Abstract:
A system facilitates automated, remote communication between a variety of individuals or entities involved in the process of providing medical services or equipment to patients. A communication module facilitates automated remote communication using a network accommodating hard wire, wireless, internet, intranet or Ethernet technologies, for example, to share information between physicians, therapists, nurses, facilities, manufacturers, insurance providers, equipment providers, payors and caregivers to expedite the therapeutic process. The inventive arrangement eliminates redundancies and promotes efficiencies that are realized through automatic generation of required documentation in expediting communications between all entities involved in the process of providing the necessary care. In one example, the inventive arrangement facilitates automatically generating a certificate of medical necessity at the time that a physician places an order for a selected prescribed therapy. In one example, the certificate of medical necessity includes an electronic signature that is acceptable to replace a hand signature on a hardcopy of the certificate as has been previously required. An inventive testing device arrangement for facilitating data retrieval from the device is also disclosed.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS  
       [0001]    This application claims priority to U.S. Provisional Application No. 60/360,218, filed on Feb. 26, 2002. 
     
    
     
       BACKGROUND OF THE INVENTION  
         [0002]    This invention generally relates to an automated system for providing home medical equipment. More particularly, this invention relates to an automated system that facilitates all steps of the process involved in communications between the various individuals or entities involved in providing medical equipment or related services.  
           [0003]    The current approach to providing home medical equipment to individual patients is time-consuming, labor-intensive, expensive and inefficient. A typical scenario begins when a patient consults their physician regarding some medical condition. The physician determines whether an assessment or testing is needed to determine whether a particular ongoing treatment plan will benefit the patient. For example, the physician may determine that the patient would possibly benefit from receiving oxygen on an ongoing basis. Making this determination typically involves diagnostic testing conducted at another facility or at the patient&#39;s home.  
           [0004]    The physician&#39;s office typically fills out a request form by hand and then faxes that to a testing facility or service provider. The request is then processed manually by the facility or provider. The provider needs to take various steps to log the request and to attempt to schedule what is needed. In the home-test situation it is necessary to coordinate with a therapist to take the appropriate test equipment to the patient&#39;s home to perform the test. Additional scheduling and communication steps typically are involved at this point in the process.  
           [0005]    Depending on whether the testing or assessment will take place in a patient&#39;s home or a testing facility, various steps must be completed. At a testing facility, for example, arrangements must be made to accommodate the patient and complete the necessary data accumulation using appropriate testing equipment. Once the information is extracted from the testing equipment, it then has to be prepared for analysis. In the in-home testing situation, a therapist must take the testing device to the patient&#39;s home where the test will be performed. In many situations, the test will have a relatively lengthy duration such that it does not make sense for the therapist to remain at the patient&#39;s home. In such situations, the therapist must return to the patient&#39;s home after the test is completed to finish the process and then eventually bring the testing device or equipment to the appropriate provider facility so that the data from the test equipment can be obtained by the provider.  
           [0006]    The results of the test obtained from the device are then put into a useable format and typically faxed to the physician&#39;s office. After receiving the fax, the physician is able to evaluate the test results and then issue an order or prescription when appropriate. This information must then be conveyed to a home medical equipment provider, by facsimile for example. At this point, the home medical equipment provider is able to arrange for providing the appropriate equipment to the patient for use by the patient on an on-going basis.  
           [0007]    Prior to providing the equipment to the patient, however, medical reimbursement payor organizations such as Medicare or other private insurance companies, typically require a third party confirmation of the in-home assessment results. Of course, this involves additional scheduling and visits to the patient&#39;s home and obtaining the test equipment data. This process introduces additional delay between the physician&#39;s initial desire to provide the patient with the home therapy and the ultimate delivery of the therapeutic device or services. This third party assessment also involves additional cost to the payor organization.  
           [0008]    Once the appropriate approvals are obtained, the home medical equipment provider arranges for the patient to receive the necessary equipment to fulfill the physician&#39;s order or prescription. This does not end the process, however, because the home medical equipment provider needs to obtain payment from the payor organization.  
           [0009]    A certificate of medical necessity (CMN) is required from the prescribing physician before the home medical equipment provider can be paid. A CMN may be, for example, Form 484.2, which is a required Medicare document for reimbursement. The required document or CMN details the specific need, medical order and equipment or services to be provided. Current regulations require that a physician complete a CMN by hand and sign the form.  
           [0010]    This additional step in the process introduces further delay and difficulty for the home medical equipment provider to obtain payment. Completing certificates of medical necessity requires a physician to take additional time to personally complete the form and manually sign the form. Because the physician does not receive any compensation for completing these forms and the patient has already received the desired treatment or therapeutic equipment, there is little motivation for a physician to complete such forms as they tend to interfere with the physician&#39;s ability to conduct the daily practice of medicine. Additionally, this portion of the process introduces further cost for the home medical equipment provider, who typically, periodically needs to send an individual to the various physician offices to obtain signed certificates of medical necessity.  
           [0011]    As can be appreciated, the entire process involves a number of individuals, duplicate efforts, burdensome paper work and unnecessary delays. There is a need for a strategy and system that facilitates the process of providing home medical equipment or similar services to a patient that avoids the unnecessary expenses and delays associated with the conventional approach. This invention addresses that need and provides further advantages.  
         SUMMARY OF THE INVENTION  
         [0012]    In general terms, this invention is an automated system that facilitates providing home medical equipment to a patient.  
           [0013]    A system designed according to this invention allows remotely located individuals, such as medical service and equipment providers and physicians all to obtain access to commonly needed information and to coordinate various tasks in an efficient manner. A communication module allows a first individual, such as a medical professional at a physician&#39;s office, to enter patient information regarding at least one patient and to enter a request for services such as testing, analysis or equipment provision for the patient. The communication module also allows a second, remotely located individual such as a medical service or equipment provider, to determine that the request has been made. The provider is able to enter information indicating the results of having performed the requested services. The first individual is then able to access the result information from the communication module and to enter an order for appropriate medical services. The second individual (i.e., the medical service or equipment provider) is then able to retrieve the order and process the order to provide the ordered services to the patient.  
           [0014]    In one example system, the communication network facilitates automatically generating a certificate of medical necessity at the time that the responsible physician enters the order for medical services. In a preferred embodiment, the certificate of medical necessity includes a digital signature or certificate that is accepted as if the physician had manually signed a printed out version of the certificate of medical necessity. In such an example, the system prompts the physician to answer a plurality of questions that are processed by the communication module so that the certificate of medical necessity is automatically generated and then submitted by the physician on-line.  
           [0015]    One example system designed according to this invention is computer network-based. A plurality of individuals including home medical equipment device manufacturers can have access to selected portions of the data maintained by the system for various purposes. A system designed according to this invention preferably includes security measures that protect the data, especially that regarding patients and medical record information.  
           [0016]    The various features and advantages of this invention will become apparent to those skilled in the art from the following detailed description of the currently preferred embodiment. The drawings that accompany the detailed description can be briefly described as follows. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0017]    [0017]FIG. 1 schematically illustrates a system designed according to this invention.  
         [0018]    [0018]FIG. 2 schematically illustrates a communication facilitator designed according to this invention.  
         [0019]    [0019]FIG. 3 is one example display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0020]    [0020]FIG. 4 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0021]    [0021]FIG. 5 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0022]    [0022]FIG. 6 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0023]    [0023]FIG. 7 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0024]    [0024]FIG. 8 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0025]    [0025]FIG. 9 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0026]    [0026]FIG. 10 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention.  
         [0027]    [0027]FIG. 11 is a display screen presentation useful for a portion of an example process handled by a physician&#39;s or provider&#39;s office using a system designed according to this invention.  
         [0028]    [0028]FIG. 12 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s or provider&#39;s office using a system designed according to this invention.  
         [0029]    [0029]FIG. 13 is another display screen presentation useful for a portion of an example process handled by a provider&#39;s office using a system designed according to this invention.  
         [0030]    [0030]FIG. 14 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s or provider&#39;s office using a system designed according to this invention.  
         [0031]    [0031]FIG. 15 is another display screen presentation useful for a portion of an example process handled by a physician&#39;s office using a system designed according to this invention. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0032]    [0032]FIG. 1 schematically illustrates a system  20  for facilitating communications between the various individuals and entities involved in the process of providing medical services or equipment to one or more patients. For discussion purposes, a home medical equipment provider will be the example provider. Other providers such as laboratories, diagnostic facilities, clinics, therapists, nursing organizations and hospitals will benefit from this invention. Although the described example focuses on the provision of home medical equipment, this invention is not so limited. Given this description, those skilled in the art will realize the wide-ranging usefulness of the inventive system.  
         [0033]    A communication facilitator  22  includes a data management module  24 , a security module  26  and a communication module  28 . In one example, the communication facilitator  22  is a computer-based network. Such a network may be implemented through internet, intranet, Ethernet technologies, private networks, wireless communication or infrared communication technologies, for example. Those skilled in the art who have the benefit of this description will be able to determine which of these available technologies (or what combinations of such technologies) will best suit the needs of their particular situation.  
         [0034]    The data module  24  includes computer software and storage that facilitates handling and maintaining the various kinds of data required during the process of providing various medical services, home medical equipment or both. The data module  24  also facilitates managing data such as physician patient records, testing or assessment requests, testing results, physician orders, etc. The security module  26  provides security measures to prevent unauthorized access to or use of data or the communication facilitator  22 . The security module  26  preferably also provides other features for authenticating various items utilized in the process as will become apparent below.  
         [0035]    It should be noted that the use of the term “module” in this description is not to be construed in a limiting sense. The various modules or divisions within the communication facilitator  22 , for example, are schematic and only for discussion purposes. A module may be a portion of software or a grouping of various portions, for example. Moreover, various functions within one module may be performed by the same software components as used within another module. The illustrated divisions or groupings of the inventive system into modules is for discussion purposes, although those skilled in the art who have the benefit of this description may realize that such divisions have applicability in a system designed according to this invention.  
         [0036]    The communication facilitator  22  facilitates communications between a medical service or equipment provider such as a home medical equipment (HME) provider  30  and a plurality of physician offices  32 , for example. The HME provider  30  is remotely located from the physician offices, which are also remote from each other. The communication facilitator  22  may facilitate modem communications, dedicated communication lines, wireless communications such as cellular networks or satellite links and other suitable media for sharing data among remotely located entities. A variety of communication devices can be used with an appropriately designed network.  
         [0037]    As will be appreciated from the following description, the communication facilitator  22  greatly simplifies, speeds up and enhances the economies associated with the process of providing medical services or home medical equipment to one or more patients. For discussion purposes, the example of providing a patient with oxygen at home will be used. This invention, however, is not limited to such a situation. A variety of types of home medical equipment and a variety of therapy regimes or modalities can be accommodated with a system designed according to this invention.  
         [0038]    In addition to communications between physician offices  32  and a home medical equipment provider  30 , the system  20  facilitates data retrieval from test equipment  40  such as an oxymeter. Portable, remote communication devices  42  such as cellular phones, personal digital assistants or so-called palm top computers are useful for communicating information to or receiving information from the communication facilitator  22 . Such remote communication devices are viable by all individuals having access to the communication facilitator  22  in one example implementation of this invention.  
         [0039]    In the illustrated example, a home medical equipment device manufacturer  44  also has restricted access to certain information within the system  20 . This may be useful in situations, for example, where a device manufacturer desires to monitor the use of the various devices available in the market to focus future research and development efforts.  
         [0040]    Referring to FIG. 2, the communication facilitator  22  includes the communication module  28  which is schematically subdivided for purposes of illustration. In one example, the communication facilitator comprises computer software, which may be stored on known storage media. A first portion  50  is dedicated, in the illustrated example, to physician access to and use of the system  20 . A second portion  52  is dedicated to the use of the system  20  by the home medical equipment provider  30 . A third portion  54  of the communication module  28  is dedicated to facilitating communications with a therapist or other medical professional who visits the patient&#39;s home as needed. Another portion  56  is dedicated to communications with entities such as the HME device supplier  44  to provide the type of access described above.  
         [0041]    The first portion  50  preferably facilitates a physician or another authorized individual from a physician&#39;s office gaining access to the network  22 . A log in module  58  preferably includes suitable programming to present the first individual at the physician&#39;s office with a login screen on a computer display or other suitable device. FIG. 3 shows an example login screen  64  illustrating the type of information associated with the physician or the physician&#39;s office so that all transactions involving that individual can be tracked and linked to associated data or information within the system  20 .  
         [0042]    Upon appropriately logging into the system, the physician preferably is presented with a main menu or navigation screen such as the example screen  66  shown in FIG. 4. As can be appreciated from the illustration, the physician preferably is presented with a plurality of options to select for performing different functions using the system  20 . In the illustrated example, the screen display  66  includes a messages portion that the physician may access to retrieve messages regarding, for example, assessment results obtained and available on the system. By selecting the choice “View Completed Assessment,” for example, the physician can obtain details regarding one or more assessments that have been performed and for which data has been appropriately entered into the network  22 . The various options for the physician will be described in the following paragraphs as an example transaction using the inventive system will be described.  
         [0043]    The beginning of a typical situation involving providing home medical equipment to a patient usually involves the patient visiting the doctor&#39;s office. To utilize the inventive system, the physician, or another authorized individual at the physician&#39;s office, enters patient data into the network  22 . A patient data module  68  facilitates gathering the information entered and associating that information with other data within the network as appropriate. In one example, each patient has a specific identification number that is associated with all records pertaining to that patient within the network, which provides convenient access and retrieval of all such information at a later time.  
         [0044]    One example screen display that prompts appropriate patient data entry is shown in FIG. 5. The screen display  70  shows the type of information that is used in one example embodiment of this invention. The type of information that may be contained in a patient&#39;s chart maintained at the physician&#39;s office can be entered into the network  22  so that such information can be used in the course of providing home medical equipment or used for other general practices by the physician. In other words, the inventive system has the additional benefit of facilitating a physician maintaining patient records in an easily accessible and useful format.  
         [0045]    In the illustrated screen display  70 , after the patient data information is appropriately entered, several selections such as scheduling an assessment, scheduling an office visit or scheduling some other event are presented which can be accessed using a mouse device or conventional keyboard, for example. The first portion  50  of the communication module  28  preferably is programmed to present a subsequent screen display to the user corresponding to the selection made.  
         [0046]    In situations where a patient&#39;s information has already been entered into the system, the authorized individual at the physician&#39;s office may choose the find option on the screen display  70  to search for that patient&#39;s records. An example screen display  72  is shown in FIG. 6 facilitating a patient search. The illustrated example embodiment of this invention preferably allows several search options such as searching by the date of birth and the first letter of the last name of the patient, searching by the patient&#39;s complete last name, searching by the patient&#39;s social security number or other identifying information such as a date of birth or phone number. Compound searching capability is included in one example implementation of this invention. The presentation of the retrieved patient records may be customized depending on the needs of a particular physician&#39;s office or specialty, for example. Those skilled in the art who have the benefit of this description will realize the various ways of presenting the patient data information to an authorized individual at a physician&#39;s office.  
         [0047]    When a physician determines that therapy involving home medical equipment may be useful for a patient, the physician often needs to request an in-home assessment to verify that the proposed therapy will be beneficial or that the patient&#39;s condition is such that an insurance company or Medicare will pay for the proposed therapy and home medical equipment. The communication module  28  facilitates such requests with a request assessment module  74 . If a physician selects the option for scheduling an assessment on the display screen  70  or  66 , the communication module  28  preferably causes the request assessment module  74  to be activated and to facilitate the request.  
         [0048]    An example screen display  76  is shown in FIG. 7 that prompts the authorized individual at the physician&#39;s office to enter the appropriate information to request that the assessment be made. The illustrated example includes an option for selecting an assessment code, which includes a plurality of predefined codes that are presented for an onscreen selection. An example code would refer to an oxymeter test for a patient that may benefit from in-home oxygen therapy. Once the required amount of information is entered into the system, the network  22  includes an indication of the requested assessment.  
         [0049]    The HME provider  30  is then able to access the information regarding the requested assessment. The HME provider  30  preferably logs into the network  22  through a login module  78  that utilizes known techniques for logging in with associated identifier information and access codes allowing the HME provider  30  to access required information for handling the assessment. For example, the security module  26  preferably ensures that the data regarding the patient&#39;s medical records within the data base management module  24  cannot be altered by the HME provider  30 . The example security module ensures that the physician has the ability to “read and write” patient records or data as needed. A variety of techniques for insuring the integrity of information within the data base module  24  or the network  22  generally can be used with a system designed according to this invention. Those skilled in the art who have the benefit of this description will be able to select the appropriate technique to best suit the needs of their particular situation.  
         [0050]    [0050]FIG. 11 illustrates an example main menu display screen  80  that allows the HME provider  30  to navigate through the network  22  to accomplish a desired objective. A retrieve request module  82  preferably is activated if the user at the HME provider  30  selects the “View Requested Assessments” choice on the display screen  80 , for example. This allows the HME provider to determine what physicians have requested specific assessments for individual cases and then to determine whether that provider desires to have that assessment performed with a view towards eventually providing the home medical equipment to that patient if necessary.  
         [0051]    [0051]FIG. 12 illustrates one example arrangement of a screen display  84  that a home medical equipment provider can use to decipher which requests it desires to accept. The illustrated example includes selection buttons  85  that can be accessed using a mouse device, touch screen or a keyboard interface, for example. The HME provider  30  selects which assessments to perform and schedules a therapist or other medical professional to go to the patient&#39;s home to perform the necessary test to complete the assessment.  
         [0052]    An example scheduling screen  86  is shown in FIG. 13. By entering information as appropriate into the system using screen  86  as a guide, a schedule assessments module  88  facilitates getting the appropriate data entered into the appropriate portions of the network  22  so that the assessment eventually gets performed by the desired therapist or other professional. The screen  86  may be presented on the display at the HME provider&#39;s facility. The same screen or a similar screen may be presented to the therapist who access the network  22  to accept the scheduled assessments. Such therapists may be employees of the HME provider or may be contractors that work with the HME provider, depending on a particular situation. The display screen  86  may be available, for example, on the portable communication device  42 , which is carried around by the therapist on a routine basis.  
         [0053]    The therapist or other professional preferably logs into the network  22  through a login module  90  with a portable communication device such as a cellular phone, laptop computer or personal digital assistant. An accept scheduled assessment module  92  preferably facilitates the therapist indicating the desire to accept and perform a particular assessment. By entering information into the network  22 , the therapist is able to communicate to the HME provider  30  that the scheduled assessment will be performed. The therapist preferably has the ability to update information in the network  22  so that the progress on various scheduled assessments is available at any time for the HME provider  30  to review. In one example, authorized individuals at the physicians&#39; offices are also able to track the progress of scheduled assessments.  
         [0054]    One time-consuming shortcoming of the process used before this invention was that the therapist typically had to obtain equipment from the HME provider, take that equipment to the patient&#39;s home, perform the necessary testing, return to the patient&#39;s home to retrieve the testing equipment, take that equipment back to the HME provider and then travel to another patient&#39;s home for another assessment. The additional travel time back and forth between the HME provider facility and the various patients&#39; homes introduces time delays and additional expense that can be avoided when using one example implementation of the inventive system.  
         [0055]    According to one embodiment of this invention, the therapist is able to take the testing device  40  to the patient&#39;s home, obtain information from the testing device after the test has been completed and to remotely communicate that information to the network  22  so that such information then becomes available to the HME provider  30  without requiring the therapist to return to the HME provider facility. Accordingly, the therapist is able to take the testing device  40  from one patient&#39;s home directly to another patient&#39;s home, which presents significant time and cost savings.  
         [0056]    A data of transfer module  96  preferably facilitates obtaining information from the testing device  40  and placing that information into appropriate portions of the network  22 . Such data transfer preferably is accomplished using known wireless communication technology.  
         [0057]    A data entry module  98  facilitates the therapist entering other information into the network needed in connection with a completed assessment report. The display screen  94  preferably prompts the therapist to enter in information such as the patient name, assessment summary information and to ensure that the data from the test device  40  is placed onto the network  22 . The display screen  94  preferably is presented on the portable communication device  42 .  
         [0058]    Once the assessment information has been completely entered into the network  22 , the HME provider  30  preferably utilizes an assessment data module  100  to ensure that the information is complete and available for review by the requesting physician.  
         [0059]    A retrieve results module  102  allows the authorized individual at the physician&#39;s office to obtain the completed assessment report online. This allows a physician, for example, to access such information even though the physician is away from her office. Such added convenience not only is beneficial for a physician to manage their practice, but also facilitates more quickly getting the necessary equipment to the patient to provide the desired therapy.  
         [0060]    An example screen display  104  is shown in FIG. 8 giving the physician a variety of options to select information to be displayed regarding the assessment. A “Proceed To Order” option on the screen  104  allows the physician to move forward in the process to order the desired home medical equipment and therapy based upon the physician&#39;s evaluation of the assessment results. An ordering and certificate of medical necessity generating module  106  facilitates the physician placing an order through the network  22  and completing a certificate of medical necessity (CMN) at the same time as placing the order. A significant advantage associated with this invention is the automatic generation and submission of CMNs.  
         [0061]    An example screen display  108  is shown in FIG. 9 to facilitate a physician placing an order or prescribing a desired therapy and provision of home medical equipment to a patient. In the illustrated example, one of the options available is selecting an order code. In this example, the network  22  preferably includes storage of a plurality of preset codes that are consistent with expected requested therapies so that order placement is easier on a repeated basis.  
         [0062]    The inventive arrangement preferably causes a CMN to be automatically generated as part of the order submission process. In the illustrated example, when the “Submit” selection on the screen  108  is chosen, the system presents the physician with a display screen  110  as shown in FIG. 10, for example. This display screen (or a series of screens, depending on a particular situation) prompts the physician to answer a series of questions to provide the necessary information for completing a CMN. Without the necessary information, the system  20  will not allow the physician to submit the order, which ensures that the HME provider  30  obtains a CMN on a timely basis, which is essential to the HME provider for obtaining reimbursement for the home medical equipment provided to the patient.  
         [0063]    A physician conveniently can utilize a computer located at their office or a remote communication device such as a personal digital assistant to complete the order process and filling out the automatically generated CMN. This portion of the example process utilizing the inventive system demonstrates one use of wireless technology for producing various information without redundancy to each participant in the process.  
         [0064]    Advantageously, the illustrated example includes incorporating a digital signature or digital certificate of authentication onto the CMN within the network  22 . The digital signature fulfills the same purpose as a manual signature by a physician on a hardcopy of the CMN. With the inventive arrangement, a hardcopy of the CMN need not be kept by the physician unless the physician desires to place one within the office copy of the patient&#39;s records, for example. A variety of known digital signature technologies may be used to facilitate secured authorization only by authorized physicians so that the integrity of an automatically generally CMN provided by the system  20  is ensured. Example cryptographic algorithms such as RSA, Diffie-Hellman technology, ElGamal and digital signature imaging. Those skilled in the art who have the benefit of this description will be able to select from among available security techniques or to custom design their own to meet the needs of their particular situation.  
         [0065]    Once the automatically generated CMN is appropriately completed, authorized and digitally signed by the physician, the order is placed on the network  22 . The HME provider  30  then is able to retrieve the order and decided whether to fulfill it. A retrieve order module  112  facilitates the HME provider  30  doing so. A display screen  114  shown in FIG. 15 facilitates completing the order at the HME provider facility  30 . As part of completing the order, the processor at the HME provider  30  preferably is required to retrieve the associated CMN from the network  22  and, in some instances is required to print out a hard copy of the CMN. The CMN is critical to obtaining reimbursement from Medicare or an insurance provider, for example. By obtaining the CMN at the same time as accepting the order, the HME provider  30  has a significant economic advantage compared to the conventional approach of trying to obtain signatures from physicians that are located all around a given geographic area and are busy attending to other aspects of their medical practice, which typically makes manually completing and signing the conventional certificate of medical necessity an undesirable task. A retrieve CMN module  116  preferably facilitates the HME provider obtaining the CMN and cooperates with the security module  26  to ensure the integrity of the CMN so that they will be acceptable by Medicare or the private insurance provider.  
         [0066]    As can be appreciated, the inventive system  20  greatly simplifies, speeds up and economizes the entire process of providing individuals with home medical equipment. The inventive system  20  handles the process from beginning to end in an automated fashion that provides up-to-date information to a variety of individuals with convenient, remote access as needed. Moreover, by automatically generating certificates of medical necessity in an acceptably authorized fashion, the inventive arrangement puts a home medical equipment provider at a significant advantage for obtaining payment for the services rendered and the equipment provided.  
         [0067]    The illustrated example implementation of this invention includes another benefit. This embodiment includes a technique for securely extracting data from the testing device  40 . The portable communication device  42  is capable of communicating with a microprocessor or controller  120  within the testing device  40 , which may be an oxymeter, for example. In one example, a hardwire connection is used between the device  40  and the device  42 . In another example, wireless communication between those two devices facilitates the necessary data extraction from the device  40  and data provision from the device  42 .  
         [0068]    The illustrated oxymeter device  40  includes a data portion  122  and a communication portion  124 , both of which are controlled by a suitably programmed controller  120 . Given this description, those skilled in the art will be able to select appropriate electronic components and to appropriately program them to achieve the results provided by this invention. In one example, the communication device  42  wirelessly communicates through the communication portion  124  using a known web clipping technique. Other known techniques are used in other examples. This allows two-way wireless communication between the devices  40  and  42 .  
         [0069]    A therapist can enter patient identification information and assessment notes, for example, that are then appropriately processed by the controller  120  to be associated with the testing data generated by operation of the device  40 .  
         [0070]    To insure accurate data is extracted from the device  40 , the memory  122  preferably only provides information to the device  42  in a read only format. In one example, the controller  120  is programmed to delete the information from the memory  122  once it is uploaded to the communication device  42  so that the extracted information cannot be later retrieved or modified.  
         [0071]    Ensuring the integrity of the information from the device  40  facilitates further streamlining the process of providing home medical equipment to a patient. This example includes protecting the information generated by the device  40  by using a conventional compression technique that puts the data into a “locked” format accessible only by authorized persons on the network  20 .  
         [0072]    In the conventional approach, a third party verification assessment is required by Medicare and most private insurance carriers. Such third party assessments are required to prevent fraud or manipulation of data from an assessment to obtain approval for home medical equipment that might not otherwise be needed. With the inventive arrangement, the security of the information from the testing device  40  can be protected so that the payor organization need not require a third party assessment verification. The security module  26  of the network  22  further preferably includes programming that ensures that data received from a testing device  40  is unalterable within the network  22 .  
         [0073]    The inventive arrangement has wide-ranging applicability for facilitating communications between various entities involved in providing medical services, equipment or both. The inventive arrangement greatly simplifies and streamlines the processes required to maximize efficiency in providing medical services or equipment to patients. The ready access to and sharing of information for various remotely located individuals using a communication module represents a significant advancement providing advantages such as reducing costs and expenses, increasing the accuracy of available information, increasing the availability of services for patients, reducing the extraneous, time-consuming workload on physicians and provides the ability for medical device manufacturers to better match the needs according to current patient care trends. The inventive arrangement has applicability beyond the provisions of home medical equipment, which was the focus of the above discussion for purposes of describing one example implementation and use of this invention.  
         [0074]    The preceding description is exemplary rather than limiting in nature. Variations and modifications to the disclosed examples may become apparent to those skilled in the art that do not necessarily depart from the essence of this invention. The scope of legal protection given to this invention can only be determined by studying the following claims.