United States Patent [19]
`Goodman
`
`[54] METHOD AND APPARATUS FORA
`PERSONAL HEALTH NETWORK
`
`[75]
`
`Inventor: David F. Goodman, San Francisco,
`Calif.
`
`[73] Assignee: LifeMasters Supported SelfCare, So.
`San Francisco
`
`[21] Appl. No.: 978,892
`
`[22] Filed:
`
`Nov. 26, 1997
`
`Related U.S. Application Data
`
`[63] Continuation of Ser. No. 518,783, Aug. 24, 1995, aban(cid:173)
`doned, which is a continuation-in-part of Ser. No. 334,936,
`Nov. 7, 1994, abandoned.
`Int. CI.6
`................................ ... .......... ... ....... A61N 5/04
`[51]
`[52] U.S. CI. .............................................................. 600/300
`[58] Field of Search ..................................... 600/300, 301,
`600/529; 128/920-925
`
`[56]
`
`References Cited
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`
`111111
`
`1111111111111111111111111111111111111111111111111111111111111
`US005827180A
`[11] Patent Number:
`[45] Date of Patent:
`
`5,827,180
`Oct. 27, 1998
`
`4,473,884
`4,490,711
`4,504,153
`4,526,474
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`
`(List continued on next page.)
`
`Primary Examiner-John P. Lacyk
`Assistant Examiner-Samuel Gilbert
`Attorney, Agent, or Firm---Orrick, Herrington & Sutcliffe,
`LLP
`
`[57]
`
`ABSTRACT
`
`A method and system for a health network comprising a
`facility, operated by a party other than the patient or health
`care provider, for collecting and routing information per(cid:173)
`taining to the health care of a patient to the patient and the
`health care provider. The health network utilizes two-way
`communication between the patient and the facility, and the
`health care provider and the facility. In one embodiment, the
`facility receives treatment instructions from the health care
`provider that are specifically developed for each patient.
`Algorithms are developed based on such instructions. The
`algorithms are then programmed into an appropriately con(cid:173)
`figured message device in the possession of the patient. The
`patient is prompted by the message device to measure and
`enter relevant physiological data, e.g., peak flow, etc., as
`dictated by the treatment instructions. Based on the mea(cid:173)
`sured physiological data and the algorithm, messages are
`displayed on the message device advising the patient of a
`specific course of treatment, e.g., to administer medicine, to
`call the health care provider, to go to the emergency room,
`etc., or, alternatively, such messages can provide more
`general information related to the patient's current health
`status. These results can be transmitted to the facility and the
`health care provider. The algorithm can be modified, as
`appropriate, to reflect changes in the treatment plan.
`
`25 Claims, 7 Drawing Sheets
`
`4
`,---i---,
`
`I
`I
`I
`I
`I
`I HEALTH CAREl
`~ _P_R.9~IQ~R_ ~
`
`1
`\.
`
`30
`
`31
`2
`,-----~------- ----
`I
`I
`20 :
`: 10
`I
`I
`I
`I
`23
`I
`I
`~ ___ ~ _____ !'~12~NI ~~~~:
`
`Cardiocom Ex. 1003
`
`

`

`5,827,180
`Page 2
`
`U.S. PATENT DOCUMENTS
`
`4,617,557 10/1986 Gordon.
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`4,662,537
`5/1987 Wolf et al. .
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`5/1987 Shimizu et al. .
`4,667,845
`5/1987 Frazier et al. .
`4,685,271
`8/1987 Ringer et al. .
`4,693,057
`9/1987 Rittinger et al. .
`4,693,371
`9/1987 Malpass.
`4,695,954
`9/1987 Rose et al. .
`4,717,042
`1/1988 McLaughlin .
`4,725,997
`2/1988 Urquhart et al. .
`4,730,846
`3/1988 Sheehan et al. .
`4,736,849
`4/1988 Leonard et al. .
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`5/1988 Stone.
`4,748,600
`5/1988 Urquhart.
`4,763,810
`8/1988 Christiansen .
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`8/1988 Pilarczyk.
`4,779,759 10/1988 Seavey.
`4,781,696 11/1988 Moulding, Jr. et al. .
`4,785,969 11/1988 McLaughlin .
`4,790,118 12/1988 Chilcoate.
`4,792,333 12/1988 Kidder.
`4,805,811
`2/1989 Wetterlin .
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`2/1989 Rappaport et al. .
`3/1989 Lambert.
`4,815,767
`4,819,352
`4/1989 Maunand.
`4,834,264
`5/1989 Siegal et al. .
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`4,838,453
`4,869,392
`9/1989 Moulding.
`3/1990 Bartell et al. .
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`4/1990 Tump.
`4,915,256
`4,939,705
`7/1990 Hamilton et al. .
`4,942,544
`7/1990 McIntosh et al.
`............. 364/413.02 X
`
`9/1990 Rowiett, Jr ..
`4,953,745
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`4,955,371
`4,971,221 11/1990 Urquhart et al. .
`4,975,842 12/1990 Darrow et al. .
`4,978,335 12/1990 Arthur, III .
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`3/1991 Doull.
`5,014,851
`5/1991 Wick.
`5,014,875
`5/1991 McLaughlin et al. .
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`5/1991 Seifers et al. .
`5,020,527
`6/1991 Dessertine .
`5,053,032 10/1991 Barclay et al. .
`5,064,071 11/1991 Kerfoot, Jr ..
`5,082,113
`1/1992 Romick.
`5,082,114
`1/1992 Bunin.
`5,099,463
`3/1992 Lloyd et al. .
`5,142,484
`8/1992 Kaufman et al. .............. 364/413.02 X
`5,152,422 10/1992 Springer.
`5,154,296 10/1992 Cutler.
`5,157,640 10/1992 Backner.
`5,163,559 11/1992 Bunin.
`5,176,285
`1/1993 Shaw.
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`1/1993 Hafner.
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`6/1993 Fine et al. .
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`6/1993 Shimizu et al. .
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`6/1993 Campbell.
`5,251,757 10/1993 Relyea et al. .
`5,259,531 11/1993 Bennett.
`5,263,596 11/1993 Williams.
`5,284,133
`2/1994 Burns et al. .
`5,286,258
`2/1994 Haber et al. .
`5,307,263
`4/1994 Brown ............................ 364/413.04 X
`5,310,060
`5/1994 Bitner et al. .
`5,339,821
`8/1994 Fujimoto ................................. 128/903
`5,390,238
`2/1995 Kirk et al.
`......................... 364/413.04
`5,542,420
`8/1996 Goldman et al. ....................... 128/630
`
`

`

`u.s. Patent
`
`Oct. 27, 1998
`
`Sheet 1 of 7
`
`5,827,180
`
`3
`I---}--~
`THIRD
`:
`I
`4
`PARTY
`I
`I
`: 34 r----l---l
`: FACILITY
`30' ~
`40
`:
`HOST
`I \ :
`" COMPUTER:
`I
`I
`1 ___ ____ ...I
`I
`I
`I HEALTH CAREl
`I PROVIDER
`I
`
`L __ ___ _
`
`FIG. 1
`
`1
`\.
`
`31--
`2
`r-----~------- ---~
`I
`I
`0.--10
`I MESSAGE
`MICRO-
`20 --r DEVICE
`PROCESSOR :
`:
`I
`I
`1 23 1
`I
`I
`PATIENT NODE I
`I
`-
`L __________________ I
`
`20
`\.
`
`FIG.2
`
`22-0
`
`24
`
`

`

`u.s. Patent
`
`Oct. 27, 1998
`
`Sheet 2 of 7
`
`5,827,180
`
`<f\
`
`TELEPHONE
`
`120 110,- PHONE/MODEM
`SWITCH
`\
`
`130
`I
`MODEM
`
`FIG.2A
`
`1~01
`
`CHARGER
`
`I
`
`15\
`
`140'-{1
`I
`
`/lP
`
`I MEMORY I
`"152
`DOCK/CRADLE
`
`MEMORY
`I
`DATA
`PORT ---r 180
`
`1
`
`5----1
`
`1
`
`1
`
`COMMUNICATIONS
`PORT
`50
`
`PHN
`1
`
`1
`
`1
`1
`
`1
`1
`
`1
`1
`
`PRIMARY HEALTH
`:--~t~!~~~~~R--:
`4
`
`FIG. 3
`
`DATA
`PROCESSOR
`
`10
`--
`
`1
`
`1
`1
`1
`
`1
`
`1
`1
`1
`1
`1
`1 54
`1
`-;
`1 ___________ _
`53---
`~ -----------,
`1----------------1
`1 3f:
`:
`HOST COMPUTER
`I-+-----'---t--i 40
`3 .....-J
`30
`1
`1
`1
`:!~I~~~~R!~~A_C~L~~ ____ J
`2
`_________ j _____ ~1_:_ ___ ,
`:
`:
`
`MESSAGE
`DEVICE
`20
`
`-
`
`I
`MEMORY
`23
`1 _____ ~ ______ ~A!~~~ ~O~~ __ J
`
`

`

`61 '
`
`65
`
`62
`
`64
`
`FIG.4b
`
`~ ( '
`
`2
`31----
`-------------j-------- - - - - - - - - - -
`DATA PROCESSOR
`MESSAGE DEVICE
`20
`10
`
`--1
`I
`I
`I
`I
`I
`I
`I
`I
`I
`: FIG. 5
`:
`I
`I
`I
`I
`MEDICAL DEVICE
`I
`I
`70
`I
`I
`-
`PATIENT NODE
`I ______ ----------------------------~
`
`1
`MEMORY
`23
`
`71---
`
`

`

`u.s. Patent
`
`Oct. 27, 1998
`
`Sheet 4 of 7
`
`5,827,180
`
`1
`\.
`
`1
`
`I
`I
`
`I
`I
`________ __ __ _ J
`
`------l
`I COMMUNICATIONS
`PORT
`58
`50
`3
`_1 __ ---------- - - - - ,
`53--
`~3
`
`1
`
`HOST
`COMPUTER
`30
`
`r--
`
`I
`I
`I NURSE
`I
`I
`80
`I
`THIRD
`I
`I
`PARTY
`I
`FACILITY
`L __ -- 1---------- 1 - - - -
`82
`--------------I-~--l
`I(cid:173)
`I
`MESSAGE
`DATA
`I
`DEVICE
`PROCESSOR
`I
`20
`10
`I
`-
`-
`I
`PATIENT NODE
`I
`1
`_________ \ _________ J
`
`I
`I
`
`I
`I
`I
`I
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`
`3~
`
`54
`4
`,- __1 ___
`
`I
`I
`I
`I
`I
`I
`
`PRIMARY
`HEALTHCARE
`PROVIDER
`40
`-
`1
`1 - - - - - - - - -
`
`-I
`I
`1
`I
`1
`
`1
`I
`I
`I
`
`\
`84
`
`FIG. 6
`
`2
`
`3
`, ____ '1- ____
`
`THIRD
`PARTY
`FACILITY
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`I
`1
`
`FIG. 7
`
`HOST
`: 3~
`COMPUTER
`1
`9
`30
`)
`- ~ (
`__________ l.. ____________ _
`t
`1
`1 , - - - - - - - - - ,
`1
`- - - - - - - - - -'
`COMPUTER r-
`91
`-
`
`1
`
`I
`I
`:
`
`PHARMACEUTICAL
`DISPENSING
`AND TRACKING
`
`2
`I FILLlNG9bACILITY I
`- - - - - - j- - - - - - - - - ~
`:
`PATIENT NODE
`:
`h-I---+I---------'~DISPENSING
`DATA
`MEMORY
`PROCESSOR :
`PACKAGE
`96
`95
`10
`I
`1
`-
`I
`1
`L ______________________ _
`
`: MESSAGE I--
`1 DEVICE
`20
`1
`I
`-
`
`~----------------
`
`1
`
`1
`
`

`

`u.s. Patent
`
`Oct. 27, 1998
`
`Sheet 5 of 7
`
`5,827,180
`
`95
`~
`
`97
`
`- 71
`/' -
`". - - ( J
`1- _ .........
`- 71
`-
`". - - ( J
`1- _
`.........
`
`97
`
`FIG. 8
`
`FIG. 9
`
`100
`
`

`

`u.s. Patent
`
`Oct. 27, 1998
`
`Sheet 6 of 7
`
`5,827,180
`
`120
`
`IS IT
`gAM?
`
`YES
`
`136
`
`122
`
`PROMPT PATIENT TO
`CHECK AND ENTER 1+ - - - - - - - - -1
`PEAK FLOW
`
`WAIT 30
`MINUTES
`
`124
`
`130
`
`126
`
`DISPLAY
`YES "NO ACTION
`REQUIRED"
`
`132
`YES
`
`FIRST
`TIME ::;
`80% ?
`
`NO
`
`128
`
`END
`SEQUENCE
`
`134
`
`YES
`
`DISPLAY
`"ALBUTEROL
`3 PUFFS"
`
`138
`
`DISPLAY
`"ALBUTEROL 1+ - - - - - - - '
`4 PUFFS"
`
`140
`
`DISPLAY
`"CALL PRIMARY
`PROVIDER"
`
`FIG.10A
`
`

`

`u.s. Patent
`
`Oct. 27, 1998
`
`Sheet 7 of 7
`
`5,827,180
`
`150
`
`174
`NO
`
`176
`
`IS IT
`9 AM OR
`6 PM ?
`
`YES DISPLAY "AZMACORT
`2 PUFFS. WASH
`MOUTH WHEN DONE"
`
`152
`
`PROMPT PATIENT TO
`CHECK AND ENTER
`PEAK FLOW
`
`DISPLAY
`IS
`PEAK FLOW YES "ALBUTEROL
`4 PUFFS"
`
`170
`
`DISPLAY
`"ALBUTEROL
`4 PUFFS"
`
`172
`
`DISPLAY "GO TO
`THE EMERGENCY
`ROOM"
`
`166
`
`PROMPT PATIENT
`TO CHECK AND
`ENTER PEAK FLOW
`
`168
`
`DISPLAY "CALL
`PRIMARY PROVIDER"
`
`FIG. 108
`
`154
`
`160
`
`156
`
`DISPLAY
`YES "NO ACTION
`REQUIRED"
`
`162
`
`158
`
`END
`SEQUENCE
`
`164
`
`WAIT 15
`MINUTES
`
`

`

`5,827,180
`
`1
`METHOD AND APPARATUS FOR A
`PERSONAL HEALTH NETWORK
`
`This application is a continuation of application Ser. No.
`08/518,783 filed on Aug. 24, 1995 which is a continuation
`in part of Ser. No. 08/334,936, filed Nov. 7, 1994 now
`abandoned.
`
`FIELD OF THE INVENTION
`
`The invention relates to a system, methods and apparatus
`for monitoring a person's health, and more particularly to a
`comprehensive patient management system.
`
`BACKGROUND OF THE INVENTION
`
`Outpatient management of chronic disease may be ideally
`described as a series of discrete tasks that are interrelated
`and modulated by information flowing back to the primary
`health care provider. The elements of outpatient care thus
`include (1) prescribing a treatment, typically drug-based; (2)
`a patient independently obtaining the prescribed medication,
`e.g., filling a prescription at a pharmacy and/or purchasing
`over-the-counter medication; (3) the patient talking the
`medication as prescribed; (4) monitoring the effects of the
`self-medicating treatment; and (5) modifying the treatment 25
`based on patient response.
`In the traditional model of outpatient management, the
`information interchange steps (4) and (5), critical to suc(cid:173)
`cessful treatment programs, occur sporadically. Oftentimes,
`the exchange occurs during a follow-up visit to the primary
`care provider or to an emergency room or hospital. Further,
`the information flow was typically one way, from the
`physician to the patient.
`More recently, in the era of the patient as consumer and
`health care reform, this situation has changed dramatically.
`The information flow is no longer so sporadic or one way,
`but the process of closely monitoring outpatient treatments
`is inconvenient to both the patients and health care provid(cid:173)
`ers. For the patient, it means numerous trips to the doctor's
`office, often for simple matters like a blood pressure check,
`that could as easily be performed at home. For the physician,
`close monitoring is inefficient, both because the issues are
`routine and it limits the ability to increase the number of
`patients under management. As a result, the known pro- 45
`cesses of outpatient management result in many patients
`"falling through the cracks" and consuming needless and
`expensive resources for trivial or routine follow-up care.
`A wide variety of devices have been proposed to improve
`outpatient management of the chronically ill. Most such 50
`devices are directed to improving patient health through
`increasing compliance with a medication regimen.
`U.S. Pat. No. 4,490,711 discloses a programmable mul(cid:173)
`tiple alarm timing device. The device may be programmed
`for up to a selected number of alarms per day. As the alarm 55
`is silenced, a counter is incremented. Thus, the counter
`indicates how many times the user was alerted to take his or
`her medication. The counter can be interrogated by pushing
`a button on the device which will cause the count to appear
`on an LCD included with the device. A memo book is used 60
`in conjunction with the timer.
`U.S. Pat. No. 4,504,153 discloses a pharmacist(cid:173)
`programmable/physician-programmable medication
`prompting system wherein a pharmacist/doctor inputs data
`regarding a medication schedule into the memory of a
`prompting device which generates a prompting signal
`according to the schedule. The prompter may be incorpo-
`
`2
`rated in the cap of a mechanized medication container. The
`cap of the container may only be opened when the prompt(cid:173)
`ing signal is present. Removal of the cap produces a reset
`signal terminating the prompt. A counter counts the number
`5 of times the reset signal is generated, providing a compli(cid:173)
`ance record.
`U.S. Pat. No. 4,695,954 discloses a medical dispenser for
`dispensing medications to a patient at prescribed times. The
`device includes apparatus for sensing whether medication is
`10 being taken as it becomes available. A nursing home/
`hospital version has a transmitter and antenna that transmits,
`in real time, patient compliance information to a nursing
`station. Also, stored patient compliance information can be
`printed out. A home version of device does not transmit
`15 compliance information, but this information can be
`retrieved from the display on the device itself.
`U.S. Pat. No. 4,975,842 discloses an electronic patient
`diary that allows a patient to electronically log the onset and
`end of a preselected health event, such as a pain episode, and
`20 subjectively assess some characteristic of the event, i.e., the
`extent of the pain. All information is recorded in memory
`and may be downloaded to an external computer. The device
`can also prompt the user regarding the time and dosage of
`medication.
`U.S. Pat. No. 5,157,640 discloses an electronic watch that
`may be programmed by direct link to a pharmacist's host
`computer to store a medication regimen. When a medication
`is to be taken, an alarm is sounded, and the medication and
`dosage are identified on the display of the watch. The watch
`is programmed by placing it in a cradle which is in com-
`munication with the host computer.
`The prior art falls far short of providing a comprehensive
`outpatient management system. Most prior art devices are
`35 simply directed to the compliance issue.
`Thus there is a need for a comprehensive outpatient
`management system which evaluates compliance with a
`medication regimen, monitors the effect of the treatment,
`allows 2-way information exchange between the provider
`40 and the patient, and reduces the physician's burden of
`closely monitoring outpatient treatment.
`
`30
`
`SUMMARY OF THE INVENTION
`
`The aforementioned need is met by a system, methods and
`apparatus for a personal health network. In one embodiment,
`the health network comprises a host computer which is in
`communication with a computer of a health care provider,
`and with a data processor that is in the possession of a
`patient. A message device, also in the possession of the
`patient, is adapted to send data to, and receive data from, the
`data processor. The host computer, which is operated by a
`party other than the patient or health care provider, functions
`as a central station for collecting, analyzing and routing data.
`In one embodiment, the host computer receives, from the
`health care provider, a treatment plan that is developed
`specifically for each patient. Algorithms are developed
`based on such a plan. The algorithms are then programmed
`into an appropriately configured message device. The
`patient is prompted by the message device to measure and
`enter relevant physiological data, e.g., peak flow, etc, as
`dictated by the treatment plan. Based on the measured
`physiological data and the algorithm, messages are dis(cid:173)
`played on the message device advising the patient of a
`specific course of action, e.g., to administer medicine, to call
`65 his health care provider, to go to the emergency room, etc.
`These results can be transmitted to the facility and the health
`care provider. The algorithm can be modified by the health
`
`

`

`5,827,180
`
`3
`care provider, as appropriate, to reflect changes in the
`treatment plan. As a result, the message device incorporates
`a customized treatment plan that is updatable based on data
`provided by the patient and health care provider.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`Further features and advantages of the invention will be
`apparent upon consideration of the foregoing objects and the
`following detailed description of preferred embodiments of
`the present invention, taken in conjunction with the accom(cid:173)
`panying drawings, in which like reference numerals refer to
`like elements, and in which:
`FIG. 1 shows a block schematic diagram of a personal
`health network in accordance with a preferred embodiment
`of the present invention;
`FIG. 2 shows a message device of the network of FIG. 1;
`FIG. 2A shows a block schematic diagram of a message
`device of the network of FIG. 1 in accordance with a
`preferred embodiment of the invention;
`FIG. 3 shows a block schematic diagram of a personal
`health network in accordance with an alternate embodiment
`of the present invention;
`FIG. 4a shows an alternate implementation of the mes(cid:173)
`sage device and data processor of FIG. 1;
`FIG. 4b shows a preferred embodiment of the alternate
`implementation of the message device of FIG. 4a;
`FIG. 5 shows an alternate embodiment of the personal
`health network of the present invention wherein compatible
`medical devices communicate with the data processor;
`FIG. 6 shows an embodiment of the personal health
`network of the present invention which includes a case
`manager nurse;
`FIG. 7 shows an embodiment of the present invention
`which incorporates a pharmaceutical dispensing and track(cid:173)
`ing system;
`FIG. 8 shows an embodiment of a dispensing package of
`FIG. 7;
`FIG. 9 shows an embodiment of a dose inhaler adapted for 40
`use with the system of FIG. 7;
`FIG. lOa shows an algorithm based on an exemplary
`treatment plan for a first asthma patient; and
`FIG. lOb shows an algorithm based on an exemplary 45
`treatment plan for a second asthma patient.
`
`4
`embodiments and/or components of the PHN 1. The host
`computer 30 of the third party facility 3 functions as a
`central station for collecting information which can be
`appropriately routed to the patient 2, health care provider 4
`5 or other location, as discussed in more detail below. The
`processor 10 and message device 20 are in the possession of
`a patient 2.
`For purposes of clarity only one patient node 2, and third
`party facility 3, and one health care provider 4 are illustrated
`10 in FIG. 1. However, it should be understood that there may
`be a plurality of patient nodes 2 and a plurality of health care
`providers 4 in communication with the third party facility 3.
`Indeed, the third party facility 3 may include more than one
`such facility (e.g., covering differing geographic or demo-
`15 graphic areas), such that patients managed by one facility 3,
`can be served by health care providers 4 that are in com(cid:173)
`munication with a different facility based on interfacility
`communications. In this way, the PHN 1 is capable of
`managing millions of patients 2 and health care providers 4
`20 by appropriate individual identification, addressing and
`messaging, which communication techniques and protocols
`are known to those of ordinary skill in the art.
`The message device 20 is a portable device, of suitable
`shape and size to be carried in the pocket, purse or briefcase
`25 of a patient. Preferably, the form factor and industrial design
`of the message device 20 are optimized for acceptance by
`the intended user, including children and senior citizens. In
`a preferred embodiment, the message device 20 is powered
`by a rechargeable power source. The message device 20
`30 receives information from the host computer 30 when the
`message device is placed in communication with the pro(cid:173)
`cessor 10. Preferably, the message device 20 and processor
`10 have complementary physical structures so that on physi(cid:173)
`cal contact, a connection is formed, for example, via male
`35 and female connectors, such that information transfer in one
`or both directions can occur. It is known to those skilled in
`the art how to implement such devices and their intercon(cid:173)
`nection.
`In one embodiment, the message device 20 provides a
`medication alarm. A patient's entire medication regimen,
`including dosing intervals, can be downloaded from the host
`computer 30 to the data processor 1 0 via communication
`line 31. This information is transferred to the message
`device 20 when it is in communication with the data
`processor 10. At the appropriate times, the patient is
`prompted by audible or tactile alerts. In a preferred embodi-
`ment shown in FIG. 2, the message device 20 includes a
`large-area backlit LCD display 21 so that the name of the
`medication and dose may be displayed. The patient turns off
`50 the alert by activating a switch 22 which also causes a
`programmable memory 23 to store the date and time the
`switch was activated. Hence, the message unit 20 stores a
`record of the so-called compliance data, including the date
`and time the switch was activated and the medication and
`55 dosage that the patient was scheduled to take. In this regard,
`if the patient's regimen is to take more than one medication
`at the same time, then each other medication will appear on
`the LCD display, e.g., one at a time after the switch is
`activated, e.g., in response to an alarm which occurs for each
`60 medication. Alternatively, multiple medications may appear
`in the LCD display such that activating the switch enters the
`time and date data for each medication displayed.
`When the message device 20 is in communication with
`the data processor 1 0, the compliance data can be uploaded
`65 to the host computer 30. Compliance data can then be
`evaluated through appropriate software and a report thereof
`generated and transmitted to one or both of the computer 40
`
`DETAILED DESCRIPTION OF THE
`INVENTION
`
`An embodiment of a personal health network ("PHN") 1
`of the present invention is show in FIG. 1. The PHN 1
`comprises at least one patient node 2, at least one third party
`facility 3 and at least one health care provider 4. Each third
`party facility 3 preferably includes a host computer 30 which
`is in communication with each patient node 2 being man(cid:173)
`aged by the facility 3 over a communication link 31. The
`host computer 30 also is in communication with each health
`care provider 4 for each patient 2, over a communication
`link 34.
`Each patient node 2 includes a data processor 10 and a
`message device 20. The data processor 10 is in communi(cid:173)
`cation with host computer 30 via communication line 31 and
`is used for downloading information to, and receiving infor(cid:173)
`mation from, message device 20. The host computer 30 is
`operated by a third party. The third party is responsible for
`the operation of the PHN 1 and placement of the software
`and, in certain cases, hardware, that comprise the various
`
`

`

`5,827,180
`
`10
`
`15
`
`5
`of the appropriate primary health care provider 4 and the
`processor 10 of patient 2. The report may be electronically
`transmitted via a suitable communications port 50 over PHN
`1, or printed on paper and mailed to the intended recipient.
`In a further embodiment, the message device 20 may receive
`other alarm information from the primary health care pro(cid:173)
`vider 4. For example, patients can be reminded about a
`scheduled visit or to schedule a visit.
`In a second embodiment of the present invention, shown
`in FIG. 3, the PHN 1 is also in communication with another
`health care facility 5 such as a diagnostic laboratory, a
`pharmacy, a clinic, or a hospital, of which only one is shown
`for clarity. Thus, in addition to the medication regimen and
`other information from each primary health care provider 4,
`the message device 20 may receive information from other
`health care facilities 5, which is transmitted to host computer
`30 via communications line 53 and then downloaded to the
`data processor 1 0 and the message device 20. Through such
`a network, patients 2 and doctors 4 can receive the results of
`tests performed at a lab or hospital 5. Such information from
`the other health care facilities 5 can also be either directly,
`via communication line 54, or indirectly, via the host com(cid:173)
`puter 30 through communication lines 53 and 34, commu(cid:173)
`nicated to the primary health care provider 4. In addition,
`statistical reports of the activities of a number of patients can
`be generated. Such reports are of value to health care
`management organizations and pharmaceutical manufactur(cid:173)
`ers.
`In a further embodiment, the message device 20 can be
`enhanced to incorporate two-way message capability when
`coupled to data processor 10. For example, by adding one or
`more switches 24 (two are shown in FIG. 2), patients can
`respond to query-type messages, enhancing the ability of
`providers 4 to track the status of their patients 12. The
`electronics required to provide the two-way message capa(cid:173)
`bility over wire-based coupling and radio frequency based
`coupling are well known to those skilled in the art.
`Advantageously, providing the switches 24 on message
`device 20 ensures that the stored data can be uploaded to the
`host computer. Alternatively, the switches 24 could be
`located on processor 10.
`In a further embodiment of message device 20, software
`and adapters can be developed so that personal digital
`assistants, such as the devices model Wizard available from
`SHARP Electronics, Inc., device model HP lOOLX available
`from Hewlett Packard, and device model Newton available
`from Apple Computer, Inc., can communicate with the data
`processor 10 to receive information from, and deliver infor(cid:173)
`mation to, the host computer 30 and to generate the alerts for
`medication regimen, store the patient compliance data, and
`to provide a display of sales information downloaded from
`data processor 1 0 and for two-way communication with
`data processor. Standard data communications can be used
`and these can be easily created by persons of ordinary skill
`in the art.
`In a further embodiment of data processor 10, a patient(cid:173)
`owned computer such as a personal computer (or
`workstation) or personal digital assistant could be used in
`place of a dedicated data processor, provided that the host
`computer 30 is provided access to the personal computer and
`can establish communications therewith in a similar manner
`as the data processor 10 described herein.
`FIG. 4a shows a further embodiment of the PHN 1
`wherein the host computer 30 is in communication with a 65
`wireless carrier 60 to provide medication reminders and
`messaging capabilities for patients who own/lease paging
`
`6
`devices 61. Wireless carrier 60 thus receives instructions
`form host computer 30 to deliver particular messages to
`specific patients 2 at predetermined times. Wireless carrier
`60 then "telephones" the patient's pager 61 in a conventional
`5 manner, or under control of an automatic operator and
`delivers the message, activating the pager 61 alarm mecha(cid:173)
`nism. The patient 2 then responds to the pager alarm by
`pressing the switch. For paging devices 61 having 2-way
`communication, pressing the switch can provide an
`acknowledgement of the message delivered, which can be
`recorded by the wireless carrier 61 as compliance
`information, which information is then communicated to the
`host computer 30. Thus, the wireless carrier 60 functions as
`the data processor 10 and the paging device 61 performs the
`messaging functions of the message device 20.
`In a preferred embodiment shown in FIG. 4b; a modified
`paging device 61' is used which includes a non-volatile
`memory 62, real-time clock 63, antenna 66 and suitable
`software 64 for storing a medication regimen or other data
`20 within the paging device 61 and for causing a message to
`appear in an alphanumeric display 65 based on the medica(cid:173)
`tion regimen or other data in the non-volatile memory 62. In
`this regard, medication reminders are likely to be repeated
`daily for a period of time. Instead of having the wireless
`25 carrier 60 send the medication alert for each alarm, at an
`extra cost for sending the same message over and over, the
`clock 63, software 64 and memory 62 within the paging
`device 61' can be used to generate the medication alert. This
`is achieved by sending a message over the wireless carrier
`30 60 that includes the complete dosing regimen, which mes(cid:173)
`sage is recognized by software 64 and which stores the
`regimen in memory 62. The software will then actuate the
`alarm and display the appropriate message as the stored
`regimen is executed, without prompting by wireless carrier
`35 60. This will reduce communication costs. If the medication
`regimen is changed, the wireless carrier 60 can re-program
`the paging device 61' as appropriate. Further, the clock 63 in
`the paging device 61 is preferably resettable by a general
`broadcast of a time control signal by the wireless carrier 60.
`40 This embodiment is better suited for paging devices having
`two-way communication capabilities so that safe receipt of
`the downloaded regimen can be confirmed.
`As previously noted, the message device 20 is placed in
`a communication with the data processor 10 to receive
`45 information from, or send information to, the host computer
`30. The data processor 1 0 may also incorporate a charger 1
`60 for charging the rechargeable power source (not shown)
`of the message device 20.
`Referring to FIGS. 1 and 2A, one particular embodiment
`50 of processor 10 is shown. Processor 1 0 communicates with
`the host computer 30 by communication link 31 and pref(cid:173)
`erably incorporates a telephone 120 and a modem 130.
`Information transfer from the host computer 30 to the data
`processor 10, and the processor 10 to the host computer 30
`55 can occur without patient interaction with the incorporation
`of suitable electronics and software known to those skilled
`in the art. In a preferred embodiment, shown in FIG. 2A, one
`such processor includes a switch 110, a telephone 120, a
`modem 130, a microprocessor 140, a memory 152 and 154,
`60 a charger 160, a dock/cradle 170 and a data port 180.
`Although not shown, processor 10 may also include a status
`lamp to indicate whether or not it is properly operating. In
`a further embodiment, not shown, the data processor 1 0 may
`include an alphanumeric display and printing capabilities.
`The dock/cradle 170 is shaped to receive message device
`20 (or a hardware interface unit for a personal digital
`assistant) so that it couples securely to the charger 160 and
`
`

`

`7
`data port 180. Once coupled, charger 160 can monitor the
`power supply of message device 20 and recharge it if
`necessary. Similarly, the electronics monitor the coupling of
`the data port 180, and after identifying the message device
`20, data transfer can begin. The coupling to charger 160 and 5
`data port 180 is preferably a male/female plug interface (not
`shown) and may be separate components, interfaces or a
`unique custom interface. In this regard, data sent to device
`20 may be stored in memory 154 and data uploa