United States Patent [191 United States Patent [191
`
`Brown
`Brown
`
`154[ MONITOlUNG SYST[1\1 FOR REMOTELY
`1541 MONITORING S YSTI~ M FOR REr"'IOTElY
`QUERYING INUlVU>UAlS
`QUERYING INVlVlUUALS
`
`PSI
`1751
`
`
`Inventor: Stephen J. Ilrown. Mountain View. Inventor: Stephen J. 8rown, Mountain Vicw,
`Ca li f.
`Calif.
`
`1731 Al;,.<;ignee:
`Ilellllh Hero Network, Inc., Mountain
`i\ssignee: Hrn lth H('t'1) N('twor k, Inc., Mountain
`1731
`View, Calif.
`View. Calif.
`
`1211 AppJ. No.: O!'l/847,009
`1211 AppJ. No.: OK/K47,OO9
`
`1221 Filed:
`1221 Filed:
`
`AlIT. 30, 1997
`Allr.30, 1997
`
`){cllltcd U.S. Allllilcalion J)llla
`1{c1at('(1 U.S. Aplll1cation Data
`
`l'rovisiODal application No. 6O,U4 1,751, Mar. 28, 1997,and
`)'rovisional application No. 60,041,75 1, Mar. 28, 1997, an d
`provisional applicntion No. 6O,U4I ,746. Mar. 28. 1997.
`provisional application No. 60,1).\1 ,746, Mar. 28, 1997.
`
`Int. Cl.6 Inl. CJ.° ............................. A61U 5/02; GOOF 15/00 ..................... ........ A6 1U 5/02; GOOF 15/00
`
`U.S. CI. . ....................
`. .......................... 6OO{300
`U.S. CI. .
`6001300
`Fi('ld of S(,lm;h
`
`... 600I300, 30 I ; ............... 600/300.301;
`Fil'ld ofScllrch
`128/898, 920--925
`1181898. 920--925
`
`lool
`
`[51]
`[511
`152[
`1521
`ISSI
`1581
`
`
`
`1561 1561
`
`R('r('renecs Cill'<l
`u.s. PAT ENT ])OCUMENTS
`u.s. PATENT DOCU MENTS
`6/ 1990 Kaufman CI al.
`............... 600/300
`..... 600/300
`6/ t990 Kaufman Cl al.
`!I1l 993 Thibado et al.
`........ 600/300
`1111993 Thibado Cl al.
`................... 6001300
`8/1995 David d al.
`128f..l(l4 X
`fl/1995 David et al.
`... t>OO!300
`' ''''''" X
`7/1997 Kehr
`7/1997 Kehr ........ ............................... (>(01300
`
`4,933,876
`4,933,876
`5,262,9U
`5,262,943
`
`5,441,0-17 5,441,0-17
`5,642.73 1
`5,642,731
`
`
`
`111II111 111II111
`
`
`
`1II1 1II1
`
`[II I Patent Number:
`[111 Patent Number:
`[451 Date of Patent:
`[451 Date of Patent:
`
`
`5,897,493 5,897,493
`Ap r. 27, 1999
`Apr. 27, 1999
`
`AnSTRAC I'
`AIlSTRAcr
`
`Primary Exallliller-Samue! Gilbert
`Primary Exallliner-Samuc! Gilbcn
`Allon",y, Age/JI, or Firm-Lumen JntclleclU~1 Properly
`Allorm.y, Agefl/, or Firm- Lumen Intellectual Properly
`Services
`Services
`
`1571 1571
`A monitoring system for rcmotely querying an individual
`A monitoring system for remotely querying an individual
`indudes a central contputer system and at least one remote
`indudes a \'""l;:ntrall""01l1putcr sy~tcm and at least one remote
`apparatus. 1be central computer system includes a server
`apparatus. The central computer system includes a server
`
`and a workstation networked 10 Ihe server for entering a sel and a workstation networked to the servcr for entering a SC I
`of queries to be answered by the individual. 1bc server
`of queries 10 b¢ allswered by the illdividual. 'lbe server
`
`includes a script gcneralor for generating a script program to indudes a script generator for generating a script program to
`be execuled by Ihe apparalus. 'Ine script program includes
`be executed by the apparatus. The script program includes
`display l"Ommands to display the queries, input commands
`display commands to display the (IUnies, input commands
`to receive responses to the queries, and a transmit command
`to receive respollSCS to the queries, and a trallsmit \."'Ommand
`to transmit Ihe responses fro m the apparatus to the central
`to transmit the respollses from the apparatus to the cenlral
`computer system. 'Ine server also indudes a database for
`computer system. The server also includc.<; a data base for
`storing the script program and the responses to the queries.
`storing the script program and the re~pom;es to the queries.
`1ne apparatus includes a modem for receiving the script
`The apparatus includes a modem for rcceiving the script
`program from Ihe server and for transmitting Ihe responses
`program fro m the server alld for trallSminillg thc responses
`to the server. The apparatus also includes a display for
`to Ihe server. The apparatus also includes a display for
`displaying the queries and input buuons fo r entcring Ihe
`displayillg the queries and input bllltO!11; for clltering thc
`responses to the queries. A pfO(.'Cssor is connected to the
`responses 10 the queries. A processor is connocted to Ihe
`modem. the display, and the input bultons. 'Ibc processor
`modem, the display. ami the illput bullons. 'Ibe pnx:essor
`executcs the script program to display the queries, receive
`cxccutes the script program to display the queries, receivc
`the responses, and transmit the respon.<;es to the central
`the responses, and transmit the responses to the cclltral
`computer system.
`computer system.
`
`I II Claims, L2 Llnm'ing Sheets
`19 Claims, 1.2 Urawinll Slwcts
`
`16""
`16""
`
`SERVER
`SERVER
`
`
`
`18 18
`
`
`
`22 22
`
`24
`24
`
`
`TELEPHONE I---i TELEPHONE I---i
`NETWORK
`NETWORK
`
`REMOTE
`REMOTE
`APPARATUS J
`APPARATUS I
`
`MONITORING
`MONITORING
`
`DEVICE J DEVICE J
`
`
`
`28 28
`
`30
`30
`
`REMOTE
`REMOTE
`APPARATUS 2
`APPARATUS 2
`
`CARDIOCOM EXH 1038
`CARDIOCOM v. BOSCH
`IPR2013-00468
`
`1
`
`

`
`U.S. Patent
`
`All!". 27, 1999
`
`Sheet 1 of 12
`
`5,897,493
`
`16"-.,..
`
`SERVER
`
`18
`
`22
`
`20
`
`24
`
`TELEPHONE
`NETWORK
`
`REMOTE
`MONITOR ING
`APPARATUS t f--'---1 DEV ICE I
`
`28
`
`REMOTE
`APPARATUS 2
`
`FIG. I
`
`18
`2
`SERVER
`8 Ir
`3
`DATABASE
`H SCRIPT PROGRAMS I
`V
`h
`40
`2,
`4
`H
`!J
`RESPONSES
`H MEASUREMENTS I
`4,
`4
`V
`6,
`V
`4
`H
`TABLE
`I
`
`48
`'v
`
`50
`"-
`52
`"-
`54
`"-
`
`MONITORING
`APPLICATION
`SCRIPT GENERATOR I
`I
`SCRIPT ASSIGNOR
`REPORT GENERATOR
`
`FIG. 2
`
`V
`20
`WORKSTATION
`I SCRI PT ENTR Y ~
`Lr5
`6
`II
`Lr5
`REPORT
`~
`8
`
`26
`REMOTE APPARATUS
`'--"
`I SCRIPT PROGRAM~ /6
`o
`r /4 2
`I RESPONSES
`I MEASUREMENTS j- _/4
`4
`i
`28 "'- MON ITORING
`DEV ICE
`
`2
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Shcel 2 of 12
`
`5,897,493
`
`62
`
`FIG. 3
`
`BUlTONS
`
`70
`
`SO
`
`82
`
`84
`
`26
`
`I-I--l TELEPHONE
`NETWORK
`
`PROCESSOR
`
`MODEM
`
`68A
`
`24
`
`UART
`
`JACK I
`
`MONITORJNG
`DEVICE
`
`72
`
`FIG. 4
`
`68B
`
`28
`
`68C
`
`3
`
`

`
`SCRIPT ENTRY SCREEN
`SCRIPT NAME: I
`
`DIABETES SCRIPT I
`
`h---- 92
`CHOICE I CHOICE 2 CHOICE 3 CHOICE 4
`
`QUERIES
`
`94 "-Ir
`
`HOW DO YOU FEEL?
`
`1 VERY 1 EJ 1 GOOD ,
`
`BAD
`
`VERY
`GOOD
`
`96
`
`"'
`
`HOW WELL ARE YOU
`MANAGING YOUR DISEASE?
`
`1 VERY '
`BADLY
`
`IBADLY 1 1 WELL ' 1 VERY 1
`WELL
`
`HOW HARD IS IT FOR YOU TO
`FOLLOW YOUR TREATMENT PLAN'
`
`1 VERY '
`HARD
`
`' HARD '
`
`' EASY ' 1 VERY '
`EASY
`
`HOW WELL DOES YOUR DOCTOR
`RESPOND TO YOUR NEEDS'
`
`VERY
`BADLY
`
`' BADLY '
`
`' WELL ' 1 VERY '
`WELL
`
`HOW HARD IS IT FOR YOU TO
`CONTROL YOUR BLOOD SUGAR'
`
`' VERY ' 1 HARD '
`HARD
`
`' EASY ' 1 VERY '
`EASY
`
`SELECT DEVICE TYPE(S)
`98~ GLUCOSE METER
`
`o PEAK FLOW METER
`o EKG
`CONNECTION TIME: I 03;00 I '\l ~ 100 I CREATE SCRIPT ~ 102 I CANCEL~104
`FIG. 5
`
`• rn
`•
`
`-N
`
`4
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Sheet 4 or 12
`
`5,897,493
`
`106
`
`110
`
`SCRIPT ASSIGNMENT SCREEN
`AVAILABLE SCRIPTS:
`PATIENTS:
`
`X DIABETES SCRIPT I 108 v--0 DAN LINDSEY
`o DIABETES SCRIPT 2
`0 MARK SMITH
`o ASTHMA SCRlPT I
`0 DEAN JONES
`
`112
`
`ADD SCRiPT
`
`ASS IGN SCRIPT
`
`DELETE SCRIPT
`
`114
`
`FIG. 6
`
`HOW DO YOU FEEL?
`
`26
`
`VERY
`BAD
`
`VERY
`BAD GOOD GOOD
`
`70A
`
`70C
`70B
`FIG. 7
`
`70D
`
`26
`
`CONNECT GLUCOSE METER
`AND PRESS BUTTON
`WIffiN FINISHED
`(PRESS)
`
`64
`
`64
`
`70A
`
`70C
`706
`FIG. 8
`
`700
`
`5
`
`

`
`fAT IENT: 1 LINDSEY, DA N 1'71
`4S
`
`58
`~
`PATlENT REPORT
`DATE OF MEASUREMENT: 1 MARCH 15, 1997 1'71
`1),6
`
`•
`rJ1
`•
`
`QUER Y RESPONSES
`HOW DO YOU FEEL?
`BAD
`I
`I
`HOW WELL ARE YOU
`MANAGING YOUR DISEASE?
`I BADLY
`I
`HOW HARD IS IT FOR YOU TO
`FOLLOW YOUR TREATMENT PLAN?
`I
`I HARD
`HOW WELL DOES YOUR DOCTOR
`RESPOND TO YOUR NEEDS?
`I WELL
`I
`HOW HARD IS IT FOR YOU TO
`CONTROL YOUR BLOOD SUGAR?
`IVERY HARD I
`
`L
`6
`
`FIG. 9
`
`160 r
`150
`140
`130 r
`1-__ 1 ~ - ----- -- ---- -- - - ----
`..J 120
`e 110
`0
`::;: 100
`90
`80 r
`70 1-------------------------- ------
`_.
`60
`,
`-,
`50
`14 16 18 20 22 24
`HOURS
`
`8
`
`10
`
`L
`12
`
`6
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Sheet 6 or 12
`
`5,897,493
`
`START
`MONITORING
`APPLlCA TION
`
`202
`
`RECEIVE
`SCRIPT DATA
`
`204
`
`206
`
`GENERATE
`AND STORE
`SCRIPT PROGRAMS
`
`RECEIVE AND
`STORE SCRIPT
`ASSIGNMENTS
`
`208 -....rvr
`
`YES
`
`NO
`
`RECEIVE
`AND STORE
`RESPONSES AND
`MEASUREMENTS
`
`RETRIEVE
`ASSIGNED SCRIPT
`
`TRANSMlT
`1---------1 ASSIGNED SCRIPT
`
`FIG. IDA
`
`210
`
`212
`
`214
`
`7
`
`

`
`u.s. Patent
`
`All!". 27, 1999
`
`Sheet 7 of 12
`
`5,897,493
`
`NO
`
`YES
`
`218
`
`RETRIEVE
`RESPONSES AND
`MEASUREMENTS
`
`220
`
`GENERATE
`AND DISPLAY
`REPORT
`
`>-Y!..!E",S,----< TO STEP 202
`
`NO
`
`224, /,, -,
`NEW
`ASSIGNMENTS?
`
`YES
`
`TO STEP 206
`
`NO
`
`TO STEP 208
`
`FIG. lOB
`
`8
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Shcct 8 of 12
`
`5,897,493
`
`START
`SCRIPT
`PROGRAM
`
`302
`
`EMIT TONES
`
`304
`
`LIG HT LED
`
`306
`
`308
`
`310
`
`PROMPT
`PATIENT
`
`EXECUTE
`SURVEY
`
`TURNOFF
`LED
`
`312
`
`WAIT TO
`CONNECT
`
`3 14
`
`EXECUTE
`CONNECTION
`
`END
`SCRIPT
`PROGRAM
`
`FIG. 11
`
`9
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Sheet 9 or 12
`
`5,897,493
`
`START
`SURVEY
`
`START
`CONNECTION
`
`402
`
`404
`
`DISPLA Y QUERY
`AND RESPONSE
`CHOICES
`
`RECEIVE
`AND STORE
`RESPONSE
`
`502
`
`CONNECT UART
`TO MODEM
`
`504
`
`CONNECT
`TO SERVER
`
`506
`
`YES
`
`YES
`
`NO
`
`408
`
`PROMPT FOR
`DEVICE
`CONNECTION
`
`4 10
`
`CONNECT UART
`TO INTERFACE
`
`412
`
`COLLECT
`AND STORE
`MEASUREMENTS
`
`END
`SURVEY
`
`FIG. 12
`
`508
`
`TRANSMIT
`RESPONSES AND
`MEASUREMENTS
`
`510
`
`RECEIVE AND
`STORE
`NEW SCRIPT
`
`END
`CONNECTION
`
`FIG. 13
`
`10
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Sheet 10 of 12
`
`5,897,493
`
`START
`MONITORING
`APPLICATION
`
`602
`
`RECEIVE
`SCRIPT DATA
`
`604
`
`606
`
`GENERATE
`AND STORE
`SCRIPT PROGRAMS
`
`RECEIVE AND
`STORE SCRIPT
`ASS IGNMENTS
`
`608
`
`YES
`
`CONNECT TO
`APPARATUS
`
`610
`
`RETRIEVE
`ASS IGNED SCRIPT
`
`612
`
`NO
`
`TRANSMIT
`ASS IGNED SCRIPT
`
`614
`
`RECEIVE
`AND STORE
`~-------------1RESPONSESAND
`MEASUREMENTS
`
`616
`
`B
`
`FIG.14A
`
`11
`
`

`
`U.S. Patent
`
`Apr. 27, 1999
`
`Shcet 11 or 12
`
`5,897,493
`
`618
`
`NO
`
`YES
`
`620
`
`RETRIEVE
`RESPONSES AND
`MEASUREMENTS
`
`622
`
`GENERATE
`AND D1SPLA Y
`REPORT
`
`~Y:..:E::S,----c TO STEP 602
`
`NO
`
`626
`
`NEW
`ASS IGNMENTS?
`
`YES
`
`TO STEP 606
`
`NO
`
`TO STEP 608
`
`FIG.14B
`
`12
`
`

`
`U.S. Patent
`
`Apr. 27,1999
`
`Sheet 12 of 12
`
`5,897,493
`
`START
`SCRIPT
`PROGRAM
`
`702
`
`DlSPLA Y QUERIES
`AND STORE
`RESPONSES
`
`704
`
`PROMPT FOR
`DEVICE
`CONNECTION
`
`706
`
`CONNECTUART
`TO INTERFACE
`
`708
`
`COLLECT
`AND STORE
`MEASUREMENTS
`
`710
`
`CONNECT UART
`TO MODEM
`
`712
`
`TRANSMIT
`RESPONSES AND
`MEASUREMENTS
`
`FIG. 15
`
`13
`
`

`
`5,897,493
`
`1
`MONITOIUNG SYSTEM FOR IU;JI,10TELY
`Q U m~YING INDIVIOUAI ... C)
`
`RELATED AI'I'LICI\1l0N INFORMATION
`
`'1l1is application dams priority from lhe provisional appli.
`cation 60/041.751 filed Mar. 28.1997 entitled ·' I-IEI\I.:I"H
`MONITORING SYSTEM COMBl NlNG INTERAC'IlVE
`PATIENT RESPONSE WITII A MED ICAL DEVICE
`INTERFACE", med Mar. 28, 1997 and the provisional
`application 60/04 J ,746 liJed Mar. 28, 1997 entitled "STORE
`AND FORWARD IIEALTII MONITOR ING SYSTEM"
`filed Mar. 28, 1997. BOlh provisional applications arc hereby
`incorporated by reference.
`
`5
`
`'"
`
`FIELD OF THE INVEN'-nON
`
`The present invention relates generally 10 reniOle moni·
`loring systems. and in particular \0 a monil0rinl!, syslcm and
`method for rcmoh:ly querying individuals.
`
`BACKGROUND OF TI-IE INVENTION
`
`In recent years, an increasing number of healthcare pro(cid:173)
`viders have initiated outpatient or home hcallhcarc programs
`for their patients. '111e p01ential bcneHts of these home
`heallhcare programs arc panicularly great for chronically ill
`patients who mu~ treat their diseases on a daily b:1Sis.
`However. the succes.<; of thcse programs is currently
`limited by the ability of he3hh!;3n; providers to mouitor the
`patients remotely to avert medical problems before they
`bocome complicated and costly. Unfortunately, no con\'e(cid:173)
`nient and cost cffeetive monitoring system exists for the
`patients who have the greatest need for monitoring, the poor
`and the elderly.
`]-'rior aHemptS to solve the problem of remotely mOl1itor- J~
`ing patients have indudtd the use of p<:rsonal computers and
`modems to est~blish communication between p:tlients and
`heallhcare llroviders. However. \.'Omputers are too expensive
`to give away amI the patielllS who already own computers
`are ouly a small fraction of the total populntiou. Further, 40
`patiellts who owu computers are typically youug. well
`educated, and have good healthcarc coverage. 'lbus, these
`patieuts do not have the greatest unmet medical nceds. The
`patients who havc the greatest unmet medical needs are the
`poor and elderly who do not own computers or who arc 45
`unfamiliar with their usc.
`Similar al1empts to establish oommunication betwecn
`patients and heallhcare providers have induded the usc of
`the internet and internet terminals. Although internettermi(cid:173)
`nals arc somewhat le:o;s costly than personal computers, they 50
`are still not sufficiently inexpensive to give away 10 patients.
`Moreover, monthly on·line access charges are prohibitive
`for poor patients.
`Prior allempts to solve tbe problem of remotely monitor(cid:173)
`ing patients have also included the usc of interactive tele- 55
`phone or video response systems. Such interactive systems
`are disclos.::d in U.s. Pat. Nos. 5,390,238 issued to Kirk et
`al. on Feb. 14. 1995,5,434,611 issued to Tamura on Jul. 18,
`1995, and 5,441,047 issued to David et aJ. on Aug. 15, 1995.
`A disadvantage of these systems is thaI they dther require a 60
`patient to call in to a t'Cntral facility to bc.l monitored or
`require the t'Cutral facility to caHthe patieut K'(.'Ording to a
`rigid monitoring schedule.
`If the patients are required to callthc \.'Cntral facility, only
`the compllant paticuts will actually call regularly to be 6S
`monitored. However. it L~ the non-compliant patieulS who
`have the greatest need for monitoring to avert medical
`
`2
`problems before they become complicated and costly. If the
`central fa!;ility calls each patieut according to a monitoring
`schedule, it is introsive to the patien1"s life and resistance to
`the monitoring grows over time. Further, it is difficult to
`identify each patient uniquely using these conventional
`ioteraeti\'C response systems. Additionally, these systems arc
`generally incapable of transmilling medical data t'Ollected in
`monitoring devices, such as blood glucose meters or p.!ak
`flow meters.
`It is aIM) known to usc monitoriug devkes with modems
`to monitor patients remotely. Unfortunately, these rnonitor(cid:173)
`iug devices do not allow flexible and dynamic querying of
`palients for other information. such as quality of life mea·
`sures or psycho.social variables of illness.
`
`OI3JEc rs AND ADVANTAGES OF TilE
`INVENT[ON
`
`is au object of the preseut
`In view of the above. it
`invention to provide a simple and inexpeusive systcm for
`:0 remotely querying patieulS amI for collccting data relating to
`the health status of the patients. II is another object of the
`invention to provide a monitoring system which allows
`llexible and dynamic updating of thc.l queries from a central
`computer system. It is a fu rther objcct of the invcution to
`!S provide a monitoring system which incurs lower tciet'Offi(cid:173)
`munications !;harges than those incurred by conventional
`monitoriug systems. Another object of the iuvention is to
`provide a monitoring system which may be used at any time
`convenient for a patient. A further object of the invention is
`JO to provide a mooitoring sys1em which combines querying of
`patients with medical device monitoring in the same 1I10ni-
`lOring session.
`These and other obje\'1s and advantages will be\.'Ome more
`apparent after consideration of the ensu ing description and
`the accompaoying drawings.
`
`SUMMARY
`The invention p1\:scnts a monitoring system and method
`for remotely querying an iudividual.111e monitoring system
`includes a central I;Qmputer system and a remote apparatus.
`The central computer system pn;fl.:rably includ ~ a server
`aod a workstation networked to the Sl.:rver. The workstation
`is for entering in the so.:rver a SCI of queries 10 be answered
`by the individual and corresponding responsc choices for
`each of the queries.
`'[be server ineludes a script generator for generating a
`script program to be executed by the apparatus. 'Ibe script
`program inclu<ks dL~play rommands to dL"play the queries
`and response choicc. ... 'Ibe script program also includes input
`commands to receive rc..<;ponscs to the queries. lbc scrvcr
`also includes a database connected to the script generator
`aod the workstation for storing the script program and the
`responses.
`'Ibe remote apparatus includes a communication device.
`such as a modem, for establishing commuoication links
`between the apparatus and the (;Cntral \.'Omputer system
`through a communication network. for receiving the scrip!
`program from the central computer system through a lirst
`communication link, and for transmilling the responses to
`the \.'Cntral computer system through a subsequcnt commu(cid:173)
`nication link, 'lbe script program rUrlher iocludes a t'Onnec(cid:173)
`tion \.'Ommand to establish the subs<:qucnl communication
`link at a prc..<;cribed connection time and a transmit t'Ommand
`to transmit the responses from the apparatus to the ceutral
`computer system through the sub!;Cquent communication
`liok.
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`FIG. "' is a schematic block diagram
`components of the apparatus of FIG. 3.
`FI G . .5
`i.~ a sample script entry screen
`prcferred embodiment of the invention.
`FIG. 6 is a sample script assignment screen according to
`the preferred embodiment of the invention.
`FIG. 7 is a sample query appearing on a display of the
`apparatus of FIG. 3.
`FIG. 8 is a sample prompt appearing on the display of the
`apparatus of FIG. 3.
`FIG. !' is a sample patient report displa~d on a worksta(cid:173)
`tion of the monitoring system of FIG. I .
`FIG. lOA is a llow chart illustrating steps included in a
`monitoring application according to the preferred embodi(cid:173)
`mem of the invention.
`FIG. lOB is a COfltinuation of the flowchart of F[G. lOt\.
`FIG. II L'i a now chart illustrating steps illcluded in a
`script program executed by the apparatus of FIG. 3 acconl(cid:173)
`ing. to the pl\:ferrcd embodiment of the invention.
`FIG. 1.2 is a now chart illustrating steps included in 3
`sUIVey routine of tbc script program of FIG. II.
`FIG. L3 is a now chart illustrating steps included in a
`!S corlllcction rOuline o f the SCripl program of F[G. II .
`FIG. 14A is a llow chart illustrating steps included in a
`monitoring application according to a second embodimcnt
`of the invention.
`FIG. 14B is a continuation of the Ilow chart of FIG. 14i\.
`FIG. 15 is a now chart illustrating steps included in a
`seript program exccutcd by the apparatus of FIG. 3 3(.'COrtI(cid:173)
`ing to the sccond embodiment of the invention.
`
`illu.~trating the
`
`according to a
`
`DESCRIPTION
`
`JO
`
`3
`The apparatus also illcludcs a display for displaying the
`queries and the responsc chai .. ..:::> 10 [he individual. input
`bunans for entering the rcslX'oscs in the apparatus. and a
`mo.;mory for sloring the scripl program and lhe responses. A
`processor is conncclcd 10 the communication device, the 5
`display, the memory, and the input bultons. '111e proc'Cssor
`CXCCUlcs Ihe scripi program to display the queries and the
`response choices, to receive [he rcspons.:s, 10 establish the
`subscqu,::ol communication link allbe prescribed connection
`lime, and to transmit lhe resporLS<!S to the central com])utcr JO
`system.
`The monitoring system preferably includes a number of
`remole apparatuses in communication with [he server for
`remolcly querying a corresponding number of individuals.
`Each of lhe individuals is associated with a respective 000 of 15
`the apparatuses. In the preferred embodiment. a number of
`sets of queries and corresponding responsc choi(."CS arc
`entered through the workstation and the script generator
`generates a corresponding number of script programs from
`the sets of queries and response choices. Each of the script :0
`programs corresponds to a respective one of the sets of
`qucries and response choices.
`Also in the preferred embodiment. the servcr includes a
`script mignor for assigning to each of the individuals at
`least one of the script programs. The database stores the
`scriPI programs, a list of the individual,>, and for each of the
`individuals. a rc..~pective pointer to
`the script program
`a$igned 10 the individual. The so.:l"\'<.!r is design<.!d to transmi t
`to each of the apparatus<:s the script program assigned to thc
`individual associated with the apparatus.
`A preferred method for using the monitoring system to
`rcmotely monitor individuals includes the steps of providing
`the individuals with a number of remote apparatuses such
`that each of the individuals is associated with a I\:spective
`one of the apparatuses. The method also includes the steps J~
`of entering in the central computer system sets of queries
`and corresponding response choices and generating in the
`ceillral computer system the script programs, whercJn each
`
`of the script programs corresponds to a respective one of the '"
`
`45
`
`S<,:IS of queries and corresponding response choices.
`'Ibe method further illCludes the steps of assigning to each
`of tbc individuals at least one of the script programs and
`storing in the database the script programs, a list of the
`individuals, and for each of the individuals, a respective
`pointer to the script program assigned to the individual. '111c
`method additionally includes the step of transmilling to each
`of the apparatuses the script program assigned 10 the indi(cid:173)
`vidual associated wilh the apparatus.
`Each apparatus preferably rcceives an assigned Sl.Tipl so
`program through a first communication link established
`between the apparatus and the server. '111e assigned script
`program is e:o::ecuted by the apparatus to display the queries
`and the response choices, to reccive the rcsponses, to
`establish a subsequent communication link 31 a prcscri\J(;d 55
`connection time, and to transmit the responses to the server
`through the subsequent communieatioll Jillk. 'l"l1c responses
`from each apparatus arc rea:ived in the server and slored in
`the database.
`
`BRIEF DESCRlPT[ON OF T il E DRAWINGS
`
`FI G. I is a schematic block diagram of a monitoring
`system according to the invention.
`FIG, 2 is a detailed block diagram of the monitoring
`system of FIG. I.
`A G. 3 is a perspective view of a remote apparatus of the
`monitoring sys1em of FIG. I .
`
`llte present invention is a monitoring system and method
`for remotely querying individuals. In a prcferred embodi(cid:173)
`ment of the invention, the individuals arc patients and the
`monitoring system is used to collect data relating to the
`health status of the patients. Ilowcver, it is to be understood
`that the invention is not limited to remotc palient mOflitor(cid:173)
`ing. ' Ibe invention may be used for any monitoring appli-
`cation which requires remote querying of individuals.
`lbe preferred embodiment of the invention is illustrated
`in FIGS. 1- 9. Referring to FIG. I , a monitoring system 16
`includes a server 18 and a workstation 20 connected to
`server 18 through a network link 22. Server 18 and work(cid:173)
`station 20 function as a central computer system for (.'Om(cid:173)
`munieating with a number of remote appa ratu.o;es. Worksta(cid:173)
`tion 20 is preferably a personal computer or network
`terminal.
`System 16 also includes a first remote apparatus 26 and a
`second remote apparatlls 32. Each apparatus is in commu(cid:173)
`nication with SClVer 18 through .t (.'Ommunication network.
`such as a telephone ootwork 24. For clarity of illuJ;lration.
`only two remote apparatuses arc shown in FIG. I. l lowcver.
`it is to be understood that monitoring system 16 may include
`hundreds of remote apparatlL'\Cs in communication with
`sclVer 18 . Each I)alienl 10 be monil0red is preferably as.<;(l-
`60 ciated with a respective one of the remote apparatuscs.
`A monitoring device 2S is connected to apparatus 26
`through a standard connection cable 30. Monitoring device
`28 is for producing measuremenL~ of a physiological (.'On(cid:173)
`dition of a patient. re(.'Ording the measurements, and trans-
`65 milling lhe measurements to appara tus 26. The type of
`monitoring device used by each patient is dependent upon
`the patiert\ 's disease. For example, for a diabetes patient.
`
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`through lhe subsequent communication link. "be steps
`included in Ihe scripi program arc shown in Ihe (low charts
`of FIGS. 1l- J3 and will be discussed in the operation
`section below.
`Referring again 10 FIG. 2, scripl assignor 52 is for
`assigning to each patient atleaSl one of tho.: script programs
`40 Slorcd in database 38. ' l1le scriPI programs 40 arc
`preferably as.signed by entering script assignment informa(cid:173)
`tion through work.':ilation 20. FIG. 6 iIlustr31es a sample
`JO script assignment screen as it appears on workstalion 20.
`lbe script assignmelll screen includes check boxes 106
`for selecting a script program 10 be as.signed. The script
`assignmelll screen also includes check boxes 108 for select(cid:173)
`ing tIle patients to whom Ihe scripi program is to be assigned.
`'Ibe script assignment screen further includes an assign
`script bUllon 112 ror .::ntering script program assig nments.
`When bUllon 1I 2 is pressed, the script assignor creates and
`slOfes for each patienl sclecled in check boxes lOS a
`respective poimer 10 the scripl program selected in check
`:0 boxes 106. Each poinler is stored in Ihe paliem look-up table
`of the database. 'Ibe ",,:ript assignment screen additionally
`includes an add scripi bunon 110 for accessing Ihe script
`entry screen and a .IciCle script bunon U4 for tickling a
`script program.
`
`5
`device 28 is a blood glucose meIer for measuring the
`palient's blood glucose L"Qllcenlralions. For an asthma
`pallen[, devi,.:: 28 is a peak flow meier for mcasuriog Ihe
`palient's peak !low rales. Such monitoring devices for
`recording and transmitting measuremems are well known in 5
`Ihe an,
`FIG. 2 is a schematic block diagram illustrating server 18,
`workstation 20. and apparatus 26 in grealer dClail. Server 18
`has a database 38 for storing script program ... 4tI. '[be scripl
`programs are cx<."<:ulab[c by each remOle apparalUl; 10 disp lay
`queries 10 patients, receive rcsponso:S 42 10 lite queries,
`collcct monitoring device mcaMJfcmcnls 44, and transmit
`responses 42 and measurements 4410 server 18. Database 38
`is designed 10 store Ihe responses 42 and measurements 44.
`Database 38 funher includes a look-up lable 46. Table 46 15
`conlains a lisl of Ihe palknls 10 be monilored, and for each
`palient, a corresponding patient identification code and a
`respective poiOier to at leas< one of the script programs 40
`assigned to the patien!.
`A monitoring application 48 is installed on server IS.
`Monitoring application 48 is a comrolling soliwan.: apl)1i(cid:173)
`cation executed by server 18 10 perfoml the v~rious func(cid:173)
`tions described in the operation section below. Monitoring
`applicalion 48 includes a script generator SO, a script
`assignor 52, and a report generator 54. Script generator SO
`is d.::signed 10 gene rat.:: script programs 40 from script entry
`information 56 entered through workstation 20.
`FIG. 3 illm;tratcs a sampl.:: SCripl en try screen as it appears
`on workstation 20. The scriPI enlry screen includcs a script
`nllnle lidd 92 for specifying the !lame of a script program 10
`be generaled. The script entry screen also includes query
`fields 94 for emcring a set of queries to be answered by a
`patien!. Each query (lc1d 94 has corresponding response
`choice (lelds 96 for entering corresponding response chokes
`for Ihe query. The script en!ry screen furthcr includes chcck
`boxes 98 for selccting a desired monitoring device from
`which to collect mcaSUremenlS, such as a blood glu<."OSC
`meier, peak now meter, or EKG.
`·l1le script entry screen addi tionally includes a <.'OnneetiOll
`lime Ileld 100 for specifying a prescribed connection lime at
`which each apllaralus executing Ihe scripl is to establio;h a
`sub!;Cquenl communicalion link to Ihe server. The conneC(cid:173)
`tion lime L~ prefcrably sclceled to be the lime at which
`telecommunications rates arc the lowest, such as 3:00 AM .
`·Ibe scri PI entry screen additionally includes a CREATE
`SCRIPT bulton 102 for instructing the scripl generator to
`generate a script program from the information enlered ill
`the script entry screen. ·Ibe script entry screen further
`includes a CANCEL bUllon 104 for canceling the informa(cid:173)
`lion entered in the screen.
`The script gcnerator is designed to create a script program
`from the informal ion entercd in the scripi entry screen. ·Ibe
`script program is executed by one or more of the remote
`apparalu.scs, as will be described in detail below. In the
`preferrc::l.l embodiment, the script program indudes display
`commands 10 display the queries and <.'Orresponding
`response choices enlered in iields 94 and 96. respcclivdy.
`The scripl program also includes inpul commands to I\!ceive
`responses 10 the queries. ·Ibe script program further includes
`a collect command to collect device measurements from the
`monitoring device specified in check boxes 98.
`The script program additionally includes a connection
`command to establish a subscqu.::nt communication link to
`the scrver at the connection time specified in field 100. 'The
`script program also includes a transmit command 10 transmit
`the rcsponses and device measuremcms 10 Ihe scrver
`
`J~
`
`" Referring again to FIG. 2, reporl generator 54 is for
`
`generating a patient report 38 from the responses and device
`measul\!ments rec.::ivecl from a patient and for displaying
`patienl rcport 58 on workstation 20. FIG. 9 shows a sample
`palien! report 58 produced by rcport generator 54. Patient
`JO report 58 includes a graph 116 of the device mcasurements.
`as well as a listing of responses 42 received from the palienl.
`Specific lechniques for writing a report gentrator program to
`display data in this manner are well known in the art.
`FIGS. 3-4 illuStrale Ihe struc1u re of remote apparatus 26
`in greater detail. Each remote apparalus in the preferred
`embodiment of Ihe monitoring syslem has a stntCIUre sub(cid:173)
`stanlially identical 10 rtomOle apllaratus 26. Referring to FIG.
`3, apparalm; 26 includ.::s a housing 62. Iiousing 62 is
`40 suOieient!y compacl to enable apparatus 26 10 1;It: hand-held
`and carried by a patienl. Apparatus 26 alSQ includes a display
`64 for displaying queries, corresponding response choices.
`and prompts to Ihe patient. In the preferred cmbodinlenl,
`display 64 is a liquid eryslal display (LCD) for displaying
`45 four lines of teXI ha \'ing up to twenty charaelcrs per line.
`Four user input bUllons 70A, 70ti, 70C, and 70]) arc
`localed adja<."Cnt display 64. l bc w;cr in put bullons arc for
`entering responses to the queries in apparatlls 26. In the
`preferred o.:mbodimenl. the use r input bullolls arc momentary
`so r..'Onl3ct pu.o;h bUllons. In an alternative cmbodimcnt, the
`bullons arc replaced by swilches or keys. '11lfee monitoring
`device jacks 6SA. 68B, and 6SC arc located on a surface of
`housing 62 . 'Ibe device jacks arc for conllCcting apparatus
`26 to a numbe r of monitoring devices through respective
`55 connection cables (not shown). Apparatus 26 also includes
`a modem jack 66 for connecting apparatus 26 to 3 telephone
`jack through a standard connection cable (nOi shown).
`Apparalu.~ 26 further includes an audio tra nsducer. such as
`a speaker 72 . Speaker 72 is for audibly nolifying the patient
`60 when unanswered queries arc stored in apparalus 26. Appa(cid:173)
`ralUs 26 also includes a visual indicator, such as a light
`emilling diode (LED) 74. LED 74 is for visually notifying
`Iho.: patient when unanswered queries stored in apparatus 26.
`FIG. 4 is a schematic block diagram illustrating apparatus
`6S 26 and ils connections 10 telephone network 24 and mOlli(cid:173)
`loring device 2S in grealer detail. Apparatus 26 includes a
`microprocessor 76 311d a memory 80 conncel.::d to micro-
`
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`procC5S0f 76. Memory 80 Slores script programs received
`queries and response choices and stores the script programs
`in database 3S . Each script program corresponds to a respec(cid:173)
`through network 24 and firmware for controlling the opo::ra(cid:173)
`lion of apparatus 26. 'Ibe tlrmware indudes a scripl inter(cid:173)
`tive one of the sets of queries entered through the script entry
`pret