Patent Publication Number: US-2007100394-A1

Title: Remotely programmable infusion system

Description:
PRIORITY INFORMATION  
      This application is a continuation of application Ser. No. 10/868,662, filed Jun. 15, 2004, pending, which is a continuation of application Ser. No. 10/097,552, filed Mar. 12, 2002, now U.S. Pat. No. 6,749,586, which is a continuation of application Ser. No.  09 / 626 , 571 , filed Jul. 27, 2000, now U.S. Pat. No. 6,355,018, which is a continuation of application Ser. No. 09/251,021, filed Feb. 16, 1999, now U.S. Pat. No. 6,228,057, which is a continuation of application Ser. No. 08/658,689, filed Jun. 5, 1996, now U.S. Pat. No. 5,871,465, which is a continuation of application Ser. No. 08/344,973, filed Nov. 25, 1994, now U.S. Pat. No. 5,573,506. The entireties of these applications are incorporated by reference herein and made a part of the present disclosure. 
    
    
     BACKGROUND OF THE INVENTION  
      1. Field of the Invention  
      The present invention relates to a remotely programmable infusion system for medical applications. More particularly, the present invention relates to an infusion system for delivering a variety of medicines and fluids that sends voice commands and queries to a remote touch-tone transceiver and that can be programmed by pressing keys on the keypad of the remote touch-tone transceiver in response to the commands and queries.  
      2. Description of the Related Art  
      Infusion devices are used in the medical field to administer and deliver medicines and other fluids to a patient. Today, due in part to rising health costs and the high cost of hospital rooms, and in part to the desire to provide comfort and convenience to patients, the medical industry has promoted in-home care for patients suffering from various maladies. Particularly, many patients require delivery and administration of medicines or other IV fluids on a regular basis. Delivery and administration is accomplished via a variety of infusion devices, such IV pumps and gravity pumps and other types of IV administration. By supplying patients with infusion devices that are lightweight and easy to use, the patients can receive their medicinal needs at home, i.e., without having to be at a hospital and without direct assistance by a care provider, such as a nurse.  
      Nevertheless, the operating parameters of infusion devices must frequently be changed, due to variations in the patient&#39;s needs. Therapy changes may also require that entire protocols be programmed. In early versions of home infusion devices, the physical presence of a care provider at the infusion device was required to reprogram the device&#39;s protocol. Such reprogramming was costly and time-consuming, thereby severely limiting the efficiency and convenience of infusion devices.  
      Since the introduction of these early home infusion devices, the medical industry has made advances in the techniques by which a home infusion device can be monitored and reprogrammed. For example, one system employs a patient activated switch on a diagnostic apparatus that causes automatic dialing of a telephone number corresponding to a care provider remote from the diagnostic apparatus. This enables the patient to communicate with the care provider through a speaker and microphone on the diagnostic apparatus, permitting interactive communication with the care provider regarding the routines to be performed by the diagnostic apparatus. This system, however, merely provides the capability for the care provider to monitor the infusion device, but does not offer the capacity to remotely reprogram the infusion device.  
      Another remote monitoring system employs a user interface for programming blood pressure testing protocol into, and downloading blood pressure data from, ambulatory blood pressure monitoring units. The user interface is connected to a central processing computer via a telephone line. Control units located at the blood pressure testing site transfer blood pressure data to the central computer, which generates comprehensive medical reports for specific patients, but which cannot transmit reprogramming signals back to the control unit.  
      Other systems employ remote computers for monitoring and reprogramming the protocol of the infusion device. In one such system, the infusion device has a delivery unit for delivering the medicinal solution and a removable logic unit for controlling operation of the delivery unit. The logic unit is either attached to or separate from the delivery unit, and the latter can be worn by the patient. The logic unit is connected to a programming computer via a telephone line. The computer can be used to program the logic unit with a logic configuration suitable for operating the delivery unit in accordance with the intended delivery requirements. Thus, while such systems provide for remote reprogramming of the protocol, they require a remotely located computer to accomplish reprogramming.  
      The previous conventional systems have a variety of drawbacks. Most importantly, they do not provide simple, interactive reprogramming by a care provider without the need for a remote reprogramming computer. The ability to have the care provider access the remotely located infusion device on a standard telephone and reprogram the infusion device via the keys on the telephone keypad is a significant advance over conventional reprogramming techniques. This is because touch-tone reprogramming is less costly, quicker, and much more convenient for both the care provider and the patient, making infusion devices easier to use and more versatile. Conventional home infusion systems also do not have the capacity to send recorded voice signals to the remote care provider instructing and asking the care provider about reprogramming the infusion device. By using recorded voice commands and queries stored in the infusion system that direct the care provider in reprogramming the infusion device, the process of reprogramming is made simpler and more efficient, with little chance of making programming errors. Therefore, a need exists for an infusion device that can be remotely programmed via a transceiver without the need for a remote programming computer and that sends recorded voice signals from the infusion device to a care provider.  
     SUMMARY OF THE INVENTION  
      Accordingly, the present invention is directed to a remotely programmable infusion system and a method for remotely programming an infusion system via a remote transceiver that substantially obviates one or more of the problems due to limitations and disadvantages of the related art.  
      Additional features and advantages of the invention will be set forth in the description that follows and in part will be apparent from the description, or may be learned by practice of the invention. The objectives and other advantages of the invention will be realized and attained by the apparatus and method particularly pointed out in the written description and claims of this application, as well as the appended drawings.  
      To achieve these and other advantages, and in accordance with the purpose of the invention as embodied and broadly described herein, the present invention defines a remotely programmable infusion system having a programmable protocol, the infusion system being remotely programmable by a remote touch-tone transceiver. The remotely programmable infusion system comprises a memory for storing a programmable protocol and a remote communication port for sending a voice signal to the remote touch-tone transceiver and for receiving a remote programming signal from the remote touch-tone transceiver. The remotely programmable infusion system also comprises a voice storage unit for storing the voice signal and a processor, coupled to the remote communication port and to the voice storage unit and to the memory, for accessing the voice signal from the voice storage unit and the programmable protocol from the memory, and for processing the programmable protocol in response to receiving the remote programming signal.  
      In another aspect, the present invention defines a method for remotely programming an infusion system. The infusion system has a voice storage unit for storing a voice signal and has a programmable protocol and is remotely programmable by a remote touch-tone transceiver. The method comprises several steps: establishing a connection between the infusion system and the remote touch-tone transceiver; accessing the voice signal from the voice storage unit in response to establishing the connection; sending the voice signal to the remote touch-tone transceiver; receiving a remote programming signal from the remote touch-tone transceiver; and processing the programmable protocol in response to receiving the remote programming signal.  
      In a further aspect, the present invention comprises a remotely programmable infusion system having a programmable protocol stored in a protocol memory, the remotely programmable infusion system being programmable by a remote touch-tone transceiver. The infusion system comprises an infusion pump for delivering fluids to a patient. The infusion pump has an infusion data port. The infusion system also comprises a homebase unit, coupled to the infusion communication port on the infusion pump via a homebase data port, for processing the programmable protocol. The homebase unit comprises a voice storage unit for storing a voice signal and a remote communication port for sending the voice signal to the remote touch-tone transceiver and for receiving a dual-tone multi-frequency (DTMF) signal from the remote touch-tone transceiver. The homebase unit further comprises a processor, coupled to the remote communication port, to the voice storage unit, and to the protocol memory, for accessing the voice signal from the voice storage unit, for accessing the programmable protocol from the protocol memory, and for processing the programmable protocol to obtain a processed programmable protocol in response to the DTMF signal. The processed programmable protocol is relayed from the processor to the infusion pump via the homebase data port and the infusion data port.  
      It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.  
      The accompanying drawings are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, to illustrate the embodiments of the invention, and, together with the description, to explain the principles of the invention. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       FIG. 1  is a diagrammatical representation of the programmable infusion system of the present invention.  
       FIG. 2  is a block diagram of the homebase unit in accordance with the present invention.  
       FIG. 3  is a flow diagram illustrating entry of an access code and the main menu in an example of the present invention.  
       FIG. 4  is a flow diagram illustrating an access code menu in accordance with an example of the present invention.  
       FIG. 5  is a flow diagram illustrating a review mode menu in accordance with an example of the present invention.  
       FIG. 6  is a flow diagram illustrating an edit mode menu in accordance with an example of the present invention.  
       FIG. 7  is a flow diagram illustrating sub-menus of the edit mode menu in accordance with an example of the present invention.  
       FIGS. 8A and 8B  represent a flow diagram illustrating a programming mode menu in accordance with an example of the present invention.  
       FIG. 9  is a flow diagram illustrating sub-menus of the programming mode menu in accordance with an example of the present invention.  
       FIG. 10  is a table illustrating the alarm functions that can be employed in the system of the present invention. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
      Reference will now be made in detail to the present preferred embodiment of the invention, an example of which is illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.  
      In accordance with the present invention, a remotely programmable infusion system is provided that allows remote programming of the infusion system from a remotely located transceiver, such as a push-button telephone. The remotely programmable infusion system includes a memory and a voice storage unit. The infusion system also includes a remote communication port, as well as a processor that is coupled to the remote communication port, the voice storage unit, and the memory. It should be understood herein that the terms “programming,” “programmable,” and “processing” are generalized terms that refer to a host of operations, functions, and data manipulation. Those terms, therefore, are not to limited herein to editing and deleting data, parameters, protocol, and codes. For example, programming and processing, as used herein, may encompass editing, changing, erasing, entering, re-entering, viewing, reviewing, locking, and inserting functions.  
      An exemplary embodiment of the apparatus of the present invention is shown in  FIG. 1  and is designated generally by reference numeral  10 . As herein embodied and shown in  FIG. 1 , the remotely programmable infusion system  10  includes a pump unit  12  and a homebase  14 . The pump unit  12  and homebase  14  may be two separate units, as illustrated in  FIG. 1 , or may comprise a single integral unit housing both the pump  12  and the homebase  14 . With both elements integrated into a single infusion device, the device may be entirely portable and programmable, both via local and remote programming devices.  
      The pump unit  12  includes a housing  16  that contains the electrical and mechanical elements of the pump unit  12 . An example of a pump unit  12  that can be used in the present invention is disclosed in U.S. Pat. No. 5,078,683, assigned to the assignee of the present invention. The pump unit  12  also includes an infusion line  18  that is connected to a patient at end  19 . The pump unit  12  further includes a display  20  and various controls  22 .  
      The homebase  14  includes a cradle  24  for holding the pump unit  12 , a cable for connecting the homebase  14  to the pump unit  12 , controls  26  for controlling operation of the homebase  14 , display lights  28  for indicating various conditions of the homebase  14 , and an internal audio device  29  for providing audio alarm signals. As embodied herein, the controls  26  include a link button  30 , a local button  32 , and a send button  34 . The display lights  28  include a wait light  36 , a phone light  38 , and an alarm light  40 . The function of the controls  26  and the display lights  28  will be described in detail below. The homebase  14  also includes a remote communication port  42  and a local communication port  44 . Preferably, the homebase  14  and pump  12  are interconnected by an infra-red communications link  46 ,  48 .  
      As embodied herein, the remote communication port  42  and the local communication port  44  each comprise a standard modem, as is well known in the art. Preferably, the modem module of the present invention is a Cermetek modem No. CH1785 or CH1782. These modem modules may operate at 2400 baud or other baud rates. Other baud rates, however, can also be employed in the present invention. The local button  32  is used to activate the local communication port  44 . For example, when the care provider is at the premises where the infusion system  10  is located, the care provider presses the local button  32 , thereby activating the local communication port  44 . The care provider can then communicate with the homebase  14  via a local telephone (not shown) at the premises that is connected to the local communication port  44 . If, on the other hand, the care provider is at a location remote from the infusion system  10 , the link button  30  is pressed, activating the remote communication port  42 . In this way, the care provider can communicate with the homebase  14  via a telephone (or other such transceiver) located at the remote location.  
      For convenience, this description refers to local and remote telephones, but it should be understood that any touch-tone or DTMF transceiver can be employed in the present invention, or for that matter, any transceiver that is capable of two-way communication and activation or selection of programming parameters both independently of and in response to various prompts and queries. It should also be understood that the term “touch-tone transceiver” is not limited to conventional push-button telephones having a 12 key keypad, with 0-9, “*”, and “#” keys. Rather, as defined herein, the term “touch-tone transceiver” refers to any transceiver capable of generating signals via a keyboard or other data entry system and thus is not limited to transceivers that generate DTMF signals, such as conventional telephones. Examples of “touch-tone transceivers” as defined herein include conventional push-button telephones, computers having a keyboard and/or mouse, transmitters that convert human voice to pulse or digital or analog signals, and pager transceivers.  
      The homebase data port  46  and pump data port  48  comprise a wireless emitter/detector pair. Preferably, data ports  46 ,  48  each comprise and infra-red emitter/detector, permitting wireless communication between the pump unit  12  and the homebase  14 . Other wireless communications ports may be employed, however, or the pump unit  12  and the homebase  14  may have their data ports  46 ,  48  hard-wired together. As described above, moreover, the pump unit  12  and the homebase  14  may comprise a single unit, obviating the need for a wireless or hard-wired link between the two units. A power cable  50  is preferably employed to provide power to the pump unit  12  via the homebase  14 . Alternatively, the pump unit  12  may have its own power cable coupled directly to the power source, as opposed to being connected through the homebase  14 .  
      With reference to  FIG. 2 , the elements included in the homebase  14  will be described. The homebase  14  comprises the remote communication port  42 , the local communication port  44 , a protocol memory  51 , a voice storage unit  52 , a processor  53 , a voice synthesizer  49 , and an access code memory  54 . The protocol memory  51 , the voice storage unit  52 , and the access code memory  54  can all be contained in the same memory device (such as a random-access memory), or in separate memory units. Preferably, the voice storage unit  52  comprises a read-only memory (ROM), and the processor  53  comprises an  8 -bit microcontroller, such as the Motorola MC68HC1 1 AOFN. The homebase  14  also includes the data port  48  for relaying information between the homebase  14  and pump unit  12 . The voice synthesizer  49  is preferably an integrated circuit that converts digitized voice signals to a signal that emulates the sound of a human voice. As embodied herein, the voice synthesizer  49  need only be used to convert the signals outgoing from the homebase  14  to the remote or local telephone and thus is not required for converting incoming signals from the remote or local telephone. The voice synthesizer may comprise an LSI speech synthesis chip commercially available from Oki, part number MSM6585.  
      The remote communication port  42 , the local communication port  44 , and the homebase data port  48  are all coupled to the processor  53  via data buses  55   a ,  56   a ,  57   a , respectively. The communication ports  42 ,  44  receive signals from a transceiver (such as a telephone) and relay those signals over the buses  55   a ,  56   a , respectively, to the processor  53 , which in turn processes the signals, performing various operations in response to those signals. The processor  53  receives digitized voice signals from the voice storage unit  52  via bus  59   a  and sends those digitized voice signals to the voice synthesizer  49  via bus  59   b , where the signals are converted human voice emulating signals. Those human voice signals are sent from the voice synthesizer  49  via buses  55   b ,  56   b ,  57   b  to buses  55   a ,  56   a ,  57   a , which in turn relay the those signals to the remote communication port  42 , the local communication port  44 , and the homebase data port  48 , respectively.  
      For example, suppose it is necessary to provide instructions to the care provider operating the remote telephone (not shown). The processor  53  sends a voice address signal over a data bus  59   a  coupling the processor  53  to the voice storage unit  52 . The voice address signal corresponds to a location in the voice storage unit  52  containing a particular voice signal that is to be sent to the remote transceiver. Upon receiving the voice address signal, the particular voice signal is accessed from the voice storage unit  52  and sent, via the data bus  59   a , to the processor  53 . The processor  53  then relays the voice signal via the data bus  59   b  to the voice synthesizer  49 , which converts the voice signal and sends the converted signal via data buses  55   b  and  55   a  to the remote communication port  42 , which sends the converted signal to the remote transceiver. The voice signal retrieved from the voice storage unit  52  may be a digitized representation of a person&#39;s voice or a computer generated voice signal (both being well known in the art). The digitized voice signal is converted by the voice synthesizer  49  to a signal that emulates the sound of a human voice. The voice signal instructs the care provider on how to respond to the voice signal and what type of information the care provider should send. As the remote transceiver may be a push-button telephone having a keypad with multiple keys, the care provider then presses the appropriate key or keys, thereby sending a DTMF signal back to the remote communication port  42  of the homebase  14 . It should be understood, however, that the remote transceiver need not be a push-button telephone, but rather any transceiver capable of sending and receiving DTMF or other similar signals. For example, the remote transceiver may be a computer or portable remote controller.  
      Suppose the DTMF signal sent by the care provider is a remote programming signal, which is transmitted from the remote telephone to the remote communication port  42  of the homebase  14 . The remote communication port  42  then relays the remote programming signal via the data bus  55   a  to the processor  53 . In response to receiving the remote programming signal, the processor  53  accesses a particular parameter of the programming protocol from the protocol memory  51 . To access the parameter, the processor  53  transmits a protocol address signal over the data bus  58  that couples the processor  53  and the protocol memory  51 . The protocol address signal corresponds to a location in the protocol memory  51  containing the parameter. The parameter is then sent from the protocol memory  51  to the processor  53  over the data bus  58 . Depending on the nature of the remote programming signal, the processor  53  can then perform one of a number of operations on the parameter, including editing, erasing, or sending the parameter back to the remote transceiver for review. Those skilled in the art will recognize that many types of signals or commands can be sent from the remote transceiver to the homebase  14  for processing. Examples of such signals, how they are processed, and their effect will be described in detail below in conjunction with the description of the operation of the present invention.  
      In accordance with the present invention, the infusion system  10  can incorporate various security measures to protect against unwanted programming of the pump protocol. Significantly, a user access code can be used to block programming except by persons with the user access code, which may be a multi-digit number (preferably a four digit number). The infusion system  10  can be equipped with one or multiple user access codes, which are stored in the access code memory. To initiate communication with the infusion system  10 , a care provider is connected to the infusion system  10  via a remote conventional push-button telephone (not shown). This connection may be initiated by a call from the care provider to the infusion system  10  (or a patient talking on a telephone located near the infusion system  10 ), or by a call from the patient to the care provider. Either way, the care provider is connected to the infusion system  10 . After the connection is made between the care provider and the infusion system  10 , the care provider is asked (via a voice signal stored in the voice storage unit  52 ) to enter the user access code. If the care provider enters a valid user access code (as explained above, there may be several valid codes), the care provider is permitted to access and/or program the pump protocol.  
      During a programming session, in certain circumstances (which will be described below), the user access codes can be reviewed, edited, and/or erased entirely and re-entered. To perform any of these functions, a programming signal is sent by the care provider (from, e.g., a remote push button telephone) to the homebase  14 . That programming signal is relayed by the remote communication port  42  to the processor  53 , which processes the signal and generates an access code address signal. The access code address signal, which corresponds to a memory location in access code memory  54  holding a user access code, is sent over a data bus  60  to the access code memory  54 . The particular user access code is then retrieved and sent back over the data bus  60  to the processor  53 , which processes the user access code in some manner.  
      To communicate with the pump  12 , the homebase is equipped with the homebase data port  48 . The pump protocol can be sent from the homebase  14  to the pump  12  via the homebase data port  48  and the pump data port  46 . Thus, for example, the processor  53  accesses the protocol from the protocol memory  51  and sends the protocol via data bus  57   a  to the homebase data port  48 . The homebase data port  48  then sends the information over the infra-red link to the pump data port  46 , where it is processed by circuitry and/or software in the pump  12 . In this way, the pump protocol can be programmed (e.g., edited, redone, reviewed, locked, re-entered, etc.).  
      The functions of the controls  26  of the infusion system  10  will now be described. The local button  32  is used to activate the local transceiver. If the care provider is located at the homebase  14 , and a local transceiver (e.g., a push-button telephone) is at that location and connected to the local communication port  44 , the local button  32  is depressed, activating the local communication port  44  and thereby providing a communication connection between the local telephone and the homebase  14 .  
      The send button  34  is designed to permit sending of the infusion system  10  protocol to a remote (or local) computer (not shown). In this way, a remote or local computer can maintain a file having the protocol of many infusion systems  10  located in various places and monitor those protocols. If the computer is remote from the infusion system  10 , a person located at the homebase  14  presses the send button  34 , which in turn downloads the existing protocol to the remote communication port  42 . The protocol is then transmitted via the remote communication port  42  to the remote computer.  
      The link button  30  is used to initiate a remote (or local) programming session, or, in other words, to enter the remote touch-tone programming mode of the infusion system  10 . When initiating a programming session, the care provider calls the telephone number corresponding to the infusion system  10  (or the patient&#39;s home phone). The call may ring at a local telephone coupled to the homebase  14  via the local communication port  44 . The patient answers the call, and the care provider and patient can communicate between the remote and local telephones via standard voice signals. This is known herein as a phone mode or patient conversation mode. The care provider then instructs the patient to depress the link button  30 , which disconnects the patient from the telephone line and initiates the programming mode described below with reference to  FIGS. 3-9 . If, however, the patient does not answer the care provider&#39;s call, the homebase may be equipped with an internal switching system that directly connects the care provider with the homebase  14  and initiates the programming mode. The internal switching may be accomplished with hardware in the homebase  14  or with software that controls the processor  53 , or with a hardware-software combination. Either way, the care provider may then begin processing the information and protocol stored in the homebase  14 . (As described above, the call may be initiated by the patient to the care provider.)  
      The functions of the display lights  28  will now be described. Preferably, the display lights  28  comprise LEDs. The wait light  36  indicates when the homebase  14  is involved in a programming session or when its is downloading the protocol to the remote computer. Accordingly, the wait light  36  tells the patient not to disturb the homebase  14  until the wait light  36  goes off, indicating that internal processing elements of the homebase  14  are inactive. The phone light  38  indicates when the care provider and the patient are involved in voice communication via the remote telephone and the local telephone and thus when the internal processing elements of the homebase  14  are inactive. The phone light  38  may also indicate when the infusion system  10  is ready. The alarm light  40  indicates various alarm conditions and functions in the infusion system  10 . The alarm conditions and operation of the alarm light in response to those conditions will be described below with reference to  FIG. 10 .  
      Illustrated in  FIGS. 3-9 , the programming mode or sequence of the present invention will be described in detail. As described above, when a care provider wants to access and process the protocol of the homebase  14  from a remote telephone, the care provider calls a telephone number corresponding to the infusion device  10 . Preferably, the call from the care provider rings at a local telephone coupled to the homebase  14 . If the call is answered by the patient (or some other person) located at the local telephone and homebase  14 , the care provider and patient communicate by standard voice signals between the remote and local telephones (i.e., communicate in the phone or patient conversation mode). During such communications, the care provider asks the patient to depress the link button  30  (or some series of buttons) on the homebase  14 , which connects the care provider with homebase  14 , terminates the phone mode, and initiates a remote touch-tone programming session. If, on the other hand, the care provider&#39;s call is not answered, the care provider may be directly connected to the homebase  14 , as described above, thereby directly initiating a remote touch-tone programming session without entering the phone mode. Alternatively, a touch-tone programming session can be initiated by a care provider located at the local push-button telephone simply by picking up the telephone handset and pressing the local button  32 , which gives the local telephone access to the homebase  14 .  
      Once the care provider has accessed the programming mode of the homebase  14 , a series of steps are followed to enable the care provider to program the operational protocol of the infusion device  10 . It should be understood that the following programming and access steps are exemplary only and that many variations can be made to the disclosed scheme.  
      With reference to  FIG. 3 , the processor  53  accesses from the voice storage unit  52  a greeting message  61 , which is transmitted to the care provider at the remote or local telephone. Following the greeting message  61 , a voice command  62  (which is accessed by the processor  53  from the voice storage unit  52 ) is sent to the care provider asking the care provider to enter an access code. Using the keys on the remote push-button telephone, the care provider enters the access code, and the processor  53  determines whether the entered access code is valid (Step  63 ). If it is valid, the processor  53  determines in Step  64  whether it is a master access code or a user access code. If the care provider has entered a master access code, the care provider is transferred (circle  65 ) to an access code menu  90  illustrated in  FIG. 4 , which provides for programming of the master and user access codes.  
      If the care provider has entered a user access code, the processor  53  accesses from the voice storage unit  52  a number of voice queries comprising a main menu  82 : (1) Step  66 —asks whether the care provider wants to review the current programmable homebase protocol, instructing the care provider to depress a particular key on the touch-tone key pad to select this option; (2) Step  67 —asks whether the care provider wants to edit the current protocol, providing a similar instruction; (3) Step  68 —asks whether the care provider wants to create an entirely new protocol, with instructions on how to select this option; and (4) Step  69 —asks whether the care provider wants to terminate the programming session and return to voice communication with the patient. If the care provider selects the review mode (Step  66 ), the care provider is transferred (circle  70 ) to a review mode menu  195  illustrated in  FIG. 5 . If the care provider selects the edit mode (Step  67 ), the care provider is transferred (circle  71 ) to an edit mode menu  200  illustrated in  FIG. 6 . If the care provider selects the create mode (Step  68 ), the care provider is transferred (circle  72 ) to a create mode menu  300  illustrated in  FIG. 8A . Finally, if the care provider selects direct conversation with the patient (Step  69 ), the connection is switched to a phone mode (Step  73 ). In the phone mode, the care provider can talk with the patient to verify programming changes (Step  74 ). The care provider can then hang up the remote telephone after completing the conversation with the patient (Step  75 ).  
      If the care provider entered an invalid access code, the following steps are followed. In response to receiving an invalid code (see Step  63 ), the care provider is asked (in Step  63 ) to enter another access code because the one previously entered was invalid. If this next entered access code is valid, the care provider is transferred (via Step  77 ) to the access code decision step (i.e., Step  64 ), and the process is as described above. If, however, the care provider enters another invalid access codes decision Step  77  goes to Step  78 , in which the care provider is told the access code is invalid and is asked to enter another access code. If this code is valid, decision Step  79  transfers the care provider to access code decision step  64 .  
      If, on the other hand, the care provider has entered a third invalid access code, decision Step  79  goes to Step  80 . The care provider is told in Step  80  that the access code is invalid and to contact a home healthcare provider to obtain a correct access code, and the homebase  14  hangs up (Step  81 ). It should be understood that any number of iterations of access code entering can be employed in the present invention. For example, if the care provider enters two invalid access codes, the homebase could hang up, or it could permit the care provider more than three tries to enter a proper access code.  
      Referring now to  FIG. 4 , the access code menu  90  will be described. If the care provider has entered a master access code, the care provider is transferred to the access code menu  90  (via circle  65 ). Upon accessing this menu, the homebase  14  generates a number of voice queries that are transmitted to the care provider and provide the care provider with a number of options. First, in Step  91 , the care provider is asked whether a new master access code is to be entered and is instructed to press a certain button on the touch tone key pad (in this case the number “1”) to select this option. If the care provider selects this option, the homebase  14  tells the care provider to enter the existing master access code (Step  92 ) and to enter a new master access code (Step  93 ). The newly entered master access code is then read back to the care provider by the homebase  14  (Step  94 ), and the homebase  14  generates a voice command that tells the care provider to press the “#” key on the key pad to accept this new master access code (Step  95 ). If the care provider presses the “#” key, the homebase  14  returns (Step  96 ) the care provider to the access code menu  90  (via circle  65 ). Those skilled in the art will recognize that the keys to be pressed by the care provider are only exemplary and that other keys could be designated to accept and/or select various options and programming 5 entries.  
      Second, in Step  97 , the care provider is asked whether a new user access code is to be entered and is instructed to press a certain button on the touch tone key pad (in this case the number “2”) to select this option. If the care provider selects this option, the homebase  14  tells the care provider to enter a new user access code (Step  98 ). If the entered new user access code already exists, the program loops around (Steps  99 - 100 ) and asks the care provider to enter a new master access code again (Step  97 ). If the newly entered user access code does not already exist, the new user access code is then read back to the care provider by the homebase  14  (Step  101 ), and the homebase  14  generates a voice command that tells the care provider to press the “#” key on the key pad to accept this new user access code (Step  102 ). If the care provider presses the “#” key, the homebase  14  returns (Step  103 ) the care provider to the access code menu  90  (via circle  65 ).  
      Third, in Step  104 , the care provider is asked whether he or she would like to query the user access codes and is instructed to press a certain button on the touch tone key pad (in this case the number “3”) to select this option. If the care provider selects this option, the homebase  14  tells the care provider in Step  105  that there are a certain number of user access codes (depending on how many there are). In Step  106 , the homebase  14  recites the user access codes to the care provider and continues reciting the user access codes (Step  107 ) until all are recited. After completing reciting the user access codes, the homebase  14  returns (Step  108 ) the care provider to the access code menu  90  (via circle  6 -E).  
      Fourth, in Step  109 , the care provider is asked whether he or she would like to erase the user access codes and is instructed to press a certain button on the touch tone key pad (in this case the number “4”) to select this option. If the care provider selects this option, the homebase  14  asks the care provider to select one of two options: (1) to erase specific user access codes, press a certain button on the touch-tone key pad (in this case the number “1”) (see Step  1   10 ); or (2) to erase all user access codes, press a different button (in this case the number “2”) (see Step  115 ). If the care provider selects Step  1   10 , the care provider is asked to enter the specific user access code to be deleted (Step  111 ), and the homebase  14  reads back that specific user access code in Step  1   12 . The homebase  14  then asks the care provider to press the “#” button on the touch-tone key pad to accept deletion of that user access code (Step  113 ) and is returned to the access code menu in Step  114 . If the care provider selects Step  115  (global deletion), the homebase  14  warns the care provider that he or she is about to erase all the user access codes and asks for the care provider to press the “#” button to accept (Step  1   16 ). The homebase then returns to the access code menu  90  (Step  117 ).  
      Fifth, in Step  118 , the care provider is asked to press a certain number (in this case “5”) to exit the access code menu. If the care provider selects this option, the homebase  14  returns (via Step  119 ) to the access code prompt  62  (see  FIG. 3 ).  
      Referring now to  FIG. 5 , the review mode will be described in detail. If the care provider has selected the review mode in Step  66 , the homebase  14  transfers (circle  70 ) the care provider to a review mode menu  195  illustrated in  FIG. 5 . Upon accessing this menu, the homebase  14  generates a number of voice queries that are transmitted to the care provider and provide the care provider with a number of options—namely, reviewing the following information: (1) the operating parameters of a continuous mode of the pump  12  (Step  120 ); (2) the operating parameters of an intermittent mode of the pump  12  (Step  121 ); (3) the operating parameters of a taper mode of the pump  12  (Step  122 ); (4) the operating parameters of a patient controlled analgesia (PCA) mode in milliliters (mL) of the pump  12  (Step  123 ); and (5) the operating parameters of a PCA mode in milligrams (mg) of the pump  12  (Step  124 ). The continuous mode refers to a pump that continually delivers fluid to the patient, whereas the intermittent mode refers to intermittent delivery of fluids. The taper mode refers to a mode in which fluid delivery is stepped-up to a base rate then stepped-down to a “keep vein open” rate periodically during administration. The PCA mode refers to the ability of the patient to self-administer an additional burst (or “bolus”) of the fluid being administered by the pump. In other words, when the present dosage of analgesia being administered to the patient by the pump is inadequate to relieve pain, the patient can self-administer a bolus shot to bolster the dosage being automatically delivered by the pump.  
      If the care provider selects review of the continuous mode (Step  120 ), the homebase  14  provides the care provider with a variety of information. The care provider is told whether the protocol is locked or unlocked (Step  125 ); whether the “air-in-line” (AIL) alarm is on or off (Step  126 ); the elapsed time in hours, minutes, and/or seconds of the present administration to the patient (Step  127 ); the programmed rate of fluid being delivered in mLs per hour (Step  128 ); the current rate of fluid in mLs per hour (Step  129 ); the volume of fluid to be infused in mLs (Step  130 ); the volume of fluid already infused (Step  131 ); the level in mLs at which the low volume alarm will sound (Step  132 ); and the last occurrence of the alarm (Step  133 ). (See also  FIG. 10 , which illustrates the alarm table.) After providing this information to the care provider, the homebase  14  in Step  134  returns to the main menu  82 .  
      If the care provider selects review of the intermittent mode (Step  121 ), the homebase  14  also provides the care provider with a variety of information. Steps  135 - 137  provide the same information as Steps  125   127 , respectively. Step  141  provides the same information as Step  131 , and Steps  145 - 146  provide the same information as Steps  132 - 133 , respectively. Additional information provided to the care provider in the intermittent mode is as follows: the programmed dose rate of fluid being delivered in mLs per hour (Step  138 ); the current dose rate of fluid in mLs per hour (Step  139 ), the dose volume of fluid to be infused in mLs (Step  140 ); the background rate in mLs per hour (Step  142 ); the time between doses (or “Q” hours) (Step  143 ); and the number of doses (Step  144 ). After providing this information to the care provider, the homebase  14  returns in Step  147  to the main menu  82 .  
      If the care provider selects review of the taper mode (Step  122 ), the homebase  14  also provides the care provider with a variety of information. Steps  148 - 150  provide the same information as Steps  125 - 127 , respectively. Step  1   54  provides the same information as Step  1   31 , and Steps  157 - 158  provide the same information as Steps  132 - 133 , respectively. Additional information provided to the care provider in the taper mode is as follows: the programmed base rate of fluid being delivered in mLs per hour (Step  151 ); the current base rate of fluid in mLs per hour (Step  152 ); the volume of fluid before taper down in mLs (Step  153 ); the step-up rate in mLs per hour (Step  1   55 ); and the step-down rate in mLs per hour (Step  1   56 ). After providing this information to the care provider, the homebase  14  returns in Step  159  to the main menu  82 .  
      If the care provider selects review of the PCA mL mode (Step  123 ), the care provider is also given information. Steps  160 - 162  provide the same information as Steps  125 - 127 , respectively. Steps  165 - 166  provide the same information as Steps  130 - 131 , respectively, and Steps  172 - 173  provide the same information as Steps  132 - 133 , respectively. Additional information provided to the care provider in the PCA mL mode is as follows: the programmed continuous rate of fluid being delivered in mLs per hour (Step  163 ); the current continuous rate of fluid in mLs per hour (Step  164 ); the bolus volume of fluid in mLs (Step  167 ); the bolus interval in hours and minutes (Step  168 ); the number of boli/hour (Step  169 ); the number of boli attempted (Step  170 ); and the number of boli delivered (Step  171 ). After providing this information to the care provider, the homebase  14  returns in Step  174  to the main menu  82 .  
      If the care provider selects review of the PICA mg mode (Step  124 ), the care provider is given other information. Steps  175 - 177  provide the same information as Steps  125 - 127 , respectively, and Steps  188 - 189  provide the same information as Steps  132 - 133 , respectively. Additional information provided to the care provider in the PCA mg mode is as follows: the concentration of fluid delivered in mg/mL (Step  178 ); the programmed continuous rate of fluid in mgs/hour (Step  179 ); the current continuous rate in mg&#39;s/hour (Step  180 ); the mgs to be infused (Step  181 ); the mgs infused in mgs (Step  182 ); the bolus dose in mgs (Step  183 ); the bolus interval in hours and minutes (Step  184 ); the number of boli/hour (Step  185 ); the number of boli attempted (Step  186 ); and the number of boli delivered (Step  187 ). After providing this information to the care provider, the homebase  14  returns in Step  190  to the main menu  82 .  
      With reference to  FIG. 6 , the edit mode will be described in detail. If the care provider has selected the edit mode in Step  67 , the homebase  14  transfers (circle  71 ) the care provider to an edit mode menu  200  illustrated in  FIG. 6 . Upon accessing this menu, the homebase  14  generates a number of voice queries that are transmitted to the care provider and provide the care provider with a number of options—namely: (1) editing the operating parameters of the continuous mode (Step  201 ); (2) editing the operating parameters of PCA mL mode (Step  202 ); and (3) editing the operating parameters of the PCA mg mode (Step  203 ). No matter which option is selected, after editing the operating parameters (or protocol) of that mode, the care provider is transferred (see circle  204 ) to the edit mode sub-menus  270 ,  280  illustrated  FIG. 7 .  
      If the care provider selects editing of the continuous mode (Step  201 ), the homebase  14  permits the care provider to edit the rate of delivery. In this mode, some parameters are maintained and others may be edited. The care provider is told the current rate at which the pump  12  is delivering fluid in mLs/hour (Step  210 ). The care provider is then asked to enter a new rate, or press the “#” button to accept the current rate (Step  211 ). Finally, the care provider is told the new rate in mLs/hour and is asked to press the “#” button on the key pad to accept the new rate (Step  212 ). After the rate has been edited, the homebase  14  transfers (circle  204 ) to the sub-menus  270 ,  280  of  FIG. 7 .  
      If the care provider selects editing of the PCA mL mode (Step  202 ), the care provider is asked to edit various parameters of the PCA mL protocol. The care provider is first told what the current continuous rate is in mLs/hour (Step  221 ), and in Step  222  is asked to enter a new continuous rate or press the “#” button to accept the present rate. The care provider is then told what the new rate is and asked to press the “#” button to accept that new rate (Step  223 ). Similar operations are performed on the bolus volume (Steps  224 - 226 ), the number of boli/hour (Steps  227 - 229 ), and the bolus interval (Steps  230 - 232 ). After editing, the homebase  14  transfers (circle  204 ) to the sub-menus  270 ,  280  of  FIG. 7 .  
      If the care provider selects editing of the PCA mg mode (Step  203 ), the care provider is asked to edit various parameters of the PCA mL protocol. The care provider is first told what the current continuous rate is in mgs/hour (Step  241 ), and in Step  242  is asked to enter a new continuous rate or press the “#” button to accept the present rate. The care provider is then told what the new rate is and asked to press the “#” button to accept that new rate (Step  243 ). Similar operations are performed on the bolus volume (Steps  244 - 246 ), the number of boli/hour (Steps  247 - 2491 , and the bolus interval (Steps  250 - 252 ). After editing, the homebase  14  transfers (circle  204 ) to the sub-menus  270 ,  280  of  FIG. 7 .  
      Referring now to  FIG. 7 , the edit mode sub-menus  270 ,  280  provide the care provider with several options after editing the protocol. The first edit mode sub-menu  270  allows the care provider to send (i.e., save) the edits to the pump  1   2  (Step  271 ) by pressing a certain key on the key pad (in this case “1”), to review the edits (Step  272 ) by pressing a different key on key pad (in this case “2”), and to cancel the edits (Step  273 ) by pressing still a different number on she key pad (in this case “3”). If the care provider selects sending the edits (Step  271 ), the new protocol is sent to the pump  12  (Step  274 ), and the care provider is told “goodbye” (Step  275 ). The care provider is then transferred to the phone or patient conversation mode (Step  276 ), and the care provider is put in connection with the patient to verify the programming (Step  277 ). After verifying the programming changes with the patient, the care provider hangs up the remote telephone (Step  278 ), and the programming session is terminated.  
      If the care provider selects reviewing the edits (Step  272 ), the homebase  14  reports the new parameters of the protocol to the care provider (Step  279 ). After reporting, the care provider is taken to the second edit mode sub-menu  280 . The second edit mode sub-menu  280  permits the care provider to select one of several options: (1) send the edits by pressing a key on the key pad (Step  281 ), (2) edit the edits by pressing a different key on the key pad (Step  282 ), or (3) cancel the edits by pressing still a different key on the key pad (Step  283 ). If the care provider selects sending the edits (Step  281 ), the new protocol is sent to the pump  12  (Step  284 ), and the care provider is told “goodbye” (Step  285 ). The care provider is then transferred to the phone or patient conversation mode (Step  286 ), and the care provider is put in connection with the patient (the patient conversation mode) to verify the programming (Step  287 ). After verifying the programming changes with the patient, the care provider hangs up the remote telephone (Step  288 ), and the programming session is terminated. If the care provider selects editing of the edits (Step  282 ), the care provider is transferred to the edit mode menu (Step  289 ) illustrated in  FIG. 6  and described above. If the care provider selects cancelling of the edits (Step  283 ), the care provider is transferred to the main menu  82  (Step  290 ).  
      With reference to  FIGS. 8A and 8B , the create mode will now be described. If the care provider selects the create mode in Step  68 , the homebase  14  transfers the care provider to a create mode menu  300 . Within the create mode menu  300 , the care provider has several options for processing the protocol: (1) the continuous mode  302 , (2) the intermittent mode  304 , (3) the taper mode  306 , and (4) the PCA mode  308 . For any of these modes to be selected, the care provider presses a predetermined number on the keypad of the remote programming transceiver or push button telephone.  
      If the care provider selects programming of the continuous mode  302  from the create mode menu  300 , the care provider is asked to program various parameters of the continuous mode protocol. The care provider is asked to enter the rate (Step  310 ), after which the entered rate is read back, and the care provider is asked to press the “#” button to accept this rate (Step  31   1 ). The care provider follows the same procedure for entering volume (Steps  312  and  313 ), low volume alarm (Steps  314  and  315 ), protocol locking (Steps  316  and  317 ), and AIL on or off (Steps  318  and  319 ). After programming, the care provider is transferred (circle  397 ) to the sub-menus of  FIG. 9 .  
      If the care provider selects programming of the intermittent mode  304 , the care provider is asked to program various parameters of the intermittent mode protocol. The care provider is asked to enter the number of “Q” hours (Step  320 ), after which the entered number of “Q” hours is read back, and the care provider is asked to press the “#” button to accept this number (Step  321 ). The care provider follows the same procedure for entering dose rate (Steps  322  and  323 ), dose volume (Steps  324  and  325 ), background rate (Steps  326  and  327 ), number of deliveries (Steps  328  and  329 ), low volume alarm (Steps  330  and  331 ), protocol locking (Steps  332  and  333 ), and AIL on or off (Steps  334  and  335 ). After programming, the care provider is transferred (circle  397 ) to the sub-menus of  FIG. 9 .  
      If the care provider selects programming of the taper mode  306 , the care provider is asked to program various parameters of the taper mode protocol. The care provider is asked to enter the total volume (Step  336 ), after which the entered total volume is read back, and the care provider is asked to press the “#” button to accept (Step  337 ) this volume. The care provider follows the same procedure for entering taper up time (Steps  338  and  339 ), taper down time (Steps  340  and  341 ), and total delivery time (Steps  342  and  343 ). The homebase unit  14  then calculates the base rate (Step  344 ) and reads this base rate back to the care provider (Step  345 ); calculates the volume before taper down (Step  346 ) and reads this volume back to the care provider (Step  347 ); and calculates the step up and step down rates (Steps  348  and  350 ) and reads these back (Steps  349  and  351 ). The care provider is also asked to enter protocol locking (Steps  352  and  353 ) and AIL on or off (Steps  354  and  355 ). After programming, the care provider is transferred (circle  397 ) to the sub-menus of  FIG. 9 .  
      If the care provider selects programming of the PCA mode  308 , the care provider is taken to a PCA mode sub-menu  360 . In the PCA mode sub-menu  360 , the care provider is asked to select the PCA mL mode (Step  361 ) or the PCA mg mode (Step  362 ). If the care provider selects the PCA mL mode, the care provider is asked to enter the protocol of this mode, including the continuous rate (Steps  363  and  364 ), total volume (Steps  365  and  366 ), bolus volume (Steps  367  and  368 ), number of boli/hour (Steps  369  and  370 ), bolus interval (Steps  371  and  372 ), low volume alarm (Steps  373  and  374 ), protocol locking (Steps  375  and  376 ), and AIL on or off (Steps  377  and  378 ). If the care provider selects the PCA mg mode (Step  362 ), the care provider is asked to enter that mode&#39;s protocol, including the concentration (Steps  379  and  380 ), continuous rate (Steps  381  and  382 ), total volume (Steps  383  and  384 ), bolus volume (Steps  385  and  386 ), number of boli/hour (Steps  387  and  388 ), bolus interval (Steps  389  and  390 ), low volume alarm (Steps  391  and  392 ), protocol locking (Steps  393  and  394 ), and AIL on or off (Steps  395  and  396 ). After programming, the care provider is transferred (circle  397 ) to the sub-menus of  FIG. 9 .  
      Referring now to  FIG. 9 , after a programming sequence in accordance with  FIGS. 8A and 8B , the care provider is transferred (via circle  397 ) to a primary create mode sub-menu  400 . In the primary create mode sub-menu  400 , the care provider can make various selections, including sending the newly programmed protocol (Step  402 ), reviewing the newly programmed protocol (Step  404 ), and cancelling the newly programmed protocol (Step  406 ). If the care provider selects send (Step  402 ), the care provider is told that the new protocol is being sent to the pump  12  and then told “goodbye” (Steps  410  and  41   1 ), and the connection is switched to the phone or patient conversation mode (i.e., communication with the patient) (Step  412 ). The care provider may then speak with the patient to verify the programming (Step  413 ) and then hang up after verifying (Step  414 ). If the cancel option  406  is selected, the care provider is transferred (Step  437 ) to the main menu  82 .  
      If the review option  404  is selected, the parameters of the new programmed protocol are reported to the care provider (Step  415 ). The care provider is then transferred to a secondary create mode sub-menu  420 , from which the care provider can select various options, including sending the new protocol (Step  422 ), editing the new protocol (Step  424 ), and cancelling the new protocol (Step  426 ). If the sending option  422  is selected, Steps  430  through  434  are performed, which are the same as those performed if the care provider were to select the sending option  402  from the primary create mode sub-menu  400 . If the editing option  424  is selected, the care provider is transferred (Step  435 ) to the create mode menu  300 . Finally, if the cancel option  424  is selected, the care provider is transferred (Step  436 ) to the main menu  82 .  
      In all of the above processing modes, the homebase  14  can be provided with a variety of features that facilitates remote or local programming of the protocol. For example, “#” key can be used to enter changes or selections. The “*”key can be used for exiting the programming mode, for backspacing from a currently operating step to a previous step or from a portion of a parameter being processed to a previous portion of that parameter, or for entering a decimal point, depending on the instance in the programming sequence. The system can be set up such that it rejects out of range values and advises on the erroneous value. If the communicating phone line is equipped with call waiting, the existence of an incoming call on the additional call waiting line does not cause the presently communicating (i.e., programming) line to hang up. With reference to  FIG. 10 , an alarm table  500  of the present invention will be described. The alarm table  500  may include a variety of alarm functions, including air in the line alarm  502  for the line  18  connecting the pump  12  to the patient, a bad battery alarm  504 , a bar code fault alarm  506 , an alarm indicating the need for a battery change  508 , a door open alarm  510 , an end of program alarm  512 , a low battery alarm  514 , a low volume alarm  516 , a malfunction alarm  518 , an occlusion alarm  520 , an over-voltage alarm  522 , a pump interrupted alarm  524 , and a pumping complete alarm  526 . All of these alarms can be made audible, with a variety of different or identical tones, or visual, via the alarm light  40 , multiple lights, or a digital or analog display. The above alarm functions are exemplary, and other alarm functions can be provided. Alternatively, only some, or one, or none of the above alarm functions can be implemented in the present invention, depending on the particular application.  
      Examples of how the alarm light  40  and internal audio device  29  operate in response to various alarm conditions will now be described. The alarm light  40  may comprise a number of lights, for example, red, yellow, green, and other colored LEDs. The audio device  29  may comprise a speaker, siren, or similar apparatus. As an example of an alarm condition and the response thereto, if the phone line is improperly connected to the homebase unit  14  or the infusion system  10  is setup in some other improper manner, red and green LEDs (which comprise the alarm light  40 ) may flash together with intermittent audio from the audio device  29 . If someone is trying to access the local mode (i.e., communicate with the homebase  14  via a local telephone connected to the local communication port  44 ) without the local telephone line being attached to the homebase  14 , a yellow LED may flash with intermittent audio. If someone is trying to access the local, send, or link modes (i.e., is depressing the link button  30 , local button  32 , or send button  34 ) without the pump  12  being properly attached to the homebase  14 , yellow and red LEDs may flash with intermittent audio. If the telephone connection between the remote or local telephone and the homebase  14  is lost, a red LED may flash with intermittent audio. Finally, if an internal system error occurs in the homebase  14  and/or pump  12 , a red LED may flash with intermittent audio. It should be understood that the above operation of the alarm light  40  and audio device  29  are only exemplary and that variations can be made on these alarms.  
      It should also be understood that the above programming and functions described in  FIGS. 3-10  provide only examples of how the care provider and the homebase unit  14  may interact via a remote or local push button telephone or similar transceiver. Therefore, additional or alternative steps and procedures can be designed and implemented for remote programming of the present invention. Accordingly, only some of the steps described above need be included in the invention; the steps may be conducted in a different order; additional or fewer protocol parameters may be controlled by the care provider; and different operational modes (i.e., other than continuous, intermittent, etc.) may be chosen.  
      Furthermore, the present invention can be used in a variety of applications. In the exemplary application described herein, the present invention is used for controlling and programming the protocol of an infusion pump. A variety of infusion applications exist for which the present invention can be used, including ambulatory IVs, insulin pumps, hospital pumps, enteral pumps, blood pumps, intra-aortal pumps, subcutaneous pumps, and spinal (or epidural) pumps. Other medical applications also exist in which the present invention can be used for remote programming, as well as other functions described above, including use with ventilators (e.g., for blood/oxygen level), respiratory equipment, EKG machines, blood/gas analyzers, enteral pumps (i.e., stomach infusion pumps), blood glucose monitors, dialysis equipment, open wound irrigation devices, and urology equipment.  
      It will therefore be apparent to those skilled in the art that various modifications and variations can be made in the apparatus and method of the present invention without departing from the spirit or scope of the invention. Thus, it is intended that the present invention cover the modifications and variations of this invention, provided they come within the scope of the appended claims and their equivalents.