assigned to the nurse, as would be indicated on a list maintained on
`the computer 401 (as communicated from the server 402), then steps
`104-1 l0 may be repeated for each of the remaining patients. After all
`patients have been processed by the nurse, the final step ll2 is
`reached.
`Benigno at 46:30-47:4
`
`Steps l02, l05 and l l0, wherein the client computer 401
`communicates with the server 402, are each described in further
`detail in steps l2l-l29, depicted in Figure 1B. In step l2l, the
`processes commences. In step 122, the modem on the client computer
`40l dials into the server 402. Again, this assumes that the computer
`401 and server 402 are to be connected via modem and standard
`telephone lines. Again, it will be understood that this connection may
`be accomplished in a variety of ways, including over telephone lines,
`via a wireless connection (cellular or otherwise), via the Internet, etc.
`Benigno at 47:6-l3
`
`Therefore, it would be highly desirable to have a system permitting
`the capability to provide home care and direct information
`communication to the physician and his or her staff in real time, so as
`to reduce the recovery period and the risk of complications.
`Benigno at 6:26-29
`
`The nurse or caregiver then sees the patient almost immediately at
`home and tracks the patient at home one or more times per day using
`the system and the information is used to create and update the
`clinical pathway database records for the patient. Real-time
`communication systems of the invention allow supervision by the
`physician, while not requiring the supervision to occur in a hospital
`setting.
`Benigno at 9:26-31
`
`The communications subsystems of the invention are important to its
`capability of providing stable acute care and tracking clinical
`pathways. Point of service communication at home using either a
`suitable electronic or computerized device is provided by the
`invention. The computer can be put into communication with a data
`storage / server computer via any suitable means, including a modem
`or network adapter.
`Benigno at ll:l4-l9
`
`.
`
`‘
`
`k
`
`i
`.
`
`‘
`
`k
`
`‘
`
`\
`
`i
`
`Assuming the connection between the client computer 401 and server
`402 is successful in step l24, then in step l25 the patient list, patient
`orders and patient questionnaire is updated. Specifically, the client
`computer 40l sends information to the server 402 regarding the
`......................................................................................................................................................................................................................................................... .\
`
`\
`
`310
`
`RPX-‘I 003, p. 1 001
`
`RPX-1003, p.1001
`
`

`
`actions that the nurse has taken (as input into the client computer 401 .
`by the nurse), and the server 402 sends to the client computer 401 the
`updated patient list, patient orders, patient questionnaires, flow of
`care, etc. Other data as appropriate may also be transmitted back and
`forth between the client computer 401 and the server 402.
`Benigno at 47:20-27
`
`(e) removing said remote
`computer from electronic
`communication with said
`first computer;
`
`i
`
`In step 127, if the data has been correctly exchanged between the
`client computer 401 and server 402, then final step 129 is
`encountered.
`Benigno at 47:29-30
`
`In step 102, the nurse, 5 using the client computer 401 (Figure 4)
`communicates with the server 402, in order to obtain updated
`pathway instructions, etc., regarding what steps to perform during
`visit(s) for one or more patient(s). The communication can take place
`via modern and standard phone lines, via wireless transmission (e.g.,
`cellular, etc.), via the Internet, or via any other communication link.
`Benigno at 46:4-9
`
`In step 105, the nurse, through client computer 401, may again
`communicate with server 402, in order to obtain the most current
`instructions and data.
`Benigno at 46:13-14
`
`Alternatively, or in addition, in step 107 the nurse may carry out
`orders created by the physician and transmitted in steps 102 and/or
`105 from the server 402 to the client computer 401.
`Benigno at 46:22-24
`
`In step 110, the client computer 401 communicates with the server
`402, in order to update both the computer 401 and server 402 as in
`steps 102 and 105. In step 111, if there are additional patients
`assigned to the nurse, as would be indicated on a list maintained on
`the computer 401 (as communicated from the server 402), then steps
`104-110 may be repeated for each of the remaining patients. After all
`patients have been processed by the nurse, the final step 112 is
`reached.
`Benigno at 46:30—47:4
`
`Steps 102, 105 and 110, wherein the client computer 401
`communicates with the server 402, are each described in further
`detail in steps 121-129, depicted in Figure 1B. In step 121, the
`processes commences. In step 122, the modem on the client computer
`401 dials into the server 402. Again, this assumes that the computer
`401 and server 402 are to be connected via modem and standard
`
`311
`
`RPX-‘I 003, p. 1 002
`
`‘
`
`$
`
`i
`
`RPX-1003, p.1002
`
`

`
`telephone lines. Again, it will be understood that this connection may
`be accomplished in a variety of ways, including over telephone lines,
`via a wireless connection (cellular or otherwise), via the Internet, etc.
`Benigno at 47:6-13
`
`Assuming the connection between the client computer 401 and server
`402 is successful in step 124, then in step 125 the patient list, patient
`orders and patient questionnaire is updated. Specifically, the client
`computer 401 sends information to the server 402 regarding the
`actions that the nurse has taken (as input into the client computer 401 S
`by the nurse), and the server 402 sends to the client computer 401 the
`updated patient list, patient orders, patient questionnaires, flow of
`care, etc. Other data as appropriate may also be transmitted back and
`forth between the client computer 401 and the server 402.
`Benigno at 47:20-27
`
`\
`
`S
`
`In step 127, ifthe data has been correctly exchanged between the
`client computer 401 and server 402, then final step 129 is
`encountered.
`Benigno at 47:29-30
`
`Based on the above, in general, when a request for a new session§
`(voice, data) is received (in step 10), a connection will be established
`for the new session (affirrnative result in step 11) if there are fewer
`Ethan C-Ch active sessions in the cell. As described above,
`time-
`sensitive sessions may be afforded priority. For instance, preferably,
`§voice sessions are given preemptive priority over data sessions for§
`fiusing channel resources. Since voice sessions must be transmitted or
`received on a real time basis, reconnection attempts for voice sessions
`are preferably not allowed. When a voice session arrives and finds all
`§channels C occupied, an active data session (if any are present) is
`§preferably
`suspended
`(step
`12)
`(or possibly terminated)
`to
`accommodate it. More specifically, when a voice session arrives in a
`cell in which all channels are occupied and fewer than H sessions are
`§in suspension, and, at least, one active session is of data type, an:
`arriving voice session will obtain a connection (step 13) but an active
`§data session will be suspended (step 12). The choice of which data
`session to be suspended or be terminated is assumed to be random.
`Rappaport at 7:44-63
`
`S
`
`In a network that employs an admission control protocol according to
`the present invention, voice calls, for example (or other time-sensitive
`stream traffic) may preempt resources of time-insensitive data calls,
`which result
`in suspended sessions that do not result in session
`failures. Priority access for hand-offs of active sessions with respect
`Eto new call sessions can also be accommodated. Mobile users thati
`......................................................................................................................................................................................................................................................... .\
`
`312
`
`RPX-‘I 003, p. 1 003
`
`RPX-1003, p.1003
`
`

`
`have some autonomy or who are perhaps exchanging time-insensitive
`data with a remote site can continue to function essentially
`Eundisturbed by link failures since the connectivity and reconnection
`Eprocedures are managed by the network in a manner
`that
`is
`§transparent to the end users. Mobile computing sessions and delay-
`§insensitive data communications,
`for example, will be able to
`continue, largely unaware of link failures.
`Rappaport at 2:44-58
`
`i
`
`In step 106 and 108, the client computer 401, via the questionnaire
`(f) within said remote
`language previously described, or through any other data collection
`computer, using said
`mechanism, may obtain data from the nurse or other source
`transmitted tokenized
`questionnaire to obtain at corresponding to the clinical pathway to be followed, as dictated by
`least one user response;
`the physician. As a result, SOAP notes may be generated, alerts can
`be generated, etc., for ultimate retransmission to the server 402.
`
`1
`
`Alternatively, or in addition, in step 107 the nurse may carry out
`orders created by the physician and transmitted in steps 102 and/or
`105 from the server 402 to the client computer 401. The results of
`such orders may generate a flow of care to be followed by the nurse,
`and/or may generate alerts, etc. In step 109, the nurse records in the
`client computer 401 compliance or non-compliance with the orders.
`If noncompliance, the reasons are also stored. gain, all such stored
`data may later be transmitted back to the server 402.
`Benigno at 46: 16-28
`
`.-
`
`F103’-‘ *3?‘
`
`
`
`
`
`
`313
`
`RPX-‘I 003, p. 1 004
`
`'
`
`§.$£‘_S'fl\{1?§
`
`l.*?:E‘.5!
`an
`Lixéér v‘
`
`
`
`
`
`RPX-1003, p.1004
`
`

`
`(g) storing said at least
`one user response within
`said remote computer;
`
`3
`
`In step 106 and 108, the client computer 401, via the questionnaire
`language previously described, or through any other data collection
`mechanism, may obtain data from the nurse or other source
`corresponding to the clinical pathway to be followed, as dictated by
`the physician. As a result, SOAP notes may be generated, alerts can
`be generated, etc., for ultimate retransmission to the server 402.
`
`Alternatively, or in addition, in step 107 the nurse may carry out
`orders created by the physician and transmitted in steps 102 and/or
`105 from the server 402 to the client computer 401. The results of
`such orders may generate a flow of care to be followed by the nurse,
`and/or may generate alerts, etc. In step 109, the nurse records in the
`client computer 401 compliance or non-compliance with the orders.
`If noncompliance, the reasons are also stored. gain, all such stored
`data may later be transmitted back to the server 402.
`Benigno at 46: 16-28
`
`(h) modifying said
`questionnaire with
`incremental changes at a
`second computer located
`at a second site;
`
`Daily communication includes SOAP notes, notification of whether
`the patient received appropriate IV medications and intravenous
`fluids, as well as the ability to communicate with nurses, and nurse
`communications with physicians for order changes.
`Benigno at 11:22-26
`
`The system is constantly evaluating itself. As the system finds new
`correlating factors, they are put in place to aid in determining changes
`to be made to the current or default clinical pathway. In addition as
`
`k
`
`‘
`
`314
`
`RPX-‘I 003, p. 1 005
`
`RPX-1003, p.1005
`
`

`
`
`
`correlations are determined between clinical pathway decisions and
`significant outcomes (z'.e., outcomes of interest), changes can be made
`to the default pathway to optimize systematically the clinical pathway
`toward the desired results. These changes can be automatically made
`or can be presented to the physician, system administrator, or other
`user for approval.
`Benigno at 21:22-29
`
`\
`
`i
`
`In addition, the present invention provides a client / server system for
`manipulation and analysis of data related to clinical pathways,
`comprising a communication network, a client workstation in
`communication with the communication network, wherein the client
`workstation comprises means for generating at least one signal
`corresponding to a clinical pathway decision and transmitting the at
`least one decision signal over the communication network, and means
`for receiving at least one signal corresponding to a clinical pathway
`modification from the communication network, and means for
`outputting the at least one modification signal to a signal processing
`means, a server on the communication network, wherein the server
`comprises a clinical pathway database for storing an initial procedure
`decision data element, corresponding to a decision point within the
`clinical pathway, and at least one subsequent decision data element
`corresponding to at least one available subsequent decision point
`within the clinical pathway, and a historical clinical pathway database
`for storing previously selected subsequent decision data elements,
`selected corresponding to the initial procedure decision data element,
`and processing means, in communication with the communication
`network, the client workstation, and the server, for performing the
`steps of receiving the at least one decision signal fiom the
`communication network, based on the received decision signal,
`selecting one of the at least one subsequent decision data elements,
`comparing the selected subsequent decision data element with the
`previously selected subsequent decision data elements stored in the
`historical clinical pathway database, and based upon predetermined
`correlation criteria, modifying the at least one subsequent decision
`data elements within the clinical pathway database, then generating at
`least one signal corresponding to a clinical pathway modification of
`the subsequent decision data elements in the clinical pathway
`database, and transmitting the at least one clinical pathway
`modification signal over the communication network to the receiving
`means of the client workstation.
`Benigno at 14:7-15:2
`
`315
`
`RPX-‘I 003, p. 1 006
`
`RPX-1003, p.1006
`
`

`
`
`
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`
`In step 102, the nurse, using the client computer 401 (Figure 4)
`(i) placing said remote
`communicates with the server 402, in order to obtain updated
`computer into electrical
`communication with said pathway instructions, etc., regarding what steps to perform during
`second computer;
`visit(s) for one or more patient(s). The communication can take place
`via modern and standard phone lines, via wireless transmission (e.g.,
`cellular, etc.), via the Internet, or via any other communication link.
`Benigno at 46:4-9
`
`1
`
`In step 105, the nurse, through client computer 401, may again
`communicate with server 402, in order to obtain the most current
`instructions and data.
`Benigno at 46:13-14
`
`Alternatively, or in addition, in step 107 the nurse may carry out
`qiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIIiiIIiiiiiiiiiiiiiiiiiiiiiiio
`
`316
`
`RPX-‘I 003, p. 1 007
`
`RPX-1003, p.1007
`
`

`
`orders created by the physician and transmitted in steps 102 and/or
`105 from the server 402 to the client computer 401.
`Benigno at 46:22-24
`
`In step 110, the client computer 401 communicates with the server
`402, in order to update both the computer 401 and server 402 as in
`steps 102 and 105. In step 111, if there are additional patients
`assigned to the nurse, as would be indicated on a list maintained on
`the computer 401 (as communicated from the server 402), then steps
`104-110 may be repeated for each of the remaining patients. After all
`patients have been processed by the nurse, the final step 112 is
`reached.
`Benigno at 46:30-47:4
`
`Steps 102, 105 and 110, wherein the client computer 401
`communicates with the server 402, are each described in further
`detail in steps 121-129, depicted in Figure 1B. In step 121, the
`processes commences. In step 122, the modem on the client computer
`401 dials into the server 402. Again, this assumes that the computer
`401 and server 402 are to be connected via modem and standard
`telephone lines. Again, it will be understood that this connection may
`be accomplished in a variety of ways, including over telephone lines,
`via a wireless connection (cellular or otherwise), via the Internet, etc.
`Benigno at 47:6-13
`
`,
`
`i
`k
`
`‘
`
`317
`
`RPX-‘I 003, p. 1 008
`
`RPX-1003, p.1008
`
`

`
`Assuming the connection between the client computer 401 and server
`402 is successful in step 124, then in step 125 the patient list, patient
`orders and patient questionnaire is updated. Specifically, the client
`computer 401 sends information to the server 402 regarding the
`actions that the nurse has taken (as input into the client computer 401 S
`by the nurse), and the server 402 sends to the client computer 401 the
`updated patient list, patient orders, patient questionnaires, flow of
`care, etc. Other data as appropriate may also be transmitted back and
`forth between the client computer 401 and the server 402.
`Benigno at 47:20-27
`
`S
`
`S
`
`In step 127, if the data has been correctly exchanged between the
`client computer 401 and server 402, then final step 129 is
`encountered.
`Benigno at 47:29-30
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`
`(j) transmitting said
`incremental changes
`from said second
`computer to said remote
`computer;
`
`Therefore, it would be highly desirable to have a system permitting
`the capability to provide home care and direct information
`communication to the physician and his or her staff in real time, so as
`to reduce the recovery period and the risk of complications.
`Benigno at 6:26-29
`
`The nurse or caregiver then sees the patient almost immediately at
`home and tracks the patient at home one or more times per day using
`the system and the information is used to create and update the
`clinical pathway database records for the patient. Real-time
`communication systems of the invention allow supervision by the
`physician, while not requiring the supervision to occur in a hospital
`setting.
`Benigno at 9:26-31
`
`The communications subsystems of the invention are important to its
`capability of providing stable acute care and tracking clinical
`pathways. Point of service communication at home using either a
`suitable electronic or computerized device is provided by the
`invention. The computer can be put into communication with a data
`storage / server computer via any suitable means, including a modem
`or network adapter.
`Benigno at 11:14-19
`
`In step 102, the nurse, using the client computer 401 (Figure 4)
`communicates with the server 402, in order to obtain updated
`pathway instructions, etc., regarding what steps to perform during
`visit(s) for one or more patient(s). The communication can take place
`via modern and standard phone lines, via wireless transmission (e.g.,
`cellular, etc.), via the Internet, or via any other communication link.
`
`318
`
`RPX-‘I 003, p. 1 009
`
`k
`
`i
`
`\
`
`\
`
`k
`
`i
`
`RPX-1003, p.1009
`
`

`
`Benigno at 46:4-9
`
`In step 105, the nurse, through client computer 401, may again
`communicate with server 402, in order to obtain the most current
`instructions and data.
`Benigno at 46:13-14
`
`Alternatively, or in addition, in step 107 the nurse may carry out
`orders created by the physician and transmitted in steps 102 and/or
`105 from the server 402 to the client computer 401.
`Benigno at 46:22-24
`
`In step 110, the client computer 401 communicates with the server
`402, in order to update both the computer 401 and server 402 as in
`steps 102 and 105. In step 111, if there are additional patients
`assigned to the nurse, as would be indicated on a list maintained on
`the computer 401 (as communicated from the server 402), then steps
`104-110 may be repeated for each of the remaining patients. After all
`patients have been processed by the nurse, the final step 112 is
`reached.
`Benigno at 46:30-47:4
`
`Steps 102, 105 and 110, wherein the client computer 401
`communicates with the server 402, are each described in further
`detail in steps 121-129, depicted in Figure 1B. In step 121, the
`processes commences. In step 122, the modem on the client computer
`401 dials into the server 402. Again, this assumes that the computer
`401 and server 402 are to be connected via modem and standard
`telephone lines. Again, it will be understood that this connection may
`be accomplished in a variety of ways, including over telephone lines,
`via a wireless connection (cellular or otherwise), via the Internet, etc.
`Benigno at 47:6-13
`
`S
`
`S
`
`k
`
`i
`k
`
`i
`
`Assuming the connection between the client computer 401 and server
`402 is successful in step 124, then in step 125 the patient list, patient
`orders and patient questionnaire is updated. Specifically, the client
`computer 401 sends information to the server 402 regarding the
`actions that the nurse has taken (as input into the client computer 401 $
`by the nurse), and the server 402 sends to the client computer 401 the
`updated patient list, patient orders, patient questionnaires, flow of
`care, etc. Other data as appropriate may also be transmitted back and
`forth between the client computer 401 and the server 402.
`Benigno at 47:20-27
`
`i
`
`In step 127, if the data has been correctly exchanged between the
`.‘....................................................................l .................................................................................................................................................................................. .\
`client computer 401 and server 402, then final step 129 is
`
`319
`
`RPX-‘I 003, p. 1 01 O
`
`RPX-1003, p.1010
`
`

`
`encountered.
`
`Benigno at 47:29-30
`
`$’?¥‘=‘3P:Z~>‘.‘l5
`T 310.
`KER? ST.$.§1F5S
`
`'
`
`(k) modifying said
`transmitted tokenized
`questionnaire in said
`remote computer with
`said incremental
`changes, thereby creating
`a modified tokenized
`questionnaire;
`
`_
`
`'
`
`Daily communication includes SOAP notes, notification of whether
`the patient received appropriate IV medications and intravenous
`fluids, as well as the ability to communicate with nurses, and nurse
`communications with physicians for order changes.
`Benigno at ll:22-26
`
`The system is constantly evaluating itself. As the system finds new
`correlating factors, they are put in place to aid in determining changes
`to be made to the current or default clinical pathway. In addition, as
`correlations are determined between clinical pathway decisions and
`significant outcomes (z'.e., outcomes of interest), changes can be made
`to the default pathway to optimize systematically the clinical pathway
`toward the desired results. These changes can be automatically made
`or can be presented to the physician, system administrator, or other
`user for approval.
`Benigno at 21:22-29
`
`k
`
`i
`
`In addition, the present invention provides a client / server system for
`manipulation and analysis of data related to clinical pathways,
`comprising a communication network, a client workstation in
`communication with the communication network, wherein the client
`workstation comprises means for generating at least one signal
`
`320
`
`RPX-‘I 003, p. 1 011
`
`RPX-1003, p.1011
`
`

`
`
`
`corresponding to a clinical pathway decision and transmitting the at
`least one decision signal over the communication network, and means
`for receiving at least one signal corresponding to a clinical pathway
`modification from the communication network, and means for
`outputting the at least one modification signal to a signal processing
`means, a server on the communication network, wherein the server
`comprises a clinical pathway database for storing an initial procedure
`decision data element, corresponding to a decision point within the
`clinical pathway, and at least one subsequent decision data element
`corresponding to at least one available subsequent decision point
`within the clinical pathway, and a historical clinical pathway database
`for storing previously selected subsequent decision data elements,
`selected corresponding to the initial procedure decision data element,
`and processing means, in communication with the communication
`network, the client workstation, and the server, for performing the
`steps of receiving the at least one decision signal from the
`communication network, based on the received decision signal,
`selecting one of the at least one subsequent decision data elements,
`comparing the selected subsequent decision data element with the
`previously selected subsequent decision data elements stored in the
`historical clinical pathway database, and based upon predetermined
`correlation criteria, modifying the at least one subsequent decision
`data elements within the clinical pathway database, then generating at
`least one signal corresponding to a clinical pathway modification of
`the subsequent decision data elements in the clinical pathway
`database, and transmitting the at least one clinical pathway
`modification signal over the communication network to the receiving
`means of the client workstation.
`Benigno at 14:7-15:2
`
`Steps 102, 105 and 110, wherein the client computer 401
`communicates with the server 402, are each described in further
`detail in steps 121-129, depicted in Figure 1B. In step 121, the
`processes commences. In step 122, the modem on the client computer
`401 dials into the server 402. Again, this assumes that the computer
`401 and server 402 are to be connected via modem and standard
`telephone lines. Again, it will be understood that this connection may
`be accomplished in a variety of ways, including over telephone lines,
`via a wireless connection (cellular or otherwise), via the Internet, etc.
`Benigno at 47:6-13
`
`\
`
`i
`
`\
`
`i
`
`k
`
`S
`
`,
`
`S
`
`k
`
`i
`
`.
`
`i
`k
`
`1
`
`Assuming the connection between the client computer 401 and server
`402 is successful in step 124, then in step 125 the patient list, patient
`orders and patient questionnaire is updated. Specifically, the client
`computer 401 sends information to the server 402 regarding the
`actions that the nurse has taken (as input into the client computer 401
`.‘....................................................................l .................................................................................................................................................................................. .\
`
`l
`
`321
`
`RPX-‘I 003, p. 1 O1 2
`
`RPX-1003, p.1012
`
`

`
`by the nurse), and the server 402 sends to the client computer 401 the
`updated patient list, patient orders, patient questionnaires, flow of
`care, etc. Other data as appropriate may also be transmitted back and
`forth between the client computer 401 and the server 402.
`Benigno at 47:20-27
`
`S
`
`In step 127, if the data has been correctly exchanged between the
`client computer 401 and server 402, then final step 129 is
`encountered.
`Benigno at 47:29-30
`Qxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx'»xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx\x\\\\x\\\\x\\\\x\\\\x\¢
`
`In step 102, the nurse, 5 using the client computer 401 (Figure 4)
`(l) removing said remote
`computer from electronic communicates with the server 402, in order to obtain updated
`communication with said pathway instructions, etc., regarding what steps to perform during
`second computer;
`visit(s) for one or more patient(s). The communication can take place
`via modern and standard phone lines, via wireless transmission (e.g.,
`cellular, etc.), via the Internet, or via any other communication link.
`Benigno at 46:4-9
`
`1
`
`In step 105, the nurse, through client computer 401, may again
`communicate with server 402, in order to obtain the most current
`instructions and data.
`Benigno at 46:13-14
`
`Alternatively, or in addition, in step 107 the nurse may carry out
`orders created by the physician and transmitted in steps 102 and/or
`105 from the server 402 to the client computer 401.
`Benigno at 46:22-24
`
`In step 110, the client computer 401 communicates with the server
`402, in order to update both the computer 401 and server 402 as in
`steps 102 and 105. In step 111, if there are additional patients
`assigned to the nurse, as would be indicated on a list maintained on
`the computer 401 (as communicated from the server 402), then steps
`104-110 may be repeated for each of the remaining patients. After all
`patients have been processed by the nurse, the final step 112 is
`reached.
`Benigno at 46:30-47:4
`
`Steps 102, 105 and 110, wherein the client computer 401
`communicates with the server 402, are each described in further
`detail in steps 121-129, depicted in Figure 1B. In step 121, the
`processes commences. In step 122, the modem on the client computer
`401 dials into the server 402. Again, this assumes that the computer
`401 and server 402 are to be connected via modem and standard
`telephone lines. Again, it will be understood that this connection may
`
`322
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`RPX-‘I 003, p. 1 O1 3
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`\
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`\
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`S
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`1
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`i
`k
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`RPX-1003, p.1013
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`

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`be accomplished in a variety of ways, including over telephone lines,
`via a wireless connection (cellular or otherwise), via the Internet, etc.
`Benigno at 47:6-l3
`
`Assuming the connection between the client computer 401 and server
`402 is successful in step l24, then in step l25 the patient list, patient
`orders and patient questionnaire is updated. Specifically, the client
`computer 40l sends information to the server 402 regarding the
`actions that the nurse has taken (as input into the client computer 40l
`by the nurse), and the server 402 sends to the client computer 401 the
`updated patient list, patient orders, patient questionnaires, flow of
`care, etc. Other data as appropriate may also be transmitted back and
`forth between the client computer 401 and the server 402.
`Benigno at 47:20-27
`
`i
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`S
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`i
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`In step 127, if the data has been correctly exchanged between the
`client computer 40l and server 402, then final step 129 is
`encountered.
`Benigno at 47:29-30
`........................................................................................................................................................................................................................................................ .\
`
`In step l06 and l08, the client computer 40l, via the questionnaire
`(m) within said remote
`language previously described, or through any other data collection
`computer, using said
`mechanism, may obtain data from the nurse or other source
`modified tokenized
`questionnaire to obtain at corresponding to the clinical pathway to be followed, as dictated by
`least one additional user
`the physician. As a result, SOAP notes may be generated, alerts can
`response;
`be generated, etc., for ultimate retransmission to the server 402.
`Benigno at 46: l6-20
`1
`........................................................................................................................................................................................................................................................ .\
`
`(n) placing said remote
`computer into electronic
`communication with a
`server;
`
`3
`
`In step l02, the nurse, using the client computer 40l (Figure 4)
`communicates with the server 402, in order to obtain updated
`pathway instructions, etc., regarding what steps to perform during
`visit(s) for one or more patient(s). The communication can take place
`via modern and standard phone lines, via wireless transmission (e.g.,
`cellular, etc.), via the Internet, or via any other communication link.
`Benigno at 46:4-9
`
`k
`
`\
`
`In step l05, the nurse, through client computer 40l, may again
`communicate with server 402, in order to obtain the most current
`instructions and data.
`Benigno at 46:l3-l4
`
`Alternatively, or in addition, in step l07 the nurse may carry out
`orders created by the physician and transmitted in steps 102 and/or
`l05 from the server 402 to the client computer 40l.
`Benigno at 46:22-24
`x....................................................................l .................................................................................................................................................................................. .\
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`323
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`RPX-‘I 003, p. 1 O1 4
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`RPX-1003, p.1014
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`

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`In step 110, the client computer 401 communicates with the server
`402, in order to update both the computer 401 and server 402 as in
`steps 102 and 105. In step 111, if there