Abstract:
A communications and database delivery service within an internetwork interacts with a service provider and its requestors/customers. A server is maintained for storing requester identifiers and service provider identifiers. A records database is maintained for storing records of digital information for customers of the service provider in accordance with the requester identifiers. An initiation message is received from a requestor over the internetwork. A notification is sent of a requested two-way video session to an IP address corresponding to the service provider. After an acceptance is received from the service provider, signals are provided over the internetwork to enable the two-way video session between respective workstations of the requestor and the service provider. A respective record is retrieved from the records database corresponding to the requester. The respective record is forwarded to the IP address corresponding to the service provider.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This is a continuation application of U.S. application Ser. No. 10/274,736, filed Oct. 21, 2002, now U.S. Pat. No. 6,947,411 entitled “Digital Data Communication System Using Video Telephony.” 
    
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH 
     Not Applicable. 
     BACKGROUND OF THE INVENTION 
     The present invention relates in general to providing services (e.g., medical care and supervision) of a service requester (e.g., medical patient) by a service provider not in the same immediate location, and, more specifically, to a method of operating an Internet-based video telephony and database system for conducting two-way video communications supplemented by presenting digital data records to a service provider automatically in response to a video telephony call. 
     In connection with providing medical care to patients, it is desirable to minimize the costs of care without compromising the quality of care. One manner of controlling costs is to treat a patient at home, thereby avoiding costs associated with a stay at a hospital. Regular nurse visitations and/or a caregiver on standby or “on-call” status are provided in order to attend to the needs of the home patient; however, the response time to react to an emergency medical situation is typically longer than when the patient is checked into a hospital. 
     In the context of hospitalization, costs can be reduced by controlling the size of the caregiving staff (e.g., nursing staff) to maximize the ratio of patients to caregiver. By maximizing the number of patients that can be handled by one caregiver, a greater cost reduction can be realized. Nevertheless, sufficient staff must be maintained to handle emergencies which may occur. 
     In a real or perceived emergency situation, a nurse or other caregiver needs to quickly establish communication (e.g., in-person communication or remote communication such as a telephone call or intercom) with the patient in order to assess their immediate needs, determine and administer an appropriate course of action, and to reassure the patient that any necessary care is forthcoming. An emergency alert may be manually initiated by a homebound patient placing a telephone call to a caregiver, by a patient pressing a call button in a hospital room, or by an automatic patient monitor detecting an alert condition. Once an emergency situation arises, the caregiver typically needs to 1) identify the patient, 2) retrieve the patient&#39;s charts or other records, 3) obtain any real-time monitoring or other information from the patient, 4) communicate any instructions or reassurances to the patient, 5) dispatch any needed assistance, and 6) update the patient&#39;s charts. A face-to-face visit (whether to a homebound patient or in a hospital room) is a relatively inefficient use of a caregiver&#39;s time, however, a conversation over an intercom or a telephone call provide only limited audio information which may be inadequate to address certain situations. 
     In connection with routine telephone calls to a service provider (medical or non-medical) or any other non-emergency communications, it can often be expected that some file records or other digital information associated with the initiator of the communication (e.g., a calling party) will be needed by the provider in handling the communication. For example, when making a routine telephone call to a doctor&#39;s office, the handling of the call is typically lengthened by the need of a responder (e.g., nurse) to access a patient file (electronic or paper). The nurse or other provider must manually initiate the file retrieval since it depends upon first learning of the identity of the requester (e.g., calling party). 
     SUMMARY OF THE INVENTION 
     The present invention has the advantages of efficient deployment of medical caregiver or other service provider resources while increasing the quality and information content of communication in response to a request or an emergency alert signal. In particular, video telephony is coupled with automatic access to an electronic database of data records pertaining to the requester (e.g., patient) which are automatically displayed to the provider (e.g., caregiver). Thus, patient care and comfort are improved while the time required to make a medical assessment and the costs of providing service are reduced. 
     In one aspect of the invention, a method is provided for operating a communications and database delivery service within an internetwork wherein communications and database delivery services are provided to a service provider and its requestor customers. The service provider and each requester customer operates a respective workstation coupled to the internetwork. A server is maintained for storing requestor identifiers and service provider identifiers. A records database is maintained for storing records of digital information for customers of the service provider in accordance with the requestor identifiers. An initiation message is received from a requester over the internetwork, wherein the initiation message identifies the requestor and includes a service provider identifier for a corresponding service provider. A notification is sent of a requested two-way video session to an IP address corresponding to the service provider. An acceptance is received from the service provider. Signals are provided over the internetwork to enable the two-way video session between respective workstations of the requestor and the service provider. A respective record is retrieved from the records database corresponding to the requestor. The respective record is forwarded to the IP address corresponding to the service provider. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a block diagram of a first embodiment of a system of the present invention. 
         FIG. 2  is a block diagram of one preferred embodiment of a computer network-enabled patient communication device. 
         FIG. 3  is a block diagram of one preferred embodiment of a computer network-enabled service provider workstation. 
         FIG. 4  is a block diagram of a system of the present invention for providing patient communications within a hospital. 
         FIG. 5  is a flowchart of a preferred method of the present invention. 
         FIG. 6  is a flowchart of a preferred method of patient to nurse communications using video telephony software. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     Referring to  FIG. 1 , the present invention includes audio and video communication links between a service provider workstation  10  and a remote location  11 . Audio (e.g., voice) communication may take place via a telephone network, such as a public switched telephone network (PSTN)  12 , and/or using computer telephony, such as Voice over IP (VoIP), transported over a data network  13  (e.g., the Internet). A video communication link is provided via data network  13 . 
     Service provider workstation  10  comprises a network-enabled personal computer workstation  14  including various peripherals (such as a video camera  15 ) and a telephone  16  which are used by a service provider agent (e.g., nurse)  17 . Remote location  11  may, for example, be at a private business or residence or may be a patient&#39;s room at a hospital. Location  11  includes a requester communication device for use by a requester  24 . The communication device is computer network-enabled and may comprise a television monitor  20 , a set-top box  21 , a video camera  22 , and a telephone  23 . Set-top box  21  may include additional peripherals (not shown) and alternatively may comprise a personal computer workstation rather than a television monitor and set-top box. 
     The present invention may initiate video telephony communication sessions as described in U.S. application Ser. No. 10/033,813, filed Dec. 20, 2001, entitled “Telephonic Addressing For Establishing Simultaneous Voice and Computer Network Connections,” and U.S. Pat. No. 6,545,697, issued Apr. 8, 2003, entitled “Video Telephony,” both incorporated herein by reference in their entirety. Thus, an interconnection (not shown) between telephone  23  and set-top box  21  which may include a separate device (not shown) for capturing a dialed telephone number may be used. A video telephony and record database server  35  is provided for performing the functions of the central server as described in the prior applications. In addition, server  35  may be used to store and make available to service provider  17  digital data pertaining to requester  24 , although such data records can also be stored elsewhere in the system (e.g., in a separate server connected to data network  13 , in computer workstation  14 , or in set-top box  21 ). 
     Computer workstation  14  and set-top box  21  have pre-assigned data network addresses (e.g., IP addresses) enabling them to exchange network packets or datagrams over data network  13 . A video telephony session of the present invention establishes a video communication link between the respective data network addresses, possibly with server  35  relaying all packets between the two endpoints. When requester  24  initiates a video telephony session, its initiating IP address is, of course, known. Unless the IP address of the service provider workstation is pre-configured into set-top box  21  and then specifically selected by requester  24 , it is determined using server  35 . Thus, set-top box  21  may be pre-configured with an IP address (or URL) of server  35 , and computer workstation  14  registers in advance with server  35  providing its telephone number and IP address. Server  35  maintains this information in a lookup table so that a video communication link can be established in response to a message from the requester&#39;s set-top box  21  providing the IP address of the set-top box and the telephone number of the service provider&#39;s workstation  10 . 
     Customer premises equipment (CPE) at remote location  11  for providing patient-to-nurse communications is shown in greater detail in  FIG. 2 . Set-top box  21  includes a controller  25  for executing video telephony software. Controller  25  is responsive to a request (i.e., alert) signal for initiating a video communication link between the requester&#39;s communication device and the service provider workstation and for initiating display of a requester&#39;s data record at the service provider workstation. A network interface  26  couples set-top box  21  to the data network (e.g., through an Internet Service Provider). Set-top box  21  also includes a modem  27  coupled to the telephone line of telephone  23 . Modem  27  may be used to capture dialed digits from telephone  23  and make them available to the video telephony software so that a separate device does not have to be provided for that purpose. The recognition of a telephone number corresponding to a service provider automatically generates the request signal that launches the video link and data retrieval. Once the video link is established, video frames received from the service provider are displayed on television monitor  20 . 
     Set-top box  21  may be preconfigured with a service provider database or identifier  28  which preferably may include the IP address or addresses of service providers (e.g. medical caregivers) if a network-based database of IP addresses is not being used. 
     The present invention allows any pertinent digital data to be retrieved and then presented to the service provider within a video telephony call. In the presently described embodiment of patient to medical caregiver communication, the digital data may be in the form of a patient medical chart or other electronically-stored digital file information. Many other beneficial uses are possible, such as retrieving account records when calling a financial institution, a utility company, or an insurance company. The digital information may be stored in a database that resides at either endpoint of the video telephony call or within a database server anywhere within the data network. As shown in  FIG. 2 , patient records  29  may be stored in set-top box  21 . This embodiment is useful when records  29  are to be shared with various separate service providers. 
     In an alternate embodiment of the invention, a voice communication link may be provided within the data network rather than within a traditional telephone network. Therefore, a microphone  30  and a speaker  31  are coupled to set-top box  21  to provide two-way voice communication. In such an embodiment, wherein a telephone number is not dialed by the requester to complete a POTS call to the service provider, some other method is required for initiating a request signal and/or identifying the desired service provider. This can be done using an alert button  32  (such as an emergency alert button or a call button used in hospital rooms) to generate a request signal. If a set-top box is pre-configured to only establish a video telephony session with one service provider workstation, then the request signal need not contain any further information. If multiple service providers are used, then a selection among pre-identified service providers or entry of identifying information can be performed using a computer mouse or keyboard, for example. 
     In yet another alternative embodiment, a patient monitor  33  or other data sensor or collector is used to generate the digital data to be communicated (rather than retrieving from a pre-existing database). For example, real-time medical monitoring information can be acquired and transmitted in parallel with the video communication link. For instance, a home-bound patient may have a heart monitor that can be remotely accessed by a nurse via the IP data network, thereby providing critical diagnostic data to the nurse as soon as the alert request signal is generated. Furthermore, monitor  33  could detect an emergency condition and automatically generate an alert request signal itself. 
     Referring to  FIG. 3 , a service provider workstation is shown. A personal computer  40  includes a controller  41  for executing video telephony software. Coupled to computer  40  are a video monitor  42 , a microphone,  43 , a speaker  44 , an input device (e.g., a mouse and/or a keyboard)  45 , and a video camera  15 . When a video telephony session is in progress, the video telephony software generates a video window  46  for displaying video images of the requester received over the data network video communication link and a data window  47  for displaying the requester data record (e.g., received from the data network or from a local database in response to a requester ID that is received over the data network). 
       FIG. 4  illustrates an embodiment of the present invention adapted for use in a hospital to allow a plurality of patient beds to be monitored from a nurse&#39;s station. Patient communication devices  50 - 53  are television/set-top box combinations or computer workstations deployed in association with respective patient beds in various hospital rooms for communicating with nurse workstations  54  and  55  (in practice, many more patient devices and nurse workstations would be deployed within a single hospital). All patient communication devices are connected to a data network  56  which may be a local area network (LAN). A server  57  is also connected to LAN  56  for serving a patient records database  58  and a database  59  storing tables providing IP addresses and patient ID&#39;s. Each patient device  50 - 53  preferably has a fixed IP address which is associated with each patient bed and/or room. When a particular patient is admitted to a particular bed, then a corresponding table  59  is updated with a patient ID corresponding to the admitted patient and which identifies the matching charts or other records in database  58  for that patient. 
     In this embodiment, both video and voice communication links may be established over LAN  56 . When a patient initiates a request by pressing an alert or emergency button coupled to their patient device, a request message is sent to server  57 . The request message includes a source IP address which identifies the corresponding patient communication device. Using that IP address, a patient ID for the patient assigned to a corresponding hospital bed or room is retrieved from table  59 . Based on the patient ID, a data record (e.g., one or more computer files) is obtained from database  58 . The IP address of a nurse&#39;s workstation assigned to provide caregiver services to the corresponding hospital bed may also be identified by consulting table  59  (assuming that there is more than one nurse workstation available). Using that IP address, video and voice communication links are established between the patient device initiating the request and the appropriate nurse&#39;s workstation. Once the IP addresses of the endpoints are determined, conventional VoIP may be launched to provide the voice channel. 
     One preferred method of the invention is shown in  FIG. 5 . In step  60 , the requester generates a request signal (e.g., by pressing an alert button or dialing a special telephone number for a service provider). The network address of the desired service provider workstation is determined in step  61 . As previously described, the network address can be obtained by consulting a database that translates an identifier (such as a telephone number) into an IP address. Alternatively, the database may assign a service provider workstation as a function of the identity of the requester (e.g., all hospital beds on a particular floor are assigned to a nurse&#39;s workstation on that floor). 
     In step  62 , a requester ID is determined. The requester ID may be pre-configured and automatically transmitted by the requester communication device, or may be determined as a result of a lookup table indexed by the IP address of the requester communication device, or may be supplied manually by the requester under control of the video telephony software, for example. The IP address of the requester device could also be used as the requester ID in some applications. 
     Depending upon the location of the database storing digital data pertinent to the requester, either step  63  or  64  may be performed. In step  63 , the database is located locally at either the requester communication device or the service provider workstation, and, consequently, the appropriate data record is retrieved locally. If accessed by the requester communication device, the data record will be transmitted to the destination network address of the service provider workstation. If locally accessible at the service provider workstation, then a requester ID may be transmitted from the requester device (or a network server doing the requester identification) to the service provider workstation to identify the record to be retrieved. 
     If the data record is stored on a network server, then the requester ID is transmitted to the server in step  64  together with the IP address of the service provider workstation so that the retrieved data record can be relayed. 
     In step  65 , a video link is established between video telephony software at the IP addresses of the requester device and provider workstation. A voice link is also established in step  66 . The voice link may simply be established by the service provider answering an incoming telephone call from the requester. Alternatively, a VoIP connection may be established between the IP addresses in parallel with the video link. 
     In step  67 , the requester data record is displayed on the service provider workstation, thereby supplementing the video and voice communication between the requester and the service provider with automatic generation of digital data to enhance the provision of services by the provider. 
     If any changes need to be made in the requester&#39;s data records as a result of the current call, the provider updates the data and then stores it back into the database in step  68 . When a particular session is complete, the video and voice communication links are terminated in step  69 . For example, the telephones may be hung up and the relaying of video data packets discontinued. 
     A particular application of the present invention to communication between a patient and a medical caregiver (e.g., a patient calling their doctor&#39;s office for information or advice) is shown in  FIG. 6 . At step  75 , a patient uses a conventional telephone to initiate a conventional telephone call to a nurse. The IP address corresponding to computer equipment used by the nurse is identified by video telephony (VT) software in step  76 . This may involve an interaction between a device for capturing a dialed telephone number and a server for storing registration data correlating telephone numbers and IP addresses. 
     In step  77 , a patient records database is queried for a patient file. A notification message is sent to the nurse requesting a video link between the nurse&#39;s computer and the patient&#39;s computer or set-top box in step  78 . In the meantime, the nurse&#39;s telephone also rings and a call may be answered. In step  79 , the nurse&#39;s computer displays a prompt by which the incoming video call can be accepted, and an indication of the nurse&#39;s acceptance is made in step  80  (e.g., by clicking an icon). 
     In step  81 , the video link is established and the patient accepts two-way video is step  82 . In response to the acceptance of the video link, the VT software forwards the appropriate patient record to the nurse&#39;s computer in step  83 . The patient record is presented on the monitor of the nurse&#39;s workstation in step  84 . During display, the record may be edited by the nurse in step  85 . An updated record is saved to the database in step  86 . 
     At the end of providing services, the nurse terminates the video and voice links in step  87 . A link termination message may be sent to the patient device by the VT software in step  88  and the links are terminated in step  89 . 
     The present invention also contemplates a communication initiated by a service provider to a customer/patient/requester, requiring only straightforward modification of the database or tables mentioned for establishing the network session. 
     Since video cameras are present at each end of the video telephony call, many useful types of information can be included in the communication session. For example, a patient could show a vial of prescription medicine to a nurse via the video link. Furthermore, the prescription label may be barcoded to identify the medication, dosage, drug interactions, etc. The barcode could be interpreted by the nurse&#39;s workstation which would then automatically upload more complete information about the medication to the nurse&#39;s display.