(12)
`
`United States Patent
`Brown
`
`(10) Patent N0.:
`(45) Date of Patent:
`
`US 6,368,273 B1
`*Apr. 9, 2002
`
`US006368273B1
`
`(54) NETWORKED SYSTEM FOR INTERACTIVE
`COMMUNICATION AND REMOTE
`
`5,596,994 A * 1/1997 Bro .......................... .. 128/905
`5,868,669 A * 2/1999 Iliff .......................... .. 600/300
`
`MONITORING OF INDIVIDUALS
`
`(75)
`(73)
`
`Inventor: Stephen J. Brown, Woodside, CA (US)
`
`Assignee: Health Hero Network, Inc., Mountain
`View, CA (US)
`
`(*)
`
`Notice:
`
`This patent issued on a continued pros
`ecution application ?led under 37 CFR
`1.53(d), and is subject to the twenty year
`patent term provisions of 35 U.S.C.
`154(a)(2).
`
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 0 days.
`
`(21)
`(22)
`
`Appl. No.: 09/300,856
`Filed:
`Apr. 28, 1999
`
`. . . .. 600/544
`6,001,065 A * 12/1999 DeVito . . . . .
`6,050,940 A * 4/2000 Braun et al. .............. .. 128/920
`
`FOREIGN PATENT DOCUMENTS
`
`EP
`EP
`WO
`WO
`
`0251520
`0320749
`9520199
`9708605
`
`1/1988
`6/1989
`7/1995
`3/1997
`
`OTHER PUBLICATIONS
`
`Reis, H, T elemea'icine: transmitting Expertise t0 the point of
`care, Toward an Electronic Patient Record ’97, Nashville,
`TN, Apr. 27—May 3, 1997, pp. 248—256, v. 3.
`
`* cited by examiner
`
`Primary Examiner—John P. Lacyk
`Assistant Examiner—Michael Astorino
`(74) Attorney, Agent, or Firm—Black Lowe & Graham,
`PLLC
`
`Related US. Application Data
`
`(57)
`
`ABSTRACT
`
`(60)
`
`(60)
`
`(51)
`(52)
`
`(58)
`
`(56)
`
`Division of application No. 08/946,341, ?led on Oct. 7,
`1997, now Pat. No. 5,997,476, which is a continuation-in
`part of application No. 08/847,009, ?led on Apr. 30, 1997,
`now Pat. No. 5,897,493.
`Provisional application No. 60/041,746, ?led on May 28,
`1997, and provisional application No. 60/041,751, ?led on
`Mar. 28, 1997.
`
`Int. Cl.7
`......................... .. A61B 5/00
`US. Cl. ......................... .. 600/300; 705/3; 600/301;
`128/904
`Field of Search ............................... .. 600/300—301,
`600/529—538, 500—509, 481—486; 128/897—898,
`904, 905, 920—925, 903
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`5,390,238 A
`5,434,611 A
`5,441,047 A
`
`2/1995 Kirk et al.
`7/1995 Tamura
`8/1995 David et al.
`
`The invention presents a networked system for communi
`cating information to an individual and for remotely moni
`toring the individual. The system includes a server and a
`remote interface for entering in the server a set of queries to
`be answered by the individual. The server is preferably a
`web server and the remote interface is preferably a personal
`computer or remote terminal connected to the server via the
`Internet. The system also includes a remotely programmable
`apparatus connected to the server via a communication
`network, preferably the Internet. The apparatus interacts
`with the individual in accordance with a script program
`received from the server. The server includes a script gen
`erator for generating the script program from the set of
`queries entered through the remote interface. The script
`program is received and executed by the apparatus to
`communicate the queries to the individual, to receive
`responses to the queries, and to transmit the responses from
`the apparatus to the server.
`
`10 Claims, 15 Drawing Sheets
`
`18
`
`8
`SERVER
`DATABASE
`
`38 /‘
`
`40 f
`
`42 J
`
`44 J
`46 j@
`|
`48 V4 MONITORING
`APPLICATION
`
`50 \"
`52v
`54v
`
`WORKSTATION ‘P 20
`
`SCRIPT ENTRY /\ 56
`
`SCRIPT ASSIGN L f\57
`IEP 58
`
`REMOTE APPARATUS '\/ 26
`
`SCRIPT PROGRAM
`
`RESPONSES
`
`/ 42
`
`MEASUREMENTS J44
`
`28 A‘ MONITORING
`DEVICE
`
`Medtronic Ex. 1010
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 1 0f 15
`
`US 6,368,273 B1
`
`16
`\
`
`:1
`SERVER /\/
`18
`
`2S
`
`REMOTE
`APPARATUS 1
`
`/'\_/3O
`
`24
`
`2
`
`COMMUNICATION
`NETWORK
`
`20
`
`:0
`
`00
`
`@ ==
`
`MONITORING ,V 28
`DEVICE
`
`REMOTE
`APPARATUS 2
`
`MONITORING
`DEVICE
`
`32
`FIG. 1
`
`18
`
`8
`SERVER
`
`38 \P
`
`DATABASE
`
`WORKSTATION w 20
`
`SCRIPT ENTRY _/'\56
`
`RESPONSES
`
`40 \f~| SCRIPT PROGRAMS | ‘—’ SCRIPT ASSIGN /\ 57
`42 \
`“4
`1 @ms
`44 \/\ MEASUREMENTS
`46 \|————|
`\J
`TABLE
`|
`
`REMOTE APPARATUS ’\/ 26
`
`APPLICATION
`50 \d SCRIPT GENERATOR |
`52 \CT SCRIPT ASSIGNOR |
`
`54 \"1 REPORT GENERATOR |
`
`<—-—>
`
`RESPONSES
`
`/ 42
`
`A
`MEA
`SUREMENTS ~/ 44
`I
`
`FIG. 2
`
`DEVICE
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 2 0f 15
`
`US 6,368,273 B1
`
`64
`| DISPIDAY h /
`80
`321
`1
`DISPLAY
`MESORY
`DRIVER
`T
`
`LED ,V74
`M
`84
`Q
`CLOCK
`76
`4 I
`I
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`PROCESSOR
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`M
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`MODEM
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`’\/26
`
`68A
`
`22
`
`66
`@
`MODEM : : TELEPHONE
`JACK
`JACK
`$
`
`78
`
`70
`\j‘
`
`BUTTONS
`
`90
`M UART
`8
`88
`I/O INTERFACE
`
`JACK1_ MONITORING
`DEVICE
`
`|
`A K2
`J C ’\/68B 28
`
`L-— JACK 3 6/ 68C
`
`FIG. 4
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 3 of 15
`
`US 6,368,273 B1
`
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`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 4 0f 15
`
`US 6,368,273 B1
`
`NUMBER: 9001 {LP}
`
`LED: 1 {LP}
`
`ZAP: {LP}
`
`CLS: {LP}
`
`DISPLAY: ANSWER QUERIES NOW?
`PRESS ANY BUTTON TO START {LF}
`WAIT: {LP}
`CLS: {LP}
`
`DISPLAY: HOW DO YOU PEEL?
`
`VERY
`VERY
`BAD BAD GOOD GOOD{LP}
`
`INPUT: 0000 {LP}
`CLS: {LP}
`DISPLAY: HOW WELL ARE YOU
`MANAGING YOUR DISEASE?
`VERY
`VERY
`WELL BADLY WELL WELL {LP}
`
`INPUT: 0000 {LP}
`CLS: {LP}
`DISPLAY: HOW HARD IS IT FOR YOU TO
`FOLLOW YOUR TREATMENT PLAN?
`VERY
`VERY
`HARD HARD EASY EASY {LE}
`
`INPUT: 0000 {LF}
`CLS: {LP}
`DISPLAY: HOW HARD IS IT FOR YOU TO
`CONTROL YOUR BLOOD SUGAR?
`VERY
`VERY
`HARD HARD EASY EASY {LP}
`FIG. 6A
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 5 0f 15
`
`US 6,368,273 B1
`
`INPUT: 0000 {LP}
`CLS: {LP}
`DISPLAY: CONNECT GLUCOSE METER
`AND PRESS ANY BUTTON
`WHEN FINISHED {LE}
`WAIT: {LP}
`
`DISPLAY: COLLECTING MEASUREMENTS {LF}
`COLLECT: GLUCOSE_METER {LE}
`CLS: {LE}
`DISPLAY: CONNECT APPARATUS T0
`TELEPHONE JACK AND
`PRESS ANY BUTTON
`WHEN PINISHED {LP}
`WAIT: {LF}
`LED: 0 {LF}
`
`DELAY: 03:00 {LF}
`DISPLAY: CONNECTING T0 SERVER {LP}
`CONNECT: {LP}
`{E0P}
`
`FIG. 6B
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 6 0f 15
`
`US 6,368,273 B1
`
`57
`9
`SCRIPT ASSIGNMENT SCREEN
`PATIENTS:
`AVAILABLE SCRIPTS:
`
`106 \f‘lzl WED 108 WEI DAN LINDSEY
`[:I MARK SMITH
`|:| DIABETES SCRIPT 2
`2 9 |:] DEAN JONES
`[:| ASTHMA SCRIPT 1
`
`110 \/\ ADD SCRIPT
`
`ASSIGN SCRIPT
`
`DELETE SCRIPT
`
`q/114
`
`FIG. 7
`
`HOW DO YOU FEEL?
`
`26
`\f‘
`
`VERY
`BAD
`
`VERY ’\/ 64
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`70B
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`AND PRESS ANY BUTTON /\/ 64
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`
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`70A
`
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`)
`\
`\
`70C
`70B
`FIG. 9
`
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`\
`70D
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 7 of 15
`
`US 6,368,273 B1
`
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`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 8 0f 15
`
`US 6,368,273 B1
`
`GENERATE
`AND STORE
`SCRIPT PROGRAM
`
`M204
`
`STORE SCRIPT W208
`ASSIGNMENTS
`
`START
`MONITORING
`APPLICATION
`
`REMOTE
`CONNECT?
`
`NO
`
`O
`
`FIG. 11A
`
`RECEIVE
`UNIQUE ID
`
`M212
`
`I
`
`RECEIVE
`AND STORE
`RESPONSES AND W214
`MEASUREMENTS
`
`I
`RETRIEVE
`ASSIGNED SCRIPT
`
`I
`TRANSMIT
`<———
`ASSIGNED SCRIPT
`
`M216
`
`M218
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 9 0f 15
`
`US 6,368,273 B1
`
`220
`
`PATIENT
`REPORT?
`
`RETRIEVE
`2Z2 \/\ RESPONSES AND
`MEASUREMENTS
`
`l
`
`GENERATE
`224 \p AND DISPLAY
`REPORT
`
`FIG. 11B
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 10 0f 15
`
`US 6,368,273 B1
`
`START
`SCRIPT
`PROGRAM
`
`302 \? ASSIGN SCRIPT ID
`
`304 \_/\ LIGHT LED
`
`I
`I
`
`306 w ERASE LAST
`RESPONSES
`
`308 \_f\ PROMPT PATIENT
`
`310 \/~ RECEIVE REPLY
`
`I
`I
`I
`
`DISPLAY QUERIES
`312 \/\ AND RECORD
`RESPONSES
`
`I
`
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`314
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`
`I
`I
`
`316 \f‘ RECEIVE REPLY
`
`COLLECT
`318 \/“ AND STORE
`MEASUREMENTS
`
`<5
`
`FIG. 12A
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 11 0f 15
`
`US 6,368,273 B1
`
`PROMPT FOR
`320
`VT PHONE LINE
`CONNECTION
`
`322 \/‘ RECEIVE REPLY
`
`324 \P TURN OFF LED
`
`I
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`326
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`
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`RESPONSES AND
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`
`I
`
`332 \P
`
`RECEIVE AND
`STORE
`NEW SCRIPT
`
`END
`SCRIPT
`PROGRAM
`
`FIG. 12B
`
`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 12 0f 15
`
`US 6,368,273 B1
`
`FIG. 13
`
`27
`V‘
`
`YOU HAVE UNANSWERED
`QUERIES. SAY "BEGIN"
`TO START SURVEY.
`
`/\/ 64
`
`FIG. 14
`
`

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`U.S. Patent
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`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 14 0f 15
`
`US 6,368,273 B1
`
`@18
`
`26
`Q
`REMOTE APPARATUS
`
`SCRIPT PROGRAM
`
`SERVER
`DATABASE
`38 \V‘
`40 \f GENERIC SCRIPTS
`41 \/\| CUSTOM SCRIPTS
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`|
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`
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`
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`MARCH 15, 1997.
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`

`
`U.S. Patent
`
`Apr. 9, 2002
`
`Sheet 15 of 15
`
`US 6,368,273 B1
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`
`US 6,368,273 B1
`
`1
`NETWORKED SYSTEM FOR INTERACTIVE
`COMMUNICATION AND REMOTE
`MONITORING OF INDIVIDUALS
`
`RELATED APPLICATION INFORMATION
`
`This application is a divisional application of application
`Ser. No. 08/946,341 ?led Oct. 7, 1997, now US. Pat. No.
`5,997,476 Which is a continuation-in-part of application Ser.
`No. 08/847,009 ?led Apr. 30, 1997, now US. Pat. No.
`5,897,493. This application also claims priority from pro
`visional application Ser. No. 60/041,746 ?led Mar. 28, 1997
`and from provisional application Ser. No. 60/041,751 ?led
`Mar. 28, 1997. This application also claims priority from
`application Ser. No. 09/201,323 entitled “Leveraging Inter
`actions With a Community of Individuals”, ?led Nov. 30,
`1998 and from application Ser. No. 09/274,433 entitled
`“Client-Initiated Leveraged Interaction With Providers”,
`?led Mar. 22, 1999. All of the above named applications are
`hereby incorporated by reference.
`
`FIELD OF THE INVENTION
`
`The present invention relates generally to communication
`systems for remote monitoring of individuals, and in par
`ticular to a netWorked system for remotely monitoring
`individuals and for communicating information to the indi
`viduals through the use script programs.
`
`BACKGROUND OF THE INVENTION
`
`In the United States alone, over 100 million people have
`chronic health conditions, accounting for an estimated $700
`billion in annual medical costs. In an effort to control these
`medical costs, many healthcare providers have initiated
`outpatient or home healthcare programs for their patients.
`The potential bene?ts of these programs are particularly
`great for chronically ill patients Who must treat their diseases
`on a daily basis. HoWever, the success of these programs is
`dependent upon the ability of the healthcare providers to
`monitor the patients remotely to avert medical problems
`before they become complicated and costly. Unfortunately,
`no convenient and cost effective monitoring system exists
`for the patients Who have the greatest need for monitoring,
`the poor and the elderly.
`Prior attempts to monitor patients remotely have included
`the use of personal computers and modems to establish
`communication betWeen patients and healthcare providers.
`HoWever, computers are too expensive to give aWay and the
`patients Who already oWn computers are only a small
`fraction of the total population. Further, the patients Who
`oWn computers are typically young, Well educated, and have
`good healthcare coverage. Thus, these patients do not have
`the greatest unmet medical needs. The patients Who have the
`greatest unmet medical needs are the poor and elderly Who
`do not oWn computers or Who are unfamiliar With their use.
`Similar attempts to establish communication betWeen
`patients and healthcare providers have included the use of
`the Internet and internet terminals. Although internet termi
`nals are someWhat less costly than personal computers, they
`are still too expensive to give aWay to patients. Moreover,
`monthly on-line access charges are prohibitive for poor
`patients.
`Other attempts to monitor patients remotely have included
`the use of medical monitoring devices With built-in modems.
`Examples of such monitoring devices include blood glucose
`meters, respiratory ?oW meters, and heart rate monitors.
`Unfortunately, these monitoring devices are only designed
`
`10
`
`15
`
`20
`
`25
`
`30
`
`35
`
`45
`
`50
`
`55
`
`60
`
`65
`
`2
`to collect physiological data from the patients. They do not
`alloW ?exible and dynamic querying of the patients for other
`information, such as quality of life measures or psycho
`social variables of illness.
`Prior attempts to monitor patients remotely have also
`included the use of interactive telephone or video response
`systems. Such interactive systems are disclosed in US. 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 al. on Aug. 15, 1995. One disadvantage
`of these systems is that they either require a patient to call
`in to a central facility to be monitored or require the central
`facility to call the patient according to a rigid monitoring
`schedule.
`If the patients are required to call the central facility, only
`the compliant patients Will actually call regularly to be
`monitored. Non-compliant patients Will typically Wait until
`an emergency situation develops before contacting their
`healthcare provider, thus defeating the purpose of the moni
`toring system. If the central facility calls each patient
`according to a monitoring schedule, it is intrusive to the
`patient’s life and resistance to the monitoring groWs over
`time.
`Another disadvantage of these conventional interactive
`response system is that they are prohibitively expensive for
`poor patients. Further, it is difficult to identify each patient
`uniquely using these systems. Moreover, these systems are
`generally incapable of collecting medical data from moni
`toring devices, such as blood glucose meters, respiratory
`?oW meters, or heart rate monitors.
`
`OBJECTS AND ADVANTAGES OF THE
`INVENTION
`In vieW of the above, it is an object of the present
`invention to provide a simple and inexpensive system for
`remotely monitoring patients and for communicating infor
`mation to the patients. It is another object of the invention
`to provide a system Which alloWs ?exible and dynamic
`querying of the patients. It is a further object of the invention
`to provide a system Which combines querying of patients
`With medical device monitoring in the same monitoring
`session. Another object of the invention is to provide a
`monitoring system Which incurs loWer communications
`charges than those incurred by conventional monitoring
`systems. A further object of the invention is to provide a
`monitoring system Which may be used at any time conve
`nient for a patient.
`These and other objects and advantages Will become more
`apparent after consideration of the ensuing description and
`the accompanying draWings.
`SUMMARY
`The invention presents a netWorked system for remotely
`monitoring an individual and for communicating informa
`tion to the individual. The system includes a server and a
`remote interface for entering in the server a set of queries to
`be ansWered by the individual. The server is preferably a
`World Wide Web server and the remote interface is preferably
`a personal computer or netWork terminal connected to the
`Web server via the Internet. The system also includes a
`remotely programmable apparatus for interacting With the
`individual. The apparatus is connected to the server via a
`communication netWork, preferably the Internet. The appa
`ratus interacts With the individual in accordance With a script
`program received from the server.
`The server includes a script generator for generating the
`script program from the queries entered through the remote
`
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`US 6,368,273 B1
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`3
`interface. The script program is executable by the apparatus
`to communicate the queries to the individual, to receive
`responses to the queries, and to transmit the responses from
`the apparatus to the server. The server also includes a
`database connected to the script generator for storing the
`script program and the responses to the queries.
`The apparatus has a communication device, such as a
`modem, for receiving the script program from the server and
`for transmitting the responses to the server. The apparatus
`also has a user interface for communicating the queries to
`the individual and for receiving the responses to the queries.
`In the preferred embodiment, the user interface includes a
`display for displaying the queries and user input buttons for
`entering the responses to the queries. In an alternative
`embodiment, the user interface includes a speech synthe
`siZer for audibly communicating the queries and a speech
`recogniZer for receiving spoken responses to the queries.
`The apparatus also includes a memory for storing the
`script program and the responses to the queries. The appa
`ratus further includes a microprocessor connected to the
`communication device, the user interface, and the memory.
`The microprocessor executes the script program to com
`municate the queries to the individual, to receive the
`responses to the queries, and to transmit the responses to the
`server through the communication netWork.
`In the preferred embodiment, the system also includes at
`least one monitoring device for producing measurements of
`a physiological condition of the individual and for transmit
`ting the measurements to the apparatus. The apparatus
`further includes a device interface connected to the micro
`processor for receiving the measurements from the moni
`toring device. The measurements are stored in the memory
`and transmitted to the server With the responses to the
`queries. The server also preferably includes a report gen
`erator connected to the database for generating a report of
`the measurements and responses. The report is displayed on
`the remote interface.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 is a block diagram of a netWorked system accord
`ing to a preferred embodiment of the invention.
`FIG. 2 is a block diagram illustrating the interaction of the
`components of the system of FIG. 1.
`FIG. 3 is a perspective vieW of a remotely programmable
`apparatus of the system of FIG. 1.
`FIG. 4 is a block diagram illustrating the components of
`the apparatus of FIG. 3.
`FIG. 5 is a script entry screen according to the preferred
`embodiment of the invention.
`FIG. 6A is a listing of a sample script program according
`to the preferred embodiment of the invention.
`FIG. 6B is a continuation of the listing of FIG. 6A.
`FIG. 7 is a script assignment screen according to the
`preferred embodiment of the invention.
`FIG. 8 is a sample query appearing on a display of the
`apparatus of FIG. 3.
`FIG. 9 is a sample prompt appearing on the display of the
`apparatus of FIG. 3.
`FIG. 10 is a sample report displayed on a Workstation of
`the system of FIG. 1.
`FIG. 11A is a How chart illustrating the steps included in
`a monitoring application executed by the server of FIG. 1
`according to the preferred embodiment of the invention.
`FIG. 11B is a continuation of the How chart of FIG. 11A.
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`FIG. 12A is a How chart illustrating the steps included in
`the script program of FIGS. 6A—6B.
`FIG. 12B is a continuation of the How chart of FIG. 12A.
`FIG. 13 is a perspective vieW of a remotely programmable
`apparatus according to a second embodiment of the inven
`tion.
`FIG. 14 is a sample prompt appearing on a display of the
`apparatus of FIG. 13.
`FIG. 15 is a block diagram illustrating the components of
`the apparatus of FIG. 13.
`FIG. 16 is a schematic block diagram illustrating the
`interaction of the server of FIG. 1 With the apparatus of FIG.
`3 according to a third embodiment of the invention.
`FIG. 17 is a ?rst sample message appearing on the display
`of the apparatus of FIG. 3.
`FIG. 18 is a second sample message appearing on the
`display of the apparatus of FIG. 3.
`FIG. 19 is a script entry screen according to the third
`embodiment of the invention.
`
`DETAILED DESCRIPTION
`
`The invention presents a system and method for remotely
`monitoring individuals and for communicating information
`to the individuals. In a preferred embodiment of the
`invention, the individuals are patients and the system is used
`to collect data relating to the health status of the patients.
`HoWever, it is to be understood that the invention is not
`limited to remote patient monitoring. The system and
`method of the invention may be used for any type of remote
`monitoring application. The invention may also be imple
`mented as an automated messaging system for communi
`cating information to individuals, as Will be discussed in an
`alternative embodiment beloW.
`A preferred embodiment of the invention is illustrated in
`FIGS. 1—12. Referring to FIG. 1, a netWorked system 16
`includes a server 18 and a Workstation 20 connected to
`server 18 through a communication netWork 24. Server 18
`is preferably a World Wide Web server and communication
`netWork 24 is preferably the Internet. It Will be apparent to
`one skilled in the art that server 18 may comprise a single
`stand-alone computer or multiple computers distributed
`throughout a netWork. Workstation 20 is preferably a per
`sonal computer, remote terminal, or Web TV unit connected
`to server 18 via the Internet. Workstation 20 functions as a
`remote interface for entering in server 18 messages and
`queries to be communicated to the patients.
`System 16 also includes ?rst and second remotely pro
`grammable apparatuses 26 and 32 for monitoring ?rst and
`second patients, respectively. Each apparatus is designed to
`interact With a patient in accordance With script programs
`received from server 18. Each apparatus is in communica
`tion With server 18 through communication netWork 24,
`preferably the Internet. Alternatively, each apparatus may be
`placed in communication With server 18 via Wireless com
`munication netWorks, cellular netWorks, telephone
`netWorks, or any other netWork Which alloWs each apparatus
`to exchange data With server 18. For clarity of illustration,
`only tWo apparatuses are shoWn in FIG. 1. It is to be
`understood that system 16 may include any number of
`apparatuses for monitoring any number of patients.
`In the preferred embodiment, each patient to be monitored
`is also provided With a monitoring device 28. Monitoring
`device 28 is designed to produce measurements of a physi
`ological condition of the patient, record the measurements,
`and transmit the measurements to the patient’s apparatus
`
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`US 6,368,273 B1
`
`5
`through a standard connection cable 30. Examples of suit
`able monitoring devices include blood glucose meters, res
`piratory ?oW meters, blood pressure cuffs, electronic Weight
`scales, and pulse rate monitors. Such monitoring devices are
`Well knoWn in the art. The speci?c type of monitoring device
`provided to each patient is dependent upon the patient’s
`disease. For example, diabetes patients are provided With a
`blood glucose meters for measuring blood glucose
`concentrations, asthma patients are provided With respira
`tory ?oW meters for measuring peak ?oW rates, obesity
`patients are provided With Weight scales, etc.
`FIG. 2 shoWs server 18, Workstation 20, and apparatus 26
`in greater detail. Server 18 includes a database 38 for storing
`script programs 40. The script programs are executed by
`each apparatus to communicate queries and messages to a
`patient, receive responses 42 to the queries, collect moni
`toring device measurements 44, and transmit responses 42
`and measurements 44 to server 18. Database 38 is designed
`to store the responses 42 and measurements 44. Database 38
`further includes a look-up table 46. Table 46 contains a list
`of the patients to be monitored, and for each patient, a
`unique patient identi?cation code and a respective pointer to
`the script program assigned to the patient. Each remote
`apparatus is designed to execute assigned script programs
`Which it receives from server 18.
`FIGS. 3—4 shoW the structure of each apparatus according
`to the preferred embodiment. For clarity, only apparatus 26
`is shoWn since each apparatus of the preferred embodiment
`has substantially identical structure to apparatus 26. Refer
`ring to FIG. 3, apparatus 26 includes a housing 62. Housing
`62 is suf?ciently compact to enable apparatus 26 to be
`hand-held and carried by a patient. Apparatus 26 also
`includes a display 64 for displaying queries and prompts to
`the patient. In the preferred embodiment, display 64 is a
`liquid crystal display (LCD).
`Four user input buttons 70A, 70B, 70C, and 70D are
`located adjacent display 64. The user input buttons are for
`entering in apparatus 26 responses to the queries and
`prompts. In the preferred embodiment, the user input buttons
`are momentary contact push buttons. In alternative
`embodiments, the user input buttons may be replaced by
`sWitches, keys, a touch sensitive display screen, or any other
`data input device.
`Three monitoring device jacks 68A, 68B, and 68C are
`located on a surface of housing 62. The device jacks are for
`connecting apparatus 26 to a number of monitoring devices,
`such as blood glucose meters, respiratory ?oW meters, or
`blood pressure cuffs, through respective connection cables
`(not shoWn). Apparatus 26 also includes a modem jack 66
`for connecting apparatus 26 to a telephone jack through a
`standard connection cord (not shoWn). Apparatus 26 further
`includes a visual indicator, such as a light emitting diode
`(LED) 74. LED 74 is for visually notifying the patient that
`he or she has unansWered queries stored in apparatus 26.
`FIG. 4 is a schematic block diagram illustrating the
`components of apparatus 26 in greater detail. Apparatus 26
`includes a microprocessor 76 and memory 80 connected to
`microprocessor 76. Memory 80 is preferably a non-volatile
`memory, such as a serial EEPROM. Memory 80 stores script
`programs received from the server, measurements received
`from monitoring device 28, responses to queries, and the
`patient’s unique identi?cation code. Microprocessor 76 also
`includes built-in read only memory (ROM) Which stores
`?rmWare for controlling the operation of apparatus 26. The
`?rmWare includes a script interpreter used by microproces
`sor 76 to execute the script programs. The script interpreter
`
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`interprets script commands Which are executed by micro
`processor 76. Speci?c techniques for interpreting and
`executing script commands in this manner are Well knoWn in
`the art.
`Microprocessor 76 is preferably connected to memory 80
`using a standard tWo-Wire 12C interface. Microprocessor 76
`is also connected to user input buttons 70, LED 74, a clock
`84, and a display driver 82. Clock 84 indicates the current
`date and time to microprocessor 76. For clarity of
`illustration, clock 84 is shoWn as a separate component, but
`is preferably built into microprocessor 76. Display driver 82
`operates under the control of microprocessor 76 to display
`information on display 64. Microprocessor 76 is preferably
`a PIC 16C65 processor Which includes a universal asyn
`chronous receiver transmitter (UART) 78. UART 78 is for
`communicating With a modem 86 and a device interface 90.
`A CMOS sWitch 88 under the control of microprocessor 76
`alternately connects modem 86 and interface 90 to UART
`78.
`Modem 86 is connected to a telephone jack 22 through
`modem jack 66. Modem 86 is for exchanging data With
`server 18 through communication netWork 24. The data
`includes script programs Which are received from the server
`as Well as responses to queries, device measurements, script
`identi?cation codes, and the patient’s unique identi?cation
`code Which modem 86 transmits to the server. Modem 86 is
`preferably a complete 28.8 K modem commercially avail
`able from Cermetek, although any suitable modem may be
`used.
`Device interface 90 is connected to device jacks 68A,
`68B, and 68C. Device interface 90 is for interfacing With a
`number of monitoring devices, such as blood glucose
`meters, respiratory ?oW meters, blood pressure cuffs, Weight
`scales, or pulse rate monitors, through the device jacks.
`Device interface 90 operates under the control of micropro
`cessor 76 to collect measurements from the monitoring
`devices and to output the measurements to microprocessor
`76 for storage in memory 80. In the preferred embodiment,
`interface 90 is a standard RS232 interface. For simplicity of
`illustration, only one device interface is shoWn in FIG. 4.
`HoWever, in alternative embodiments, apparatus 26 may
`include multiple device interfaces to accommodate moni
`toring devices Which have different connection standards.
`Referring again to FIG. 2, server 18 includes a monitoring
`application 48. Monitoring application 48 is a controlling
`softWare application executed by server 18 to perform the
`various functions described beloW. Application 48 includes
`a script generator 50, a script assignor 52, and a report
`generator 54. Script generator 50 is designed to generate
`script programs 40 from script information entered through
`Workstation 20. The script information is entered through a
`script entry screen 56. In the preferred embodiment, script
`entry screen 56 is implemented as a Web page on server 18.
`Workstation 20 includes a Web broWser for accessing the
`Web page to enter the script information.
`FIG. 5 illustrates script entry screen 56 as it appears on
`Workstation 20. Screen 56 includes a script name ?eld 92 for
`specifying the name of a script program to be generated.
`Screen 56 also includes entry ?elds 94 for entering a set of
`queries to be ansWered by a patient. Each entry ?eld 94 has
`corresponding response choice ?elds 96 for entering
`response choices for the query. Screen 56 further includes
`check boxes 98 for selecting a desired monitoring device
`from Which to collect measurements, such as a blood glu
`cose meter, respiratory ?oW meter, or blood pressure cuff.
`Screen 56 additionally includes a connection time ?eld
`100 for specifying a prescribed connection time at Which
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`US 6,368,273 B1
`
`7
`each apparatus executing the script is to establish a subse
`quent communication link to the server. The connection time
`is preferably selected to be the time at which communication
`rates are the lowest, such as 3:00 AM. Screen 56 also
`includes a CREATE SCRIPT button 102 for instructing the
`script generator to generate a script program from the
`information entered in screen 56. Screen 56 further includes
`a CANCEL button 104 for canceling the information entered
`in screen 56.
`In the preferred embodiment, each script program created
`by the script generator conforms to the standard ?le format
`used on UNIX systems. In the standard ?le format, each
`command is listed in the upper case and followed by a colon.
`Every line in the script program is terminated by a linefeed
`character {LF} and only one command is placed on each
`line. The last character in the script program is a UNIX end
`of ?le character
`Table 1 shows an exemplary listing
`of script commands used in the preferred embodiment of the
`invention.
`
`TABLE 1
`
`SCRIPT COMMANDS
`
`Command
`
`CLS: {LF}
`ZAP: {LF}
`
`LED: b{LF}
`
`DISPLAY: {chars} {LF}
`
`COLLECT: device{LF}
`
`NUMBER: aaaa{LF}
`
`CONNECT: {LP}
`
`Description
`
`Clear the display.
`Erase from memory the last set of query
`responses recorded.
`Turn the LED on or off, where b is a binary
`digit of O or 1. An argument of 1 turns on the
`LED, and an argument of 0 turns off the LED.
`Display the text followi