Abstract:
A networked system for remotely determining the health status of an individual or a plurality of individuals and to remotely communicate intervention protocols to an individual or a plurality of individuals using microprocessor controlled communication devices.

Description:
PRIORITY CLAIM  
       [0001]    This application claims the benefit of U.S. provisional patent application serial No. 60/379,330, filed May 8, 2002, which is hereby incorporated by reference. 
     
    
     
       FIELD OF THE INVENTION  
         [0002]    This invention relates generally to remote health monitoring systems, as applied to patients and health care providers to establish an easy deployable, proactive patient management and communication platform to timelier monitor and manage patient disease. In particular, the invention relates to a multi-user remote health monitoring system that is capable of reliably identifying and interactively querying patients, healthcare providers, and healthcare analysts across remote systems to ascertain current health status of patients and to timely communicate health maintenance and treatment related information to the patient.  
         BACKGROUND OF THE INVENTION  
         [0003]    In the traditional, treatment-based model of care, patients only interact with their care providers at scheduled appointments, or when their health status has deteriorated to the point of necessitating a trip to the emergency room or hospital. The patient&#39;s deteriorated health status results in a more expensive treatment and time-consuming recovery. This is particularly true with demographic analyses showing how aging populations exhibit a major drain of health care resources as chronic diseases manifests by more visits to doctors offices, clinics, hospitals, and emergency rooms. Furthermore, all population groups, the young, middle-age, and the elderly, face new health threats including increased drug resistance to mutating infectious agents, and the looming threat of bioterrorism based events. Finally, diminishing government support to Medicare and Medicaid stresses the importance of having a remote monitoring and data management platform to rapidly identify patient disease and offer timely medical interventions to minimize individual patient health deterioration and to limit the deterioration of health in population groups.  
           [0004]    Critical gaps exist in our nation&#39;s ability to anticipate, detect and respond to epidemics that may be ‘natural’ or that which may be attributed to bioterrorism due to ineffective disease surveillance and fragmented information systems. Federal, state, and local agencies urgently need (i) surveillance capabilities to accelerate time-to-detection and monitor preparedness at the local level, and (ii) integrated information solutions that enable rapid statistical analyses and facilitate investigations.  
           [0005]    Surveillance systems should monitor the health of the population in real time and on a continuous basis. Many medical conditions offer only a brief window between diagnosis and treatment. In addition, many infectious diseases, for example, anthrax, cannot be successfully treated once the condition has become advanced but can be treated if caught early. Thus, the window of time during which effective intervention is possible can be very narrow.  
           [0006]    In order to facilitate rapid responses, surveillance systems must be capable of monitoring information on an ongoing basis. In order to intervene successfully to acute and chronic medical conditions and to prevent the onset of new ones requires the existence of a health surveillance system capable of providing a continuous, real-time (or as near real-time as possible), and accurate overview of a population&#39;s health.  
         SUMMARY OF THE INVENTION  
         [0007]    The invention presents a networked system for remotely identifying, querying and monitoring the health related parameters of a plurality of individuals who are homebound, at healthcare facilities and their respective healthcare providers, by a two-way multiple cross platform communication system. The system includes a server and a workstation for entering into the server query sets to be answered by the individuals using personal digital assistants (PDA) based computers, laptop computers, desktop computers, and cellular telephones. The server is preferably a World Wide Web server and the workstation is preferably a personal computer or network terminal connected to the web server via a secure Internet connection. The system also includes a remotely programmable apparatus for identifying and interacting with the individuals. The remotely programmable apparatus is connected to the server via a communication network, preferably a secure Internet connection. The remotely programmable apparatus interacts with the individuals in accordance with script programs received from the server.  
           [0008]    The server includes a script generator for generating script programs from the query sets, which are entered through a client station. The script programs are developed at the client station and deployed across the multi platform network. The scripts are reconfigurable and responsive to incoming answers executed by the microprocessor-based remotely programmable apparatuses, PDAs, computers, and cellular telephones. The client station communicates the query sets to the individuals, receives responses to the query sets, and to transmits the responses from the remotely programmable apparatus to the server. The server includes a database connected to the script generator for storing the script program, and the responses to the queries. The database also stores a list of individuals or individual types, and for each individual or individual type, has a pointer to at least one script program. The server also has a report generator, an analytical engine that can retrieve stored responses and other information from the database, follow up on specific bits of information that fulfills certain criteria as determined by the operator, organize and numerically manipulate the dataset for the purpose of analysis, and represent the information contained therein in a pictorial form, such as a graph or chart, etc.  
           [0009]    The remotely programmable apparatus has a communication device, such as a modem, for receiving the script programs from the server and for transmitting the responses to the server. The remotely programmable apparatus also has a user interface for communicating the query sets to the individuals and for receiving the responses to the query sets. In the preferred embodiment, the user interface includes a display for displaying the query sets and user input buttons for entering the responses to the query sets.  
           [0010]    The remotely programmable apparatus also includes a memory for storing the script programs and the responses to the query sets. The remotely programmable apparatus further includes a microprocessor connected to the communication device, the user interface, and the memory. The microprocessor executes the script programs to identify the individual, communicate the query sets to the individual, receive the responses to the query sets, and transmit the responses to the server through the communication network.  
           [0011]    In one preferred embodiment, the system also includes at least one monitoring device for producing measurements of a health condition or parameter of a patient and for transmitting the measurements to the apparatus. The monitoring device can also be used to help the remotely programmable apparatus identify the individual operator. The remotely programmable apparatus includes a device interface connected to the microprocessor for receiving the measurements and information from the monitoring device. The measurements are stored in the memory and transmitted to the server along with the operator&#39;s identity and the responses to the query sets. The server also preferably includes a report generator connected to the database for generating a report of the measurements and responses. The report is displayed on the workstation.  
           [0012]    In another preferred embodiment, the system includes a monitoring application that is capable of acquiring data (responses and measurements) from either the remote apparatus or the database and use this data to select another script to be sent to one or more monitoring devices, not necessarily the one from which it received the said data, according to criteria that have been established in advance by the public health workers and/or healthcare providers.  
           [0013]    As the present invention has multi-user capabilities, it is able to identify each individual or individual type in order to select the correct script program. In one preferred embodiment, the individual can enter his or her unique identification code into the remotely programmable apparatus. The code is sent to the server and used to determine which script program to send back to the apparatus.  
           [0014]    In another preferred embodiment, the system uses a data card, which contains information about an individual&#39;s identity. The remotely programmable apparatus includes a data card reader in which the data card can be placed and read. A personal identification number (PIN) can also be used in conjunction with the data card in order confirm an individual&#39;s identity. In this preferred embodiment, the present invention resembles an ATM machine.  
           [0015]    The system of the present invention can also identify an individual by intercepting data from a separate information system. Data sent from a server of the separate information system to a printer can pass through the remotely programmable apparatus, which can identify the individual and send the data to the server of the present invention. Data passing through the remotely programmable apparatus can also trigger a script program, which can display queries for the individual to answer, or send information to the printer to be printed. An example of this preferred embodiment has the remotely programmable apparatus located in series between an information system server and an information system printer. Alternatively, this data can also include that entered on the keyboard, that which is stored in the RAM, or that which is stored in a given set of files or a folder information system server. In any case, the data is captured by a software program and analyzed using the same set of rules as that above, to trigger a script on the apparatus.  
           [0016]    In addition, the system would also have the capability of collecting data from a range of sources, such as Interactive Voice Response Systems, Internet based forms, wireless devices and the invention enabled monitoring appliances, and integrating the above data into the database, after conversion into the standardized format.,  
           [0017]    Furthermore, the server has multiple software programs to establish remote patient education; health condition data stratification; psychological diagnostic assessments and interventions; health behavior rewards and incentives; integration of health and entertainment media; disease modeling and predictive algorithms, including diabetes, cardiovascular, respiratory, weight loss, fitness, stress, smoking cessation, and mental health; content filtering systems and methods,  
           [0018]    Finally, the data analysis, methods, criteria for data segregation, and techniques and methods to automate several of the functions of the operator, in order to achieve quicker response times, reduced administration costs and reduction in the possibility of errors are described. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0019]    [0019]FIG. 1 is a block diagram of a networked system according to a preferred embodiment of the invention.  
         [0020]    [0020]FIG. 2 is a block diagram illustrating the two-way interaction of the components of the system of FIG. 1.  
         [0021]    [0021]FIG. 3 is a block diagram of a preferred embodiment where a plurality of remotely programmable apparatuses communicate to a client station via an Internet server;  
         [0022]    [0022]FIG. 4 is a diagram illustrating the remotely programmable device as used for chronic care of a patient in a home setting;  
         [0023]    [0023]FIG. 5 is a diagram illustrating the remotely programmable device as used for health surveillance in a hospital;  
         [0024]    [0024]FIG. 6 is an illustration of script entry inputs to a mobile or cellular phone;  
         [0025]    [0025]FIG. 7 is an illustration of digital screen shots in a preferred embodiment of the invention using digital-based or Web television;  
         [0026]    [0026]FIG. 8 is an illustration of medical devices in communicating with the remotely programmable device;  
         [0027]    [0027]FIG. 9 is a home screen shot as would appear on the client station preferred embodiment of the invention;  
         [0028]    [0028]FIG. 10 is screen shot of patient work list as would appear on the client station preferred embodiment of the invention;  
         [0029]    [0029]FIG. 11 is a screen shot of a patient results report as would appear on the client station preferred embodiment of the invention;  
         [0030]    [0030]FIG. 12 is a screen shot of a trend report as would appear on the client station preferred embodiment of the invention;  
         [0031]    [0031]FIG. 13 is a screen shot of patients&#39; notes as would appear on the client station preferred embodiment of the invention;  
         [0032]    [0032]FIG. 14 is a screen shot of a trend report of an individual patient as would appear on the client station preferred embodiment of the invention;  
         [0033]    [0033]FIG. 15 is a screen shot of a survey questionnaire to an individual patient as appearing on the patient&#39;s personal computer in a web-preferred embodiment of the invention;  
         [0034]    [0034]FIG. 16 is a screen shot of a trend chart to an individual patient as appearing on the patient&#39;s personal computer in the web-preferred embodiment of the invention;  
         [0035]    [0035]FIG. 17 is a screen shot of a “view my results” report as appearing on the patient&#39;s personal computer in the web-preferred embodiment of the invention;  
         [0036]    [0036]FIG. 18 is a screen shot of a “Special Report” as appearing on the patient&#39;s personal computer in the web-preferred embodiment of the invention;  
         [0037]    [0037]FIG. 19 is a screen shot of a “Trends-Weight Control” as appearing on the patient&#39;s personal computer and the client station in the web-preferred embodiment of the invention;  
         [0038]    [0038]FIG. 20 is a screen shot of a “Trends-Rhythm Strip” as appearing on the patient&#39;s personal computer and the client station in the web-preferred embodiment of the invention; and  
         [0039]    [0039]FIG. 21 is a screen shot of a “Trends-Blood Pressure and Pulse” as appearing on the patient&#39;s personal computer and the client station in the web-preferred embodiment of the invention. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0040]    This application incorporates by reference, in their entirety as though set forth fully herein, each of the applications listed below:  
         [0041]    U.S. patent application Ser. No. 10/356,720 filed Jan. 30, 2003.  
         [0042]    U.S. patent application Ser. No. 10/319,427 filed Dec. 12, 2002.  
         [0043]    U.S. patent application Ser. No. 10/279,749 filed Oct. 23, 2002.  
         [0044]    U.S. patent application Ser. No. 10/233,296 filed Aug. 30, 2002.  
         [0045]    U.S. patent application Ser. No. 09/971,785 filed Oct. 4, 2001.  
         [0046]    U.S. patent application Ser. No. 09/810,856 filed Mar. 16, 2001.  
         [0047]    U.S. patent application Ser. No. 09/810,334 filed Mar. 14, 2001.  
         [0048]    U.S. patent application Ser. No. 09/799,852 filed Mar. 5, 2001.  
         [0049]    U.S. patent application Ser. No. 09/761,337 filed Jan. 16, 2001.  
         [0050]    U.S. patent application Ser. No. 09/665,442 filed Sep. 19, 2000.  
         [0051]    U.S. patent application Ser. No. 09/658,209 filed Sep. 8, 2000.  
         [0052]    U.S. patent application Ser. No. 09/653,664 filed Sep. 1, 2000.  
         [0053]    U.S. patent application Ser. No. 09/540,482 filed Mar. 31, 2000.  
         [0054]    U.S. patent application Ser. No. 09/237,194 filed Jan. 26, 1999.  
         [0055]    U.S. patent application Ser. No. 09/422,046 filed Oct. 10, 1999.  
         [0056]    U.S. patent application Ser. No. 60/461,526 filed Apr. 8, 2003.  
         [0057]    U.S. patent application Ser. No. 60/461,105 filed Apr. 7, 2003.  
         [0058]    U.S. patent application Ser. No. 60/360,708 filed Apr. 4, 2003.  
         [0059]    [0059]FIG. 1 is a block diagram of a networked system  10  according to a preferred embodiment of the invention. The network system  10  comprises a server  12  that receives input from a remotely programmable device  18  (referred to as a “Health Buddy”), a personal digital assistant (PDA)  22 , and a computer  26  via signal communication lines  14 . In signal communication with the server  12  is a client station  16  that uses programs to analyze the inputted data, prepare, and output reports  30  via communication lines  34  to output devices represented by a laptop computer  36 , a digital television or web TV  38 , and a mobile or cellular telephone  42 . The digital television is a web TV or microprocessor equivalent peripheral.  
         [0060]    [0060]FIG. 2 is a block diagram illustrating the two-way interaction of the components of the system of FIG. 1 using an Internet server  52 . Between the Internet server  52 , two-way communication occurs between the remotely programmable device  18 , the digital television  38 , the computer  26 , the PDA  22 , and the cellular telephone  42 . The two-way communication is in the form of data inputted to the Internet server  52  and scripted dialogues sent from the Internet server  52  and the remotely programmable device  18 , the digital television  38 , the computer  26 , the PDA  22 , and the cellular telephone  42 . The two-way communication also occurs between the laptop computer  36  (not shown). Among the two-way communication sent between the Internet server  52  are the output reports  30 .  
         [0061]    [0061]FIG. 3 is a block diagram of a preferred embodiment where a plurality of remotely programmable apparatuses  18  communicate over phone lines  19  (either wired or wireless) to the client station  16  from the Internet server  52  along communication lines  14 . Patients located at home or in hospitals and clinics use the remotely programmable apparatus  18  to establish two-way communication with the client station  16 .  
         [0062]    [0062]FIG. 4 and FIG. 5 are diagrams that illustrate the remotely programmable device  18  as used in chronic care of a patient in a home setting, and in a hospital setting, respectively, each setting having a series of scripts appropriate for the home, hospital, or clinic setting. The remotely programmable device  18  has a first input button  18 A, a second input button  18 B, a third input button  18 C, a fourth input button  18 D, and an alphanumeric display  18 E. Each input button  18 D either changes the alphanumeric display  18 E or issues commands to exchange data and scripts with the client station  16  (not shown). The four user input buttons  18 A,  18 B,  18 C, and  18 D are located adjacent to the display  18 E and are for entering in the device  18  responses to queries and prompts. In the preferred embodiment, user input buttons  18 A,  18 B,  18 C, and  18 D are momentary contact push buttons. In alternative preferred embodiments, the user input buttons  18 A,  18 B,  18 C, and  18 D may be replaced by switches, keys, a touch sensitive display screen, or any other data input device.  
         [0063]    [0063]FIG. 4 shows a representative sampling of home-appropriate scripts as would appear on the display  18 E as sent by the client station  16  (not shown) to a home setting. A first script  18 F queries “Hello Mary: What is your weight today”. Highlighted in black a patient punches input buttons  18 B or C that are aligned with “Less” or “More” as displayed, respectively, until the weight “ 120 ”, is reached. Thereafter, “OK” is punched using input button  18 D, bringing up a second script  18 G that states “Reminder: A weight gain may be a sign of fluid retention. Be sure to take your medicines and call Dr. Jones if your weight goes up more than 2 pounds.” After “OK” is punched, using input button  18 D, a third script  18 H is presented on the display  18 E. The third script provides an educational quiz that states “Daily Health Quiz: What is the best way to avoid feeling thirsty? 1. Drink water constantly, 2. Save your fluids for mealtime and when you are feeling very thirsty; 3. Eat more salt”. Choices  1 ,  2 , and  3 , in this illustration, are aligned with the first, second and third input buttons  18  A-C. The patient then uses input button  18 A to select answer 1,  18 B to select answer 2, or  18 C to select an answer 3.  
         [0064]    [0064]FIG. 5 shows a representative sampling of hospital or clinic-appropriate scripts as would appear on the display  18 E as sent by the client station  16  (not shown) to a clinic or hospital situation. A first script  18 L queries “Does the patient have . . . (choose the firs that applies) 1. Fever, 2. Acute GE (N or V and D), 3. Acute Weakness/Facial Paralysis”, 4. None of the Above”. The choices 1, 2, 3, and 4 appear at the bottom of first script  18 L in a horizontal bar and align respectfully with the first input button  18 A, the second input button  18 B, the third input button  18 C, and the fourth input button  18 D. The appropriate input button is pressed depending on the condition of the patient. Thereafter, a second script  18 L appears on the display  18 E and queries “Does the patient have . . . (choose the first that applies) 1. a rash, 2. altered mental status, 3. cough/shortness of breath, 4. none of the above.” The choices 1, 2, 3, and 4 appear at the bottom of first script  18 L in a horizontal bar and align respectfully with the first input button  18 A, the second input button  18 B, the third input button  18 C, and the fourth input button  18 D. Highlighted in black choice  1  is made by punching first input button  18 A. Thereafter, a third script  18 M appears and queries “Has this patient attended a large public group gathering in the past 2 weeks?”, and a “Yes” or “No” are given as the only answer options that are respectively aligned with the first input button  18 A and the second input button  18 B. The answer “Yes” is selected by pressing the first input button  18 A.  
         [0065]    [0065]FIG. 6 illustrates a representative set of scripts as they would appear in a preferred embodiment of a cellular or mobile telephone. The scripts are substantially similar to the scripts sent to the remotely programmable device  18 . A cellular telephone  42  with an alphanumeric display  44  and a keypad  46  receives a first script  44 A from the client station  16  (not shown) that states “Welcome back Mary. Thank you for using the Health Buddy. Begin whenever your are ready. Continue”. An appropriate key is pressed on the keypad  46  for “continue” to be selected. This response brings a second script  44 B that queries “Have you checked your blood sugar in the last 24 hours?” with a “No” or “Yes” as the answer options. In this example, the “Yes” answer option is selected via the keypad  18 . This brings up a third script  44 C that queries “What was your most recent blood sugar? (Input the number using the numeric keypad).” In this example “ 77 ” is entered via the keypad  46 . At another time, the telephone  44  is sent a fourth query  44 D that states “Hello Mary, what is your weight today? (Input the number using the numeric keypad).” In this example, “ 120 ” is entered. Optionally, a statement if this weight represents an increase from a previously entered value, an appropriate key assigned to “less” or another key assigned to “more” is pressed depending a given patient&#39;s particular situation.  
         [0066]    [0066]FIG. 7 is an illustration of digital screen shots in a preferred embodiment of the invention using digital television  38 . The scripted queries are sent by the client station  16  (not shown) to the digital television  38  with responses provided by the patient via a keyboard  38 C. A first screen shot  38 A with a first script  38 A 1  that states “A fasting blood sugar between  71  and  140  is considered a healthy level”. A second screen shot  38 B with a second script  38 B 1  that queries “What was your most recent blood sugar? (Use the left and right arrows to input the number)”, to which, the patient enters “ 73 ” at screen location depicted by  38 B 2  using the keyboard  38 C.  
         [0067]    The remotely programmable device  18  is configured to receive multiple medical instruments via standard telephone jacks. FIG. 8 is a representative illustration of the medical devices capable of being attached to the device  18  via a communications port  18 J to transmit objectively measured physiologic values. Among the devices include a glucometer  62 , a sphygmomanometer  66 , a peak flow spirometer  72  to measure lung function, an oxygen sensor  76  to measure blood oxygen levels, and weight balance  80 . Other devices (not shown) would be devices that qualitatively or quantitatively report cholesterol, HbA 1 c, blood coagulation measures, temperature, ECG, cardiac events, ICD devices, other heart pacing devices, EEG, other neurological measures, peak flow, oxygen consumption, other measures of metabolism, sleep measures including waking, breathing, and restlessness (CPAP readings). Other preferred embodiments include multiple medical devices coupled to or is integrated with another medical device which houses interactive functions. For example, a glucometer that couples with an insulin pump enabled with interactive functions, or a spirometry device that couples to a CPAP device enabled with interactive remote monitoring functions. These coupled interactive medical devices send signal transmissions to the communications port  18 J.  
         [0068]    The remotely programmable device  18  similarly configured to receive input of environmental measurements of which a patient is exposed to, for example, temperature, humidity, presence or absence of chemical agents, biological agents, or radioactivity in the air, water, or food.  
         [0069]    Other preferred embodiments of the microprocessor based PDA  22 , the computer  26 , the laptop computer  36 , the cellular telephone  42 , and the digital television  38  include receiving scripted queries as described above for the remotely programmable device  18 . Furthermore, the PDA  22 , the computer  26 , the laptop computer  36 , the cellular telephone  42 , and the digital television  38  are configurable to receive transmissions from the physiologic and environmental measuring devices as similarly communicated to the remotely programmable device  18 . Other preferred embodiments of the microprocessor based remotely programmable device  18 , the PDA  22 , the computer  26 , the laptop computer  36 , the digital television  38 , and the cellular telephone  42  include receiving transmissions from physiologic and environmental measuring devices via Bluetooth or equivalent infra-red or other wireless transmissions.  
         [0070]    FIGS.  9 - 21  illustrate web based or Internet or intranet preferred embodiments as presented on monitors or displays of the computer  26 , the laptop computer  36 , the PDA  22 , and the digital television  38 . FIG. 9 is a home screen shot  92  as would appear on the client station  16  and that includes a menu bar  93 , and a “Live Training-Getting Started”  96  section that gives the manager operating the client station  16  options to either remotely monitor patients, enroll patients, or schedule sessions with patients in communication with the client station  16  via the microprocessor based remotely programmable device  18 , the PDA  22 , the computer  26 , the laptop computer  36 , the digital television  38 , and the cellular telephone  42 . The patient&#39;s data is brought up by entering the name of the patient in a “Find Patient” box  94 .  
         [0071]    [0071]FIG. 10 is screen shot of patient work list as would appear on the client station  16  preferred embodiment of the invention. The patient work list includes a Responders&#39; Risk Summary section  102 , a patient summary section  104  that enumerates responders and Non-Responders, a Responders-by-date section  106  with demographic data, and a non-responders-by date section  108  with demographic data. The Responders&#39; Risk Summary is categorized by symptoms, behavior, Knowledge, and General information into High, Medium, Low, and None risk groups.  
         [0072]    [0072]FIG. 11 is a screen shot of a patient results report as would appear at the client station preferred embodiment of the invention. Here answers to queries are itemized in a results table  112  by question, response to the question, the category of question, and the aspect or parameter measured. The answers from a given patient are categorized into none, low, medium, and high risk groups.  
         [0073]    [0073]FIG. 12 is a screen shot of a trend report  112  as would appear at the client station  16  preferred embodiment of the invention. Here the trend report  112  includes the name and demographics  124  of a patient and a graphic plot  126  of a measure parameter, in the case, a weight trend by date.  
         [0074]    [0074]FIG. 13 is a screen shot of patients&#39; notes  132  as would appear on the client station  16  preferred embodiment of the invention. The patients&#39; notes  132  includes a Care Manager section  134  detailing insurance and primary physician data, and a tabular section  136  that lists a compilation of dated notes relevant to the care of patients.  
         [0075]    [0075]FIG. 14 is a screen shot of a multi parameter trend note  140  of a patient as would appear on the client station  16  preferred embodiment of the invention. The multi parameter trend note  140  includes a patient information section  141  that lists the patient&#39;s name, patient&#39;s address, physician, medical group, case manager, current program and first response date. The multi parameter trend note includes measurements of several physiologic parameters in graphic format by date. For example, the graph includes a plot of systolic blood pressure  143 , a plot of weight  145 , a plot of diastolic blood pressure  146 , and a plot of edema  148 . FIG. 14 is a screen shot of a trend report of an individual patient of the client station preferred embodiment of the invention;  
         [0076]    [0076]FIG. 15 is a screen shot of a “Take My Survey”  152  section of a home page where a survey questionnaire posed to an individual patient as appearing on the patient&#39;s PDA  22 , personal computer  26 , laptop computer  36 , or digital television  38  in a web-preferred embodiment of the invention. A query  154  asking “Last night, did you need to increase number of pillows you slept on because of trouble breathing?—Yes or No” appear on the left side of the screen shot. On the right side of the screen shot is a question entry box  156  with “ask me” entry input button where the patient types in a specific question, or alternatively, selects from an adjacent pull down menu of categorized questions.  
         [0077]    [0077]FIG. 16 is a screen shot of a “View My Trend Charts”  162  section of a home page where a trend graphic of a measured parameter of an individual patient is presented as appearing on the patient&#39;s PDA  22 , personal computer  26 , laptop computer . 36 , or digital television  38  in a web-preferred embodiment of the invention. A trend chart graphic  164  of weight plotted against date is presented on the left side of the screen shot. On the right side of the screen shot is the question entry box  156  with “ask me” entry button where the patient types in a specific question, or alternatively, selects from an adjacent pull down menu of categorized questions.  
         [0078]    [0078]FIG. 17 is a screen shot of a “view my results” report  172  as appearing on the microprocessor-based equipment in the web-preferred embodiment of the invention. On the left side of the screen shot is a table  174  listing the questions sent by the client station  16  (not shown) and responses by the patients, each categorized by risk level. On the right side of the screen shot is the question entry box  156  with “ask me” entry button where the patient types in a specific question, or alternatively, selects from an adjacent pull down menu of categorized questions.  
         [0079]    [0079]FIG. 18 is a screen shot of a “Special Report”  182  as appearing on the patient&#39;s microprocessor-based equipment in the web-preferred embodiment of the invention. A user ID entry box  184  and a Password entry box  186  with submit button is shown on the right side of the screen shot. The password entry box uses a personal identification number (PIN) assigned by the manager of the client station  16  or designate.  
         [0080]    [0080]FIG. 19 is a screen shot of a “Trends” report  192  as appearing on the patient&#39;s microprocessor-based equipment and the client station in the web-preferred embodiment of the invention. A screen button  193  is pressed to present the trend report  192 . Other buttons include a “Blood Pressure and Pulse” button  194 , and a “Rhythm Strip” button  195 . A weight chart  196  is shown along with a tabular data table  198  having columns of date, weight, Sys/Dia(mean of the systolic and diastolic blood pressure), and Pulse.  
         [0081]    [0081]FIG. 20 is a screen shot of a “Trends” report  192  where the “Rhythm Strip” button  195  is pressed to present a panel of EKG readings  204  appearing on the patient&#39;s microprocessor-based equipment and the client station  16  in the web-preferred embodiment of the invention.  
         [0082]    [0082]FIG. 21 is a screen shot of a “Trends”  192  as appearing on the patient&#39;s microprocessor-based equipment and the client station  16  in the web-preferred embodiment of the invention when the “Blood Pressure and Pulse” button  194  is pressed. A three-line graphic plot  212  is shown in which the systolic blood pressure (top line), the diastolic blood pressure (middle line), and the pulse (bottom line) is shown plotted against date.  
         [0083]    While the preferred embodiment of the invention has been illustrated and described, as noted above, many changes can be made without departing from the spirit and scope of the invention. Accordingly, the scope of the invention is not limited by the disclosure of the preferred embodiment.