NL2033201B1

NL2033201B1 - System and method for monitoring at least one patient

Info

Publication number: NL2033201B1
Application number: NL2033201A
Authority: NL
Inventors: Laurens Bierling Bart; Guillauma Jean Catharina Heijkants Ralf; Klein-Jan Eline; Stamatelou Eleni; Anita De Mare Lieke; Hamilton Jeffrey Dellimore Kiran
Original assignee: Goal 3 B V
Priority date: 2022-09-30
Filing date: 2022-09-30
Publication date: 2024-04-08

Abstract

A system and method are described for monitoring at least one patient. The comprises at least one individual monitoring device, a central monitoring device, and at least one computing 5 device communicatively connected to the at least one individual monitoring device and the central monitoring device, wherein the at least one individual monitoring device comprises at least one sensor conﬁgured to sense a health parameter of the corresponding patient and to produce input data based on that health parameter, wherein the at least one computing device is conﬁgured to calculate at least one health waming score representing an estimated health level of at least one 10 patient based on the corresponding input data, wherein the central monitoring device comprises a ﬁrst display conﬁgured to display at least one ﬁrst section of health information about a corresponding one of the at least one patient, wherein each ﬁrst section of health information comprises a visual depiction of the corresponding patient, wherein the state of the patient in the visual depiction reﬂects the corresponding health waming score. 15 Fig. IB

Description

SYSTEM AND METHOD FOR MONITORING AT LEAST ONE PATIENT

The present disclosure relates to a system for monitoring at least one patient as well asto a method for monitoring at least one patient.

Every year, millions of neonates, infants and children under the age of five die because of lack of timely treatment or lack of medical resources. There is consequently a high need for earlier detection of patient deterioration and adequate response in low-resource settings, for example in relatively poor countries and regions.

Patients who have fragile health often remain under monitoring in hospitals and medical clinics for an extended period of time, and such a patient’s health may deteriorate or fluctuate over a fairly long period of time, for example hours or days. Neonates are a particular group of patients which regularly require such extended observation. Typically, healthcare workers monitor a ward of patients, distributing their attention over them. Patients being monitored will remain in bed and the monitoring mainly consists of guarding whether their overall health deteriorates to such an extent that checks or interventions by a medical practitioner are required.

In high-resource settings, automated patient monitoring systems are in use to detect situations in which a vital sign of a patient deteriorates to such an extent that urgent intervention is required. However, in low-resource settings, there are generally high patient loads, low equipment budgets, and low numbers of well-trained or experienced healthcare workers. This is the case particularly in infant care in countries before the demographic transition, and in elderly care in countries after the demographic transition.

In these cases, the number of patients may be stretched bevond the point where it is possible to monitor each patient and provide appropriate care according to a preferred quality standard. Therefore. a risk-based triage approach is required to determine which patients to check and which patient to prioritize for intervention. Existing automated systems are not designed for triage.

Several decision aids can be used to help healthcare workers detect patient decline at an carly stage, supporting the efficient distribution of healthcare workers’ limited time for checks and timely intervention. For example. a combination of subjective assessments and continuous vital signs monitoring can provide input for calculating a health warning score, in order to support detecting changes in the health level of a patient and involve healthcare workers when needed.

However, despite their clinical advantages, such decision aids alone are often insufficient to improve clinical outcomes in low resource settings and consequently these have not been adopted widely in these settings. This is due to various problems: the lower and widely varying levels of skill and experience of healthcare workers in these settings limit their ability to perform subjective assessments of patients and decide on intervention needs; the low availability and reliability of continuous vital signs monitoring imposes a heavy burden on healthcare workers to perform many manual vital signs checks at regular intervals; and the calculations for comparing patient states are tedious, time-consuming, and insufficiently sensitive to changes. This often makes it prohibitivelv complex and time-consuming to use such decision aids in practice.

It is a goal of the system and method described in this document to answer the as-yet unmet need for tools which can overcome the afore-mentioned problems. It is a further goal to allow for early identification of patient deterioration. It is a further goal to provide intuitive information to healthcare workers at the right level of detail. It is a further goal to give context- appropriate advice on clinical actions to be performed by healthcare workers.

According to a first aspect, at least one of these goals is achieved at least partially in a system for monitoring at least one patient, comprising at least one individual monitoring device, a central monitoring device, and at least one computing device communicatively connected to the at least one individual monitoring device and the central monitoring device, wherein the at least one individual monitoring device comprises at least one sensor configured to sense a health parameter of the corresponding patient and to produce input data based on that health parameter; wherein the at least one computing device is configured to calculate at least one health warning score representing an estimated health level of at least one patient based on the corresponding input data: wherein the central monitoring device comprises a first display configured to display at least one first section of health information about a corresponding one of the at least one patient, wherein each first section of health information comprises a visual depiction of the corresponding patient, wherein the state of the patient in the visual depiction reflects the corresponding health warning score.

Such a system can monitor a patient automatically using a number of sensors, combine the input data into a health warning score, and display a representation reflecting the health warning score in various places.

Such a system may relieve healthcare workers from manual checking and calculation work. By combining data from multiple individual monitoring devices in a central monitoring device, such a system allows a healthcare worker to keep an overview of an entire ward and to appropriately divide limited attention and resources.

In certain embodiments, the central monitoring device is configured to display the at least ong section of health information according to a predetermined prioritization of patients, wherein preferably the section of health information corresponding to the patient with the worst health level has the highest priority.

In certain embodiments, the displaying of the at least one section of health information according to a predetermined prioritization of patients comprises reordering at least two sections of health information according to their respective corresponding health warning scores, and/or selectively displaying at least one section of health information based on its corresponding health warning score.

Certain embodiments are further configured to periodically produce a visual and/or auditory indication that a clinical action should be performed on the corresponding patient, wherein a visual and/or auditory indication is produced each time a predetermined time interval expires after the previous indication, wherein the predetermined time interval and/or the clinical action to be performed is based on the health warning score of the corresponding patient.

Certain embodiments are further configured to produce a visual and/or auditory indication representing an alarm status, based on determining that the health waming score of at least one patient crosses a predetermined threshold indicating a worsening health level.

In certain embodiments, the at least one computing device is configured to periodically or substantially continuously recalculate the at least one health warning score based on an aggregation of input data produced during an input data aggregation time window, for instance a sliding time window, and to periodically or substantially continuously redisplay health information based on the recalculated health warning score.

In certain embodiments, the at least one computing device is configured to weight the input data received during the input data aggregation time window, wherein preferably more recently received input data is assigned a higher weight in the recalculation of the health warning score.

In certain embodiments, the length of the input data aggregation time window is different from the recalculating and/or redisplaying frequency.

In certain embodiments, the at least one health warning score is calculated by taking the average or median of a plurality of input data values, wherein each input data value is obtained by mapping a raw input data value to a standardized range.

In certain embodiments. the at least one individual monitoring device comprises a second display configured to display a second section of health information about the corresponding patient, reflecting the health warning score corresponding to that patient.

In certain embodiments, the second section of health information comprises a visual depiction of the corresponding patient, wherein preferably the first display and second display are configured to display different visual depictions.

In certain embodiments, at least one visual depiction of a patient has realistic proportions, movements, and/or colors, and/or wherein at least one visual depiction of a patient reflects the health warning score corresponding to the patient at least in that a more distressed patient is depicted in case of a worse health level.

In certain embodiments, at least one health information section further comprises health parameter information about at least one health parameter of the corresponding patient, based on the corresponding input data.

In certain embodiments, the health parameter information comprised in the at least one health information section comprises a modification of a corresponding part of the visual depiction of the patient.

In certain embodiments, the at least one computing device is configured to determine that at least one sensor is not producing valid input data, wherein preferably not producing valid input data comprises the input data not covering a large enough part of a predetermined time window, and/or the input data comprising non-physiological values.

In certain embodiments, the at least one individual monitoring device and/or the central monitoring device is further configured to produce a visual and/or auditory indication that a user should perform a corrective action on at least one sensor, in case the at least one computing device determines that the at least one sensor is not producing valid input data.

In certain embodiments, the at least one sensor of the at least one individual monitoring device comprises at least two sensors which are configured to produce input data based on at least one same health parameter.

In certain embodiments, in case both of the at least two sensors are producing the same type of input data, the at least one computing device is configured to calculate the at least one health warning score based on one sensor out of the two sensors, wherein the at least one computing device is configured to select that one sensor based on a predetermined prioritization of the at least two sensors.

In certain embodiments, the at least one sensor of the at least one individual monitoring device includes a ballistography sensor embedded in a holder with a flat surface for the corresponding patient to lie on.

According to a second aspect, at least one of these goals is achieved at least partially in a method for monitoring at least one patient, preferably using a system according to any of the preceding claims, comprising sensing at least one health parameter of the at least one patient and producing input data based on that at least one health parameter. using at least one sensor applied to the patient; calculating at least one health warning score representing an estimated health level of the at least one patient, based on the corresponding received input data, using at least one computing device; and displaying at least one first section of health information about a corresponding one of the at least one patient, using a first display, wherein each first section of health information comprises a visual depiction of the corresponding patient, wherein the state of the patient in the visual depiction reflects the corresponding health warning score.

This will be further described with reference to the following figures which show illustrative embodiments.

Figure 1A shows an embodiment of a method for monitoring at least one patient.

Figure 1B shows a schematic view of an embodiment of a system for monitoring at least one patient.

Figures 2A-B show perspectives of an embodiment of a monitor unit.

Figure 3 shows an embodiment of an individual monitoring device attached to a patient. 5 Figure 4 shows an example of views displayed by a monitor unit.

Figures 5A-G show examples of adapting visual depictions.

Figures 6A-C show examples of health information.

Figures 7A-C show examples of monitoring situations with different patient health level and corresponding health information.

Figures 8A-C show examples of monitoring situations with different sensor status and corresponding health information.

Figures 9A-C show examples of views displayed by a central monitoring device.

Figure 1A shows an embodiment of a method for monitoring at least one patient, for example a neonate, infant or child. The depicted method includes the following steps. For illustrative purposes, reference is made to a system depicted in figure 1B which is described in more detail below. However, the method could be implemented using a different system.

Step 301 comprises sensing at least one health parameter of at least one patient and producing input data based on that at least one health parameter, using at least one sensor applied to the patient.

The health parameters may include vital signs. Health parameters may include one or more of pulse rate, heart rate, heart rhythm, heart rate variability, capillary refill time, blood pressure, central venous pressure, respiration rate, breathing pattern, breathing effort, tidal volume, oxygen saturation, perfusion index, CO2 concentration, movement, brain activity, neuromuscular function, temperature, urine output, cardiac output and pain.

Input data on health parameters may be produced via estimations (subjective assessment) by a healthcare worker, for example by estimating a degree of consciousness of a patient based on the patient’s behavior in response to stimuli. The data resulting from subjective assessment may be input into the system manually by a healthcare worker, for example via an input means of a monitoring device. Input data on health parameters may also be produced via measurements (objective assessment), or via a combination of estimations and measurements. In both cases, production of the input data is typically performed by a healthcare worker.

Measurements may be performed by a healthcare worker. Some measurements may be performed manually without any devices, for example by feeling and/or counting a patient’s pulse or breathing. Alternatively or additionally, some measurements may be performed by a healthcare worker using sensors. for example by applying a thermometer or applying a non-invasive blood pressure sensor. The data produced via such a measurement may be input into the system manually by a healthcare worker, for example via an input means of a monitoring device, or may be input into the system automatically by the sensor if the sensor is appropriately configured and connected to the system.

In case a health worker produces input data, they may do so via spot-checks, which refers to performing estimations or measurements during short time windows, for example one minute or as long as it takes to produce a minimum amount of input data reliably, with a longer interval in between spot-checks, for example a quarter hour, half hour, or hour, or two or more hours.

Producing input data via spot-checks may be labor intensive, because it typically requires an amount of work proportional to the amount of input data produced.

Alternatively or additionally, some measurements may be performed automatically by a monitoring system via a connected sensor applied to a patient, producing input data which is automatically input into the system.

A system including a combination of spot-checking on the one hand and regular or substantially continuous automatic input on the other hand may be referred to as a hybrid system.

Using a hybrid system may be optimal for providing the highest possible quantity and/or quality of care, particularly in low-resource settings. A hybrid system may be configured for monitoring at least one patient, preferably multiple patients, via an individual monitoring device comprising sensors producing input data regularly or substantially continuously automatically, and to monitor atleast one other patient, preferably multiple other patients. by receiving input data only via spot- checks, optionally only via manual spot-checks. In this case, it 1s advantageous to monitor the patients with the worst health level via sensors, and the other patients via spot-checking. This allows for a relatively good quality of monitoring using a limited number of individual monitoring devices.

Using sensors, input data may be produced at a certain regular sampling rate, for example every 1, 2,3, 5, 30 seconds or 1, 2, 5, 10, 15, or 30 minutes, or at a sampling rate higher than every second. Alternatively, using a sensor, input data may be produced at a substantially continuous rate, wherein data is produced frequently, for example every 1 second or more frequently, and the interval between moments at which input data is produced is not regulated to be of a predetermined size, but the timing of production is instead dependent on circumstances, for example on the properties of the health parameter which is sensed and/or the properties of the sensor which is used. For example, input data from a heart rate sensor may be produced at a rate equal to the heart rate, which may vary over time.

Alternatively or additionally, using sensors, input data may be produced incidentally, for example In response to a user input and/or input data may be produced as spot-checks at an interval based on the patient’s health level which may be determined by a monitoring system.

Step 302 comprises calculating at least one health warning score representing an estimated health level of the at least one patient, based on the corresponding received input data, using at least one computing device.

In practice, it tums out that such a health warning score may be used as a heuristic to determine when intervention by a healthcare worker such as a doctor is urgently required, but also to predict health problems hours or even as much as a day in advance, and to suggest a regime of more frequent spot-checks.

Various types of health warning score may be used for monitoring patient health, for example a

Pediatric Early Warming Score (PEWS) or a variant thereof like the Modified Pediatric Early

Warning Score (MPEWS) or PEWS for in Resource Limited settings (PEWS-RL), Early Warning

Score (EWS) or a variant thereof, Glasgow Coma Scale or a variant thereof like Modified Glasgow

Coma Scale, Blantyre Coma Score, quick Sequential Organ Failure Assessment (Q-SOFA) or a variant thereof like Liverpool qSOFA (LqSOFA). Pediatric Logistic Organ Dysfunction-2 score (PELOD-2) or a variant thereof like quick PELOD-2 (qPELOD-2), Pediatric Risk of Mortality (PRISM IN) or a variant thereof like PRISM IV, Pediatric Index of Mortality score (PIM) or a variant thereof, FEAST PET score (Fluid As Expansive Supportive Therapy Pediatric Emergency

Triage). Pediatric Early Death Index (PEDIA), Inpatient Triage, Assessment and Treatment score (ITAT), Clinical Risk Index for Babies (CRIB) or a variant thereof like CRIB II, Lamberéné Organ

Dysfunction Score (LODS) or a variant thereof, Pediatric Multiple Organ Dysfunction Score (P-

MODS). Systematic Inflammatory Response Syndrome criteria (SIRS criteria), Coagulopathy of

Severe Trauma (COAST), and level of response score (AVPU scale: Alert, Voice, Pain,

Unresponsive).

The various types of health warning scores are based on corresponding estimation, measurement, and/or calculation methods, which may differ in terms of the included health parameters, the formulas for calculating the scores, and the indicated clinical actions. There may be different variants of a type of health waming score, each variant based on a corresponding variant of the corresponding estimation, measurement, and/or calculation method.

Features relating to the calculation 302 and use of a health warning score will be described below, wherein it is generally assumed that the calculated health warning score is a PEWS variant.

Various examples will describe and show specific methods of calculating and using a PEWS variant. However, the same features generally apply to different methods of calculating and using a

PEWS, as well as to different types of health warning scores. Furthermore, in the PEWS method of scoring, a lower health warning score represents a better overall health level and a higher health warning score represents a worse overall health level. It will be clear to the skilled person how to adapt the described features in the opposite case.

As mentioned above, each type of health warning score will be calculated 302 using specific health parameters, and calculating different health warming scores may require different health parameters. For each health parameter which is used, a value may be determined based on input data produced by one or more sensor types. A single sensor or multiple sensors of the same sensor type may produce input data from which multiple different health parameters may be determined. Two sensors of different sensor types may produce input data from which the same health parameter may be determined.

If there are different sensor types which may be used to determine the same health parameter, then multiple sources of input data may be available for a certain patient. To calculate the value for a certain health parameter, the input data from multiple sensors of different sensor types may be combined, for example by averaging the health parameter values determined based on their respective input data. Alternatively, a single sensor out of the multiple available sensors may be used to determine the health parameter value. The decision which sensor to use may be based on a prioritization of sensor types. This order may for example be based on the typical precision, frequency, or time coverage of the input data produced by that sensor type.

Table 1 shows an illustrative preference order of sensor types on which to base the determination of a health parameter to be used in the calculation of a health warning score of the

PEWS type. a

Tabdie i

The health parameters listed in Table 1 are heart rate (HR), pulse rate (PR), respiration rate (RR). oxygen saturation (Sp02), BP (blood pressure), and movement index. The sensors listed are electro-cardiogram sensor (ECG), capnography sensor (capno), plethysmography sensor (SpO2 sensor), blood pressure monitor (BP monitor). and ballistography sensor (BSG-sensor).

In Table 1 it can be seen that certain types of sensors are preferred but not required for the measurement of health parameters for calculation 302 of the health warning score. For example, the heart rate may be determined based on input data produced by a plethysmography sensor and/or a ballistography sensor, without requiring the electro-cardiogram sensor, and the respiration rate may be determined based on input data produced by a ballistography sensor, without requiring an electro-cardiogram sensor or capnography sensor. Limiting the number of sensors used for monitoring, and determining at least two health parameters from the same sensor, may save expenses and ease maintenance, which may be advantageous in low-resource settings.

A health warning score may be calculated 302 by combining values of a plurality of health parameters of the same patient. These values may be based on momentary input data, or may be based on input data per health parameter aggregated over a certain time window, for example 30 seconds, 1, 5, 15 or 30 minutes, or |, 2, 3, or 4 hours. Aggregating input data may involve taking an average or median of the input data values produced during the time window, or preferably taking a weighted average where more recent data has a higher weight, for example linearly higher weight.

If a predetermined minimum amount of input data, for example momentary input data. input data over a minimum part of the time window, or the whole time window, is not available to a system tasked with calculating a health warning score, then no health warning score may be calculated and/or sensor problem may be indicated to the user. It is advantageous to use sensors which are reliable and easy to apply. to ensure that input data 1s available over as much time as possible, and that the input data is comparable between different times and patients.

In order to use a health parameter value for the calculation of a health warning score, raw input data values may be mapped to a certain standardized range which is the same for all health parameters to be used in the calculation. In the case of PEWS, the value of the health parameter may be converted into a value in the range of 0-4. The calculation may then consist of summing or averaging the standardized values to obtain a health warning score. In case three health parameters are used, for example heart rate, respiration rate and oxygen saturation, a health warning score based on summing will have a value in the range 0-12. Each value of the health warning score may represent a certain clinical action type or time interval, for example certain subranges of the total range of possible health warning score values may be mapped to a certain clinical action type or time interval.

The standardized input data values produced typically consist of integer values in a small range, for example 5 values from 0 to 4 in case of PEWS, or up to around 10 values. The reason why small integer values are typically used is that these are easier to produce manually by a health care worker, for example according to a chart, and result in easier health warning score calculations. By using a system to automatically produce input data and calculate health warning scores, the same standardized range may more easily be used with more granular values, for example tens, hundreds, or thousands of values, or substantially continuous values, for example up to the precision of the computing device used. Such more granular values may be fractional values in a predefined standardized range, for example with one, two, or more values behind the decimal point. In practice this added granularity turns out to result in surprisingly more predictive value of the resulting health warning score.

The mapping of a health parameter value to a standardized range may be performed by determining whether the health parameter value is normal, abnormal or critical. A value in a normal range may be mapped to a minimal standardized value, for example 0. A critical range may be above or below the abnormal range, and a value in such a range may be mapped to a maximal standardized value, for example 4. An abnormal range may be between the normal range and a critical range, and may be mapped to an intermediate standardized value, for example 1.

The mapping of a health parameter value to a standardized range may be dependent on the age of the patient, or on other personal characteristics of the patient, such as disease or comorbidities. Table 2 shows an example mapping of health parameter values to normal, abnormal, or critical ranges, depending on patient age. Table 2 shows values for heart rate (HR) in beats per minute (BPM), respiration rate (RR) in terms of breaths per minute (BrPM), and oxygen saturation (Sp02) in terms of percentages (%).

Age HR(BPM) RR(BrPM) SpO2(%) 0-3 | months | <80 or 80-110 or <16 or 16-30 or <85 85-90 >190 150-190 >90 60-90 (no upper (no upper limit) limit) 3- | months | <70 or 70-100 or <16 or 16-25 or 12 >180 150-180 >80 50-80 1-4 | years <60 or | 60-90 or 120- | <13 or 13-20 or >170 170 >70 40-70 4- years <50or | 50-700r110-} <IIor 11-20 or 12 >150 150 >50 30-50 >12 | years <40 or | 40-60 or 100- | <10 or 10-20 or >140 140 >30 17-30

Table 2

As an alternative to mapping health parameters to just three possible values for normal, abnormal or critical ranges, a more granular mapping may be used. For example, multiple intermediate ranges between the normal range and the critical range may be distinguished, so that parameter values may be mapped to four, five or more incremental value ranges below the lowest value of the normal range and/or above the highest value of the normal range.

More preferably, parameter values outside the normal range are mapped to a continuous or substantially continuous standardized range of values, that is, tens, hundreds, or thousands of values or more, as may be represented by a real number up to a certain degree of precision as opposed to a small integer number. That way, escalating abnormal values may have a continuously increasing effect on the health waming score. For example, health parameters values in the normal range may be mapped to a minimal standardized value, for example 0, and in the critical range may be mapped to a maximum standardized value, for example 4. Health parameter values in the abnormal range may be mapped to a continuous range of values, for example, between 1 and 4.

The mapping to the continuous range of values may be linear or for example logarithmic, exponential, or binomial. A linear mapping is preferred because this is easier to explain and to reproduce manually for healthcare workers.

Formula 1 is an example of a linear mapping from health parameter values to standardized ranges, wherein x; ; is the value of the health parameter £ in time t and f(x; ;) its corresponding health warning score. The limits x; 14 apn and X; pi apn and Xto crit and Xhi crit are the lowest and highest values of the abnormal range and critical range respectively, for the health parameter {.

Ï & „ie © Sisi osn SP Agy > Ni en 3 . meen jg Sin JEL Niki, NE PEG a Nii NBG vod oo . «Vidi ore RD Age DF Bp ® Tiga priv

Formula Ì

Mapping of raw input data values to a certain standardized range and aggregation of input data values over a time window may be performed in arbitrary order in order to arrive at a health warning score for a patient.

Preferably, in a monitoring method, the health waming score is recalculated 302 from the individual health parameters multiple times over an extended period of time. The health warming score may be recalculated periodically, based on a predefined recalculation frequency, for example every 1,2, 3, 5, 30 seconds or 1, 2, 5, 10, 15, or 30 minutes or substantially continuously.

The sampling rate and/or the size of the input data aggregation time window may not be the same as the recalculation frequency. If the recalculation frequency is different from the input data aggregation time window, this may be referred to as a sliding window calculation.

Step 303 comprises displaying at least one first section of health information about a corresponding one of the at least one patient, wherein each first section of health information comprises a visual depiction of the corresponding patient, wherein the state of the patient in the visual depiction reflects the corresponding health warning score. Step 304 is optional and comprises displaying at least one second section of health information about at least one individual patient, reflecting the health warning score corresponding to the at least one patient, on a separate display for each of the at least one patient.

For ease of description, it will be generally assumed 1n this description that health information will be displaved in discrete sections, each section associated with a single patient, with at most one section being displayed per patient. However, this is not necessary for the method to achieve at least part of the advantages described. For example, there may be multiple discrete screen areas which contain health information about a certain patient, and together. those areas may form a health information section for that patient.

Preferably, in a monitoring method, a health information section or a relevant part of a health information section is redisplayed 303, 304 based on a recalculated health warning score or other updated information multiple times over an extended period of time. The health information may be redisplaved periodically, based on a predefined redisplaying frequency, for example every 1,2,3,5,30 seconds or 1, 2, 5, 10, 15, or 30 minutes, or whenever updated input data, an updated health parameter value, and/or an updated health warning score is available.

Preferably, a rounded value of a calculated health warning score is displayed, for ease of interpretation by a user. For example, a health warning score may be rounded from a fractional value to an integer value.

Each subrange of a standardized health parameter value or health warming score may be mapped to a certain display characteristic, for example a color. The health parameter, health warning score and/or other parts of the corresponding health information may be displayed with that display characteristic in order to aid quick and intuitive understanding by a user. A certain subrange or subranges may be considered normal and may be mapped to a default or background color, a certain subrange or subranges representing worse health may be considered abnormal and may be mapped to for example the color yellow, and a certain subrange or subranges representing a yet worse health level may be considered critical and may be mapped to for example the color red. In case a method is used in which both health parameters values and health warning scores may be considered normal, abnormal or critical, there may be no direct relation between these two types of normal, abnormal, or critical.

The unavailability of a health parameter or health warning score may also be mapped to a display characteristic, for example a color. A placeholder element, for example a question mark, may be displayed with that display characteristic instead of the corresponding value, in case no value is available.

It is noted that a variety of embodiments of methods for adapting visual depictions 210 of patients are described below, wherein parts of health information sections 200 are displayed with display characteristics, for example colors, based on the corresponding health parameter or health warning score. A health parameter value or placeholder 225, a health parameter icon 222, a health parameter area or corresponding sensor area 211 of a visual depiction 210, a current health waming score or placeholder 230, a historical health warning score 232, an area of a visual depiction 210 not associated with a specific health parameter or sensor, a direction indicator 233, a header or border 240 of a health information section 200, and/or an element corresponding to a health information section 200 in an overview section 260 of a view may be depicted with the associated display characteristic. For readability, in the relevant figures, only the header and/or border 240 are generally shown with the display characteristic associated with the corresponding health warning score, wherein a blue color associated with a missing value is represented by sparse shading, see figure 8B, a yellow color associated with an abnormal value range is represented by a dense shading, see figure 8C, and a red color associated with a critical value range is represented by a dense cross-hatching, see figure 7C.

Figure 1B shows a schematic view of an embodiment of a system 100 for monitoring at least one patient. The communication connections are depicted schematically.

A system 100 for monitoring at least one patient comprises at least one individual monitoring device 110, preferably multiple individual monitoring devices 110, at least one computing device 140, and preferably a central monitoring device 170. The at least one computing device 140 is communicatively connected to the at least one individual monitoring device 110 and the central monitormg device 170.

An individual monitoring device 113 comprises at least one sensor 111, preferably multiple sensors 111, and preferably a monitor unit 113.

For example, the system 100 shows in figure 1B comprises three individual monitoring devices 110, each comprising four sensors 111 of different types. Preferably, all individual monitoring devices 110 of the system 100 comprise the same sensor types, so as to produce input data which can form a basis for comparable health warning scores. Each of the individual monitoring devices 110 in figure 1B is applied to a different corresponding patient.

An individual monitoring device 110 preferably comprises a monitor unit 113 configured to be connected to the sensors 111. This monitor unit 113 is then communicatively connected to at least one computing device 140. For this purpose, the individual monitoring device 110 comprises at least one first communication unit 112 configured for sending input data to at least one computing device 140 and/or for receiving information for the display (to be discussed below) from the at least one computing device 140, possibly one communication unit 112 for sending input data and another communication unit 112 for receiving information.

Features of an embodiment of a monitor unit 113 will be described below with reference to figure 2. Features of an embodiment of an individual monitoring device attached to a patient will be described below with reference to figure 3.

A system 100 for monitoring at least one patient comprises at least one computing device 140 configured for calculating at least one health warning score representing an estimated health level of at least one patient based on the corresponding input data. The system 100 may comprise a single computing device 140 connected to all individual monitoring devices 110, or one computing device 140 for each individual monitoring device 110, or a smaller number of computing devices 140 than individual monitoring devices 110, each connected to multiple, but not all individual monitoring devices 110.

The at least one computing device 140 is communicatively connected to the at least one individual monitoring device 110 and the central monitoring device 170 via at least one connection. The computing device 140 may be communicatively connected via a wireless or wired connection. A wireless connection may be more convenient to install and/or may create less clutter in a medical care setting. A wired connection may be more secure and therefore more helpful in protecting patient data.

In order to set up a system 100 for monitoring at least one patient, at least one physical computing device 140 may be provided to the prospective user. Alternatively, a computer program product or computer-readable storage medium may be provided comprising instructions which, when the program is executed by a computer, cause that computer to carry out the calculation step.

As vet another altemative, access means, for example login credentials, may be provided to allow the user to access a remote service over a network such as the internet, in order to access a computer operated by a service provider which carries out at least part of the calculation step.

The at least one computing device 140 need not be external to the individual monitoring device 110 and the central monitoring device 170 but may instead be a component part of one of these devices, in which case at least one of the respective first and second communication units 112, 172 will also be a component part of that device and may comprise an internal data transfer or processing component of that device. It may even be that the computing device 140 is external to the individual monitoring device 110 and the central monitoring device 170 but a part of the health warning score calculation task is split off as a separate preprocessing or post-processing step, which the individual monitoring device 110 and/or the central monitoring device 170 is configured to perform.

A system 100 for monitoring at least one patient preferably comprises a central monitoring device 170 communicatively connected to the at least one computing device 140. For this purpose. the central monitoring device 170 comprises at least one second communication unit 172 and a display 171 configured for displaying at least one second visual depiction reflecting the at least one health warning score, and preferably an input means 173, for example in that the display 171 is a touch screen. It is possible to include multiple central monitoring devices 170, in order to allow multiple users to access the patient health information.

The central monitoring device 170 may comprise a tablet computer. Analogously to the computing device 140, a computer program product or computer-readable storage medium may be provided comprising instructions which, when the program is executed by a computer, cause that computer to carry out the displaying step. As yet another alternative, access means, for example login credentials, may be provided to allow the user to access a remote service over a network such as the internet, in order to access a computer operated by a service provider which carries out a rendering or preprocessing step to allow a user’s computer to carry out the displaying step in order to embody the central monitoring device 170.

Figures 2A-B show perspectives of an embodiment of a monitor unit 113.

A monitor unit 113 is preferably configured to be portable. It comprises a hard case 114, which may be made of plastic and may have a bottom side configured to stand on a flat surface.

The case 114 may have at least one handle 115, for example on the top side. The monitor unit 113 preferably has a size and shape which make it easy to carry in a single hand. The size may be comparable to that of a handbag, for example a height between 20 and 30 cm, a width between 20 and 30 cm, and a depth between 10 and 15 cm, and the weight may be comparable to that of a laptop computer, for example between 0.5 and 4 kg.

A monitor unit 113 comprises a display 116 on at least one side of the case 114. The case may be shaped such that the display is tilted back slightly for ease of viewing for a standing user when set on a table or bedside stand. For example, the display 116 may be configured for displaying health parameters, a health warning score calculated by a computing device 140, a visual depiction associated with the corresponding patient, context information and/or settings.

A monitor unit 113 may be provided with input means 123 configured for allowing a user to change what is displayed on the display 116, for example by switching to a different view, or to change settings of the monitor unit 113 or of connected sensors 111. The case 114 may be provided with physical user input buttons as input means, or indicator lights (not depicted), preferably on the same side of the case 114 as the display 116. Additionally or alternatively, the display 116 may be a touch screen, navigation point or push-button so as to form input means.

A monitor unit 113 comprises connecting means, for example at least one connector 119, preferably multiple connectors 119, which is configured to connect to a corresponding connector 118 of a sensor 111, for example to a connector 118 at the end of a cable 117 of a sensor 111. The at least one connector 119 may be located on a lateral side of the case 114. The connector 119 may be configured to receive data from the corresponding sensor 111, configure behavior settings of the corresponding sensor 111, and/or provide power to the corresponding sensor 111. Alternatively, one or more sensors 111 may be communicatively connected to the monitor unit 113 using a different type of connecting means 119, for example a wireless communication adapter configured for wireless communication.

A monitor unit 113 may comprise general electronics components, such as a processor and some form of memory (not visible). one or more general data connectors 120, for example a USB-

A connector, configured for example to connect further sensors 111 and/or to update firmware of the monitor unit 113, and a power supply, for example a rechargeable battery. The case 114 may be provided with a power connector 121 configured for connecting to an external power supply element, for example a wall plug cable. A physical power switch 122 may be provided to tum the monitor unit 113 on or off.

A monitor unit 113 may further be provided with an ethernet port 123 configured for connecting the monitor unit as part of the individual monitoring device 110 to the rest of the system, for example to the computing device 140 in addition to or as an altemative to a wireless network connection, and/or a sound speaker 124 configured to, for example, produce an auditory indication in certain cases, such as in case a patient acquires an alarm status.

A monitoring system 100 may be operated to assist healthcare workers in monitoring at least one patient in a continued, guided human-machine interaction process. This process may involve producing or taking input data, processing input data to assess patients’ health, helping users to understand the state of the monitoring system 100 and/or of the patient and to operate the monitoring system 100, allowing a user to provide input for controlling the system, and advising a user on actions to be taken to maintain optimal operation of the system and/or to care for patients.

A monitoring svstem 100 may be operated to assist healthcare workers in monitoring at least one patient in a continued, guided human-technology interaction process. This process may involve producing or taking input data, processing input data to assess patients’ health level, helping users to understand the state of the monitoring system 100 and/or of the patient and to operate the monitoring system 100, allowing a user to provide input for controlling the system, and instructing a user on actions to be taken to maintain optimal operation of the system and/or to care for patients.

A type of health waming score may be associated with a corresponding monitoring regimen to be predetermined, for example based on user settings, in which each value of the health warming score means that certain types of spot-checks are required to be performed with a certain maximum interval. In a certain regimen, the possible values of a health warning score may be divided into ranges. wherein each range means that the corresponding patient requires spot- checking with a certain maximum time interval, wherein typically health warning score values corresponding to a worse health level require smaller spot-checking time intervals.

A monitoring system 100 may be configured to track for at least one patient, preferably all patients, being monitored when and/or how the patient should be spot-checked based on the patient’s health warning score according to the corresponding regimen. This may involve tracking when a patient has last been spot-checked. The system can then produce an indication at the corresponding time when a patient has last been spot-checked, and/or that a spot-check should be performed. and/or which type of spot-check should be performed. The system may be configured to produce an indication that a spot-check should be performed a certain time interval after the previous spot-check indication was produced, or after the previous spot-check was performed, or after a user input relating to the previous spot-check was input into the system.

A monitoring system 100 may be configured to indicate for a certain patient that an individual monitoring device 110 of the system should be applied to that patient to provide regular or substantially continuous automatic input, or that an individual monitoring device 110 applied to the patient should be removed and the patient should be monitored by spot-checking instead, based on that patient’s health warning score or one of a patient’s individual health parameters. Preferably, it is indicated that an individual monitoring device 110 should be applied when or one of the patient’s individual health parameters crosses a predetermined threshold indicating a worsening health level and/or it is indicated that an individual monitoring device 110 should be removed when or one of the patient’s individual health parameters crosses a predetermined threshold indicating an improving health level.

A monitoring system 100 may be configured to indicate that a sensor of the system should be corrected by being spot-checked, reapplied to a patient and/or reconnected to the system, in case a sensor is not producing input data or is producing incomplete data, as described above in relation to figures 5, 8B, and SC.

A monitoring system 100 may be configured to assign a patient an alarm status. which may mean that at least one clinical action is urgently required to be performed on that patient, when a patient’s health warning score or one of a patient’s individual health parameters crosses a predetermined threshold, which may be referred to as an alarm threshold, indicating a worsening health level. The term clinical action may refer to various types of actions, for example spot- checking, but also for example performing an invasive or non-invasive medical procedure on the patient, changing settings of a life support system, or resuscitating the patient. In case a patient enters an alarm status, the system may indicate that one or more clinical actions are required, and/or which type or types of clinical action is required, and/or present multiple types of clinical actions for a user to choose from.

Producing an indication may involve displaying a visual indication like changing the color of at least a part of a patient’s health information section or displaying an icon in a patient’s health information section, on the corresponding individual monitoring device 110 and/or on the central monitoring device 170, as described in detail elsewhere in this description. Alternatively or additionally, producing an indication may involve producing an auditory indication from the individual monitoring device 110 and/or from the central monitoring device 170. Such indications may assist healthcare workers in performing the correct spot-checks at the correct times. An indication of an alarm may be of greater intensity than other indications, for example using brighter or larger visual indications, or louder, more frequent, and/or higher sound. This may assist healthcare workers in intervening quickly and appropriately when required.

A monitoring system 100 may be configured to receive input comprising feedback from healthcare workers about an indication. Feedback may be, for example, a confirmation indicating that a spot-check, corrective action on a sensor, or intervention has been performed. a confirmation indicating that a which type of spot-check, corrective action on a sensor, or intervention has been performed, an input of input data produced via a spot-check, or a deactivation of the indication indicating that a spot-check or intervention has not been performed. Such input may be received via a corresponding individual monitoring device 110 and/or the central monitoring device 170. An indication may be stopped automatically when it has not been responded to for a certain amount of time. In case of an alarm status, when the health waming score crosses the threshold again to indicate an improving health level, the indication may be stopped either immediately or after a predetermined period of time.

Figure 3 shows an embodiment of an individual monitoring device attached to a patient.

The depicted embodiment of an individual monitoring device 110 includes at least one sensor 111, in this case four sensors 111A, 111B, 111C, 111D, configured to be applied to a patient. Alternatively, other numbers of sensors may be included, for example a single sensor. A sensor 111 may include connecting means. for example a cable 117 with a connector 118 configured to be connected to a corresponding connector serving as connecting means 119 of a monitor unit 113.

Each sensor 111 is configured for sensing at least one health parameter of a patient to which it is applied, for example a vital sign, and for producing input data based on the sensed at least one health parameter. It is noted that depending on the sensor type, a sensor being applied to a patient may involve only indirect contact between the sensor and the patient, and/or a sensor may be applied to a patient in the sense that a patient is placed on the sensor, as may be the case with for example a ballistography sensor. In a monitoring device 110, the sensors are preferably configured to automatically produce input data multiple times over an extended period of time. input data may be produced periodically, or in response to certain triggers from the environment or the monitoring device 110. Preferably, the input data is produced regularly and/or substantially continuously. In order to ensure that the input data produced by multiple sensors of the same type applied to different patients is comparable, it is important that sensors 111 are configured to be casily, correctly, reliably, and/or consistently applied to a patient.

The depicted sensors include a ballistography sensor (also referred to as BSG-sensor) 111A comprising a holder with a flat surface, for example a mattress, blanket, or mat, provided with a film-like pressure sensor or load-cell sensor, which may be configured to sense heart rate, pulse rate, respiration rate, movement, and indirectly neurological state, consciousness and/or approximations of other health parameters. The use of such a sensor is particularly advantageous in low-resource settings and/or when applied to neonates, infants or children, because it is easy to correctly apply such a sensor simply by resting the patient on the holder or on a mattress laid on the holder and it will supply data reliably.

The depicted embodiment comprises an electro-cardiogram sensor (also referred to as

ECG) 111B comprising electrodes configured to be attached to the patient, for example a 3-lead

ECG applied to the chest of a patient, which may be configured to sense heart rate, pulse rate, and/or respiration rate. The depicted embodiment comprises a blood pressure sensor 111C (also referred to as BP sensor or BP monitor), comprising for example a cuff configured to be attached to the upper arm of a patient, which may be configured to sense blood pressure and/or pulse rate.

The depicted blood pressure sensor 111C is non-invasive. Invasive blood pressure sensors may alternatively be used. but non-invasive embodiments are preferred as these are configured to be gasier to correctly apply. The depicted embodiment comprises a plethvsmography sensor (also referred to as oxygen saturation sensor or SpO2 sensor) 111D, for example a pulse oximeter configured to be attached to the hand, wrist, fingers, foot or toe of a patient, which may be configured to sense pulse rate, respiration rate, perfusion index and/or oxygen saturation.

Alternatively, only some of these types of sensors may be included, or multiple instances of sensors of the same type may be included.

Other types of sensors may also be used, for example a capnography sensor (also referred to as hypoxia sensor) (not depicted) comprising a part configured to be connected to the mouth of a patient, for example a mask or tube, and an infrared sensor or other spectography sensor for detecting large molecules in exhaled air, or a temperature sensor comprising for example a skin thermometer.

The individual monitoring device 110 is configured for sending the produced input data to acomputing device 140. In the depicted embodiment, this step is performed by a monitor unit 113 which comprises a communication unit 112 (not visible), and the individual monitoring device 110 comprises connecting means 119 configured for communicatively connecting the sensors 111 to the monitor unit 113, in order to transfer the input data to the computing device 140 via that communication unit 112. This is a preferred design because in practice, each patient will usually need multiple sensors 111 as well as a monitor unit 113; the monitor unit 113 may also need a communication unit 112 to receive a health warning score back from the computing device 140 (as will be described further on in this description); and providing the communication unit 112 as part of the monitor unit 113 results in a more practical and robust individual monitoring device 110.

Alternatively, the sensors of the individual monitoring device 110 may comprise at least one communication unit 112 separate from the monitor unit 113, and the sensors 111 may use the at least one separate communication unit 112 on an individually or shared manner to send input data to a computing device 140. In the latter case, the sensors 111 and the monitor unit 113 of the individual monitoring device 110 may be configured to function substantially independently from each other and may be provided together or separately. Such an alternative communication unit 112 may for example comprise an active NFC tag or other wireless dongle, although wired communication may be more secure and may therefore be preferred for privacy reasons.

Figure 4 shows an example view displayed by a monitor unit 113.

The central monitoring device 170 and the monitor unit 113, if any, may be configured to display various views on their respective displays 116, 171. A view may comprise at least one health information section 200 and/or a general information section 250.

Preferably. a display 116, 171 is configured to display at least one general information section 250 on all respective views, for example, on the top and/or bottom of these views. Certain views may comprise one or more additional or alternative general information sections 250, for example a general information editing section, in addition to or in place of at least one health information section 200.

A general information section 250 may include a device or bed number 251; a name, age, type. and/or icon 252 associated with the patient: physiological or technical alarm sections 253 showing alarm statuses; a technical state section 254 showing the state of various components of the unit 113, for example the sound speaker 124, communication unit 112, and/or power supply 121; and/or a time/date section 255.

A general information section 250 may include links to a history section 256 showing trend graphs of vitals, trend graph of a health waming score and/or a history of significant events such as alarm statuses which have occurred in the monitoring unit 113 in the past; patient metadata 257, showing information associated with a patient to be entered and/or edited manually, one or more device settings sections 258 showing for which types of behavior the device 110 is configured; and one or more alarm settings sections 259 providing options to the users to provide feedback to alarm statuses.

A general information section 250 may include a user information section (not depicted) showing information about the present user, for example a number, name, or role, and accepting input to change the user, for example by logging in or out by employing user credentials.

A general information section 250 may include one or more input elements, for example on-screen buttons, which are configured to allow a user to change which view is displayed, to edit settings of the corresponding device, and/or to manually input health parameter values and/or context information to be displayed or used by the corresponding device.

A view may comprise at least one health information section 200. Generally, a monitor unit 113 will be configured to display a single health information section 200 associated with the corresponding patient, whereas the central monitoring device 170 will show multiple health information sections 200, each associated with a different patient.

A health information section 200 may comprise a visual depiction 210 of a patient, input data information 220, health warming score information 230 (see for example figures 5B and 5C) and/or a header or and/or border 240, wherein different views may show different combinations or version of sections in order to adapt to different types of users with different levels of training. The monitor unit 113 may be configured to display a certain view, for example only a visual depiction 210 of a patient, on the display 116 in case no user input has been received via the input means of the device for a certain amount of time. This may function like a screensaver.

A visual depiction 210 of a patient may be configured to be easily interpretable to a user, in particular an untrained or lay user. To this end, the visual depiction 210 may look the way a patient might appear to a visitor of a hospital ward. It is preferably a realistic depiction, for example a realistically proportioned and/or realistically colored depiction of a patient. Realistic proportioning may mean that the patient’s body and/or face has proportions which naturally occur in humans.

Realistic coloring may mean that the patient has a skin color, eye color, and/or hair color which naturally occurs in humans.

The depicted patient is preferably oriented upright, that is, with the head in the direction of the top side of the display. It has been determined this orientation is most intuitive because this is how people most often view other people. Although other orientations, for example an upside- down orientation with the head in the direction of the bottom side of the display, a sideways orientation, or an orientation at an angle may be most intuitive to certain specialist groups, for example, an orientation with the head in a generally downward direction at an angle may be most intuitive to anesthesiologists, who most often view patients from that angle when working. depiction 210 may be chosen to be adapted to the corresponding patient. For example, in case the monitor unit 113 is intended to be used for a neonate, infant or child, the visual depiction 210 may be chosen to be a realistically proportioned depiction of a neonate, infant or child.

A health information section 200, in particular a visual depiction 210, may be updated periodically with a certain frequency, or each time updated information, in particular an recalculated health warning score, is available, or in response to certain triggers, for example in response to user inputs.

The state of the patient depicted in a visual depiction 210 may be adapted to the health state of the corresponding patient. based on the health warning score and/or individual health parameters of the patient. For example, specific areas of the visual depiction 210 may be adapted to this end.

A visual depiction 210 may comprise parameter areas 211 containing health parameter information or sensor information, for example parameter areas 211A, 221B, 211C, and 211D, corresponding to a health parameter and/or to a sensor 111. Relative to a depiction of the patient, these parameter areas 211 may be positioned in the location of an organ exhibiting the corresponding health parameter and/or positioned in the typical location of the corresponding sensor 111. Parameter areas 211 may be depicted differently depending on the input data values produced for the corresponding health parameter, for example by changing the color based on a corresponding normal, abnormal, or critical range, such as vellow if the input data value for the corresponding parameter is abnormal, and red if the input data value for the corresponding parameter is critical.

The visual depiction 210 depicted in figure 4 shows a heart area 21 1A representing the heart rate and/or pulse rate which is shaped as a heart icon and/or positioned in the representation at the anatomical location of the heart of the patient. The depicted visual depiction 210 shows a lung area 211B representing the respiration rate which is shaped like lungs and/or positioned in the representation at the anatomical location of the lungs of the patient. Multiple parameters areas 211 may overlap each other and the shapes of the areas may be adapted to accommodate this overlap.

The depicted visual depiction 210 shows an SpO2 sensor area 211C representing the oxygen saturation which is shaped like an SpO2 sensor and/or positioned in the representation at a typical location of an SpO2 sensor on the patient. The depicted visual depiction 210 shows a blood pressure sensor area 211D representing the blood pressure which is shaped like a blood pressure sensor and/or positioned in the representation at a typical location of a blood pressure sensor on the patient.

A visual depiction 210 may comprise a face area 212 which may show a realistic depiction of a face of a patient, wherein the face being realistic may mean that the face is at least realistically proportioned. The facial expression depicted in the face area 212 may be adapted to represent a better or worse health level, respectively, of the patient by showing a more distressed expression, for example crying, or less distressed expression, for example smiling. A visual depiction 210 may comprise other adaptive areas 213 which may be adapted to represent a better or worse health level, respectively, of the patient by showing more or less of a certain visibly unhealthy physiological property, for example blue skin discoloration. A visual depiction 210 may comprise posture areas 214 which move or change shape to represent different postures of a patient to represent a better or worse health level of the patient, for example by showing a more open and/or relaxed posture in case of a lower health warning score. The posture of a depicted patient may comprise the position of the limbs, for example the orientation and/or tension of the arms and/or legs. Compare figure 5.

A visual depiction 210 may be animated to represent a better or worse health level of the patient by adapting the state of the depicted patient. for example by showing less energetic, less regular, and/or less relaxed movements in case of a health warning score indicating a worse health level. A visual depiction 210 may be animated to show more movement in case more movement is detected through a sensor 111, for example a ballistography sensor 111A.

It has been determined experimentally that a visual depiction 210 of a patient which has one or more of the above-described features is particularly intuitive to users, in particular users with no training like parents or guardians, or users with little training. Such lay users will more easily understand the objective assessment of the health state of the corresponding patient, and will be assisted in knowing when to intervene and/or to call a healthcare worker for intervention based on such a visual depiction 210. In particular, a visual depiction which is adapted to the health status of the patient in multiple ways, for example wherein both the posture and the facial expression are adapted, has been determined to convey the health status of a patient to users in an intuitive way.

An intuitive appearance is particularly important when a user may observe a visual depiction 210 on a display view comprising multiple visual depictions 210, and/or briefly. and/or peripherally.

Input data information 220 may comprise at least one parameter section 221, for example parameter sections 221A, 221B, 221C, and 221D, for at least one health parameter of a patient and/or sensor 111. A parameter section 221 may provide information about a corresponding parameter and/or about a sensor applied to the patient to measure the corresponding parameter. The input data information 220 may be presented in text, number, graph and/or symbol form.

The depicted input data information 220 comprises a heart rate section 221A providing information regarding the heart rate and/or pulse rate and/or corresponding sensor. The depicted input data information comprises a respiration rate section 221B providing information regarding the respiration rate and/or corresponding sensor. The depicted input data information comprises an oxygen saturation section 221C providing information regarding the oxygen saturation and/or corresponding sensor. The depicted input data information comprises a blood pressure section 221D providing information regarding the blood pressure and/or the corresponding sensor.

Multiple parameter sections 221 may be ordered regularly in the view, for example horizontally or vertically in succession.

A parameter section 221 may comprise an icon 222 representing the corresponding health parameter or sensor 111; a name or abbreviation 223 of the corresponding health parameter or sensor 111; a graph 224 of the corresponding input data; one or more most recent, momentary or aggregated numerical values 225 of the corresponding health parameter which may be accompanied by alarm thresholds, and/or an input element 226 such as a virtual button of a touch screen configured to instruct a sensor to start a measurement, for example in case a corresponding sensor is not configured to sense the corresponding health value continuously because this might cause discomfort to the patient.

Figure 5 shows examples of visual depictions associated with a patient, representing an embodiment of a method for adapting visual depictions 210 to represent a higher or lower health warning score of a patient, particular health parameters of a patient, and/or other status information of the patient and/or of the system 100.

Further embodiments for adapting representations for the same or other purposes will be described further on in this description. The features of different embodiments of a method for adapting visual depictions 210 and/or health information sections 200 can generally be combined with each other.

A computing device 140 may be configured to determine that a certain individual monitoring device 110 is not producing input data for at least one health parameter which is required to calculate a health warning score, for example because a corresponding sensor 111 is not included, is not attached, or is defective. In that case the computing device 140 may determine that it is not possible to calculate a health warning score for the corresponding patient.

In case it is not possible to calculate a health waming score for a certain patient, an indication may be produced that a user should perform a corrective action on that least one corresponding sensor 111, for example to attach or reattach that sensor to the system 100. For example, a visual indication may comprise adapting the visual depiction 210 of the patient by showing a patient in a neutral way corresponding to a normal or abnormal health warning score, by showing a header and/or border 240 in a neutral color such as gray, and/or by showing a corresponding icon, for example an X-shaped icon, on or with the visual depiction 210. An example of this is shown in the visual depiction in figure SA.

A computing device 140 may be configured to determine that a certain individual monitoring device 1 is producing incomplete data because a certain sensor 111 is producing input data intermittently, is producing input data for only part of the health parameters which it can sense, is producing input data inconsistent with input data about the same health parameter produced by a different sensor 111, and/or is producing non-physiological data, that is, input data values which cannot be produced by a living human. This may be caused by the sensor being incorrectly applied, for example, by the sensor being loose.

The fraction of a certain time window during which a sensor produces input data may be referred to as the coverage of that sensor’s input data. A lack of availability of input data for a certain fraction of the time may be referred to as a lack of sensor coverage. A lack of sensor coverage is a particularly common occurrence in low-resource settings due to for example the use of low-quality sensors, lack of skilled healthcare workers to correctly apply the sensors to a patient, or a less orderly ward environment. In such settings, sensor coverage has been observed to routinely be between 40 and 70 percent of the time, so that between 30 and 60 percent of the time there is no sensor coverage. Accordingly, it has been determined that a sensor coverage minimum of between 40 and 70 percent, for example 40, 50, 60, or 70 percent of the time are feasible. This in tum means that an averaging time window for a health parameter of at least 30 minutes may be minimal to obtain sufficient input data.

In the case of a lack of sensor coverage for at least one required sensor 111 during a certain input data aggregation time window, the computing device 140 may determine that it is not possible to calculate a health warning score for the corresponding patient. visual depiction

In case it is not possible to calculate a health warning score for a certain patient, an indication may be produced that a user should perform a corrective action on that least one corresponding sensor 111, for example to correct the application of that sensor to the patient. 250r example, a visual indication may comprise adapting the visual depiction 210 of the patient by showing a patient in a neutral way corresponding to a normal or abnormal health warning score, by showing a header and/or border 240 in a neutral color such as gray, and/or by showing a corresponding icon, for example a question mark, on or with the visual depiction 210. The adaptation may be different than in the case wherein input data is not produced at all for at least one health parameter. An example of this is shown in figure SB.

In cases wherein a computing device 140 is configured and able to calculate a health warning score, a monitoring device may be configured to adapt a visual depiction 210 associated with the corresponding patient to that health waming score by . An embodiment of a method for adapting a visual depiction to the corresponding health warning score is depicted in figures 5C- 5G.

The visual depiction shown in figure 5C corresponds to a health warning score in a normal range, for example 0-2 on the PEWS scale. The patient is depicted with a happy facial expression, a natural, healthy and/or neutral color, an open posture. Such a representation may instruct a user to follow normal monitoring procedure.

The visual depiction shown in figure 5D corresponds to a health waming score in an abnormal range. for example 3-5 on the PEWS scale. The patient is depicted with neutral facial expression, a natural, healthy and/or neutral color, and a resting posture. Such a representation may instruct a user to monitor the patient closely and/or to spot-check the patient within 2 hours.

The visual depiction shown in figure 5E corresponds to a health warning score in a first critical range, for example 6-8 on the PEWS scale. The patient is depicted with a distressed facial expression, a natural, healthy, and/or neutral color, and a resting posture. Such a representation may instruct a user to monitor the patient closely and/or to spot-check the patient within 60 minutes.

The visual depiction shown in figure SF corresponds to a health warning score in a second

I5 critical range, for example 9-10 on the PEWS scale. The patient is depicted with a distressed facial expression, a natural, healthy and/or neutral color in parts of the body and an unhealthy or unnatural color in other parts of the body, for example the extremities, and a resting posture. Such a representation may instruct a user to monitor the patient closely and/or to spot-check the patient within 30 minutes.

The visual depiction shown in figure SG corresponds to a health warning score in a third critical range, for example 11-12 on the PEWS scale. The patient is depicted with a distressed facial expression, an unhealthy or unnatural color over all of the body, and a resting posture. Such a representation may instruct a user to monitor the patient closely and/or to intervene immediately and/or alert a doctor.

In summary, in the depicted embodiment, in case a health warning score transitions to a range indicating a worse health level, individual features such as the facial expression, posture or color of the visual depiction may change over a range of forms to represent a worse health level. A facial expression may change from happy to neutral to distressed. A color may change from natural, healthy, and/or neutral to unnatural and/or unhealthy. A posture may change from open to resting or tense. Different features may change forms at different values of the health warning score. Features may change in discrete steps to represent discrete ranges of the health warning score.

Figures 6A-C show examples of health information sections 200, representing an embodiment of a method for adapting health information sections 200, in particular visual depictions 210, associated with a patient to different types of users with different levels of skill.

A health information section 200 may be shown on an individual monitoring device 110 for the corresponding individual patient. One or more health information sections 200 may be shown on a central monitoring device 170 for some or all patients being monitored by the system 100.

In order to know to which skill level a health information section 200 should be adapted, a device may be configured to maintain user profiles wherein it is tracked what the skill level or preference of a user is, and may be configured to request that a user log in or to allow a user to log in.

In case no user is logged in and/or in case no input has been received for a long time, a device may show a default health information section 200. By default, a health information section 200 intended for unskilled or relatively low-skilled or lay users may be shown on an individual monitoring device 110, while a health information section 200 intended for medium-skilled or high-skilled users may be shown on a central monitoring device 170.

Figure 6A shows a health information section 200 intended for unskilled or relatively low- skilled or lay users, for example parents or guardians. Such a section 200 may comprise a visual depiction 210 which is a depiction of a person, as a patient might look to a visitor. Realistic might mean that the depiction has realistic colors, for example a skin color, and/or which is provided with additional realistic visual details, for example hair. It may omit input data information 220 and/or health waming score information 230.

The depicted visual depiction 210 may reflect the health warning score via animation, posture, and/or adaptive areas 213 and/or may show parameter areas 211 only for health parameters or sensors 111 with an abnormal or critical input data value. The visual depiction 210 may be updated based on the most recently recalculated health warning score relatively frequently, for example every | second, every 5 seconds, every minute or every 5 minutes.

It has surprisingly been found that, while animation and frequent updates help relatively low-skilled users understand the health state of a patient, both the feature of showing less animation in the visual depiction 210 and the feature of updating the visual depiction 210 less frequently help relatively highly skilled users to more quickly and accurately cognitively process provided patient health information as a decision support indicator. Therefore, the health information section 200 shown in figure 6A may be displayed on an individual monitoring device 110, for example as a default or screen saver, but other health information sections 200 may be displayed on the central monitoring device 170.

Figure 6B shows a health information section 200 intended for medium-skilled users, for example nurses. Such a section 200 may comprise a visual depiction 210 of a patient which has neutral, background, and/or subdued colors, for example gray or black, and/or which is not provided with additional realistic visual details. The health information section 200 may take up a relatively large area, for example over half of the health information section 200. It may comprise input data information 220 and health warning score information 230. The input data information 220 may comprise at least one parameter section 221 comprising an icon 222 and numerical values 225 and may or may not comprise a graph 224. The depicted visual depiction 210 may not be animated. The health warning score information 230 may comprise a current health warning score 231 and/or a placeholder and a historical health waming score 232.

A historical waming score 232 may for example be the health warning score corresponding to the previous input data aggregation time window, or the last health warning score which could be calculated given the available input data, or a health warning score calculated for a certain moment a predetermined amount of time in the past, for example 10 minutes earlier, or an average of the available health warning scores over a certain time window toward the past, for example the last hour.

In case no current health warning score 231 can be calculated at a certain moment, the corresponding historical health warning score 232 may replace the current health warning score 231 as a best estimation of the patient’s health level, and may determine behaviors of a monitoring system 100. For example, a patient’s alarm indication may not be stopped, if their historical health warning score 232 remains above an alarm threshold and no current health warning score 231 can be calculated.

Figure 6C shows a health information section 200 intended for highly skilled users, for example doctors. Such a section 200 may comprise a visual depiction 210 of a patient which has neutral and/or subdued colors, for example gray or black, and/or which is not provided with additional realistic visual details. The health information section 200 may take up a relatively small area, for example less than half of the health information section 200. It may comprise input data information 220 and health waming score information 230. The input data information 220 may comprise at least one parameter section 221 comprising an icon 222, numerical values 225, and a graph 224. The depicted visual depiction 210 may not be animated. The health warning score information 230 may comprise a current health warning score 231 and a historical health warning score 232.

Figures 7A-C show examples of monitoring situations and corresponding health information sections, representing an embodiment of a method for adapting health information sections 200 to represent a better or worse health level of a patient, particular health parameters of a patient, and/or other status information.

In each of these figures, a health information section 200 is depicted next to an individual monitoring device 110 displaying a view. The depicted health information section 200 may be displayed concurrently on a central monitoring device 170, or may be an alternate view which may be displayed on the monitor unit 110 in response to a user input.

It is noted that the input data information 220 in the view depicted on the individual monitoring device 110 and the input data information 220 in the health information section 200 reflect the same input data, yet they comprise information about a different subset of sensors 111.

Figure 7A shows a case wherein an individual monitoring device 110 is applied for monitoring a patient and a low health warning score representing good health has been calculated.

A corresponding health information section 200 may comprise health warming score information 230 comprising a current health warning score 231 of 1, down from a historical health warning score 232 of 6. The health information section 200 may further comprise a direction indicator 233 indicating the direction of change of the health warning score, which may be overlaid on a visual depiction 210 of the patient. A direction indicator 233 may comprise an arrow pointing down when the health warning score went down, an arrow pointing up when the health warning score went up from the historical value, and/or a question mark or similar indicator when no current health waming score is available. The parameter areas 211 of health parameters in a normal range may have neutral, background, and/or subdued colors

Figure 7B shows a case wherein an individual monitoring device 110 is applied for monitoring a patient and a middling health warning score representing middling health has been calculated. A corresponding health information section 200 may comprise health waming score information 230 comprising a current health warning score 231 of 3, equal to a historical health warning score 232 of 3. The health warning score has not changed, so no direction indicator 233 is displayed. In case at least one health parameter of the patient is sensed to be abnormal, the corresponding parameter area 211 of the visual depiction may be colored in the corresponding alarm color, yellow. The same holds for the corresponding parameter sections 221 of the input data information 220. In case some health parameters are abnormal but none are critical, the health warning score information 230 is also colored yellow.

Figure 7C shows a case wherein an individual monitoring device 110 is applied for monitoring a patient and a high health waming score representing bad health has been calculated.

A corresponding health information section 200 may comprise health warming score information 230 comprising a current health warning score 231 of 10, equal to a historical health warning score 232 of 10. The health warning score has not changed, so no direction indicator 233 is displayed.

One health parameter of the patient is sensed to be abnormal and two (in this case, all) other health parameters of the patient are sensed to be critical, so one parameter area 211 of the visual depiction is colored vellow, while the two other parameter areas 211 are colored red. The same holds for the corresponding parameter sections 221 of the input data information 220. The health warning score information 230 is also colored red.

It is noted that in each of the figures 7A-C, the corresponding parameter sections 221 of the input data information 220 in the view displayed on the individual monitoring device 110, which comprises no visual depiction 210 of the patient, are also colored yellow or red to reflect abnormal or critical values.

Furthermore, these figures show health information sections 200 comprising respective headers and/or borders 240 which are adapted to show the health waming score of the patient, in this case by a corresponding color. Headers and/or borders 240 may also show basic information, for example the number of the corresponding individual monitoring device 110, and/or the patient’s name and/or age.

Figures 8A-C show examples of monitoring situations and corresponding health information sections, representing an embodiment of a method for adapting health information sections 200 to represent incomplete or unusable input data.

Figure 8A shows a case wherein an individual monitoring device 110 is applied to a patient. In certain cases, the device comprises enough sensors of the right types to produce input data on enough health parameters to calculate a health warning score for the patient. For example, the device 110 may comprise four different sensors 111 producing input data on at least three health parameters. A health information section 200 can be displayed.

Figure 8B shows another case wherein an individual monitoring device 110 is applied to a patient. In certain cases, a sensor of the device 110 is applied incorrectly, so that not enough sensors 111 of the right types are correctly applied to the patient to produce input data on enough health parameters to calculate a health warning score for the patient. For example, the device 110 comprises an SpO?2 sensor 111D capable of producing input data on pulse rate, respiration rate, perfusion index and oxygen saturation (compare figure 10), but this sensor 111D is incorrectly applied, for example, it 1s loose. A ballistography sensor 111A is also present. which is able to produce input data on heart rate and respiration rate, but no source of input data on oxygen saturation is present, so the health warning score calculation, in this case a PEWS calculation, cannot be performed. In this case, in the health information section 200, the SpOQ2 sensor area 211C of the visual depiction 210 and/or the SpO2 sensor section 221C of the health parameter information 220 may be marked as missing, for example by being depicted in cyan. No health warning score can be generated. so the current health warning score 231 of the health warning score information 230 may be marked as missing, for example by being depicted in cyan and/or as a question mark. If the face area 212 or other areas or features of the visual depiction 210 are selected to represent the health warning score, these may be omitted or depicted in a neutral manner.

Figure 8C shows another case wherein an individual monitoring device 110 is applied to a patient. In certain cases, the device 110 does not comprise enough sensors 111 of the right types to produce input data on enough health parameters to calculate a health warnmg score for the patient.

For example, the device 110 may comprise a model of SpO2 sensor 111D capable of producing input data on pulse rate and oxygen saturation but not input data on respiration rate. In that case the selected PEWS calculation cannot be performed. In this case, in the health information section 200, the lung area 211B of the visual depiction 210 and/or the lung section 221B of the health parameter information 220 may be marked as missing, for example by being depicted in cyan. No health warning score can be generated, so the current health warming score 231 of the health warning score information 230 may be marked as missing, for example by being depicted in the corresponding technical alarm color, cyan and/or as a question mark. If the face area 212 or other areas or features of the visual depiction 210 are selected to represent the health warning score, these may be omitted or depicted 1n a neutral manner. It may be the case that, at the same time, one of the health parameters of the patient is in an abnormal or critical state, for example the heart rate is abnormal. In this case it may be marked correspondingly, for example in yellow, but still no health warning score may be generated.

It is noted that in the figures 8B and 8C, the corresponding parameter sections 221 of the input data information 220 in the view displayed on the individual monitoring device 110, which comprises no visual depiction 210 of the patient, are also colored blue to reflect missing values, at least in cases where no abnormal or critical historical value is shown.

Furthermore, these figures show health information sections 200 comprising respective headers and/or borders 240 which are adapted to show the historical health warning score of the patient, in case no current health waming score is available.

Figures 9A-C show examples of views displayed by a central monitoring device 170.

A view displayed by the central monitoring device 170 may comprise multiple health information sections 200 associated with different patients. The system 100 may comprise a large number of individual monitoring devices 110.

It is generally believed in healthcare practice that a monitoring system 100 should display all health information about all patients at all times, in order to ensure that no spot-checks or alarm indications are missed. However, in low resource settings, wards may contain so many patients that this is infeasible without making the displayed information difficult to read, particularly when also making accommodation for relatively low-skilled users by including visual depictions of patients.

In such cases a monitoring system 100 may still be useful as an early warning, or triage system.

Therefore, the central monitoring device 170 may be configured to not show health information sections 200 for all patients monitored by the individual monitoring devices 110 of the system 100 at the same time. The central monitoring device 170 may be configured to display only a predetermined maximum number of health information sections 200 as part of the view. This maximum number may be fixed for the device 170 or may be set by the user. Configuring the device 170 with such a maximum may be advantageous to enable the system to usefully display health information as part of health information sections 200 at a desired level of detail (compare the embodiment described with reference to figures 6A-6C).

Which health information sections are displayed may be determined at least one part by user selection. Health information sections 200 are displayed as part of views which generally comprise multiple health information sections 200. The selection mechanism may comprise, for example, selecting one of several discrete views, scrolling through a virtual view which is larger than the area of the display, and/or selecting a part of a collection of health information sections 200 from a data structure or database.

For allowing a user to select health information sections 200 to be displayed. a view displayed by the central monitoring device 170 may comprise an overview section 260, for example as a sidebar beside the health information sections 200 or in a separate view for the health information sections 200, comprising information about the total number of health information sections 200 which is available for viewing, the presence and/or location of certain health information sections 200 in one or more available views, and/or navigation elements for changing the organization of a collection of health information sections 200.

Selecting health information sections 200 to be displayed may comprise filtering health information sections 200 in a view which is displayed by the device 170, and/or from a data structure or database of health information sections 200. Filtering may be performed based on, for example, a criterion like the name of the patient or the number of the corresponding individual monitoring device 110.

The central monitoring system 170 may allow the user to reorder and/or move health information sections 200 in a view which is displayed by the device 170, and/or may allow the user to reorder a data structure or database of health information sections 200.

In healthcare settings where multiple patients are being monitored, many spot-check indications may be given in a short period of time or concurrently. This may be distracting or stressful for healthcare workers, particularly in the case of auditory indications and particularly in low-resource settings where there is not enough time to perform all the required spot-checks. This phenomenon is known as “alarm fatigue”.

In order to reduce or prevent alarm fatigue, a monitoring system 100 may be configured to determine a prioritization of patients. Patients may be displayed on a central monitoring device 170 according to the prioritization. This way the system 100 may assist a user in efficiently spending their time by providing advice on which patients to tum to first for spot-checking, performing other clinical actions, performing corrective actions on sensors, or performing other activities. A healthcare worker using such a system 100 receives a more even amount of information as the number of medical and technical issues requiring attention in a ward varies over time.

A prioritization may assign higher priority to a first patient than to a second patient in case the first patient has a health warning score indicating a worse health level, in case the first patient has a health waming score in a higher critically class, for example normal, abnormal, or critical, in case the first patient has an active alarm status and the second patient has no active alarm status, in case the first patient has an active alarm status which has been active longer than the longest active alarm status of the second patient, or in case the first patient is connected to an individual monitoring device 110 and the second patient is not. Multiple criteria for prioritization may be applied in a hierarchy. A central monitoring device 170 may be configured to allow a user to set one or more criteria for prioritization via an input means.

Based on a determined prioritization, a monitoring system 100 may select which health information to display in various ways, which may be employed alone or in combination. These ways may be applied as an alternative or in addition to the user selection described above.

A monitoring system 100 may provide only a limited number of indications at the same time, providing only the indications which have the highest priority, wherein the priority of an indication may be based on the priority of the corresponding patient. However, it may be the case that certain types of indications. such as indications of alarm statuses, are always shown provided even if the limited number is exceeded. Other indications may be suppressed or delayed until one of the predefined number of indications is stopped. for example by being confirmed or deactivated, or by timing out. A monitoring system 100 may selectively display health information sections by displaying health information sections only for a predefined or maximum number of patients at the same time. The selection may be based on the patients” respective health warning scores, for example by displaying only health information sections for patients above a certain level of prioritization, based on a prioritization of patients. A monitoring system 100 may reorder displaved health information sections, based on a prioritization of patients. The reordering may be based on the patients” respective health warning scores, for example by ordering patients according to their level of prioritization based on a prioritization of patients. Patients with a higher priority may for example be displayed larger, first, on top, or in front. An ordering of the health information sections 200 may be updated periodically, either with a certain frequency or each time updated information, in particular recalculated health warming scores, is available, or in response to certain triggers, for example in response to user inputs.

Figure 9A shows a view comprising a general information section 250, a number of health information sections 200, and an overview section 260. In this case, nine health information sections numbered 1-9 are displayed. In this case the health information sections 200 are ordered by the number of the corresponding individual monitoring device 110. An overview section 260 may display all available health information sections 200 in abstracted form, such as a similarly shaped smaller block containing only a number and name abbreviation, or as a list, or as a visual depiction of a data structure. The overview section 260 may indicate, for example by highlighting, which health information sections 200 are being displayed in the present view. In the view of figure 9A, for example, it may be possible to select health information sections 200 by scrolling through a virtual view formed by the health information sections 200, or by scrolling or clicking in the overview section 260. The settings button may allow a user to switch to a view which allows the user to select or reorder the health information sections 200, or for example to log in or out or to select visual depictions 210 intended for users with a different skill level.

Figure 9B shows a case wherein the health information sections 200 have been prioritized based on criticality class, wherein the device 170 displays only those health information sections 200 where at least one health parameter is abnormal or critical. Furthermore, the health information sections 200 have been sorted, to show health information sections 200 comprising critical health parameters first. As a secondary hierarchical criterion, the health information sections 200 are reordered to display health information sections 200 in a particular order, namely in order of the health warning scores. An overview section shows health information sections which do not fit the display.

Figure 9C shows a case wherein the health information sections 200 have been prioritized based on criticality class, but now to include only those where at least one health parameter is critical. In this case, only three health information sections 200 are shown, fewer than the maximum number of health information sections 200 which fit in the view.

Claims

CONCLUSIONS

I. System for monitoring at least one patient, comprising at least one individual monitoring device, a central monitoring device, and at least one calculation device communicatively connected to the at least one individual monitoring device and the central monitoring device; wherein the at least one monitoring device for an individual comprises at least one sensor adapted to sense a health parameter of the corresponding patient and to produce input data based on that health parameter; wherein the at least one calculation device is arranged to calculate at least one health warning score that represents an estimated health level of at least one patient. based on the corresponding input data: wherein the central monitoring device comprises a first display. configured to display at least a first portion of health information about a corresponding one of the at least one patient, each first portion of health information comprising a visual image of the corresponding patient, the condition of the patient in the visual image reflecting the corresponding health alert score .

2. System according to any one of the preceding claims, wherein the central monitoring device is designed to display at least part of health information in accordance with a predetermined prioritization of patients, preferably the part of health information corresponding to the patient with the worst health level has the highest priority.

The system of claim 2, wherein displaying the at least a portion of health information in accordance with a predetermined prioritization of patients includes: reordering at least two portions of health information in accordance with their respective corresponding health alert scores, and/or selectively displaying at least some health information based on its corresponding health alert score.

A system according to any one of the preceding claims, further adapted to periodically produce a visual or auditory indication that a clinical action should be performed on the corresponding patient, wherein a visual and/or auditory indication is produced each time a predetermined time interval expires after the previous indication, where the predetermined time interval and/or clinical action to be performed is based on the health alert score of the corresponding patient.

5. System according to any of the preceding claims, further adapted to produce a visual and/or auditory indication that represents an alarm status. based on determining that at least one patient's health alert score exceeds a predetermined threshold indicative of a deteriorating health level.

6. System according to any one of the preceding claims, wherein the at least one calculation device is arranged to periodically or substantially continuously recalculate the at least one health warning score based on an input data merge produced during an input data merge time window, for example a sliding time window , and to periodically or substantially continuously redisplay health information based on the recalculated health alert score.

The system of claim 6, wherein the at least one calculation device is further arranged to weight the input data received during the input data merging time window, preferably giving more recently received input data a higher weight in recalculating the health alert score.

The system of claim 6 or 7, wherein the length of the input data merging window is different for the recalculation and/or redisplay frequency.

A system according to any one of the preceding claims, wherein the at least one health alert score is calculated by taking the mean or median of a plurality of input data values, each input data value being obtained by mapping raw input data values to a standardized range.

System according to any one of the preceding claims, wherein the at least one monitoring device for an individual comprises a second display, adapted to display a second part of health information about the corresponding patient, which reflects the health alert condition corresponding to that patient.

11. System according to claim 10, wherein the second part of health information comprises a visual image of the corresponding patient, wherein preferably the first screen and the second screen are adapted to display different visual images.

System according to any one of the preceding claims, wherein at least one visual image of a patient has realistic proportions, movements, and/or colors, and/or wherein at least one visual image of a patient reflects the health alert score corresponding to the patient, at least in that a patient who is more upset 1s is depicted in the case of a worse health level.

System according to any one of the preceding claims, wherein at least one health information part further comprises health parameter information about at least one health parameter of the corresponding patient, based on the corresponding input data.

A system according to any one of claims 12 or 13, wherein the health parameter information included in the at least one health information part comprises an adjustment of a corresponding part of the visual image of the patient.

System according to any one of the preceding claims, wherein the at least one calculation device is arranged for determining that at least one sensor is not producing valid input data, wherein preferably the failure to produce valid input data includes that the input data is not a large cover enough of a pre-image time window, and/or that the input data includes non-physiological values.

16. System according to claim 15, wherein the at least one monitoring device for an individual and/or central monitoring device is further arranged to produce a visual and/or auditory indication that a user should perform a corrective action on at least one sensor , in the event that the at least one calculation device determines that the at least one sensor is not producing valid Input Data.

17. System according to any of the preceding claims, wherein the at least one sensor of the at least one monitoring device for an individual comprises at least two sensors, which are adapted to produce input data based on at least one of the same health parameters.

System according to claim 17, wherein, in the event that both of the at least two sensors produce the same type of input data, the at least one calculation device is arranged to calculate the at least one health warning score based on a sensor from the two sensors, wherein the at least one calculation device is adapted to select that one sensor based on a predetermined prioritization of the at least two sensors.

System according to any one of the preceding claims, wherein the at least one sensor of the at least one monitoring device for an individual comprises a ballistography sensor, incorporated in a holder with a flat surface for the corresponding patient to lie on.

20. Method for monitoring at least one patient, preferably using a system according to any one of the preceding claims, comprising: sensing a health parameter of the at least one patient and producing input data based on the at least one health parameter, using at least one sensor applied to the patient: calculating at least one health alert score representing an estimated health level of the at least one patient, based on the corresponding input data, using at least one calculation device; displaying at least a first piece of health information about a corresponding one of the at least one patient, using a first display, wherein each first piece of health information includes a visual image of the corresponding patient, with the patient's condition in the visual image reflects the corresponding health alert condition.