Abstract:
A remote monitoring system for monitoring a plurality of medical devices at a patient care or home care facility. The system includes a device integration server in communication with wireless relay modules for receiving data packets from the medical devices including an identifier and data for each medical device. The system also includes a data management system and an outbound web server. The data management system is configured to log data for the medical devices. The web server is configured to provide webpages including the data of the medical devices for display on a remote monitoring computer, subject to authentication of an associated data request from the monitoring computer. The Web server is configurable to look up patient information from a secure source when user has appropriate permissions. In addition, the device integration server is configured to process alert messages received from the wireless relay modules and, in response, to transmit text message information to the wireless relay modules to be relayed to one or more text messaging recipients.

Description:
RELATED APPLICATIONS 
     This application is related to U.S. application Ser. No. 13/006,769, filed Jan. 14, 2011, entitled “Wireless Relay Module for Remote Monitoring Systems”, and to U.S. application Ser. No. 13/006,784, filed Jan. 14, 2011, entitled “Medical Device Wireless Network Architectures,” each of which is incorporated by reference in its entirety herein. 
     FIELD OF THE INVENTION 
     The present application is directed to a remote monitoring system for monitoring medical devices in communication with a wireless communication network, and more particularly, to a remote monitoring system for monitoring medical devices that communicate with the wireless communication network via one or more wireless relay modules and a wireless relay network. 
     BACKGROUND OF THE INVENTION 
     In critical care and home care health service centers including hospitals, clinics, assisted living centers and the like, care giver-patient interaction time is at a premium. Moreover, response times by care givers to significant health conditions and events can be critical. Systems of centralized monitoring have been developed to better manage care giver time and patient interaction. In such systems, physiological data from each patient is transmitted to a centralized location. At this centralized location, a single or small number of technicians monitor all of this patient information to determine patient status. Information indicating a patient alarm condition will cause the technicians and/or system to communicate with local care givers to provide immediate patient attention, for example via wireless pagers and/or cell phones, and/or by making a facility-wide audio page. 
     Implementing such centralized monitoring systems using wireless networks may present a number of difficulties. In order to effectively monitor patient status using information provided by a variety of medical devices that may be dynamically assigned to patients in a variety of rooms and on a variety of floors in a facility, it would be desirable to establish communications between the medical devices and the centralized location by means of a local area network such as, for example, a “WiFi” network based on IEEE 802.11 standards. However, as such networks are typically already in place in facilities to support a variety of other functions (for example, physician access to electronic medical records (EMRs), facility administrative systems and other functions), it is often undesirable to secure sufficient local area network access for the purpose of providing centralized monitoring. Moreover, when a patient is located remotely from a critical care health service center (for example, at home), access to traditional local area network facilities such as a WiFi network may be unavailable or not sufficiently reliable to support critical care monitoring applications. 
     Clearly, for improved efficiencies in centralized monitoring of critical care and home care health service centers, it may be desirable to provide a single “off-site” centralized monitoring location for monitoring several geographically-dispersed critical care health service centers. 
     As an alternative to conventional WiFi or IEEE 801.11-based local area networks, ZIGBEE networks based on the IEEE 802.15.4 standard for wireless personal area networks have been used for collecting information from a variety of medical devices in accordance with IEEE 11073 Device Specializations for point-of-care medical device communication, including for example pulse oximeters, blood pressure monitors, pulse monitors, weight scales and glucose meters. See, e.g.,  ZIGBEE Wireless Sensor Applications for Health, Wellness and Fitness , the ZIGBEE Alliance, March 2009, which is incorporated by reference herein in its entirety. As compared to present IEEE 802.15.1 BLUETOOTH wireless personal area networks, for example, ZIGBEE networks provide the advantage of being dynamically configurable, for example, in “self-healing” mesh configurations, and operating with low power requirements (enabling, for example, ZIGBEE transceivers to be integrally coupled to the medical devices under battery power). However, transmission ranges between individual ZIGBEE transceivers are generally limited to no more than several hundred feet. As a consequence, such networks are suitable for on-site communications with medical devices, but unusable for centralized monitoring locations located off-site. Therefore, a hybrid system may be employed in which one or more wireless personal area networks are configured to facilitate on-site communications between medical devices and one or more wireless relay modules which are further configured to communicate with off-site centralized monitoring systems (for example, via a wireless wide-area network (WWAN) such as a mobile telephone data network, for example, based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated wireless data channels). Such a relay module and system are respectively described in the related patent applications entitled “Wireless Relay Module for Remote Monitoring Systems” (U.S. application Ser. No. 13/006,769, filed Jan. 14, 2011) and “Medical Device Wireless Network Architectures” (U.S. application Ser. No. 13/006,784, filed Jan. 14, 2011) which have been incorporated by reference within this patent application. 
     In accordance with applicable patient data privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), communication of information between the monitored medical devices and the central monitoring location must be done securely, and medical device and associated patient information must be made available only to personnel accessing the centralized monitoring systems who are in possession of the appropriate access credentials. In order to be viable, the centralized monitoring system must also be capable of recognizing medical device information indicating an alert condition requiring response by on-site or other specialized personnel and reaching those on-site or specialized personnel to report the alert condition in a timely fashion. 
     Thus, it would be desirable to provide a remote, centralized medical information monitoring system that communicates over a wireless network of wide reach (for example, a wireless wide area network) with one or more critical care and/or home care health service centers via one or more wireless relay modules at each site, where the wireless relay modules relay communications provided by on-site medical devices over a wireless local area network or wireless personal area network. It would further be desirable for the centralized medical information monitoring system to be capable of also configuring medical devices according to associations with individual sites and patients, of logging communications from medical devices, of displaying medical device data to users of the centralized medical information monitoring system who are able to provide sufficient credentials, and of recognizing medical device alert conditions and reporting these conditions to responsible personnel in a timely fashion. In addition, it would be desirable for the centralized information monitoring system to be capable of transmitting information to the medical devices via the wireless relay modules for operating and maintaining the medical devices, including for example software upgrades and library upgrades downloaded to the medical devices. 
     SUMMARY OF THE INVENTION 
     The present invention is directed to a remote monitoring system and method for monitoring the status of a plurality of medical devices located remotely from the monitoring system at a patient care or home care facility. In accordance with one embodiment of the invention, one or more medical devices (including but not limited to including for example, respirators, enteral feeding devices, pulse oximeters, blood pressure monitors, pulse monitors, weight scales and glucose meters) are provided at a patient care or home care facility. An interface circuit is coupled to each medical device, and is configured for communicating with one of a plurality of the wireless relay modules via a wireless relay network. The wireless relay modules are further configured to communicate with the remote monitoring device over an internet-accessible wireless communication network, and preferably, a wireless wide-area network (WWAN) such as a mobile telephone data network including (for example, based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated wireless data channels). Also, for compliance for example with HIPAA regulations, communications over each of the wireless networks are preferably conducted securely. 
     The remote monitoring system and method includes a device integration server in communication with the wireless relay modules for receiving data packets from the wireless relay modules including information provided by the medical devices. This information includes identification of an associated medical device and data of the medical device, and is preferably encrypted or otherwise securely transmitted, for example, in compliance with HIPAA patient data privacy provisions. In addition, the information may include encrypted or otherwise securely transmitted patient identification information, which in addition may preferably be coded in its unencrypted state to avoid any reference to the patient&#39;s identity. 
     The remote monitoring system also includes a data management system including a secure device web server and a device control database, and an outbound web server. The data management system is configured to log information provided to the device integration server concerning the medical devices. The web server is configured to provide webpages including the data of the medical devices for display on a remote monitoring computer, subject to authentication of an associated data request originating from the monitoring computer. 
     The remote monitoring system may further be configured for secure communications with a patient care database node that securely stores associated patient information, and for providing additional access to the remote monitoring computer upon receiving sufficient requestor authentication for configuring medical devices to patients and for controlling the operation of the medical devices. In addition, the remote monitoring system may be configured to process alert messages received from the wireless relay modules and, in response, transmit text message information to the wireless relay modules to be relayed to one or more text messaging recipients. Alternatively, the remote monitoring system may be configured to transmit the text message directly to the one or more text messaging recipients. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The invention will become more readily apparent from the Detailed Description of the Invention, which proceeds with reference to the drawings, in which: 
         FIG. 1  presents a block diagram of an exemplary remote monitoring system for remotely monitoring medical devices according to the present invention; 
         FIG. 2  presents a flow diagram illustrating an exemplary method for registering medical devices with the remote monitoring system according to  FIG. 1 ; 
         FIG. 3(   a ) presents a flow diagram illustrating an exemplary method for retrieving and viewing medical data via the remote monitoring system according to  FIG. 1 ; 
         FIGS. 3(   b )- 3 ( d ) illustrate exemplary screen displays for retrieving and viewing the medical data according to the method of  FIG. 3(   a ); 
         FIG. 4(   a ) presents a flow diagram illustrating an exemplary method for issuing a command to a medical device via the remote monitoring system according to  FIG. 1 ; 
         FIGS. 4(   b ) and  4 ( c ) illustrate exemplary screen displays for commanding a medical device according to the method of  FIG. 4(   a ); 
         FIG. 5(   a ) presents a flow diagram illustrating an exemplary method for recognizing and reporting an alert condition according to medical data logged via the remote monitoring system according to  FIG. 1 ; 
         FIG. 5(   b ) illustrates ad exemplary screen display for selecting a recipient for receiving an alert message according to the method of  FIG. 5(   a ); and 
         FIG. 6  presents a block diagram of an exemplary computer or server device suitable for use in the remote monitoring system according to  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Reference will now be made in detail to exemplary embodiments of the invention, including the best modes contemplated by the inventors for carrying out the invention. Examples of these exemplary embodiments are illustrated in the accompanying drawings. While the invention is described in conjunction with these embodiments, it will be understood that it is not intended to limit the invention to the described embodiments. Rather, the invention is also intended to cover alternatives, modifications, and equivalents as may be included within the spirit and scope of the invention as defined by the appended claims. 
     In the following description, specific details are set forth in order to provide a thorough understanding of the present invention. The present invention may be practiced without some or all of these specific details. In other instances, well-known aspects have not been described in detail in order not to unnecessarily obscure the present invention. 
     For the purpose of illustrating the present invention, exemplary embodiments are described with reference to  FIGS. 1-6 . 
     In this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art to which this invention belongs. 
     A diagram of an exemplary system  100  for monitoring medical devices in accordance with the present invention is illustrated in  FIG. 1 . For example, one or more medical devices  10  are provided at a patient facility  20  for monitoring the medical condition and/or administering medical treatment to one or more patients. Patient facility  20  may comprise a critical care health service center (for example, including hospitals, clinics, assisted living centers and the like) servicing a number of patients, a home facility for servicing one or more patients, or a personal enclosure (for example, a backpack) that may attached to or worn by an ambulatory patient. 
     Associated with each medical device  10  is an interface circuit  15  that includes a transceiver having one or more of a transmitter and/or a receiver for respectively transmitting and receiving signals in a facility-oriented wireless network  17  such as, for example, a Low-Rate Wireless Personal Area Networks or “LR-WPAN,” ZIGBEE network or another low-power personal area network such as a low power BLUETOOTH network, existing or presently under development or consideration. See, e.g., Houda Labiod et al.,  Wi - Fi, Bluetooth, Zigbee and WiMax , Springer 2010, which is incorporated by reference herein in its entirety. It should be understood that interface circuit  15  may be contained within or disposed external to medical device  10  in accordance with the present invention. 
     Also provided within the patient facility  20  are one or more relay modules  30 . Each relay module  30  includes a first transceiver for receiving signals from and transmitting signals to the interface circuits  15  in the facility-oriented wireless network, and further includes a second transceiver for wirelessly transmitting signals to and receiving signals from an access point  40  via a wireless wide-area network (“WWAN”)  52 . Suitable WWANs for use with the present invention include, for example, networks based on a Global System for Mobile Communications (GSM) or Code Division Multiple Access (CDMA) cellular network or associated with the 2G, 3G, 3G Long Term Evolution, 4G, WiMAX cellular wireless standards of the International Telecommunication Union Radiocommunication Sector (ITU-R). See, e.g., Vijay Garg,  Wireless Communications  &amp;  Networking , Morgan Kaufmann 2007, which is incorporated by reference herein in its entirety. For compliance with HIPAA regulations, communications over each of the facility-oriented wireless network and WWAN are preferably conducted securely using, for example, using a Secure Sockets Layer (SSL) protocol or a Transport Layer Security (TLS) protocol. 
     As illustrated in  FIG. 1 , the access point  40  useable with the present invention includes an inbound server (“device integration server”)  41  that incorporates or otherwise has access to a transceiver for communicating with the relay modules  30  over the WWAN. Medical device data received by the device integration server  41  over the WWAN is forwarded to a secure device web server  42 , which is configured for example to log the received data in association with identification information of the associated medical devices in a device control database  44 . An outbound web server  43  is configured, for example, to receive and qualify data retrieval requests submitted by one or more of remote monitoring devices  62  over a broad-band network  50  (for example, over the Internet). For each qualified request, the outbound web server  43  requests associated medical device data to be retrieved from the device control database  44  via the secure device web server  42 , requests associated program data for constructing a display page from a metadata and applications database  46 , and requests associated patient data to be retrieved and from a patient database  66  provided in a patient care database node  60  over a secure link  54  via a secure patient web server  64 . The secure link  54  can be implemented, for example as another WWAN using a SSL protocol or a TLS protocol. By separating medical device data and patient data to be respectively stored and managed by access point  40  and patient care database node  60 , certain economies of scale can be achieved by configuring the access point  40  to support a number of different patient care facilities each maintaining its own secure patient care database node  60  to ensure privacy and control of its associated patient data. 
     In this case, for example, a third party service provider may host the access point  40  to simultaneously support a number of distinct patient and/or home care facilities, thereby eliminating the need for each of these facilities to configure and maintain their own private access point facilities and providing hosting service to each facility that are likely far less than the costs of configuring and maintaining dedicated access point facilities by each care facility provider. It should be noted however that, consistent with principles of the present invention, access point  40  and patient care database node  60  may nevertheless be integrated into a single access point or node (for example, by a provider of a very large-scale facility provider monitoring many hundreds or thousands of patients). In either case, and as further described herein, the outbound web server  43  provides an interface for authenticated clinicians to retrieve patient and medical data from each of the patient care database node  60  and the access point  40  in a convenient and transparent manner such that the details of the configurations and operation of the access point  40  and patient care database node  60  are of no consequence to the clinicians. 
     Returning to  FIG. 1 , upon retrieving the requested medical device data and patient data, the outbound web server  43  then proceeds to format and transmit the retrieved medical device and patient data for display by one of monitoring devices  62  according to the retrieved program data. 
     In addition, and as will be further described herein, the device integration server  41  of  FIG. 1  is configured to transmit information and commands to the relay modules  30 , for example, for transmitting medical device alert messages to other WWAN-reachable nodes (for example, cellular telephones of emergency attendants), and/or transmitting operating commands and/or software or firmware updates to the medical devices  10  via the interface circuits  15  and facility-oriented wireless network  17 . 
     Further, in addition to monitoring and sending commands to medical devices, the device integration server  41  may also be configured to receive and analyze patient metric information from the secure patient web server  64  via the outbound web server  43  and secure device web server  42 , or by an alternate and direct secure data link to the secure patient web server  64  in order to prevent unsafe medical device usage based upon the patient metrics information. In this manner, the device integration server  41  would function as an additional failsafe for preventing operating errors that could result in patient harm due. For example, in the case that the patient metric information indicates that an enteral feeding pump is associated with a neonate, the device integration server  41  may act to discard remote monitoring commands programming large bolus or excessive feeding rates that could be harmful to a young child. Alternatively, if the patient metric information indicates that a specific feeding rate or bolus amount has been prescribed by a doctor or clinician, the device integration server may act to discard remote monitoring commands programming a rate or bolus that deviates from the prescription. 
       FIG. 2  illustrates a flow diagram of one exemplary method  200  in accordance with the invention for registering medical devices  10  with the system  100  of  FIG. 1 . The method  200  begins at step  202 , at which an authorized technician having access to one of the remote monitoring devices  62  provides authenticating credentials (for example, a recognized log-in and password) to the outbound web server  43 , and the web server responds by transmitting a device set-up screen to the remote monitoring device  62  requesting medical device identifying information and associated patient identifying information. 
     At step  204 , the outbound web server  43  preferably queries the metadata and application database  46  according to one or more of identifying information for the technician and/or identifying information for the patient to identify an associated patient care database node  60  from a plurality of patient care database nodes for the patient and record a destination address for the associated patient care database node  60  in the metadata and application database  46  in association with the identifying data for the medical device  10  and/or identifying information for the patient. Identifying information for the patient is preferably generated anonymously (for example as a random number), and transmitted at step  206  to the patient care database node  60  for association with securely-stored patient identifying information. At step  208  of the method  200  of  FIG. 2 , the outbound web server  43  requests that the secure device web server  42  assign an area of the device control database  44  for logging associated data for the medical device  10  as it is received by the device integration server  41 , such that it can be later retrieved by the outbound web server  43  upon receiving an authorized request from an authenticated user operating one of the remote monitoring terminals  62 . 
     It should be readily understood by one skilled in the art that step  204  of method  200  for identifying and storing the address of the patient care database node  60  may be omitted in accordance with the invention if a single patient care database node is utilized with system  100  of  FIG. 1 . 
       FIG. 3(   a ) presents a flow diagram illustrating one exemplary method  300  in accordance with the invention for retrieving and viewing data for a registered medical device  10  according to the system of  FIG. 1 . The method  300  begins at step  302  with an authorized user having access to one of the remote monitoring devices  62  provides authenticating credentials (for example, a recognized log-in and password) to the outbound web server  43 . At step  304 , based on the authenticating credentials, the outbound web server  43  queries the metadata and applications database  46  to identify the address of a patient care database node  60  to which the authorized user is entitled to obtain access, and at step  306 , requests data from the patient care database node  60  relating to at least one identified patient for which the user is authorized to view medical device data, including for example a listing of medical devices  10  which are presently associated with the identified patient. 
     At step  308  of the method  300  of  FIG. 3(   a ), the outbound web server  43  queries the device control database  44  via the secure device web server  42  for status information to determine which of the listed medical devices are presently active according to the data logged by the device control database  44 . It should be noted that one or more of a medical device  10 , its associated interface device  15 , an associated wireless relay module  30  and/or the device integration server  41  may be programmed to provide data from the medical device  10  to the device integration server  41  at predetermined, preset intervals. 
     Upon obtaining the status information, the outbound web server  43  prepares a display page, according for example to display information retrieved from the metadata and applications database  46 , to display a listing of medical devices  10  available for monitoring the user at the remote monitoring device  62 .  FIG. 3(   b ) presents a first exemplary screen display  320  that provides an array of medical devices  10  available for monitoring according to device type. For example, in the screen display  320  of  FIG. 3(   b ), available device types include ventilators  321 , urology devices  322 , energy delivery devices  323 , pulse oximeters  324 , predictive thermometers  325 , tympanic thermometers  326  and food pumps  327 . Each of the device types  321 - 327  in  FIG. 3(   b ) is presented with an identifying label (for example, label  321 A) and an identifying image (for example, image  321 B) for ease of recognition. 
     Once a device type is selected by a user (for example, in response to an associated mouse-over or mouse-click executed by the authorized user), a second exemplary screen display  330  as illustrated by  FIG. 3(   c ) may preferably transmitted by the outbound web server  43  for display at the remote monitoring device  62 . In the display  330 , labels  337 A are provided in association with images  337 B in order to identify individual food pumps (for example, by patient and/or by logical or physical location). Medical devices  10  that are unavailable may for example preferably be depicted with a label  337 A′ (“Off Line”) and an image  337 B′ (depicting the device with a slash or cross applied over the image) that clearly distinguish the unavailable medical devices  10  from available medical devices  10 . 
     Once an individual device is selected by a user (for example, once again, in response to an associated mouse-over or mouse-click executed by the authorized user), a third exemplary screen display  340  as illustrated by  FIG. 3(   d ) may preferably transmitted by the outbound web server  43  for display at the remote monitoring device  62 . In the display  340 , for example, device information of the medical device  10  (in this case, a food pump) is displayed in a screen  347 A recreating a current screen generated by the medical device  10 . In addition, the screen display  340  includes a panel  347 B providing identifying information for the medical device  10  (in this case, a pump location), a panel  347 C for displaying a message indicating a current error condition of the pump, and an icon button  347 D for selecting an alternate “status” mode of the screen display  340 . The screen display  340  also includes a control icon button  347 E for selecting a system set-up screen display, and a control icon button  347 F for enabling device control from the remote monitoring device  62 . For example, upon selecting the control icon  347 F, the screen display  340  may preferably be refreshed to include the medical devices screen  347 A and one or more operable buttons that mimic the appearance of control buttons on the medical device. The control button features are described in greater detail below in relation to  FIGS. 4(   b ) and  4 ( c ). 
     It should be readily understood that exemplary computer screen images  320 ,  330  and  340  and corresponding navigation depicted by  FIGS. 3(   b ),  3 ( c ) and  3 ( d ) are for illustration purposes only and that many other user screen images displays and interface tools may be utilized for carrying out the present invention including, for example, computer screens that depict accessible medical devices by other means than device type as illustrated in  FIG. 3(   b ). For example, as a suitable alternative to the screen image  340  of  FIG. 3(   d ) that conveys information from a single medical device, it is possible to implement displays that provide information from multiple medical devices. In addition, it should be readily understood that the outbound web server  43  will preferably be operable to prepare display pages for display on any of a wide variety of display devices (including, for example, workstations, personal computers, tablet devices including tablet computers, and display-based mobile devices including personal digital assistants, smartphones, portable game systems and the like. 
       FIG. 4(   a ) presents a flow diagram illustrating an exemplary method  400  in accordance with the invention for issuing a command to a medical device  10  via the system  100  according to  FIG. 1 . The method  400  begins at step  402  with a clinician (also referred to as a “user” herein) logging into the outbound web server  43  and navigating to the device screen display  340  of  FIG. 3(   d ) (for example, as described above with reference to  FIGS. 3(   a )- 3 ( d )). At step  404 , the clinician proceeds to select the “Enable Full Control” button  347 F of  FIG. 3(   d ) to initiate an operational command directed to the medical device  10 , and is preferably provided with a request for authentication pertaining in particular to the patient associated with the medical device  10 . At step  406 , patient authentication information provided by the clinician is forwarded by the outbound web server  43  to a patient care database node  60  according to a patient care database node address stored by the metadata and applications database  46  in association with the clinician, and the clinician is authenticated for the patient by the outbound web server  43  upon receipt of an authentication confirmed message from the patient care database node  60 . 
     Upon receipt of the patient authentication, a control request is forwarded by the outbound web server  43  at step  408  to the secure device web server  42  to be logged in the information record of the device control database  44  that is associated with the medical device  10  (and optionally, with an anonymous ID for the patient). At step  410 , the secure device web server forwards the control request to the device integration server  41 , which transmits an associated device control command over the secure WWAN  52  for receipt by an associated wireless relay module  30  at step  412 . The wireless relay module  30  wirelessly communicates the command to the medical device  10  via an associated device interface  15 , and awaits a reply confirming execution of the command transmitted by the device interface  15 . 
     At step  414 , the device integration server  41  receives an update message from the wireless relay module  30  via the secure WWAN  52  which confirms that the command was executed by the medical device  10 . At step  416 , the device integration server  41  forwards the update message to the secure device web server  42  to be logged in the information record of the device control database  44  that is associated with the medical device  10 . Optionally, and preferably, the secure device web server  42  forwards information pertaining to the update message to the outbound web server  43 , and the outbound web server  43  prepares an updated display screen that is transmitted to the remote monitoring device  62  to indicate that the command has been executed. 
     Alternatively, at step  404 , the authenticated clinician may select the “System Setup” control icon button  347 E to perform a command other than an operational command directed to the medical device  10 .  FIG. 4(   b ) illustrates a display screen  450  that is presented to the clinician upon selecting the control icon button  347 E. The display screen  450  includes a number of icon buttons that may be selected by the clinician (for example, as the result of a mouse-over or mouse-click initiated by the clinician) to select a specific setup command. For example, icon button  451  may be selected to initiate a command for providing identification information of the medical device  10 . Icon button  452  may be selected to provide text paging in response to an alert condition, as is further described herein. Icon button  453  may be selected to initiate a software or firmware download for updating the medical device  10 . 
     Icon button  454  may be selected to initiate a diagnostic test of the medical device  10 .  FIG. 4(   c ) illustrates an exemplary display screen  460  that may be displayed to the clinician upon selection of the icon button  454 . Via the display screen  460  of  FIG. 4(C) , the clinician may select one or more of (including a progression of) a series of diagnostic tests  461  directed to components of the medical device (for example, including power components, memory components, alarm components and the like). Alternatively and/or in addition, the clinician may select one or more of a series of performance statistics  462  to be gathered and displayed (for example, including various device error statistics such as feed error, rotor error and flush error rates for a food pump). In addition, perhaps most usefully before issuing a software and/or firmware download command, the clinician may select a version number test  463  to obtain version identifying information for the software and/or firmware (preferably including, for example, a software and/or firmware download history). Optionally, processes for performing the diagnostic tests  461 , preparing the performance statistics  462  and identifying the software and/or firmware version number  463  may run automatically without specifically being selected by the clinician, with a complete reporting of all results on the display screen. 
     In a similar manner to that performed by the method of  FIG. 4(   a ), it is possible to issue a bandwidth priority command or instruction to a relay module, such as relay module  30  of  FIG. 1 , for the relay module to grant priority for relaying information received from a particular medical device relative to other medical devices that may send or receive communications via this relay module. 
     Referring again to  FIG. 4(   b ), icon button  455  may be selected to enable the clinician to specify data transfer rates, priorities and other parameters relating to the wireless transceiver of the interface device associated with the medical device. Icon button  456  may be selected to provide the clinician with the an alarm history, event history and other information as has been logged for example for the medical device in the device control database  44  of  FIG. 1 . 
       FIG. 5(   a ) presents a flow diagram illustrating one exemplary method in accordance with the invention for recognizing and reporting an alert condition according to medical data logged via the system  100  according to  FIG. 1 . The method  500  begins at step  502  with the transmission of an alert message by a wireless relay module  30  over the secure WAN  52  to the device integration server  41 . In this case, the wireless relay module  30  is configured to analyze a message type of a message transmitted by an associated medical device  10  to determine that the message is an alert message, and to transmit the message to the device integration server  41  upon determining that the message is an alert message (for example, as a priority message). Alternatively, the wireless relay module  30  may simply queue all messages for transmission to the device integration server  41  in order upon receipt, and rely upon the device integration server  41  to analyze an associated message type to determine that a message is an alert message. 
     Upon determining that the transmitted message is an alert message, the device integration server  41  proceed, at step  503 , to log the message in the device control database  44 , and at step  504 , invokes a text messaging application that retrieves text messaging numbers associated with identifying information of the medical device  10  and/or anonymous patient identifying information. The text messaging application may preferably retrieve the text messaging numbers by queries the metadata and applications database  46  to identify the address of an associated patient care database node  60 , and either making a direct request or instructing the outbound web server  43  to request the text messaging numbers from the associated patient care database node  60 . 
     At step  506 , the device integration server  41  sends one or more messages including the retrieved text messaging numbers and text message information according to the alert message to one or more wireless relay modules  30  over the secure WWAN  52 . At step  508 , the one or more wireless relay modules  30  transmit the text message information addressed to the text messaging numbers over one or more of the secure WWAN  52  and/or the facility-oriented wireless network  17 . 
       FIG. 5(   b ) illustrates a “Text Paging”  452  screen display  550  that may be invoked, for example, by using the method  400  of  FIG. 4(   a ) for issuing a command to a medical device  10 . Specifically, and with particular reference to  FIGS. 3(   d ) and  4 ( b ), the text paging screen  550  is displayed at the remote monitoring device of an authenticated clinician upon the clinician&#39;s selection of the “system Setup” icon button  347   e  of the screen display  340 , and thereafter upon the clinician&#39;s selection go the “Text Paging” icon button of the screen display  450 . As illustrated in  FIG. 5(   b ), the “Text Paging” screen display  550  include a listing of one or more names  551  of individuals responsible for responding to alert messages of at least two types: “Error Messages”  553 , which may for example indicate a malfunction of the medical device  10 , and/or “Info Messages”  554 , which may for example indicate a significant patient health condition (for example, a patient respiration rate below a preset minimum rate specified for a ventilator device  321  of  FIG. 3(   b ). 
     The information retrieved by the outbound web server  43  to prepare this display is preferable retrieved from the patient care database node  60 , by providing on one or more of identifying information for the medical device  10  and/or anonymous patient identifying information stored in the device control database  44 . Upon recognizing an alert message for the medical device  10 , the information provided on the “Text Paging” screen display may be retrieved by the device integration server  41  by querying the metadata and applications server  46  to retrieve address information for the patient care database node  60 , and forwarding a text paging information request to the patient care database node  60  based upon one or more of identifying information for the medical device  10  and/or anonymous patient identifying information stored in the device control database  44 . 
       FIG. 6  shows an illustrative computer system  600  suitable for implementing server and computer components of the present invention (for example, including device integration server  41 , secure device web server  42 , outbound web server  43 , and secure patient web server  64 ). The computer system  600  as described herein may comprise, for example, a personal computer running the WINDOWS operating system, or a server computer running, WINDOWS Server, LINUX or another UNIX-based operating system. Alternatively, the computer system  600  described herein may comprise a mobile device, tablet devices or computers, or information appliance running, for example, an operating system in the group including Symbian, Android, Apple iOS, Blackberry, Microsoft Windows Phone, Linux, Palm/HP WebOS, BADA, MAEMO and MEEGO. The above-described methods carried out by the server and computer components of the present invention may be implemented on the computer system  600  as stored program control instructions directed to control application software. 
     Computer system  600  includes processor  610 , memory  620 , storage device  630  and input/output devices  640 . One of the input/output devices  640  may preferably include a display  645 . Some or all of the components  610 ,  620 ,  630  and  640  may be interconnected by a system bus  650 . Processor  610  may be single or multi-threaded, and may have one or more cores. Processor  610  executes instructions which in the disclosed embodiments of the present invention are the steps described, for example, in one or more of  FIGS. 2 ,  3 ( a ),  4 ( a ) or  5 ( a ). These instructions may be stored in one or more of memory  620  or in storage device  630 . Information may be received and output using one or input/output devices  640 . Memory  620  may store information and may comprise a computer-readable medium, such as volatile or non-volatile memory. Storage device  630  may provide storage for system  600  including for the example, the previously described database, and may be a computer-readable medium. In various aspects, storage device  630  may be one or more of a flash memory device, a floppy disk drive, a hard disk device, and optical disk device, and/or a tape device. 
     Input devices  640  may provide input/output operations for system  600 . Input/output devices  640  may include one or more of a keyboard, a pointing device, and/or microphone. Input/output devices  640  may further include a display unit for displaying graphical user interfaces, a speaker and a printer and any of a number of other serial devices (for example, configured as Universal Serial Bus (USB)-based devices 
     It should of course, be understood that while the present invention has been described with respect to disclosed embodiments, numerous variations are possible without departing from the spirit and scope of the present invention as defined in the claims. 
     Moreover, it is intended that the scope of the present invention include all other foreseeable equivalents to the elements and structures as described herein and with reference to the drawing figures. Accordingly, the invention is to be limited only by the scope of the claims and their equivalents.