Abstract:
A medical screening apparatus and method includes a housing containing a user interface, an automatic medical test apparatus and a transmitting means for communicating the output of the medical test apparatus to a remote site for analysis. In one aspect, the user interface is a video display terminal capable of receiving user data and for displaying the medical test output. Preferably, the test output is automatically transmitted via a global telecommunication network, such as the Internet, to the remote site.

Description:
CROSS REFERENCE TO CO-PENDING APPLICATION 
     This application claims the benefit of the filing date of co-pending Provisional Patent Application Ser. No. 60/183,592 filed Feb. 18, 2000, and entitled Retinal Screening Apparatus. 
    
    
     BACKGROUND 
     Diabetes is a leading cause of blindness in the United States. Unfortunately, despite access to medical care, many patients are going undiagnosed in terms of their diabetic eye disease. Many efforts have been directed to screening; however, such efforts are still ineffective. An HMO states that only 33% of its diabetic patients are actually obtaining yearly eye exams, despite widespread educational efforts. Glaucoma is another serious cause of blindness in the United States that is under detected. 
     In an effort to increase the percentage of patients who are obtaining yearly eye exams to detect diabetes effects, glaucoma and other eye problems in an earliest possible stage, a new approach is warranted. 
     SUMMARY 
     The present invention is an apparatus and method for conducting a medical screening test on a user patient. 
     In one aspect of the invention, the medical screening apparatus includes a housing, a user interface mounted in the housing for inputting patient-related data, medical test apparatus mounted in the housing for conducting a medical test on a user and generating a test output, and means for communicating with the medical test apparatus for transmitting the test output and patient data to a remote site for analysis. 
     In one aspect, the apparatus further includes a control means in the housing for controlling the user interface, activation of the medical test apparatus and operation of the transmitting means. Preferably the control means includes a central processing unit executing a control program stored in a memory coupled to the central processing unit. 
     The transmitting means preferably comprises means for communicating the test output to the remote site via a global telecommunication network, such as the Internet. 
     In another aspect, the user interface preferably comprises a video display terminal. The display terminal can be capable of receiving only user input data in response to visual prompts generated by the control means. Alternately, the video display terminal is also capable of displaying the test output. 
     In one specific aspect, the medical test apparatus is a retinal screening apparatus. The retinal screening apparatus preferably includes a digital retinal camera. Means are provided for establishing a predetermined position of the user&#39;s or patient&#39;s eye with respect to the camera. This position may be provided by a chin support mounted at a fixed distance from the camera in the housing or a seat mounted on the housing at a fixed distance from the camera. 
     In another aspect, the invention is a method of automatically conducting a medical screening test on a user or patient. The method includes steps of providing a housing, providing a user interface in the housing for receiving user-related data, providing a medical test apparatus in the housing for automatically executing a medical test on a user and generating a test output, and transmitting the test output to a remote site for analysis. 
     Preferably, the user interface is implemented by providing a video display terminal in the housing which is capable of receiving user data in response to visual prompts generated by a control means on the video display terminal and/or displaying the medical test output on the display terminal. 
     The method further includes the step of providing the test apparatus as a retinal screening apparatus which includes a digital retinal camera. The method includes the steps of establishing a predetermined position of the patient&#39;s eye from the digital camera for implementing the retinal screening test. 
     The medical screening apparatus and method of the present invention affords numerous advantages. The primary advantage is the easy and quick taking of a medical screening test on a user or patient. This simple procedure causes users to more readily have the medical screening test performed so as to detect any diseases at an earlier stage. The entire operation of the apparatus is automated so as to simplify its use by numerous users when the apparatus is placed in a public location, such as a shopping mall, etc. 
     The apparatus is also capable of taking one or more tests. The use of the global telecommunication network for transmitting the test results enables each test to be analyized by a central test organization for test result consistency. 
    
    
     BRIEF DESCRIPTION OF THE DRAWING 
     The various features, advantages and other uses of the present invention will become more apparent by referring to the following detail description and drawing in which: 
     FIG. 1 is a pictorial representation of a kiosk type remote unit used in the retinal screening apparatus of the present invention; 
     FIG. 2 is a pictorial representation of the internal components in the kiosk shown in FIG. 1; 
     FIG. 3 is a block diagram of the internal components of a remote unit shown in FIG. 1; and 
     FIG. 4 is a pictorial representation of a wide area implementation of the retinal screening apparatus of the present invention. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     Referring now to the drawing, and to FIGS. 1-4 in particular, there is depicted a retinal screening apparatus and system according to the present invention. The system  10 , shown in FIG. 4, includes at least one and preferably a plurality of remote units  12  which are each situated in a public place capable of exposure to large numbers of people, such as malls, movie theaters, etc. 
     Each remote unit  12  is in the form of a stand alone housing  14  which, in the exemplary embodiment shown in FIGS. 1 and 2, is in the form of a kiosk. The housing  14  may take any shape with the illustrative cylindrical shape being understood to be by example only. Square, and other multi-sided housing configurations are also possible. 
     The outer surfaces of the housing  14  are amenable to advertisements from local merchants as well as educational information concerning eye disease. Instructions for use of the retinal screening apparatus  12  may also be placed on the exterior of the housing  14 . 
     As shown in FIGS. 1 and 2, a chair or seat  16  is optionally attached to the housing  14  by means of a support bracket  18 . The entire seat  16  and support bracket  18  may be fixedly or, preferably, pivotally attached to the housing  14 . This enables the seat  16  to be pivoted into close proximity with the housing  14  so as not to protrude a great distance beyond the peripheral extent of the housing  14  when not in use. 
     It should be noted that the size of the seat  16  and the length of the bracket  18  may be selected to provide an appropriate focal distance for a patient from a fixation target  21  which is mounted in front of or slightly adjacent to a lens  20  of a camera  22  mounted within the housing  14 . The lens  20  is covered by a protective plate, such as a transparent glass or plastic panel mounted in the side wall of the housing  14 . 
     In certain applications, it may be desirable to dispense with the seat  16  and merely provide a mark on the floor at a set distance from the fixation target  21  to properly locate a patient for the retinal screening exam as described hereafter. 
     As shown in FIG. 1, a user interface  26  is mounted in the housing  14  with an exterior surface accessible through the wall of the housing  14 . The input interface  26  may take a number of different forms, including a conventional keypad, pushbuttons or, as shown in FIGS. 1 and 2, a touchscreen. 
     The touchscreen  26  is usable to provide instructions to the user as well as to accept inputs by means of the user touching selected portions of the touchscreen  26  on which appear input selections, including a keyboard display to enable a user to enter user demographics, such as name, address, phone number, age, weight, sex, and other information pertinent to a retinal exam. 
     An optional display  30  in the form of a video monitor is also mounted in the housing  14 . The monitor  30  is used, as described hereafter, to display clinical retinal photographs of different eye diseases as well as photographs of healthy eyes to enable a user to self compare their retinal image with a set of control retinal images. The monitor  30  can thus display both the patient&#39;s own retinal image as well as one control image of a diseased eye or a healthy eye. 
     It should also be noted that the user interface  26  when implemented in the form of a touchscreen may also be combined with the monitor  30  into a single touchscreen monitor as is readily available in the marketplace. 
     Preferably, the monitor  30  is a color monitor to more adequately display the retinal image. 
     Although not shown, a service door is provided in the wall of the housing  14  to allow access to the interior of the housing  14  for service or replacement of the various components of the retinal screening apparatus mounted within the housing  14 . 
     The camera  22  is preferably a digital retinal camera that takes digital retinal photographs through a non-dilated pupil of a user seated in the chair  16  or standing at a spaced distance from the fixation target  21 . By example, a digital retinal camera sold by Canon as model CR-5 camera using MVC 5000 retinal imaging software can be used to capture, display and store high resolution retinal images of patient conditions. 
     The camera  22  is preferably provided with an auto focusing lens system, including infrared sensors and a motor lens focusing drive to auto focus on a patient&#39;s eye. Alternately, a fixed focal length lens can be used. 
     For added clarity, a chin support may be mounted by means of a bracket, not shown, on the housing  14  so as to receive a patient&#39;s chin and position the patient&#39;s eyes at a set distance from the fixation target  21  and the adjacent camera  22 . 
     Also housed with the housing  14  is a central processing unit  40 , such as a microprocessor, microcontroller, etc. The central processor, hereafter referred to as a CPU  40 , accesses a stored program contained in a memory  42 , either contained within the microprocessor  40  or as a separate memory element connected in data communication with the CPU  40 . 
     The CPU  40  thus is capable of generating instructions for use of the retinal screening apparatus  12  as well as receiving patient input demographics, displaying a set of control digital retinal images and patient retinal images on the monitor  30 . 
     In use, the touchscreen  26  or, in a printed chart mounted on the housing  14  of the retinal screening apparatus  12 , a set of instructions will be provided. A patient will input various patient demographics, such as name, address, telephone number, age, weight, sex, name and address of the patient&#39;s eye doctor, etc., into the CPU  40  via the touchscreen  26  or other input interface provided on the housing  14 . A patient will sit in the chair  16  and fix his or her chin on the chin pad, if a chin pad is provided, or fix his or her forehead against a forehead rest, if provided. At a set time or by means of a start button provided on the housing  14 , the apparatus  12  is activated. The camera  22  auto focuses the lens  20  to the proper focal length and takes a digital retinal image of one of the patient&#39;s eyes. The patient then shifts his or her position relative to the fixation target  21  and then repeats the above process to enable the camera  22  to take a digital retinal image of the patient&#39;s other eye. 
     The camera  22  outputs the digital images to the CPU  40  which converts the digital information into digital images which can be displayed on the monitor  30 , either by themselves or in a side-by-side comparison with a set of control images showing healthy and diseased eyes. 
     An important feature of the present apparatus  10  is a network connection provided by a network interface  44  from the CPU  40  to a central CPU or station  46  shown in FIG.  4 . The network interface  44  provides connection to a data communication network  48 , also shown in FIG.  4 . The data communication network  48  may be any type of data communication network, such as a wide area or local area telephone network using dedicated telephone lines through a modem which comprises the network interface  44  to the central station  46  or, if the patient can input his or her eye doctor&#39;s address and telephone number, directly to his or her eye care physician. 
     The network  48  may also comprise wireless data communication networks, such as the Internet. In this instance, the network interface comprises a conventional modem connection to a service provider. The central station  46  will have an IP address allowing access to the data transmitted from any of the remote units  12 . Alternately, cellular telephone and satellite systems, etc., may constitute the network  48 . 
     Likewise, if a patient can input his or her eye doctor&#39;s Internet address or e-mail address, the digital retinal images can be sent directly through the Internet  48  to the specified eye doctor. 
     In the case where the digital retinal information is sent to the central station  46 , the central station  46  can print the digital retinal images for examination by an ophthalmologist or eye care specialist. The diagnosis of any eye disease can be handled with different levels of concern and educational information sent back to the patient. When severe eye disease is detected, a higher degree of concern will be raised in follow-up with the patient advising the patient to contact an eye care specialist would then be strongly recommended by either by telephone call, letter or both. If the patient&#39;s eye doctor is provided by the patient, the same information can be sent directly to the specified doctor. 
     The end result of the use of the retinal image apparatus of the present invention is that more people are exposed to easy and free retinal eye examinations thereby increasing the probability of identifying patients with diabetic retinopathy, glaucoma or other eye diseases earlier in the course of the disease. As numerous studies have shown, early intervention with medical treatment can significantly reduce the risk of loss of vision and blindness. 
     In general, the retinal examination apparatus of the present invention includes a housing, an auto focus, digital retinal camera mounted within the housing, the user interface for inputting patient demographics, a display for displaying captured digital retinal images of the patient&#39;s eyes and/or comparing the patient&#39;s digital retinal images with healthy and diseased eyes for self comparison by the patient, and a network interface for connection to a communication network wherein the captured digital retinal images of each patient are transmitted to the patient&#39;s doctor or to a central station for comparison and follow-up, if follow-up is needed. 
     Although the present invention has been described as a retinal screen apparatus devised specifically for taking and transmitting digital retinal images of a patient&#39;s eyes, the present invention also contemplates the retinal screening process as being but one of a number of separate and/or available functions which may be provided in a so-called “medical kiosk”. In this configuration, a housing similar to the housing  14  may also incorporate other medical test equipment, such as glucose test equipment utilizing an oxygen sensor attachable to a patient to measure the patent&#39;s blood sugar levels. A blood pressure cuff may also be provided to obtain a patient&#39;s blood pressure. Pulmonary function equipment including a breathing tube and suitable test equipment may also be mounted within the housing  14  to measure a patient&#39;s pulmonary capacity. Of course, each specific test would require its own test equipment mounted within the housing  14  to measure and digitize the input data collected during each specific test. However, the resulting data, when properly formatted by the CPU  40 , can then be transmitted via the network  48  to the central station  46 . The central station  46  will then compare each specific test data with specific body functions standards, such as safe or unhealthy glucose levels, blood pressure levels or pulmonary functions. Appropriate results will then be transmitted to the patient&#39;s doctor or primary health care provider as indicated on the input demographic information or sent directly to the patient with an explanation and whether or not further physician examination is appropriate.