Patent Publication Number: US-2016246781-A1

Title: Medical interaction systems and methods

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to and the benefit of the filing date of U.S. Provisional Application No. 62/118,036, filed on Feb. 19, 2015, entitled “NOVEL COMPUTER IMPLEMENTED SYSTEMS AND METHODS FOR MEDICAL COMMUNICATION, MEDICAL RECORD KEEPING, AND DOCUMENTATION”, which is hereby incorporated by reference in its entirety. 
    
    
     FIELD OF THE INVENTION 
     This patent specification relates to the field of medical communication, language translation, and medical record keeping and documentation. More specifically, this patent specification relates to computer implemented methods and systems for client devices to allow medical staff to communicate with patients in a variety of languages and to record and document the patient&#39;s response to questions and gather medical consent. This includes explanations and information given to patients. 
     BACKGROUND 
     Doctors, clinics, and hospitals in the United States are responsible for treating the entire gamut of the community in which they operate. This obligates them to accepting patients who may not communicate well enough in English or other primary language of the medical staff to make their care appropriate and meaningful. Changing global demographics have resulted in cities with populations of peoples who have relocated and not adapted to the norms of the country where they reside or are visiting. 
     Typically, the disparity of language is often addressed by patients seeking treatment from healthcare providers in their own communities who spoke their language. This is not always possible and many patients find themselves under the care of a healthcare provider or being treated in a hospital where they cannot communicate with the doctors or other staff. This is not a new phenomenon especially in a country whose population is the result of successive large waves of immigrants from a wide range of countries. 
     What is new is a federal mandate that all patients be afforded care that they can understand and legally consent to. The responsibility for the translation falls on the healthcare provider, such as a doctor, nurse, nurse practitioner, and the like, in his office or on the hospital/clinic where the patient is seen and treated. Often patients arrive with a friend or relative who speaks both their language and English. Ancillary hospital personnel, housekeeping and dietary staff from the same immigrant communities as the patients, no longer meet legal guidelines to assist in translating for patients. Their translations have no official legal certification, and involving unofficial translators poses the risk of breaching of privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 
     When the use of certified independent interpreters is needed, the cost of their services is the responsibility of the healthcare provider&#39;s office or the hospital. This cost cannot be borne by or passed on to the patient or the medical insurance, including Medicare and Medicaid. 
     There is therefore a financial and ethical incentive for hospitals and healthcare providers to use novel computer implemented methods and systems to communicate with patients in different languages and to record important patient responses and information using electronic client devices. 
     BRIEF SUMMARY OF THE INVENTION 
     A medical interaction system for providing cross-language communication between a first user and a second user is provided. In some embodiments, the system may include: a speaker for providing audio output to the users; a graphical user interface for displaying visual information output to and receiving user input from the users; and a processor in communication with the speaker and the graphical interface, in which the processor is configured to identify a first language selected by the first user with the graphical user interface, identify a second language selected by the second user with the graphical user interface, receive first language input from the first user, interpret the first language input into a second language output, provide the second language output to the second user, receive second language input from the second user, determine second user consent to the second language output, interpret the second language input into first language output, and provide the first language output to the first user. 
     According to another embodiment consistent with the principles of the invention, a medical interaction method for providing cross-language communication between a first user and a second user is provided. The method may include: identifying a first language selected by the first user; identifying a second language selected by the second user; receiving first language input from the first user; interpreting the first language input into a second language output; providing the second language output to the second user; receiving second language input from the second user; determining second user consent to the second language output; interpreting the second language input into first language output; and providing the first language output to the first user. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Some embodiments of the present invention are illustrated as an example and are not limited by the figures of the accompanying drawings, in which like references may indicate similar elements and in which: 
         FIG. 1  depicts an illustrative example of some of the components and computer implemented methods which may be found in a medical interaction system according to various embodiments described herein. 
         FIG. 2  illustrates a block diagram showing an example of a server which may be used by the system as described in various embodiments herein. 
         FIG. 3  shows a block diagram illustrating an example of a client device which may be used by the system as described in various embodiments herein. 
         FIG. 4  depicts a block diagram illustrating some exemplary input/output interfaces of a client device which may be used by the system as described in various embodiments herein. 
         FIG. 5  illustrates a block diagram illustrating some modules of a medical interaction system which may function as software rules engines according to various embodiments described herein. 
         FIG. 6  shows a block diagram illustrating an example workflow of a medical interaction system according to various embodiments described herein. 
         FIG. 7  depicts a block diagram of an example of a method for providing medical interaction between two users according to various embodiments described herein. 
         FIG. 8  illustrates a block diagram of an example of an alternative method for providing medical interaction between two users according to various embodiments described herein. 
         FIG. 9  shows a screenshot of an example graphical user interface displayed on a client device of the system according to various embodiments described herein. 
         FIG. 10  depicts a screenshot of an example graphical user interface displayed on a client device of the system according to various embodiments described herein. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well as the singular forms, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. 
     Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one having ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and the present disclosure and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein. 
     DEFINITIONS 
     As used herein, the term “computer” refers to a machine, apparatus, or device that is capable of accepting and performing logic operations from software code. The term “software”, “software code” or “computer software” refers to any set of instructions operable to cause a computer to perform an operation. Software code may be operated on by a “rules engine” or processor. Thus, the methods and systems of the present invention may be performed by a computer based on instructions received by computer software. 
     The term “electronic device” as used herein is a type of electronic device comprising circuitry and configured to generally perform functions such as recording audio, photos, and videos; displaying or reproducing audio, photos, and videos; storing, retrieving, or manipulation of electronic data; providing electrical communications and network connectivity; or any other similar function. Non-limiting examples of electronic devices include; personal computers (PCs), workstations, laptops, tablet PCs including the iPad, cell phones including iOS phones made by Apple Inc., Android OS phones, Microsoft OS phones, Blackberry phones, digital music players, or any electronic device capable of running computer software and displaying information to a user, memory cards, other memory storage devices, digital cameras, external battery packs, external charging devices, and the like. Certain types of electronic devices which are portable and easily carried by a person from one location to another may sometimes be referred to as a “portable electronic device” or “portable device”. Some non-limiting examples of portable devices include; cell phones, smart phones, tablet computers, laptop computers, wearable computers such as watches, Google Glasses, etc. and the like. 
     The term “client device” or sometimes “electronic device” or just “device” as used herein is a type of computer generally operated by a person. In some embodiments, a client device is a smart phone or computer configured to receive and transmit data to a server or other electronic device which may be operated locally or in the cloud. Non-limiting examples of client devices include; personal computers (PCs), workstations, laptops, tablet PCs including the iPad, cell phones including iOS phones made by Apple Inc., Android OS phones, Microsoft OS phones, Blackberry phones, or generally any electronic device capable of running computer software and displaying information to a user. Certain types of client devices which are portable and easily carried by a person from one location to another may sometimes be referred to as a “mobile device” or “portable device”. Some non-limiting examples of mobile devices include; cell phones, smart phones, tablet computers, laptop computers, wearable computers such as watches, Google Glasses, etc. and the like. 
     The term “computer readable medium” as used herein refers to any medium that participates in providing instructions to the processor for execution. A computer readable medium may take many forms, including but not limited to, non-volatile media, volatile media, and transmission media. Non-volatile media includes, for example, optical, magnetic disks, and magneto-optical disks, such as the hard disk or the removable media drive. Volatile media includes dynamic memory, such as the main memory. Transmission media includes coaxial cables, copper wire and fiber optics, including the wires that make up the bus. Transmission media may also take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications. 
     As used herein the term “data network” or “network” shall mean an infrastructure capable of connecting two or more computers such as client devices either using wires or wirelessly allowing them to transmit and receive data. Non-limiting examples of data networks may include the internet or wireless networks or (i.e. a “wireless network”) which may include wifi and cellular networks. For example, a network may include a local area network (LAN), a wide area network (WAN) (e.g., the Internet), a mobile relay network, a metropolitan area network (MAN), an ad hoc network, a telephone network (e.g., a Public Switched Telephone Network (PSTN)), a cellular network, or a voice-over-IP (VoW) network. 
     As used herein, the term “database” shall generally mean a digital collection of data or information. The present invention uses novel methods and processes to store, link, and modify information such digital images and videos and user profile information. For the purposes of the present disclosure, a database may be stored on a remote server and accessed by a client device through the internet (i.e., the database is in the cloud) or alternatively in some embodiments the database may be stored on the client device or remote computer itself (i.e., local storage). A “data store” as used herein may contain or comprise a database (i.e. information and data from a database may be recorded into a medium on a data store). 
     In describing the invention, it will be understood that a number of techniques and steps are disclosed. Each of these has individual benefit and each can also be used in conjunction with one or more, or in some cases all, of the other disclosed techniques. Accordingly, for the sake of clarity, this description will refrain from repeating every possible combination of the individual steps in an unnecessary fashion. Nevertheless, the specification and claims should be read with the understanding that such combinations are entirely within the scope of the invention and the claims. 
     New medical interaction systems and methods are discussed herein. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the present invention. It will be evident, however, to one skilled in the art that the present invention may be practiced without these specific details. 
     The present disclosure is to be considered as an exemplification of the invention, and is not intended to limit the invention to the specific embodiments illustrated by the figures or description below. 
     The present invention will now be described by example and through referencing the appended figures representing preferred and alternative embodiments. As perhaps best shown by  FIG. 1 , an illustrative example of some of the physical components which may comprise a medical interaction system (“the system”)  100  according to some embodiments is presented. The system  100  is configured to provide medical interaction, such as medical communication, medical record keeping, documentation, and the like, between users  101  that are proficient in different languages. Users  101  may include healthcare providers  101 A, such as doctors, nurses, nurse practitioners, physicians assistants, dentists, and the like, and healthcare recipients  101 B, such as patients, care receivers, patient representatives, and the like. The system  100  may also facilitate the transfer of data and information between one or more access points  103 , client devices  400 , printers  107 , remote databases  106 , and servers  300  over a data network  105 . A data store  308  accessible by the server  300  may contain one or more databases. The data may comprise any information that one or more users  101  desire to input into the system  100  including information on one or more users  101 , information requested by one or more users  101 , information supplied by one or more users  101 , and any other information which a user  101  may desire to input or enter into the system  100 . 
     In this example, the system  100  comprises at least one client device  400  (but preferably more than two client devices  400 ) configured to be operated by one or more users  101 . Client devices  400  can be mobile devices, such as laptops, tablet computers, personal digital assistants, smart phones, and the like, that are equipped with a wireless network interface capable of sending data to one or more servers  300  with access to one or more data stores  308  over a network  105  such as a wireless local area network (WLAN). Additionally, client devices  400  can be fixed devices, such as desktops, workstations, and the like, that are equipped with a wireless or wired network interface capable of sending data to one or more servers  300  with access to one or more data stores  308  over a wireless or wired local area network  105 . The present invention may be implemented on at least one client device  400  and/or server  300  programmed to perform one or more of the steps described herein. In some embodiments, more than one client device  400  and/or server  300  may be used, with each being programmed to carry out one or more steps of a method or process described herein. 
     In some embodiments, the data provided by a user  101 ,  101 A,  101 B, may comprise information to facilitate the medical care of one or more users  101 B. This data may be referred to as medical history data which may be used to form an electronic health record which may be stored in a database on a data store  308  and/or printed as a hard copy by a printer  107 . Additionally, medical history data of a user  101 B may be stored on or retrieved from a remote database  106 . For example, a third party remote database  106  may be accessed by the system  100  to retrieve blood work results or an X-ray image may be stored in a doctor&#39;s office remote database  106  which is physically remote from the location where the X-ray was taken. 
     In some embodiments, the system  100  may comprise a client device  400  with input/output (I/O) interfaces  404  ( FIG. 3 ) which may include a graphic user interface (GUI)  404 A ( FIGS. 4, 9, and 10 ) which may be operated by both a healthcare provider  101 A and a healthcare recipient  101 B. For example, the system  100  may be configured to be accessed by a client device  400 , such as smartphone or tablet computer, with a GUI  404 A which may be operated by both the healthcare provider  101 A and the healthcare recipient  101 B allowing them to communicate and build an electronic medical record which may be stored on a database  106  or a data store  38  or may be printed out on a printer  107 . 
     In alternative embodiments, the system  100  may comprise two or more client devices  400 , each with input/output (I/O) interfaces  404  ( FIG. 3 ) which may include a (GUI)  404 A ( FIGS. 4, 9, and 10 ). A healthcare provider  101 A may operate a GUI  404 A of a first client device  400  and a healthcare recipient  101 B may operate a GUI  404 A of a second client device  400 . For example, the system  100  may be configured to be accessed by a first client device  400 , such as smartphone, with a first GUI  404 A which may be operated by the healthcare provider  101 A, and accessed by a second client device  400 , such as computer, with a second GUI  404 A which may be operated by the healthcare recipient  101 B. The system  100  may allow the first client device  400  of the healthcare provider  101 A and the second client device  400  of the healthcare recipient  101 B to communicate, thereby allowing the healthcare provider  101 A and the healthcare recipient  101 B to build an electronic medical record which may be stored on a database  106  or a data store  38  or may be printed out on a printer  107 . 
     Referring now to  FIG. 2 , in an exemplary embodiment, a block diagram illustrates a server  300  of which one or more may be used in the system  100  or standalone. The server  300  may be a digital computer that, in terms of hardware architecture, generally includes a processor  302 , input/output (I/O) interfaces  304 , a network interface  306 , a data store  308 , and memory  310 . It should be appreciated by those of ordinary skill in the art that  FIG. 2  depicts the server  300  in an oversimplified manner, and a practical embodiment may include additional components and suitably configured processing logic to support known or conventional operating features that are not described in detail herein. The components ( 302 ,  304 ,  306 ,  308 , and  310 ) are communicatively coupled via a local interface  312 . The local interface  312  may be, for example but not limited to, one or more buses or other wired or wireless connections, as is known in the art. The local interface  312  may have additional elements, which are omitted for simplicity, such as controllers, buffers (caches), drivers, repeaters, and receivers, among many others, to enable communications. Further, the local interface  312  may include address, control, and/or data connections to enable appropriate communications among the aforementioned components. 
     The processor  302  is a hardware device for executing software instructions. The processor  302  may be any custom made or commercially available processor, a central processing unit (CPU), an auxiliary processor among several processors associated with the server  300 , a semiconductor-based microprocessor (in the form of a microchip or chip set), or generally any device for executing software instructions. When the server  300  is in operation, the processor  302  is configured to execute software stored within the memory  310 , to communicate data to and from the memory  310 , and to generally control operations of the server  300  pursuant to the software instructions. The I/O interfaces  304  may be used to receive user input from and/or for providing system output to one or more devices or components. User input may be provided via, for example, a graphical user interface, a keyboard, a touch pad, and/or a mouse. System output may be provided via a display device, a graphical user interface, a speaker, and/or a printer  107  ( FIG. 1 ). I/O interfaces  304  may further include, for example, a serial port, a parallel port, a small computer system interface (SCSI), a serial ATA (SATA), a fibre channel, Infiniband, iSCSI, a PCI Express interface (PCI-x), an infrared (IR) interface, a radio frequency (RF) interface, and/or a universal serial bus (USB) interface. 
     The network interface  306  may be used to enable the server  300  to communicate on a network, such as the Internet, the data network  105 , the enterprise, and the like, etc. The network interface  306  may include, for example, an Ethernet card or adapter (e.g., 10BaseT, Fast Ethernet, Gigabit Ethernet, 10 GbE) or a wireless local area network (WLAN) card or adapter (e.g., 802.11a/b/g/n). The network interface  306  may include address, control, and/or data connections to enable appropriate communications on the network. A data store  308  may be used to store data. The data store  308  may include any of volatile memory elements (e.g., random access memory (RAM, such as DRAM, SRAM, SDRAM, and the like)), nonvolatile memory elements (e.g., ROM, hard drive, tape, CDROM, and the like), and combinations thereof. Moreover, the data store  308  may incorporate electronic, magnetic, optical, and/or other types of storage media. In one example, the data store  308  may be located internal to the server  300  such as, for example, an internal hard drive connected to the local interface  312  in the server  300 . Additionally in another embodiment, the data store  308  may be located external to the server  300  such as, for example, an external hard drive connected to the I/O interfaces  304  (e.g., SCSI or USB connection). In a further embodiment, the data store  308  may be connected to the server  300  through a network, such as, for example, a network attached file server. 
     The memory  310  may include any of volatile memory elements (e.g., random access memory (RAM, such as DRAM, SRAM, SDRAM, etc.)), nonvolatile memory elements (e.g., ROM, hard drive, tape, CDROM, etc.), and combinations thereof. Moreover, the memory  310  may incorporate electronic, magnetic, optical, and/or other types of storage media. Note that the memory  310  may have a distributed architecture, where various components are situated remotely from one another, but can be accessed by the processor  302 . The software in memory  310  may include one or more software programs, each of which includes an ordered listing of executable instructions for implementing logical functions. The software in the memory  310  may include a suitable operating system (O/S)  314  and one or more programs  320 . 
     The operating system  314  essentially controls the execution of other computer programs, such as the one or more programs  320 , and provides scheduling, input-output control, file and data management, memory management, and communication control and related services. The operating system  314  may be, for example Windows NT, Windows 2000, Windows XP, Windows Vista, Windows 7, Windows 8, Windows 10, Windows Server 2003/2008 (all available from Microsoft, Corp. of Redmond, Wash.), Solaris (available from Sun Microsystems, Inc. of Palo Alto, Calif.), LINUX (or another UNIX variant) (available from Red Hat of Raleigh, N.C. and various other vendors), Android and variants thereof (available from Google, Inc. of Mountain View, Calif.), Apple OS X and variants thereof (available from Apple, Inc. of Cupertino, Calif.), or the like. The one or more programs  320  may be configured to implement the various processes, algorithms, methods, techniques, etc. described herein. 
     Referring to  FIG. 3 , in an exemplary embodiment, a block diagram illustrates a client device  400  of which one or more may be used in the system  100  or the like. The client device  400  can be a digital device that, in terms of hardware architecture, generally includes a processor  402 , input/output (I/O) interfaces  404 , a radio  406 , a data store  408 , and memory  410 . It should be appreciated by those of ordinary skill in the art that  FIG. 3  depicts the client device  400  in an oversimplified manner, and a practical embodiment may include additional components and suitably configured processing logic to support known or conventional operating features that are not described in detail herein. The components ( 402 ,  404 ,  406 ,  408 , and  410 ) are communicatively coupled via a local interface  412 . The local interface  412  can be, for example but not limited to, one or more buses or other wired or wireless connections, as is known in the art. The local interface  412  can have additional elements, which are omitted for simplicity, such as controllers, buffers (caches), drivers, repeaters, and receivers, among many others, to enable communications. Further, the local interface  412  may include address, control, and/or data connections to enable appropriate communications among the aforementioned components. 
     The processor  402  is a hardware device for executing software instructions. The processor  402  can be any custom made or commercially available processor, a central processing unit (CPU), an auxiliary processor among several processors associated with the client device  400 , a semiconductor-based microprocessor (in the form of a microchip or chip set), or generally any device for executing software instructions. When the client device  400  is in operation, the processor  402  is configured to execute software stored within the memory  410 , to communicate data to and from the memory  410 , and to generally control operations of the client device  400  pursuant to the software instructions. In an exemplary embodiment, the processor  402  may include a mobile optimized processor such as optimized for power consumption and mobile applications. The I/O interfaces  404  can be used to receive data and user input and/or for providing system output. User input can be provided via a plurality of I/O interfaces  404 , such as a keypad, a graphical user interface  404 A ( FIG. 4 ), a speaker  404 B ( FIG. 4 ), a keyboard  404 C ( FIG. 4 ), a touch screen, a camera, a microphone, a scroll ball, a scroll bar, buttons, bar code scanner, voice recognition, eye gesture, and the like. System output can be provided via a display device such as a liquid crystal display (LCD), touch screen, and the like. The I/O interfaces  404  can also include, for example, a serial port, a parallel port, a small computer system interface (SCSI), an infrared (IR) interface, a radio frequency (RF) interface, a universal serial bus (USB) interface, and the like. 
     The radio  406  enables wireless communication to an external access device or network. Any number of suitable wireless data communication protocols, techniques, or methodologies can be supported by the radio  406 , including, without limitation: RF; IrDA (infrared); Bluetooth; ZigBee (and other variants of the IEEE 802.15 protocol); IEEE 802.11 (any variation); IEEE 802.16 (WiMAX or any other variation); Direct Sequence Spread Spectrum; Frequency Hopping Spread Spectrum; Long Term Evolution (LTE); cellular/wireless/cordless telecommunication protocols (e.g. 3G/4G, etc.); wireless home network communication protocols; paging network protocols; magnetic induction; satellite data communication protocols; wireless hospital or health care facility network protocols such as those operating in the WMTS bands; GPRS; proprietary wireless data communication protocols such as variants of Wireless USB; and any other protocols for wireless communication. The data store  408  may be used to store data. The data store  408  may include any of volatile memory elements (e.g., random access memory (RAM, such as DRAM, SRAM, SDRAM, and the like)), nonvolatile memory elements (e.g., ROM, hard drive, tape, CDROM, and the like), and combinations thereof. Moreover, the data store  408  may incorporate electronic, magnetic, optical, and/or other types of storage media. 
     The memory  410  may include any of volatile memory elements (e.g., random access memory (RAM, such as DRAM, SRAM, SDRAM, etc.)), nonvolatile memory elements (e.g., ROM, hard drive, etc.), and combinations thereof. Moreover, the memory  410  may incorporate electronic, magnetic, optical, and/or other types of storage media. Note that the memory  410  may have a distributed architecture, where various components are situated remotely from one another, but can be accessed by the processor  402 . The software in memory  410  can include one or more software programs, each of which includes an ordered listing of executable instructions for implementing logical functions. In the example of  FIG. 3 , the software in the memory system  410  includes a suitable operating system (O/S)  414  and programs  420 . 
     The operating system  414  essentially controls the execution of other computer programs, and provides scheduling, input-output control, file and data management, memory management, and communication control and related services. The operating system  414  may be, for example, LINUX (or another UNIX variant), Android (available from Google), Symbian OS, Microsoft Windows CE, Microsoft Windows 7 Mobile, Windows 7, Windows 8, Windows 10, iOS (available from Apple, Inc.), webOS (available from Hewlett Packard), Blackberry OS (Available from Research in Motion), and the like. The programs  420  may include various applications, add-ons, etc. configured to provide end user functionality with the client device  400 . For example, exemplary programs  420  may include, but not limited to, a web browser, social networking applications, streaming media applications, games, mapping and location applications, electronic mail applications, financial applications, and the like. In a typical example, the end user  101  typically uses one or more of the programs  420 , optionally along with a network, to perform one or more steps of a medical interaction method of the system  100 . 
       FIG. 4  shows some example input/output interfaces  404  ( FIG. 3 ) of a client device  400  according to various embodiments described herein. In some exemplary embodiments, a GUI  404 A may comprise a resistive or capacitive touch screen. The GUI  404 A may be in communication with the processor  402  ( FIG. 3 ) through the local interface  412  ( FIG. 3 ). Additionally, the GUI  404 A may receive touch input from a user  101  ( FIG. 1 ) and/or display visual information which may be communicated to and from the processor  402 . In further embodiments, a GUI  404 A may be configured with a variety of touch screen technologies that have different methods of sensing touch such as capacitive sensing, surface capacitive touch sensing, surface acoustic wave sensing, projected capacitance sensing, mutual capacitance sensing, self-capacitance sensing, infrared grid sensing, infrared acrylic projection sensing, optical imaging, dispersive signal sensing, acoustic pulse recognition sensing, or any other suitable tactile input that may detect touch input on a display device. A GUI  404 A may also comprise a display device such as a Liquid Crystal Display (LCD), a Cathode ray tube (CRT) display, a Field emission display (FED), a Vacuum fluorescent display (VFD), a Surface-conduction electron-emitter display (SED), a thin or thick film electro-luminescence (EL) display, an inorganic or organic light emitting diode (LED, OLED) display, a Plasma display panel (PDP), a gas discharge display (Nixie tube), or any other suitable display for outputting visual information. 
     In some embodiments, a speaker  404 B may comprise a sound device configured to produce or create one or more audible sounds at one or more volume levels. The speaker  404 B may be in communication with the processor  402  ( FIG. 3 ) through the local interface  412  ( FIG. 3 ). Additionally, the speaker  404 B may output audio information which may be communicated from the processor  402 . In further embodiments, a speaker  404 B may comprise a buzzer, a piezoelectric sound producing device, a dielectric elastomer sound producing device, a buzzer, a moving coil loudspeaker, an electrostatic loudspeaker, an isodynamic loudspeaker, a piezo-electric loudspeaker, or any other device capable of producing one or more sounds. 
     In some embodiments, a keyboard  404 C may comprise QWERTY, numerical, or the like, keyed input device that may be manipulated by a user  101  ( FIG. 1 ) to provide input to the system  100 . The keyboard  404 C may be in communication with the processor  402  ( FIG. 3 ) through the local interface  412  ( FIG. 3 ). Additionally, the keyboard  404 C may receive information which may be communicated to the processor  402 . A keyboard  404 C may comprise any type of keyboard which may be used with an electronic device  400 . 
       FIG. 5  depicts a block diagram showing some software rules engines which may be found in a system  100  ( FIG. 1 ) and which may preferably be configured to run on a processor  402  of a client device  400  and/or optionally on a processor  302  of a server  300  ( FIGS. 1 and 2 ) according to various embodiments described herein. In some embodiments, one or more client devices  400  may be configured to run one or more software rules engines or programs  420  such as a communication engine  421  and/or a recommendation engine  422 . In this embodiment, the engines  421 ,  422 , are configured to run on at least one client device  400 . Additionally, a client device  400  may be in communication with a server  300  and data store  308  comprising a database of medical history data which may be used to form an electronic health record of one or more users  101  ( FIG. 1 ). The engines  421 ,  422 , may read, write, or otherwise access data in the database of the data store  308 . Additionally, data may be sent and received to and from one or more client devices  400  ( FIGS. 1 and 3 ) which may be in wired and/or wireless electronic communication with a server  300  through a network  105 . In other embodiments, a communication engine  421  and/or a recommendation engine  422  may be configured to run on a client device  400  and/or server  300  with data transferred to and from one or more servers  300  in communication with a data store  308  through a network  105 . In still further embodiments, a server  300  and a client device  400  may be configured to run a communication engine  421  and/or a recommendation engine  422 . 
     The communication engine  421  may be configured to govern electronic communication between severs  300 , third party databases, and client devices  400 . Data from severs  300 , third party databases  106 , and client devices  400  may be received by the communication engine  421  which may then electronically communicate the data to the recommendation engine  422 . Likewise, data from the recommendation engine  422  may be received by the communication engine  421  which may then electronically communicate the data to severs  300 , third party databases  106 , and client devices  400 . In some embodiments, the communication engine  421  may govern the electronic communication by initiating, maintaining, reestablishing, and terminating electronic communication between the server  300  and one or more third party databases, client devices  400 , and other servers  300 . In further embodiments, the communication engine  421  may control the radio  406  or other network interface ( FIG. 3 ) of a client device  400  to send and receive data to and from one or more third party databases  106 , client devices  400 , and other servers  300  through a network connection  104  ( FIG. 1 ) over a network  105  ( FIG. 1 ). 
     The communication engine  421  may be configured to receive language input from a user  101  through an I/O interface  404  of a client device  400  such as through a GUI  404 A and/or a keyboard  404 C. Optionally, the communication engine  421  may be configured to receive language input from a user  101  through an I/O interface  404  of a client device  400  which comprises a microphone. The communication engine  421  may also be configured to output or display images, graphics, videos, indicia, and other visual information as language output through a GUI  404 A and/or to output sounds, audio recordings, and other audio information through a speaker  404 B. In some embodiments, the communication engine  421  may be configured to output visual information through a GUI  404 A and to output audio information through a speaker  404 B in a first language selected by a first user  101 A and in a second language selected by a second user  101 B. In further embodiments, the communication engine  421  may be configured to output visual information through a GUI  404 A and to output audio information through a speaker  404 B in a plurality of language outputs which may be selected by one or more users  101 . 
     In some embodiments, the communication engine  421  may govern the electronic communication between the server  300 , data store  308 , and/or a third party database  106  to allow medical history data on a patient to be stored in or retrieved from a data store  308 , and/or a third party database  106 . For example, the communication engine  421  may govern the electronic communication between the server  300  of the system  100  and a server  300  operated by a hospital or healthcare network thereby allowing medical history data to be sent to and retrieved from the a data store  308  and/or third party database  106  of the hospital or healthcare network. 
     In some embodiments, the communication engine  421  may be configured to interpret between a first language, a second language, a third language, and/or any other number of languages. A first language refers to any language which may be preferred or selected by a first user  101 A, while a second language refers to any language which may be preferred or selected by a second user. Since they system  100  provides translation, it is desired that the first language is a different language than the second language. In further embodiments, the communication engine  421  may interpret between a first language and a second language by querying a database accessible to the system  100  for a second language output that may be associated with a first language input. For example, a healthcare provider  101 A may select a first language of English and a healthcare recipient  101 B may select a second language of Spanish. The healthcare provider  101 A may select a first language input comprising a question in English about where the healthcare recipient  101 B is feeling pain. The communication engine  421  may query a database, such as may be stored on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ), to return the same question or its equivalent in Spanish which may then comprise the second language output. In alternative embodiments, the communication engine  421  may interpret between a first language and a second language by using an on-the-fly translation engine such as Google Translate® or an equivalent. 
     In some embodiments, the communication engine  421  may be configured to identify language selections by a user  101 . The communication engine  421  is further configured to communicate in multiple modalities. That is, the communication engine  421  may display prerecorded videos, audio, text, or images to the users  101  in a variety of languages. These video, audio, text, or images files may be stored on the client device  400  or on a remote computer such as a server  300  and accessed through a data network  105 . The communication engine  421  is also configured to record user responses to questions (also called “user input data”). Some non-limiting ways the communication engine  421  may record patient input data are: (1) by recording a user&#39;s  101  touch on the GUI  404 A of a client device  400  (e.g. a user  101  may touch a “YES” or “NO” button on the screen of the client device  400 ), (2) by recording a user&#39;s voice, (3) by capturing a user&#39;s signature or other input on the GUI  404 A of the client device  400 . The communication engine  421  may provide one or more language outputs as audio and/or visual information through a speaker  404 B and/or a GUI  404 A. The user may then select a desired language by providing input to a GUI  404 A, keyboard  404 C, or other I/O interface  404 . The communication engine  421  may use the language selection input to identify a first language selected by a first user  101 A, a second language selected by a second user  101 B, a third language selected by a third user, and so on. Once a language is selected by the user  101 , the communication engine  421  may use that language selection to send and receive language output and input to that user  101 . 
     In some embodiments, the recommendation engine  422  may be configured to determine and/or to store user consent in a database, such as may be stored on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ). The recommendation engine  422  may be configured to provide language output on an I/O interface  404  to a user  101  in the form of a question that ascertains if the user  101  understands and/or consents to language output that was previously provided to the user  101 . The user  101  may then provide language input, such as an affirmative input or a negative input, through the I/O interface  404  which may be communicated to the recommendation engine  422  and used to determine the understanding or consent to the language output. For example, a second user  101 B may select a language of Hindi and be provided second language output comprising instructions for care of their medical condition in Hindi by the communication engine  421  through a speaker  404 B and/or GUI  404 A. The communication engine  421  may then provide second language output on a GUI  404 A and/or speaker  404 B comprising the question “Do you understand and consent to the treatment provided?” and the words “Yes” and “No” in Hindi. The second user  101 B may then provide second language input by selecting “Yes” and “No” displayed on the GUI  404 A in Hindi. If the second user  101 B selects the affirmative “Yes”, the recommendation engine  422  may determine that the second user  101 A does consent and/or understands the previous second language output comprising the instructions. If the second user  101 B selects the negative “No”, the recommendation engine  422  may determine that the second user  101 A does not consent and/or understand the previous second language output comprising the instructions. Once the recommendation engine  422  has determined the consent and/or understanding of the second user  101 B, the consent information may be communicated to the communication engine  421  which may then store the consent information in a database, such as may be stored on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ). 
     In some embodiments, a recommendation engine  422  may be configured to provide recommendations based on input provided by a user  101  of the system  100 . Input by a user  101  may comprise language input and/or language output received by an I/O interface  404  which may be received by the communication engine  421  and communicated to the recommendation engine  422 . In further embodiments, the system  100  may include a plurality of pre-recorded video files, audio files, and text messages in multiple (at least 2) languages which may be stored in a database, such as a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ) accessible to the system  100 . Based on language input or output received from a user  101 , the recommendation engine  422  may select or retrieve one or more pre-recorded video files, audio files, or text messages which may be used to form a recommendation to be output to a user  101  through an I/O interface  404 . The spoken/video portions of the application will be recorded clearly in a standard format preferably by native speakers of each language and maintained in language sets on a database accessible to the system  100 . For example, the communication engine  421  may be configured to display to a user  101  a video explaining the signs of a heart attack based on patient input data that indicates chest pain (e.g. a patient enters “yes” when asked about chest pain). The video in this example will be a prerecorded video in the patient&#39;s preferred language as determined by the system  100 . 
     For example, the recommendation engine  422  may determine that immediate medical attention is necessary based on certain pre-defined criteria (e.g. a healthcare recipient  101 B provides language input through a GUI  404 A of the system  100  that they are having difficulty breathing). The recommendation engine  422  may then retrieve one or more recommendations from a database on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ) accessible to the system  100  such as; “seek immediate medical help”, or “display videos on choking” associated with the language input provided by the healthcare recipient  101 B. The recommendations may then be communicated to the communication engine  421  which may then output the recommendations as video files, audio files, or text messages through a GUI  404 A and/or speaker  404 B. 
     In further embodiments, the recommendation engine  422  may be configured to provide recommendations based on medical history data of a healthcare recipient  101 B that may be retrieved from a database on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ) accessible to the system  100 . The recommendation engine  422  may direct the communication engine  421  to retrieve or access data from the database and to output the recommendation through an I/O interface. For example, if a healthcare recipient  101 B provides language input or output data that relates to a high body temperature and the feeling of chills through a GUI  404 A, the communication engine  421  may communicate the data to the recommendation engine  422  which may direct the communication engine  42  to retrieve a language output from a database that instructs the patient  101 B to drink fluids and to avoid taking a cold medication that may interfere with a blood pressure medication that the healthcare recipient  101 B is currently taking as recorded in the healthcare recipient&#39;s  101 B medical history data in the database. This recommendation may then be output as a video file, audio file, or text message by the communication engine  421  through a GUI  404 A and/or speaker  404 B. 
     In some embodiments, medical history data may include any data that may be descriptive of a user  101 , such as a healthcare provider  101 A or a healthcare recipient  101 B, which may be stored in a database on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ) accessible to the system  100 . The data may include, but is not limited to: the chief complaint, including the location, duration, description of symptoms, chronologic course of the complaint, treatments to date; Surgical History, types and descriptions of surgeries and dates; Medical History including but not limited to medication taken currently and in the past, allergies, smoking history, alcohol history, non-prescription drug or recreational drug history, cancer, and stroke; Review of Systems: General/Constitutional including but not limited to average weight, weight loss or gain, general state of health, sense of well-being, strength, ability to conduct usual activities, exercise tolerance; Skin/Breast including but not limited to rash, itching, pigmentation moisture or dryness, texture, changes in hair growth or loss, nail changes, bruising, birthmarks, moles, ulcers, decubiti, sun exposure and protection, breast lumps, tenderness, swelling, nipple discharge; Eyes/Ears/Nose/Mouth/Throat including but not limited to headaches (location, time of onset, duration, precipitating factors), vertigo, lightheadedness, injury; change in vision, double vision, tearing, blind spots, pain, inflammation, infections, scotomata, ptosis, nose bleeding, colds, obstruction, discharge, epistaxis, sinus pain, dental difficulties, gingival bleeding, dentures, tinnitus, change in hearing, running or discharge from the ears, deafness, dizziness, mouth and throat hoarseness, dysphagia, bleeding gums, sore throat, ulcers or sores in the mouth, neck stiffness, pain, tenderness, masses in thyroid or other areas; Cardiovascular System including but not limited to chest pain, precordial pain, sub sternal distress, syncope, dyspnea, palpitations, weakness, intolerance of exercise, varicosities, swelling of extremities, known murmur, hypertension, asystole, orthopnea, nocturnal paroxysmal dyspnea, edema, cyanosis, hypertension, varicosities, phlebitis, claudication; respiratory tract including but not limited to cough (time of day), sputum (amount in tablespoons or cups per day and color), change in sputum, night sweats, nocturnal dyspnea, wheezing, pain (location, quality, relation to respiration), shortness of breath, stridor, hemoptysis, respiratory infections, tuberculosis or exposure to it, fever; Gastrointestinal System including but not limited to nausea, vomiting, diarrhea, constipation, quality of appetite, change in appetite, dysphagia, gas, heartburn, melena, change in bowel habits, use of laxatives or other drugs to alter the function of the gastrointestinal tract, food idiosyncrasies, abdominal pain, eructation, hematemesis, jaundice, constipation, hemorrhoids, abnormal stools (clay-colored, tarry, bloody, greasy, foul smelling); Genitourinary System including but not limited to urinary tract: dysuria, change in color of urine, change in frequency of urination, pain with urgency, incontinence, edema, retention, urgency, nocturia, hematuria, polyuria, oliguria, change in color or urine, stones, infections, nephritis, hesitancy, change in size of stream, dribbling, libido, genital tract (female) menstrual history (onset of menses, regularity, last period, dysmenorrhea, menorrhagia, metrorrhagia), post-menopausal bleeding, dyspareunia, obstetric history (number and results of pregnancies-gravida/para), contraceptive use, discharge, pain or discomfort, pruritus, history of venereal disease, sexual history; genital tract (male) penile discharge, pain or discomfort, pruritus, skin lesions, hematuria, history of venereal disease, sexual history; Musculoskeletal System including but not limited to heat; redness; swelling; limitation of motion; deformity; crepitation: pain in a joint or an extremity, the neck, or the back, especially with movement, muscular weakness, atrophy, cramps; Neurologic/Psychiatric Systems including but not limited to nervous system: Paralyses, incoordination, dizziness, tremor, ataxia, difficulty in speaking, change in speech, paresthesia, loss of sensation, seizures, syncope, changes in memory; Psychologic status including but not limited to predominant mood (nervousness, depression, hallucinations) nervousness, instability, depression, phobia, sexual disturbances, criminal behavior, insomnia, night terrors, mania, memory loss, perseveration, disorientation, previous psychiatric care; Allergic/Immunologic/Lymphatic/Endrocrine Systems including but not limited to reactions to drugs, food, insects, skin rashes, trouble breathing, hematopoietic spontaneous or excessive bleeding, fatigue, enlarged or tender lymph nodes, pallor, history of anemia, transfusions, Rh incompatibility, asthenia, endocrine system tremor, palpitations, intolerance of heat or cold, polyuria, polydipsia, polyphagia, diaphoresis, exophthalmos, goiter, hormone therapy, growth, secondary sexual development. Optionally, the data can then be printed and made part of the patient&#39;s legal medical record after being confirmed accurate by the healthcare provider  101 A and/or healthcare recipient  101 B. 
       FIG. 6  shows a block diagram illustrating an example workflow  600  of a medical interaction system  100  ( FIG. 1 ) according to various embodiments described herein. In this example workflow  600  the first user  101  ( FIG. 1 ) may comprise a healthcare provider  101 A, such as a doctor, and the second user  101  may comprise a healthcare recipient  101 B such as a patient. The workflow  600  may be performed with a client device  400  ( FIGS. 1, 3, and 4 ) which may comprise a GUI  404 A ( FIG. 4 ) and a speaker  404 B ( FIG. 4 ). In this example, the first user  101 A may select their preferred or first language using the GUI  404 A in step  601 . Next, the system  100  may initiate the selection of the second language or preferred language of the second user  101 B in step  602 . The second user  101 B may select their second language using the GUI  404 A of the electronic device  400  in step  603 . The first user  101 A may input information in a first language that may be interpreted by the system  100  and the information may be output in the second language, such as in with text, audio, and/or video in the second language in step  604 . The second user  101 B may input responses and consent information in the second language through the GUI  404 A or other I/O interface  404  which may be stored in a database such as on a data store  308  accessible to the system  100  in step  605 . In some preferred embodiments, selections and responses entered by the first  101 A and/or second  101 B user may trigger an audible confirmation. For example, when a Spanish speaking second  101 B touches the “si” or “no” button or icon on a GUI  404 A of the electronic device  400  in response to a yes/no question, the device  400  may audibly output the word “si” or “no” so that the second  101 B has audible confirmation that the intended response was given. Further questions may be selected by the system  100 , such as by the recommendation engine  422 , on by the first user  101 A forming first language input which may be interpreted and output as second language output in step  606 . The scope of the questions may include, but is not limited to, the complete review of systems, explanation of procedures, informed consent, discharge instructions, and/or any other medically or legally relevant information. In fact, this same format can be used for pre-translated standardized communication in fields other than medicine. 
     The second user  101 B may input responses and consent information in the second language through the GUI  404 A or other I/O interface  404  which may be stored in a database such as on a data store  308  accessible to the system  100  in step  607 . Based on the responses and consent, the recommendation engine  422  may communicate one or more recommendations to the communication engine  421  which may be displayed or output to the second user  101 B and recorded in the database. The first  101 A and second  101 B users may continue to operate the client device according to this workflow until desired. In some embodiments, the questions and responses of the first  101 A and second  101 B users may be printed or exported in both the interviewer&#39;s, or first user&#39;s  101 A, first language and the patient&#39;s, or second users&#39;  101 B, second language for verification and confirmation. In further embodiments, a bilingual copy of the questions and responses of the first  101 A and second  101 B users may be printed, provided through electronic message, or otherwise available for the patient or second user  101 B which may be authenticated and signed by the patient  101 B to indicate that the responses are correct preferably for legal purposes and implications. 
       FIG. 7  depicts a block diagram of an example of a method for providing medical interaction (“the method”)  700  between two users, such as a healthcare provider  101 A ( FIG. 1 ) and a healthcare recipient  101 B ( FIG. 1 ), according to various embodiments described herein. In some embodiments of the method  700 , the first user or healthcare provider  101 A may first choose his preferred or first language on a client device  400  and the system  100  will record this selection and communicate (e.g. with text, with audio messages, and/or with video messages) with the first user in that first language in step  701 . At step  702 , if the first  101 A and second  101 B user are proficient in the same language, the method  700  may continue to step  703  in which the second user  101 B intake may be initiated and prerecorded videos, images, audio, and/or text may be displayed in the second language on the client device  400 . In some embodiments, a full question set, or a portion thereof chosen by a particular clinic for its specific intake form, may be loaded on a client device  400  such as an iPad. The second user  101 B intake performed in step  703  may include the showing or streaming of video questions to the second user  101 B and would allow the second user  101 B to provide input with the client device  400  to answer the questions chosen for intake of the second user  101 B. 
     If the first  101 A and second  101 B users are not proficient in the same language, the method  700  may continue to step  704  in which a list of available languages may be displayed on the client device  400  to the second user  101 B. In this example, the first user  101 A will then hand the client device  400  to the second user or healthcare recipient  101 B and the system  100  will display a choice of available languages to the second user  101 B. In step  705 , if a preferred or second language is chosen by the second user  101 B, the system  100  will then record the preferred or second language of the second user and communicate (e.g. with text, with audio message, and/or with video message) with the second user in that chosen second language in step  703 . If the second user  101 B does not choose a preferred or second language in step  705 , the method may continue to step  709 . 
     After the second user  101 B intake is initiated in step  703 , optionally the second user  101 B responses may be recorded in the medical record or medical history data of the second user  101 B in step  706  and stored in a data base in a data store  308 , data store  408  ( FIG. 3 ), or remote database  106  ( FIG. 1 ). In some embodiments, the second user  101 B responses may be printed out or ported to an electronic medical record and not stored in the client device  400  or the server  300 . In further embodiments, no second user  101 B identification data may be stored by the client device  400  to avoid HIPPA concerns. Optionally, after step  703 , the method  700  may continue to step  707  in which a rules engine, such as the communication engine  421  ( FIG. 5 ), presents the first user  101 A and second user  101 B with videos and other communication modalities to assist with intake, diagnosis, and treatment. Next in step  708 , the recommendation engine  422  ( FIG. 5 ) may determine consent of the second user  101 B to treatment and/or medical diagnosis. If the second user  101 B does not consent, the method  700  may continue to step  709  in which the process  700  may be repeated or a human translator may be requested. If the second user  101 B does consent, the method  700  may continue to step  706  and the consent may be stored in a database in a data store  308 , data store  408 , or remote database  106 . 
       FIG. 8  illustrates a block diagram of an example of an alternative method for providing medical interaction between two users (“the method”)  800  according to various embodiments described herein. In some embodiments, the method  800  may start  801  and a first language selected by the first user  101 A ( FIG. 1 ) may be identified in step  802 . The first language may be identified by the communication engine  421  through input provided by the first user  101 A through an I/O interface  404  ( FIG. 3 ), such as a GUI  404 A ( FIG. 4 ), keyboard  404 C ( FIG. 4 ), microphone, and the like, of a client device  400  ( FIGS. 1, 3, and 4 ). For example, one or more languages may be displayed on the screen of a GUI  404 A and the first user  101 A may touch the screen to select the first language. 
     In step  803 , a second language selected by the second user  101 B ( FIG. 1 ) may be identified. The second language may be identified by the communication engine  421  through input provided by the second user  101 B through an I/O interface  404 , such as a GUI  404 A, keyboard  404 C, microphone, and the like, of a client device  400 . For example, one or more languages may be displayed on the screen of a GUI  404 A and the second user  101 B may touch the screen to select the second language. 
     Next, first language input from the first user  101 A may be received by the communication engine  421  in step  804 . The first language input may comprise questions, direction, or other information in the first language which the first user  101 A desires to communicate to the second user  101 B. For example, the first user  101 A may speak or type into an I/O interface  404  of the client device  400  and the information may be communicated to the communication engine  421 . 
     In step  805 , the first language input may be interpreted into a second language output. The communication engine  421  may interpret the first language input provided by the first user into second language output which may be comprise audio and/or video of an individual conveying the interpreted information in the second language. 
     The second language output may then be provided to the second user  101 B through the client device  400  in step  806 . The communication engine  421  may output the second language output through an I/O interface  404 , such as a speaker  404 B and/or GUI  404 A. For example, the communication engine  421  may direct the client device  400  to produce the second language output as a video or sound clip for the second user  101 B in the second language. 
     In step  807 , second language input from the second user  101 B may be received by the communication engine  421 . The second language input may comprise questions, answers, or other information in the second language which the second user  101 B desires to communicate to the first user  101 A. For example, the second user  101 B may speak or type into an I/O interface  404  of the client device  400  and the information may be communicated to the communication engine  421 . 
     Next in step  808 , second user  101 B consent to the second language output may be determined by the recommendation engine  422 . The recommendation engine  422  may be configured to provide language output on an I/O interface  404  to a second user  101 B in the form of a question that ascertains if the second user  101 B understands and/or consents to language output that was previously provided to the second user  101 B. The second user  101 B may then provide language input, such as an affirmative input or a negative input, through the I/O interface  404  which may be communicated to the recommendation engine  422  and used to determine the understanding or consent to the language output of the second user  101 B. In further embodiments, the recommendation engine  422  may store second user  101 B consent in a database, such as may be stored on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ). 
     In step  809 , the second language input may be interpreted into first language output. The second language input may be communicated from an I/O interface  404  to the communication engine  421  which may interpret the second language input into first language output. The first language output may comprise audio and/or video of an individual conveying the interpreted information in the first language. 
     The first language output may then be provided to the first user  101 A through the client device  400  in step  810 . The communication engine  421  may output the first language output through an I/O interface  404 , such as a speaker  404 B and/or GUI  404 A. For example, the communication engine  421  may direct the client device  400  to produce the first language output as a video or sound clip for the first user  101 A in the first language. Once the desired information has been exchanged between the first  101 A and second  101 B users, the method  800  may finish  811 . 
       FIGS. 9 and 10  show examples of screenshots of a graphical user interface (GUI)  404 A displayed on the screen of a client device  400  of the system  100  according to various embodiments described herein. The screenshots of  FIGS. 9 and 10  are exemplary in nature as different arrangements, visual layouts, and styles of graphical user interfaces (GUI)  404 A may be displayed by the system  100 . In the following non-limiting example, a GUI  404 A may be used by the system  100  ( FIG. 1 ) to provide medical interaction between two or more users  101  ( FIG. 1 ). In some embodiments, the system  100  may display a video clip to a second user or healthcare recipient  101 B in the video window  902  ( FIG. 9 ) of the GUI  404 A. The video clip may be stored locally on the data store  408  ( FIG. 3 ) of the client device  400  ( FIGS. 1, 3, and 4 ) or on a data store  308  ( FIGS. 1 and 2 ) of a server  300  ( FIGS. 1 and 2 ) and accessed by the client device  400  through a data network  105  ( FIG. 1 ). Each video clip may ask the second user  101 B for a response. In preferred embodiments, the content of the video presented may be pre-translated by medically trained, certified medical translators where such certification exists, and reviewed for medical-legal accuracy. Optionally, the name of the language that the system is outputting may be displayed as titling in the videos themselves or elsewhere on the GUI  404 A screen, or both. For example, if the first language comprises Italian and the second language comprises French, the system  100  a question input in Italian by a first user  101 A may be output in French with possible answers to the question also output in French and optionally the name of the first and/or second language may also be displayed as titling proximate to the respective first and/or second language displayed on the GUI  404 A. 
     The second user  101 B may see the questions and information written in his selected second language in the text and illustration window  903  ( FIG. 9 ) of the GUI  404 A as well as hear it spoken to him by a native speaker of his language through a speaker  404 B ( FIG. 4 ) who may visually appear in a video window  902  on the screen of the GUI  404 A speaking the question or information. The second user  101 B may interrupt at any point and indicate if he needs further clarification or repetition, such as by touching a question icon  906  ( FIG. 9 ) which may be displayed in the input window  904  ( FIG. 9 ) of a touch screen GUI  404 A. By interacting with a question icon  906  which preferably may be displayed on each screen of the GUI  404 A on the client device  400 , the second user  101 B may be provided an audible and/or visual explanation of a question. This is particularly useful in cases in which the second user  101 B may be unfamiliar with presented medical terminology. 
     The second user  101 B may provide second language input comprising responses which may include yes, no, a number, multiple choice or other simple single entry responses which will be indicated by the patient by touching an appropriate screen icon, such as an affirmative icon  905  ( FIG. 9 ), question icon  906  ( FIG. 9 ), negative icon  907  ( FIG. 9 ), explained to the second user  101 B at the outset or at the time of the question. 
     The system may present a series of icons  905 ,  906 ,  907 , in an input window  904  or other text or images onto a text and illustration window  903  of the GUI  404 A interface on the client device  400 . Such icons may include but are not limited to: an affirmative icon  906  optionally comprising a green circle with the word “yes” in the second user&#39;s  101 B selected second language; a negative icon  907  optionally comprising a red circle with the word “no” in the second user&#39;s  101 B selected second language; a question icon  907  optionally comprising a yellow circle with a question mark for the second user  101 B to request clarification, one or more large numbered circles, several buttons or icons with choices included in the verbal question. These may be shape, color and word coded for clarity. Illustrations of the human body or parts thereof may be displayed for the users  101  to indicate the location of a symptom in a text and illustration window  903  on the GUI  404 A. Therefore, the system  100  may be configured to accept and record a second user&#39;s  101 B touch on a touch screen GUI  404 A of a client device  404  to indicate a symptom or area of concern. 
     A confirmation button similar in function to “enter” to accept the response or indicate comprehension of the information provided which the second user  101 B will be asked to touch at regular intervals during the interaction to confirm comprehension, consent, comfort, and to continue. Once the response is given, which may form second language input, by the second user  101 B touching the appropriate screen icon or button, the first user  101 A may touch a “next question” button or icon displayed in the first user&#39;s  101 A or doctor&#39;s options window  901  ( FIG. 9 ) to display a subsequent question or clip. The first user  101 A may have several other buttons to use at his discretion ask the patient, such as button&#39;s or icons in a first language which may be used to provide second language output including but not limited to: Is everything clear so far?; Do you have any questions or concerns at this point?; Is the language you are hearing completely clear and understandable to you?; Do you need to take a break to go to the bathroom or have a cup of water?; and Would you like me to repeat the question? In this manner, the communication engine  421  may operate the processor  402  ( FIG. 3 ) to output first language input, second language output, and second language input on the screen of the GUI  404 A simultaneously. 
     As an initial intent of the system is to establish rapport between the first user  101 A or doctor and second user  101 B or patient while eliciting information from the patient about his medical history. Optionally, the users  101 A,  101 B may take turns tapping a screen button in their respective areas of the screen on a single client device  400  to create a fun game-like quality to the interaction. 
     The results of the first  101 A and second  101 B user interaction may be collected in a standardized organized format conforming to medical standard and legal standard. The standard medical record is necessary for proper documentation of the patient data upon which diagnostic tests such as xrays, laboratory studies, MRI, etc are based. It is also the body of information which the physical examination should confirm. It is important also because payment by insurance companies and government agencies such as Medicare is predicated on the completeness of the medical record. Therefore, the system  100  is configured to record the second user  101 B responses and interaction using the client device  400 . The response data (e.g. yes, no, I agree, I don&#39;t agree, etc.) may then be stored in a database, such as may be stored on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ). Optionally, the database may be located on a server  300  and thus the response data is transmitted to the server  300  from the client device  400  through a data network  105 . 
     The first user  101 A of the system  100  will have available all of the standard elements of the medical history data, plus additional options to include but not limited to explanations of proposed or recommended treatments, informed consents, and instructions to the second user  101 B. The first user  101 A may elect to present all of the questions in the set to a second user  101 B or select a subset of these questions. Additionally, the system  100  may elicit from the first user  101 A questions or instructions which he would like added to the available set, as well as additional languages he would like to be offered. Communication with a server  300  and data store  308  allows for these additional question and language options to be added in its continual maintenance and updates and may allow for a first user  101 A to directly add content to the database in the form of original recorded audio and/or video questions. These may be identified by the contributor to be either for the contributor&#39;s own use or made available to all users  101 . In further embodiments, a user  101 A to user  101 B communication feature may also be provided via online connection to allow a first  101 A and second  101 B user which are remote from each other to communicate through two different client devices  400 . In still further embodiments, the system  100  may collect information from a second user  101 B by recoding the second user&#39;s  101 B actions such as touching the touch screen GUI  404 A of a client device  400  or verbally interacting with the client device  400 . 
     After the first user  101 A has finished interviewing the second user  101 B, the results page may be displayed on the GUI  404 A of the client device  400 . A non-limiting example of a screen which may be used is shown by  FIG. 10 . The back icon  952  ensures that if a mistake was made, it can be corrected. The export icon  953  may bring up options prompting the first user  101 A to send the results to a printer  107  and/or save the results, which may be displayed in the patient results window  951 , to a database such as may be stored on a data store  308  ( FIG. 2 ), data store  408  ( FIG. 3 ), or a remote database  106  ( FIG. 1 ). Finally, the first user  101 A can save the data and start with a new patient by touching the new patient icon  954 . 
     It will be appreciated that some exemplary embodiments described herein may include one or more generic or specialized processors (or “processing devices”) such as microprocessors, digital signal processors, customized processors and field programmable gate arrays (FPGAs) and unique stored program instructions (including both software and firmware) that control the one or more processors to implement, in conjunction with certain non-processor circuits, some, most, or all of the functions of the methods and/or systems described herein. Alternatively, some or all functions may be implemented by a state machine that has no stored program instructions, or in one or more application specific integrated circuits (ASICs), in which each function or some combinations of certain of the functions are implemented as custom logic. Of course, a combination of the two approaches may be used. Moreover, some exemplary embodiments may be implemented as a computer-readable storage medium having computer readable code stored thereon for programming a computer, server, appliance, device, etc. each of which may include a processor to perform methods as described and claimed herein. Examples of such computer-readable storage mediums include, but are not limited to, a hard disk, an optical storage device, a magnetic storage device, a ROM (Read Only Memory), a PROM (Programmable Read Only Memory), an EPROM (Erasable Programmable Read Only Memory), an EEPROM (Electrically Erasable Programmable Read Only Memory), a Flash memory, and the like. 
     Embodiments of the subject matter and the functional operations described in this specification can be implemented in digital electronic circuitry, or in computer software, firmware, or hardware, including the structures disclosed in this specification and their structural equivalents, or in combinations of one or more of them. Embodiments of the subject matter described in this specification can be implemented as one or more computer program products, i.e., one or more modules of computer program instructions encoded on a tangible program carrier for execution by, or to control the operation of, data processing apparatus. The tangible program carrier can be a propagated signal or a computer readable medium. The propagated signal is an artificially generated signal, e.g., a machine generated electrical, optical, or electromagnetic signal that is generated to encode information for transmission to suitable receiver apparatus for execution by a computer. The computer readable medium can be a machine readable storage device, a machine readable storage substrate, a memory device, a composition of matter effecting a machine readable propagated signal, or a combination of one or more of them. 
     A computer program (also known as a program, software, software application, script, or code) can be written in any form of programming language, including compiled or interpreted languages, or declarative or procedural languages, and it can be deployed in any form, including as a standalone program or as a module, component, subroutine, or other unit suitable for use in a computing environment. A computer program does not necessarily correspond to a file in a file system. A program can be stored in a portion of a file that holds other programs or data (e.g., one or more scripts stored in a markup language document), in a single file dedicated to the program in question, or in multiple coordinated files (e.g., files that store one or more modules, sub programs, or portions of code). A computer program can be deployed to be executed on one computer or on multiple computers that are located at one site or distributed across multiple sites and interconnected by a communication network. 
     Additionally, the logic flows and structure block diagrams described in this patent document, which describe particular methods and/or corresponding acts in support of steps and corresponding functions in support of disclosed structural means, may also be utilized to implement corresponding software structures and algorithms, and equivalents thereof. The processes and logic flows described in this specification can be performed by one or more programmable processors executing one or more computer programs to perform functions by operating on input data and generating output. 
     Processors suitable for the execution of a computer program include, by way of example, both general and special purpose microprocessors, and any one or more processors of any kind of digital computer. Generally, a processor will receive instructions and data from a read only memory or a random access memory or both. The essential elements of a computer are a processor for performing instructions and one or more memory devices for storing instructions and data. Generally, a computer will also include, or be operatively coupled to receive data from or transfer data to, or both, one or more mass storage devices for storing data, e.g., magnetic, magneto optical disks, solid state drives, or optical disks. However, a computer need not have such devices. 
     Computer readable media suitable for storing computer program instructions and data include all forms of non volatile memory, media and memory devices, including by way of example semiconductor memory devices, e.g., EPROM, EEPROM, and flash memory devices; magnetic disks, e.g., internal hard disks or removable disks; magneto optical disks; and CD ROM and DVD ROM disks. The processor and the memory can be supplemented by, or incorporated in, special purpose logic circuitry. 
     To provide for interaction with a user, embodiments of the subject matter described in this specification can be implemented on a computer having a display device, e.g., a CRT (cathode ray tube) or LCD (liquid crystal display) monitor, for displaying information to the user and a keyboard and a pointing device, e.g., a mouse or a trackball, by which the user can provide input to the computer. Other kinds of devices can be used to provide for interaction with a user as well; for example, feedback provided to the user can be any form of sensory feedback, e.g., visual feedback, auditory feedback, or tactile feedback; and input from the user can be received in any form, including acoustic, speech, or tactile input. 
     Embodiments of the subject matter described in this specification can be implemented in a computing system that includes a back end component, e.g., as a data server, or that includes a middleware component, e.g., an application server, or that includes a front end component, e.g., a client computer having a graphical user interface or a Web browser through which a user can interact with an implementation of the subject matter described is this specification, or any combination of one or more such back end, middleware, or front end components. The components of the system can be interconnected by any form or medium of digital data communication, e.g., a communication network. Examples of communication networks include a local area network (“LAN”) and a wide area network (“WAN”), e.g., the Internet. 
     The computing system can include clients and servers. A client and server are generally remote from each other and typically interact through a communication network or the cloud. The relationship of client and server arises by virtue of computer programs running on the respective computers and having a client server relationship to each other. 
     Further, many embodiments are described in terms of sequences of actions to be performed by, for example, elements of a computing device. It will be recognized that various actions described herein can be performed by specific circuits (e.g., application specific integrated circuits (ASICs)), by program instructions being executed by one or more processors, or by a combination of both. Additionally, these sequence of actions described herein can be considered to be embodied entirely within any form of computer readable storage medium having stored therein a corresponding set of computer instructions that upon execution would cause an associated processor to perform the functionality described herein. Thus, the various aspects of the invention may be embodied in a number of different forms, all of which have been contemplated to be within the scope of the claimed subject matter. In addition, for each of the embodiments described herein, the corresponding form of any such embodiments may be described herein as, for example, “logic configured to” perform the described action. 
     The computer system may also include a main memory, such as a random access memory (RAM) or other dynamic storage device (e.g., dynamic RAM (DRAM), static RAM (SRAM), and synchronous DRAM (SDRAM)), coupled to the bus for storing information and instructions to be executed by processor. In addition, the main memory may be used for storing temporary variables or other intermediate information during the execution of instructions by the processor. The computer system may further include a read only memory (ROM) or other static storage device (e.g., programmable ROM (PROM), erasable PROM (EPROM), and electrically erasable PROM (EEPROM)) coupled to the bus for storing static information and instructions for the processor. 
     The computer system may also include a disk controller coupled to the bus to control one or more storage devices for storing information and instructions, such as a magnetic hard disk, and a removable media drive (e.g., floppy disk drive, read-only compact disc drive, read/write compact disc drive, compact disc jukebox, tape drive, and removable magneto-optical drive). The storage devices may be added to the computer system using an appropriate device interface (e.g., small computer system interface (SCSI), integrated device electronics (IDE), enhanced-IDE (E-IDE), direct memory access (DMA), or ultra-DMA). 
     The computer system may also include special purpose logic devices (e.g., application specific integrated circuits (ASICs)) or configurable logic devices (e.g., simple programmable logic devices (SPLDs), complex programmable logic devices (CPLDs), and field programmable gate arrays (FPGAs)). 
     The computer system may also include a display controller coupled to the bus to control a display, such as a cathode ray tube (CRT), liquid crystal display (LCD) or any other type of display, for displaying information to a computer user. The computer system may also include input devices, such as a keyboard and a pointing device, for interacting with a computer user and providing information to the processor. Additionally, a touch screen could be employed in conjunction with display. The pointing device, for example, may be a mouse, a trackball, or a pointing stick for communicating direction information and command selections to the processor and for controlling cursor movement on the display. In addition, a printer may provide printed listings of data stored and/or generated by the computer system. 
     The computer system performs a portion or all of the processing steps of the invention in response to the processor executing one or more sequences of one or more instructions contained in a memory, such as the main memory. Such instructions may be read into the main memory from another computer readable medium, such as a hard disk or a removable media drive. One or more processors in a multi-processing arrangement may also be employed to execute the sequences of instructions contained in main memory. In alternative embodiments, hard-wired circuitry may be used in place of or in combination with software instructions. Thus, embodiments are not limited to any specific combination of hardware circuitry and software. 
     As stated above, the computer system includes at least one computer readable medium or memory for holding instructions programmed according to the teachings of the invention and for containing data structures, tables, records, or other data described herein. Examples of computer readable media are compact discs, hard disks, floppy disks, tape, magneto-optical disks, PROMs (EPROM, EEPROM, flash EPROM), DRAM, SRAM, SDRAM, or any other magnetic medium, compact discs (e.g., CD-ROM), or any other optical medium, punch cards, paper tape, or other physical medium with patterns of holes, a carrier wave (described below), or any other medium from which a computer can read. 
     Stored on any one or on a combination of computer readable media, the present invention includes software for controlling the computer system, for driving a device or devices for implementing the invention, and for enabling the computer system to interact with a human user. Such software may include, but is not limited to, device drivers, operating systems, development tools, and applications software. Such computer readable media further includes the computer program product of the present invention for performing all or a portion (if processing is distributed) of the processing performed in implementing the invention. 
     The computer code or software code of the present invention may be any interpretable or executable code mechanism, including but not limited to scripts, interpretable programs, dynamic link libraries (DLLs), Java classes, and complete executable programs. Moreover, parts of the processing of the present invention may be distributed for better performance, reliability, and/or cost. 
     Various forms of computer readable media may be involved in carrying out one or more sequences of one or more instructions to processor for execution. For example, the instructions may initially be carried on a magnetic disk of a remote computer. The remote computer can load the instructions for implementing all or a portion of the present invention remotely into a dynamic memory and send the instructions over the air (e.g. through a wireless cellular network or wifi network). A modem local to the computer system may receive the data over the air and use an infrared transmitter to convert the data to an infrared signal. An infrared detector coupled to the bus can receive the data carried in the infrared signal and place the data on the bus. The bus carries the data to the main memory, from which the processor retrieves and executes the instructions. The instructions received by the main memory may optionally be stored on storage device either before or after execution by processor. 
     The computer system also includes a communication interface coupled to the bus. The communication interface provides a two-way data communication coupling to a network link that is connected to, for example, a local area network (LAN), or to another communications network such as the Internet. For example, the communication interface may be a network interface card to attach to any packet switched LAN. As another example, the communication interface may be an asymmetrical digital subscriber line (ADSL) card, an integrated services digital network (ISDN) card or a modem to provide a data communication connection to a corresponding type of communications line. Wireless links may also be implemented. In any such implementation, the communication interface sends and receives electrical, electromagnetic or optical signals that carry digital data streams representing various types of information. 
     The network link typically provides data communication to the cloud through one or more networks to other data devices. For example, the network link may provide a connection to another computer or remotely located presentation device through a local network (e.g., a LAN) or through equipment operated by a service provider, which provides communication services through a communications network. In preferred embodiments, the local network and the communications network preferably use electrical, electromagnetic, or optical signals that carry digital data streams. The signals through the various networks and the signals on the network link and through the communication interface, which carry the digital data to and from the computer system, are exemplary forms of carrier waves transporting the information. The computer system can transmit and receive data, including program code, through the network(s) and, the network link and the communication interface. Moreover, the network link may provide a connection through a LAN to a client device such as a personal digital assistant (PDA), laptop computer, or cellular telephone. The LAN communications network and the other communications networks such as cellular wireless and wifi networks may use electrical, electromagnetic or optical signals that carry digital data streams. The processor system can transmit notifications and receive data, including program code, through the network(s), the network link and the communication interface. 
     Although the present invention has been illustrated and described herein with reference to preferred embodiments and specific examples thereof, it will be readily apparent to those of ordinary skill in the art that other embodiments and examples may perform similar functions and/or achieve like results. All such equivalent embodiments and examples are within the spirit and scope of the present invention, are contemplated thereby, and are intended to be covered by the following claims.