Note: Descriptions are shown in the official language in which they were submitted.
CA 02366420 2002-O1-16
PATIENT CARE AND COMMUNICATION SYSTEM
BACKGROUND OF THE IIvTVENTION
1. Field of the Invention
The present invention relates to a patient care and communication system
which incorporates telephone communication therein. The system utilizes a PBS
to provide
staff to-staff, staff=to-patient andlor external telephone communications. The
system is also
capable of performing tasks such as monitoring medical equipment in patient
rooms and
maintaining patient medical data; facilitating staff to-staff or staff to-
patient visual and data
communications; and tracking the location of staff members or patients to
provide maximum
patient care. More detailed descriptions of the staff patient communications
and the
monitoring of the medical equipment is provided in U.S. Patent 5,455,851 and
U.S. Patent
5,465,082.
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CVO 95!23378 2 ~ PCT!'US95l02da0
~ 2.. Description of the Related Art ..
In hospital or other health care environments, the
nursing staff as well as other staff members are required to
maintain and update patient information, provide patient .
care, and assist physicians in the treatment of patients. . ~.
Often, these tasks have to be performed even though there
are personnel shortages. Further, as medical technology
continues to develop to provide treatment for a greater _
number of medical conditions, the volume of information that
j0 is maintained for each patient continues to grow rapidly. -_
As a result, stress on the nursing staff has increased and
information overload is fast approaching.
To more fully understand the above problem
relating to health care, consider the types of data which
~5 are maintained for an individual patient. Typically, the
staff members need to know the patient's name and address as
well as any special dietary, environmental or physical space
requirements- of the patient. The attending physician or
nursing staff may want to know the patient's condition, ~._ -
p medical history and recent vital sign data. If the patient
has had any diagnostic tests such as x-rays or ultrasound
images made at the hospital, or at any other hospital, the _.
attending physician may want to compare these test results , .
with the results of newer tests to see how the patient's w -
25 condition has progressed.-~ In addition, if any medication "_
has been prescribed, the physician or nursing staff may want
to know the identity of the medication, when the last ~~ose
was taken and how the patient has complied with the dosage
schedule.
30 Current systems utilized to manage such
information includes the manual writing and processing of
the information. Electronic systems utilized to process and .
store the information involve multiple computers, each
CA 02366420 2002-O1-16
WO 95!23378 PCT/US95102440
3
- ~ configured to process portions of the vast amount of -
information. To obtain all the information in one place the .;
information stored in each computer system must be manually
combined. Furthermore, such electronic systems do not . -
provide visual displays of text at stations provided in the -::y
patient's room, at the nurse control station or at stations - .
provided in areas of the health care facility frequently w ,
.,
occupied by the health care personnel. - -.
In addition to processing the above information,
~0 the nursing staff attending to a number of patient s rooms w
may want to have some indication of each patient's condition
at nursing stations which are far removed from the patient's
r
:
S
bed. For example, if the patient has been admitted for a
heart condition, it would be helpful if any recent vital - ,
~5 signs that may indicate the onset of a heart attack could be ~-
displayed at the nurses station When the patient presses a -_
call button. -
One such system described in U.S. Patent No.
4,835,372 to Gombrich et al. relates to a patient
20 identification system for relating items with patients and
.for ensuring that an identified item corresponds to an -
identified patient. The system includes a computer system
interconnected to a plurality of remote terminals by _ -
conventional telephone wiring. A RF modem provides for
25 transmission and reception of RF signals to and from a bar
=~=v=i,=.
code reading device, and the RF modem provides for w
transmission and reception of signals via existing telephone
wire to and from the computer system using data over voice -
technology. ~ ..
30 Another problem faced by care givers and by
hospital administrators is determining the location of key
personnel and equipment. In an emergency or during periods
of personnel shortages, the ability to quickly locate an
CA 02366420 2002-O1-16
WO 95123378 PCTlU595l024.I0
4
.., : _ _-.
- 1 attending physician or other staff member to provide maximum
patient care is desirable. Moreover, when special equipment
is required to treat an emergency condition or when a ward ,
of a hospital is experiencing personnel shortages, it is
desirable that the equipment be quickly located to reduce ,
the time spent to locate the equipment. _ w -
one type of system utilized to locate personnel ' -
within a hospital or other health care facility relies on
audio paging systems, sign-in and sign-out sheets and
broadcast paging systems. In a given situation, the audio . ,
paging system would be tried first. This system may not be
effective if the person to be located is in an area where ,
the paging system is not functioning properly or has been
turned down, or if the person has left the hospital. After ..
an unsuccessful audio page, the sign-in and sign-out sheets
may be checked. If, however, the person to be located w
forgot to use the sign-in sheet or sign-out sheet, critical
time may be lost in a second attempt to use the audio paging
system. In addition, a search of the sign-in and sign-out
sheets may require more time than is available in an
emergency situation. ~ --
When the person to be located is outside of the .
hospital, broadcast paging systems are often the best way to
convey an important message. These systems require the .
individual trying to locate the person to call the paging
service, leave a message, wait for the paging service to ~~'~'
send the message to the individual's pocket pager and 'then .
wait for the person being paged to call the paging service,
receive the message and respond.
Another type of currently used locator system
utilizes either radio frequency signals or infra-red signals
to communicate the position of a mobile individual or object
to a network of stationary transceivers. one such system,
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WO 95123378 PCTIUS95I02sa0
1 the InfraCom locating and signaling system available from
United Identification Systems Corp, is designed for use in a
hospital environment. Using this system, a network of -.
infra-red transceivers located throughout a hospital can
5 both transmit data to and receive data from a portable badge ~.
worn'by hospital personnel or attached to the equipment to
be located. This badge transmits a programmed
S
identification signal to the network allowing the position
of the badge to be indicated on a display of the floor plan
of the hospital. ___ _,_.~_ : . -
'Another exemplary system, the TELOC PLUS personnel _ _~_
~ ~.
locator system available from Teloc, znc., also uses~two-way
infra-red signaling to communicate the position of a
portable badge in a stationary transceiver. In addition, --,
the Teloc system may be coupled to a private branch exchange .
(PBX) to allow telephone calls from an individual to be ..y
routed to the telephone that is closest to the badge or to --
direct an intercom message to that telephone, thus providing --
an alternative to an audio paging system. Each of these . -
systems is limited in the type of information that may be _ :..
conveyed between the stationary transceiver network and the
transceiver on the badge. In the described systems, only
identification information providing an indic~.tion that
switches, which are located on the badge :have been
activated, may be transmitted from the badge. Furthermore,
if the transceiver on the badge fails or is damaged, a blank
badge must be programmed to take its place. This pro~am ,_
operation may be time consuming, leaving the individual or w
the piece of equipment invisible to the locating system for ..
that period of time: ~.
Therefore, a need exists for a patient care and
communication system which integrates a staff locating
system with a system which facilitates visual and data
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WO 95/23378 ~ PCTIUS95102.ta0
. ~ communications between staff members and patients and which -_
maintains patient data. A need also exists for a patient
care and communication system which utilizes a private-
branch exchange to provide staff-to-staff, staff-to-patient
and/or external communications. The present invention n
provides a patient care and communication system which
provides communications through a PBX and which is capable
of performing tasks such as monitoring medical equipment in -_ _,
patient rooms and maintaining patient medical data, --
p facilitating voice, visual and data communications between -y
staff members and the patients, as well as a system for ~--_.-:.
. :.:r .,~-r:
tracking staff members to provide maximum patient care.
}= ~=w
SUMMARY OF THE INVENTION
I~ The present invention relates to a patient care
and communication system which includes a central station -' ~ -
having means for facilitating visual and data communications ' -
relating to health care and a plurality of remote stations
connected to the central station. The remote stations
include processing means for facilitating the visual and ,
data communications and display means for displaying the
visual communications. '
The central station includes means fcxr determining '-.
which of the plurality of remote stations are transmitting
the visual and data commur~ications and which of the - '=~-~''
plurality of remote stations are to receive the visual and
data communications. In addition, the central station ''
includes means for establishing a communication link between
the transmitting stations and the receiving stations, and
30 each of the plurality of remote stations includes telephone . .
circuitry for connection to a private-branch exchange for
telephone communications therebetween.
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7 ,
_ ~ Preferably, the plurality of remote stations ,-.
includes control stations, patient stations and staff
stations and the central station includes means for
directing the visual and data signals transmitted to the
control stations to a predetermined number of patient
stations and a predetermined number of staff stations.
The present invention also provides a patient care ~~.-
and communication system where the plurality of remote
stations are configured and adapted for association in a ~_
group network such that predefined visual and data signal
communications are transmitted to each station in the group.
L.. i :. ..V .'...-..
Zone controller means are provided to interface the central
processing means to the transmitting and receiving stations.
In the preferred embodiment, the central station
~5 also includes means for controlling the private-branch '.w
exchange to establish audio communication between a
predetermined number of control stations, a predetermined -- :-
number of the patient stations and a predetermined number of .
the staff stations.
The patient stations of the present invention
include patient control means which is connected thereto and -
provide a remote communication link between the patient and
staff members or the patient and outside callers. The
patient control means has a keypad, a speaker and a
microphone for telephone~communications to other stations or
for external telephone communications. It should be noted -':;~::
that external communications includes telephone '' -
communications from within the hospital environment to .
locations outside the hospital environment, generally via
public telephone lines.
The system of the present invention also relates
to a method of providing patient care and communication
between patient rooms and nurse stations in a health care
CA 02366420 2002-O1-16
facility. The method includes the steps of connecting a plurality of remote
stations to a central station so as to facilitate visual and data
communications
therebetween, and connecting each remote station and the central station to a
private-branch exchange for audio communications between the remote
stations. At least one of said plurality of remote stations is positioned in
each
patient room located within the health care facility, positioning at least one
of
said plurality of remote stations in each nurse station of said health care
facility, attending the remote station in each nurse station to receive the
visual
and data signals from said central station and the audio signals from the PBX
and responding to the audio, visual and data signals.
Various aspects of the invention are as follows:
A patient control unit, which comprises: a housing;
at least one switch positioned at least partially within said housing and
accessible from an exterior surface of said housing;
a plurality of conductors extending from said housing for electrically
coupling
said at least one switch to remote processing circuitry, said plurality of
conductors including a test conductor;
wherein said at least one switch has a first terminal coupled to a first of
said
plurality of conductors and said at least one switch has a second terminal
coupled to a first voltage reference; and
at least one self test switch positioned within said housing, said at least
one
self-test switch having a first terminal coupled to said test conductor and a
second terminal coupled to said first of said plurality of conductors, such
that
when said remote processing circuitry provides a test signal to said test
conductor said at least one self-test switch actuates to enable a continuity
test
of at least one connection between the control unit and other electronic
equipment to be performed by the remote processing circuitry.
A patient care and communication system which comprises:
a plurality of remote stations each having processing means for facilitating
communications relating to patient care between said plurality of remote
stations and a nurse station; and
patient control means coupled to at least one of said plurality of remote
stations for audio communications with the nurse station, said patient control
means including verification means coupled to said processing means of said
CA 02366420 2002-O1-16
8a
at least one remote station for verifying the electrical continuity of
conductors
connected between said at least one remote station and said patient control
means, said verification means including at least one self-test switch within
said patient control means, coupled to said processing means, wherein said
processing means causes said verifying to be performed periodically by
controlling switching states of said self-test switch, said at least one self-
test
switch enabling a continuity test of at least one connection between the
patient control means and other electronic equipment to be performed by the
processing means.
Apparatus for monitoring and controlling environmental facilities within
at least one room of a health care facility, which comprises:
a plurality of remote stations, including at least one nurse control station
located at a nurse station, and at least one patient station located in said
at
least one room, said remote stations connected to a central processor to
facilitate visual and data communications therebetween, said plurality of
remote stations having processing means for facilitating said visual and data
communications and having display means for displaying said visual and data
communications, and having means for establishing a communication link
between said transmitting stations and said receiving stations;
a wireless receiver positioned within said at least one room having
environmental facilities therewithin;
a wireless transmitter located within said at least one room, said
wireless transmitter having a housing, a processor within said housing, and a
patient select member connected to said processor, such that activation of
said patient select member causes said wireless transmitter to transmit
control data to said wireless receiver associated with said patient select
member; and
a controller connected to said wireless receiver and said environmental
facilities, said controller being configured to receive said control and
status
data from said wireless receiver and to control said environmental facilities
in
response to said control data.
A method for monitoring and controlling environmental facilities within
at least one room of a health care facility, comprising:
CA 02366420 2002-O1-16
8b
connecting a plurality of remote stations. including at least one nurse
control
station located at a nurse station and at least one patient station located in
said at least one patient room, a central processor to facilitate visual and
data
communications therebetween, said plurality of remote stations having
processing means for facilitating said visual and data communications and
having display means for displaying said visual and data communications,
and said central processor having means for determining which of said
plurality of remote stations are transmitting said visual and data
communications and which of said plurality of remote stations are to receive
said visual and data communications, and having in a for establishing a
communication link between said transmitting stations and said receiving
stations;
positioning a wireless receiver within said at least one room having
environmental facilities therewith in;
positioning portable wireless transmitter within said at least, room,
said wireless transmitter having a patient se member, such that activation of
said patient select/member causes said wireless transmitter to transmit
control data to the wireless receiver associated with said patient select
member;
connecting said wireless receiver and said environmental facilities to a
controller, said controller being configured to receive control data from said
wireless receiver and to control said environmental facilities in response to
said control data; and
activating said wireless transmitter to transmit said control data.
BRIEF DESCRIPTION OF THE DRAWINGS
The preferred embodiments of the invention are described hereinbelow
with 20 reference to the drawings wherein:
Fig. 1 is an illustration of the components of one embodiment of the
patient care and communication system configuration of the present invention;
Fig. 2 is a functional block diagram of an alternative embodiment of a
system configuration of the present invention;
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$c
Fig. 3 is a functional block diagram of another alternative embodiment
of a system configuration of the present invention, illustrating grouping
arrangements for the stations;
Fig. 4 is a functional block diagram of another alternative embodiment
of a system configuration of the present invention;
Fig. 5 is a circuit block diagram for the central processing unit
illustrated in Figure 1;
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WO 95123378 PCTNS95t02~.t0
..J
- ~ . Fig. 6 is flow-chart diagram for the central :,
processing unit illustrated in Fig. 1; ~ -
Fig. ? is a block diagram for the fail safe -
feature associated with the system of the present invention;
w5 Fig. 8 is a flow-chart diagram of the fail safe
feature illustrated in Fig. 7; y
Fig. 9 is a functional block diagram of a system
configuration similar to Fig. 1, illustrating a patient
station having peripheral equipment connected thereto;
Fig. 10 is a block diagram for the nurse control ~ -.-
station illustrated in Fig. 1;
f~~~;~
- Fig. 11 is a circuit block diagram for the~audio
circuitry of the keyboard of the nurse control station
illustrated in Fig. 1. , -
i5 Figs. 12 and 13 are circuit block diagrams for the
internal circuitry for the patient stations illustrated in - -
Fig. 1;
Figs. 14a and l4b illustrate an exemplary flow-
chart diagram of an operation of the patient station of Fig. -
~ 1
Fig. 15 is a flow-chart diagram associated with -
the internal circuitry for the patient stations illustrated .
in Fig. 1; ,.. -
Figs. 16 and 17 are circuit block diagrams for the ~ -.
5 internal circuitry for fife staff stations illustrated in
Fig. 1; ,
Figs. 18, 19 and 20 are tables which illustrate
various call indications and associated tones generated by
the stations in response to a particular call condition;
Fig. 21 is flow-chart diagram for the central
processing unit illustrated in Fig. 12; and
Fig. 22 is a circuit diagram for the patient
control unit illustrated in Fig. 10 and showing self-test
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CVO 95!23378 1 O PCTNS9S/02a.~0
j circuitry for performing automatic continuity tests of .~. "
interconnecting wires;
. Fig. 23 is an illustration of the components of an
alternative embodiment of the patient care and communication
system of the present invention;
Fig. 24 is a functional block diagram of the -_.
alternative embodiment of the patient care and communication ~; . .
system configuration of Fig. 23, illustrating a private-
branch exchange connected to the stations for telephone -
~0 communications;
Fig. 25 is a circuit block diagrams for an
alternative embodiment of the internal circuitry for the
patient stations illustrated in Fig. 23;
Fig. 26 illustrates the data frames for
5 communication between the stations and the private-branch
exchange;
Fig. 27 illustrates the data frames for ~.,
communication from the stations to the private-branch
exchange in an expanded form; .
20 Fig. 28 illustrates the data frames for
communication from the private-branch exchange to the
stations in an expanded fona;
Fig. 29 is a circuit block diagram for an
alternative embodiment of the internal circuitry for the
25 Patient control units il~.ustrated in Fig. 23;
Fig. 30 is a circuit block diagram for an
alternative embodiment of the internal circuitry for the -- ,__
nurse control stations illustrated in Fig. 23; ..
Fig. 31 is an illustration of the components of
30 another alternative embodiment of the patient care and
communication system configuration of the present invention;
35 _
r
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«'O 95123378 PCTlUS9i1024-f0
- ~ Fig 32 illustrates exemplary input and output
waveforms for the waveshaping and conditioning circuitry of
Fig. 25;
Fig. 33 is a block diagram of the components of an
exemplary portable transmitter according to the present
invention;
~ Figs. 34-36 illustrate a side elevational view,
top, plan view and a bottom plan view, respectively, of a _
housing for the transmitter components of Fig. 33;
Figs. 37 and 38 illustrate front and rear views,
respectively, of a personnel card used with the transmitter
housing and components of Fig. 35; _.
Fig. 39 is an exemplary configuration for a
patient room within a health care facility;
Fig. 4o is a circuit block diagram of an infrared
receiver and environmental facilities within the patient
room of Fig. 39, which are connected to a controller;
Fig. 41 is an alternative configuration for a , - -
patient room within a health care facility, illustrating the
utilization of a wireless system for controlling
environmental facilities in the room; and
Fig. 42 is a block diagram of an alternative ~-, w
portable transmitter embodiment according to the present _w
invention.
J
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS '
Generally, the patient care and communication
system of the present invention includes a communication
network that provides routine and emergency signaling to
health care facility staff members and provides high
fidelity voice communication and data transmission between
CA 02366420 2002-O1-16
12
staff members in. the health care facility and/or between
patients and the Staff members.
The exemplary embodiments of the automatic staff
locator system of the patient care and communication system
of the present invention described below, use a'memory card
. as a personal database. As used herein, a memory card is a
device approximately the same size and shape as an ordinary
credit card which includes a non-volatile programmable
memory. In the card used in the embodiments described
p below, two types of memory are used: an electronically
erasable read only memory (EEROM) located internal to the
card and a magnetic stripe located on the surface of the
card. It is contemplated, however, that other forms of
internal memory, such as a ferro--electric RAM or a CMOS
~5 memory with an integral battery, nay be used. It is also
contemplated that the functions described below may be
implemented with other types of external memory, such as
laser card technologies which either augment or replace the
card memory. A more detailed description of the staff
20 locator system_and its op~r~t~on is described in commonly
assigned U.S. Patent 5,45 5,851.
25 SYSTEM CONFIGLi~RATIONS AND CO~lUNICATIONS
Fig. 1 is an illustration of the major components
of the patient care and communication system according to
the present invention, which includes central processor unit
(CPU) 2412, nurse control stations 2414, patient stations
30 2416, staff stations 2418 and zone contzollers 2420.
Generally, the nurse contzol stations 2414 are installed at
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~'VO 95!23378 1 3 PCTIUS9al02.i40
~ nurse stations located in various areas of the hospital or
health care facility and provide a communication link to
patients in their rooms. The patient stations 2416 are
installed in patient rooms and can be configured to
S correspond to one patient or to multiple patients. The :-
patient stations 2416 include patient station display 3230,
~ speaker 3618, microphone 3620 and patient control unit 3210, _-
all of which will be described in more detail below. ~ .
The staff stations 2418 are preferably installed ~-
~~ in locations frequently occupied by other staff members in ;
the hospital, such as staff locker rooms. Staff stations
2418 include staff station display 2422, speaker 4018 and
microphone 4020, all of which will also be described in more
detail below. The zone controllers 2420 include shared-RAM
15 (S-RAM) memory 2512 (shown in Fig. 2) which is utilized as a
buffer memory for data received from either CPU 2412 or from
any of the above noted stations, hence the term shared-RAM. _.
As will be described in more detail below, the
various types of stations which are positioned at different - -
20 locations within the hospital interact with the aid of the ~~~-.
CPU 2412 to perform numerous operations to reduce the
information overload currently plaguing hospital staff . w _ .
members. Examples of the operations involving CPU 2412 w
include a call priority operation which prioritizes incoming ~-.-
25 calls (or messages) to ntfrse control station 2414 based upon a;=
the type of message received, so that staff members respond
to the highest priority calls first. For example, if'~he
incoming message relates to a fault in a smoke alarm secured -..
in the patient's room, that message will be given the
30 highest priority. Another operational example is a nurse
follow operation which allows staff members to selectively
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BYO 95123378 PCTlUS9S/02.1.~0
~4
1 route incoming calls directed to a nurse control station, to : - ,
selected patient stations and/or staff stations so that when ~~ ,
the staff members attending the nurse control station are
required to leave the area, incoming calls to that station .
can be routed to locations where appropriate staff members -
can respond to the call. Another operational example is a
voice paging operation which allows staff members to
communicate with selected patient stations 2416 and/or staff
stations 2418 from the nurse control station 2414. The
interaction between the stations when performing these , ~_,
exemplary operations ar tasks, as well as other operations,
is conducted via a communication link which will be
described in more detail below.
Fig. 3 illustrates the major components of system y
2410 arranged in groups. As shown, CPU 2412 of the system
of the present invention is configured, dimensioned and
adapted to interface through zone controller systems 2413 .,w
with a predetermined number of station groups of patient
stations 2416, staff stations 2418, and/or any combination
thereof (e.g., the number of groups ranging between 1 and x, ~ ..
where "x" is preferably 8). Each station group includes
between 1 and "n" stations; where "n" is preferably 35, and .-_
a predetermined number of station groups can be assigned to
between 1 and "m" nurse control stations 2414, where "m" is
preferably 8.. For example, if a ward in a hospital has one
hundred patient rooms (numbered from 100 to 200) which are
single occupancy rooms, a staff locker room (Room 201' and a :' .. .
staff kitchen (Room 202), one patient station 2416 would be
installed in each patient room and one staff station 2418
would be installed in the staff locker room and the staff
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BYO 95f23378 PCTNS95f024.10
~ kitchen. An exemplary array of station groupings (or the
call assignment configuration) is shown in Table I below:
Table 1
RMl RM2 RM3.....RM32 RM33 RM34 RM35 -
GROUP 1 100 101 102.....132 133 201 202 -
GROUP 2 120 121 122.....152 153 201 202 ~ . . .
GROUP 8 154 I55 156.....186 187 201 202
As shown in this exemplary call assignment configuration,
0 rooms 100 through 133, 201 and 202 are assigned to station w
group 1. Rooms 120 through 153, 201 and 202 are assigned to -v.--z~--
station group 2 and rooms 154 through 187, 201 and 202 are
assigned to station group 8. The station groupings can
overlap in room coverage;-thus, as illustrated in table I . .,
~5 above, station groups 1 and 2 both include rooms 120 through -y.
133.
In addition to the station groupings, the system .
of the present invention is configured so that each station -
group is assigned to a predetermined number of nurse control
20 stations 2414. Table II below, illustrates an exemplary --=
call assignment configuration for station groupings and
their assignment to the nurse control stations 2414: w.
T.bl~ n -
Oroup I Oroup 2 ...:. Otoup 8 . .
' NCSI YES Ylj ..... YES ,
NCS2 YFS NO ..... NO
. - '- -__ t:
. t:.- -
NCS8 NO YFS ..... NO
30 In this exemplary configuration, communication transmitted
by any of the stations assigned to station group one (rooms
100-133, 201 and 202) will be directed to nurse control
' 35
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6
._;
~ station one (NCS1) and to NCS2 so that staff members
attending-either nurse control station 2414 can respond to
the call. Communications transmitted by any of the stations
assigned to station group two (rooms 120-153, 201 and 202)
will be directed to NCS1 and NCS8 so that staff members - . . ;
attending either nurse control station 2414 can respond to
the call. Communications transmitted by any of the stations = ' '
assigned to station group eight (rooms 154-187, 201 and 202) r ~_-~
will be directed to NCS1 so that staff members attending
~0 NCS1 can respond to the call.
In the preferred embodiment, the patient care and
:,:::~e
communication system of the present invention can include
:°-~--.:. .:=,
four call assignment configurations. To illustrate, the r~~="':
call assignment configurations can be utilized to
~5 automatically (or manually) assign stations (2416 or 2418)
to station groups and station groups to nurse control
stations 2414 for day operation, for evening operation, for
weekend operation and/or for holiday operation. _'
Referring now to Fig. 4 which illustrates an w
20 alternative system configuration in which, central
processing unit 2412 is connected to external communication .. .
equipment such as broadcast paging system 2720, external
computer 2722, printer 2724, and/or staff locator system - _ .
2428. Broadcast paging system 2720 may be utilized by the
25 system of the present in4ention to locate staff members or w
_ . <:
other personnel who are not within the hospital or other
health care facility. The broadcast paging system mad be
any known type capable of interfacing with a computer. _y ~,-.
Preferably, broadcast paging system 2720 and CPU 2412 -
30 communicate via serial communication ports connected to each
device. Staff locator system 2428 may be provided to locate
CA 02366420 2002-O1-16
staff members anywhere in the hosp~.tal or_ other health care
facility as described'in U.S. Patent 5,465,082.
In addition to locating staff members,
5. staff locator system 2428 may be utilized to track or locate
patients in the hospital. To utilize the staff locator
system to locate patients, each patient is provided with an
identification badge or bracelet which includes the
components as disclosed for identification badge worn by
0 staff members and described above. The identification badge
or. bracelet continually transmits the identification signal.
of the patient and the central computer system continually
monitors the identification signal to update the location of
the bracelet and the patient. The location infonaation of
S the staff member or patient is transferred to CPU 2412 via
data link 2726 (shown in Fig. 4) which may be any known type
of communication link utilized to facilitate communication
between computer systems. External computer 2722 interfaces
to CPU 2412 and performs computing functions including
20 extracting or inputting data stored or otherwise processed
within CPU 2412:. printer 2724 may be utilized to extract
hard copies of data.stored or otherwise processed within CPU
- 2412 including problem reports generated by the system, as
will be described in more detail below.
25 Fig. 2 illustrates a functional block diagram of
an alternative system configuration, which includes main
hospital computer 2530 configured to interface with CF~U 2412
to provide staff members with additional patient
information, or to transfer from CPU 2412 to the main
30 hospital computer patient information which maybe utilized
for billing purposes. For example, information pertaining
CA 02366420 2002-O1-16
WO 95123378 ~ 1 8 PCTIUS95l024.10
- ~ to the types and quantities of prescription or intravenous y...
drugs taken by the patient and the types of treatments
received by the patient (e. g., X-rays or CT-scans), as well
as the physician time spent with the patient, may be
transferred to the main hospital computer to provide the
hospital with more accurate billing information.
Preferably, main hospital computer 2530 is interfaced with
CPU 2412 via hospital personal computer 2540, system
personal computer 2550, RS-232/RS-484 converter 2520 and
zone controller 2560. In this configuration, the integrity __:,
of the main hospital computer is maintained and the serial
conversion from RS-232 protocol to RS-484 protocol is
accomplished. _.
Fig. 5 illustrates the hardware components of -w
central processing unit (CPU) 2412. The CPU 2412 includes
microprocessor 2810, three Mbytes of memory 2820 (2 Mbytes _ -
of flash ROM and 1 Mbyte of RAM) having stored programs -
(e.g., operating system and application programs), and
communication interface 2830. Preferably, microprocessor
2810 is an MC68000 16-bit microprocessor manufactured by ..
Motorola Inc. In addition to the above circuits, CPU 2412
includes watchdog circuit 2840 which receives a one shot
trigger from microprocessor 2810, at a predetermined time
interval, preferably 300 msec., to ensure that the
Z5 microprocessor is functioning. If, however, microprocessor
2810 fails to timely trigger watchdog circuit 2840; then the
watchdog circuit will initiate an automatic reset of 'the
microprocessor, thus preventing the microprocessor from -
locking-up for~extended periods of time.
30 Communication interface 2830 and communication
ports 2850 are provided to facilitate communication between
CA 02366420 2002-O1-16
VVO 95I233Z8 PCTIUS951(i24.10
~s
CPU 2412 and zone controllers 2420 and between CPU 2412 and
y
,.
the external communication equipment. As noted above, the
preferred communication protocol'includes the RS-485 serial
communication protocol. Accordingly, communication
interface 2830 is configured to accommodate RS-485
_' . -
communication utilizing RS-485 drivers/receivers which are
known in the art. _-
An exemplary operational flow of CPU 2412 is shown '-
in Fig. 6. Initially, the CPU is in a listen mode. In the ;
listen mode the CPU continuously polls or otherwise w
interrogates the different components attached thereto. For
w:
example, as shown in Fig. 6, the CPU will periodically~poll 'r"~='~
each shared-RAM (S-RAM) 2512 (shown in Fig. 2) of each zone
controller (step 2910) in a manner described hereinbelow.
~5 If the S-RAM does not have a message frame received from a _ .
station within the zone controller grouping, CPU 2412
returns and polls the next zone controller (step 2920).
Preferably, as will be described in more detail below data ..
transmitted between the CPU 2412 and the zone controller :'.
20 2420 or between the zone controller 2420 and the stations
(either 2414, 2416 or 2418) are in the form of message
frames which include station identity information as well as
. the message data relating to a particular function.
If, however, the S-RAM does have a message frame
25 stored therein, CPU 2412~uti11 retrieve the message frame
(step 2930) and analyze the received message frame by
determining what patient station, staff station or nu~'se
control station the message frame was received from and if _ ;
the frame was received from a patient station, by organizing
30 or obtaining any patient information associated with that
particular patient station (step 2940). The DATA field
CA 02366420 2002-O1-16
WO 95123378 PCT/US9S/02.~~0
2 0 .,
~ within the INFORMATION field of the received message frame
is then interpreted by the CPU, which determines whether a
response to the associated patient station, staff station or
nurse control station massage frame is necessary (step
2950). If a response is not required, CPU 2412 returns to -. _
poll the next zone controller. ;~ _-
However, if a response is due, the CPU then starts ':
the task associated with the information included in the
message frame (step 2960). Upon completion of the task, CPU
~0 2412 returns to the listen mode and begins palling the next
zone controller connected thereto as described above.
The components of zone controller 2420 include a
-....
microcontroller, memory having stored programs (e. g., system
or application programs) and a communication interface
~S connected to communication ports. The connection of the y -
zone controller 2420 components is the same as equivalent
components~of CPU 2412, as shown in Fig. 5. The zone
controller 2420 also includes the shared-RAM (S-RAM) 2512, ~
shown in Fig. 2, which is connected to the microcontroller. ..
20 Preferably, the,microcontroller is the 64180 . .
microcontroller, manufactured by Motorola and the S-RAM .-
includes 2 kilobytes of memory.
A communication interface and communication ports _.
are provided to facilitate communication between zone
5 controller 242'0, CPU 2412rand slave devices, such as patient
station 2416, staff station 2418 and/or nurse control
station 2414. The communication protocol may be any l~iiown ~- .
serial communication protocol, such as RS-232 or RS-485. ..
The RS-485 protocol is preferred in the embodiment according
30 to the present invention. Accordingly, the communication
interface is configured to accommodate RS-485 communication
CA 02366420 2002-O1-16
WO 95123378 PCTIUS9~1024.10
2~
- ~ utilizing RS-485.drivers/receivers which are known in the ..
art. Each zone controller 2420 also includes a Watchdog w
circuit which operates similarly to the watchdog circuit in -
CPU 2412. Thus, the watchdog circuit prevents the
microcontroller from locking-up if the watchdog circuit is -_
not polled at the predetermined time interval, preferably
300 msec., by the microcontroller. -
The communication link between the zone
controllers and stations or between the stations and
0 peripheral equipment connected to the station is in a .:
master-slave relationship. In the communication link
G.e..
between the zone controllers 2420 and the stations, the zone w
controllers are the master stations and the nurse control :;~.
stations, patient stations or staff stations are the slave ~y _
~5 stations. Whereas, in the communication link between the
stations and the peripheral equipment, the stations (e:g., w .
the patient stations) are the master stations and the .w.
peripheral equipment is the slave. The master station is in w
control of the data link and transmits command frames to the
20 slave stations. The master station maintains separate -~ ..
sessions (i.e., communication links) with each slave station
attached to the link. To illustrate and again referring to
Fig. 2, if zone controller 2420 is connected to a group of
- patient stations (1 to n) and/or connected to a group of
25 staff stations (1 to m),'~he zone controller (master) will '~~
periodically poll each patient station (slave) to retrieve
message frames. The slave station responds to the com'inands
from the master station and can send one message to the
master station per poll from the master station.
30 The master station may communicate with the slave
stations in one of two logical states. One state is the .
r
CA 02366420 2002-O1-16
WO 95!23378 2 2 PCTILTS9s102.1.~0
- ~ IN3TIALIZATION state which is used to initialize the --
master/slave station (e. g., identify for' each communication
link which device connected thereto is the master and which
is the slave). A second state is the INFORMATION TRANSFER
state which permits the master and slave stations to
transmit and receive control or application information '-
transmitted across the data link between the master station
and the slave stations in the form of message frames or
blocks of data. -
In the preferred embodiment, the message frames
may be one of three types. The first type of message frame
is the INFORMATION FORMAT frame (I-frame) which is used to . .v.;_
-vW.
transmit application information (e. g., message information
associated with a particular function or station status --
data) between the master and slave stations. The I-frame :-
may also acknowledge receipt of a frame from a transmitting ~. w v
station. The second type of message frame is the . . -
SUPERVISORY FORMAT frame (S-frame) which performs control
functions, such as acknowledging the receipt of a poll from
the master station or requesting the temporary suspension of
the transmission of I-frames. The third type of message
frame is the UNNUMBERED FORMAT frame (U-frame) which is also ~ _, -
used for control purposes, such as performing.data link
initialization or tests. -'
As noted, the~data (or information) transmitted
between master and slave stations is preferably configured ''~~'
in the form of a message frame. The preferred message frame
includes five fields, similar to the frame shown below: -~v .
ADDRESS/LENGTH/CONTROL/INFORMA.TION/FCS
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WO 95!23378 2 3 PCTlUS95102.t.10
~ Where, the ADDRESS field is one byte in length and .-
identifies the patient station involved in the particular _~
frame transaction (each station has a unique address which
allows the CPU and zone controller to identify which station
sent the frame); the LENGTH field is one byte in length and
..
contains the size of the frame, in bytes, excluding the _~ _~,
address and length fields; the CONTROL field includes the
command and response information used to maintain data-flow
accountability of the communication link between the zone y_ ,.
controller (master) and the patient station (slave); and the
INFORMATION field retains a predetermined number of bytes of
ar
data, preferably between 1 and 145 bytes, relating to the
application data, such as, the data associated with the ,.
activation of the nurse call button (hereinafter "the nurse
~5 call data"). The frame-check-sequence (FCS) field,
typically one byte in length, is used to check for -.
transmission errors between the master and slave stations or - ..
devices.
The system of the present invention may transmit a
20 predetermined number of message frames, preferably between 1 W
and 8 frames, before an acknowledgement or response to a
transmitted frame is received. As a result, the CONTROL
field is utilized to maintain data-flow accountability of
the communication link, as noted above.
. ~r ji ;.:....:..:
':
35
CA 02366420 2002-O1-16
WO 95/23378 2 4 PCTNS9SI424.10
- ~ Shown in table III below is the CONTROL field bit
encoding for the master and slave stations. '
Table III
CONTROL 6dd bit encoding (mutu station):
Lframe format:
:7:6:5:4:3:2:1:0: ' '
:xx:xx:0
. . . . . . . :-> Normally sei m biaary 0 . .
. . . . . . .-> N(S) - '
. . . . > N(R) - _
> P .
CONTROL field bit eacoding (aLve tution):
I-fume facmat: -
:7:6:5:4:3:2:1:0: .a.'.::.~-
:xx:zz:0 _
. . . . . . . :-> Normally act to binary 0 .
. . . . . . .-> N(S)
. . . N(R) _ . ,
>F
The send sequence number N(S) (bits 1, 2 and 3)
indicates the sequence number associated with a transmitted
frame. Basically, the sequence number is a message counter ;-
which counts the number of message frames sent,to a ~ -
.receiving station. The receive sequence number N(R) (bits
1, 2 and 3) indicates the next sequence number that is
expected at the receiving station. The receive sequence
number may also serve as an acknowledgement of the previous
frame. In addition, the transmitting station maintains a
send state variable V(S) which is the sequence number of the
next message frame to be transmitted, and the receiving -
station maintains a receive state variable V(R), which _
contains the number that is expected to be in the sequence
number of the next frame. The send state variable is
CA 02366420 2002-O1-16
WO 95123378 ~ 5 PCT/US95102.1.J0
~ incremented with each message frame transmitted and placed .
in the send sequence number N(s) field in the frame.
Upon receiving a frame, a receiving station checks
for a transmission error by comparing the send sequence
number with the receive state variable. If the frame is ..
acceptable (i.e., the send sequence number and the receive _
state variable are equal), the receiving station increments
the receive state variable V(R) and interpolates the
variable into the receive sequence number field N(R) in the
0 next outbound message frame. If, on the other hand, the
send state variable V(S) does not match the receive sequence w
number N(R) in the message frame, the receiving station
decrements the send state variable V(S) and retransmits the _
last message frame when the next frame has to be . .
~5 transmitted.
To establish an interactive communication link
between stations, the master station uses the poll bit (P)
to solicit a status response (e.g., an S-frame) or an I- -
frame from a slave station. Generally, the slave station _ =
20 does not transmit a frame to a master station until a _~
message frame with an active poll bit (i.e., P is set to
logic 1) is received from the master frame. In the .
preferred embodiment, the polling rate of the-master station
is aperiodic or not ffixed. The polling rate is dependent
25 upon a number of factors such as the baud rate and the type
of message frame being sent by the slave station. For
example, if the baud rate is 9600 and if all the slave
stations respond to a poll by the master station with an S-
frame, the polling rate is approximately 20 msec. However, - _
30 if a slave station responds'with an I-frame which includes
64 bytes of display data the rate (or time) before the
CA 02366420 2002-O1-16
WO 95123378 , 2 6 PCTlUS95/02-l40
' j master station will poll the next slave station is .,
approximately 64 cosec. Generally, at 9600 baud, one byte of
data is transferred in one millisecond.
The slave station responds to an active poll bit
with an I-frame or S-frame format message frame. In the - ~ _
preferred embodiment, the slave station has 15 cosec. to .--
start transmitting the responding message frame and 150 y
cosec. to complete transmission of the frame which is
identified by activating the Final bit (F) (i.e., F is set -
~0 to a logic 1). -
If the slave station fails to. successfully respond
. ...~ .:~:
to the polling frame of the master station with either an S-
. i
frame or I-frame, for a predetermined number of polls, = -'~-
,..,_
preferably 10, that particular station will be marked as _
I5 disconnected and will be polled at slower rate (preferably,
about every 10 sec.) until the master station receives at '._.
least one message frame from that particular slave station.
When a station or other equipment connected to the system of
the present invention are determined to be disconnected, the
20 identity of the station or other equipment and the room ..
location of the equipment are stored in a problem report
which can be printed on hard or soft copy via printer 2724
. and/or external computer 2722, shown in Fig. 4: ~.
Alternatively, the problem report can be displayed on nurse
25 control station display X272 shown in Fig. 32 upon the
proper keying of direct select keys 3374 of nurse control v_;='
station display 3272 pursuant to menu prompts. '' ..w
35
r
CA 02366420 2002-O1-16
WO 95123378 ,Z ?, PCT/US9Sl024.t(1
- 1 Referring now to Table IV below, the CONTROL field ,.,w
encoding for the commands and responses used by an S-frame
are shown:
Tablc IV
CONTROL field bit eacodin~ (master station): ..
- 5 S-frame forma: ' .. ;
:7:6:5:4:3:2:1:0; - - .
:zz:::01
. . . . . . . :-> Normally set to biauy 1 -. _ . .
. . . . . .-> Commands:
. . . . . .-> H'mary 0 - Rxeive Ready (RR)
. . . . . .-> Hinary 1 - Rexive NoT Ready (RNR) -
. . . . > N(R) . -
> Poll bit (P) . ' a,a.=j,':
- ~';,:.
COTVT'ROL Feld bit tacadi~ (aLve ttatio~; -=~
s~ ...
S-format:
:7:6:5:4;3:2:1:0: ~ w
.....;01
. . . . . . .-:-> Normally set to binary 1 - .
15 ...... ~ .
. . . . . -> Commands: . -
. . . . . - > Binary 0 - Reeeive Ready (RR) . . .
. . . . . .-> Binary 1 - Receive Not Ready (RNR)
. . . . > N(IU .
> Fica! bit (F~ _ _
20 The receive ready (RR) command is used by either w .:
the master or the slave station to indicate that it is ready -
to receive an I-frame and/or acknowledge previously received v - ,
frames by using the receive sequence number. 'If a station --
had previously, indicated~that it was busy by using the
25 receive not ready (RNR) command, the station then uses the
y,.~.,:.
RR command to indicate that it is now free to receive data
(e. g., an I-frame).
As noted, receive not ready (RNR) is used by a
receiving station to indicate a busy condition in response
30 to polling by a master station. This notifies the
CA 02366420 2002-O1-16
WO 95123378 ~ 2 8 PCTlIiS9sl02.t.10
~ transmitting station that the receiving station is unable to
accept I-frames: The RNR command may also be utilized to
acknowledge a previously transmitted frame by using the
receive sequence number.
The commands and responses used by a U-frame are
shown below in Table V:
Table V
CONTROL field eaeoding (muter action)
U-frame foemat:
:7:6:5:4:3:2:1:0: ' ,
.....:11 - -
. . . . . . .-:-> Normally set to binary 3
. . . . . .-> Commands:
- . . . , . -> 0 - Sa lair. Mode (SBv!) . -~:=~ -:,z
. . . . . .-> 1 - Reaa Jnit.- Mode (RiT~
. . . . . .-> 2 - Test Meauge (fM?
. . . . . .-> 3 - ioop Back (LB)
. . . . . -> a - Broadcast (BC)
> pon bit (n . '.
..
CONTROL field eaeodiog (slave station)
U-fonaat y -
:7:6:5:4:3:2:1:0: : . ,..
1::..:11
. . . . . . .-:-> Noimaity set io binary 3
. . . . . .-> Comaunda:
. . . . . -> o - s« mic. Moae (s>a~l~ ;
. . . . . -> 1 - Reset Iait. Mode (RIAfj . - _
. . . . . .-> 2 - Teat Message (T'~ . _
. . . . . .-> 3 - Loop Boer (LB) . ..
> F'mal bit (~
r.. _
The:set initia~ization mode (SIM) is used by a
master or slave station to initialize the master/slave
session (or communication link) . The SIM command puts, the :5~ ~_:. j y_
master and slave stations in the initialization state. Upon _::'
receiving the SIM command, the receiving station clears the
send state variable number V(S) and.the receive state -. .
variable V(R), thus clearing a retransmit buffer (not
r
CA 02366420 2002-O1-16
WO 95123378 2 9 PCTIUS9~1024.10
_.;.;
- ~ shown). The SIM command is used by a station on power-up or
to clear a lock-up condition of the station. The reset
initialization mode (RIM) is used by a master or slave ,
station to sat an information transfer state. This command
also serves as an acknowledgement of the SIM command.
The test message (TM) command is used to test data
- lines. The receiving station responds with a LB command -
which carries (or echoes back) the same data received from ;.
the message frame where the TM command was active. Failure
of a slave station to echo back the same data received in
the message frame causes the master station to identify the ''~':;_=
station as disconnected and the station identity and == '-==~=v
:_.:
location are added to the problem report.
The broadcast (BC) command (bits 2-6) is used by a _
y5 master station to transmit data to all slave stations. The -
master station sends this command while the P bit is set to
a logic zero and the address field of the message frame,
noted above, contains "FF" hex.
The bit encoding for the INFORMATION field of the
20 message frame noted above will now be described. : -
Preferably, the INFORMATION field consists of four fields
which identify the priority level of the message frame, the
station ID, the type of message and data to augment the
message type:
25 ~
PATH/RSP ID:REQ_ID/DATA/O _
The PATH field, shown below in Table VI, may be
four bytes in length and contains routing information and
30 frame transition priority data. The transition priority
data identifies to the CPU the priority level associated
CA 02366420 2002-O1-16
V4'U 95!23378 PCTIUS9SI024-10
~ with the received I-frame. As a result, the system of the --
present~invention_can prioritize incoming message frames so -
as to organize staff responses thereto in order of priority,
as will be described in more detail below. The last byte of
5 this field preferably includes an address expansion bit
which when set to logic one identifies 'that the next 'byte of ~.
data is the station address field which identifies which
slave station is sending the message frame.
Taet~ vI
PATH field bit eaeodiog:
:7:6:5:4:3:2:1:0: ..-
. . . . . . .-:-> Sution Addters
. . . > Priority: binuy 2 - alarm,
binary 1 - eventlcaotrol, _
. . . > binary 0 - da4 type
~ 5 . > Address expansion set to logic 1 = eext byte _ -
is station address
The RSP ID:REQ ID field, shown below in Table VII,
contains response/request tag (ID) data. Upon receiving a --
request message (type bit is set to logic 1), the slave
station sends a specific response message (e.g., an I- y ..,
frame). If there is no specific response, the slave station
sends generic acknowledgement typically in the form of an S-
frame. ~ ~ - -
Table VII .
RSP ffl:REQ_iD field bit eacodip~ - .
25 :7:6:5:4:3:2:1:0:
........ :-_
. . .. . .. :-> respooseJtequeatlD -
- . :..:
. . w':
. . > local master: bitury 1 = local master '
requcsUrespoosc .. ' .
> type: logic 1 = request, logic 0 = response
30 Generally, the DATA field may be 128 bytes in
length and contain application specific data and preferably,
consists of three fields: -
CA 02366420 2002-O1-16
WO 9Sl23378 PCT/tJS95102.t.10
31
-' ~ . LENGTH/DTYPE/TEXT
Where, the LENGTH field, typically 1 byte in
length, contains the size in bytes of the DTYPE and TEXT
_ 5 ..fields; the DTYPE field, typically one byte in length, . .
contains data codes such as the type of message being sent,
y e.g., code blue; and the TEXT field which may be 126 bytes
in length, contains application specific data, e.g., message
data associated with a particular function or station status
data, which is utilized to augment the DTYPE field by '
identifying a textual message associated with the particular -.
,:~_ =- ~r.
function identified in the DTYPE field. For example, if the "~'~'"
DTYPE field identifies a "code blue" code, the TEXT field "
will include the text which should be'displayed on other v- w
15 stations, such as the staff station. w
In the event of a failure within the CPU 2412, the -.
system of the present invention also provides a fail safe
feature which is activated upon detection by the nurse
control stations 2414, the patient stations 2416 and/or
20 staff'stations 2418. An exemplary embodiment of the
.configuration for fail safe operation is shown in Fig. 7.
In this configuration, fail safe bus (FSa) 3020 is connected
- between .each patient station 2416, each corresponding staff . '
station 2418 and zone indicator assembly 3022. If a failure
~ occurs in.the CPU 2412, each patient station 2416 and
a:_ _
corresponding staff station 2418 will fail to receive a
polling signal from their corresponding zone controllers. _.
As a result, each station will operate in a local mode'
utilizing the fail safe bus. When in the local mode,
30 activation of any of the functions which have access to the
fail safe bus will cause a response at a particular patient
. station, the staff stations and at the zone indicator
assembly connected to the group, to allow staff members in
CA 02366420 2002-O1-16
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32
.., . .
- ~ the vicinity of the station utilizing the fail safe bus to .
respond.
An operational flow associated with the above
described exemplary fail safe feature will be described with
reference to Figs. 7-9. As noted, upon failure of the CPU
2412, the stations associated with the system of the present
invention operate in the local mode. In response to _:
activation of a fail safe device (e.g., the nurse call ~_
button 3250, the code blue switch 3234 or the emergency
switch 3232) the system first determines whether the cause
of the fail safe was from the activation of nurse call
button 3250 of patient-control unit 3210 (shown in Fig. 9)
(steps 3110 and 3120) . Nurse call button 3250, code blue -''t;':'v
switch 3234 and/or emergency switch 3232 are connected to
patient station 2416 and provide either a general indication
to staff members that the patient needs assistance or an
emergency indication relating to the patients immediate .
health condition. Nurse call button 3250 allows the patient w
to indicate the need for general assistance, whereas, -code .
blue switch 3234 and emergency switch 3232 allow staff
members to activate the appropriate staff response to the
patient s health condition. For example, if the patient is
experiencing a heart attack a staff member would activate
the code blue switch. .
~5 If the cause o~ the fail safe was due to the
activation of nurse call button 3250, the patient station
responds by activating nurse call indicator 3222 of
indicator assembly 3220 associated with that particular w_.
patient station and by displaying a "nurse call" massage on
patient station display 3230 (step 3122). Next, the staff
stations 2418 (shown in Fig. 1) associated with the group of
patient stations 2416 respond by displaying a "nurse call" -
message on staff station display 2422 (step 3124). Zone
CA 02366420 2002-O1-16
V~'O 95!23378 PCT/I3S95/02.1a0
33
~ indicator assembly (ZIP), 3022 activates the nurse call
indicator of zone indicator 3024 (e. g., indicators i through
8, shown in Fig. 7) associated with the particular group of ,--
patient stations (step 3126). For example, if the nurse
call button is activated by a patient station associated
with group 1, the nurse call indicator of the group 1 zone y
indicator 3024 associated with zone indicator assembly 3022
will be activated. Manual reset of the patient station by a ~ .
staff member responding to the call returns the FSB and the
1p patient stations to the idle local mode (step 3128).
If the cause of the fail safe was not from the
. . i. ~',:-'.
activation of the nurse call button, the fail safe system
then determines if the fail safe was caused by the
activation of emergency switch 3232 (step 3130). If fail
safe operation was caused by the activation of emergency
switch 3232, patient station 2416 responds by activating the
emergency indicator associated With that patient station and ~,~.
by displaying an "emergency" message on patient station
display 3230 (step 3132). Preferably, the emergency
indicator is the same indicator as nurse.call indicator " '
3222. However, activation of indicator 3222 in the
emergency mode results in a blink light at a predetermined
. rate in pulses per minutes (PPM) as illustrated in the table ...y
of Fig. 19. Whereas, activation of indicator.3222 in the
nurse call mode results ~n a steady lamp intensity. Second, v.
staff station or stations 2418 associated with the subject
patient station, displays an "emergency" message on staff _
station display 2422, shown in Fig. 1 (step 3134). Next, .
zone indicator assembly 3022 activates the emergency
indicator of zone indicator 3024 associated with the group '
with which the particular patient station belongs (step
3136). Staff members responding to the emergency call, _
r
CA 02366420 2002-O1-16
WO 95123378 PCTlU59;/02-1.t0
34
' ~ manually reset emergency switch 3232 (step 3138), thus .
returning the fail safe system to the idle local mode. . -
If, on the other hand, the cause of the fail safe
was not from the activation of an emergency switch; then,
S according to this exemplary embodiment, the fail safe '- ..
operation was activated by code blue switch 3234. The
patient station responds to the code blue call by activating
code blue indicator 3228 associated with patient station
2416 to which the code blue switch is operatively connected,
p and by displaying a "code blue" message on patient station
display 3230 (step 3140). Secondly, staff station or
stations 2418 associated with the group of patient stations "'~''-
2416, displays a "code blue" message on station display 2422
(step 3142). Zone indicator assembly 3022 also activates
the code blue indicator associated with the subject patient
station group number (step 3144). Manual reset of code blue
switch 3234 by the responding staff members returns the fail v
safe bus to the idle local mode (step 3146).
20 NURSE CONTROL STATION
The nurse control portion of the present invention -
will now be described with reference to Fags. 9 and 10.
- Fig. 9 illustrates a system configuration in which
- peripheral equipment is connected to patient station 2416
25 and in which nurse control station 2414 includes main
processor 3270, keyboard 3236 and nurse control station
display 3272. Nurse control station display 3272 can'~be
user programmed to perform functions, such as initiating a
code blue operational sequence, either through keyboard 3236
30 or direct select keys 3274. The direct select keys 3274
allow staff members to select specific functions in response
to menu driven prompts. _
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ii'O 95123378 ~ 3 5 PCT/US9i102440
- ~ Fig. 10 is a block diagram which illustrates
hardware components for nurse control station 2414. Nurse
control station 2414 includes main processor circuitry 3310,
keyboard circuitry 3312 and display circuitry 3314. Main
processor circuitry 3310 includes microprocessor 3316, such
as the 16 bit model 286 microprocessor manufactured by Chips :.
& Technology, Inc., 2 Mbytes of memory 3318 having stared ~w
programs (e.g., system and application programs) and
communication interface 33:20 connected to communication
0 parts 3322.
Preferably, communication interface 3320 and
.: -_;
communication ports 3322 are provided to facilitate data
communication between zone controller 2420, CPU 2412 and the .
nurse control station 2414. As noted above, the preferred ~,.
~5 communication protocol includes the RS-485 serial
communication protocol. Accordingly, communication
interface 3320 is configured to accommodate RS-485
communication utilizing RS-485 drivers/receivers which are w
known in the art.
20 Keyboard circuitry 3312 includes microcontroller ._
3324, such as model 8052 manufactured by Intel, which
includes internal memory having, preferably, 4 Kbytes of ROM ~ _-
and 256 bytes of RAM, keypad interface 3326 which is
. connected to keys 3328 and facilitates communication between
25 a staff member and the nurse control station. Communication
~ _.;.::-
interface 3330 and communication port 3332 are provided as a
data communication link to main processor circuitry 3310.
As noted, the preferred communication protocol includes the
RS-485 serial communication protocol. Accordingly, w .
30 communication interface 3330 is configured to accommodate .-
RS-485 communication utilizing RS-485 driversjreceivers ..
which are known in the art.
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3fi.
._, :;:. -_; -
~ Keyboard 3236 .(shown in Fig. 9) includes speaker '
3338, handset 3340 and microphone 3342 which facilitate __
audio communication between nurse control station 2414,
patient stations 2416 and/or staff stations 2418, via audio
controller 3344. The audio circuit portion 3410 of nurse
control station 2414 will now be described with reference to
Fig. 11, which illustrates the hardware configuration for _
the audio portion of the keyboard. As shown, audio pair ..
3412 from main processor 3270 of nurse control station 2414 -w
(shown in Fig. 9) is connected to the front end of audio
controller 3344. Preferably, the front end of audio ~~
i '.. f :.:
~.~=y ao_ t.:
controller 3344 includes a coupled 600 vhm balanced .v:=:,
transformer 3414 which isolates the internal audio circuitry %w
of nurse control station 2414 from the external audio w
circuits. Depending upon whether the audio signal is being
received or transmitted, the back end of audio controller
3344 either directs the audio signal to keyboard speaker
3338 or to handset 3340, or directs the audio signal from ..
microphone 3342 to transformer 3414. .
Preferably, audio controller 3344 is a 341.18 audio ~_ _'
controller manufactured by Motorola. Audio input signals
from main processor 3270 of nurse control station 2414, w
which pass through the audio controller are darected to
keyboard speaker 3338 via amplifier 3416 or to handset 3340
via relay controller 341'$ controlled by microcontroller 3324 w
(shown in Fig. 10). Audio generated by the nurse control
station via microphone 3342 or handset 3340 is trans~rred .
through relay controller 3418 to audio controller 3344 and
onto the audio pair as shown. The audio pair from keyboard
circuitry 3312 is directed to the equipment panel via main
processor circuitry 3310, as shown in Fig. 10. ..
Display circuitry 3314 includes microprocessor
3346, such as model 8051 manufactured by Intel, memory 3348 ' w
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..;
~ having stored programs (e.g., system and application _
programs), video controller 3350 which is connected to nurse - ..
control station display 3272 and'facilitates the display of
the visual communication signals. Select key interface 3352 ~_
is connected to direct select keys 3274 and is provided to
identify to microprocessor 3346 which direct select key 3274
has been depressed. Communication interface 3354 and .
communication port 3356 are provided as a data communication
link to main processor circuitry 3310. As noted, the ~ .
preferred communication protocol includes the RS-485 serial
communication grotocol. Accordingly, communication
_J..~',
interface 3354 is configured to accommodate RS-485 ~ ~~~r"_
communication utilizing RS-485 drivers/receivers which are -
known in the art.
PATIENT STATION
The patient station portion of the present .y -
invention will now be described with reference to Figs. 4, 9
and 12, 13, 14A and 14B. Turning initially to Fig. 9,
2p patient station 2416 is a microprocessor controlled - .
interface between CPU 2412, the patient bedside equipment -
and peripheral equipment. The communication link between
- CPU 2412 and the bedside or peripheral equipment is via the ~..w
master/slave communication link described above. Examples -
of the patient bedside equipment include heart monitors,
respirators, pulse oxymeters or I.V. pumps which include
data communication ports to serially transmit data.
Examples of peripheral equipment include gatient control =
unit 3210, staff presence switch 3254, indicator assembly w
3220, code blue switch 3234, emergency code switch 3232 -
and/or a smoke detector (not shown). Staff presence switch
3254 is preferably located by the door of the patient rooms
and is provided to activate indicator 3220 and to cause
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«'O 95!23378 PCT/US9~102.t.1(1
38
- ~ patient station 2416 to send a message frame to CPU 2412 .
indicating the particular type of staff member who is .~
present in the patient's room, as will be described in more
detail below. In addition, patient station 2416 may be
operatively connected to a side-rail communication system '.
(not shown) installed in a side-rail of the patient's bed, ; _
as well as bed sensors which sense whether the patient is in ; w
the bed. Side-rail communication system may be connected to .. ..
the audio output ports 3624, shown in Fig. 13, to facilitate _
audio communication at the side-rail. ; _ ,
Fig. 12 is a circuit block diagram for the patient
station circuitry 3510 installed within patient station .
2416. The patient station circuitry 3510 includes
microprocessor 3512, such as model 64180 manufactured by
~5 Motorola operating at a frequency of 12.888 MHz. via crystal ~'
3514, 96 Kbytes of memory 3516 (e.g., 64 Kbytes of flash ROM __~ w
and 32 Kbytes of RAM) having stored programs, e.g., system
and application programs. In this exemplary configuration,
the data and address buses of the microprocessor are . ..-_
2p connected to memory, e.g., RAM 3518 and an EPROM 3520. _ ._.
Memory decoder 3522 is utilized to select between RAM 3518 . -
and EPROM 3520 in response to a particular address on the , .-
- address bus. The address bus is also connected to a pair of _.
latches 3524 and 3526 which interface the microprocessor to
25 status indicators, the fail safe bus (FSB), the audio
control circuitry, and to switches and other peripheral
equipment connected to the patient station, as shown:' In .
addition, I/O decoder 3528 is utilized to select between w
either latch in response to a particular address on the
30 address bus. Incoming signals from the above noted -.
peripheral equipment are received by buffer 3530 and then
transferred to the data-bus upon being enabled by I/O
decoder 3528.
r
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.J
- 1 Utilizing the preferred micraprocessor 3512 (i.e., ' ',
the Motorola 64180), serial communication. between the zone
controller 2420 and microprocessor 3512 or between the .
bedside equipment and microprocessor 3512, may be
accomplished through either one of two asynchronous serial
' communication ports 3532 and 3534 which are, preferably,
configured to RS-485 protocol utilizing RS-485 ' -.
driver/receivers (RS-485 D/R) 3536 and 3538 as shown.
Fig. 13 is a circuit block diagram for the audio
portion 3610 of patient station 2416. As shown, audio pair
3612 from an equipment panel (e. g., audio matrix 2510 shown
i~Jr'~ ~i'Y~~;
in Fig. 2) is connected to the front end of audio controller w''
3614. Preferably, the front end of audio controller 3614
- ,_-..
.:~ ::
includes a coupled 600 ohm balanced transformer 3616 which
isolates the internal audio circuitry of patient station
2416 from the external audio circuits. Depending upon
whether the audio signal is being received or transmitted, _
the back end of audio controller 3614 either directs the
audio signal to patient station speaker 3618 or to an v
external audio speaker, such as speaker 3252 of patient
control unit 3210, shown in Fig. 9, or directs the audio w
signal from microphone 3620 to transformer 3616. . -
- Preferably, audio controller 3614 is a 34118 audio _ _,
controller manufactured by Motorola. Audio input signals
from audio matrix 2510 i~hich pass through the audio
:v l:r
controller are directed to patient station speaker 3618 via
amplifier 3622 and/or to audio outgut parts 3624 via'
amplifier 3626 and relay controller 3628. Audio signals ..y
generated by the patient station via microphone 3620 are
selectively transferred through audio controller 3614 onto
the audio pair as shown. Mute switch 3630 may be provided
to allow a staff member to manually short out the microphone v
so as to prevent audio signals from being generated at the
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patient station. In addition, the audio circuitry for the
patient~station may include input audio ports 3632 which -
facilitate a connection between 'external entertainment
equipment, such as a television or a radio, and audio output
5 ports 3624 via relay switch 3628. To illustrate, audio -. w
signals from a television iri the patient's room can be
directed from patient station 2416 to speaker 3252 in
patient control unit 3210 (shown in Fig. 9) to bring the -
audio from the television closer to the patient.
Referring again to Fig. 9, each patient station
2416 may be coupled to external peripheral equipment, such --
:a-. r.
as controllers, indicators and/or switches, which provide
medical instrument data and/or patient status data to staff
members and which facilitate patient control of w
~5 environmental facilities within the patient's room, as will
be described below. Figs. 14a and 14b represent an
exemplary operational flow-chart of the interaction between
the patient station and the bedside equipment and between
the patient station and the CPU so as to facilitate -
communication between the bedside equipment and the CPU. - -
Initially, the patient station monitors the inputs from the
external peripheral equipment (e.g., switches) to determine -- -
if the equipment has been activated (steps 37,3.0 and 3720). --
If a switch or other peripheral equipment is activated, a - .
25 message frame associated with the activated switch will be - -
a.: :~_:__
stored in the memory of patient station circuitry 3510, ;._._:;::_:
shown in Fig. 12 (step 3722) and transferred to zone' .
controller 2420. If, on the other hand, a switch has not --.
been activated then the patient station will poll the
30 bedside equipment via serial port 3534 (shown in Fig. 12) w
for status or message information and interpolate field
parameters onto the received message (step 3724 and 3726).
The message frame is then stored in patient station memory
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4~
~ 3516 (shown in Fig. 12) and remains therein until the _
patient station 2416 is polled by the zone controller 2420
corresponding to the patient station (steps 3728, 3730 and
3732). ,
Once polled, the patient station transfers the
message frame to the S-RAM 2512 (shown in Fig. 2) of the
zone controller until the last byte of the frame has been ..
transferred (i:e., the F bit is set to logic 1) (steps 3734 .
and 3736). The zone controller then determines if the
message frame, received is an S-frame or an I-frame, and if
the message frame is an S-frame the zone controller .
~. ~.-__
acknowledges the message frame and the patient station
returns to monitor the switch inputs (steps 3738 and 3740). '~~'°
If the received message frame is an I=frame the frame ,is --. , y
~5 transferred to the CPU which determines whether a response w
to the transmitting station is required (steps 3742, 3744 - w
and 3746). If no response is required the CPU stores the w
received data and the patient station returns to monitor the
switch inputs, as shown. If, however; a response is
0 required a response message frame is sent to the zone
controller and stored in the S-RAM (step 3748). The zone . -.-
evntroller polls the patient station and if a received ready
- (RR) command is received in return, the response message
. frame is transferred to and stored in the patient station
25 (steps 3750 and 3752). ~
Once the response message frame is received the
patient station performs the task associated with the'' ~,,
information in the frame (step 3754). In addition to , ..
sending a response message to the patient station, the CPU
30 may also be required to send a message frame to the nurse
control station to alert staff members of potential faults
either through tone and visual indications similar to those
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CVO 95123378 ~ 2 PCTlUS95/02~.1(O
- ~ illustrated in Fig. 18 or by adding the information to the -
problem report described above (step 3756).
Referring again to Fig. 9, in the preferred
embodiment, patient station 2416 is connected to patient .
control unit 3210 via data link 3246 . Patient control unit ~~
3210 includes control buttons 3248 which facilitate patient
control of the environmental facilities within the patient's . .v
room, via patient station 2416 and CPU 2412. Such
environmental facilities include, for example, the
television, radio, draperies and the room lighting.
Nurse call button 3250 is provided to enable the
_=zr ::
patient to call the nurse control station or stations within
the group. As noted above, the communication between
stations is facilitated by CPU 2412 utilizing the .
~5 master/slave communication link described above.
Fig. 15 illustrates an exemplary operational flow
for the patient control unit 3210 in combination with
patient station 2416. Upon activation of nurse call button ,-.~ ..
3250 of patient control unit 3210 (shown in Fig. 9), patient
station 2416 receives the switch activation data via data
,link 3246 and buffers 3530 (shown in Fig. 12). - ~ .
Microprocessor 3512 then interpolates field data onto the .
- received message to farm a message frame, as described -
above, and stores the message frame in RAM 3518 (step 3810).
Once stored i~'i memory, the nurse call data remains
:.,,~.>>.
therein until the patient station is polled by the zone
controller (step 3820). Once polled, the message frame is ~=w~'~
then transferred to the zone controller and stored in the S-
RAM (step 3830). The data remains in the S-RAM until the S- '.
RAM is polled by CPU 2412, upon which, the message frame is
then transferred to the CPU (step 3840).
Reception of the message frame in the CPU causes -
the CPU to begin the station task identified in the
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W0 95123378 . 4 3 PCT/US9s/02a40
1 TNFORMATION field of the I-frame (step 3850), to determine ~',-
the message received from the patient station and provide an
appropriate response thereto (steps 3860 and 3870). For -~-
this example, CPU 2412 is responding to the activation of
;. 5 nurse call button 3250 of patient control unit 3210. The
initial response to the activation of the nurse control y
-_ button is to return a message frame to the patient station
to activate nurse call indicator 3222 of indicator assembly '
3220 (shown in Fig. 9). In addition, the CPU prioritizes
~0 the message frame utilizing the transition priority data of
the PATH field and then sends to the nurse control station
. ~._;
or stations connected in the group associated with the
patient station, a message frame including tone and display
data identifying the patient and the associated room number
15 (steps 3880 and 3890). At this point, the station task is
completed and the CPU returns to the listen task. Manual ,
reset of the patient station by a responding staff member :.. -.
deactivates indicator 3222 and clears the message from the
nurse control station display. -
20 Referring once again to Fig. 9 patient station w'w y
2416 may also be connected to staff presence switch 3254,
indicator assembly 3220, code blue switch 3234 and/or
- emergency code switch 3232. In the configurat-ion shown, .y-
staff presence switch 3254 is connected to patient station _ _-.-.
25 2416 via data link 3256'and when properly activated provides ~.:_
~~.~.-..~ .
patient station 2416 with a signal indicative of the type of
staff member present in the patient's room. Once activated, . __
a message frame (e.g., an I-frame) is transferred to the CPU
and an appropriate response is returned to that particular
30 patient station, in a manner described above.
The responding frame from the CPU 2412 includes
information to cause the activation of an indicator in
indicator assembly 3220 which corresponds with the type of
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44
1 staff member in the patient's room. To illustrate, if the
staff member entering the patient room is a registered nurse
(RN), that person would activate switch 3258 which in turn
would activate indicator 3224 of ind'lcator assembly 3220 via
patient station 2416 and CPU 2412. If the staff member
entering the room is a licensed practical nurse (LPN), that
person would activate switch 3260 of staff presence switch
3254, Which in turn would activate indicator 3226 of
indicator assembly 3220 via patient station 2416 and CPU
2412. If, on the other hand, the staff member entering the -
room is an aide, then that person would activate switch 3262
of staff presence switch 3254, which in turn would activate
indicator 3228 of indicator assembly 3220. When the staff
member leaves the patient's room, the particular staff ..,._
member switch is deactivated so as to deactivate indicator
assembly 3220. _-
In the preferred embodiment, indicator assembly
3220 is a four lamp light fixture (e. g., a dome lamp) having
colored lenses associated with each lamp. The fixture is w
secured or otherwise positioned on the wall outside the . _
patient's room, preferably above the doorway, to allow staff _-- _
members in the hallway to simply look at each indicator -
assembly and determine the type of staff member in a
particular patient's room, if any. Alternatively, the
indicator assembly may 1~ any known type sufficient to
provide staff members with an indication as to the type of
staff member in a patient's room, for example, the indicator .'
may be a LCD display which identifies the type and the name
of the staff member in the patient's room in response to
information provided to the system by the above described
staff locator system, described in more detail in commonly -
assigned U.S. Application Serial No. 07/924,101, filed
August 3, 1992, which is a continuation-in-part of copending
CA 02366420 2002-O1-16
~5
U.S. Patent 5,291,399.
Code blue: switch 3234 and emergency code switch
3232 are connected to patient station 2416 via data links
3264 and 3266, respectively, as shown in Fig. 9, and are
provided to allow staff members to initiate code blue or
emergency responses directly from the patient s room. As
noted above, code blue.and/or emergency code procedures may
also be initiated from nurse control station 2414.
Initiation of the code blue response procedure at a patient
station 2416 will result in the following occurrences.
Initially the code blue data signal received from the code
blue switch is stored in the patient station memory as a
message frame, in a manner described above. The
microprocessor 3512 (shown in Fig. 12) in the patient
station 2416 then waits to be polled from the zone
controller 2420 before transferring the data to the zone
controller. Once palled by. zone controller 2420 the message
20 frame is transmitted.to the zone controller and stared in
the S-RAM 2512 until the S-RAM is polled by CPU 2412. Once
the message frame is received within the CPU the message
. frame is prioritized and the station task associated with
'_ the data within the INFORMATION field of the message frame
25 ' is initiated. '
An example of a station task performed by the CPU
in response to the activation of a code blue switch will be
described below. Initially CPU 2412 determines the message
type received from zone controller 2420. Next the CPU
30 performs Whatever function is associated with the message,
in this example the message relates to the code blue
function. In response to the code blue function, the CPU
' 2412 sends to the particular patient station an I-frame
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which includes data to cause activation of particular
peripheral equipment as well as devices within the patient
station 2416, e.g., a tone code and an indicator assembly
activation code. Next CPU 2412 determines which staff
station or stations 2418 and which nurse control station or -~ : :.
stations 2414 are grouped with the subject patient station
2416. Thereafter, CPU 2412 sends to each associated staff
station an I-frame including message data to display "code -.
blue" on staff station display 2422 of staff station 2418. -.-
Next CPU 2412 sends a message to the ZIA 3022, shown in Fig.
7, to activate the proper indicator associated with the
patient station group -in a manner similar to that described
above with reference to fail safe bus 3020.
The CPU 2412 then sends an I-frame to each nurse
~5 control station grouped with the patient station to display - -.
the room number and identity of the patient subject to the -
code blue function, on the display of the nurse control - -,
station. The CPU 2412 then sends to the nurse control '
station an I-frame including appropriate control signals
20 associated with the patient station message. Once the above
steps are accomplished the station task is completed and the
CPU 2412 returns to the listen task.
The system of the present invention.may also be :.-
configured to monitor medical equipment being used to treat
25 the patient (i.e., bedsi'~e equipment). Such bedside -
~.> ~_.:'..-,
equipment may be connected to communication port 3534 (shown
in Fig. 12) of patient station 2416. In instances where the
serial data from the bedside equipment is not configured for --
RS-485 protocol, serial data converter 2520 (shown in Fig.
30 2) may be interconnected between serial port 3854 of patient
station 2416 and the serial: port of the bedside equipment.
Typically, the serial port of the bedside equipment is -
configured to pperate with RS-232 protocol, thus, serial
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WO 95123378 PCTNS9;/02.1.10
~ data,converter 2520 would be an RS-485 to RS-232 converter '--.
which is known in the art.
Examples of the above'described bedside equipment --
are shown in Figs. 9. As shown, a heart rate monitor 3280 w
is connected to patient station 2416 via data link 3282,
which as noted above is operatively connected to nurse ~.:-_,
control station 2414 via zone controller 2420 and CPU 2412.
The patient station (acting as a master station) polls heart _.
rate monitor 3280 (operating as a slave station) to verify
that the patients heart rate falls within the proper range -;
as determined by the monitor. The zone controller
periodically polls patient station 2416, as described above ;~--r'---_,_
for an S-frame or an I-frame message frame. Typically with
respect to this example, if no fault is detected the patient ~- _
station will respond to the polling of the zone controller ,_~ .
with an S-frame indicating proper operation of heart rate
monitor 3280. However, a fault detected in monitor 3280 -w
will be stored in RAM 3518 of patient station circuitry 3510
(shown in Fig. 12) along with the appropriate field data in .
20 the form of an I-frame, and the I-frame is transferred to __ -,
zone controller 2420 and CPU 2412 in a manner described
above. The CPU then analyzes the I-frame and an appropriate -.~-"
- alarm sequence is initiated to notify staff members at nurse
control station 2414 of the detected fault.
25 As another ex~nple, an intravenous (IV) pump 3284
is connected to patient station 2416 via data link 3286,
which as noted above is operatively connected to nurse
control station 2414, via zone controller 2420 and CPU 2412. w .
In this example, the IV pump is periodically monitored by
30 patient station 2416 to ensure the flow rate of the pump is
appropriate. If a failure is detected, a message frame
including the error message is transferred to CPU 2412 in a .
manner set forth above. The CPU the initiates an
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48
1 appropriate alarm sequence, such as displaying a message on
the monitor of nurse control station 2414, that the IV
container is empty and needs to be changed. It should be
noted, that numerous other types of bedside equipment may be
monitored by the system of the present invention, including - --.-
respirators and heart monitors. '.-;
Transmitter 3290 is hardwired to the bedside -
equipment, e.g., heart rate monitor 3280, and is provided to .
enable a central computer system to determine what room or .v
other area of the health care facility the bedside equipment
is located and to transmit operation data generated by the -
bedside equipment, such as status data or other data-
associated with the operation of the equipment. In this
configuration, transmitter 3290 transmits an identification w
signal and the operation data to an IR transceiver which is
in communication with the central computer through a network
server as described in Application Serial No. 07/924,101. -
The central computer determines which transceiver received
the identification signal of the bedside equipment and
transfers the location data of the equipment and the
operation data to CPU 2412 via data link 2728 (shown in Fig.
4). Transmitter 3290 may be a radio frequency transmitter --
operating at a frequency of approximately 300~MHz, which are _
available from Dallas Semiconductor, Inc.
- ~ . .-.
STAFF STATION .
Referring again to Fig. 1, staff station 248 is
similar in design to patient station 2416. In the preferred
embodiment, staff station 2418 may be configured, in the
initial system configuration setup, to operate in a "duty"
mode or a "staff" mode. In the "duty" mode staff station
2418 provides patient call indications on staff station
display 2422, as well as facilitating communication with
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- 1 nurse control station 2414. In the "staff" mode staff ;.
station 2418 facilitates communication with nurse control w
station 2414.
Fig. 16 illustrates hardware configurations for .
the staff station circuitry 3910 installed within staff
- station 2418. The staff station circuitry 3910 includes w --
'_ microprocessor 3912, such as model 64180 manufactured by
Motorola operating at a frequency of 12.888 MHz. via crystal
3914, 96 Kbytes of memory 3916 (e.g., 64 Kbytes of flash ROM
and 32 Kbytes of RAM) having stored programs, e.g., system
and application programs. In this exemplary configuration,
the data and address buses of the microprocessor are - ~~_'
:.=-y=:':
connected to the memory, e.g., RAM 3918 and an EPROM 3920. =="~-'
'--<;.-..
Memory decoder 3922 is utilized to select between RAM 3918
and EPROM 3920 in response to a particular address on the
address bus. The address bus is also connected to a pair of
latches 3924 and 3926 which interface the microprocessor to -.~.-_
status indicators, the fail safe bus (FSB), the audio v
control circuitry, and to switches and other peripheral
equipment connected to the staff station, as shown. In -
addition, I/O decoder 3928 is utilized to select between
either latch in response to a particular address on the
- address bus. Incoming signals from the above-noted
- peripheral equipment are received by buffer 3930 and then
transferred to the data'=bus upon being enabled by I/O
decoder 3928.
Utilizing the preferred microprocessor (i.~'., the
Motorola 64180), serial communication between the zone
controller and the microprocessor may be accomplished
through asynchronous serial communication port 3932 which
is, preferably, configured to RS-485 protocol utilizing RS-
- 485 driver/receiver (RS-485 D/R) 3934 as shown.
r
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Fig. 17 illustrates hardware configurations for
the audio portion 4010 of staff station 2418. As shown,
audio pair 4012 from an equipment panel (e. g., audio matrix
2510 shown in Fig. 2) is connected to the front end of audio
,~ controller 4014. Preferably, the front end of audio
controller 4014 includes a coupled 600 ohm balanced
transformer 4016 which isolates the internal audio circuitry ' ~.~-
of staff station 2418 from the external audio circuits. - .
Depending upon whether the audio signal is being received or
transmitted, the back end of audio controller 4014 directs
the audio signal to staff station speaker 4018 or directs
the audio signal from microphone 4020 to audio matrix 2510
via audio controller 4014
Preferably, audio controller 4014 is a 34118 audio
~5 controller manufactured by Motorola. Audio input signals w
from audio matrix 2510 which pass through the audio ~~.
controller are directed to staff station speaker 4018 via . __
amplifier 4022. Audio generated by the staff station via
microphone 4020 is selectively transferred through audio
20 controller 4014 onto the audio pair as shown. Mute switch ,;
4024 may be provided to allow a staff member to manually ~ w
short out the microphone so'as to prevent audio signal from ~, -
. being generated at the patient station. ,. '
. SYSTEM FUNCTIONS : ._
25 The-patient cafe and communication system of the
present invention may be programmed to perform numerous
operations associated with patient care and communica'~~ions
within a hospital or other health care facility. The
following functions are exemplary of the numerous types of
30 features and the functional flow (or data exchange) between
the different stations, the CPU and the zone controller
utilize the above described preferred master/slave
communication link.
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51
_ ~ a. Call Priority
Message frames usually in the farm of an I-frame ~ .
originated by a nurse control station, a patient station
and/or a staff station are interpreted by CPU 2412 and
assigned a priority level based upon the type of message y .,
frame received (i.e., the DTYPE field of the INFORMATION
field contains the message type which corresponds to the . -_
priority level that Grill be assigned to the frame). In
addition, the message associated with the TEXT field of the
message frame is displayed on nurse control station display
3272 of a nurse control station 2414 in order of priority
level. The priority levels are preprogrammed during the
initial set-up of the system configuration, but may be v
altered by staff members at nurse control station 2414 via .
keyboard 3236 or direct select keys 3274 (shown i:n Fig. 9).
The highest priority call will be displayed first and other
calls will follow in descending order according to the ~,.
priority level.
Preferably, each, call originated has specific ~ ,_
audible and visual signaling based an the call priority
level which are distributed to the necessary nurse control _ _.
- stations, zone indicator assembly, gatient stations and/or
_ staff stations via CPU 2412 and their respective zone
_ controller. Figs. 18-20 represent tables illustrating
exemplary embodiments of~call priority levels, their
_: v_. ,:
associated visual and tone indications which are generated
at either the nurse control station, the patient station ~y',
and/or the staff station. Fig. 18 illustrates the preferred -
visual display which appear on nurse control station display
3272 and the tones generated at speaker 3238 (shown in Fig.
in response to the various priority levels. For example,
in response to the activation of code blue switch 3234 . .
(shown in Fig. 9) CPU 2412'will transmit to nurse control
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1 station 2414 a message frame instructing the nurse control ,
station to display on the nurse control station display 3272
a flashing arrow directed at a direct select key 3274 to _.
indicate which key will enable~the staff member to connect .
the audio of the nurse control station to the audio of the '. _
patient station and respond to the call. The arrow will w '
flash at a rate of approximately 120 pulses per minute' '
(PPM). In addition, the room number and bed number --
associated with the patient station to which the code blue
switch is connected and the "CODE BLUE" message will be w
displayed on nurse control station display 3272. An audible
tone at the rate of 120 PPM will also be generated at
speaker 3238 of nurse control station 2414. c-~~t=-:°;r
The preferred response at patient station 2416, -
shown in Fig. l9, to the activation of the code blue switch - -
will be to pulse a station call and bed call placement LED
indicators (not shown), which may be positioned on the front
panel of patient station 2416, at a rate of 120 PPM, and to
pulse a code blue indicator of the corresponding group
indicator assembly 3024 via ZIA 3022 (shown in Fig. 7) at a ~...'_w
rate of 120 PPM.
The preferred response at staff station 2418, r .
shown in Fig. 20, to the activation of the coc'~e blue switch
. will be to pulse an incoming call LED indicator which may be
positioned on the front panel of staff station 2418, at a
rate of 120 PPM, to display on staff station display 2422
(shown in Fig. 1) the room and bed number associated c~ith
the patient station to which code blue switch 3234 is
connected and to display the "CODE BLUE" message; to pulse a
blue indicator of the corresponding group indicator assembly
3024 via ZIA 3022, at a rateaf 120 PPM; and to generate an .
audible tone at the rate of 120 PPM at speaker 4018 of staff _
station 2418 (shown in Fig. 1).
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53
- ~ b. Nurse Follow , w'
The nurse follow feature allows a staff member to
selectively direct incoming calls to a particular nurse
control station to selected patient stations and/or staff
,5 stations. To illustrate, this feature may allow the staff
member to program the nurse control station to distribute ~ -_
_ incoming calls to a single patient station, to patient
stations where particular staff members have activated
respective staff presence switches (e.g., switch 3254, shown w
in Fig. 9) and/or to all patient or staff stations assigned
to the group associated with the particular nurse control
station. Thus, when a staff member is required to leave the
-=
area of a nurse control station, incoming calls to the nurse
control station can be routed to locations where appropriate
j5 staff members can respond to the call.
In operation, a staff member attending nurse
control station 2414 may utilize direct select keys 3274
(show in Fig: 9) in response to menu driven prompts to .
configure the system to operate in the nurse follow mode.
In the nurse follow mode, calls which are directed to'the w -w
nurse control station 2414 via CPU 2412 and corresponding ~ ~ ,
zone controllers 2420 will automatically be routed to the
- station or stations selected by the staff members or to
stations in locations where that staff member or other staff
25 members are determined ~o be present by staff locator system
2428 (shown in Fig. 4 and described in U.S. Application
Serial No. 07/924,101). __.
For example, if the staff member selects the nurse ~,
follow feature which routes incoming calls to patient
30 stations where the RN switch 3258 of staff presence switch
3254 (shown in Fig. 9) has'been activated, CPU 2412 will
direct the incoming call to the nurse control station to any
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54
- ~ room in the group where switch 3258 of staff presence switch .-
3254 has been activated.
As another example, CPU 2412 of the patient care
and communication system interacts with the central computer
system of staff locator system 2428, shown in Fig. 4. In y. -
this configuration, the identification badges are in
communication with the central computer system in a manner
described in Application Serial No. 07/924,101, which is
incorporated herein by reference. In particular, Figs. 4
and 17c of that application, show the identification badge
1111, which is worn by the staff member, continually
transmits the identification signal (of the staff member)
and the central computer system continually monitors the y ,
identification signal to update the location of the badge . ,
(and the staff member). The location information of the
staff member is transferred to CPU 2412 via data link 2726
(shown in Fig. 4) which may be any known type of
communication link utilized to facilitate communication
between computer systems. Therefore, when a call is
directed to a nurse control station 2414 programmed to -.:
operate in the nurse follow mode, CPU 2412 will route the
incoming call to a station '(either 2416 or 2418) positioned
- nearest the detected location of the staff member. In an
- alternative embodiment, a staff member attending the nurse -
control station may want~to route incoming calls to _
locations of other staff members. In this embodiment, the
nurse control station can be programmed in the nurse ~'ollow
mode to route the incoming calls intended for nurse control - -
station 2414, to stations where the othex staff members have
been detected by the staff locator system.
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- ~ ~ c. Voice Paging
The voice page feature allows staff members to
communicate to selected patient and/or staff stations from
the nurse control station. To illustrate, this feature
allows a staff member to communicate to all staff members - -
who have activated staff presence switches associated with
the nurse control station (i.e., within the same group) and
all staff members in areas where staff stations are located.
Fig. 21 illustrates an exemplary operational flow for the
voice paging feature of the present invention. initially,
the staff member desiring to page all staff members within
;,,:'.
the assigned group, programs nurse control station 2414 via
direct select keys 3274 (shown in Fig. 9) which activate
menu driven functions (step 4410). The menu driven -
instructions from the nurse control station are then
transferred to the CPU via zone controller 2420 in a manner
described above (step 4420). The CPU analyzes the - -
instructions, e.g., determines the identification of the
patient and/or staff stations and their associated zone w
controllers and the GPU performs the function associated ,_
with the received message frame (step 4430, 4440 and 4450).
Thereafter, the CPU causes the audio connection between each . ~ -
station and the nurse control station and notifies the
- paging staff member to begin talking (steps 4460 and 4470). -
Alternatively; the voice paging feature may ~ :, =. 'y
utilize staff locator system 2428, shown in Fig. 4 to
determine the location of a staff member or members ski that '._
the staff member attending nurse control station 2414 may
communicate with the patient and/or staff stations nearest
to each staff member or members being paged.
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56
- ~ d. Room Monitoring ;.
The room monitoring feature allows staff members
attending a nurse control station 2414 to activate the audio .
system of either a selected number of patient stations 2416 _.
or to manually step or automatically scan through each '.
patient station 2416 in each room associated with the
station grouping, described above, in a predetermined order _
for a predetermined period of time so as to activate -
microphone 3520 of patient station 2416, enabling staff -..
members to listen for sounds of distress or other
uncharacteristic noises sows to check on the well being of -°
a~patient or patients: Preferably, the predetermined order
for monitoring rooms is from the lowest room number to the
highest and the predetermined period of time is
approximately ten seconds. In operation, the staff member . _'
attending nurse control station 2414 configures the system
for automatic room monitoring by depressing direct select _w
keys 3274 of nurse control station display 3272 in response .-
to menu driven prompts. Once configured for automatic -
monitoring, CPU 2412 sends a message frame to each -patient
station in the above noted order to activate microphone 3620
(shown in Fig. 13) of audio circuitry 3610, via audio
- controller 3614, for a period of ten seconds ,to allow the . .
attending staff member to listen for distress noises and _
other uncharacteristic poises.
~.':-: i
DIAGNOSTICS '"
The system of the present invention also provides
diagnostic features which continuously monitor system
components. As noted above, system faults are communicated
to the nurse control station and/or to the staff station and ~ ..
added to the problem report. Hard and/or soft copies of the
problem report may be obtained from printer 2724 and/or
r
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._
~ external computer 2722 (shown in Fig. 4) or the problem
report may be displayed on nurse control station display
3272 when the "problem reports" feature is selected by -
direct select keys 3274 shown in Fig. 9.
In. addition, the operation of selected periphery
devices in the patient s room are continuously monitored and
-_ any failures are brought to the attention of the staff
member at a nurse control station within the group. For =.
example, the wiring to code blue switch 3234, the smoke
alarm and/or the nurse call button 3250 on patient control
unit 3210 may be monitored for damaged to the wires between
such periphery devices and patient station 2416.
"_-_.~_
Fig. 22 shows the hardware components for patient ;:;-=-v<;
control unit 3210 which is connected to patient station
2416. Preferably, the wiring is tested by microprocessor _
3512 (shown in Fig. 12) activated signals in combination -
with the wire test circuitry 4510. Wire test circuit 4510
includes resistor 4512 and field effect transistor (FET)
4514 which are connected between call wire 4516 and nurse y.. --
call wire 4518, as shown. In this configuration,
microprocessor circuitry 3510 of patient station 2416, shown _'
in Fig. 12, periodically turns on FET 4514 via call wire w-.
- 4516 therefore completing the ground path connecting call ~-
wire 4516 and nurse call wire 4518. Microprocessor 3512 - -
then interrogates nurse call wire 4518 via buffer 3530
-:-:-~.::ra
(shown in Fig. 12) in response to microprocessor driven -
instructions, so as to perform a continuity check of''the
nurse call feature of patient control unit 3210.
Preferably, the period between each wire test is two ,-
seconds. Wire test circuit 4510 may be utilized to perform
wire tests between any periphery equipment and the processor
associated with the station to which the peripheral
equipment is connected. In the event the continuity check
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' 1 fails, a failure alarm sequence is initiated to notify staff : , ,
members'of the wire failure and which wire in which -
periphery device has failed. ~ '
The patient care and communication system of the
present invention also includes external diagnostic device - -
2570 connected to serial data converter 2520, as shown in
Fig. 2. Preferably, external diagnostic device 2570 is a
modem provided to facilitate external diagnostics of the
patient care and communication system of the present .:-
invention, via converter 2520 and zone controller 2560.
External diagnostic device 2570 allows a technician or other
service personnel to remotely verify and update the
configuration of the system in a manner similar to that
performed by staff members attending a nurse control .~_.
i5 station. In addition, the external diagnostic device 2570
allows the technician or other service personnel to view the
system problem report which, as noted above, includes
information as to which stations or equipment are not --
operational. , :_
. , -:: .
STATIONS WITH PBX TELEPHONE INTERFACE
An alternative embodiment for the system
configuration is shown in Figs. 23 and 24. ~.n this
- embodiment a private-branch exchange (PBX) 2430 is connected
to nurse control statiol~s 2414, patient stations 2416 and
staff stations 2418 for providing staff-to-staff, staff-to-
patient and/or external telephone communications for'the
hospital environment. The PBX 24.30 also connects to a ~ -
plurality of telephones throughout the facility and to or
from external telephone lines of the telephone local
exchange or central office. The components of a PBX for
processing data and controlling the telephone operations are _ -
well known. The PBX according to the present invention
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W'O 95123378 ~ 9 PCTlLS9s1024-t0
- ~ includes a processor, associated memory and stored programs.
The preferred PBX according to the present invention is the
IDS-228, manufactured by EXECUTONE Information Systems, Inc.
Each station is provided with a PBX interface which
facilitates PBX telephone or voice communications
therebetween. System data communications are accomplished .
in a manner described above utilizing zone controllers 2420
and,the above described protocol. _.
Fig. 25 is a circuit block diagram of the patient
station 2416 according to the alternative embodiment, which
includes a telephone circuit 4610, which in turn connects to
the PBX 2430. The patient station further includes a r:
~~.si.
receiver unit 4800 for sensing or receiving signals
transmitted from the portable badges. As shown, the patient
~5 station 2416 is a microprocessor controlled interface having
similar system data communications as the patient station -
described above with reference to Figs. 4, 9 and 12-14b. w
Further, the telephone circuit 4610 facilitates telephone
communication between a patient via patient station control
unit 3210, shown in Fig. 23, and the internal and external
.telephone systems via PBX 2430, shown in Fig. 24.
According to the alternative embodiment, the
receiver unit 4800 receives wireless electromagnetic
transmissions, preferably infrared and frequency modulated
25 (FM), from a portable transmitter. The transmissions from
y \'r<.
the portable transmitter include transmitter ID signals.
The receiver in turn forwards an information packet
including the received transmitter ID signals to the central ~ v
processing unit 2412 which determines the identity and
30 location of the transmitter. The information packet from
the receiver 4800 is preferably forwarded to the central
_ processing unit 2412 through zone controller 2420. '
Alternatively, the information packet is forwarded to the
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WO 95123378 PCT/US95I02.t.10
- ~ PBX 2430 through telephone circuit 4610. According to the -,
alternative embodiment of the present invention, the PBX
2430 is capable of processing the information packet from .
the receiver 4800 to determine the identity and location of -
the transmitter, both independently from or as a shared '-
resource of the central processing unit 2412. Of course, ;..-
the information packet from the receiver 4800 may be _-
forwarded to the central processing unit 2412 via the PBX --
2430 or vice versa.
Typically, telephone voice and data communication
between each station and the PBX 2430 is in the form of '
..; -
message frames which are divided into fields, e.g.,'a data
field and a control field. As an example, the data field
associated with voice data to the station is approximately
75 64 kilobits in length and the control field is approximately '---
2 kilobits in length. The control field includes a sync bit
for synchronizing communications between the telephone and
the PBX. The preferred transmission rate far data is 19.2
kilobits per second. ~. -
According to the alternative embodiment, a robbed
bit signaling technique is utilized for transferring data
from the patient, staff or nurse control station to the PBX.
For example, utilizing this technique, one bit within every
fourth transmission of the voice/data stream is utilized for ~ w
the transmission of the system data. Thus the effective
data transmission rate of the control data is approximately --_;:'.
2 kilobits per second. '" _.
Figs. 26-28 illustrate typical system timing and w
format diagrams for the communication of data frames between
the stations of the present invention and the PBX 2430. As
shown in Fig. 26, the data transmitted from the
microprocessor or microcontroller (hereinafter identified as -
"microprocessor") within each ,station is configured in a 16
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bit parallel data word on the microprocessor data bus, which
is preferably framed by one (1) start bit and seven (7) stop
bits. Communications with the PBX system, on the other
hand, are in a serial mode, therefore, the 16 bit parallel
:. 5 data word is converted to a serial data stream in the
telephone circuit within each station, via parallel-to-
serial converter 4620, shown in Fig. 25. In addition, a _.:
synchronization bit (sync bit) is added into each .
microprocessor data frame to maintain clock alignment
between the PBX and the station.
Preferably, telephone voice transmissions between
,::
the PBX and the telephone are in the PCM format which.may
utilize the primary, secondary or both channels. As shown
in Fig. 25, PCM CODEC 4630 compresses the voice information ~.
into PCM format. Transmitter conditioner 4640 amplifies and w_
modulates each frame for transmission to the PBX 2430. The
primary channel is preferably a 64 kilobits channel used to ~ -
transfer control information to and from peripheral devices 'w -
(e.g., the PBX), a synchronization bit for the hardware, and .
the voice signal. The secondary channel is also a 64
kilobit channel which is utilized to transfer EIA data and . -
controls for serial communications, such as for RS-232
applications. r. .: v
- Figs. 27 and 28 illustrate exemplary message frame
formats and timing in an expanded form for telephone voice
~; ~:.-:_:_,
and data information between each station and the PBX. As -~-
shown in Fig. 27, data from the microprocessor is in'~a 16 ~'
bit parallel format and is framed by one start bit and seven
stop bits to form the microprocessor (uP) data frame, where
each uP data frame is approximately 8ms in length.
Telephone voice,. data and information packet including
'transmitter ID from microprocessor 3510, shown in Fig. 25,
is then converted to a serial data bit stream via parallel-
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62
..,
to-serial converter 4620 which then transfers the serial
signal to transmitter conditioner 4640. Transmitter '
conditioner 4640 amplifies and modulates the PCM signal for v
transmission to the PBX 2430 via the 4-pair telephone wire.
An exemplary embodiment of the format and timing
of data transmitted from the PBX to a telephone, patient -
station, staff station or nurse control station is shown in _
Fig. 28. Return telephone voice and data information, e.g., '
data to notify a called party who called, is generated in
the PBX and is formatted into an 8 bit PBX data frame of
approximately 8 ms. in length (i.e., 1 ms/bit). Two of the _
$'Y..' ~'. ~,~ -.
eight bits are designated as auxiliary. A sync frame is
then added into each bit portion of the PBX data frame and ~:~~T.:
the resultant signal is conditioned for PCM transmission to
a station, e.g., either nurse control station 2414, patient -
station 2415 and/or staff station 2418. - -
Referring again to Fig. 25, the PCM signal
received at a station from PBX 2430 is processed through a .w
waveshaper and conditioner 4650. The waveshaper and .
conditioner 4650 converts the received signals from the PCM
format to a serial digital format, recovers the .
synchronization clock to sync the timing via phase-locked
- loop 4670, and recaptures the telephone voice. and data
- information. Data retrieved by the receiver waveshaping and .,
conditioning 4650 is tr~sferred to serial-to-parallel
converter 4660 which converts the data from a serial format _
to a parallel format for interaction with microprocessor
3512 and PCM CODEC 4630. PCM CODEC 4630 decodes the digital --.,
voice information for subsequent transmission of analog y -
voice information to control unit 3210 for broadcast through
speaker 4720, shown in Fig: 29.
According to the alternative embodiment, infrared .
sensitive photodiodes 4810 of receiver 4800 senses infrared
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63
- 1 transmissions from an infrared transmitter and converts the ---
infrared signals to electrical signals. Waveshaper and
conditioner 4820 conditions and amplifies the electrical
signals and FM receiver 48f0 demodulates the data for the
carrier signal and serially transfers the received data to -
an I/O port of microprocessor 3512. According to the -- -
alternative embodiment of the invention, the receiver 4800 ~ -.
is.capable of receiving infrared transmissions from portable -.= '
transmitters at a distance of around 30 feet or greater from
the station. Microprocessor 3512 receives the serial data
from the FM receiver 4830 and extracts the transmitter ID
k ~~~:
information. The extracted information is reformatted and 'r"
forwarded in an information packet to the PBX 2430 or the r-'~==
central processing unit 2412 for further processing and
location determination.
Figs. 33-38 show the components of an exemplary
wireless electromagnetic transmitter, such as an infrared
transmitter, which may be incorporated into a badge unit
5110, as well as various other known portable mediums, and a
personnel or patient card 5200. The badge units are
preferably adapted to be worn by staff members and/or
patients within a health care facility using clip 5120, or --..
- adapted to be releasably attached to stationary or mobile ~. ',
devices or equipment using a suitable adhesive, identified _.,-
as 5130, or like mediums such as VELCRO~. In instances
where the transmitters are attached to devices or equipment, .
the transmitter permits tracking of such devices so sas to .
permit staff members to easily determine the location of the
device for retrieval and allow the badges to transmit
information regarding the status of the equipment, such as
on/off status. The badge unit includes a microcontroller
4900 for controlling the operations of the badge and a
transmitter 4910 for transmitting signals to a plurality of
CA 02366420 2002-O1-16
receivers, The microcontroller 4900 is preferably a single
integrated circuit,chip which includes a processor and RAM
and ROM memory.
Preferably, the transmitter is enclosed'in a
housing which is shaped and sized like. an ordinary credit
carts or smaller. Figures 34-36 illustrate the side, top and
bottom views, respectively, of the badge housing. The
housing 5140, as shown, is approximately 3.8 inches in
length, 2.27 inches in width and .39 inches in thickness.
The housing 5140 includes a slot 5350 which is configured to
receive personnel card 5200 shown in Figs. 37 and 38. Badge
unit 5110 also includes electrical contacts 5160 which. are
connected to microcontroller 4900 of badge unit 5110 as
shown in Fig. 33~ Contacts 5160 are provided to engage
corresponding contacts 5220 on the personnel card 5200 for
data communications therebetween, as will be described in
more detail below. A more detailed description of the badge
unit is described in commonly assigned U.S.~Patent 5,455,851.
The ROM memory may be of the programmable type and
stores software programs for operating the badge. These
programs include: programs for controlling the~transmitter
4910; for monitoring operational parameters; and for
interfacing with externa-~ devices. The RAM memory includes
._ a database for storing information including an
identification code of the badge and operational parameters
which are retrieved and monitored by the processor far
operating the badge unit. The database may further include
information regarding the person associated with the badge,
e.g., medicine which the person is allergic to. The
. database may also include information relating to an
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~ associated object, e.g., medical equipment and its operating
parameters or data. . .
Functions associated with the processor include:
logical and arithmetic operations and coordination of data
5 transfer to and from the microcontroller 4900. In the ~__
preferred embodiment, the processor also performs a fail
safe function Which periodically transmits a message to the
central processing unit 2412 via patient station 2416 and
PBX 2430. The periodic message, e.g., a fail safe code, is
10 provided to inform the central processing unit 2412 that the
badge is operational. Thus, if the message is not received -
from the badge wnit, the central processing unit 2412
determines that either the badge unit has malfunctioned or
that the badge unit is not within the operational confines '
T5 of the system of the present invention, e.g., a staff member
has left the hospital environment. The identification code
of the badge may be utilized as the fail safe code which is -~-y-_
periodically transmitted. y
A microcontroller such as the PIC~16C5X
20 manufactured by Microchip Technology, Inc. is used in the .. .
preferred embodiment of the present invention. It is
apparent to one skilled in the art that any microcontroller ,- - _
having equivalent performance characteristics...and similar in
size may also be used.
25 An edge conne~or 4920, shown in Fig. 36, . _=
:,._.
facilitates interfacing to the components of the badge from
an external device, such as diagnostic medical equip~i~nt . ._'
(not shown). The edge connector 4920 preferably has four
connections which include a "Bidirect I/t~" connection to an
30 input/output port of the microcontroller 4900 for y
bidirectional communication with the microcontroller 4900.
Data can be written into or read out of the microcontroller
memory by the external device ("the Base") through this
r
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- 1 connection. The Base preferably includes processing, . -,
storage and interfacing capabilities for_ communicating with ~ -
- and transferring information between the Base and the badge.
A standard serial interface protocol such as RS232 may be
used for such communications. In instances where the badge = v ;-
unit is connected to a medical device, such as a heart
monitor, connector 4920 is connected to the serial port of
the heart monitor and status data, e.g., the heart rate of ~-
the patient being monitored; of the heart monitor is ~.
transferred to microcontroller 4900 and then transmitted via
transmitter 4910 to the patient station receiver described
... :=-..
above, or to an independent wireless receiver which~will be
described hereinbelow.
Another connection associated with edge connector -.
4920 is an "In-Base" connection which is monitored by the
microcontroller 4900. An active signal at the "In-Base"
input indicates that the microcontroller is to relinquish
control to the external device. The badge according to the
present invention is powered by a battery, which preferably
is made of lithium. Other battery designs such as NICAD ~- -
(nickel cadmium) rechargeable type or solar cell may also be
used. The charge battery LED indicator 4950 provides a -
- visual indication of the charge status of the-battery. The -~
charge battery circuitry may also be connected to '
microcontroller 4900, as shown in Fig. 33, so that the ...s~.:=: '~
microcontroller can transfer the battery charge status
information to the patient station via transmitter 49'i0.
Alternatively, microcontroller 4900 may include a software
counter which counts the number of transmissions from
transmitter 4910 to determine the battery charge status of
the badge. After a predetermined number of transmissions, .
microcontroller 4900 transmits to the patient station the -
battery charge status information, e.g.,.the battery power
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- ~ is low. Preferably, the predetermined number of
transmissions is based on the average power used per
transmission and the statistical life of the battery. ;
Another input of the edge connector 4920 may be . -,
S used to recharge the battery. The fourth connection of the
edge connector 4920 is a spare input/output. The badge w
includes a light sensitive LED 4930 for providing wireless
means for inputting data to the microcontroller 4900 by w
serially strobing data with a light source into the _ ~~ .
microcontroller 4900. y
An oscillator 4940 is connected to the
~: t;_:.
microcontroller 4900 for providing an oscillation signal,
which in turn generates a clock signal for clocking or °''r='=~-:'r
timing purposes. In the preferred embodiment, the
~5 oscillator 4940 includes a resistor/capacitor combination
for providing a clock which operates at a frequency of ~,
around 455 kilohertz. Due to variations in the tolerances
of the resistor/capacitor combination, the clock rate for
each badge unit will vary from one badge to another w.
substantially around 455 kilohertz. The microcontroller
4900 includes a prescaler for providing time and clock
signals.
A mode select switch 4960, preferably a normally " -.
open pushbutton switch, facilitates manual communication to ~ '=
the microcontroller 490(J~for functions such as mode select -
or transmission of a preselected message. Typically, the
function selected is dependant upon the number and sequence
of button pushes. Examples for the modes of operation
include: "erase memory" for erasing the Contents of the RAM
memory; "turn-off transmitter" for disabling any
transmission from the badge; "card reinsertion" for turning
off the badge when the personnel card is removed until a
card is reinserted; "ID code change" for changing the ID
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68
' ~ code to a special preselected code to signal an abnormal
condition; and "disable counters" mode, which overrides
parameter operations for turning'off or disabling the badge
and maintains badge operations.
Badge units which are worn by patients or
releasably affixed to a.structure which is proximal to the
patient as shown in Fig. 39, may include a patient select _ ~~ ~-_
switch or member 4970 shown in Fig. 36 which facilitates
patient control of the environmental facilities within the
patient's room and the nurse call function. Preferably, the
patient select switch is a normally open pushbutton switch
which controls such environmental facilities.or the nurse
call function via transmitter 4910 of the patient station
2416 and CPU 2412 utilizing the communication techniques . .:
~5 described above. Such environmental facilities include, for ,
example, the television 5310, radio, draperies, thermostat
5320 or the room lighting. Selection and control of a
particular environmental facility or the nurse control
function is dependant upon the number and sequence of button
pushes. Data transmissions between the badge unit and the
patient station is similar to the infrared data .
transmissions described above.
In an alternative embodiment shown in Figs. 39 and
40, the badge unit may interface with an independent
wireless electromagnetic receiver, preferably infrared
receiver 5330. In one embodiment, each wireless receiver is
located within the patient room and connected to a
controller 5370 which responds to control data received from
receiver 5330 to control the environmental facilities. In -
another embodiment, each wireless receiver is connected to
either the central processing unit 2412 through zone
controller 2420 onto the PBX 2430. In this embodiment,
central processing unit 2412 or PBX 2430 will respond to the
CA 02366420 2002-O1-16
WQ 95!23378 PCT/US9S/02.i.t0
1 control data in a similar manner as controller 5370 and
communications between the independent receiver and the w .
central processing unit 2412 or the PBX 2430 is similar to .
the above described communications relating to receiver
4800, shown in Figs. 23 and 25. As shown in Fig. 40, -
infrared light sensitive diode array 5340 receives infrared
'. signals, preferably frequency modulated infrared signals, .~.
transmitted from badge units 5140 within approximately 30 ~ , .
feet of the receiver. Waveshaping and amplifier network
5350 conditions and amplifies the signals generated by the
diode array 5340. FM receiver 5360 demodulates the control r=~w.
_~
,
:.a.: :Y .. 1.::
data from the carrier signal and serially transfers~the .~~<
received control data to controller 5370. .
Referring to Fig. 40, each independent infrared -
receiver 5330 is connected to a controller 5370 having a
processor, memory and stored programs. Controller 5370
receives the serial data from FM receiver 5360 and extracts
the badge control data, e.g., the number and sequence of
button pushes of the patient select switch 4970. The ~~'
extracted control data is processed by controller 5370 to
determine which environmental facility is being selected and
' which control function is to be performed. Preferably, each
- environmental facility is assigned an identification code - w
which is stored in the memory of the controller. In this ,
.
configuration, when control data is received by the
_
;
._
~.
_
controller, the controller determines which identification
code has been received to select the desired environmental
facility. For example, if the controller determines that .
the television has been selected, the controller may then be
instructed to turn the television on or off, to change the
channel or to increase or decrease the volume. A more
detailed description of the FM infrared receiver and its
f5
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1 operation is described in U.S. Patent No. 4,977,519 to J.
Crimmins, which is incorporated by reference. , w
Referring to Fig. 41, an alternative embodiment of
the patient room configuration of Fig. 39 is shown. Ln this
embcdiment, all devices which were connected by wires, e.g.,
the patient station 2416 and~thermostat 5320 shown in Fig. -w
39, except the ceiling wireless receiver 5330, have been _
made wireless and portable. All functions performed by the -. _.
devices within the room as shown in Fig. 39 are performed by
the wireless units. The wiring installation of the system
as shown in Fig. 41, simply requires the Wiring installation
of wireless receiver 5330 within each patient room, ''~~°W
connecting the wireless receiver to a central computer,
controller or to the PBX. Generally, previously wired ...
devices for controlling the environment are replaced with a
unit with an integral_transmitter. For example, thermostat
5320 includes a wireless transmitter 5322. Thermostat 5320
measures the ambient temperature within the room and .~ .
transmits the temperature data~to receiver 5330 via
transmitter 5322. In addition, the patient may control _
.other environmental facilities within the room, e.g., a
television, via badge 5140 as described above. As shown in -
- Fig. 41, the thermostat 5320 and the badge 57r40 are placed
-~ on a night stand within the room and proximal to the
patient. '~
The functions of the patient station 2416 and
pillow speaker 3210 may be performed by an enhanced badge -.
unit having components as shown in Fig. 42. The enhanced
badge unit includes voice and display communication controls
for communicating information previously performed by the
patient station 2416 and pillow speaker 3210. The enhanced
badge unit includes all the operations previously described
for the badge unit and further includes: a wireless
_
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receiver., e.g., an infrared receiver 5410 for receiving
information; a card reader 5420 for reading information
_ stored in the- personnel card; -a vroice circuit 5430 for
receiving voice signals from speaker 5440 and for
=translating digital signals to audio signals received from
microphone 5450; a keypad 5460 for keypad entry of data; a
display 5470 for displaying information such as data entered
from the keypad 5460 or data received from the receiver
5410; and a membrane switch (not. shown) for special
designated functions such as an emergency call or sending a
selected message. A more-detailed description of the
enhanced badge unit is described in U.S. Patent 5.455,851.
An exemplary personnel o.r patient card 5200 is
shown in Figs. 37 and 38 and operates in a manner similar to
the personnel card shown and described in commonly assigned
U.S.-Patent 5,465,082..
shown, the personnel card is configured and dimensioned for
:insertion within the slot 5150 of the badge unit 5110, shown
~in Fig. 35. The front surface of the card may include a
printed logo and other identification information.
The rear surface of the card includes an
identifier circuit 5210 Which interfaces with
microcontroller 4900 of the badge unit to perform a lockout
function. The identifier circuit includes a ROM which has a
validation code stored therein and circuitry to read the
validation code from the ROM and transfer the data to -
electrical contacts 5220. Such circuitry is known to those
skilled in the art. Preferably, the identifier circuit is
'in the form of a single integrated circuit which is
preferably dimensioned at approximately .25 inches square
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72
and between about 0.002 of an inch and about 0.004 of an
inch thick for mounting on the rear surface of the card.
Electrical contacts 5220 of card 5200 are connected to
identifier circuit 5210 so that when the card is inserted w '
into the badge unit slot 5150, contacts 5220 are engaged
with contacts 5160 of the badge unit. The identifier
circuit transfers a validation code to the microcontroller
4900 of the badge unit. Microcontroller 4900 then ..
determines whether the card validation code is valid so as
to activate the badge unit circuitry and permit the person
in possession of the card to use the badge unit. If the
microcontroller 4900 determines that the validation~code is
improper or that no validation code is received, then
microcontroller 4900 will deactivate the badge unit
circuitry and prevent the person in possession of the card
from using the badge unit. -
Fig. 29 is a circuit black diagram of the patient
control unit 3210. Patient control unit 3210 includes -. -
telephone keypad 4710, speaker 4720 and microphone 4730 ::
which are connected to PCM CODEC 4630 in telephone circuit
4610 and provide telephone voice and data communications ~ .
between the patient stations and PBX 2430. The PCM CODEX - .
- 4630 may include a DTMF decoder for decoding.DTMF tones from
- the telephone keypad 4710.
Fig. 30~is a circuit block diagram of the nurse
control station 2414 which includes PBX interface or
telephone circuitry 4610 connected to microcontroller'3324,
keys 3328, speaker 3338, handset 3340 and microphone 3342 to w
provide telephone communications between the nurse control -
station and the other stations and/or to provide external
telephone communications. Staff stations 2418 include the
same components as shown in Figure 25 for the patient
stations 2416, except in the staff stations, the speaker
r
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CVO 9123378 PCTIUS9s102440
-~ : : . ~-.
1 4018, keypad 4019 and microphone 4020 for providing
telephone communications between the staff station and the
. ~ other stations and/or to provide external telephone -
communications are integrated within the staff station. -
Communications between the staff stations 2418 and the PBX
2430 are same as described for the patient stations 2416 and
axe shown in Figures 26 to 28.
STATIONS USING A PBX FOR TELEPHONE
AND SYSTEM DATA COl~~iUNICATIONS
Another alternative embodiment for the system
configuration is shown in Fig. 31. In this embodiment =:'~"v
private-branch exchange (PBX) 2430 is connected to central
w _p
computer 5010, to nurse control stations 2414, patient
stations 2416 and staff stations 2418 and is provided to . -
facilitate system data communications as well as staff-to-
staff, staff-to-patient and/or external telephone
communications for the hospital environment.
Central computer 5010 provides standard control of
20 PBX 2430 such as processing telephone data received by the
PBX and providing the PBX with the connection information to
interconnect particular stations for voice communications. y
For example, if a staff member attending a nurse control - -
station calls a patient station where another staff member
25 is attending~to a patient, central processing unit 5010 ,
processes the telephone data, e.g., patient station identity '_-~r~:"-=~-
of the called party, and provides the PBX with-the necessary ,
information to interconnect the two stations. In addition, ~-_-y
central processing unit 5010 is utilized to process the
30 System data to perform system functions, e.g., the call
priority, nurse follow, voice paging and room monitoring
functions as previously described. The system data is
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74
-,
preferably formatted in the following protocol by ,,
microprocessor 3512:
ST; SYSTEM DATA; SP
where the ST field is a one byte start message field. The
SYSTEM DATA field is preferably between one and 16 bytes in
length and provides the PBX with the system data, e.g, code
blue data. The SP field is a one byte stop message field. .
According to an alternate embodiment, the PBX 2430
includes capabilities to process the telephone data and ~ :..
automatically connect the calling stations with the~called
stations for telephone and/or data communications
independent of central processing unit 5010. ' .
The PCM signal received at a station from PBX 2430
is then processed through a waveshaping and conditioning
network 4650, shown in Fig. 25. Network 4650 converts the -..
received signal from the PCM format to a serial digital
format, recovers the synchronization clack to sync the
timing via phase-locked loop 4670, and recaptures the _, -
telephone voice and data information and the system data.
System Data is retrieved by the receiver waveshaping and w .
- conditioning network 4650 using an alternate.mark inversion _'
(AMI) conversion technique. The AMI conversion method
changes the level of the output signal for each positive -
crossing of the zero line by the input signal, as shown in =-y
~.,
Fig. 32.
It will be understood that various modifications
can be made to the embodiments of the present invention
herein disclosed without departing from the spirit and scope
thereof. For example, various system configurations are
contemplated, as well as various types of protocols utilized
to communicate between the numerous stations utilized within
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- ~ the system of the present invention. In addition, numerous
functions aside from those described herein may be
programmed and performed in the'system of the present
invention. Therefore, the above description should not be
con_trued as limiting the invention but merely as ;
exemplifications of preferred embodiments thereof. Those
' skilled in the art will envision other modifications within
the scope and spirit of the present invention as defined by
the claims appended hereto.
_ .
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~.. Y;!.'.'~~' .
35
