# US 5,752,976 A · World wide patient location and data telemetry system for implantable medical devices

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- Number: US 5,752,976 A
- Document ID: US5752976A
- Status: Granted
- Kind: A
- Application number: 08/494,218
- Filed: 1995-06-23
- Granted: 1998-05-19
- Earliest claimed: 1995-06-23
- Assignees: Medtronic, Inc.
- Inventors: Edwin G. Duffin; David L. Thompson; Steven D. Goedeke; Gregory J. Haubrich
- Web page: https://patentgrep.com/patent/US5752976A

## CPC

- A61N 1/37282: {characterised by communication with experts in remote locations using a network}
- G16H 40/63: for local operation
- G16H 40/67: for remote operation
- A61B 5/1112: {Global tracking of patients, e.g. by using GPS}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A system and method for communicating with a medical device implanted in an ambulatory patient and for locating the patient in order to selectively monitor device function, alter device operating parameters and modes and provide emergency assistance to and communications with a patient. The implanted device includes a telemetry transceiver for communicating data and operating instructions between the implanted device and an external patient communications control device that is either worn by or located in proximity to the patient within the implanted device transceiving range. The control device preferably includes a communication link with a remote medical support network, a global positioning satellite receiver for receiving positioning data identifying the global position of the control device, and a patient activated link for permitting patient initiated personal communication with the medical support network. A system controller in the control device controls data and voice communications for selectively transmitting patient initiated personal communications and global positioning data to the medical support network, for initiating telemetry out of data and operating commands from the implanted device and transmission of the same to the medical support network, and for receiving and initiating re-programming of the implanted device operating modes and parameters in response to instructions received from the medical support network. The communications link between the medical support network and the patient communications control device may comprise a world wide satellite network, hard-wired telephone network, a cellular telephone network or other personal communications system.

## Claims

### Claim 1

A system for communicating patient device information to and from a medical device adapted to be implanted in an ambulatory patient and with a remote medical support network comprising:
an implanted device telemetry transceiver within the adapted to be implanted medical device for communicating data and operating instructions to and from the medical device, the implanted device telemetry transceiver having a transceiving range adapted to be extending outside the patient's body when said device is implanted a distance sufficient to receive and transmit such telemetered communications; and
an external patient communications control device adapted to be located in relation to the patient within the device transceiving range including:
a system controller for facilitating communications with the implanted medical device;
an implant wireless interface including a control device telemetry transceiver for receiving and transmitting coded communications between the system controller and the implant device telemetry transceiver;
a global positioning system coupled to said system controller for providing positioning data identifying the global position of the patient to the system controller; and
communications means for communicating between the external communications control device and a remote medical support network.

### Claim 2 (depends on 1)

The system of claim 1 further comprising:
communications network interface means coupled to the system controller and the communications means for selectively enabling the communications means for transmitting the positioning data to the medical support network and for selectively receiving commands from the medical support network.

### Claim 3 (depends on 2)

The system of claim 2 further comprising:
an external patient communications device adapted to be located in relation to the patient within the device transceiving range for providing patient voice and data communications with the system controller, so that patient voice communications may be effected through the communications interface means and the communications means with the remote medical support network.

### Claim 4 (depends on 3)

The system of claim 3 wherein the communications interface means may effect two-way communication of voice and/or data between the remote medical support network and the patient communications device and implanted device telemetry transceiver.

### Claim 5 (depends on 4)

The system of claim 4 wherein said communications means further comprises at least one of the group consisting of:
a cellular telephone network;
a satellite-based telecommunication network;
a hard-wired telephone communications system; and
a hard-wired interface for computer based system for local area and for modem-based communications systems.

### Claim 6 (depends on 3)

A system as set forth in claim 3 further comprising interface means for use by a patient and by which said patient can initiate communications between said external communications device and said remote medical network through patient input to said external patient communications device.

### Claim 7 (depends on 2)

The system of claim 2 wherein the communications interface means may effect two-way communication of voice and/or data between the remote medical support network and the patient communications device and implanted device telemetry transceiver by inclusion of cards for accessing one or all of the communications means.

### Claim 8 (depends on 7)

The system of claim 7 wherein said communications means further comprises at least one of the group consisting of:
a cellular telephone network;
a satellite-based telecommunication network;
a hard-wired telephone communications system; and
a hard-wired interface for computer based system for local area and for modem-based e-mail communications systems.

### Claim 9 (depends on 2)

The system of claim 2 wherein said communications interface means further comprises:
portable satellite communications means for interfacing with a satellite based communications network for communicating with said patient communications control device.

### Claim 10 (depends on 2)

The system of claim 2 wherein said communications interface means further comprises:
portable cellular communications means for interfacing with a cellular telephone communications network for communicating with said patient communications control device.

### Claim 11 (depends on 2)

The system of claim 2 wherein said communications interface means further comprises:
hard-wired telephone communications means for interfacing with a telephone communications network for communicating with said patient communications control device.

### Claim 12 (depends on 10)

The system of claim 10 wherein said hard-wired telephone communications means is hard-wired to a room telephone outlet of a patient's room for a patient confined to the area of the room.

### Claim 13 (depends on 2)

The system of claim 2 wherein said communications interface means further comprises:
portable personal communications means for interfacing with a telephone communications network for communicating with said patient communications control device.

### Claim 14 (depends on 1)

The system of claim 1 wherein: said medical device being adapted to be implanted further comprises:
storage means for storing programmed operating commands received by said implanted device telemetry transceiver for controlling operations of said implanted device;
means for therapeutically treating the patient in accordance with programmed operating commands;
means for monitoring a patient condition and providing patient condition data; and
means for selectively initiating the operation of said therapeutic treatment means and said monitoring means through said operating commands received by said implanted device telemetry transceiver; and
said communications means of said patient communications control device further comprises means for receiving operating commands from said communications network interface; and
said system controller further comprises means for operating said control telemetry transceiver for transmitting said operating commands to said implantable device telemetry transceiver to thereby store said operating commands in said storage means and effect a commanded operation of said implantable device in response thereto.

### Claim 15 (depends on 14)

The system of claim 14 wherein: said medical device being adapted to be implantable further comprises:
means for monitoring a patient condition and providing patient condition data; and
means for selectively initiating the operation of said monitoring means through said operating commands received by said implantable device telemetry transceiver; and
said system controller further comprises means for operating said control telemetry transceiver for initiating operation of said monitoring means and for telemetering said monitored patient condition data to said patient communications control device transceiver for communication to said medical support network.

### Claim 16 (depends on 1)

A system as set forth in claim 1 and further comprising;
real time or continuous clock means in said external patient communications control device for determining instant time,
means to coordinate the resetting of clock via a signal received from said GPS system so as to ensure that all external patient communications control devices are in time synchronized operation.

### Claim 17 (depends on 16)

A system as set forth in claim 16 wherein each external patient communications control device maintains a memory means for determining when communication by it to said medical network is appropriate and wherein said medical network has means to affect a time instant value stored in said memory means so that said medical network means can optimize a set of non-overlapping time or band location slots for communication with other external patient communications control device.

### Claim 18 (depends on 1, 17)

A system as set forth in claim 1 or 17 which further includes means to prevent powerup of the GPS to predetermined times related to times in which communication with said medical network shall occur.

### Claim 19 (depends on 1, 3)

A system as set forth in claim 1, 3, or 16 also having patient activated emergency alarm means on said external patient communications control device which instigates communication with said medical network on patient demand.

### Claim 20 (depends on 1)

A system as set forth in claim 1 wherein said external patient communications device further comprises a three axis accelerometer and means for interpreting acceleration signals therefrom to establish a patient's motion from a last GPS indicated location.

### Claim 21

A method for communicating patient device information to and from a medical device implanted in an ambulatory patient and with a remote medical support network comprising:
providing an implanted device telemetry transceiver within the implanted medical device for communicating data and operating instructions to and from the medical device in a coded communication, the implanted device telemetry transceiver having a transceiving range extending outside the patient's body a predetermined distance sufficient to receive and transmit coded telemetry communications at a distance from the patient's body; and
providing an external patient communications control device adapted to be located in relation to the patient within the device transceiving range for communicating between the implanted medical device and a medical support network; and
responding to an emergency condition of the patient in accordance with the steps of:
receiving global positioning data signals in the communication control device for identifying the global position of the patient to the patient communications control device; and
transmitting communication indicating an emergency condition and the global position of the patient from the patient communications control device to the medical support network.

### Claim 22 (depends on 21)

A method as set forth in claim 21 comprising the additional step of powering up the communications circuitry only in accord with a predetermined schedule.

### Claim 23 (depends on 22)

A method as set forth in claim 22 and further comprising, timing said predetermined schedule so that each patient in the system has a unique time for performing maintenance communications with said medical network.

### Claim 24 (depends on 23)

A method as set forth in claim 23 wherein said medical network, when communicated with by each said patient provides a system clock update to said patient's communications circuitry.

### Claim 25 (depends on 21)

A method as set forth in claim 21 comprising the additional step of powering up the GPS circuitry to reaquire a GPS location on a periodic basis.

### Claim 26 (depends on 21)

The method of claim 21 wherein said step of responding to an emergency condition of the patient in further comprises the step of:
communicating voice messages from said patient to said medical support network.

### Claim 27 (depends on 26)

The method of claim 26 wherein said step of responding to an emergency condition of the patient in further comprises the step of:
communicating voice messages to said patient from said medical support network.

### Claim 28 (depends on 26)

The method of claim 26 wherein said step of responding to an emergency condition of the patient in further comprises the step of altering an operating mode of said implanted medical device in response to the emergency condition.

### Claim 29 (depends on 28)

The method of claim 28 wherein said step of altering an operating mode of said implanted medical device further comprises:
transmitting an operating programming command to said patient communications control device from said medical support network;
in said patient communications control device, transmitting a reprogramming command to said implanted device telemetry transceiver.

### Claim 30 (depends on 21)

The process of claim 21 including the step:
in the absence of an emergency patient condition, periodically reporting the location of the patent to the medical network.

### Claim 31 (depends on 21)

A method as set forth in claim 21 further comprising the steps of determining a last valid GPS indicated location and storing said location in a memory,
Tracking output from a time clock and a three axis accelerometer and storing such output in memory,
computing the current location based on signals received from said three axis accelerometer and from said time clock with reference to the last GPS location.

### Claim 32

Apparatus for communicating patient device information to and from a medical device adapted to be implanted in an ambulatory patient and with a remote medical support network comprising:
an implanted device telemetry transceiver within the implanted medical device for communicating data and operating instructions to and from the medical device in a coded communication, the implanted device telemetry transceiver having a transceiving range extending outside the patient's body a predetermined distance sufficient to receive and transmit coded telemetry communications at a distance from the patient's body; and
an external patient communications control device adapted to be located in relation to the patient within the device transceiving range for communicating between the implanted medical device and a medical support network comprising means for responding to an emergency condition of the patient further comprising:
means for providing positioning data identifying the global position of the patient to the patient communications control device; and
means for transmitting an encoded communication indicating an emergency condition and the global position of the patient from the patient communications control device to the medical support network.

### Claim 33 (depends on 32)

The apparatus of claim 32 wherein said external patient communications device is adapted to be located in relation to the patient within the device transceiving range and further comprises communications interface means for effecting two-way communication of voice and/or data between the remote medical support network and the patient communications device and implanted device telemetry transceiver.

### Claim 34

A system for communicating patient device information to and from a medical device adapted to be implanted in an ambulatory patient and with a remote medical support network comprising:
an implanted device telemetry transceiver within the implanted medical device for communicating data and operating instructions to and from the medical device in a coded communication, the implanted device telemetry transceiver having a transceiving range extending outside the patient's body a predetermined distance sufficient to receive and transmit coded telemetry communications at a distance from the patient's body; and
an external patient communications device adapted to be located in relation to the patient within the device transceiving range for communicating between the implanted medical device and a communication system,
a medical support network in communicative connection through said communications system with said implanted medical device.