patient record registry
from being interfered with by information sent from an illegal apparatus.
In the above-described blood pressure data processing system, the
blood pressure monitor is connected to the patient record management
device via a communication network and a network connection device.
In the above-described blood pressure data processing system, the
network connection device may be a mobile communication terminal.
BRIEF EXPLANATION OF THE DRAWINGS
FIGS. 1A and 1B are schematic configuration views showing a blood
pressure data processing system according to embodiments of this
invention.
FIG. 2 is a hardware configuration of a blood pressure monitor
according to these embodiments.
FIG. 3 is a schematic view showing a part where a patient can operate
provided in a main unit of the blood pressure monitor of the invention.
FIG. 4 shows a panel on the back surface of the main unit of FIG.
3.
FIG. 5 shows another blood pressure monitor of the embodiments.
FIG. 6 shows an example of the panel of FIG. 4.
FIG. 7 shows an example of the contents of a blood pressure measurement
data file according to certain embodiments of the invention.
FIG. 8 shows an example of timings of the blood pressure measurements
used in certain embodiments of the invention.
FIG. 9 shows another example of timings of the blood pressure measurements
used in the invention.
FIG. 10 shows an example of an analysis and judgment procedure
for diagnosis of hypertension used in this invention.
FIG. 11 is a flowchart of the initial data entry by a person with
diagnostic authority according to the first embodiment.
FIG. 12 is a flow chart of the life habit data entry by a patient
according to the first embodiment.
FIG. 13 is a flow chart of the blood pressure measurement according
to the first embodiment.
FIG. 14 is a flow chart of the data retrieval by the person with
diagnostic authority according to the first embodiment.
FIG. 15 is a flow chart of a blood pressure measurement data processing
according to a second embodiment.
FIG. 16 is a flow chart of a blood pressure measurement data processing
according to a third embodiment.
DETAILED DESCRIPTION OF THE INVENTION
In the following, embodiments of this invention will be explained
with reference to the drawings.
In each embodiment, description is made for a blood pressure monitor
and a blood pressure data processing system which can measure a
patient's blood pressure when the patient is at home or at a hospital
(outpatient), compare and verify the blood pressure, and thereby
assist a hypertension diagnosis to be made by a person with the
authority to diagnose the patient.
In medical diagnosis and treatment of hypertension and the like,
for constructing an approach to "what kind of diagnosis to
be made based on what kind of examination, and what kind of treatment
(prescription) should be given", a person with the authority
to diagnose a patient indicates measuring time and the like to the
patient, makes an appropriate judgment on a result of measurement,
prescribes an objective treatment (prescription), and provides instructions
for administration of antihypertensive accurately and safely by
using a blood pressure monitor and a blood pressure data processing
system of this invention. In other words, a blood pressure monitor
for home use is turned into a tool not only for health control as
conventionally used, but also for treatment of hypertension and
the like.
FIGS. 1A and 1B are schematic configuration views of a blood pressure
data processing system according to three embodiments of this invention.
When a patient who is a subject of a treatment or diagnosis measures
a blood pressure using a blood pressure monitor 1 which measures
blood pressure by means of an arm band or cuff 2, various information
including the measurement data is stored in a memory of the blood
pressure monitor 1, and then registered in a patient record data
file 10 corresponding to the patient in a server apparatus 11 of
a medical facility 7 such as a clinic or hospital to be used as
information for treatment and diagnosis. There are three main methods
for transferring data for registering various information including
the measurement data in the memory of the blood pressure monitor
1 into the corresponding patient record data file 10 in the server
apparatus 11: transferring methods (1) and (2) shown in FIG. 1A
and transferring method (3) shown in FIG. 1B. The patient record
file 10 is registered for each patient, and the server apparatus
11 manages the patient record data file 10.
The transferring method (1) shown in FIG. 1A is a method wherein
a patient brings the blood pressure monitor 1 to the medical facility
7, and by direct connection via a cable with a personal computer
12, dedicated to persons with authority to diagnose the subject,
the data is transferred to the corresponding patient record data
file 10 in the server apparatus 11 via the cable and the personal
computer 12.
Transferring method (2) is a method wherein a portable memory card
15 that has been previously mounted on the blood pressure monitor
1 is drawn out and mounted on a memory card reader/writer 13 of
the personal computer 12, and the memory card reader/writer 13 makes
access to the mounted memory card 15 to read out various information
such as blood pressure measurement data written into the memory
card 15 and transfers the data to the patient record data file 10
in the server apparatus 11. Both transferring methods (1) and (2)
are off-line data transferring methods, and the on-line data transferring
method (3) is shown in FIG. 1B.
In transferring method (3), various information such as blood pressure
measurement data stored in the internal memory of the blood pressure
monitor 1 is transferred via a mobile terminal (hereinafter, referred
to as a mobile) 3 such as portable telephone set being connected
with the blood pressure monitor 1, a radio base station 4 located
at the closest point and a network 5 such as the Internet or a telephone
network, to be stored in the corresponding patient record data file
10 in the server apparatus 11 of the medical institute 7 via a data
processing center 6 or a communicator 8 corresponding to the medical
facility 7. The mobile 3, the closest radio base station 4, the
data processing center 6 and the communicator 8 can be regarded
as relay apparatuses for communication. The network 5 is an Internet
VPN (virtual private network) and the like having security. It goes
without saying that in this case, the information concerning the
patient is protected by encryption or provision of a password for
the person with the authority to diagnose the patient to fetch the
information.
The data processing center 6 is provided for a plurality of medical
facilities 7, and has the function of performing collection of communication
data sent to the respective medical facilities 7 and distribution
of data to patient records. Alternative to the mobile 3, a communicator
9 such as personal computer may be connected to the blood pressure
monitor 1 via a cable and the information stored in the internal
memory of the blood pressure monitor 1 may be stored in the corresponding
patient record data file 10 in the server apparatus 11 of the medical
facility 7 via the communicator 9 and the network 5 in the same
manner as described above.
In addition, the personal computer 12 can access the patient record
data file 10 via the server apparatus 11 of the corresponding medical
facility 7 via an intrahospital LAN (local area network).
First Embodiment
In the first embodiment, explanation will be mode for the case
where the blood pressure monitor 1 is brought to the medical facility
7 by way of transferring method (1) as described above, and the
brought-in blood pressure monitor 1 is directly connected with the
personal computer 12 via a cable, whereby the data is transferred.
FIG. 2 shows a hardware configuration view of the blood pressure
monitor 1 used in the first embodiment as well as the other embodiments.
The blood pressure monitor 1 includes a main unit 16 and a cuff
2 connected to the main unit 16. The cuff 2 incorporates a pressure
sensitive sensor 2B for detecting a pressure from the artery when
wound around an arm of a patient or the like. The main unit 16 includes:
a control portion 20 incorporating a CPU (central processing unit)
or the like for centrally controlling and managing the blood pressure
monitor 1; a pressurizing pump 21 for pressurizing the cuff 2; a
blood pressure value computing portion 22 for executing a predetermined
computation on a blood pressure value which is a result of measurement
to calculate a maximum blood pressure, a minimum blood pressure,
a pulse rate and the like; a display 23 for displaying various kinds
of information; an operation input portion 24 to be operated for
inputting various kinds of information; a memory portion 25 for
storing programs, data and the like; a timer 26; a card R(read)/W(write)
portion 27 to which the memory card 15 is detachably mounted, for
reading and writing information with respect to the mounted memory
card 15; an external I/F (interface) portion 28 implemented by USB
or the like, for connecting an external terminal such as mobile
3; a buttery portion 29 for supplying power for driving; a sound
output portion 30 for outputting sounds; and a housing portion 31.
Components 21-30 are connected to the control portion 20, and the
control portion 20 controls each portion connected thereto.
FIG. 3 shows a schematic view of a part provided in the main unit
16 of the blood pressure monitor 1 which a patient can operate.
In the main unit 16 of FIG. 3, as a part to be operated by a patient,
the operation input portion 24 is illustrated together with the
display 23. The display 23 shows a maximum blood pressure, a minimum
blood pressure, a pulse, a current time and the like. The operation
input portion 24 includes a button 505 to be operated when the blood
pressure measurement is performed at home, a button 506 to be operated
when the measurement is performed at the medical facility 7, a button
507 to be operated for setting a time, a button 508 to be touched
for manipulating input data, a button 509 to be operated for turning
ON/OFF the source of the monitor 1, and a button 510 to be operated
for starting the pressurizing operation by the pressurizing pump
21 for starting a blood pressure measurement.
As is illustrated, on the side surface of the main unit 16 are
attached the external I/F 28, a cuff connecting portion 2A to which
the cuff 2 is to be connected, and a card inserting portion 27A
provided in association with the card R/W portion 27.
As shown in FIG. 4, on the back surface of the main unit 16 is
provided a panel 422 which is accessible only to a person with the
authority to diagnose the subject, as well as a buttery case cover
424 in association with the buttery portion 29. The panel 422 is
usually closed by a panel cover 423, but when a patient brings the
blood pressure monitor 1 to the medical facility 7 and a person
with the authority to diagnose the patient opens the same with a
special key 421 possessed individually, the panel cover 423 is opened,
thereby making the panel 422 operable.
FIG. 5 shows the outside appearance of the main unit 16 of another
blood pressure monitor 1 of the first embodiment, and in this drawing,
a touch panel type display 234 wherein the display 23 and the operation
input portion 24 are provided in an integrated manner. The touch
panel type display 234 is usually provided for a patient, however,
when the blood pressure monitor 1 is brought to the medical facility
7, and a person with the authority to diagnose the patient enters
a password which is previously registered with a numerical keypad
of the touch panel type display 234, the touch panel type display
234 can be switched to the screen which is exclusive for the person
with the authority to diagnose the patient.
In the manner as described above, in the blood pressure monitor
1, the part where a patient operates and the part where a person
with the authority to diagnose the patient makes settings or operates
are separated from each other by a partition or a panel cover 423
with the key 421, or by providing a password which is specific for
the person with the authority to diagnose the patient, with the
result that instructions for measurement made by the person with
the authority to diagnose the patient can be inputted safely and
reliably and unintended modifications (for example made by a third
party) can be prevented.
FIG. 6 is a view showing an example of the panel 422 illustrated
in FIG. 4. As illustrated, the panel 422 is provided with a button
501 to be operated by a person with the authority to diagnose the
patient of the medical facility 7 for setting information, a button
502 to be operated for setting information during an outpatient
consultation at the medical facility 7, a button 503 to be operated
for designating night-time measurements of blood pressure, a button
503A to be operated for performing measurement of blood pressure
in consideration of administration of medicine, buttons 504A, 504B
and 504C to be operated in accordance with life therapies for the
patient, a button 504 to be operated for calling information such
as blood pressure measurement data stored in the memory, and a button
511 to be operated for clearing stored information.
FIG. 7 shows an example of contents of the blood pressure measurement
file 40 used in the first embodiment as well as the other embodiments.
The blood pressure measurement data file 40 is written into the
memory portion 25 of the blood pressure monitor 1, as well as written
into the memory card 15 for storage when such memory card 15 is
mounted on the card R/W portion 27 and is ready for data writing.
Referring to FIG. 7, the blood pressure measurement data file 40
includes a basic data group D1, an event data group D2, a measurement
data group D3, an analysis and judgment result data group D4 and
a special event data group D5. The basic data group D1 includes
a terminal identification code D11 for uniquely identifying a corresponding
blood pressure monitor 1, a patient code D12 for uniquely identifying
a patient corresponding to the blood pressure monitor 1, a medical
facility code D13 and a doctor code D14 for identifying a medical
facility and a person with the authority to diagnose the patient
which are permitted to process the pressure measurement data file
40, a pass word D15 for authenticating a person with the authority
to diagnose the patient, and a patient record No. code D16 assigned
to the corresponding patient record data file 10.
The event data group D2 includes a measurement instruction data
group defining contents of measurement instructions by a person
with the authority to diagnose the patient and a challenge setting
data group defining life therapies. The measurement instruction
data group includes data D21 instructing measurement of white-coat
hypertension, data D22 instructing measurement concerning dipper,
and data D23 instructing measurement of morning surge. The challenge
setting data includes data D24 to D26 representing no smoking, dieting
and walking. Each of the data D21 to D26 is set at "1"
when a measurement instruction is made or a life therapy is set,
while being set at "0" when such an instruction is not
made.
The measurement data group D3 includes measurement data D3i (i=1,
2, 3, . . . , n) which is acquired every time a blood pressure measurement
is performed. The measurement data D3i includes data of day and
hour (minute) of blood pressure measurement, data of measured maximum
blood pressure and minimum blood pressure, data of pulse and data
for identifying the place of measurement (at home or as an outpatient
at the medical facility 7). The data of place is referred for diagnosing
the white-coat hypertension. The analysis and judgment result data
group D4 and the special event data group D5 will be described later.
FIGS. 8 and 9 show examples of settings of blood pressure measurement
times using the blood pressure monitor 1. As a setting example of
blood pressure measurement time, explanation will be made for the
case where a patient works and a blood pressure measurement should
be performed 4 times a day when the patient is awake.
First, at the medical facility 7, a person with the authority to
diagnose the patient sets a blood pressure measurement pattern which
is suited for the patient: 4 times a day when the patient is awake
in this case. More specifically, the person with the authority to
diagnose the patient opens the panel cover 423 of the blood pressure
monitor 1 as shown in FIG. 4 to be used for blood pressure measurement
or, in the case of the apparatus as shown in FIG. 5, enters a password
specific to the person with the authority to diagnose the patient
to thereby display a screen for the person with the authority to
diagnose the patient to make settings as shown, for example, in
FIG. 6. Then the person with the authority to diagnose the patient
presses the button 501 to make a setting and inputs pattern data
defining a plurality of timings of blood pressure measurement for
the patient (4 times a day when the patient is awake). Next, the
patient operates the operation input portion 24 of the blood pressure
monitor 1 (operates the buttons 507 and 508) and inputs time information
indicating a daily habit pattern of the patient such as going-to-bed
time and wakeup time which will influence blood pressure measurements
(hereinafter, referred to as life style data).
The control portion 20 variably adjusts the pattern data of blood
pressure measurement according to the life style data thus inputted,
calculates times when blood pressure measurements should be performed
in a day, and stores the setting in the memory portion 25 or the
like. Since clocking is executed by the timer 26, the control portion
20 controls the sound output portion 30 to output alarm sounds such
as light melodies or buzzer sounds or controls the display 23 to
blink the legend of "alarm" at every blood pressure measurement
time set in the memory portion 25, for example 5 minutes before
every blood pressure measurement time, for urging the patient to
perform a blood pressure measurement.
Next, the details of the variable adjustment of pattern data of
blood pressure measurement based on the life style data by the control
portion 20 as described above will be explained. Once life style
data of the patient is inputted and a daily wakeup time is set,
a setting is made so that a first blood pressure measurement is
performed directly after the patient wakes up. And next, a setting
is made so that a second blood pressure measurement is performed
after the first measurement and before the patient starts his or
her activities that day. This second measurement depends on the
life style data of the patient and is generally performed 30 minutes
to 1 hour after the first measurement and at least before going
out for work, though the patient may have breakfast between the
first and the second blood pressure measurements. In the case where
the life style data of the patient according to this embodiment
indicates that the patient goes out for work 1 hour after wakeup,
a setting is made so that the second measurement is performed 45
minutes after the first measurement. Next, on the basis of the life
style data, a setting is made so that a third measurement is performed
when the patient comes home and hence still has physical and mental
stresses left over from work, and a fourth measurement is performed
just before the patient goes to bed, preferably at least 30 minutes
before going to bed when the patient has finished the activities
of that day. Preferably, such measurements are continuously performed
for 4 days or more including a day-off over 2 weeks or more, in
order to achieve an accurate diagnosis. A chart of the timings automatically
set in this manner is shown in FIG. 8. When a measuring time arrives,
the patient confirms that the button 505 representing "home
measurement" in FIG. 3 is in the ON condition and starts a
blood pressure measurement.
It is to be noted that the number of times of blood pressure measurements,
for example one measurement or three measurements for averaging
the measurements, may be set by the person with an authority to
diagnose the patient to operate the button 501.
In the case where the patient goes to the medical facility 7 and
undergoes a blood presser measurement during the above period of
blood pressure measurement, the measurement of blood pressure is
performed by pressing the button 506 representing "outpatient
measurement". The timing chart of FIG. 8 shows a case in which
an outpatient measurement is performed between the second and the
third blood pressure measurements. Though not being illustrated,
it is also possible to configure the system so that whether the
measurement is performed in the presence of a person with the authority
to diagnose the patient or in the absence of a person with the authority
to diagnose the patient such as at a waiting room may be made distinguishable.
In this manner, when the button 505 or 506 is operated and thus
in the ON condition, data corresponding to the button in the ON
condition is registered in correspondence with the place data of
the measurement data D3i.
Although the blood pressure measurements are performed when the
patient is awake in the above example, blood pressure measurements
may be performed when the patient is asleep. Specifically, the person
with the authority to diagnose the patient inputs a blood pressure
measurement pattern defining timings of blood pressure measurement
by pressing the button 503 together with the button 501 so that
the patient goes to bed while wearing the cuff 2 on the arm after
performing a measurement before going to bed, and a measurement
is performed every certain period of time, for example, every 30
minutes or every 2 hours. This can be achieved by operating input
buttons 1 to 10 in the case of the panel 422 of FIG. 6, or the input
buttons of the numerical keypad in the case of FIG. 5. In this manner,
a blood pressure measurement pattern when the patient is asleep
is set by the person with the authority to diagnose the patient,
and the blood pressure measurement pattern thus set is registered
in the memory portion 25, whereby a blood pressure is automatically
measured every period of time that is set by the person with the
authority to diagnose the patient by means of the cuff 2 worn on
the arm even when the patient is asleep.
Furthermore, the control portion 20 may identify the blood pressure
measurement pattern according to the contents of the measurement
instruction data of the event data group D2 set by the person with
the authority to diagnose the patient, variably adjust the identified
blood pressure measurement pattern based on the life style data
of the patient and determine a plurality of timings of blood pressure
measurements. Specifically, when the data D22 (dipper setting) of
the event data group D2 is set at "1" for the person with
the authority to diagnose the patient to diagnose an abnormality
of blood pressure when the patient is asleep, the control portion
20 identifies a blood pressure pattern based on the data 22, variably
adjusts the identified blood pressure pattern in accordance with
the life style data of the patient, and determines a plurality of
timings of blood pressure measurements, for example, as shown in
FIG. 9.
In this case, the blood pressure measurement pattern may differ
between when the patient is asleep and when the patient is awake,
however, the setting may be made so that the measurement is performed
every certain time in an interval as the same as that of the measurements
when the patient is asleep, all day over 24 hours. When some events
that will influence the blood pressure measurements such as exercise,
driving, meals, smoking or drinking occur in daily life, the patient
may input the event by operating the button of FIG. 6. The inputted
event is sequentially registered in the special event data group
D5 of the pressure measurement data file 40 chronologically in accordance
with the timing when the event is inputted.
Furthermore, the person with the authority to diagnose the patient
operates the button 503A in FIG. 6 to enable recognition and storage
of presence/absence of administration of medicine and kinds of medicine
by means of the corresponding input buttons 1 to 10. When information
indicating presence/absence of administration of medicine and kinds
of medicine under administration is inputted, the information is
sequentially registered in the special event data group D5 of the
blood pressure measurement data file 40. Furthermore, as buttons
for the "challenge mode" which denote life therapies (improvement
of life style), buttons 504A to 504C of "no smoking",
"dieting" and "walking" are provided, and by
operating the respective buttons corresponding to the life therapies
challenged according to the instruction by a person with the authority
to diagnose the patient or the patient's own intent, such information
can be stored as data D24 to D26 of the blood pressure measurement
data. In this case, three life improving events by life therapies
are presented, however, the events are not limited to the above.
As described above, in the blood pressure measurement data file
40, the basic data group D1 which is initially set, the event data
group D2 to be set by the person with the authority to diagnose
the patient in accordance with the circumstances of the patient,
the measurement data group D3i obtained by blood pressure measurements
at the measurement times shown in FIGS. 8 and 9, for example, and
the special event data group D5 are stored.
The blood pressure monitor 1 according to this embodiment assists
a hypertension diagnosis of a patient by a person with the authority
to diagnose the patient by performing an analysis such as comparing
and inspecting the measurement data D3i of the measurement data
group D3 obtained by performing blood pressure measurements in timings
set as described above in accordance with a predetermined procedure,
and registering the analysis and judgment result data group D4 indicating
results of the analysis and judgment in the blood pressure measurement
data file 40 for presentation to the person with the authority to
diagnose the patient. In this context, a diagnosis of hypertension
is just an example and target symptoms to be diagnosed are not limited
to this. One example of an analysis and judgment procedure for hypertension
diagnosis according to this embodiment is shown in FIG. 10 in a
tabular manner. This analysis procedure is implemented by the CPU
of the control portion 20 executing an analysis and judgment program
previously stored in the memory portion 25. Herein a maximum blood
pressure value is used as a blood pressure measurement data (blood
pressure value) for the analysis.
Referring to FIG. 10, a first blood pressure measurement data directly
after wakeup (A) and a second blood pressure measurement data (B)
are compared, and if B/A is a certain value or more, in this case
130% or more, "MS" is outputted. This output operation
writes the result into the analysis and judgment result data group
D4 of the blood pressure measurement data file 40 or to display
it on the display 23. "MS" means a rapid rise of blood
pressure in the morning (so-called morning surge) which is considered
to be a precursor of cardiovascular accidents such as acute myocardial
infarction.
Next, an average blood pressure value of 24 hours and a blood pressure
value measured in day-time are compared. In the measurement pattern
shown in FIG. 8, a value of the fourth measurement just before going
to bed or an average value of the first measurement just after waking
up and the fourth measurement just before going to bed is employed
as an average blood pressure value of 24 hours (C), and measurement
data of the third measurement directly after coming home is employed
as a blood pressure value of a day-time measurement (D). As a result
of comparison of C and D, if the value of D/C is less than 100%,
for example, "in-D" (which means an inverted dipper, and
considered as a patient who is likely to have organ damage since
the blood pressure higher in the night-time than in the day-time
or the 24 hour average) is outputted; if D/C is not less than 100%
and not more than 110%, "non-D" (which means a non-dipper
indicating that the increase in day-time blood pressure is slight
with respect to night-time blood pressure) is outputted; if D/C
is not less than 110% and not more than 120%, "D" (which
means a dipper, indicating that a decrease in night-time blood pressure
is normal) is outputted; and if the D/C is more than 120%, "ex-D"
(which means an extreme dipper, indicating that the decrease is
excessive) is outputted.
In the case of the blood pressure measurement according to the
timing chart as shown in FIG. 9, a computation is performed in the
same manner as the measurement pattern of FIG. 8 while considering
an average of blood pressure values when the patient is asleep as
a night-time blood pressure value (C') and an average of blood pressure
values measured when the patient is asleep excluding the measurement
data from just after waking up and the measurement data from just
before going to bed as a day-time blood pressure value (D), and
a result is outputted.
Additionally, the patient brings the blood pressure monitor 1 at
the time of going to the medical facility 7, and a specific value
(E) measured when the patient is at the medical facility 7, in particular,
a blood pressure value (E) measured in front of a person with the
authority to diagnose the patient is compared with an average (D)
of measurement data when the patient is awake excluding a blood
pressure value measured just after waking up and a blood pressure
value measured just before going to bed. If E/D is a certain value
or more, for example, 120% or more in this case, "WH"
(which means "white-coat hypertension") is outputted.
Alternative to the average (D) of measurement data when the patient
is awake excluding a blood pressure value measured just after waking
up and a blood pressure value measured just before going to bed,
a blood pressure value (D) measured just after coming home, or any
blood pressure values (D) measured when the patient is awake excluding
just after waking up and just before going to bed may be employed.
It goes without saying that a blood pressure monitor provided at
a hospital may be used rather than the patient's blood pressure
monitor 1.
Furthermore, among the functions of analysis and judgment for the
blood pressure data, monitoring of blood pressure after administration
of medicine and monitoring of blood pressure during conducting a
life therapy (improvement of life style) as a challenge mode are
possible. That is, kinds of medicine are recognized, and a starting
day of administration can be inputted with the button 503A and the
keys 1 to 10 of FIG. 6. First, a blood pressure value (A), a blood
pressure value (B) measured 30 minutes after waking up, B/A before
or during administration (represented by "m"), and A,
B, B/A of predetermined days or a predetermined period from m (represented
by "n") are recorded, A, B, B/A are compared between m
and n, and the increase/decrease thereof is outputted by % or the
like, thereby checking the effect of the administration and the
life therapy (improvement of life style).
The % values to be used for these analyses and judgments are set
in accordance with the kinds of hypertension which are objects of
the diagnosis, and these values may be appropriately changed via
the panel 422 according to the judgment by a person with the authority
to diagnose the patient. Also the blood pressure values are selectively
read out from the measurement data D3i and the computation formula
for these selectively readout blood pressure values may be set in
accordance with the type of hypertension which is to be diagnosed.
Furthermore, by referring the special event data group D5 (exercise,
driving, meals, smoking, drinking and the like) recorded in the
blood pressure measurement data file 40, it is possible to grasp
the relationship between these special events and the measured blood
pressure data and the results of analysis and judgment.
FIGS. 11 to 14 are flowcharts showing a series of procedures as
described above. Referring to these flowcharts, operations of the
blood pressure data processing system according to the first embodiment
will be explained.
A patient visiting the medical facility 7 consults a person with
the authority to diagnose the patient, and the person with the authority
to diagnose the patient determines pattern data and event data for
blood pressure measurement in order to diagnose hypertension in
the patient based on the result of the consultation, and turns ON
the power by pressing the button 509 of the blood pressure monitor
1 (step S1, hereinafter step is abbreviated as simply "S").
As a result of this, an initial setting such as program reset is
executed in the blood pressure monitor 1 (S2). The person with the
authority to diagnose the patient opens the panel cover 423 with
the key 421 and presses the button 501 in the panel 422 which is
provided for a person with the authority to diagnose the patient
to make a setting, and accordingly the blood pressure monitor 1
is ready to receive instructions by the person with the authority
(S3). In this mode, the screen for patient is not displayed. The
person with the authority to diagnose the patient selects, for example,
a dipper measurement in selecting an event, and accordingly the
data D22 of dipper classification selected in the event data group
D2 is set at "1" (S4). Thereafter, measurement pattern
data is inputted (S5). Herein, since the person with the authority
to diagnose the patient presses the button 503 corresponding to
night-time measurement data, timings of night-time measurements
are set temporally (S6).
The person with the authority to diagnose the patient confirms
medical record data written in a patient record, and inputs a patient
record No., a patient code and the like, and based on such inputted
data, a blood pressure measurement data file 40 for that patient
is generated and written into the memory portion 25. The blood pressure
measurement data file 40 may be generated at the personal computer
12 and transferred to the blood pressure monitor 1 via a cable to
be written into the memory portion 25, or may be transferred online
over the network 5.
As the blood pressure measurement data file 40 is generated, the
person with authority to diagnose the patient enters a doctor code
and a password (S8) which are then stored in the basic data group
D1 of the generated blood pressure measurement data file 40 (S9),
to complete preparation for the pressure measurements (S10). Thereafter,
a method for collecting data is selectively set (S11). In this case,
an assumption is made that offline selection of data collection
is executed by the transferring method (1) as shown in FIG. 1A (S12).
Therefore, the measurement data D3i and the like will be written
into the blood pressure measurement file 40 set in the memory portion
25. Afterwards the person with the authority to diagnose the patient
closes the panel 422 with the panel cover 423, locks with the key
421, and turns OFF the power by operating the button 509 (S13).
Then the blood pressure monitor 1 is handed to the patient, the
person with the authority to diagnose the patient explains to him/her
about blood pressure measurement at home, and the patient starts
the blood pressure measurement at home.
As shown in FIGS. 3 and 4, since the patient is not allowed to
operate the panel 422 to be operated by the person with the authority
to diagnose the patient, the contents that are inputted by the person
with the authority to diagnose the patient by operating the panel
422 will not be changed by the patient, which secures proper measurement
and diagnosis.
In measuring a blood pressure at home using the blood pressure
monitor 1, the patient turns the power on by operating the button
509 (S21) to cause the display 23 to display an input screen for
life style data (S22). Referring to this screen, the patient inputs
a time of going to bed (S23). Concretely, the patient operates the
button 508 while monitoring the time being displayed in the display
23, and when a desired time of going to bed is displayed, the time
setting button 507 is pressed to input the time of going to bed.
Subsequently, also a time of waking up is inputted in the same
manner (S24). In this case, only the time of going to bed and the
time of waking up are inputted, however, various time data determining
the specific life style of the patient such as time of coming home
and time of going to work may be inputted.
In the manner as described above, the control portion 20 variably
adjusts the timing represented by the measurement pattern data inputted
by the person with the authority to diagnose the patient at the
medical facility 7 to determine a plurality of timings for measuring
blood pressure on the basis of the inputted life style data, and
stores them in the memory portion 25 as well as displays them on
the display 23 (S25).
Once the measurement times have been automatically set in the manner
as described above, the patient prepares for blood pressure measurement.
Upon turning ON the power by operation of the button 509 of the
blood pressure monitor 1 (S30), clocking is executed by the timer
26, and when the time reaches the first measurement time set in
the memory portion 25 or 5 minutes before the first measurement
time, an alarm is outputted as described above (S21). Then the patient
confirms the outputted alarm and starts a blood pressure measurement.
Concretely, the patient winds the cuff 2 around the arm, presses
the button 510 of the blood pressure monitor 1, thereby starting
the blood pressure measurement (S32). A blood pressure is measured
in this manner (S33), and a result of the blood pressure measurement
is displayed in the display 23 together with a numerical table.
A maximum blood pressure, a minimum blood pressure and a pulse number
obtained in the measurement are also recorded in the measurement
data file 40 of the memory portion 25 as the measurement data D3i
together with the measurement time (S34). At this time, "at
home" is recorded in the data representing the place in the
measurement data D3i. This information is automatically recorded
in response to a turning ON operation of the button 505 for an at
home measurement made by the patient.
Blood pressure measurements are repeated in the manner as described
above every time the set measurement times arrive, and the measurement
data D3i thereof is sequentially registered in the blood pressure
measurement data file 40 (S35). The analysis and judgment process
as described above is then executed in accordance with the program
for analysis and judgment stored in the memory portion 25, and the
result is written into the analysis and judgment data group D4 of
the blood pressure measurement data file 40 (S36, S37).
In this way, the blood pressure measurements at home by the patient
and the analysis and judgment end.
Later, the patient brings the blood pressure monitor 1 to the medical
facility 7, and consults a person with the authority to diagnose
the patient. The person with the authority to diagnose the patient
receives the blood pressure monitor 1 presented by the patient,
connects the blood pressure monitor 1 with the personal computer
12 via the cable as shown in the data transferring method (1) of
FIG. 1A, presses the button 509 of the blood pressure monitor 1
to turn ON the power (S40). Thereafter, the person with the authority
to diagnose the patient opens the panel cover 423 using the key
421, making the panel 422 operable (S41), and presses the button
502 displaying outpatient in the panel 422 (S42). Then the person
with the authority to diagnose the patient enters a doctor code
and a password for requesting readout of the blood pressure measurement
data file 40 by operating the keyboard of the personal computer
12 (S43). Upon receiving the doctor code and the password, the control
portion 20 of the blood pressure monitor 1 collates the received
doctor code and the password with the doctor code D14 and the password
D15 recorded in the blood pressure measurement data file 40 of the
memory portion 25, and if it is determined that the received password
and doctor code coincide with those recorded in the memory portion
25, or in other words, if the read request is verified, the control
portion 20 permits readout of the blood pressure measurement data
file 40, whereby preparation for data transfer of the blood pressure
measurement data file 40 to the personal computer 12 completes at
the personal computer 12 end (S44).
In this manner, since readout of the blood pressure measurement
data file 40 is permitted only when the read request is verified,
it is possible to prevent the data from being read in response to
an unverified request by a third party and thus invasion of privacy
of individual patients can be avoided.
Afterwards, as the person with the authority to diagnose the patient
presses the call button 504 in the panel 422, the blood pressure
measurement data file 40 in the memory portion 25 is written into
the patient record data file 10 of the server apparatus 11 of the
medical facility 7 through the personal computer 12 via the connected
cable (S46). Then, the blood pressure measurement data file 40 thus
read is read out from the patient record data file 10 of the server
apparatus 11 to be displayed on the screen of the personal computer
12 (S47).
The person with the authority to diagnose the patient judges the
presence/absence of various kinds of symptoms such as hypertension
and determines a prescription with reference to the analysis and
judgment result data group D4 of the display contents, and then
judges whether or not continuous blood pressure measurement is required
(S48). If continuous measurement is required, the button 511 of
the panel 422 is not operated, whereas if it is judged to finish
the blood pressure measurement, the button 511 is operated and the
contents of the blood pressure measurement data file 40 in the memory
portion 25 are cleared.
Since the contents of the blood pressure measurement data file
40 are displayed, the person with the authority to diagnose the
patient can confirm the analysis and judgment result data group
D4 based on the previously set contents such as measurement time
and measurement interval required for obtaining blood pressure value
information useful for diagnosis and treatment of hypertension,
and useful indexes for assisting a diagnosis and treatment of hypertensions
such as dipper and non-dipper.
Furthermore, by confirming the displayed special event data group
D5 and challenge setting data, it is possible to derive useful indexes
for diagnosing types of hypertension in association with the courses
before and after administration, changes after administration, smoking
and meals, and life therapies (improvement of life style) such as
exercise.
Also by confirming the contents representing a place in the displayed
measurement data D3i, it is possible to efficiently determine the
presence/absence of "white-coat hypertension", by comparing
measurement data obtained when the patient is at the medical facility
and particularly with the person with the authority to diagnose
the patient, and a daily measurement data.
In this manner, information such as prescriptions determined by
the person with the authority to diagnose the patient while referring
to the contents of the blood pressure measurement data file 40 is
inputted via the keyboard 14 of the personal computer 12, and inputted
to the corresponding patient record data file 10 of the server apparatus
11 (S49). Thereafter, the blood pressure monitor 1 is lent to the
patient again if it is determined that continuous measurement of
blood pressure is required. To the contrary, if a determination
for ending the measurement is made, the blood pressure monitor 1
is collected from the patient.
The terminal identification code D11 is set for the blood pressure
monitor 1, and the patient record No. code D16 is set for the blood
pressure measurement data file 40. Furthermore, since the password
D15 is required for reading out the data, privacy and security concerning
the contents recorded in the blood pressure measurement data file
are secured.
By means of the blood pressure monitor 1 having the features as
described above, information for diagnosing types of hypertension
(for example, judgment of dipper, non-dipper, inverted dipper and
extreme dipper) and information for diagnosing the white-coat hypertension
that have been difficult to perform heretofore and numerical values
for determining a morning blood pressure increase (morning surge)
or increased ratio with respect to the measurement before going
to bed can be obtained with extreme easiness, which gives an advantage
in diagnosis of hypertension to the person with the authority to
diagnose the patient. Furthermore, in conventional systems, it has
been impossible to determine a correlation between blood pressures
measured at night and blood pressures measured early in the morning
by a conventional simple blood pressure measurement and hence it
has been difficult to administer proper antihypertensive medications.
According to this embodiment, however, assistance of proper and
efficient administration of antihypertensive medications by a person
with authority to diagnose the patient becomes possible.
FIG. 15 is a flowchart showing a procedure of processing blood
pressure measurement data according to a second embodiment of the
invention. In the above-described first embodiment, the blood pressure
measurement data file 40 is transferred off-line by cable connection,
however, in this embodiment, online transfer via cable connection
using a mobile 3 is employed. In this embodiment, only the method
for data transferring is different from that of the first embodiment,
and other processing procedures, functions and configuration of
the apparatus are as the same as those shown in the first embodiment,
the explanation of which will be omitted.
With reference to FIG. 15, as explained above, when a series of
blood pressure measurements completes and the measurement data group
D3, the analysis and judgment result data group D4 and the like
are registered in the blood pressure measurement data file 40, the
patient connects the mobile 3 such as a portable phone to the blood
pressure monitor 1 via the external I/F port 28 in order to transfer
the blood pressure measurement data file 40 (S60). Then, by way
of dial-up connection to a radio destination, the mobile 3 becomes
connected with the data processing center 6. At this time, the password
D15, the patient code D12 and the terminal identification code D11
registered in the blood pressure measurement data file 40 are transmitted,
and the data processing center 6 receives these data and verifies
the blood pressure monitor 1 according to the received contents
(S62). Notified that the blood pressure monitor 1 has been verified,
the blood pressure monitor 1 transmits data of the blood measurement
data file 40 (S63), the data processing center 6 receives the transmitted
blood pressure measurement data file 40 (S64) and transmits a response
that the reception has completed to the blood pressure monitor 1
via the mobile 3, and then the blood pressure monitor 1 having received
this ends the series of processes (S65).
Thereafter, the data processing center 6 interrogates the server
apparatus 11 of the medical facility 7 which is a destination of
transmitting the blood pressure measurement data file 40 whether
or not data transmission is approved, and verification is relatively
conducted between the medical facility 7 and the server apparatus
11 (S67). This communication between the data processing center
7 and the server apparatus 11 is preferably carried out via VPN
or a dedicated line for security.
Upon reception of approval data of data transmission from the server
apparatus 11 of the medical facility 7, the data processing center
6 transmits the contents of the blood pressure measurement data
file 40 to the server apparatus 11 (S68), and the server apparatus
11 writes the contents of the blood pressure measurement data file
40 thus received into the corresponding patient record data file
10 (S69). Afterwards the processing of the data processing center
6 ends.
The person with authority to diagnose the patient accesses to the
corresponding patient record data file 10 of the server apparatus
11 via the LAN (not shown) of the medical facility 7 from the personal
computer 12 (S70), makes a diagnosis with reference to the contents
of the blood pressure measurement data file 40 to determine a prescription,
and inputs the determined prescription by operating the keyboard
14. The inputted prescription is then recorded on the corresponding
patient record data file 10 (S71).
FIG. 16 is a flowchart of blood pressure measurement data processing
according to a third embodiment. In this embodiment, data of the
blood pressure measurement data file 40 is transferred by using
the memory card 15. In this embodiment, only the method for data
transferring is different from that of the first embodiment, and
other processing procedures, functions and configuration of the
apparatus are as the same as those shown in the first embodiment,
the explanation of which will be omitted.
Referring to FIG. 16, blood pressure measurements are performed
in the procedure as described above, and after completion of recording
the contents of the measurement data group D3 and the like in the
blood pressure measurement data file 40, as well as recording the
analysis and judgment result data group D4, the memory card 15 in
which the blood pressure measurement data file 40 is written is
removed from the blood pressure monitor 1 and the blood pressure
monitor 1 is turned OFF (S80).
The patient brings the removed memory card 15 to the medical facility
7 when coming there as an outpatient, and the person with authority
to diagnose the patient mounts the memory card 15 thus brought in
the memory card reader/writer 13 of the personal computer 12 and
reads out the measurement data file 40 stored therein (S81).
At this time, in order to prevent illegal readout, when the person
with authority to diagnose the patient enters a read request including
a doctor code and a password by operating the keyboard 14 in response
to a request for entry of a doctor code and a password (S82, S83),
the entered doctor code and password are compared with the doctor
code D14 and password D15 recorded in the memory card 15, and if
they coincide with each other, the read request is verified, so
that the blood pressure measurement data file 40 is read out from
the memory card 15 (S84), and the measurement data group D3 and
the analysis and judgment result data group D4 of the measurement
data file 40 thus read out is displayed on the personal computer
12 (S85).
In the above description, it is assumed that the analysis and judgment
data group D4 is previously generated in the blood pressure monitor
1, however, the analysis and judgment data group D4 may be generated
in the personal computer 12. Specifically, the personal computer
12 may perform analysis and judgment in the same manner as described
above on the basis of the measurement group data D3 of the blood
pressure measurement data file 40, and the result may be displayed
on the screen of the personal computer 12.
Since the person with authority to diagnose the patient diagnoses
and determines a prescription for the patient while referring to
the result of the analysis thus displayed, the contents are inputted
from the keyboard 14 and the read out blood pressure measurement
data file 40 and the inputted prescription contents are additionally
registered in the patient record data file 10 which is previously
fetched to the server apparatus 11 of the medical facility 7 or
the personal computer 12 of the person with authority to diagnose
the patient (S86). After completion of registration, the memory
card 15 mounted on the memory card reader/writer 13 is initialized
(S87).
It is to be understood that the above embodiments are for illustrative
purposes only, and not intended to be limiting. The scope of this
invention, therefore, is set forth in the claims and is intended
to include any modifications within the equivalent meaning and scope
of the claims. |