Abstract:
A communications network, system, and method includes a server; a primary device in communication with the server through a communications channel, wherein the primary device comprises a component that detects data transmissions from the server, converts the detected data transmissions into audio transmissions, and audibly transmits the audio transmissions; and a secondary device connected to the primary device and adapted to be operated by an individual in response to the audio transmissions. The component comprises an audio processor that receives a first set of electrical signals corresponding to any of queries, instructions, and messages from the server; converts the first set of electrical signals to a second set of electrical signals capable of being audibly synthesized; and audibly synthesizes the second set of electrical signals. The housing unit comprises a household appliance. The component comprises an audio processor that detects audio transmissions, and converts the audio transmissions to data transmissions.

Description:
STATEMENT OF RELATED CASES  
       [0001]     This application is a continuation of U.S. application Ser. No. 11/524,117, filed Sep. 20, 2006, which is a continuation of U.S. application Ser. No. 11/1 50,301, filed Jun. 13, 2005, which is a continuation of U.S. application Ser. No. 09/658,209, filed Sep. 8, 2000, now U.S. Pat. No. 6,968,375, which is a continuation in part of U.S. application Ser. No. 09/300,856, filed Apr. 28,1999, now U.S. Pat. No. 6,368,273, which is a divisional application of application Ser. No. 08/946,341, filed Oct. 7, 1997, now U.S. Pat. No. 5,997,476, which is a continuation in part of application Ser. No. 08/847,009, filed Apr. 30, 1997, now U.S. Pat. No. 5,897,493 which, in turn claims the benefit of Provisional applications 60/041,746 and 60/041,751, both filed Mar. 28,1997.  
         [0002]     This application is also related to: (i) U.S. Pat. Nos. 5,985,559 and 6,101,478, both continuations in part of U.S. Pat. No. 5,897,493; (ii) U.S. Pat. No. 6,248,065, a divisional of U.S. Pat. No. 5,997,476; (iii) U.S. Pat. No. 6,270,455, a continuation in part of U.S. Pat. No. 5,997,476; (iv) U.S. Pat. No. 6,381,577, which is a continuation of U.S. Pat. No. 6,101,478; (v) abandoned applications Ser. No. 09/531,237, a continuation in part of U.S. Pat. Nos. 6,368,273 and 09/378,188 a continuation of U.S. Pat. No. 5,985,559; (vi) co-pending application Ser. No. 10/279,749, which is a continuation in part of application Ser. No. 10/233,296, which is a continuation in part of co-pending application Ser. No. 09/665,442, which is a continuation in part of U.S. Pat. No. 6,381,577, and (vii) co-pending applications (a) 11/093,167, (b) 11/093,168, (c) 11/132,427 and (d) 11/150,301. Each of the patents and/or applications referenced are incorporated by reference. 
     
    
     FIELD OF THE INVENTION  
       [0003]     The present invention relates generally to communication systems for remote monitoring of individuals, and in particular to a networked system for remotely monitoring individuals and for communicating information to the individuals through the use of script programs.  
       BACKGROUND OF THE INVENTION  
       [0004]     In the United States alone, over 100 million people have chronic health conditions, accounting for an estimated $700 billion in annual medical costs. In an effort to control these medical costs, many healthcare providers have initiated outpatient or home healthcare programs for their patients. The potential benefits of these programs are particularly great for chronically ill patients who must treat their diseases on a daily basis. However, the success of these programs is dependent upon the ability of the healthcare providers to monitor the patients remotely to avert medical problems before they become complicated and costly. Further, success requires compliance with the program, which is often dependent on providing messages or other reminders to patients so that they will stay with the program. Unfortunately, no convenient and cost effective monitoring system exists to accomplish these objectives. While these problems are particularly acute for the poor and the elderly, all demographic groups could significantly benefit from remote communication and monitoring systems.  
         [0005]     Prior attempts to monitor patients remotely have included the use of personal computers and modems to establish communication between patients and healthcare providers, either directly or via an Internet site. However, computers are too expensive to give away and the patients who already own computers are only a fraction of the total population.  
         [0006]     Other attempts to monitor patients remotely have included the use of medical monitoring devices with built-in modems. Examples of such monitoring devices include blood glucose meters, respiratory flow meters, and heart rate monitors. While these devices can be quite successful, their multimedia capabilities are often limited. In addition, many patients simply may prefer to interact with a device they are more familiar with, such as a television.  
         [0007]     Prior attempts to monitor patients remotely have also included the use of interactive telephone or video response systems. Such interactive systems are disclosed in U.S. Pat. No. 5,390,238 issued to Kirk et al. on Feb. 14, 1995, U.S. Pat. No. 5,434,611 issued to Tamura on Jul. 18,1995, and U.S. Pat. No. 5,441,047 issued to David et al. on Aug. 15, 1995. One disadvantage of these systems is that they either require a patient to call in to a central facility to be monitored or require the central facility to call the patient according to a rigid monitoring schedule.  
         [0008]     If the patients are required to call the central facility, only the compliant patients will actually call regularly to be monitored. Non-compliant patients will typically wait until an emergency situation develops before contacting their healthcare provider, thus defeating the purpose of the monitoring system. If the central facility calls each patient according to a monitoring schedule, it is intrusive to the patient&#39;s life and resistance to the monitoring grows over time. Further, it is difficult to identify each patient uniquely using these systems. Moreover, these systems are generally incapable of collecting medical data from monitoring devices, such as blood glucose meters, respiratory flow meters, or heart rate monitors.  
         [0009]     As such, there exists a need for a simple and inexpensive system for remotely monitoring patients and for easily communicating information to the patients. There is also a need to encourage patient&#39;s compliance with a prescribed treatment plan.  
       SUMMARY  
       [0010]     The present invention provides a system for remotely interacting with an individual. The system includes a server, a remote interface device for assigning in the server a set of queries to be answered by the individual, a remotely programmable apparatus for interacting with the individual and a broadcaster in communication with the server and the remotely programmable apparatus.  
         [0011]     By using the entertainment medium of interactive television with its ability to receive a large bandwidth of data, the present invention can more easily communicate interactive entertaining/educational information to potential and existing patients. The interactive nature of the received data makes it easy for a user to access interactive programs related to corresponding entertainment/advertisement content or related to user adherence to a predefined regimen.  
         [0012]     In accordance with another aspect of the present invention, an answering service sends a series of questions as voice communication from a stored set of questions to the remote apparatus for the individual to respond to, when the voice communication button is activated. The answering service stores responses to each provided question in the series of questions and provides a service based on the individual&#39;s response to the questions. The provided service is communication with a health care professional or a service provider. Also, the answering service includes a speech recognition component for receiving spoken responses to the series of questions and a speech synthesis component for making the set of queries into a series of questions.  
         [0013]     In accordance with yet another aspect of the present invention, the remotely programmable apparatus includes an appliance component for providing appliance functionality. The appliance component is an alarm clock, a kitchen appliance, or an entertainment device.  
         [0014]     In accordance with still another aspect of the present invention, the remotely programmable apparatus includes a monitoring component for producing measurements of a physiological condition of the individual. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0015]     The foregoing aspects and many of the attendant advantages of this invention will become more readily appreciated as the same becomes better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein:  
         [0016]      FIG. 1  is a block diagram of networked system formed in accordance with a first embodiment of the present invention;  
         [0017]      FIG. 2  is a block diagram illustrating the interaction of the components of the system of  FIG. 1 ;  
         [0018]      FIG. 3  is a perspective view of a remotely programmable apparatus of the system of  FIG. 1 ;  
         [0019]      FIG. 4  is a block diagram illustrating the components of the apparatus of  FIG. 3 ;  
         [0020]      FIG. 5  is a script entry screen according to the preferred embodiment of the invention;  
         [0021]      FIG. 6A  is a listing of a sample script program according to the preferred embodiment of the invention;  
         [0022]      FIG. 6B  is a continuation of the listing of  FIG. 6A ;  
         [0023]      FIG. 7  is a script assignment screen according to the preferred embodiment of the invention  FIG. 8  is a sample query appearing on the apparatus of  FIG. 1S A-D;  
         [0024]      FIG. 9  is a sample prompt appearing on the display of the apparatus of  FIG. 3 ;  
         [0025]      FIG. 10  is a sample report displayed on a workstation of the system of FIGS.  1 A-D;  
         [0026]      FIG. 11A  is a flow chart illustrating the steps included in a monitoring application executed by the server of FIGS.  1 A-D according to the present invention;  
         [0027]      FIG. 11B  is a continuation of the flow chart of  FIG. 11A ;  
         [0028]      FIG. 12A  is a flow chart illustrating the steps included in the script program of  FIG. 6A-6B ;  
         [0029]      FIG. 12B  is a continuation of the flow chart of  FIG. 12 ;  
         [0030]      FIG. 13  is a perspective view of a remotely programmable apparatus according to an embodiment of the present invention;  
         [0031]      FIG. 14  is a sample prompt appearing on a display of the apparatus of  FIG. 13 ;  
         [0032]      FIG. 15  is a block diagram illustrating the components of the apparatus of  FIG. 13 ;  
         [0033]      FIG. 16  is a schematic block diagram illustrating the interaction of the server of FIGS.  1 A-D with the apparatus of  FIG. 3  according to another embodiment of the present invention;  
         [0034]      FIG. 17  is a first sample message appearing on the display of the apparatus of  FIG. 3 ;  
         [0035]      FIG. 18  is a second sample message appearing on the display of the apparatus of  FIG. 3 ;  
         [0036]      FIG. 19  is a script entry screen according to an embodiment of the present invention;  
         [0037]      FIGS. 20 and 21  are block diagrams of alternate embodiments of the present invention;  
         [0038]      FIG. 22  is a flow chart illustrating the process performed by the system of  FIG. 21 ; and  
         [0039]      FIGS. 23 and 24  are example broadcast programming presentations with an included script program. 
     
    
     DETAILED DESCRIPTION  
       [0040]     The present invention provides a system and method for remotely monitoring individuals and for increasing individual use of health programs. In a first embodiment of the invention, the individuals are patients and the system is used to collect data relating to the health status of the patients. However, it is to be understood that the invention is not limited to remote monitoring of patients. The system and method of the invention may be used for any type of remote monitoring and program adherence application. The invention may also be implemented as an automated messaging system for communicating information to individuals, as will be discussed in an alternative embodiment below.  
         [0041]     A first embodiment of the invention is illustrated in FIGS.  1 A and  2 - 12 . Referring to  FIG. 1 , a networked system  16  includes a server  18  and a workstation  20  connected to the server  18  through a communication network  24 . The server  18  is preferably a world wide web server and the communication network  24  is preferably the Internet. It will be apparent to one skilled in the art that the server  18  may comprise a single stand-alone computer or multiple computers distributed throughout a network. The workstation  20  is preferably a personal computer, remote terminal, or web TV unit connected to the server  18  via the Internet. The workstation  20  functions as a remote interface for entering in the server  18  messages and queries to be communicated to the patients.  
         [0042]     The system  16  also includes multiple remotely programmable apparatus, such as first and second apparatuses  26  for monitoring multiple patients. Each apparatus  26  is designed to interact with a patient in accordance with script programs received from the server  18 . Each apparatus  26  is in communication with the server  18  through the communication network  24 , preferably the Internet. Alternatively, each apparatus  26  may be placed in communication with the server  18  via wireless communication networks, cellular networks, telephone networks, satellite networks or any other network which allows each apparatus  26  to exchange data with the server  18 . It is to be understood that the system  16  may include any number of remotely programmable apparatuses for monitoring any number of patients.  
         [0043]     In the preferred embodiment, each patient to be monitored is also provided with a monitoring device  28 . The monitoring device  28  is designed to produce measurements of a physiological condition of the patient, record the measurements, and transmit the measurements to the patient&#39;s remotely programmable apparatus through a standard connection cable  30 . Examples of suitable monitoring devices  28  include blood glucose meters, respiratory flow meters, blood pressure cuffs, electronic weight scales, and pulse rate monitors. Such monitoring devices are well known in the art. The specific type of monitoring device  28  provided to each patient is dependent upon the patient&#39;s disease or health treatment needs. For example, diabetes patients are provided with a blood glucose meter for measuring blood glucose concentrations, asthma patients are provided with respiratory flow meters for measuring peak flow rates, obesity patients are provided with weight scales, etc.  
         [0044]      FIG. 2  shows the server  18 , the workstation  20 , and the apparatus  26  in greater detail. The server  18  includes a database  38  for storing script programs  40 . The script programs  40  are executed by each apparatus  26 , to communicate queries and messages to a patient, receive responses  42  to the queries, collect monitoring device measurements  44 , and to transmit responses  42  and measurements  44  to the server  18 . The database  38  is designed to store responses  42  and measurements  44 . The database  38  further includes a look-up table  46 . The table  46  contains a list of the patients to be monitored, and for each patient, a unique patient identification code and a respective pointer to one or more script programs  40  assigned to the patient. Each remotely programmable apparatus  26  is designed to execute assigned script programs  40  received from the server  18 . The script programs  40  may include queries, reminder messages, informational statements, useful quotations, or other information of benefit to the patient. See Appendix A for example script programs.  
         [0045]      FIGS. 3-4  show the structure of a remotely programmable apparatus  26  according to the preferred embodiment. Referring to  FIG. 3 , the apparatus  26  includes a housing  62 . The housing  62  is sufficiently compact to enable the apparatus  26  to be hand-held and carried by a patient. The apparatus  26  also includes a display  64  for displaying queries and prompts to the patient. In the preferred embodiment, the display  64  is a liquid crystal display (LCD).  
         [0046]     The apparatus  26  includes five user input buttons  70 A,  70 B,  70 C,  70 D and  70 E that are located on the same side of the apparatus  26  as the display  64 . The user input buttons  70 A-D are for entering in the apparatus  26  responses  42  to the queries and prompts. In the preferred embodiment, the user input buttons  70 A-D are momentary contact push buttons. In alternative embodiments, user input buttons  70 A-D may be replaced by switches, keys, a touch sensitive display screen, or any other data input device.  
         [0047]     The user input button  70 E is a emergency or other services button and is preferably red, but may be of any size, shape, or color that draws special visual or tactile attention to the user. The services provided by the user input button  70 E are described in more detail below.  
         [0048]     Three monitoring device jacks  68 A,  68 B, and  68 C are located on a surface of housing  62 . The device jacks  68 A-C are for connecting the apparatus  26  to a number of monitoring devices  28 , such as blood glucose meters, respiratory flow meters, or blood pressure cuffs (not shown in  FIG. 3 ). The apparatus  26  also includes a modem jack  66  for connecting the apparatus  26  to a telephone jack through a standard connection cord (not shown). The apparatus  26  further includes a visual indicator, such as a light emitting diode (LED)  74 . The LED  74  is for visually notifying the patient that he or she has unanswered queries stored in the apparatus  26 .  
         [0049]      FIG. 4  is a schematic block diagram illustrating the components of the apparatus  26  in greater detail. The apparatus  26  includes a microprocessor  76  and a memory  80  connected to the microprocessor  76 . The memory  80  is preferably a non-volatile memory, such as a serial EEPROM. The memory  80  stores script programs  40  received from the server  18 , measurements  44  received from the monitoring device  28 , responses  42  to queries. The microprocessor  76  also includes built-in read only memory (ROM), which stores firmware for controlling the operation of the apparatus  26 . The firmware includes a script interpreter used by the microprocessor  76  to execute the script programs  40 . The script interpreter interprets script commands, which are executed by the microprocessor  76 . Specific techniques for interpreting and executing script commands in this manner are well known in the art.  
         [0050]     The microprocessor  76  is preferably connected to memory  80  using a standard two-wire interface. The microprocessor  76  is also connected to the user input buttons  70 , the LED  74 , a clock  84 , and a display driver  82 . The clock  84  indicates the current date and time to the microprocessor  76 . For clarity of illustration, clock  84  is shown as a separate component, but is preferably built into the microprocessor  76 . The display driver  82  operates under the control of the microprocessor  76  to display information on the display  64 . The microprocessor  76  is preferably a PIC 16C65 processor. The modem  86  is connected to a telephone jack  22  through the modem jack  66 . The modem  86  is for exchanging data between the server  18  and the processor  76  through the communication network  24 . The data includes the script programs  40  which are received from the server  18  as well as the responses  42  to queries, the device measurements  44 , the script identification codes, and the patient&#39;s unique identification code, which the modem  86  transmits to the server  18 . The modem  86  is preferably a complete 28.8 K modem commercially available from Cermetek, although any suitable modem may be used. The processor  76  also includes a component that connects to the telephone jack  22  and a microphone  88  and a speaker  89 , thereby allowing telephone calls to be processed.  
         [0051]     The device interface  90  is connected to the device jacks  68 A,  68 B, and  68 C. The device interface  90  is for interfacing with a number of monitoring devices  28 , such as blood glucose meters, respiratory flow meters, blood pressure cuffs, weight scales, or pulse rate monitors, through device jacks  68 A-C.  
         [0052]     The device interface  90  operates under the control of the microprocessor  76  to collect measurements  44  from the monitoring devices  28  and to output the measurements to the microprocessor  76  for storage in the memory  80 . In the preferred embodiment, the interface  90  is a standard RS232 interface. For simplicity of illustration, only one device interface  90  is shown in  FIG. 4 . However, in alternative embodiments, the apparatus  26  may include multiple device interfaces to accommodate monitoring devices that have different connection standards.  
         [0053]     Referring again to  FIG. 2 , the server  18  includes a monitoring application  48 . The monitoring application  48  is a controlling software application executed by the server  18  to perform the various functions described below. The application  48  includes a script generator  50 , a script assignor  52 , and a report generator  54 . The script generator  50  is designed to generate the script programs  40  from script information entered through the workstation  20 . The script information is entered through a script entry screen  56 . In the preferred embodiment, script entry screen  56  is implemented as a web page on the server  18 . The workstation  20  includes a web browser for accessing the web page to enter the script information.  
         [0054]      FIG. 5  illustrates the script entry screen  56  as it appears on the workstation  20 . The screen  56  includes a script name field  92  for specifying the name of a script program to be generated. The screen  56  also includes entry fields  94  for entering a set of queries to be answered by a patient. Each entry field  94  has corresponding response choice fields  96  for entering response choices for the query. The screen  56  further includes check boxes  98  for selecting a desired monitoring device  28 , such as a blood glucose meter, respiratory flow meter, or blood pressure cuff, from which to collect measurements  44 .  
         [0055]     The screen  56  additionally includes a connection time field  100  for specifying a prescribed connection time at which each apparatus  26  executing the script is to establish a subsequent communication link to the server  18 . The connection time is preferably selected to be the time at which communication rates are the lowest, such as 3:00 AM. The screen  56  also includes a CREATE SCRI PT button  102  for instructing script generator  50  to generate a script program  40  from the information entered in screen  56 . The screen  56  further includes a CANCEL button  104  for canceling the information entered in screen  56 .  
         [0056]     In the preferred embodiment, each script program  40  created by script generator  50  conforms to the standard file format used on UNIX systems. In the standard file format, each command is listed in the upper case and followed by a colon. Every line in the script program  40  is terminated by a linefeed character {LF}, and only one command is placed on each line. The last character in the script program  40  is a UNIX end of file character {EOF}. Table 1 shows an exemplary listing of script commands used in the preferred embodiment of the invention.  
                         TABLE 1                           SCRIPT COMMANDS            Command   Description               CLS: {LF}   Clear the display.       ZAP: {LF}   Erase from memory the last set of query responses recorded.       LED: b{LF}   Turn the LED on or off, where b is a binary digit of 0 or 1. An argument           of 1 turns on the LED, and an argument of 0 turns off the LED.       DISPLAY: {chars}{LF}   Display the text following the DISPLAY command.       INPUT: mmmm {LF}   Record a button press. The m&#39;s represent a button mask pattern for           each of the four input buttons. Each m contains an “X” for disallowed           buttons or an “0” for allowed buttons. For example, INPUT: 0X0X{LF}           allows the user to press either button #1 or #3.       WAIT: {LF}   Wait for any one button to be pressed, then continue executing the           script program.       COLLECT: device{LF}   Collect measurements from the monitoring device specified in the           COLLECT command. The user is preferably prompted to connect the           specified monitoring device to the apparatus and press a button to           continue.       NUMBER: aaaa{LF}   Assign a script identification code to the script program. The script           identification code from the most recently executed NUMBER           statement is subsequently transmitted to the server along with the query           responses and device measurements. The script identification code           identifies to the server which script program was most recently           executed by the remote apparatus.       DELAY: t{LF}   Wait until time t specified in the DELAY command, usually the           prescribed connection time.       CONNECT: {LF}   Perform a connection routine to establish a communication link to the           server, transmit the patient identification code, query responses, device           measurements, and script identification code to the server, and receive           and store a new script program. When the server instructs the           apparatus to disconnect, the script interpreter is restarted, allowing the           new script program to execute.                  
 
         [0057]     The script commands illustrated in Table 1 are representative of the preferred embodiment and are not intended to limit the scope of the invention. After consideration of the ensuing description, it will be apparent to one skilled in the art many other suitable scripting languages and sets of script commands may be used to implement the invention.  
         [0058]     The script generator  50  preferably stores a script program template which it uses to create each script program  40 . To generate a script program  40 , the script generator  50  inserts into the template the script information entered in the screen  56 . For example,  FIGS. 6A-6B  illustrate a sample script program  40  created by the script generator  50  from the script information shown in  FIG. 5 .  
         [0059]     The script program  40  includes display commands to display the queries and response choices entered in fields  94  and  96 , respectively. The script program  40  also includes input commands to receive responses  42  to the queries. The script program  40  further includes a collect command to collect device measurements  44  from the monitoring device  28  specified in the check boxes  98 . The script program  40  also includes commands to establish a subsequent communication link to the server  18  at the connection time specified in field  100   FIG. 5 . The steps included in the script program  40  are also shown in the flow chart of  FIGS. 12A-12B  and will be discussed in the operation section below.  
         [0060]     Referring again to  FIG. 2 , the script assignor  52  is used to assign script programs  40  to the patients. The script programs  40  are assigned in accordance with script assignment information entered through workstation  20 . The script assignment information is entered through a script assignment screen  57 , which is preferably implemented as a web page on the server  18 .  
         [0061]      FIG. 7  illustrates a sample script assignment screen  57  as it appears on workstation  20 . The screen  57  includes check boxes  106  for selecting a script program  40  to be assigned, and check boxes  108  for selecting the patients to whom the script program is to be assigned. The screen  57  also includes an ASSIGN SCRIPT button  112  for entering the assignments. When button  112  is pressed, the script assignor  52  creates and stores for each patient selected in check boxes  108  a respective pointer to the script program  40  selected in the check boxes  106 . Each pointer is stored in the patient look-up table  46  of the database  38 . The screen  57  further includes an ADD SCRIPT button  110  for accessing the script entry screen and a DELETE SCRIPT button  114  for deleting a script program  40 .  
         [0062]     Referring again to  FIG. 2 , the report generator  54  is designed to generate a patient report  58  from the responses  42  and the device measurements  44  received in the server  18 . The patient report  58  is displayed on the workstation  20 .  FIG. 10  shows a sample patient report  58  produced by the report generator  54  for a selected patient. The patient report  58  includes a graph  116  of the device measurements  44  received from the patient, as well as a listing of the responses  42  received from the patient. Specific techniques for writing a report generator program to display data in this manner are well known in the art.  
         [0063]     The operation of the preferred embodiment is illustrated in  FIGS. 1-12 .  FIG. 11A  is a flow chart illustrating steps included in the monitoring application executed by the server  18 .  FIG. 11B  is a continuation of the flow chart of  FIG. 11A . In step  202 , the server  18  determines if new script information has been entered through the script entry screen  56 . If new script information has not been entered, the server  18  proceeds to step  206 . If new script information has been entered, the server  18  proceeds to step  204 .  
         [0064]     As shown in  FIG. 5 , the script information includes a set of queries, and for each of the queries, corresponding response choices. The script information also includes a selected monitoring device type from which to collect device measurements  44 . The script information further includes a prescribed connection time for each apparatus to establish a subsequent communication link to the server  18 . The script information is generally entered in the server  18  by a healthcare provider, such as the patients&#39; physician or case manager. Of course, any person desiring to communicate with the patients may also be granted access to the server  18  to create and assign script programs  40 . Further, it is to be understood that system  16  may include any number of remote interfaces for entering script generation and script assignment information in the server  18 .  
         [0065]     In step  204 , the script generator  50  generates a script program from the information entered in the screen  56 . The script program is stored in the database  38 . Steps  202  and  204  are preferably repeated to generate multiple script programs, e.g., a script program for diabetes patients, a script program for asthma patients, etc. Each script program corresponds to a respective one of the sets of queries entered through the script entry screen  56 . Following step  204 , the server  18  proceeds to step  206 .  
         [0066]     In step  206 , the server  18  determines if new script assignment information has been entered through the assignment screen  57 . If new script assignment information has not been entered, the server  18  proceeds to step  210 . If new script assignment information has been entered, the server  18  proceeds to step  208 . As shown in  FIG. 7 , the script programs are assigned to each patient by selecting a script program through check boxes  106 , selecting the patients to whom the selected script program is to be assigned through check boxes  108 , and pressing the ASSIGN SCRIPT button  112 . When button  112  is pressed, the script assignor  52  creates for each patient selected in the check boxes  108  a respective pointer to the script program selected in the check boxes  106 . In step  208 , each pointer is stored in the look-up table  46  of the database  38 . Following step  208 , the server  18  proceeds to step  210 .  
         [0067]     In step  210 , the server  18  determines if any of the apparatuses are remotely connected to the server. Each patient to be monitored is preferably provided with his or her own remotely programmable apparatus, which has the patient&#39;s unique identification code, stored therein. Each patient is thus uniquely associated with a respective one of the apparatuses. If none of the apparatuses is connected, the server  18  proceeds to step  220 . If an apparatus is connected, the server  18  receives from the apparatus the patient&#39;s unique identification code in step  212 . In step  214 , the server  18  receives from the apparatus  26  the query responses  42 , device measurements  44 , and script identification code recorded during execution of a previously assigned script program. The script identification code identifies to the server  18  which script program was executed by the apparatus to record the query responses  42  and device measurements  44 . The responses, device measurements, and script identification code are stored in the database  38 .  
         [0068]     In step  216 , the server  18  uses the patient identification code to retrieve from the table  46  the pointer to the script program assigned to the patient. The server  18  then retrieves the assigned script program from the database  38 . In step  218 , the server  18  transmits the assigned script program to the patient&#39;s remotely programmable apparatus through the communication network  24 . Following step  218 , the server  18  proceeds to step  220 .  
         [0069]     In step  220 , the server  18  determines if a patient report request has been received from the workstation  20 . If no report request has been received, the server  18  returns to step  202 . If a report request has been received for a selected patient, the server  18  retrieves from the database  38  the measurements  44  and query responses  42  last received from the patient, step  222 . In step  224 , the server  18  generates and displays the patient report  58  on the workstation  20 . As shown in  FIG. 10 , the report  58  includes the device measurements  44  and query responses  42  last received from the patient. Following step  224 , the server  18  returns to step  202 .  
         [0070]      FIGS. 12A-12B  illustrate the steps included in the script program executed by the apparatus  26 . Before the script program is received, the apparatus  26  is initially programmed with the patient&#39;s unique identification code and the script interpreter used by microprocessor  76  to execute the script program. The initial programming may be achieved during manufacture or during an initial connection to the server  18 . Following initial programming, the apparatus  26  receives from the server  18  the script program assigned to the patient associated with the apparatus  26 . The script program is received by the modem  86  through a first communication link and stored in the memory  80 .  
         [0071]     In step  302 , microprocessor  76  assigns a script identification code to the script program and stores the script identification code in the memory  80 . The script identification code is subsequently transmitted to the server  18  along with the query responses  42  and the device measurements  44  to identify to the server  18  which script program was most recently executed by apparatus  26 . In step  304 , the microprocessor  76  lights LED  74  to notify the patient that he or she has unanswered queries stored in the apparatus  26 . The LED  74  preferably remains lit until the patient answers the queries. In step  306 , the microprocessor  76  erases from the memory  80  the last set of query responses recorded.  
         [0072]     In step  308 , the microprocessor  76  prompts the patient by displaying on the display  64  “ANSWER QUERIES NOW? PRESS ANY BUTTON TO START”. In step  310 , the microprocessor  76  waits until a reply to the prompt is received from the patient. When a reply is received, the microprocessor  76  proceeds to step  312 . In step  312 , the microprocessor  76  executes successive display and input commands to display the queries and response choices on the display  64  and to receive responses to the queries.  
         [0073]      FIG. 8  illustrates a sample query and its corresponding response choices as they appear on the display  64  The response choices are positioned on the display  64  such that each response choice is located proximate a respective one of input buttons  70 A-D. In the preferred embodiment, each response choice is displayed immediately above a respective input button  70 A-D. The patient presses the button  70 A-D corresponding to his or her response. The microprocessor  76  stores each response in the memory  80 .  
         [0074]     In steps  314 - 318 , the microprocessor  76  executes commands to collect the device measurements  44  from a selected the monitoring device  28 . The script program specifies the selected monitoring device from which to collect the measurements. In step  314 , the microprocessor  76  prompts the patient to connect the selected monitoring device  28 , for example a blood glucose meter, to one of device jacks  68 A-C. A sample prompt is shown in  FIG. 9 . In step  316 , the microprocessor  76  waits until a reply to the prompt is received from the patient. When a reply is received, the microprocessor  76  proceeds to step  318 . In step  318 , the microprocessor  76  collects device measurements  44  from the monitoring device  28  through the interface  90 . The measurements  44  are stored in the memory  80 .  
         [0075]     In step  320 , the microprocessor  76  prompts the patient to connect the apparatus  26  to the telephone jack  22  so that the apparatus  26  may connect to the server  18  at the prescribed connection time. In step  322 , the microprocessor  76  waits until a reply to the prompt is received from the patient. When a reply is received, the microprocessor  76  turns off the LED  74  in step  324 . In step  326 , the microprocessor  76  waits until it is time to connect to the server  18 . The microprocessor  76  compares the connection time specified in the script program to the current time output by the clock  84 .  06 - 0632   
         [0076]     In step  328 , the microprocessor  76  establishes a subsequent communication link between the apparatus  26  and the server  18  through the modem  86  and the communication network  24 . If the connection fails for any reason, the microprocessor  76  repeats step  328  to get a successful connection. In step  330 , the microprocessor  76  transmits the device measurements  44 , query responses  42 , script identification code, and patient identification code stored in the memory  80  to the server  18  through the subsequent communication link. In step  332 , the microprocessor  76  receives through the communication network  24  a new script program from the server  18 . The new script program is stored in the memory  80  for subsequent execution by the microprocessor  76 . Following step  332 , the script program ends.  
         [0077]     One advantage of the monitoring system of the present invention is that it allows each patient to select a convenient time to respond to the queries, so that the monitoring system is not intrusive to the patient&#39;s schedule. A second advantage of the monitoring system is that it incurs very low communications charges because each remote apparatus connects to the server  18  at times when communication rates are lowest. Moreover, the cost to manufacture each remote the apparatus  26  is very low compared to personal computers or internet terminals, so that the monitoring system is highly affordable.  
         [0078]     A third advantage of the monitoring system is that it allows each apparatus  26  to be programmed remotely through script programs  40 . Patient surveys, connection times, display prompts, selected monitoring devices, patient customization, and other operational details of each apparatus  26  may be easily changed by transmitting a new script program  40  to apparatus  26 . Moreover, each script program  40  may be easily created and assigned by remotely accessing the server  18  through the Internet. Thus, the invention provides a powerful, convenient, and inexpensive system for remotely monitoring a large number of patients.  
         [0079]      FIGS. 13-15  illustrate a second embodiment of the invention in which each remotely programmable apparatus includes all of the functionality of the first embodiment described above while also including speech recognition and speech synthesis functionality.  FIG. 13  shows a perspective view of the remotely programmable apparatus  27  according to the second embodiment. The apparatus  27  includes a speaker  72  for audibly communicating queries and prompts to the patient. The apparatus  27  also includes a microphone  118  for receiving spoken responses to the queries and prompts. The apparatus  27  may optionally include a display  64  for displaying prompts to the patient, as shown in  FIG. 14 .  
         [0080]      FIG. 15  is a schematic block diagram illustrating the components of the apparatus  27  in greater detail. The apparatus  27  is similar in design to the apparatus  26  of the preferred embodiment except that the apparatus  27  includes an audio processor chip  120  in place of the microprocessor  76 . The audio processor chip  120  is preferably an RSC-164 chip commercially available from Sensory Circuits Inc. of 1735 N. First Street, San Jose, Calif. 95112.  
         [0081]     The audio processor chip  120  has a microcontroller  122  for executing script programs received from the server  18 . A memory  80  is connected to the microcontroller  122 . Memory  80  stores the script programs and a script interpreter used by the microcontroller  122  to execute the script programs. The memory  80  also stores measurements received from the monitoring device  28 , responses to the queries, script identification codes, and the patient&#39;s unique identification code.  
         [0082]     The audio processor chip  120  also has built in speech synthesis functionality for synthesizing queries and prompts to a patient through the speaker  72 . For speech synthesis, the chip  120  includes a digital to analog converter—(DAC)  142  and an amplifier  144 . The DAC  142  and the amplifier  144  drive the speaker  72  under the control of the microcontroller  122 .  
         [0083]     The audio processor chip  120  further has built in speech recognition functionality for recognizing responses spoken into the microphone  118 . Audio signals received through the microphone  118  are converted to electrical signals and sent to a preamp and gain control circuit  128 . The preamp and gain control circuit  128  is controlled by an automatic gain control circuit  136 , which is in turn controlled by the microcontroller  122 . After being amplified by the preamp  128 , the electrical signals enter the chip  120  and pass through a multiplexer  130  and an analog to digital converter (ADC)  132 . The resulting digital signals pass through a digital logic circuit  134  and enter microcontroller  122  for speech recognition.  
         [0084]     The audio processor chip  120  also includes a RAM  138  for short-term memory storage and a ROM  140 , which stores programs executed by the microcontroller  122  to perform speech recognition and speech synthesis. The chip  120  operates at a clock speed determined by a crystal  126 . The chip  120  also includes a clock  84  that provides the current date and time to the microcontroller  122 . As in the preferred embodiment, the apparatus  27  includes an LED  74 , display driver  82 , modem  86 , and device interface  90 , all of which are connected to the microcontroller  122 .  
         [0085]     The operation of the second embodiment is similar to the operation of the preferred embodiment except that queries, response choices, and prompts are audibly communicated to the patient through the speaker  72  rather than being displayed to the patient on the display  64 . The operation of the second embodiment also differs from the operation of the preferred embodiment in that responses to the queries and prompts are received through the microphone  118  rather than through user input buttons.  
         [0086]     The script programs of the second embodiment are similar to the script program shown in  FIGS. 6A-6B , except that each display command is replaced by a speech synthesis command and each input command is replaced by a speech recognition command. The speech synthesis commands are executed by the microcontroller  122  to synthesize the queries, response choices, and prompts through speaker  72 . The speech recognition commands are executed by the microcontroller  122  to recognize responses spoken into microphone  118 .  
         [0087]     For example, to ask the patient how he or she feels and record a response, the microcontroller  122  first executes a speech synthesis command to synthesize through the speaker  72  “How do you feel? Please answer with one of the following responses: very bad, bad, good, or very good.” Next, the microcontroller  122  executes a speech recognition command to recognize the response spoken into the microphone  118 . The recognized response is stored in the memory  80  and subsequently transmitted to the server. Other than the differences described, the operation and advantages of the second embodiment are the same as the operation and advantages of the preferred embodiment described above.  
         [0088]     Although the first and second embodiments focus on querying individuals and collecting responses to the queries, the system of the invention is not limited to querying applications. The system may also be used simply to communicate messages to the individuals.  FIGS. 16-19  illustrate a third embodiment in which the system is used to perform this automated messaging function. In the third embodiment, each script program contains a set of statements to be communicated to an individual rather than a set of queries to be answered by the individual Of course, it will be apparent to one skilled in the art that the script programs may optionally include both queries and statements.  
         [0089]     The third embodiment also shows how the queries and statements may be customized to each individual by merging personal data with the script programs, much like a standard mail merge application. As mentioned above, the individual may be identified for selection of individualized information either through an individual identification code associated with the remote apparatus  26  and stored in memory  80 . Referring to  FIG. 16 , personal data relating to each individual is preferably stored in the look-up table  46  of the database  38 . By way of example, the data may include each individual&#39;s name, the name of each individual&#39;s physician, test results, appointment dates, or any other desired data. As in the preferred embodiment, the database  38  also stores generic script programs  40  created by the script generator  50 .  
         [0090]     The server  18  includes a data merge program  55  for merging the data stored in table  46  with generic script programs  40 . The data merge program  55  is designed to retrieve selected data from table  46  and to insert the data into statements in generic script programs  40 , thus creating custom script programs  41 . Each custom script program  41  contains statements that are customized to an individual. For example, the statements may be customized with the individual&#39;s name, test results, etc. Examples of such customized statements are shown in  FIGS. 17-18 .  
         [0091]     The operation of the third embodiment is similar to the operation of the preferred embodiment except that the script programs are used to communicate messages to the individuals rather than to query the individuals. Each message is preferably a set of statements. Referring to  FIG. 19 , the statements may be entered in the server  18  through the script entry screen  56 , just like the queries of the preferred embodiment.  
         [0092]     Each statement preferably includes one or more insert commands specifying data from table  46  to be inserted into the statement. The insert commands instruct the data merge program  55  to retrieve the specified data from the database  38  and to insert the data into the statement. For example, the insert commands shown in  FIG. 19  instruct the data merge program  55  to insert a physician name, an appointment date, a patient name, and a test result into the statements. As in the preferred embodiment, each statement may also include one or more response choices, which are entered in fields  96 .  
         [0093]     Following entry of the statements and response choices, CREATE SCRIPT button  102  is pressed. When the button  102  is pressed, the script generator  50  generates a generic script program from the information entered in the screen  56 . The generic script program is similar to the script program shown in  FIGS. 6A-6B , except that the display commands specify statements to be displayed rather than queries. Further, the statements include insert commands specifying data to be inserted into the script program. As in the preferred embodiment, multiple script programs are preferably generated, e.g., a generic script program for diabetes patients, a generic script program for asthma patients, etc. The generic script programs are stored in the database  38 .  
         [0094]     Following generation of the generic script programs, the server  18  receives script assignment information entered through the script assignment screen  57 . As shown in  FIG. 7 , the script programs are assigned by first selecting one of the generic script programs through the check boxes  106 , selecting individuals through the check boxes  108 , and pressing the ASSIGN SCRIPT button  112 . When the button  112  is pressed, the data merge program  55  creates a custom script program  41  for each individual selected in check boxes  108 .  
         [0095]     Each custom script program  41  is preferably created by using the selected generic script program as a template. For each individual selected, the data merge program  55  retrieves from the database  38  the data specified in the insert commands. Next, the data merge program  55  inserts the data into the appropriate statements in the generic script program  40  to create a custom script program  41  for the individual. Each custom script program  41  is stored in the database  38 .  
         [0096]     As each custom script program  41  is generated for an individual, the script assignor  52  assigns the script program  41  to the individual. This is preferably accomplished by creating a pointer to the custom script program and storing the pointer with the individual&#39;s unique identification code in the table  46 . When the individual&#39;s remotely programmable apparatus connects to the server  18 , the server  18  receives from the remotely programmable apparatus  26  the individual&#39;s unique identification code. The server  18  uses the unique identification code to retrieve from the table  46  the pointer to the custom script program assigned to the individual. Next, the server  18  retrieves the assigned script program from the database  38  and transmits the script program to the individual&#39;s remotely programmable apparatus  26  through the communication network  24 .  
         [0097]     The apparatus receives and executes the script program. The execution of the script program is similar to the execution described in the preferred embodiment, except that statements are displayed to the individual rather than queries.  FIGS. 17-18  illustrate two sample statements as they appear on the display  64 . Each statement includes a response choice, preferably an acknowledgment such as “OK”. After reading a statement, the individual presses the button  70 A-D corresponding to the response choice to proceed to the next statement. Alternatively, the script program may specify a period of time that each statement is to be displayed before proceeding to the next statement. The remaining operation of the third embodiment is analogous to the operation of the preferred embodiment described above.  
         [0098]     Although it is presently preferred to generate a custom script program  41  for each individual as soon as script assignment information is received for the individual, it is also possible to wait until the individual&#39;s apparatus  26  connects to the server  18  before generating the custom script program  41 . This is accomplished by creating and storing a pointer to the generic script program  40  assigned to the individual, as previously described in the preferred embodiment. When the individual&#39;s apparatus  26  connects to the server  18 , the data merge program  55  creates a custom script program  41  for the individual from the generic script program  40  assigned to the individual. The custom script program  41  is then sent to the individual&#39;s apparatus  26  for execution.  
       ALTERNATE EMBODIMENTS  
       [0099]     In an alternate embodiment, when the user or patient (the terms user and patient are used interactively) activates the user input button  70 E (hereinafter the red button) a command signal is sent to the processor  76 . The processor  76  dial a preset phone number according to the command signal. The preset phone number is that of an answering service at the server  18  or at a workstation  20 . The answering service identifies the patient or user associated with the remote apparatus  26  that generated the call based on an identifier sent with the call and user information stored in memory in the database (similar to caller ID). The system (server  18  or workstation  20 ) that receives the call then retrieves patient information with previous patient/user responses stored at the server&#39;s database  38 , within memory at the workstation  20 , or at some other remotely located storage site. The retrieved patient information is displayed to a live person who is in telephonic communication with the patient. This allows the patient to be placed in immediate contact with a person who has displayed before them the patient&#39;s personal health information or other patient historical information. The person receiving the call provides effective communication with the patient, because of the ability to view pertinent information.  
         [0100]     In an alternate embodiment, an automated answering service is the recipient of the call made by the remote apparatus  26 . The automated answering service asks a series of questions according to the retrieved patient information in order to triage the patient toward different actions depending upon the situation. The patient information also includes previous patient interactions with the automated answering service.  
         [0101]     The system receiving the call process patient responses according to the content associated with the question asked. Content is one of the following categories: symptoms; behavior; knowledge. The categories include such things as requests for service or product orders. In one example, the automated answering service asks “do you have difficulty breathing? press the red button if you are.” If the patient then presses the red button, the call is forwarded to a case manager or a nurse on call.  
         [0102]     In another example, red button selection is associated with a request for service. When the red button is pressed, the automated answering service asks “do you need someone to change your bed? press the red button if yes.” If the patient presses the red button, a home care agency coordinating ancillary daily activity services is notified or is forwarded the call. Other service companies, such as transport companies or concierge service companies, are other possible recipients of forwarded calls depending what actions are available to the patients.  
         [0103]     The automated answering service is dynamically adaptable based on previous interactions with the automated answering service. For example, the past couple of times the patient activated the red button and answered the question(s), the patient was connected to an emergency health care worker. If the worker determined through review questions of the patient&#39;s present condition, maybe information generated by the monitoring device sent over the network  24  to a workstation operated by the worker, and retrieved patient information that no emergency existed, the worker records this situation into the patient&#39;s records. If the patient&#39;s record includes a number of false alarms that exceed a predetermined limit over a period of time, the automated answering service reprograms itself so that the next time the patient activates the red button the patient is directly connected to a live person that is designated for non-emergency patient interaction or to other questions that direct the patient to the person designated for non-emergency patient interaction. This frees-up emergency healthcare workers from dealing with someone who has a history of not needing their expertise.  
         [0104]      FIGS. 20 and 21  illustrate alternate embodiments of the invention illustrated in  FIG. 1 . In  FIG. 20 , the remote apparatus  26  is a personal computer including a processor and a user interface, e.g., display, keyboard, mouse, or other input and output devices (not all shown), that receives the script program, processes the script program and presents the script program for user interaction. For example, the script program requires that the personal computer present an image of a stand-alone remote apparatus  350 , such as the Health Buddy™, produced by Health Hero Network, Inc., on the display. The user then interacts with the displayed image of the stand-alone remote apparatus by operating the user interface(s) of the personal computer to select displayed responses. The displayed image of the stand-alone remote apparatus presents a virtual image with the same functionality as the apparatuses  26  and  27 , as described above in  FIGS. 3 and 13 . It can be appreciated to those of ordinary skill in the art that the system of  FIG. 20  provides all or part of the functionality of the apparatuses shown in  FIGS. 3 and 13 , but does it on a personal computer.  
         [0105]      FIG. 21  includes all the components of the  FIG. 1  and a digital television network  36  in communication with the server  18  and the remote apparatus  26 . The remote apparatus  26  of  FIG. 21  is an interactive television system that includes a processing unit  33 , such as a satellite broadcast receiving, set-top processor with OpenTV signal processing software, a display  34 , such as a television set, and a user interface  35 , such as a remote control. The remote apparatus  26 , through the processing unit  33 , is coupled to the communication network  24 , the digital television network  36  and the monitoring device  28 .  
         [0106]     The processing unit  33  includes a CPU, memory and embedded software for receiving and processing both digital entertainment and advertisement content and digital script programs. Also, the processing unit  33  allows the user to view the entertainment and advertisement content, such as television programming, and interact with (i.e., respond to) the script programs. The script program(s) sent from the server  18  are viewable on the display  34  as they would appear on the display  64  of apparatus  26  or are viewed on a portion of the display  34 . For example, the question with options shown in  FIG. 8  would appear on the display  34 . The user makes a selection of one of the choices by using the user interface  35 , i.e., giving voice commands that are processed by a voice recognition system, controlling and activating a cursor, etc. Example methods of making a selection are to control a cursor icon on the display screen of the display  34  and activate the cursor icon when it is co-located with one of the choices, to assign different keyboard keys are designated as a different one of the displayed choices. Another method is to have the user interface include voice actuation software for processing user voice commands that request selection of a desired choice.  
         [0107]     With respect to this invention, a “broadcast” includes any form of delivering the content from a source to many viewers, including transmission over the airwaves or via cable, the Internet, a closed-circuit network, or other means of communication. A “broadcast” does not require multiple persons to watch at once, but rather can include multiple individual and independent viewings, such as in the form of video on demand or access to web pages. Moreover, the term “broadcast” may include a single tailored transmission from a source to a single intended viewer. Accordingly, while a “broadcast” may include a transmission from one point to multiple recipients, it is not limited to that case. Likewise, with respect to this invention, a “broadcast” is “transmitted” in any of the above forms.  
         [0108]     The processing unit  33  is a multimedia processor that receives transmitted broadcast programs from a digital broadcast network  36  via a communication link, such as a satellite or cable link. The processing unit  33  also transmits as well as receives data via the communication network  24 . In addition, the multimedia processor has expansion ports to support additional user interface and other devices, such as keyboards, joysticks, trackballs, and to accept add-on circuits for enhanced sound, video, or processing performance.  
         [0109]      FIG. 22  is an example for illustrative purposes only of a method for increasing user use of script programs by allowing the user to quickly access the script program during viewing of an entertainment or advertisement program in an interactive TV system.  FIG. 22  illustrates a process performed by the system shown in  FIG. 21 . At block  400 , the server  18  generates an interactive script program. In an alternate embodiment, the script program is fully or partially created at another remotely coupled computer, such as workstation  20 , and added to multimedia content, then the script program and multimedia content is sent to the server  18  In one embodiment, the script program is specialized for a specific user according to a health care professional request or to a predefined health regimen based on user profile information. In an alternate embodiment the script program is generated in relation to entertainment or advertisement content that it will later be broadcasted with. Next, at block  402 , the generated script program is combined with digitally produced entertainment or advertisement content, i.e., a multimedia presentation, to create digital broadcast programming. The digital broadcast programming is then broadcasted or transmitted over the chosen communication link, block  406 . At block  408 , the processing unit  33  receives and processes the digital broadcast programming then presents the entertainment or advertisement content and the script program. The processing unit  33  as directed by software instructions previously imbedded in the processing unit  33 , included with the digital broadcast programming or a combination of both processes the digital broadcast programming by determining its content and how that content is to be presented on the display  34 . For example, the processing unit  33  determines if the script program is to be referenced by an icon over the entertainment content or displayed on a portion of the display with the entertainment content. As part of the presentation from block  408  the user is informed of any script program included in the broadcast programming, block  410 . Then, at block  426 , the user is presented with the script program after the user selects or activates the indication, e.g., an icon. Lastly, at block  428 , the user interacts with the script program by responding to any queries and inputting any requested measurements or other responses. The interaction with the script program is similar to that described above for the system of  FIG. 1 . In another embodiment, the script program is presented in conjunction with the entertainment or advertisement content without requiring the user to select or activate an indicator.  
         [0110]      FIGS. 23 and 24  are example images presented on the displays  34  in the system illustrated in  FIG. 22 .  FIG. 23  illustrates a screen shot of a broadcast program  250  that includes entertainment content  252 , such as a video program on heart surgery, and an icon  254 . The icon  254  indicates that a script program is available for the viewer. In order for the viewer to access the script program, the viewer selects the icon  254 . The program broadcasted from the broadcast network  24  may have included an entire script program or just a portion of a script program. If the entire script program were included with the broadcast, selection of the icon  254  would begin execution of the script program that was received. However, if only a portion of the script program was received and, for example, that portion only required that the icon  254  be displayed with the entertainment content  252 , selection of the icon  254  sends a signal through a back channel, i.e., the link to the communication network  24 , to the server  18 . The sent signal is a request for the rest of or just more of the script program to be sent to the apparatus  26  either through broadcast network  36  or communication network  24 .  
         [0111]      FIG. 24  illustrates a screen shot of a broadcast program  250  that includes entertainment content  252  and a section that presents a script program image  256 . In this example the viewer can interact with the script program image  256  while simultaneously viewing the entertainment content  252 . As in  FIG. 22  above, the script program may be fully or partially received and processed by the processing unit  33 . And again, if it has only been partially received, viewer interaction at a predetermined spot in the displayed interaction process automatically initiates a request through the back channel to the server  18  for the rest of the script program.  
         [0112]     Because the broadcast program  250  is a digital broadcast, it can be readily appreciated by those of ordinary skill in the art of digital interactive television, that the entertainment content may be paused until viewer completion of the script program. The script program which can be sent with an initial broadcast program or during presentation of a previously delivered broadcast program that is being presented on the display may also include instructions to pause the entertainment content until viewer completion of the script program at which time the entertainment program resumes. For example, the viewer&#39;s/patient&#39;s doctor creates a message at the workstation  20  requesting that the patient as soon as possible send blood pressure measurement readings. This message is generated as a new script program at the server  18 . The server  18  then sends the new script program to the broadcast network  36 . The broadcast network  36  includes hardware and/or software mechanisms for saving the new script program for inclusion with the next patient requested entertainment or advertisement content to be sent to the patient in the case where the patient is not presently viewing a broadcast from the broadcast network  36  or for just broadcasting the script program alone. If the patient is presently viewing entertainment or advertisement content received from the broadcast network  36 , the new script program is received, processed and presented to the patient by the apparatus  26 . The received new script program may include instructions to pause the presently viewed entertainment or advertisement content.  
         [0113]     If the script program is specified for a particular patient, the server  18  or broadcast network  36  encodes the script program for that patient. The apparatus of that patient includes a decoding component within the processing unit  33  for decoding the encoded script program received with the broadcast program. For example, the script program includes a weight history chart of the patient. The present invention wants only the patient corresponding to this weight history chart to have viewing access. Therefore, it is encoded for transmission and encoded only by the corresponding patient&#39;s apparatus  26 .  
         [0114]     It can be appreciated to one of ordinary skill in the art that this decision, as with the other flow diagram decisions, can be an inherent decision in the processing of the received entertainment/advertisement programming and script program.  
         [0115]     The embodiments of  FIGS. 20 and 21  may also be implemented without any entertainment or advertisement content and perform the functions as to those that illustrated and described for  FIG. 1 .  
         [0116]     The script programs or entertainment/advertisement programming can be designed for education and training of users. For example, the script program or information content could show a user, such as a patient, how to effectively use a medical treatment device. Also, the script program or information content could describe to users, such as doctors, nurses or anyone other professional, different treatment styles, plans or new medication.  
         [0117]     A wide variety of information may be collected, delivered and analyzed in accordance with the present invention. For example, abandoned U.S. patent application Ser. No. 09/378,188 which is a continuation of U.S. Pat. No. 5,985,559, and unassigned U.S. Patent Application attorney docket No. HERO-1-1089 which is a continuation of U.S. patent application Ser. No. 09/041,809 (the text of which are hereby incorporated by reference) discusses information related to disease causes, treatments, and cures. Script programs include a set of queries for requesting data on lifestyle, environment, behavior, drug compliance, drug response over time, and other aspects. This data is then analyzed to identify trends and establish subgroups with similar responses.  
         [0118]     Individuals&#39; behavioral and environmental information in conjunction with their gene sequence information is analyzed to find drug candidates and drug targets. Individuals previously designated as having a high risk for developing a particular disease are each given an apparatus  26 . Queries related to the individuals&#39; behavior and environment are included in a script program sent from a server  18  to the apparatus  26  or from a server  18  to the apparatus  26  through a broadcast network  36 . The individuals&#39; responses are sent back to the server  18 . The process of collecting individuals&#39; information can take place over a long period of time to ensure accurate data and to allow researchers to observe progression of the disease. A data mining program on the server analyzes the individuals&#39; behavioral and environmental information, as well as their gene sequence information. Differences in gene sequence information, or in behavioral and environmental factors between individuals who show a severe disease phenotype and those who show a mild severe disease phenotype can then be distinguished and used to develop new drug candidates, targets, or general treatments.  
         [0119]     Genetic testing allows an individual to determine whether or not he or she has a predisposition to a certain disease. The degree of expressivity of a certain disease will be determined in part by an individual&#39;s environment and lifestyle. The environment and lifestyle information is retrieved from responses to queries sent from the server  18  to the apparatus  26  or from the server  18  to the apparatus  26  through the broadcast network  36 . The present invention interprets a patient&#39;s gene sequence information and his or her environment and lifestyle to come up with a personalized prognosis. This procedure can be repeated many times over the course of a disease state to monitor a patient&#39;s condition. In addition, disease-causing pathogens can also have their genes sequenced. Using these sequences in combination with information about a patient&#39;s environment and lifestyle, the present invention comes up with a personalized treatment plan, ideally to eliminate the pathogen. It is also possible to use the procedure described above to monitor the course of the disease-state produced by a pathogen. Finally, a genotype-to-phenotype map or database can be constructed for developing better treatments and aiding in research.  
         [0120]     Although the above description contains many specificities, these should not be construed as limitations on the scope of the invention but merely as illustrations of some of the presently preferred embodiments. Many other embodiments of the invention are possible. For example, the scripting language and script commands shown are representative of the preferred embodiment. It will be apparent to one skilled in the art many other scripting languages and specific script commands may be used to implement the invention.  
         [0121]     Moreover, the invention is not limited to the specific applications described. The system and method of the invention have many other applications both inside and outside the healthcare industry. For example, pharmaceutical manufacturers may apply the system in the clinical development and post marketing surveillance of new drugs, using the system as an interactive, on-line monitoring tool for collecting data on the efficacy, side effects, and quality of life impact of the drugs. Compared to the current use of labor-intensive patient interviews, the system provides a fast, flexible, and cost effective alternative for monitoring the use and effects of the drugs.  
         [0122]     The system may also be used by home healthcare companies to enhance the service levels provided to customers, e.g., panic systems, sleep surveillance, specific monitoring of disease conditions, etc. Alternatively, the system may be used to monitor and optimize the inventory of home-stationed health supplies. As an example, the system may be connected to an appropriate measuring device to optimize timing of oxygen tank delivery to patients with chronic obstructive pulmonary disease (COPD).  
         [0123]     The system and method of the invention also have many applications outside the healthcare industry. For example, the system may be used for remote education over the Internet, facilitating educational communication with children or adult trainees who lack access to sophisticated and expensive computer equipment. The system may also be used by law enforcement officers to perform on-line surveillance of individuals on probation or parole.  
         [0124]     In an alternate embodiment, the software and hardware components of any one of the remote apparatuses  26  or  27  are incorporated directly into a monitoring device. This allows a patient to only have to interact with one device for their entire health monitoring needs.  
         [0125]     Further, the invention has numerous applications for gathering data from remotely located devices. For example, the system may be used to collect data from smart appliances, such as identification check systems. Examples of appliances that are used as smart appliances are refrigerator, telephone, stove, clock radio, VCR, or any other electrical or non-electrical device including the monitoring device  28 . The smart appliance includes some or all of the components of the remote apparatuses  26  or  27  as illustrated in  FIGS. 4 and 15 . The smart appliance with the necessary hardware or software components provides all the interactive capabilities described and shown for remote apparatuses  26  or  27 , see  FIGS. 8-12 ,  14 ,  17  and  18 . In one embodiment, the assigned scripts are in the form of a recorded voice that is sent over the communication network (e.g., voice over IP) to the appliance or remote apparatus. Also, the user responds to the voice scripts through activation of buttons according to instructions in the voice scripts or by verbally responding to the voice scripts. The verbal responses by the user are sent to the server or workstation over the communication network (e.g., voice over I P). The server or workstation includes a voice recognition component for interpreting the user&#39;s verbal responses, records the response and determines the next question or request (verbal or otherwise) to be sent to the user according to the responses. Live voice communication is also possible between the remote apparatus and the server or workstation over the communication network.  
         [0126]     Also, the monitoring device includes a communication component for allowing the monitoring device to send data directly to the server  18 . The server  18  then sends the monitoring device data to the patient&#39;s smart appliance for display to the patient. In an alternate additional setup, the monitoring device sends the data to the smart apparatus.  
         [0127]     Alternatively, the system may be applied to the remote monitoring of facilities, including safety and security monitoring, or to environmental monitoring, including pollution control and pipeline monitoring. Many other suitable applications of the invention will be apparent to one skilled in the art.  
         [0128]     Therefore, the scope of the invention should be determined not by the examples given, but by the appended claims and their legal equivalents.