Abstract:
A system and method for automatically calculating an accurate recommended dosage for hormone replacement therapy and automating the life cycle of a patient&#39;s treatment over time. The system and method can automatically acquire relevant patient parameters and apply a consistent formulaic approach to help reduce incorrect dosage determinations. A pellet insertion size may be determined and documented based on a calculated dosage, and an insertion side and lot numbers may be tracked and managed. In addition, corresponding revenues may be tracked and profitability may be reported for hormone replacement therapy practices.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims priority to, and is a continuation-in-part of, U.S. patent application Ser. No. 13/721,949 filed on Dec. 20, 2012, and entitled “SYSTEMS AND METHODS FOR CALCULATING PATIENT DOSAGE,” which claims priority to, and is a continuation of, U.S. patent application Ser. No. 13/548,714, filed Jul. 13, 2012, which claims priority to U.S. Provisional Patent Application No. 61/507,318, filed on Jul. 13, 2011. This application also claims priority to U.S. Provisional Patent Application Ser. No. 61/951,415 filed on Mar. 11, 2014, and entitled “SYSTEM AND METHOD FOR AUTOMATED DOSAGE CALCULATION AND PATIENT TREATMENT LIFE CYCLE.” 
     
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH 
       [0002]    N/A 
       BACKGROUND OF THE INVENTION 
       [0003]    The present invention relates to systems and methods for providing a treatment to a patient, for example, providing and monitoring hormone replacement therapy. More particularly, the invention relates to systems and methods for automating a patient treatment lifecycle and a recommended dosage for the patient with respect to hormone replacement therapy. 
         [0004]    Hormone replacement therapy includes estradiol and testosterone for females and testosterone for males. Data supports that hormone replacement therapy with pellet implants is more effective and a more bio-identical method to deliver hormones in both men and women. Not only do pellet implants deliver a biologically identical hormone, the pellet implants deliver the hormones in the proper human ratio. Pellet implants are made up of either estradiol or testosterone and are placed under the skin to deliver consistent, healthy levels of hormones for 3-5 months in women and 4-6 months in men. Pellet implants deliver hormones directly into the blood stream, and the release of hormones from pellets is dependent on heart rate and cardiac output (i.e., the rate of hormone release is controlled through the action of the cardiovascular system). Thus, pellet implants result in hormone delivery that nearly approximates what the human gonad can do. In addition, pellet implants can inhibit the fluctuations, or ups and downs, of hormone levels seen with other conventional methods of hormone delivery. 
         [0005]    Estrogen delivered by subcutaneous pellets, maintains the normal ratio of estradiol to estrone. This is important for optimal health and disease prevention. Pellets do not increase the risk of blood clots like conventional or synthetic hormone replacement therapy. In both men and women, testosterone has been shown to increase energy, relieve depression, increase sense of well being, relieve anxiety, and improve memory and concentration. Testosterone, delivered by pellet implant, increases lean body mass (muscle strength, bone density) and decreases fat mass. Men and women need adequate levels of testosterone for optimal mental and physical health and for the prevention of chronic illnesses like Alzheimer&#39;s and Parkinson&#39;s disease and heart attacks, which are associated with low testosterone levels. 
         [0006]    The insertion of pellets is a relatively painless procedure done under local anesthesia. The pellets are usually inserted in the lower abdominal wall or upper buttocks through a small incision, which is then taped closed. The experience of the health care professional matters a great deal, not only in placing the pellets, but also in determining the correct dosage of hormones to be used. 
         [0007]    Traditionally, determination of recommended dosage for hormone replacement therapy requires that a physician consider numerous factors, including patient age, weight, height, health conditions, contraindications, hormonal levels, previous and current medications, and the like. In all, a proper determination involves correct consideration and weighing of many factors, some of which the physician may not even have easy access to, such as a patient&#39;s detailed health record. 
         [0008]    However, even if the patient&#39;s detailed health record is accessible, many hormone replacement therapy practices require the physician to re-enter data related to the patient to track and/or calculate the proper dosage. This is time consuming and often results in erroneous data entered into input fields of a dosage monitoring system. 
       SUMMARY OF THE INVENTION 
       [0009]    The present invention overcomes the aforementioned drawbacks by providing a system and method that automatically calculates an accurate recommended dosage for hormone replacement therapy and automates the life cycle of the patient&#39;s treatment over time. In particular, the present invention can automatically acquire relevant patient parameters and apply a consistent formulaic approach to minimize incorrect dosage determinations, optimize and document a pellet insertion size given the calculated dosage, and track and manage insertion side and lot numbers. In addition, the present invention can track revenues generated and report profitability for hormone replacement therapy practices. 
         [0010]    In accordance with one aspect of the invention, a method for providing a dosage on a device including an electronic circuit, an input device, and a display screen is provided. The method includes receiving, from the input device, an input signal of a user indicating an input directed to a patient sex and patient status. The patient status is automatically determined from a group including new patient, returning patient, and booster patient based on the input. If the patient sex is female, the electronic circuit determines an effective estradiol dosage and an effective testosterone dosage using dosage calculation methods selected based on the patient status, automated female input parameters, and female tracking parameters. If the patient sex is male, the electronic circuit determines an effective testosterone dosage using dosage calculation methods selected based on the patient status, automated male input parameters, and male tracking parameters. 
         [0011]    The automated male and female input parameters may include patient physical activity level, number of patient visits, patient age, height, weight, race, number of pregnancies, number of live births, number of abortions, history of renal disease, active liver disease, history of hysterectomy, history of cervical cancer, history of ovarian cancer, history of fibrocystic breast disease, history of breast cancer, current follicle stimulating hormone (FSH) level, current testosterone level, current estradiol level, current non-pellet estradiol dose, history of acne or facial hair, history of hair loss, history of polycystic ovary syndrome (PCOS), history of heavy menses, and history of metabolic syndrome. 
         [0012]    The female and male tracking parameters include pellet insertion location, pellet insertion side, pellet dose, pellet lot numbers, insertion notes, previous testosterone dose, and previous estradiol dose. Based on the patient status, automated female and male input parameters, and female and male tracking parameters, the determined effective dosages are calculated and displayed on the display screen. The electronic circuit also determines an estradiol pellet size insertion corresponding to the effective estradiol dosage and a testosterone pellet size insertion corresponding to the effective testosterone dosage using a pellet allocation algorithm. In addition, the electronic circuit also tracks and reports a profitability metric for the patient and provides access to news articles, research articles and videos related to hormone replacement therapy. 
         [0013]    In accordance with another aspect of the invention, a system for determining a dosage is provided. The system includes an input device, a display screen, and at least one electronic circuit. The electronic circuit is configured to receive, from the input device, an input signal of a user indicating an input directed to a patient sex and patient status. The patient status is automatically determined from a group including new patient, returning patient, and booster patient based on the input. If the patient sex is female, the electronic circuit determines an effective estradiol dosage and an effective testosterone dosage using dosage calculation methods selected based on the patient status, automated female input parameters, and female tracking parameters. If the patient sex is male, the electronic circuit determines an effective testosterone dosage using dosage calculation methods selected based on the patient status, automated male input parameters, and male tracking parameters. 
         [0014]    The automated male and female input parameters may include patient physical activity level, number of patient visits, patient age, height, weight, race, number of pregnancies, number of live births, number of abortions, history of renal disease, active liver disease, history of hysterectomy, history of cervical cancer, history of ovarian cancer, history of fibrocystic breast disease, history of breast cancer, current follicle stimulating hormone (FSH) level, current testosterone level, current estradiol level, current non-pellet estradiol dose, history of acne or facial hair, history of hair loss, history of polycystic ovary syndrome (PCOS), history of heavy menses, and history of metabolic syndrome. 
         [0015]    The female and male tracking parameters include pellet insertion location, pellet insertion side, pellet dose, pellet lot numbers, insertion notes, previous testosterone dose, and previous estradiol dose. Based on the patient status, automated female and male input parameters, and female and male tracking parameters, the determined effective dosages are calculated and displayed on the display screen. The electronic circuit also determines an estradiol pellet size insertion corresponding to the effective estradiol dosage and a testosterone pellet size insertion corresponding to the effective testosterone dosage using a pellet allocation algorithm. In addition, the electronic circuit also tracks and reports a profitability metric for the patient and provides access to news articles, research articles and videos related to hormone replacement therapy. 
         [0016]    In accordance with another aspect of the invention a computer-implemented method of providing a dosage and a patient treatment life-cycle on a device comprising an electronic circuit, an input device, and a display screen is provided. The method includes receiving, using the device, an input signal of a user indicating an input directed to a patient sex and a patient status. The patient status is automatically determined by the electronic circuit and includes at least one of a new patient, a returning patient and a booster patient. The electronic circuit determines at least one of an effective estradiol dosage and an effective testosterone dosage using calculation methods selected based on the patient status, automated input parameters, and tracking parameters. A pellet allocation algorithm, stored on the electronic circuit, is applied to determine an estradiol pellet size insertion corresponding to the effective estradiol dosage. A testosterone pellet size insertion is also determined corresponding to the effective testosterone dosage. A quantity of the estradiol pellet size insertion and the testosterone pellet size insertion are minimized. The determined effective dosages, the estradiol pellet size, and the testosterone pellet size are displayed on the display screen. 
         [0017]    The foregoing and other aspects and advantages of the invention will appear from the following description. In the description, reference is made to the accompanying drawings which form a part hereof, and in which there is shown by way of illustration a preferred embodiment of the invention. Such embodiment does not necessarily represent the full scope of the invention, however, and reference is made therefore to the claims and herein for interpreting the scope of the invention. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0018]      FIG. 1  is a schematic system diagram of an exemplary system configured to implement the present invention. 
           [0019]      FIG. 2  is a block diagram of an exemplary communication device configured to be implemented into the system of  FIG. 1 . 
           [0020]      FIG. 3  is a block diagram of an exemplary server configured to be implemented into the system of  FIG. 1 . 
           [0021]      FIG. 4  is a flow chart setting forth the steps of processes for determining a dosage for hormone replacement therapy for a female patient in accordance with the present invention. 
           [0022]      FIG. 5  is a flow chart setting forth the steps of processes for determining a dosage for hormone replacement therapy for a male patient in accordance with the present invention. 
           [0023]      FIG. 6  is a flow chart setting forth the steps of processes for automatically calculating an accurate recommended dosage for hormone replacement therapy and automating a life cycle of a patient&#39;s treatment over time in accordance with another aspect of the present invention. 
           [0024]      FIG. 7  is an exemplary screen shot of a user interface of the communication device that prompts a user to select a patient type. 
           [0025]      FIG. 8  is an exemplary screen shot of a new patient dialog screen displayed on the user interface. 
           [0026]      FIG. 9  is an exemplary screen shot of a patient list displayed on the user interface. 
           [0027]      FIG. 10  is an exemplary screen shot of a patient list displayed on the user interface that may be presented to the user after searching for an existing patient. 
           [0028]      FIG. 11  is an exemplary screen shot of an existing patient dialog screen displayed on the user interface. 
           [0029]      FIG. 12  is an exemplary screen shot of a dosing calculation page that may be displayed to the user on the user interface once patient information has been entered or selected. 
           [0030]      FIG. 13  is an exemplary screen shot of a prescribe patient dialog screen displayed on the user interface. 
           [0031]      FIG. 14  is an exemplary screen shot of a patient information dialog screen including the patient&#39;s insertion history displayed on the user interface of the communication device. 
           [0032]      FIG. 15  is an exemplary screen shot of the prescribe patient dialog screen of  FIG. 13  showing lot numbers of pellets inserted into the patient. 
           [0033]      FIG. 16  is an exemplary screen shot of a search screen for searching lot numbers corresponding to the patient. 
           [0034]      FIG. 17  is an exemplary screen shot of a patient consult request form to be filled with information about the patient. 
           [0035]      FIG. 18  is an exemplary screen shot of a patient consults screen showing a list of consult requests awaiting response from the user. 
           [0036]      FIG. 19  is an exemplary screen shot of an individual patient consult screen after selecting the patient consult request from the list of consult requests of  FIG. 18 . 
           [0037]      FIG. 20  is an exemplary screen shot of a patient consult requests status screen. 
           [0038]      FIG. 21  is an exemplary screen shot of a patient consult response screen showing relevant patient parameters and a recommended course of action. 
           [0039]      FIG. 22  is an exemplary screen shot of a news videos and updates screen showing links to news videos and updates related to hormone replacement therapy. 
           [0040]      FIG. 23  is an exemplary screen shot of a knowledge base articles search screen for searching through relevant articles on hormone replacement therapy. 
           [0041]      FIG. 24  is an exemplary screen shot of a products screen showing available products for the patient to purchase. 
           [0042]      FIG. 25  is an exemplary screen shot of a pellet calendar for assigning financial numbers to patient prescriptions. 
           [0043]      FIG. 26  is an exemplary screen shot of a daily pellet list for entering financial information related to a patient visit. 
           [0044]      FIG. 27  is an exemplary screen shot of a patient bill widow showing checkout amounts to be attached to the patient visit of  FIG. 26 . 
           [0045]      FIG. 28  is an exemplary screen shot of an end of day report screen showing a full financial view of a hormone replacement therapy practice. 
           [0046]      FIG. 29  is an exemplary screen shot of a prescription summary report screen showing patient and gender counts and revenues and dosing fees per provider. 
           [0047]      FIG. 30  is a schematic diagram of an organization structure configured to be implemented into the system of  FIG. 1 . 
           [0048]      FIG. 31  is an exemplary screen shot of a provider screen providing a provider record to specify an office. 
           [0049]      FIG. 32  is an exemplary screen shot of an assistant login screen that is linked to a provider. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0050]    Referring now to  FIG. 1 , a system  100 , such as a dosage monitoring system, is shown that is configured to determine a recommended dosage for hormone replacement therapy and automate the life cycle of the patient&#39;s treatment over time. The system  100  may include, but is not limited to, a communication device  102 , a network  104 , a user interface (UI) presentation server  108 , an application server  106 , a cache server  112 , and a database  114 . Also depicted is a physician user  110 , for illustrative purposes. In one exemplary embodiment, the functionality of the UI presentation server  108 , application server  106 , and cache server  112  may be combined into one or two servers without affecting the efficacy of the system  100 . Also, servers  106 ,  108  and  112  may include identical components or may differ in composition, and are described generically herein as “server  106 ,  108 ,  112 ”. 
         [0051]    The UI presentation server  108  may provide the user interface to the communication device  102  over the network  104 . The network  104  may be a local or wide, wired or wireless, network including, for example, the Internet. Data input through the communication device  102  may be forwarded to the application server  106  for processing and/or storage in the database  114 . The database  114  may be accessible by the server  106 ,  108 ,  112  and may store data regarding the patient, patient test results, prior dosing information, prior side effects, and any other medically significant information. The server  106 ,  108 ,  112  may access the database  114  for information and may also store information therein. The cache server  112  may save frequently-used data for fast access as needed. The database  114  may be a stand-alone database server, a persistent drive, and operating software associated with the application server  106 , a cloud-computing database “cloud”, or may be implemented by other means. The communication device  102  is configured to communicate with the UI presentation server  108  over the network  104  to send and obtain data regarding a patient. The patient data can include, but is not limited to, information needed for enabling the determination of recommended dosages for hormone replacement therapy. 
         [0052]    Referring now to  FIG. 2 , there is provided a more detailed block diagram of the communication device  102 . The communication device  102  may be, but is not limited to, a mobile phone, a smart phone, a PDA, a tablet Personal Computer (“PC”), or the like. Notably, the communication device  102  can include more or less components than those shown in  FIG. 2 . For example, the communication device  102  may include a wired system interface, such as a universal serial bus interface (not shown in  FIG. 2 ). The communication device  102  may further include an antenna  202  for receiving and transmitting Radio Frequency (RF) signals, for example. A receive/transmit (Rx/Tx) switch  204  may selectively couple the antenna  202  to a transmitter circuitry  206  and a receiver circuitry  208 . 
         [0053]    The receiver circuitry  208  may be configured to demodulate and decode the RF signals received from a network (e.g., the network  104  of  FIG. 1 ) to derive information therefrom. The receiver circuitry  208  is coupled to a controller  210  via an electrical connection  234 . The receiver circuitry  208  may provide the decoded RF signal information to the controller  210 . The controller  210  uses the decoded RF signal information in accordance with the function(s) of the communication device  102 . The controller  210  also provides information to the transmitter circuitry  206  for encoding and modulating information into RF signals. Accordingly, the controller  210  is coupled to the transmitter circuitry  206  via an electrical connection  238 . The transmitter circuitry  206  may communicate the RF signals to the antenna  202  for transmission to an external device (e.g., network equipment of network  104  of  FIG. 1 ). 
         [0054]    The controller  210  may store the decoded RF signal information in a memory  212  of the communication device  102 . Accordingly, the memory  212  is connected to and accessible by the controller  210  through an electrical connection  232 . The memory  212  can be a volatile memory and/or a non-volatile memory. For example, the memory  212  can include, but is not limited to, a Random Access Memory (RAM), a Dynamic Random Access Memory (DRAM), a Static Random Access Memory (SRAM), Read-Only Memory (ROM), and flash memory. The memory  212  may also have stored therein software applications  252  and user-defined rules  254 . The software applications  252  may include, but are not limited to, applications operative to provide telephone services, network communication services, Internet connectivity and access services, commerce services, email services, web based services, and/or electronic calendar services. 
         [0055]    As shown in  FIG. 2 , one or more sets of instructions  250  may also be stored in the memory  212 . The instructions  250  can also reside, completely or at least partially, within the controller  210  during execution thereof by the communication device  102  of  FIG. 1 . In this regard, the memory  212  and the controller  210  can constitute non-transient machine-readable media. The term “machine-readable media”, as used here, refers to a single medium or multiple media that store the one or more sets of instructions  250 . The term “machine-readable media”, as used here, also refers to any medium that is capable of storing, encoding or carrying the set of instructions  250  for execution by the communication device  102  and that cause the communication device  102  to perform one or more of the methodologies of the present disclosure. 
         [0056]    The controller  210  is also connected to a user interface  230 . The user interface  230  may include input devices  216 , output devices  224 , and software routines (not shown in  FIG. 2 ) configured for a user to interact with and control the software applications  252  installed on the communication device  102 . Such input and output devices respectively include, but are not limited to, a display  228 , a speaker  226 , a keypad  220 , a directional pad (not shown in  FIG. 2 ), a directional knob (not shown in  FIG. 2 ), a microphone  222 , a Push-To-Talk (“PTT”) button  218 , sensors  240 , a camera  242 , and a Radio Frequency Identification (“RFID”) reader  244 . 
         [0057]    Referring now to  FIG. 3 , there is provided a more detailed block diagram of the server  106 ,  108 ,  112  of  FIG. 1 . While  FIG. 3  illustrates a traditional server architecture, it is noted that other configurations may also be used. For example, some or all of the hardware or software may be distributed among multiple servers. Likewise, functionality may be distributed across or incorporate the use of communications networks including the Internet. To this end, parts or all of the hardware and software described herein may represent so-called “cloud” computing solutions. As another non-limiting example, the user interface may be distributed across multiple devices, including servers, mobile devices, non-mobile computing devices, and the like. Likewise, software may be run as a dedicated application, distributed across remote servers and/or served from the “cloud”, run in a browser, or be embodied in a mobile application. 
         [0058]    The server  106 ,  108 ,  112  may include a system interface  322 , a user interface  302 , a Central Processing Unit (CPU)  306 , a system bus  310 , a memory  312  connected to and accessible by other portions of the server  106 ,  108 ,  112  through the system bus  310 , and hardware entities  314  connected to the system bus  310 . At least some of the hardware entities  314  perform actions involving access to and use of the memory  312 , which can be a Random Access Memory (RAM), a disk driver and/or a Compact Disc Read Only Memory (CD-ROM). Some or all of the listed components  302 - 322  can be implemented as hardware, software and/or a combination of hardware and software. The hardware includes, but is not limited to, an electronic circuit. 
         [0059]    The server  106 ,  108 ,  112  may include more, less or different components than those illustrated in  FIG. 3 . The hardware architecture of  FIG. 3  represents one embodiment of a representative server configured to provide supporting services to a user of a communication device (e.g., communication device  102  of  FIG. 1 ). For example, the server  106 ,  108 ,  112  may implement a method for lookup of available auctions using an external database in communication with the server  106 ,  108 ,  112  (database not depicted), or the server may use its existing disk drive unit  316 , computer-readable storage medium  318  and other facilities to store auction information, as needed. It may also provide dosage factor data to the communication device  102 , as needed. Exemplary embodiments of said method will be described below in relation to  FIGS. 4-5 . 
         [0060]    Hardware entities  314  can include microprocessors, Application Specific Integrated Circuits (ASICs) and other hardware. Hardware entities  314  can include a microprocessor programmed for facilitating the provision of the automatic software function control services to a user of the communication device (e.g., communication device  102  of  FIG. 1 ). In this regard, it should be understood that the microprocessor can access and run various software applications (not shown in  FIG. 3 ) installed on the server  106 ,  108 ,  112 . Such software applications include, but are not limited to, database applications. 
         [0061]    As shown in  FIG. 3 , the hardware entities  314  can include a disk drive unit  316  comprising a computer-readable storage medium  318  on which is stored one or more sets of instructions  320  (e.g., software code or code sections) configured to implement one or more of the methodologies, procedures, or functions described herein. The instructions  320  can also reside, completely or at least partially, within the memory  312  and/or within the CPU  306  during execution thereof by the server  108 . The memory  312  and the CPU  306  also can constitute machine-readable media. The term “machine-readable media”, as used here, refers to a single medium or multiple media (e.g., a centralized or distributed database, and/or associated caches and servers) that store the one or more sets of instructions  320 . The term “machine-readable media”, as used here, also refers to any medium that is capable of storing, encoding or carrying a set of instructions  320  for execution by the server  106 ,  108 ,  112  and that cause the server  106 ,  108 ,  112  to perform any one or more of the methodologies of the present disclosure. 
         [0062]    Referring now to  FIGS. 4-5 , flow charts setting forth exemplary steps  400 ,  500  for determining a dosage for hormone replacement therapy are provided. Exemplary embodiments of the disclosure are presented in  FIGS. 4-5  with respect to methods for calculating hormone replacement therapy (HRT) dosage, in particular for calculation of SOTTOPELLE™ HRT dosage. References to “HRT” in the descriptions to  FIGS. 4-5  herein are understood to specifically refer to SOTTOPELLE™ HRT, unless otherwise indicated. It is understood that the tables, lookup values, factors used in these embodiments may vary depending on several variables, such as but not limited to therapy regimens, drug used, drug concentration, absorption, efficacy, and the like. 
         [0063]    Although use of a communication device  102 , as described in  FIG. 2 , is presented herein, the present disclosure is not limited in this regard. The methods are useful with alternative devices as well, such as portable computer applications, PDA applications, and tablet computing devices, and the like. The exemplary steps  400 ,  500  described in  FIGS. 4-5  may be performed by an electronic circuit of the communication device  102 , with the assistance of the physician  110 , servers  106 ,  108 ,  112 , database  114  and Internet  104 , consistent with an embodiment of the disclosure. 
         [0064]    Returning to  FIG. 4 , to start the process for determining the dosage for a female patient, a patient type is identified at decision block  402 . The patient type may be determined by the electronic circuit, as previously described with respect to  FIG. 3 . Additionally, or alternatively, the physician  110  of  FIG. 1  may manually input the patient type directly into the communication device  102  or, the patient type may be determined from the patient name and/or a unique identification number combined with a lookup of patient information stored in the database  114 . The patient types identified at block  402  may include: A Female New Patient, as shown at process block  403 , which may be a female patient that has never been treated with HRT or someone who has not received pellets for over ten months; A Female Return Patient, as shown at process block  404 , which may be a female patient that has been treated with HRT and is returning for ongoing treatment; Or a Female Booster Patient, as shown at process block  405 , which may be a female patient that has been treated with HRT needing an additional dose prior to the patient&#39;s next dose. 
         [0065]    Once the patient type is identified, input parameters may be input into the communication device, regardless of which patient type is identified, at process block  406 . The input parameters may include, but are not limited to, patient age, height, weight, race, number of pregnancies, number of live births, number of abortions, history of renal disease, active liver disease, history of hysterectomy, history of cervical cancer, history of ovarian cancer, history of fibrocystic breast disease, history of breast cancer, current follicle stimulating hormone (FSH) level, current testosterone level, current estradiol level, current non-pellet estradiol dose, history of acne or facial hair, history of hair loss, history of polycystic ovary syndrome (PCOS), history of heavy menses/fibroids, and history of metabolic syndrome. 
         [0066]    If the patient type is a Female New Patient at block  403 , once the input parameters are input at process block  406 , various lookup tables may be consulted by the electronic circuit to determine various factors for estradiol and testosterone dosage calculation as well as dosage adjustment factors for various conditions and problems at process block  408 . Exemplary lookup tables used in an embodiment of the disclosure for female patients are shown below and may include Female Estradiol Weight/Age (Table 1), Female Estradiol Age (Table 2), Female Estradiol FSH (Table 3), Female Testosterone Weight (Table 4), Female Testosterone Age (Table 5), Female Testosterone Testosterone (Table 6), Conjugated Estrogen, Estradiols Pills, Estradiol Patch, Biestradiol Cream or Tabs, and Problem Factor. Exemplary tables used for HRT follow: 
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 1 
               
             
             
               
                   
               
               
                 Female Estradiol Weight/Age 
               
             
          
           
               
                   
                 Weight/Age Ratio (lbs/Years) 
                 Lookup Value (mg) 
               
               
                   
                   
               
               
                   
                   0-1.5 
                 1 
               
               
                   
                 1.6-2.5 
                 2 
               
               
                   
                 2.6-3.9 
                 3 
               
               
                   
                 &gt;4 
                 2 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
             
           
               
                 TABLE 2 
               
             
             
               
                   
               
               
                 Female Estradiol Age 
               
             
          
           
               
                   
                 Age (Years) 
                 Lookup Value 
               
               
                   
                   
               
             
          
           
               
                   
                 &lt;40 
                 3 
               
               
                   
                 40-50 
                 5 
               
               
                   
                 51-60 
                 15 
               
               
                   
                 61-68 
                 12.5 
               
               
                   
                 &gt;68 
                 4 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 3 
               
             
             
               
                   
               
               
                 Female Estradiol FSH 
               
             
          
           
               
                   
                 FSH 
                 Lookup Value 
               
               
                   
                   
               
               
                   
                  &lt;31 
                 0 
               
               
                   
                 31-50 
                 1 
               
               
                   
                  51-100 
                 2 
               
               
                   
                 &gt;100 
                 3 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
             
           
               
                 TABLE 4 
               
             
             
               
                   
               
               
                 Female Testosterone Weight 
               
             
          
           
               
                   
                 Weight (lbs.) 
                 Lookup Value (mg) 
               
               
                   
                   
               
             
          
           
               
                   
                  75-150 
                 75 
               
               
                   
                 151-200 
                 87.5 
               
               
                   
                 &gt;200 
                 100 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
             
           
               
                 TABLE 5 
               
             
             
               
                   
               
               
                 Female Testosterone Age 
               
             
          
           
               
                   
                 Age (Years) 
                 Lookup Value 
               
               
                   
                   
               
             
          
           
               
                   
                 0-67 
                 1 
               
               
                   
                 &gt;67 
                 0.63 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
             
           
               
                 TABLE 6 
               
             
             
               
                   
               
               
                 Female testosterone Testosterone 
               
             
          
           
               
                   
                 Testosterone 
                 Lookup Value (mg) 
               
               
                   
                   
               
             
          
           
               
                   
                 0-20 
                 37.5 
               
               
                   
                 21-100 
                 25 
               
               
                   
                 &gt;100 
                 0 
               
               
                   
                   
               
             
          
         
       
     
         [0067]    After obtaining the lookup values from the various tables at process block  408 , additional problem adjustment factors may be determined at process block  410 , disease history may be factored in at process block  412 , and other adjustments may be determined at process block  414 . In an embodiment of the disclosure, these various considerations may include, but are not limited to: Female Estradiol Problem Factor, Conjugated Estrogen, Estradiols Pills, Estradiol Patch, Biestradiol Cream or Tabs, and Problem Factor. Exemplary adjustment factors applied to the dosage determined after application of the lookup values to the base dosage, i.e., “test dosage” may include, but are not limited to: for history of acne or facial hair, dosage=test dosage×0.90; history of hair loss, dosage=test dosage×0.88; hysterectomy, if YES, dosage=test dosage×0.88; history of PCOS, dosage=test dosage×0.75; history of heavy menses, if YES, dosage=test dosage×0.88; history of metabolic syndrome, if YES, DO NOTHING; persistent breast pain, if YES, dosage=test dosage×0.80; mid-cycle bleeding, if YES, dosage=test dosage×0.80; headache, if YES, dosage=test dosage×0.75; fluid retention, if YES, dosage=test dosage×0.75; and, fibrocystic breast disease, if YES, dosage=test dosage×0.70. Also, if the FSH is &gt;=30 and age is between 20 and 50 years, then the FSH adjustment lookup value is set to 12.5. 
         [0068]    Next, at process block  416 , formula may be applied to determine female dosage for estradiol and testosterone. Female dosage calculations involve two calculations, one for extradiol and the other for testosterone. The estradiol calculation involves calculating the weight/age ratio, age, current FSH levels, a problem factor multiplier and an FSH adjustment factor. The weight/age ratio is calculated by dividing the weight in pounds by the age in years. As indicated above, the weight/age ratio is then used to lookup the weight/age ratio lookup value from Table 1. The age is then used to lookup the lookup value in the Female Estradiol Age lookup table (Table 2). The value of the current FSH level is then used to find the corresponding lookup value in the Female Estradiol FSH lookup table (Table 3). These values are then summed into a single value and then multiplied by any problem factor adjustment values from process block  410 , and added to the calculation. The estradiol dosage is thus calculated in Equation (1) as: 
         [0000]      Estradiol dosage=((Weight Age Ratio Lookup+Age Lookup+FSH Lookup)×Problem Factor)+FSH Adjustment
 
         [0069]    Similarly, the testosterone calculation involves calculating the weight lookup value, current testosterone level lookup value and testosterone age lookup value. The weight is used to obtain a value from the Female Testosterone Weight lookup table (Table 4). The current testosterone level is used to obtain a value in the Female Testosterone Testosterone lookup table (Table 5). These two values are then summed. The age is used to obtain a value in the Female Testosterone Age lookup table (Table 6). The obtained testosterone age lookup value is then multiplied by the sum of the testosterone weight and testosterone testosterone lookup values. The testosterone dosage is thus calculated in Equation (2) as: 
         [0000]      Testosterone dosage=(Weight Testosterone Lookup+Testosterone Level Lookup)×Testosterone Age Lookup
 
         [0070]    Once the dosage is calculated at process block  418 , exception logic may be applied at process block  420  at the physician&#39;s discretion, for example, for pre-menopausal women. For example, pre-menopausal females do not receive estradiol except in the case where current estradiol level is &lt;10 or if the pre-menopausal female patient exhibits symptoms of migraines. For pre-menopausal women without estradiol level &lt;10 or migraines, estradiol calculated dose becomes 0.00. At process block  422 , a final dosage for the new female patient is determination. 
         [0071]    Like the dosage calculations for female new patients, female return dosage calculations, as indicated at process block  404 , also involve two components: one for estradiol and the other for testosterone. The method includes all the steps included for a new patient, and also determining the patient&#39;s previous dosage at process block  407  after receiving the input parameters at process block  406 . The previous dosage obtained at process block  407  may be directly input or may be saved in the database  114  of  FIG. 1 . The female return patient estradiol dosage is then calculated at process block  416  using the following Equation (3): 
         [0000]      Estradiol dosage=((Weight Age Lookup+Age Lookup+FSH Lookup+Current Dose Lookup)×Problem Factor)
 
         [0072]    Female Return Testosterone dosage is calculated using the following Equation (4): 
         [0000]      Testosterone dosage=(Weight Testosterone Lookup+Testosterone Level Lookup)×Testosterone Age Lookup
 
         [0073]    Calculation of female booster dosages, as shown at process block  405 , for estradiol and testosterone is determined at process block  416 , respectively, by taking the previous estradiol dosage and dividing by 2.00, and taking the previous testosterone dosage and dividing by 3.00. 
         [0074]    Referring now to  FIG. 5 , the exemplary steps  500  for determining the dosage for a male patient are provided. To start the process for determining the dosage for the male patient, a patient type is identified at decision block  502 . The patient type may be determined by the electronic circuit, as previously described with respect to  FIG. 3 . Additionally, or alternatively, the physician  110  of  FIG. 1  may manually input the patient type directly into the communication device  102  or, the patient type may be determined from the patient name and/or a unique identification number combined with a lookup of patient information stored in the database  114 . The patient types identified at block  502  may include: A Male New Patient, as shown at process block  503 , which may be a male patient that has never been treated with HRT or someone who has not received pellets for over ten months; A Male Return Patient, as shown at process block  504 , which may be a male patient that has been treated with HRT and is returning for ongoing treatment; Or a Male Booster Patient, as shown at process block  505 , which may be a male patient that has been treated with HRT needing an additional dose prior to their next dose. 
         [0075]    Once the patient type is identified, input parameters may be input into the communication device, regardless of which patient type is identified, at process block  506 . The input parameters may include, but are not limited to, patient age, height, weight, race, history of hypertension, history of diabetes, history of colon cancer, history of testicular cancer, history of BPH, history of metabolic syndrome, physical activity level, history of prostate cancer, history of renal disease, active liver disease and current testosterone level. 
         [0076]    If the patient type is a Male New Patient at block  503 , once the input parameters are input at process block  506 , various lookup tables may be consulted by the electronic circuit to determine a base dosage for testosterone and adjustment factors for various conditions and problems. Exemplary lookup tables used in an embodiment of the disclosure for male patients include Male Age and Male Weight, Exemplary tables used for HRT follow: 
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
             
           
               
                 TABLE 7 
               
             
             
               
                   
               
               
                 Male Age 
               
             
          
           
               
                   
                 Age (Years) 
                 Lookup Value 
               
               
                   
                   
               
             
          
           
               
                   
                 &lt;69 
                 1 
               
               
                   
                 &gt;68 
                 0.8 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 8 
               
             
             
               
                   
               
               
                 Male Weight 
               
             
          
           
               
                   
                 Weight (lbs.) 
                 Lookup Value (mg) 
               
               
                   
                   
               
               
                   
                 &lt;151 
                 1200 
               
               
                   
                 151-175 
                 1400 
               
               
                   
                 176-200 
                 1600 
               
               
                   
                 201-225 
                 1800 
               
               
                   
                 226-250 
                 2000 
               
               
                   
                 251-275 
                 2200 
               
               
                   
                 276-300 
                 2400 
               
               
                   
                 301-350 
                 2600 
               
               
                   
                 351-400 
                 2800 
               
               
                   
                 &gt;400 
                 3000 
               
               
                   
                   
               
             
          
         
       
     
         [0077]    After obtaining the lookup values from the various tables at process block  508 , additional problem adjustment factors are determined at process block  510 , disease history is factored in at process block  512 , and other adjustments are determined at process block  514 . In an embodiment of the disclosure, these various considerations may include, but are not limited to: Diabetes and Metabolic Syndrome. In the case of Diabetes or Metabolic Syndrome, the testosterone dosage is increased by 100 milligrams (mg), for example. Exemplary adjustment factors applied to the dosage determined after application of the lookup values to the base dosage, i.e., “test dosage” may include, but are not limited to: for history of BPH, dosage=test dosage×0.95; history of prostate cancer, dosage=test dosage×0.90; history of both prostate cancer and BPH, dosage=test dosage×0.90; physical activity level: sedentary/work only, decrease dosage by 100 mg, work+exercise 5 times/week, increase dosage by 100 mg; testosterone level &gt;=700, no treatment; monthly testosterone injection (100-200 mg), no change in dosage; weekly testosterone injection (100-200 mg), increase dosage by 100 mg; testosterone gel (1.62%) used, increase dosage by 100 mg. 
         [0078]    Next, at process block  516 , formula may be applied to determine male dosage for testosterone HRT. Male dosage calculations involve a single calculation for testosterone. The testosterone calculation involves calculating the weight lookup value, age lookup value, obtaining the current testosterone dose value, if any, and applying any additional adjustments (from above). As indicated above, the age is used to lookup the age lookup value from Table 7. The weight is then used to lookup the lookup value in the Male Weight lookup table (Table 8). These values are then multiplied together with the applicable adjustment factor to determine the testosterone dosage. The testosterone dosage is thus calculated in Equation (5) as: 
         [0000]      Testosterone dosage=Age Testosterone Lookup×Weight Testosterone Lookup×other Adjustment Multiplication Factor
 
         [0079]    Dosage calculations for male return patients, as shown at process block  504 , are provided at process block  507  by application of the following Equation (6): 
         [0000]      If Current Testosterone Dosage&lt;400.00 mg, then 
         [0000]      Return Testosterone dosage=previous Testosterone Dosage+200.00 mg; 
         [0000]      Else 
         [0000]      Return Testosterone dosage=previous Testosterone Dosage 
         [0080]    Male booster testosterone dosage, as shown at process block  505 , is dependent on existing or previous historical conditions such as BPH, cancer or combinations thereof, as included in the adjustment factor calculated for male new patients, above. The booster testosterone dosage is then determined in Equation (7) as: 
         [0000]      Booster testosterone dosage=previous testosterone dosage+(0.20×adjustment Multiplication Factor)
 
         [0081]    Turning now to  FIG. 6 , a flow chart setting forth exemplary steps  600  for automatically calculating an accurate recommended dosage for HRT and automating a life cycle of a patient&#39;s treatment over time is provided. To start the process, a patient type is obtained at decision block  602 . The patient type may be determined by the user, such as the physician  110  of  FIG. 1 , for example, who may be prompted by the system to input the patient type directly into the user interface of the communication device  102  of  FIG. 1 , for example. As shown in  FIG. 7 , an exemplary user interface  230  of the communication device  102  is provided that prompts the user to select one of the patient types  702 . The patient types  702  may include a Female New Patient, a Female Existing/Return Patient, a Female Booster Patient, a Male New Patient, a Male Existing/Return Patient, and a Male Booster Patient. 
         [0082]    Returning to  FIG. 6 , once the patient type is selected by the user, the system controller  210  may access the set of instructions  250 , as shown in  FIG. 2 , to automatically determine whether the patient is a new or existing patient at decision block  602 . If the patient is a new patient at decision block  602 , the system may prompt the user to add the new patient&#39;s information at process block  604 . In one embodiment, the user may enter the new patient information prior to the patient&#39;s appointment so that the user may select the newly entered patient to calculate dosing, as shown at process block  606 , ahead of time. When the user selects a new patient on the user interface  230  shown in  FIG. 7 , a new patient dialog screen  802  may be activated on the user interface  230 , as shown in  FIG. 8 . Several fields  804  may be provided on the new patient dialog screen  802  for the user to fill in. The fields  804  may include, but at not limited to first name, last name, last four digits of the patient&#39;s social security number, date of birth, height, and race of the patient. Once the user enters the patient&#39;s date of birth and height into the corresponding fields  804 , the age in years and the height in inches, for example, may be automatically calculated by the set of instructions stored in the system. Once the necessary new patient information is obtained, the user may click a save button  806  that will save the patient information in the database  114 , of  FIG. 1 , and open a new patient dosage calculation page, as will described in further detail below. 
         [0083]    When the new patient&#39;s information is entered into the system by the user ahead of time (i.e., prior to the patient&#39;s appointment), the user may be provided with an exemplary patient list  902  displayed on the user interface  230 , as shown in  FIG. 9 . The patient list  902  may be presented to the user after selecting a list patients button  904 , which generates a list of patients stored in the system database. The user may then choose the previously entered patient by using a search input field  906  and clicking a search button  908  to find the newly entered patient. The new patient may be selected, for example, by clicking on the patient name displayed in the patient list  902 , and the new patient dosage calculation may be initiated at process block  606 , as will be described in further detail below. In addition, an add new patient button  910  may be provided on the user interface  230  of  FIG. 9  to allow the user to create a new patient record. This may be the case, for example, if the user thought he/she entered the new patient&#39;s information prior to the patient&#39;s appointment, but in reality did not. Clicking the add new patient button  910  will direct the user back to the new patient dialog screen  802  shown in  FIG. 8 . 
         [0084]    Returning to  FIG. 6 , if the patient is an existing patient at block  602 , the system may prompt the user to select the existing patient from a patient list, for example, at process block  608 .  FIG. 10  shows an exemplary patient list  1002  displayed on the user interface  230  that may be presented to the user after searching for an existing patient using a search input field  1004  and clicking a search button  1006 . The user may then choose an existing patient from the patient list  1002  at process block  608 . Additionally, the set of instructions stored on the system controller can determine, based on dosing history and demographics, for example, if the calculation is a Female New Patient, a Female Existing/Return Patient, a Female Booster Patient, a Male New Patient, a Male Existing/Return Patient, and a Male Booster Patient. 
         [0085]    In the case where a returning patient has not previously been entered into the system, the user may select an add existing patient button  1008  on the bottom to activate an existing patient dialog screen  1102  on the user interface  230 , as shown in  FIG. 11 . Several fields  1104  may be provided on the existing patient dialog screen  1102  for the user to fill in. The fields  1104  may include, but at not limited to first name, last name, last four digits of the patient&#39;s social security number, date of birth, height, and race of the patient. Once the user enters the patient&#39;s date of birth and height into the corresponding fields  1104 , the age in years and the height in inches, for example, may be automatically calculated by the set of instructions stored in the system. Once the necessary patient information is obtained, the user may click a save button  1106  that will save the patient information in the database  114 , of  FIG. 1 , and open a patient dosage calculation page, as will described in further detail below. If, however, the user decides to select an existing patient from the list, a list patients button  1108  may be provided on the existing patient dialog screen  1102  to return to the patient list  1002  shown in  FIG. 10 . 
         [0086]    Returning to  FIG. 6 , once the existing patient is chosen at process block  608 , the set of instructions  250 , as shown in  FIG. 2 , are configured to automatically fill in patient information at process block  609  based on patient records, patient medical history, previous dosing calculations, and historical hormone insertions, for example. Thus, dosage accuracy may be increased by minimizing errors on the dosing input screen and the amount of effort required to calculate a dose may be decreased. Patient information obtained from the patient&#39;s records that may automatically filled in at process block  609  may include, but is not limited to, patient age, weight, height, and race. Patient information obtained from the patient&#39;s medical history or the patient&#39;s previous dosing calculations that may be automatically filled in at process block  609  may include, but is not limited to, number of pregnancies, number of live births, number of abortions/miscarriages, history of renal disease, active liver disease, hysterectomy, history of cervical cancer, history of ovarian cancer, fibrocystic breast disease, history of breast cancer, can, facial hair, hair loss, history of PCOS, history of heavy menses/fibroids, history of metabolic syndrome, premenopausal, and menstrual migraines. 
         [0087]    Thus, in one non-limiting example, if the patient has a history of renal disease, the electronic circuit may be configured to store this medical history corresponding to the patient. The electronic circuit may further be configured to automatically display this relevant medical history corresponding to the patient on the user interface for subsequent dosing since, once identified, the patient will always have a history of renal disease. 
         [0088]      FIG. 12  shows an exemplary dosing calculation page  1202  that may be displayed to the user on the user interface  230  once the patient information has been entered or selected. In addition, many of the values on the dosing calculation page  1202  may automatically be filled in. For example, age  1204  may automatically be calculated from the date of birth previously acquired, and race  1206 , height  1208 , and weight  1210  may automatically be filled in per the patient&#39;s stored profile. In one embodiment, weight  1210  may be changed directly on the dosing calculation page  1202 , as weight may fluctuate with each visit. Symptoms  1212  may also automatically be filled in per the latest dosage calculation on record. Previous Estradiol dose  1214  may automatically be filled in based on the last full dosage on file for the return or booster patient. The system uses the actual historical inserted dose based on the pellets inserted to calculate the previous estradiol dose  1214 . The previous estradiol dose  1214  is different from the calculated estradiol dose  1218  since it is often not possible to obtain the exact calculated dose as the pellets are in discrete amounts, as will be discussed in further detail below. Thus, the last full-dose (i.e., the non-booster dose) is used to calculate the previous estradiol dose  1214 . Alternatively, the previous estradiol value  1214  can be manually changed for the purposes of the dose calculation. Previous Testosterone  1216  may also automatically be filled in based on the last full dosage on file for the return or booster patient. The system uses the actual historical inserted dose based on the pellets inserted to calculate the previous testosterone dose  1216 . The previous testosterone dose value  1216  is different from the calculated testosterone dose  1220  since it is often not possible to obtain the exact calculated dose as the pellets are in discrete amounts. Thus, the last full-dose (i.e., the non-booster does) is used to calculate the previous testosterone dose  1216 . Alternatively, the previous testosterone value  1216  can be manually changed for the purposes of the dose calculation. 
         [0089]    Returning again to  FIG. 6 , once the patient information is added at process block  604  for a new patient, or automatically filled in at process block  609  for an existing patient, the dosage may be calculated at process block  606 . The dosage calculation may be computed for both new and existing patients at process block  606 , and thus, the same reference numerals will be used to describe the remaining steps  600  of the process. In one embodiment, the dosage may be calculated as previously described with respect to the estradiol dosage and testosterone dosage calculations in equations 1 through 7 and the corresponding look up tables 1 through 8. 
         [0090]    Once the dosage is calculated at process block  606 , the system allows the user to decide whether the calculation type (e.g., New Return Booster), is appropriate at decision block  608 . If the user deems the calculation type inappropriate at process block  608 , the dosage may be recalculated at process block  606 . However, if the user deems the calculation type appropriate at process block  608 , the user is provided an option to manually adjust the calculation at decision block  610 . If the system recognizes that the user does not manually adjust the calculation at decision block  610 , the system will prompt the user to prescribe the calculated dosage at process block  612 . However, if the system recognizes that the user manually adjusts the calculation at process block  610 , the system may record a manually adjusted dosage at process block  614 . The system will then prompt the user to prescribe the calculated dosage at process block  612 . 
         [0091]    Referring again to  FIG. 12 , the system may prompt the user to prescribe the calculated dosage by proving a prescribe button  1222 . Clicking the prescribe button  1222  may activate the set of instructions stored on the system controller to display a prescribe patient dialog screen  1302  on the user interface  230 , as shown in  FIG. 13 . The prescribe patient dialog screen  1302  may include calculated dosages  1303 , the patient&#39;s name, gender and age, and a past insertion history  1306 . The patient insertion history  1306  may include, for example, the patient&#39;s last four insertions, the date of insertion, the estradiol insertion amount in mg, the testosterone insertion amount in mg, the insertion side and the calculation type. As such, the patient insertion history  1306  may help support the user&#39;s decision making related to a patient&#39;s dosages, for example. 
         [0092]    Upon creating the prescription, the system may provide the user with fields on the prescribe patient dialog screen  1302  to enter prescription information. As shown at process block  616  of  FIG. 6 , the prescription information to be provided may include, but is not limited to, insertion location of the pellet, insertion side, pellet dose, lot numbers and insertion notes about the insertion, all of which may be saved in the patient historical profile. 
         [0093]    Insertion location of the pellet may be in the patient&#39;s hip or abdomen, for example. Based on the historical insertion information for the patient, the system may default the insertion location value based on the previous insertion, as shown on the prescribe patient dialog screen  1302  in  FIG. 13 . If the previous insertion location is in the abdomen, for example, the abdomen will be automatically selected. Alternatively, the user may choose to manually change this value. The insertion side  1304  (i.e., left or right) of the pellet may be based on historical insertion information  1306  for the patient. Similar to the insertion location, the system may default the insertion side value based on the previous insertion. For example, if the previous insertion side is on the left, the system will automatically select the opposite side (i.e., the right), as shown in  FIG. 13 . Alternatively, the user may choose to manually change this value. As such, the system may take the manually entered values corresponding the insertion side and/or location and store them for future dose calculations of the particular patient. 
         [0094]    The pellet dose  1308  may be based on the calculated dose, and the system may automatically suggest the combination of pellets that most closely matches the calculated dosage and that yield the least number of pellets, as shown at process block  618  in  FIG. 6 . As shown in  FIG. 13 , this is performed for both estradiol and testosterone. The user may manually modify the pellets suggested by the system by clicking on a first icon  1310 , such as a plus sign icon, and a second icon  1312 , such as a minus sign icon, to increase or decreases the number of pellets, respectively. The system may automatically calculate the pellet dose  1308  based on the pellet sizes chosen and automatically update the pellet dose  1308  totals as the user adds or subtracts pellets. As a non-limiting example, the case where the calculated estradiol dose is 25 mg, the system may suggest two pellets, namely one 15 mg pellet and one 10 mg pellet. However, the user may choose to use two 12.5 mg pellets. Or the user may use his or her discretion to dose a 12.5 mg pellet and a 10 mg pellet using a total of 22.5 mg which is less than the calculated dosage. Whatever the final dosage is selected, the system tracks the actual historical insertion amount. 
         [0095]    In another embodiment, the pellet dose  1308  may be automatically calculated at process block  618  in  FIG. 6  using a pellet allocation algorithm, for example. The pellet allocation algorithm, as shown in Appendix A, maybe accessed by the set of instructions stored on the system controller to accurately determine optimal pellet insertion given a calculated dosage. Because pellets are in discreet amounts, it is often not possible to insert the exact calculated amount. For example, conventional testosterone pellets are typically available is the following dosages: 25 mg, 37.5 mg, 50 mg, 87.5 mg, 100 mg, and 200 mg. Similarly, conventional estradiol pellets are typically available in the following dosages: 6 mg, 10 mg, 12.5 mg, 15 mg, 18 mg, 20 mg, 22 mg, and 25 mg. In order to calculate the optimal pellet insertion dosage, the pellet allocation algorithm uses the best available approximation, such that the system should produce a final dosage as close to the calculated dosage amount as possible. For instance, if the calculated dosage is 36.75 mg in estradiol, the system may choose a 20 mg+18 mg=38 mg over a sub-optimal allocation of 20 mg+15 mg. There is no bias to the final dosage being greater or less except in the case of the bias being equal, then the system chooses less. The pellet allocation algorithm also uses the least number of pellets to determine the optimal pellet insertion. Since each pellet is an extra subcutaneous insertion, the system targets a pellet combination that minimizes the number of pellets. For example, given a calculated dose of 25 mg estradiol, the system may choose one 25 mg estradiol instead of two 12.5 mg estradiol or one 10 mg and one 15 mg estradiol to achieve the same result. In addition, the pellet allocation algorithm may incorporate some specific biases based on real world experience. For large testosterone doses, a normally suggested single 200 mg is broken into two 100 mg to speed up initial hormone absorption by the body, for example. 
         [0096]    The base pellet allocation algorithm, shown in Appendix A, uses a nested loop strategy, such that, for each pellet size starting from the largest to smallest, the pellet size is subtracted from the calculated dose and the result is evaluated. If the result of the subtraction is less than zero then the next smallest pellet size is subtracted from the calculated does and the result is evaluated. If the result of the subtraction is less than zero, then the next (smaller) pellet size is subtracted from the calculated dose. This process is repeated until the result of the subtraction is greater than zero−once greater than zero. If the result of the subtraction is greater than zero, the previous pellet amount result (negative) and the current pellet amount (positive) are compared, and the lesser of the absolute value of the previous pellet amount and the current pellet amount is taken to obtain the closest approximation. 
         [0097]    Thus, the pellet allocation algorithm yields a suboptimal approximation in cases where a combination of lesser pellet sizes yields a better approximation when the calculated dose allows for a larger pellet size to be used. For example, if the calculated testosterone is 112.5 mg, based on the base allocation algorithm above, the algorithm would yield one 100 mg testosterone pellet. However, a combination of 87.5 mg+25 mg yields an exact amount. This problem may solved by iterating the base algorithm (above) with the largest pellet being a smaller size with each successive iteration. For instance, the base algorithm would be re-run with the largest testosterone pellet size of 100 mg (sans the 200 mg pellet). If a closer approximation results, then that is taken. If not, the base algorithm is run again with the largest pellet size being the next smallest down. In this instance, the base algorithm is re-run with 87.5 mg being the largest pellet size (sans the 100 mg pellet). On this iteration, the system would arrive at a better approximation than the original run. The iterations would only go on until an exact match is found (in which case there is no longer a need to search for a better approximation) or until the maximum pellet is also the smallest pellet. If a particular iteration yields a solution that is not better than the previous (defined by a smaller absolute value of the difference from the calculated value), then the previous solution is used because it guarantees a lesser number of pellets. 
         [0098]    Once the pellet does is automatically calculated at process block  618 , the user may be provided an option to manually enter the estradiol pellet size insertion and the testosterone pellet size insertion, rather than using the estradiol pellet size insertion and the testosterone pellet size insertion determined by the pellet insertion algorithm. Next, the user may enter the lot numbers corresponding to the pellets to be inserted into the patient at process block  616 . Lot number fields  1314 , as shown in  FIG. 13 , may be provided on the prescribe patient dialog screen  1302  for the user to enter the corresponding lot numbers  1501 , as shown in  FIG. 15 . For compliance to health safety rules, all pellets inserted into patients must have the pellet&#39;s lot number recorded. Thus, the system creates lot number fields  1314  for each pellet chosen. In the case above, the system would create two lot number fields  1314  to enter the 12.5 mg pellet and the 10 mg pellet. In the case where multiple pellets of the same size are inserted, the system will create lot number fields  1314  for each pellet. For example, if two 12.5 mg pellets are chosen, the system will create two lot number fields. If there are multiple lot number fields of the same pellet type and size, a copy icon  1502 , as shown in  FIG. 15 , can copy the lot number of the pellet above. It is often the case that the similar type and size pellets carry the same lot number. In addition, once lot numbers are entered into the system, the user may use a search lot numbers function  1602 , as shown in  FIG. 16 , to find lot numbers by patient name, lot number, and insertion date range, for example. 
         [0099]    Once the insertion location of the pellet, insertion side, pellet dose, lot numbers and insertion notes about the insertion are obtained at process block  616  in  FIG. 6 , another user, for example a medical assistant, may adjust the patient information and enter new patient information, such at a blood work number, at process block  620 . Each time a patient returns for additional dosages, the steps  600  are repeated for the existing patient and saved in the patient&#39;s profile for future dosage calculations. 
         [0100]    In yet another embodiment, the dosage system may consider the number of return visits when factoring the calculated dosing value. For example, upon the first return of a female dosing patient, the testosterone dosage amount may be reduced by 12.5 mg prior to taking into account historical factors. Previously, the return calculation for females was driven by the previous testosterone dose multiplied by historical factors. The historical factors being, but not limited to, acne, facial Hair, and history of PCOS. The new calculation is as follows in Equation (8): 
         [0000]      Testosterone dosage=(previous testosterone dose−12.5)*historical factors
 
         [0101]    As shown in  FIG. 14 , a patient information dialog screen  1402  is shown on the user interface  230  of the communication device. The patient information dialog screen  1402  may display the patient&#39;s insertion history  1404 . In the embodiment shown in  FIG. 14 , when the user clicks on the new patient button  910  of  FIG. 9 , the patient information dialog screen  1402  is displayed on the user interface  230 . The patient information can be modified by the user prior to clicking the save button  1406 . 
         [0102]    In addition to the factors used to calculate the dosage in equation (8) above, non-pellet testosterone usage may be incorporated. For example, if non-pellet testosterone is indicated in the calculation, then testosterone calculation is set to 0.00. In addition, or alternatively, if a return patient is premenopausal and their current estradiol level is greater than 10 mg, for example, and the patient does not show symptoms of menstrual migraines, then the estradiol return and booster calculation is set to 0.00. Physical activity level may also be incorporated into the dosage calculation. The physical activity level of the patient may include, but is not limited to, sedentary/work only, work plus exercise three times per week, and work plus exercise five time per week. If the activity level of the patient is indicated as sedentary/work only, the dosage calculation may be configured to decrease the testosterone dose by 100.00 mg, for example. If the activity level of the patient is indicated as work plus exercise three times per week or work plus exercise five time per week, the dosage calculation may be configured to increase the testosterone dose by an appropriate mg and 100.00 mg, respectively. In addition, if the patient has a history of BPH, the dosage calculation may be configured to decrease the testosterone calculation by 5%, for example. Alternatively, if the patient has a history of prostate cancer, the dosage calculation may be configured to decrease the testosterone calculation by 5%. Or if the patient has a history of both BPH and prostate cancer, the dosage calculation may be configured to decrease the testosterone calculation by 10%, for example. 
         [0103]    In one exemplary embodiment, the above described dosing system may include a comprehensive toolkit for providing hormone replacement therapy. The comprehensive toolkit may provide ancillary support functions, including, but not limited to, patient consult requests and response, articles, videos, forms, news and updates, products purchasing, financial reports, and assistant assignments. 
         [0104]    The patient consult function may allow users to submit a question for a particular patient, for example. To begin a patient consult, the system may securely routes the consult request electronically to Sottopelle Therapy headquarters, for example. A notification email may then be sent alerting staff of the HRT provider and the consult request can be pulled from a database application. A response can be written into the consult request record, and a notification email may be sent to the provider requesting the consult that their consult request has been responded to. The user can go to a patient consults area where they can securely view all patient consults, past and present. 
         [0105]    Users can initiate a patient consult request by filling out information about the patient using a form  1700 , as shown in  FIG. 17 . The system will automatically fill in patient information based on the patient selected. The following fields are available to describe the patient&#39;s situation: patient last name, age, weight, gender, relevant medication and supplements, relevant patient history, patient symptoms, hysterectomy, both ovaries removed, lab results label, E2, T-total, PSA, T-free, total T3, free T4, FSH, TSH, previous labs and dosages, date, previous labs: E2, previous dosage: E2, previous labs: test, previous dosage: test, previous labs: FSH, date, previous labs: E2, previous labs: test, previous dosage: E2, previous dosage: test, previous labs: FSH, your choice, your choice: E2, your choice: test. Once the form  1700  is submitted, the provider is notified via email and the patient consult request record becomes visible in the patient consult response application. 
         [0106]    The system may display consult requests  1800  awaiting response, as shown in  FIG. 18 , as well as a tab  1802  for past patient consults, to allow users to edit the patient consult records and submit a response. Users may respond to a patient consult with some or all patient consult information conveniently visible, as shown in  FIG. 19 . Once a response is submitted, the provider is notified via email and the patient consult response record becomes visible in the patient consult response application. Users may also be provided with the status of the patient consult requests  1800 , as shown in  FIG. 20 , indicating if the response is available or unavailable, for example. The patient consult concludes with a printable page of all relevant parameters along with a response to the particular patient&#39;s condition and recommended course of action, as shown in  FIG. 21 . 
         [0107]    In one embodiment, the system offers informational resources pertaining to hormone replacement therapy articles, videos, forms, news and updates, as shown in  FIG. 22 . News videos and updates may include, but are not limited to Instagram videos, Twitter texts, Facebook posts, Pinterest photos, Sottopelle and Hormone Replacement Therapy News, marketing brochures, office forms, important articles, and instructional videos. As shown in  FIG. 23 , users may also search through relevant articles on hormone replacement therapy by entering a search term. The system can then access the web-based library to obtain the latest research, resources and information on HRT and pellets. Further, as shown in  FIG. 24 , the system allows for the following products to be purchased including, but not limited to, hair repair, DIM, health and wellness, oil of evening primrose, calcium pyruvate, liquid vitamin D3, traumeel tablets, sleep wellness, slow flow, TrocarPak female, TrocarPak male, male trochar kit, and female trochar kit. 
         [0108]    The dosing system may also provide tools for tracking revenues per patient visit. By doing so, the system can generate end-of-day top line reports on a per office level to providers needing to get a clearer financial picture of their practice. The system can automatically populate a pellet calendar  2500 , shown in  FIG. 25 , with patient prescriptions as described previously. Medical assistants, for example, as well as providers can view the pellet calendar  2500  which allows for financial numbers to be assigned to each prescription. Users can do this by clicking on a day  2502 . The system automatically populates a daily pellet list  2600 , as shown in  FIG. 26 , allowing users to enter financial information attached to each visit. The daily pellet list  2600  may show, but is not limited to, the following values: patient name, age, visit type (new/return/booster), gender (male/female), estradiol pellets inserted during the visit, and testosterone pellets inserted during the visit 
         [0109]    In another embodiment, the system provides a patient insertion superbill modal window  2700 , shown in  FIG. 27 , that allows for patient checkout amounts to be attached to each patient visit. The patient information and pellet insertion amounts may all automatically be pre-filled and include: patient name, age, visit type (new/return/booster), gender (male/female), estradiol pellets inserted during the visit, and testosterone pellets inserted during the visit. Thus, the users only need to enter financial information (e.g., cash, credit, debit, check) into the superbill modal window  2700  and totals  2702  can be automatically calculated. 
         [0110]    The financial information and patient visits can be summarized to provide a full financial view of the practice in the form of an end of day (EOD) report  2800 , as shown in  FIG. 28 . The following metrics may automatically be calculated and displayed in a format that can be printed and emailed: (1) Daily totals: cash, credit, debit, check and grand total; (2) Month To Day Totals: cash, credit, debit, check and grand total—includes a date range search; (3) Daily Total Patient: count patients for the day for each gender; and (4) Month to Day Total Patients: count patients for the day for each gender and may includes a date range search. 
         [0111]    The financial numbers may be aggregated for the provider to track the number of patients, prescription and pellets to manage day-to-day operations including patient and gender count per provider for a given date range, revenues per provider for a given date range, and dosing fee per provider for a given date range. The financial numbers may be displayed in the form of a prescription summary report  2900 , for example, as shown in  FIG. 29 . 
         [0112]    The system may be a full multi-user system allowing providers to create secure login for assistants, for example, to interact with patients, pellet insertions, and other patient visit information. The system automatically keeps track of which login belong to which provider so when the assistant logs in, only patients related to the corresponding office are shown. Multiple providers  3000  can be linked to the same office  3002 , as shown in  FIG. 30 , allowing multiple providers in the same office to share patient information, and allowing a provider record  3100  to specify an office, as shown in  FIG. 31 . Likewise, a medical assistant login  3200  may be linked to a provider, as shown in  FIG. 32 . 
         [0113]    The present invention has been described in terms of one or more preferred embodiments, and it should be appreciated that many equivalents, alternatives, variations, and modifications, aside from those expressly stated, are possible and within the scope of the invention. 
         [0000]    
       
         
               
             
               
               
             
               
               
             
               
               
             
               
               
             
               
               
             
               
               
             
               
             
               
               
             
               
             
               
               
             
               
             
               
               
             
               
             
               
               
             
               
             
               
               
             
               
               
             
               
               
             
               
               
             
               
               
             
               
               
             
               
             
               
               
             
               
             
               
               
             
               
             
               
               
             
               
               
             
               
             
           
               
                 APPENDIX A 
               
               
                   
               
             
             
               
                 #CALC PELLETS 
               
               
                 estrsizes = [25,22,20,18,15,12.5,10,6] 
               
               
                 SMALLEST_ESTR=6 
               
               
                 testsizes = [200,100,87.5,50,37.5,25] 
               
               
                 SMALLEST_TEST=25 
               
               
                 nf = NumberFormat.getNumberInstance( ) 
               
               
                 print nf.parse(calc_testosterone) 
               
               
                 estr = StringMaker.parseDouble(Util.replaceAll(calc_estradiol, ‘’,‘’,‘’‘’)) 
               
               
                 test = StringMaker.parseDouble(Util.replaceAll(calc_testosterone, 
               
               
                 ‘’,‘’,‘’‘’)) 
               
               
                 print ‘calc_estradiol’, calc_estradiol, ‘estr’, estr 
               
               
                 print ‘calc_testosterone’, calc_testosterone, ‘test’, test 
               
               
                 lusemap = HashMap( ) 
               
               
                 usemap = HashMap( ) 
               
               
                 uselist = [ ] 
               
               
                 cnt=0 
               
               
                 remaining = estr 
               
               
                 smallest = SMALLEST_ESTR 
               
               
                 while remaining &gt; 0 and cnt&lt;100: 
               
             
          
           
               
                   
                 for pellet in estrsizes : 
               
             
          
           
               
                   
                 if pellet &lt;= remaining : 
               
             
          
           
               
                   
                 uselist.append(pellet) 
               
               
                   
                 existing = usemap.get(pellet) 
               
               
                   
                 if existing is None : existing = 0 
               
               
                   
                 existing = existing + 1 
               
               
                   
                 usemap.put(pellet, existing) 
               
               
                   
                 remaining = remaining − pellet 
               
               
                   
                 break 
               
             
          
           
               
                   
                 if remaining &lt; smallest : 
               
             
          
           
               
                   
                 uselist.append(smallest) 
               
               
                   
                 existing = usemap.get(smallest) 
               
               
                   
                 if existing is None : existing = 0 
               
               
                   
                 existing = existing + 1 
               
               
                   
                 usemap.put(smallest, existing) 
               
               
                   
                 remaining = remaining − smallest 
               
             
          
           
               
                   
                 cnt=cnt+1 
               
             
          
           
               
                 print ‘estr’, estr, ‘uselist’, uselist 
               
               
                 print ‘estr’, estr, ‘usemap’, usemap 
               
               
                 total = 0.00 
               
               
                 total1 = 0.00 
               
               
                 total2 = 0.00 
               
               
                 last = 0.00 
               
               
                 n=0 
               
               
                 while n &lt; len(uselist) : 
               
             
          
           
               
                   
                 pellet = uselist[n] 
               
               
                   
                 if (n+1) &lt; len(uselist) : total1 = total1 + pellet 
               
               
                   
                 else : last = pellet 
               
               
                   
                 total2 = total2 + pellet 
               
               
                   
                 n=n+1 
               
             
          
           
               
                 print ‘total1’, total1, ‘total2’, total2, ‘last’, last 
               
               
                 if (estr − total1) &gt;= (total2 − estr): 
               
             
          
           
               
                   
                 total = total2 
               
             
          
           
               
                 else : 
               
             
          
           
               
                   
                 total = total1 
               
               
                   
                 uselist = uselist[0:len(uselist)−1] 
               
               
                   
                 usemap.put(last, usemap.get(last)−1) 
               
             
          
           
               
                 for use in usemap : 
               
             
          
           
               
                   
                 elabelmap.get(use) 
               
               
                   
                 lusemap.put(elabelmap.get(use), usemap.get(use)) 
               
             
          
           
               
                 estrlist = uselist 
               
               
                 estrmap = usemap 
               
               
                 estrlmap = lusemap 
               
               
                 print ‘FINAL ESTR PELLET USAGE’ 
               
               
                 print ‘estr’, estr, ‘estrlist’, estrlist 
               
               
                 print ‘estr’, estr, ‘estrmap’, estrmap 
               
               
                 print ‘estr’, estr, ‘estrlmap’, estrlmap 
               
               
                 request.setAttribute(‘estrlist’, estrlist) 
               
               
                 request.setAttribute(‘estrmap’, estrmap) 
               
               
                 request.setAttribute(‘estrlmap’, estrlmap) 
               
               
                 lusemap = HashMap( ) 
               
               
                 usemap = HashMap( ) 
               
               
                 uselist = [ ] 
               
               
                 cnt=0 
               
               
                 remaining = test 
               
               
                 smallest = SMALLEST_TEST 
               
               
                 print ‘remaining’, remaining 
               
               
                 while remaining &gt; 0 and cnt&lt;100: 
               
             
          
           
               
                   
                 for pellet in testsizes : 
               
             
          
           
               
                   
                 print ‘TESTCALC: pellet’, pellet, ‘remaining’, remaining 
               
               
                   
                 if pellet &lt;= remaining : 
               
             
          
           
               
                   
                 uselist.append(pellet) 
               
               
                   
                 existing = usemap.get(pellet) 
               
               
                   
                 if existing is None : existing = 0 
               
               
                   
                 existing = existing + 1 
               
               
                   
                 usemap.put(pellet, existing) 
               
               
                   
                 remaining = remaining − pellet 
               
               
                   
                 break 
               
             
          
           
               
                   
                 if remaining &lt; smallest : 
               
             
          
           
               
                   
                 uselist.append(smallest) 
               
               
                   
                 existing = usemap.get(smallest) 
               
               
                   
                 if existing is None : existing = 0 
               
               
                   
                 existing = existing + 1 
               
               
                   
                 usemap.put(smallest, existing) 
               
               
                   
                 remaining = remaining − smallest 
               
             
          
           
               
                   
                 cnt=cnt+1 
               
             
          
           
               
                 print ‘test’, test, ‘uselist’, uselist 
               
               
                 print ‘test’, test, ‘usemap’, usemap 
               
               
                 total = 0.00 
               
               
                 total1 = 0.00 
               
               
                 total2 = 0.00 
               
               
                 last = 0.00 
               
               
                 n=0 
               
               
                 while n &lt; len(uselist) : 
               
             
          
           
               
                   
                 pellet = uselist[n] 
               
               
                   
                 if (n+1) &lt; len(uselist) : total1 = total1 + pellet 
               
               
                   
                 else : last = pellet 
               
               
                   
                 total2 = total2 + pellet 
               
               
                   
                 n=n+1 
               
             
          
           
               
                 print ‘total1’, total1, ‘total2’, total2, ‘last’, last 
               
               
                 if (test − total1) &gt;= (total2− estr): 
               
             
          
           
               
                   
                 total = total2 
               
             
          
           
               
                 else : 
               
             
          
           
               
                   
                 total = total1 
               
               
                   
                 uselist = uselist[0:len(uselist)−1] 
               
               
                   
                 usemap.put(last, usemap.get(last)−1) 
               
               
                   
                 for use in usemap : 
               
             
          
           
               
                   
                 tlabelmap.get(use) 
               
               
                   
                 lusemap.put(tlabelmap.get(use), usemap.get(use)) 
               
             
          
           
               
                 testlist = uselist 
               
               
                 testlmap = lusemap