RU2830116C1 - Method and system for supporting medical decisions to ensure quality control of medical care and patient safety - Google Patents

Abstract

FIELD: monitoring systems.

SUBSTANCE: invention relates to a method for automatic monitoring and control of health indicators of patients. Method comprises continuous automatic monitoring of patients, namely obtaining and fixing the following parameters: heart rate of the patient; patient's respiratory rate; blood sugar level; electrolyte level; level of body hydration; capillary blood oxygen saturation level; non-invasive blood pressure; invasive blood pressure; heart rate variability indicators; eating behavior indicators; composition and discipline of drug intake; visualization of said indicators in real time at the request of the user; patient’s health state change is predicted, wherein at this stage the patient’s integral indicator “patient’s status” is calculated; calculation of the patient’s status forecast for next 15 minutes; notification of medical personnel based on a notification sheet when identifying an unfavorable prognosis; plan-actual analysis of the treatment or rehabilitation process is carried out, wherein at this stage personnel manipulations with the patient are recorded; notifying the attending medical staff about the planned manipulations with the patient; manipulation qualification; qualification of the fact of violation of treatment or rehabilitation plans; visualization of reports on registered violations of treatment or rehabilitation plans; patient’s health risks are monitored in terms of compatibility of medicinal agents by identifying risks of incompatibility of the medicinal agent with those medicinal agents, which are included in the treatment plan; identifying the risks of incompatibility of the medicinal agent with those medicinal agents that the patient received outside the plan; notification of medical personnel based on a notification sheet when identifying risks; patient’s health risks are monitored in terms of compatibility of therapy measures and manipulations by identifying risks of incompatibility of therapy measures or manipulations with those therapy measures or manipulations, which are included in the treatment plan; identifying risks of incompatibility of a therapy or manipulation with those therapeutic measures or manipulations that are received by the patient outside the plan; notification of medical personnel based on a notification sheet when identifying risks; monitoring safety of medical activity by identifying risks of violation of medical reporting processes; registration of risks of distortion of medical information; notifications of medical personnel based on a notification sheet when identifying process disturbances and risks of distortion of medical information; reporting on registered violations at user request.

EFFECT: more accurate monitoring of patient’s health indicators.

3 cl

Description

AREA OF TECHNOLOGY

This technical solution relates to the field of medicine and computer technology, in particular to a method for automatically managing the quality of medical care in intensive care units.

LEVEL OF TECHNOLOGY

A solution selected as an analogue is known from the prior art, RU 2622498 C1, published on 15.06.2017. This source of information describes a method for improving the quality of medical care associated with an electronic information system, including electronic testing of a patient with automatic processing of the results for a doctor, identifying the leading pathology, entering the results into the system and retrieving optimal treatment technologies from databases filled in by clinics and scientists, characterized in that electronic testing of a patient is carried out remotely by the patient independently logging into the "patient block" of the system, while adults conduct testing themselves, and with children it is carried out by parents; for each patient, the patient's morbidity index is calculated, defined as the ratio of the number of diseases or cases of exacerbation of chronic diseases for the period of time preceding the examination to the period preceding the examination, in months; create a database including a set of information from the patient's medical history, with the ability for the physician to select data and enter additional data using the "physician block" of the system, linked to the "expert scientist block" and the "clinic block", respectively, designed with the ability to enter data on new diagnostic/treatment technologies in the areas of activity of the clinics and with the ability to enter data on clinics in accordance with the patient's pathology; in accordance with the leading pathology of the patient, the areas of activity of the clinics are selected according to the nomenclature of medical specialties, while the choice of clinics corresponds to the selected technologies and doctors who own the technologies, and when extracting data, each area according to the leading pathology corresponds to certain technologies and doctors from different clinics around the world who own them, on the basis of which recommendations are formed on the choice of a country, clinic, treatment technology, doctor who owns the technology, optimal cost of treatment with the ability to track the effectiveness of treatment based on the results of electronic testing; receive a conclusion in the form of a calculation of the comparative cost of travel and treatment from a list of clinics from countries with price lists updated in the database, issued by the system, choosing the best option and receiving a quantitative conclusion on minimizing costs for insurance companies, the state and the patient.

The proposed technical solution is aimed at eliminating the shortcomings of the current level of technology and differs from previously known ones in that the proposed solution significantly ensures more effective control based on automatic management of the quality of medical care and patient safety.

ESSENCE OF THE INVENTION

The technical problem, which the claimed solution is aimed at solving, is the creation of a method for automatic quality control of medical care, directly, in the processes of treatment, rehabilitation, prevention or provision. Additional embodiments of the present invention are presented in the dependent claims of the invention.

The technical result coincides with the purpose of the invention and additionally consists in increasing the level of quality of medical care.

The stated result is achieved through the implementation of a method for automatic quality control of medical care, which includes stages at which the following is carried out:

Continuous automatic monitoring of patients is carried out, namely, obtaining and recording the following indicators: patient's heart rate; patient's respiratory rate; blood sugar level; electrolyte level; body hydration level; capillary blood oxygen saturation level; non-invasive blood pressure; invasive blood pressure; heart rate variability indicators; eating behavior indicators; composition and discipline of taking medications; visualization of the above indicators in real time upon user request;

a forecast of changes in the health status of patients is carried out, and at this stage the following is carried out: calculation of the integral indicator of the patient "patient status"; calculation of the forecast of the patient's status for the next 15 minutes; notification of medical personnel based on the notification sheet upon identification of an unfavorable prognosis;

a plan-fact analysis of the treatment or rehabilitation process is carried out, and at this stage the following is carried out: registration of personnel manipulations with the patient; notification of the attending medical personnel about planned manipulations with the patient; qualification of the manipulation; qualification of the fact of violation of treatment or rehabilitation plans; visualization of reports on registered violations of treatment or rehabilitation plans;

control of patient health risks in terms of compatibility of medicinal products is carried out by: identifying the risks of incompatibility of a medicinal product with the standards of medical care; identifying the risks of incompatibility of a medicinal product with those medicinal products that are included in the treatment plan; identifying the risks of incompatibility of a medicinal product with those medicinal products that the patient received outside the plan; notifying medical personnel based on a notification sheet when identifying risks;

control of patient health risks in terms of compatibility of therapeutic measures and manipulations is carried out by: identifying the risks of incompatibility of a therapeutic measure or manipulation with the standards of medical care; identifying the risks of incompatibility of a therapeutic measure or manipulation with those therapeutic measures or manipulations that are included in the treatment plan; identifying the risks of incompatibility of a therapeutic measure or manipulation with those therapeutic measures or manipulations that the patient received outside the plan; notifying medical personnel based on a notification sheet when identifying risks;

control over the safety of medical activities is carried out by: identifying the risks of violations of medical reporting processes; registering the risks of distortion of medical information; notifying medical personnel based on a notification sheet when identifying violations of processes and risks of distortion of medical information; reporting on registered violations at the request of users;

quality control of medical care is carried out, namely: registration of violations of executive discipline by patients and/or medical personnel; escalation of information on violations of treatment or rehabilitation plans according to escalation lists; reporting on registered violations at the user's request.

In a particular embodiment of the described method, the indicators of eating behavior are the body mass index, food menu, meal schedule, and the number of calories consumed.

In another particular embodiment of the described method, the qualification of manipulation is the type of manipulation, the time of manipulation, the duration of manipulation, the area of the body that was manipulated, and the actual performer of the manipulation.

DETAILED DESCRIPTION OF THE INVENTION

In the following detailed description of the embodiment of the invention, numerous implementation details are set forth in order to provide a clear understanding of the present invention. However, it will be apparent to one skilled in the art how the present invention may be used with or without these implementation details. In other instances, well-known methods, procedures, and components have not been described in detail in order not to unnecessarily obscure the features of the present invention.

In addition, it will be clear from the above description that the invention is not limited to the embodiment shown. Numerous possible modifications, changes, variations and substitutions, preserving the essence and form of the present invention, will be obvious to those skilled in the art.

This technical solution is implemented to manage safety risks of medical activities and control the quality of medical care in intensive care units, intensive therapy units, surgery units and other high-tech medical care units.

At the stage of predicting changes in the patient's health condition, the following is performed: calculation of the predicted integral patient indicator "patient status" for the next 15 minutes; notification of medical personnel based on the notification sheet upon identification of an unfavorable prognosis. At the stage of plan-fact analysis of the treatment or rehabilitation process, the following is performed: registration of personnel manipulations with the patient; notification of the attending medical personnel about planned manipulations with the patient; qualification of the manipulation (type of manipulation, time of manipulation, duration of manipulation, planned/unplanned); qualification of the fact of violation of treatment or rehabilitation plans; visualization of reports on registered violations of treatment or rehabilitation plans. At the stage of monitoring patient health risks in terms of compatibility of medicines, the following is performed: identification of the risks of incompatibility of the medicine with the standards of medical care; identification of the risks of incompatibility of the medicine with those medicines that are included in the treatment plan; identification of the risks of incompatibility of the medicine with those medicines that the patient received outside the plan; notification of medical personnel based on the notification sheet upon risk identification. At the stage of patient health risk control in terms of compatibility of therapy and manipulation activities, the following is performed: identification of risks of incompatibility of a therapy activity or manipulation with the standards of medical care; identification of risks of incompatibility of a therapy activity or manipulation with those therapy activities or manipulations that are included in the treatment plan; identification of risks of incompatibility of a therapy activity or manipulation with those therapy activities or manipulations that the patient received outside the plan; notification of medical personnel based on the notification sheet when identifying risks. At the stage of medical activity safety control, the following is performed: identification of risks of violation of medical reporting processes; registration of risks of distortion of medical information; notification of medical personnel based on the notification sheet when identifying violations of processes and risks of distortion of medical information; reporting on registered violations upon user request. At the stage of medical care quality control, the following is performed: registration of violations of executive discipline on the part of patients and/or medical personnel; escalation of information on violations of treatment or rehabilitation plans according to escalation lists; reporting on registered violations upon user request.

In a frequent embodiment, the claimed method additionally comprises the process of "Retrospective analysis of the patient's condition", in which the calculation of trends of the indicators is performed, which are calculated with a frequency of 1 second (optionally possible: 1 minute, 1 hour, 6 hours, 12 hours, 24 hours, 48 hours, 96 hours, 7 days, etc.): "patient's heart rate"; "velocity of propagation of the console wave"; "patient's respiratory rate"; "level of oxygen saturation of capillary blood"; "non-invasive arterial pressure (systolic and diastolic)"; "invasive arterial pressure (systolic and diastolic)"; "indicators of heart rate variability (degree of tension of regulatory systems as a response to stress effects, indicator of activity of regulatory systems)".

The stages of continuous automatic patient monitoring and prognosis of changes in the patient's health condition are implemented using medical devices - bedside monitors, infusion pumps, pumping stations, artificial lung ventilation devices, contactless patient monitoring devices, devices for automatic registration of treatment regimen events - continuous automatic patient monitoring is carried out, namely, obtaining and documenting (identification and determination of the fact of medical care, creation of an electronic medical record in the database) the following patient monitoring indicators: patient's heart rate; pulse wave propagation velocity; patient's respiratory rate; blood sugar level; electrolyte level; body hydration level; capillary blood oxygen saturation level; non-invasive blood pressure; invasive blood pressure; heart rate variability indicators; eating behavior indicators; composition of medications taken; drug intake discipline; visualization of the above indicators in real time upon user request.

By means of the module for assessing the state of the patient's neurological function, which receives patient monitoring indicators as input, the "neurological status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's neurological function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of the condition and to escalate information about the deterioration of the severity of the health condition; visualization of the "neurological status" indicator in real time at the user's request.

By means of the patient's circulatory function assessment module, which receives patient monitoring indicators as input, the "circulatory status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's circulatory function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the "circulatory status" indicator in real time at the user's request.

By means of the patient's respiratory function assessment module, which receives patient monitoring indicators as input, the "respiratory system status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's respiratory function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the "respiratory system status" indicator in real time at the user's request.

By means of the module for assessing the state of the patient's anti-inflammatory function, which receives patient monitoring indicators as input, the "status of obvious inflammation and sepsis" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's anti-inflammatory function, which is used to calculate and predict the integral indicator "status of obvious inflammation and sepsis", group patients based on the severity of the condition and to escalate information about the deterioration of the severity of the health condition; visualization of the "status of obvious inflammation and sepsis" indicator in real time at the user's request.

By means of the patient's urinary function assessment module, which receives patient monitoring indicators as input, the "kidney damage status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's urinary function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the "kidney damage status" indicator in real time at the user's request.

By means of the patient liver condition assessment module, which receives patient monitoring indicators as input, the “liver damage status” indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's liver function, which is used to calculate and predict the integral “patient status” indicator, group patients based on the severity of the condition and to escalate information about the deterioration of the severity of the health condition; visualization of the “liver damage status” indicator in real time at the user's request.

By means of the patient's body hemostasis assessment module, which receives patient monitoring indicators as input, the "hemostasis status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's body hemostasis function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the "hemostasis status" indicator in real time at the user's request.

By means of the patient's digestive function assessment module, which receives patient monitoring indicators as input, the "gastrointestinal tract status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's digestive function, which is used to calculate and predict the integral "gastrointestinal tract status" indicator, group patients based on the severity of the condition and to escalate information about the deterioration of the severity of the health condition; visualization of the "gastrointestinal tract status" indicator in real time at the user's request.

By means of the module for assessing the state of the body's endocrine system, which receives patient monitoring indicators as input, the calculation of the "endocrine system status" indicator is performed - a qualitative indicator of the loss of adaptability of the patient's endocrine function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the "endocrine system status" indicator in real time at the user's request.

By means of the module for assessing the state of the body's oxygenation function, which receives patient monitoring indicators as input, the "anemia status" indicator is calculated - a qualitative indicator of the loss of adaptability of the patient's oxygenation function, which is used to calculate and predict the integral "patient status" indicator, group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the "anemia status" indicator in real time at the user's request.

By means of the module for calculating and forecasting the integral indicator "patient status", which receives integral indicators of the patient's body functions and patient monitoring indicators as input, the indicator "patient status" is calculated - a qualitative indicator of the patient's condition, at the current time and a forecast for 15 minutes ahead from the current time mark, wherein the forecast is performed on the basis of a composite mathematical model of time series, organized as an ensemble of simpler statistical and structural models, which are used to group patients based on the severity of their condition and to escalate information about the deterioration of the severity of their health; visualization of the indicator "patient status" in real time at the user's request.

By means of the patient risk analysis module, which receives patient monitoring indicators as input, the risks of worsening the severity of the patient's condition are assessed based on events of monitoring indicator trends going beyond the patient's individual norms; notification of medical personnel based on the notification sheet when the risk of worsening the severity of the patient's condition is identified.

By means of the plan-fact analysis module, which receives data from devices for automatic registration of treatment regimen events as input, as well as medical records with treatment plans for patients, the plan-fact analysis of the treatment or rehabilitation process is performed, and at this stage the following is performed: registration of personnel manipulations with the patient; notifications to the attending medical personnel about planned manipulations with the patient; qualification of the manipulation; qualification of the fact of violation of treatment or rehabilitation plans; visualization of reports on registered violations of treatment or rehabilitation plans.

By means of the patient risk analysis module, which receives input data from infusion pumps, pumping stations, devices for automatic recording of treatment regimen events, as well as medical records with patient treatment plans, the assessment of health risks to patients in terms of drug compatibility is carried out by: identifying the risks of drug incompatibility with standards of medical care; identifying the risks of drug incompatibility with those drugs included in the treatment plan; identifying the risks of drug incompatibility with those drugs that the patient received outside the plan.

By means of the patient risk analysis module, which receives data from the automatic treatment event recording devices as input, as well as medical records with patient treatment plans, the patient health risks in terms of compatibility of treatment measures and manipulations are monitored by: identifying the risks of incompatibility of a treatment measure or manipulation with the standards of medical care; identifying the risks of incompatibility of a treatment measure or manipulation with those treatment measures or manipulations that are included in the treatment plan; identifying the risks of incompatibility of a treatment measure or manipulation with those treatment measures or manipulations that the patient received outside the plan; notifying medical personnel based on the notification sheet upon risk identification.

The clinic risk analysis module, which receives medical records with a report of identified risks of medical information distortion as input, monitors the safety of medical activities by: identifying risks of violation of medical reporting processes; registering risks of medical information distortion; notifying medical personnel based on a notification sheet when identifying violations of processes and risks of medical information distortion; reporting on registered violations at the request of users.

The clinic's risk analysis module, which receives medical records with a report of identified risks of medical information distortion as input, controls the quality of medical care, namely: registration of violations of executive discipline by patients and/or medical personnel; escalation of information on violations of treatment or rehabilitation plans according to escalation lists; reporting on registered violations at the user's request.

Examples of implementation.

At the stage of continuous automatic patient monitoring, the following indicators are received and documented (identified and determined as having provided medical care, created in the database): "patient's heart rate"; "console wave propagation velocity"; "patient's respiratory rate"; "blood sugar level"; "electrolyte level"; "body hydration level"; "capillary blood oxygen saturation level"; "non-invasive blood pressure (systolic and diastolic)"; "invasive blood pressure (systolic and diastolic)"; "heart rate variability indicators (the degree of tension of regulatory systems as a response to stress, the indicator of regulatory systems activity)"; "eating behavior indicators (body mass index, diet menu, meal schedule, number of calories consumed)"; "composition of prescribed medications" and "medication intake discipline"; visualization of the above indicators in real time is possible upon user request.

The calculation of the qualitative indicator of the patient's condition "patient status" is determined by a five-point scale of the severity of the patient's condition, where the value "1" corresponds to the condition "the patient is dying"; the value "2" corresponds to "the patient's condition is worsening"; the value "3" corresponds to the condition "the patient is stably severe"; the value "4" corresponds to the condition "the patient has clearly improved"; the value "5" corresponds to the condition "the patient is ready to be transferred to a regular ward".

Integral assessment of the main functions of the body, implemented by calculating the integral indicators of the loss of adaptability of the main functions of the body, such as: "neurological status", "circulatory status", "respiratory system status", "status of obvious inflammation and sepsis", "kidney damage status", "liver damage status", "hemostasis status", "gastrointestinal tract status", "endocrine system status", "anemia status" on a five-point scale, where the value "5" corresponds to "norm", the value "4" corresponds to "below normal condition", the value "3" corresponds to "dysfunction", the value "2" corresponds to "stable insufficiency", the value "1" corresponds to "stable failure"; visualization of indicators of the loss of adaptability of the main functions of the body in real time upon user request.

The calculation of the integral indicator "neurological status" is determined on a five-point scale, where the value "1" corresponds to the state of "atonic coma and states close to it", the value "2" corresponds to the state of "growing deepening of coma", the value "3" corresponds to the state of "stupor (moderate coma, stable state)", the value "4" corresponds to the state of "general cerebral or focal symptoms without a decrease in the level of wakefulness below deep stupor, disorientation, agitation", the value "5" corresponds to the state of "norm".

The calculation of the integral indicator "circulatory system status" is determined on a five-point scale, where the value "1" corresponds to the state of "stable failure of function, ineffectiveness of pharmacological correction", the value "2" corresponds to the state of "stable insufficiency requiring significant pharmacological correction", the value "3" corresponds to the state of "dysfunction requiring minor pharmacological correction", the value "4" corresponds to the state of "function is preserved, but requires correction from the point of view of the need to compensate for other organs (e.g., an increase or decrease in blood pressure is desirable)", the value "5" corresponds to the state of "corresponds to the severity of the condition, the circulatory system, if necessary, compensates for the insufficient work of other systems".

The calculation of the integral indicator “respiratory system status” is determined on a five-point scale, where the value “1” corresponds to the state of “failure of function despite artificial ventilation of the lungs”, the value “2” corresponds to the state of “need for aggressive modes of artificial ventilation of the lungs”, the value “3” corresponds to the state of “need for artificial ventilation of the lungs”, the value “4” corresponds to the state of “significant strain of spontaneous breathing, requiring oxygen therapy”, the value “5” corresponds to the state of “spontaneous breathing adequate to the patient’s condition”;

The calculation of the integral indicator “status of overt inflammation and sepsis” is determined on a five-point scale, where the value “1” corresponds to the state of “septic shock”, the value “2” corresponds to the state of “infectious lesion of several organs (severe sepsis)”, the value “3” corresponds to the state of “infectious lesion of one organ or system (sepsis)”, the value “4” corresponds to the state of “SIRS (possibly non-infectious inflammation)”, the value “5” corresponds to the state of “absence of overt inflammation”.

The calculation of the integral indicator "renal damage status" is determined on a five-point scale, where the value "1" corresponds to the state of "persistent anuria for 3 or more days", the value "2" corresponds to the state of "need for hemodiafiltration", the value "3" corresponds to the state of "increased creatinine above 200 mmol/l, possibly with initial signs of oliguria", the value "4" corresponds to the state of "increased creatinine to 200 mmol/l without a decrease in diuresis", the value "5" corresponds to the state of "norm";

The calculation of the integral indicator "hemostasis status" is determined on a five-point scale, where the value "1" corresponds to the state of "unstoppable bleeding (the last stage of DIC syndrome, thrombocytopenia less than 20)", the value "2" corresponds to the state of "severe bleeding or recurrent pulmonary embolism", the value "3" corresponds to the state of "clinical signs of bleeding or thrombosis", the value "4" corresponds to the state of "laboratory dysfunction without clinical signs", the value "5" corresponds to the state of "norm".

The calculation of the integral indicator "liver damage status" is determined on a five-point scale, where the value "1" corresponds to the state "increase in bilirubin over 10 norms and/or lactate over 4 mmol/l", the value "2" corresponds to the state "the same plus increase in lactate to 4 mmol/l and/or gross changes in coagulation factors", the value "3" corresponds to the state "increase in bilirubin and/or liver enzymes from 2 to 10 norms", the value "4" corresponds to the state "increase in bilirubin and/or liver enzymes to 2 norms", the value "5" corresponds to the state "norm".

The calculation of the integral indicator "gastrointestinal tract status" is determined on a five-point scale, where the value "1" corresponds to the state of "persistent congestion ("silent" stomach)", the value "2" corresponds to the state of "sluggish peristalsis, no stool", the value "3" corresponds to the state of "episodic congestion through the gastric tube, episodic vomiting", the value "4" corresponds to the state of "constipation", the value "5" corresponds to the state of "normal".

The calculation of the integral indicator “endocrine system status” is determined on a five-point scale, where the value “1” corresponds to the state “insulin therapy more than 100 U per day”, the value “2” corresponds to the state “insulin therapy more than 50 U per day”, the value “3” corresponds to the state “need for constant correction with insulin”, the value “4” corresponds to the state “periodic, without the need for constant correction with insulin”, the value “5” corresponds to the state “normal”.

The calculation of the integral indicator "anemia status" is determined on a five-point scale, where the value "1" corresponds to the state "hemoglobin below 70 g/l despite blood transfusions", the value "2" corresponds to the state "hemoglobin not below 70 g/l after blood transfusions", the value "3" corresponds to the state "hemoglobin not below 70 g/l without the need for blood transfusions", the value "4" corresponds to the state "hemoglobin not below 100 g/l without the need for blood transfusions", the value "5" corresponds to the state "norm".

The calculation of the risks of deterioration of the patient's condition is implemented on the basis of identifying trends in monitoring indicators that go beyond the patient's individual norms.

The data required to implement the claimed solution may be collected by means of at least a device for contactless recording of patient vital signs in continuous mode in a lying position (RU 2698441 C2), a device for continuous non-invasive adaptive recording of central arterial pressure (RU 2755273 C1), bedside patient monitors (for example, Philips Intellivue MP50, Philips Intellivue MP90), fitness bracelets, wearable kits such as Polar NU, video cameras connected to computing equipment and located within the medical facility.

A device for contactless recording of patient vital signs in continuous mode while lying down, includes:

a body made in the form of a plastic casting and placed in close proximity to the patient's bed or attached to the bed using fastening devices;

a controller located directly in the housing, including amplifier 1 (U1), amplifier 2 (U2), providing additional signal amplification to expand the dynamic range of the device in the event of mechanical impacts on the sensor (C1) and key (K1), a signal recording device (SRD), which, when power is turned on, connects to the cloud service using a secure SSL connection and, at the level of the application data transfer protocol, continuously transmits to the cloud application the pulse rate per minute, respiratory rate per minute, hemodynamic activity index, motor activity index, intervalogram;

sensor (C1), represented by a piezoelectric sensor of the EmfitR-Series family, placed in a cover, which is fixed to the bed under the patient's mattress in the area where the shoulder blades of the bedridden person are located, while the sensor (C1) is connected to amplifier 1 (U1) by a coaxial cable.

A device for continuous non-invasive adaptive recording of central arterial pressure includes: a means for recording a ballistocardiogram signal and its primary processing, a cloud or a local server, designed with the ability to receive data from said means, process them and transmit the processed data to recipients, wherein the means for recording a ballistocardiogram signal and its primary processing includes:

at least two sensors for recording mechanical vibrations on the surface of the patient's body,

at least two analog amplifiers of signals from each mechanical vibration sensor, analog filters and ADC,

one or more control modules; wherein the control module is configured to transmit data to a cloud or a local server.

Models are trained using at least the following open datasets: Medical Information Mart for Intensive Care III (MIMIC III); Medical Information Mart for Intensive Care IV (MIMIC IV); High time resolution ICU data set (HiRID); eICU Collaborative Research Database; Amsterdam Medical Data Science (AMDS); Datasets obtained during previous piloting stages; Dataset of the Treatment and Rehabilitation Center.

The process of preparing the received data. Collection, cleaning, augmentation of data from equipment (Draeger patient monitors, fitness bracelets such as Spovan PPG HRV ECG, chest fitness kits such as Polar H10); Collection, cleaning, augmentation of data from patient safety zone equipment; Automation of the process of marking up the collected data using the data factory; Automation of binding the marking up of the collected data with concepts from the knowledge graph; Automation of the process of processing articles and extracting knowledge from articles; Automation of binding terms to the knowledge graph.

Approaches to training. Using AutoML (LAMA, etc.); Using autotesting of models; Using simple (linear or quasilinear) models if such models provide high quality; Dividing the incoming data flow into categories to prepare different models for each category. Building ensembles of models, where for each category of input data there is a highly specialized model that shows the best result.

Description of methods. Decision support methods: Models and methods of predictive and prescriptive analytics that allow predicting the development of a situation based on the analysis of historical data and automating decision-making in real time; Models and methods based on open data sources and unstructured information; Identification of anomalies in treatment and rehabilitation processes and search for their causes.

Video image analysis methods: detection and identification of objects in complex environments; pattern recognition taking into account context and signals from multiple sources (fusion of data from different types of sensors); autonomous semantic segmentation, classification and identification of objects, decomposition into sub-objects and recognition of individual details.

Extracting facts from the received information: Semantic tagging of images in a complex environment; Identification of objects in images and in numerical series; Identification of personnel and patients; Classification of movements, PPE, skin defects, manipulations, medications; Qualification of facts according to reference models; Generation of labels-justifications for automatically made decisions.

This technical solution implements the reception, storage and processing of data by means of at least the following technical elements:

Network switch in a fail-safe configuration;

Computing equipment in a fault-tolerant configuration consisting of:

branch server; operational database server; archive database server.

A computing system (equipment) capable of providing data processing necessary for the implementation of the claimed solution generally contains the following components: one or more processors, at least one memory, a data storage facility, input/output interfaces, an input facility, and network interaction facilities.

When executing machine-readable instructions contained in the RAM, the processor of the device is configured to perform the basic computing operations necessary for the functioning of the device or the functionality of one or more of its components.

Memory is usually implemented as RAM, where the necessary program logic is loaded, providing the required functionality. When implementing the proposed solution, the memory volume required to implement the proposed solution is allocated.

The data storage facility can be implemented as NVME, HDD, SSD disks, RAID array, network storage, flash memory, etc. The facility allows for long-term storage of various types of information, such as the above-mentioned files with user/passenger data sets, databases containing records of time intervals measured for each user, user identifiers, etc.

Interfaces are standard means for connecting and operating peripheral and other devices, such as USB, RS232, RJ45, COM, HDMI, PS/2, Lightning, etc.

The choice of interfaces depends on the specific design of the device, which can be a personal computer, mainframe, server cluster, thin client, smartphone, laptop, etc.

A keyboard may be used as a data input means in any embodiment of the system implementing the described method. The keyboard hardware may be any known one: it may be either a built-in keyboard used on a laptop or netbook, or a separate device connected to a desktop computer, server or other computer device. The connection may be either wired, in which the keyboard connecting cable is connected to a PS/2 or USB port located on the desktop computer system unit, or wireless, in which the keyboard exchanges data via a wireless communication channel, for example, a radio channel, with a base station, which, in turn, is directly connected to the system unit, for example, to one of the USB ports. In addition to the keyboard, the following may also be used as data input means: a joystick, a display (touch display), a projector, a touchpad, a mouse manipulator, a trackball, a light pen, speakers, a microphone, etc.

Network interaction means are selected from a device that provides network reception and transmission of data, for example, Infiniband, Ethernet, Wi-Fi interface, Bluetooth module, BLE module, NFC module, IrDa, RFID module, GSM modem, etc. The means are used to organize data exchange via a wired or wireless data transmission channel, for example, WAN, PAN, LAN, Intranet, Internet, WLAN, WMAN or GSM.

The components of the device are connected via a common data transmission bus.

The present application materials present a preferred disclosure of the implementation of the claimed technical solution, which should not be used as limiting other, particular embodiments of its implementation that do not go beyond the scope of the requested scope of legal protection and are obvious to specialists in the relevant field of technology.

Claims (9)

1. A method for automatic monitoring and control of patients’ health indicators, including the following stages: Continuous automatic monitoring of patients is carried out, namely, obtaining and recording the following indicators: patient's heart rate; patient's respiratory rate; blood sugar level; electrolyte level; body hydration level; capillary blood oxygen saturation level; non-invasive blood pressure; invasive blood pressure; heart rate variability indicators; eating behavior indicators; composition and discipline of taking medications; visualization of the above indicators in real time upon user request; a forecast of changes in the health status of patients is carried out, and at this stage the following is carried out: calculation of the integral indicator of the patient "patient status"; calculation of the forecast of the patient's status for the next 15 minutes; notification of medical personnel based on the notification sheet upon identification of an unfavorable prognosis; a plan-fact analysis of the treatment or rehabilitation process is carried out, and at this stage the following is carried out: registration of personnel manipulations with the patient; notification of the attending medical personnel about planned manipulations with the patient; qualification of the manipulation; qualification of the fact of violation of treatment or rehabilitation plans; visualization of reports on registered violations of treatment or rehabilitation plans; control of patient health risks in terms of compatibility of medicinal products is carried out by: identifying the risks of incompatibility of a medicinal product with those medicinal products that are included in the treatment plan; identifying the risks of incompatibility of a medicinal product with those medicinal products that the patient received outside the plan; notifying medical personnel based on a notification sheet when identifying risks; control of patient health risks in terms of compatibility of therapeutic measures and manipulations is carried out by: identifying the risks of incompatibility of a therapeutic measure or manipulation with those therapeutic measures or manipulations that are included in the treatment plan; identifying the risks of incompatibility of a therapeutic measure or manipulation with those therapeutic measures or manipulations that the patient received outside the plan; notifying medical personnel based on a notification sheet when identifying risks; The safety of medical activities is monitored by: identifying the risks of violations of medical reporting processes; registering the risks of distortion of medical information; notifying medical personnel based on a notification sheet when identifying violations of processes and risks of distortion of medical information; reporting on registered violations at the request of users. 2. The method according to item 1, wherein the indicators of eating behavior are the body mass index, food menu, meal schedule, and the number of calories consumed. 3. The method according to item 1, wherein the qualification of the manipulation is the type of manipulation, the time of manipulation, the duration of manipulation, the area of the body subjected to manipulation, the actual performer of the manipulation.