Patent Abstract:
Patients with chronic illnesses resist using conventional automated healthcare management systems to supply necessary clinical data because such systems feel impersonal, preferring to actually visit a clinic where the patient interacts with various healthcare practitioners. In this invention, the patient interacts with a clinical management system via a series of initial GUI screens that replicate the experience of actually visiting the clinic. Additional screens allow the patient to submit clinical information, to communicate with that patient&#39;s healthcare practitioner and other healthcare practitioners, to access management information that aids the patient in managing that patient&#39;s chronic illness, and to access educational information regarding that chronic illness. The clinical management system may be used to manage a plurality of different chronic illnesses while providing a consistent look and feel to the screens. At least one appearance characteristic can be altered to indicate the particular chronic illness to which a screen applies.

Full Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    The present application is a divisional of and claims the benefit of U.S. patent application Ser. No. 09/967,923, filed Oct. 2, 2001, the entire disclosure of which is incorporated by reference herein. 
     
    
     STATEMENT OF GOVERNMENT SUPPORT 
       [0002]    This invention was made with U.S. Government support under Grant Number NOI-LM6-3544 awarded by the National Institutes of Health and Grant Number DAMDI7-94-V-4015 awarded by the Department of Defense. The U.S. Government has certain rights in the invention. 
     
    
     BACKGROUND OF THE INVENTION 
       [0003]    1. Field of Invention 
         [0004]    The invention generally relates to using a distributed network to clinically manage chronic illnesses. 
         [0005]    2. Description of Related Art 
         [0006]    Managing chronic illnesses is both costly and difficult. Both patients and healthcare practitioners wish to decrease costs and inconvenience by reducing unnecessary clinic visits. However, the management quality of a chronic illness increases with the frequency that the clinical data obtained from the patient is updated. Automated and manual medical devices may be operated by a patient to provide the updated clinical data. However, the patient can operate the device improperly or has little opportunity to supply the clinical data to the healthcare practitioner. 
         [0007]    For example, U.S. Pat. No. 6,039,688 to Douglas et al. describes a therapeutic behavior modification program, compliance monitoring and feedback system. This system provides a series of milestones for patients to achieve to maintain good health. Patients may access the system over the Internet to review compliance data and to receive motivation. This system is designed around a community support motif that allows the patient to access various graphic representations of a community to access different parts of the system. 
       SUMMARY OF THE INVENTION 
       [0008]    However, patients with chronic illnesses often resist using such systems as that described in the 688 patent because such systems often feel impersonal. Patients also often fail to supply the clinical data through the conventional automated and manual medical devices, again due to the impersonal nature of the systems used to supply such data to the healthcare practitioner. Thus, while such systems provide the ability to manage a chronic illness using a distributed network to supply the necessary clinical data from the patient to the healthcare practitioner and to communicate information to and from the patient, patients with chronic illnesses often tend to avoid using such systems. 
         [0009]    Rather, patients with chronic illnesses often strongly tend to prefer actually visiting a clinic dedicated to managing the healthcare of patients with such chronic illnesses. At such actual clinic visits, the patient interacts with various nurses and other healthcare management staff members and, most importantly, with a personal healthcare practitioner with whom the patient has developed a relationship. However, such actual clinic visits are expensive for healthcare insurers and are burdensome for patients with chronic illnesses to make at the needed frequency. 
         [0010]    This invention provides systems and methods that provide a graphical user interface-based clinical management that simulates an actual visit to a physical clinic directed to managing a chronic illness. 
         [0011]    This invention separately provides systems and methods that increase patient compliance by replicating the experience of the patient visiting an actual clinic directed to managing a chronic illness. 
         [0012]    In various exemplary embodiments of the systems and methods according to this invention, the patient interacts with the clinical management system via a series of graphical user interface screens accessed over a distributed network. Various initial graphical user interface screens replicate the experience of actually visiting a clinic directed to a particular chronic illness. Additional graphical user interface screens allow the patient having a chronic illness to submit updated clinical information to the clinical management system. Various other graphical user interface screens allow the patient having a chronic illness to communicate with that patient&#39;s personal healthcare practitioner as well as various staff members of the clinic that are involved with that patient in managing that patient&#39;s chronic illness. Various other graphical user interface screens provide management information to the patient usable to aid the patient in managing that patient&#39;s chronic illness, such as warnings, information and care reminders. 
         [0013]    Still other various exemplary graphical user interface screens allow a patient having a chronic illness to access current and archived information regarding that chronic illness, such as new findings, management advice and the like. 
         [0014]    In various exemplary embodiments, the clinical management system may be used to manage a plurality of different chronic illnesses. As is well known in the art, patients having one chronic illness often develop one or more additional chronic illnesses. In this case, the patient having multiple chronic illnesses can use a single clinical management system to manage all of that patient&#39;s chronic illnesses using a consistent metaphor for the various chronic illnesses. In various exemplary embodiments, while different specific information may be provided depending on the type of chronic illness, the information is provided using a consistent look and feel to the graphical user interface screens. However, to distinguish between different types of chronic illnesses, in various exemplary embodiments, when dealing with a particular chronic illness, the graphical user interfaces have at least one appearance characteristic that is modified to visually indicate the particular chronic illness to which that screen currently applies. For example, in various exemplary embodiments, the appearance of the graphical user interface screens can be color coded depending on the particular chronic illness. 
         [0015]    In various exemplary embodiments, to allow a patient who has multiple chronic illnesses to easily determine which chronic illness is being managed, an elevator metaphor is used that replicates the organization of an actual clinic into separate floors for each different chronic illness. 
         [0016]    These and other features and advantages of this invention are described in, or are apparent from, the following detailed description of various exemplary embodiments of the systems and methods according to this invention. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0017]    Various exemplary embodiments of this invention will be described in detail, with reference to the following figures, wherein: 
           [0018]      FIG. 1  is a block diagram of one exemplary embodiment of a chronic illness management system according to this invention; 
           [0019]      FIG. 2  is a block diagram showing in greater detail one exemplary embodiment of the clinic system of the chronic illness management system of  FIG. 1 ; 
           [0020]      FIG. 3  shows one exemplary embodiment of a screen of a graphical user interface showing a virtual clinic according to this invention; 
           [0021]      FIG. 4  shows one exemplary embodiment of a screen of a graphical user interface representing a lobby of the virtual clinic of  FIG. 3 ; 
           [0022]      FIG. 5  shows one exemplary embodiment of a screen of a graphical user interface representing an open door to a public library of the virtual clinic of  FIG. 3 ; 
           [0023]      FIG. 6  shows various exemplary embodiments of portions of a graphical user interface screen representing bulletin board notices according to this invention; 
           [0024]      FIG. 7  shows one exemplary embodiment of a screen of a graphical user interface representing a clipboard of the lobby of  FIG. 4 ; 
           [0025]      FIG. 8  shows one exemplary embodiment of a screen of a graphical user interface representing an elevator metaphor according to this invention; 
           [0026]      FIG. 9  shows one exemplary embodiment of a screen of a graphical user interface representing an opened elevator door showing a virtual clinic for a specific chronic illness according to this invention; 
           [0027]      FIG. 10  shows a first exemplary embodiment of a main patient data screen of a graphical user interface according to this invention for a patient having diabetes; 
           [0028]      FIG. 11  shows one exemplary embodiment of an on-screen contextually relevant message displayed over information displayed on the main patient data screen of  FIG. 10 ; 
           [0029]      FIG. 12  shows one exemplary embodiment of an update patient information form screen according to this invention; 
           [0030]      FIG. 13  shows one exemplary embodiment of a screen of a graphical user interface usable to access an educational article according to this invention; 
           [0031]      FIG. 14  shows one exemplary embodiment of a screen of a graphical user interface usable to display a tabular representation of hypoglycemic and/or hyperglycemic events according to this invention; 
           [0032]      FIG. 15  shows one exemplary embodiment of a patient supplied data screen of a graphical user interface usable to display a blood sugar log according to this invention; 
           [0033]      FIG. 16  shows one exemplary embodiment of a screen of a graphical user interface usable to display a date selection graphic according to this invention; 
           [0034]      FIG. 17  shows one exemplary embodiment of a screen of a graphical user interface usable to display a linear graph according to this invention; 
           [0035]      FIG. 18  shows one exemplary embodiment of a screen of a graphical user interface usable to display histograms according to this invention; 
           [0036]      FIG. 19  shows one exemplary embodiment of a screen of a graphical user interface usable to display a pie chart according to this invention; 
           [0037]      FIG. 20  shows one exemplary embodiment of a screen of a graphical user interface usable to display multiple pie charts according to this invention; 
           [0038]      FIG. 21  shows one exemplary embodiment of a screen of a graphical user interface usable to display a table of laboratory results according to this invention; 
           [0039]      FIG. 22  shows one exemplary embodiment of a screen of a graphical user interface usable to display medication tables according to this invention; 
           [0040]      FIG. 23  shows one exemplary embodiment of a screen of a graphical user interface usable to display a data entry table for medication according to this invention; 
           [0041]      FIG. 24  shows one exemplary embodiment of a screen of a graphical user interface usable to display an exercise log according to this invention; 
           [0042]      FIG. 25  shows one exemplary embodiment of a screen of a graphical user interface usable to display a blood pressure log according to this invention; 
           [0043]      FIG. 26  shows one exemplary embodiment of a sere-en of a graphical user interface displaying a tabular data summary and patient and healthcare practitioner comments according to this invention; 
           [0044]      FIG. 27  shows one exemplary embodiment of a screen of a graphical user interface usable to enter patient comments into a tabular summary according to this invention; 
           [0045]      FIG. 28  shows one exemplary embodiment of a screen of a graphical user interface displaying a date selection graphic according to this invention; 
           [0046]      FIG. 29  shows one exemplary embodiment of a screen of a graphical user interface displaying educational information according to this invention; 
           [0047]      FIG. 30  shows one exemplary embodiment of a screen of a graphical user interface displaying a particular educational information according to this invention; 
           [0048]      FIG. 31  shows one exemplary embodiment of a screen of a graphical user interface displaying a contacts page according to this invention, 
           [0049]      FIG. 32  shows a second exemplary embodiment of the main patient data screen of the graphical user interface according to this invention for a patient having a chronic kidney illness; 
           [0050]      FIG. 33  shows the main patient data screen of  FIG. 30  displaying another educational article according to this invention; 
           [0051]      FIG. 34  shows a second exemplary embodiment of the patient supplied data screen of the graphical user interface according to this invention displaying an automated cycler flow sheet; 
           [0052]      FIG. 35  shows a second exemplary embodiment of the screen of a graphical user interface usable to display linear graphs according to this invention; 
           [0053]      FIG. 36  shows a second exemplary embodiment of the screen of the graphical user interface usable to display a table of laboratory results according to this invention; 
           [0054]      FIG. 37  shows a second exemplary embodiment of the screen of the graphical user interface usable to display medication tables according to this invention; 
           [0055]      FIG. 38  shows a second exemplary embodiment of the screen of the graphical user interface displaying an educational page according to this invention for patients having a chronic kidney illness; 
           [0056]      FIG. 39  shows one exemplary embodiment of a screen of a graphical user interface usable to display recipes available to patients according to this invention; 
           [0057]      FIG. 40  shows the graphical user interface screen of  FIG. 34  displaying an educational article on kidney disease; 
           [0058]      FIGS. 41A-B  show the graphical user interface of  FIG. 34  displaying an educational article about peritoneal dialysis having selectable links according to this invention; 
           [0059]      FIG. 42  shows one exemplary embodiment of a screen of a graphical user interface displaying an abstract of an educational article for patients having a chronic kidney illness according to this invention; 
           [0060]      FIGS. 43 and 44  show various exemplary embodiments of screens of a graphical user interface displaying procedure instructions to a patient; 
           [0061]      FIGS. 45A-45C  and  46 A- 46 E show various exemplary embodiments of screens of a graphical user interface usable to display specific procedure instruction and troubleshooting information for performing the procedure illustrated in  FIGS. 43 and 44 ; 
           [0062]      FIGS. 47A-47I  show one exemplary embodiment of a screen of a graphical user interface usable to display daily routine information for peritoneal dialysis patients according to this invention; 
           [0063]      FIG. 48  shows another exemplary embodiment of a screen of the graphical user interface according to this invention usable to display on-screen contextually relevant messages; 
           [0064]      FIG. 49  shows one exemplary embodiment of a screen of a graphical user interface that enables access to the patient&#39;s healthcare practitioners over a distributed network according to this invention; 
           [0065]      FIG. 50  shows one exemplary embodiment of a screen of a graphical user interface usable by a healthcare practitioner to access a patient&#39;s healthcare records according to this invention, 
           [0066]      FIGS. 51A and 51B  show various exemplary embodiments of a practitioner screen of a graphical user interface usable to display various exemplary embodiments of alerts, messages and reminders according to this invention; 
           [0067]      FIGS. 52 ,  54  and  55  show various exemplary embodiments of screens of a graphical user interface displaying medication tables to a practitioner according to this invention; 
           [0068]      FIG. 53  shows one exemplary embodiment of a screen of a graphical user interface displaying insulin pump information to a practitioner according to this invention; 
           [0069]      FIG. 56  shows one exemplary embodiment of a screen of a graphical user interface displaying tabular data summary and healthcare practitioner comments to a patient according to this invention; 
           [0070]      FIG. 57  shows one exemplary embodiment of a screen of a graphical user interface usable to add a new patient or practitioner according to this invention; 
           [0071]      FIG. 58  shows one exemplary embodiment of a screen of a graphical user interface usable to submit practitioner registration information; 
           [0072]      FIG. 59  shows one exemplary embodiment of a screen of a graphical user interface usable to submit patient registration information according to this invention; 
           [0073]      FIGS. 60-62  show various exemplary embodiments of the screens of a graphical user interface usable to submit patient lab data according to this invention; 
           [0074]      FIGS. 63-65  show various exemplary embodiments of screens of a graphical user interface usable to input patient reminder information according to this invention; 
           [0075]      FIG. 66  shows one exemplary embodiment of a main visitor data screen of a graphical user interface according to this invention; 
           [0076]      FIGS. 67A-67G  show one exemplary embodiment of a screen of a graphical user interface displaying project description information according to this invention; 
           [0077]      FIG. 68  shows one exemplary embodiment of a patient message list screen of a graphical user interface according to this invention; 
           [0078]      FIG. 69  shows one exemplary embodiment of a patient message list screen of a graphical user interface according to this invention; 
           [0079]      FIG. 70  shows one exemplary embodiment of a screen of a graphical user interface usable to add a message according to this invention; 
           [0080]      FIG. 71  shows one exemplary embodiment of a healthcare practitioner message list screen of a graphical user interface according to this invention; 
           [0081]      FIG. 72  shows one exemplary embodiment of a healthcare practitioner message list window of a graphical user interface according to this invention; 
           [0082]      FIG. 73  shows a first exemplary embodiment of a healthcare practitioner message list screen of a graphical user interface according to this invention after a patient has been selected by a healthcare practitioner, and 
           [0083]      FIG. 74  shows one exemplary embodiment of a healthcare practitioner message list window of a graphical user interface according to this invention after a patient has been selected by a healthcare practitioner. 
       
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
       [0084]      FIG. 1  shows one exemplary embodiment of a chronic illness management system  100  that is usable to manage one or more chronic illnesses. As shown in  FIG. 1 , the chronic illness management system  100  according to this invention includes one or more healthcare practitioner data terminals  130 , one or more patient data terminals  120 , and zero, one or more visitor data terminals  140 , that are connected by a network  110  to a clinic system  200  that implements a virtual clinic. The network  110  may be a local area network (LAN), a wide area network (WAN), the Internet, an intranet, an extranet, or any other known or later-developed type of distributed network  110  usable to connect patients, healthcare practitioners and/or visitors to the clinic system  200 . 
         [0085]    Thus, the chronic illness management system  100  connects patients, healthcare practitioners and/or visitors to the virtual clinic over a distributed network. Access and privileges of the chronic illness management system  100  are determined by a user&#39;s status as a patient, a healthcare practitioner, or a visitor. Patient users may provide quantitative clinical data, based on the operation of a medical device  122 , and/or comments to their healthcare practitioner over one of the one or more patient data terminals  120 . The chronic illness management system  100  uses the network  110  to connect patients having one or more chronic illnesses, healthcare practitioners of various occupations, for example, specialized healthcare practitioners. primary care healthcare practitioners, nurses, and the like, and visitors to the clinic system  200 . 
         [0086]    In various exemplary embodiments, each patient data terminal  120 , each healthcare practitioner data terminal  130 , and/or each visitor data terminal  140  can be implemented using standard personal computers, laptop computers, handheld computers, and/or personal digital assistants, or the like, having one or more of a network interface, a data display device, such as a video monitor, one or more input devices, such as a keyboard and/or a mouse, and a network browser software program, or any other known or later-developed hardware elements, any other known or later-developed software components, or any known or later-developed combination of such hardware components and software components that may provide equivalent functionality. Each patient data terminal  120  may also have an input/output interface to which the medical device  122  can be connected to allow clinical data to be directly downloaded from the medical device  122  and sent over the network  110  to the clinic system  200 . 
         [0087]      FIG. 2  shows in greater detail one exemplary embodiment of the clinic system  200  of  FIG. 1 . In the exemplary embodiment of the system  200  shown in  FIG. 2 , the clinic system  200  shows a network interface  210 , an (optional) firewall  212 , a memory  230 , a controller  220 , a control/data bus  240  and a database  232  that stores at least some of the information described below. The network interface  210  can, in various exemplary embodiments, provide system security by encrypting and transmitting through a secure portion by using, for example, hypertext transfer protocol secure (HTTPS) running over a secure socket layer (SSL) or by any other known or later-developed security mechanism. The optional firewall  212 , if implemented, uses a combination of hardware elements and/or software components that moderates the communication of the clinic system  200  with systems external to the clinic system  200  and vice versa. The optional firewall  212 , if implemented. uses, for example, an external proxy server that decides whether communications are safe to pass through to the clinic system  200 . 
         [0088]    In general, the memory  230  can include one or more of random access memory, read only memory, hard disks, writeable optical disks, flash memory or the like. In general, the controller  220  receives data from and generates instructions to the other components of the clinic system  200 , and reads, writes and processes data. The database  232  stores at least information concerning patients and healthcare practitioners, clinical data received from patients, laboratory test results, information concerning medications that will be or have been prescribed to and/or used by one or more patients, educational information, and general information concerning the chronic illness management system  100 . 
         [0089]    It should he appreciated that the following discussion is generally equally directed to standard windowed graphical user interfaces and graphical user interfaces using web-based implementations, where each graphical user interface “screen” is a distinct web page written in HTML, XML or any other known or later-developed web page authoring language. As a result, in various exemplary embodiments, the selectable icons of the following description are implemented as hypertext links to related web pages or to distinct regions of a current web page. However, it should be appreciated that any other known or later-developed graphical user interface implementation technique could be used to implement the graphical user interface screens and/or graphical user interface elements described herein. 
         [0090]    Thus, it should also be appreciated that this graphical user interface can be implemented as a Windows-based system, rather than as a web-based system. In this case, the graphical user interface screens are distinct portions of the graphical user interface that is accessed by specific Windows events that are associated with particular selectable icons or other interactive elements or widgets. As a result, the selectable icons and other interactive elements of these graphical user interface screens can be implemented as Windows widgets or the like. 
         [0091]    It should also be appreciated that, in the following discussion of the graphical user interfaces and screens according to this invention, selecting a selectable icon or other interactive element can include activating any feature of the graphical user interface that generates a new screen or allows the patient to enter data, for example, by using a drop-down list box, a dialog box, an option button, or the like. An on-screen indicator usable to select a feature of the graphical user interface may be, for example, a mouse pointer, a cursor, or any other known or later-developed on-screen indicator used in conjunction with, for example, a mouse, a touch pad, a touch screen, a light pen, a joystick, a trackball or any other known or later-developed on-screen location input device. 
         [0092]    As shown in  FIG. 3 , when a patient or a visitor logs onto the chronic illness management system  100  from one of the data terminals  120 ,  130  or  140  via the network  110 , the clinic system  200  presents a graphical user interface screen  300  having a graphic representation of a clinic  304  of the outside of a clinic building. In some exemplary embodiments, this graphic representation of the clinic  304  shows, for example, an entrance door  302  to the clinic, and one of mote of a name of the clinic or the building, reflections of the sky in the clinic windows, surrounding walkways and flowerbeds, and a name of the clinic program to which the patient belongs. This graphic representation of the clinic  304  provides the patient with a feeling that the patient is effectively visiting an actual clinic, which is both familiar and assuring. 
         [0093]    In various exemplary embodiments, the graphic representation of the clinic  304  further elicits a feeling of timeliness by changing aspects of the graphic representation of the clinic  304  to reflect the time of day and time of year when the patient logs onto the system. For example, if the patient logs on during a summer day, the graphic representation of the clinic  304  shown in  FIG. 3  shows the clinic during a summer day with blue skies reflected in the clinic windows and blossoming flowerbeds outside the clinic entrance. Other graphic representations of the clinic  304  are automatically displayed on the screen corresponding to the different seasons and time of day. For example, a graphic representation for a winter day may show blue skies reflected in the clinic windows, snow piled on the flowerbeds and ledges of the clinic, and snowflakes drifting down from the sky. The graphic representation of the clinic  304  for both summer and winter nights may, for example, show darkened clinic windows that reflect night skies and stars. Aspects of the graphic representation of the clinic  304  can be altered based on holidays and/or other calendar events. 
         [0094]    The graphic representation of the clinic  304  shown in  FIG. 3  is part of a graphical user interface that allows the patient and others to access various screens of the chronic illness management that generally mimic activities that could normally have been pursued during an actual visit by the patient to the clinic. Various clinical data and information elements can also be displayed to the patient using these graphical user interface screens. When the patient selects the entrance door icon  302  of the graphic representation of the clinic  304  shown in  FIG. 3 , in various exemplary embodiments, the entrance door icon  302  opens using animation. In any case, a graphical user interface screen  400 , as shown in  FIG. 4 , of the graphical user interface is displayed in place of the screen  300 . 
         [0095]      FIG. 4  shows one exemplary embodiment of the graphical user interface screen  400 . The screen  400  includes a graphic representation of a clinic lobby  402 . When used, the animated graphic representation of opening the entrance door icon  302  to enter the clinic lobby  402  invokes the feeling of an actual clinic visit. By mimicking an actual clinic visit, the patient&#39;s familiarity with the clinical monitoring program can be enhanced, as can be the patient&#39;s compliance with the monitoring program. As shown in  FIG. 4 , the graphical representation of the clinic lobby  402  includes, for example, furniture and rugs, a smiling receptionist standing behind a counter, a sign-in clipboard icon  408  located on a counter  407 . a door icon  404  leading to a public access library area, and a bulletin board icon  410  usable to access a bulletin board system. Again, the graphic representation of the clinic lobby  402  shows a scene that the patient would expect to encounter during an actual clinic visit. 
         [0096]    In various exemplary embodiments, when the clipboard icon  408  is initially indicated, such as by hovering the cursor over the clipboard  408 , (or is initially selected), the clipboard icon  408  rises by animation above the counter  407 . This rising of the clipboard icon  408  invites the patient to sign into the clinic, just as the patient would do in an actual clinic visit. In response to the user selecting the raised clipboard icon  408 , a graphical user interface screen  500 , as shown in  FIG. 7 , is displayed in place of the graphical user interface screen  400 . 
         [0097]    When the door icon  404  to the public access library area of the clinic lobby  402  of  FIG. 4  is selected, the door icon  404  opens by animation to the position shown in  FIG. 5 . This open door icon  405  invites not only patients. but other visitors who have accessed the chronic illness management system  100  to access public information about the chronic illness management system  100 . 
         [0098]    The bulletin board  410  of  FIG. 4  displays various monthly notice icons  420  that may be characterized by graphic designs corresponding to the respective content of the notice. For example, one type of notice may be a holiday notice that contains a graphic design corresponding to the respective holiday for the current month. For example, as shown in  FIG. 6 , a January holiday notice  421  may display a party hat, while the other graphics  422 - 425  for the holiday notices may be displayed during the appropriate month. Other graphic designs may readily correspond to other holidays or events. Selecting a different bulletin board notice icon  412  of the bulletin board  410  shown in  FIG. 4  may provide access to educational information on chronic illnesses managed by the clinic system  200 . This information may be provided, for example, by links to other network sites, such as Internet sites or worldwide web sites that provide educational information about particular chronic illnesses. For example, during January, a link to the website of the American Diabetes Association may warn diabetics to watch for freezing of their extremities. 
         [0099]    The bulletin board icon  410  shown in  FIG. 4  also displays a news item icon  412  concerning chronic illnesses managed by the clinic system  200 . When the news item icon  412  is selected, the graphical user interface screen  1100 , as shown in  FIG. 13 , is displayed in place of the graphical user interface screen  400 . 
         [0100]    As shown in  FIG. 7 , the graphical user interface screen  500  includes a graphic representation of a clipboard  502 . The patient enters the patient&#39;s name or a username and a password into the clipboard  502 , for example, by using a pair of data entry input boxes  504  and  506 . Data is entered into these data entry boxes  504  and  506  by the patient using the keyboard or other data entry device of the patient&#39;s data terminal  120 . Access to other screens of the clinic system  200 , which would otherwise be open to an authorized patient, would be denied to a patient or other person who lacks an authorized password. The patient may change an authorized password by selecting the change password icon or hypertext link  508  shown on the clipboard  502  in  FIG. 7 . 
         [0101]    The graphical user interface screen  500  shown in  FIG. 7 , and various other data entry screens displayed by the clinic system  200 , frequently show two buttons: a submit button  510  and a reset button  512 . The submit button  510 , when selected, sends the data entered by the user, such as the patients name and password entered into the data entry boxes  504  and  506  to the clinic system  200 . The reset button  512  allows the patient to reset the data in the data entry boxes  504  and  506  when an error is made. Of course, it should be appreciated that the submit and reset functions associated with the submit and reset buttons  510  and  512 , respectively, may also be implemented by enabling the enter and backspace keys of a keyboard. It should also be appreciated that data entry in the various screens of the chronic illness management system  100  described herein is not limited to buttons, but may also include, for example, dropdown list boxes, data entry input boxes, dialog boxes and the like, and/or commercial voice recognition software programs that recognize data entry commands and entered data. 
         [0102]    Once the patient has gained authorized access to the clinic system  200 , the clinic system  200  recognizes that patient&#39;s chronic illness from its patient records stored in the database  232 . However, the clinic system  200  may be used to manage more than one chronic illness of a patient. As shown in  FIG. 8 , in various exemplary embodiments, when such a patient, for example, a patient suffering from both diabetes and kidney disease, signs into the clinic on the clipboard  502  shown in  FIG. 7 , the graphical user interface screen  500  is automatically replaced with the graphical user interface screen  600 , as shown in  FIG. 8 . In various exemplary embodiments, the screen  600  includes a graphic representation of an elevator  602  having a control panel  610 . By selecting, for example, the second floor elevator button icon  612 , which is labeled “My Kidney Team”, the patient signals that patient&#39;s intention to visit the kidney disease clinic portion of the clinic system  200 . Similarly, by selecting the third floor elevator button icon  614 , labeled “My Diabetes Team”, the patient signals that patient&#39;s intention to visit the diabetes clinic portion of the clinic system  200 . 
         [0103]    As shown in  FIG. 9 , in various exemplary embodiments, in response to the user indicating or activating the second floor elevator button  612 , such as, for example, by putting the cursor over the second floor elevator button icon  612 , an animation of the elevator door  620  opening onto a graphical representation of the kidney disease clinic  630  is displayed. Once the elevator door  620  is shown in the fully open position and the user selects the second floor elevator button icon  612 , the screen  600  is replaced with the particular exemplary embodiment of a main patient data screen that is appropriate for the kidney clinic portion of the chronic illness management system, i.e., the kidney clinic main patient data screen  3200 , as shown in  FIG. 32 . Similarly, in various exemplary embodiments, in response to the user indicating or activating the third floor elevator button  614 , such, for example, by putting the cursor over the elevator button icon  614 , an animation of the elevator door  620  opening onto a graphical representation of the diabetes clinic is displayed. Again, once the elevator door  620  is shown in the fully open position and the user selects the third floor elevator button icon  614 , the screen  600  is replaced with the graphical user interface screen  700 , as shown in  FIG. 10 . It should be appreciated that the number of clinics and the number of clinic floors accessed by the elevator  602  will depend upon the number of distinct chronic illnesses managed by the chronic illness management system  100 . 
         [0104]    Alternatively, the animation of the elevator door  620  opening can occur in response to the user selecting one of the elevator floor button icons  612 - 616 . In this case, after the elevator door  620  reaches the fully open state, the screen  600  is immediately replaced with the screen of the graphical user interface that is associated with the selected elevator floor button  612 - 616 . 
         [0105]    The patient suffering from multiple chronic illnesses may also return to the clinic lobby  402  after visiting a particular clinic by selecting the lobby elevator button icon  616 . In response to the user indicating or activating the lobby floor elevator floor button icon  616 , such as. for example, by putting the cursor over the lobby elevator button icon  616 , the elevator door  620  is, in various exemplary embodiments, animated to show the elevator  602  opening onto the graphical representation of the clinic lobby floor. After the elevator door  620  opens onto a graphical depiction of the clinic lobby floor and the user selects the lobby floor elevator button icon  616 , the screen  600  is automatically replaced with the screen  400  shown in  FIG. 4 . This graphical representation of elevator movement between floors to reach various clinics again mimics the experience the patient would expect to undergo during an actual clinic visit. 
         [0106]    As shown in  FIG. 10 , after an authorized patient signs into the clinic system  200  using the screen  500 , and depending on whether the elevator paradigm underlying the screen  600  is used to select a particular clinic for one of a number of chronic illnesses experienced by the patient, the screen  500  or the screen  600  is replaced with a main patient data screen  700 . In the particular exemplary embodiment shown in  FIG. 10 , a patient suffering from diabetes has accessed the main patient data screen  700 . Thus, the particular content of the main patient data screen  700  shown in  FIG. 7  is that for a patient suffering from diabetes. 
         [0107]    Of course, it should be appreciated that the particular contents of the main patient data screen  700  will depend on the particular chronic illness that the patient who has accessed the main data screen  700  is suffering from and may also depend upon whether the patient has used the elevator control panel  610  to select from multiple chronic illnesses. However, it should be appreciated that, in various exemplary embodiments of the chronic illness management system  100  according to this invention, the various main patient data screens, such as the screens  700  and  3200 , maintain a consistent look and feel for the various icons, data portions and other elements, other than disease-specific data. between the various chronic illnesses that may be managed using the chronic illness management system  100 . 
         [0108]    In particular, it should be appreciated that the main patient data screen, such as the screens  700  and  3200 , is the initial screen shown to patients after the patients sign into any one of the one or more different disease-specific clinics that may be implemented in the chronic illness management system  100 . In various exemplary embodiments, to maintain the consistent look and feel between such different chronic illness clinics, the main patient data screen  700  includes, for example, a frame  800  and a central display area  710 . To maintain the consistent took and feel of the main patient data screen  700 , the frame  800  and the central display area  710  are maintained in consistent locations, shapes and relative proportions. In various exemplary embodiments; the frame  800  is displayed above and to the left of the central display area  710 . However, it should be appreciated that the frame  800  can be positioned in any desired location within the main patient data screen  700 . 
         [0109]    However, because a consistent look and feel for the main patient data screen is maintained regardless of the particular chronic illness clinic that is being accessed, it is possible that a patient suffering from multiple chronic illnesses could have difficulty remembering which particular chronic illness is currently being accessed. Accordingly, in various exemplary embodiments, to help identify which particular chronic illness clinic is being accessed through the main patient data screen, such as the screens  700  or  3200 , the background  810  of the frame  800  or of a frame  3202  of the screen  3200 , can be color coded based on the particular chronic illness clinic that the user is visiting using the main patient data screen  700 . For example, the background  810  for the diabetes clinic main data screen  700  could be blue, while the background  810  for the frame  3202  of the kidney disease clinic main data screen  3200  could be green. Thus, any graphical user interface screen having a frame  800  having a blue background  810  has been accessed through the diabetes clinic portion of the clinic system  200  and/or is displaying diabetes-related data, clinical information, and/or educational information. 
         [0110]    In various exemplary embodiments, the frame  800  may include, for example, a selectable icon or hypertext link  820  displaying the user&#39;s name, a date indicator  822 , a selectable icon or hypertext link  824  that is linked to another screen of the graphical user interface, and a selectable icon or hypertext link  826  that is linked to a website for a sponsor of the clinic system  200 , such as a university that is associated with the virtual clinic. In various exemplary embodiments, the frame  800  may also include, for example, a selectable messages icon or hypertext link  832 , a selectable clinical data icon or hypertext link  834 , a selectable education icon or hypertext link  836 , a selectable contact icon or hypertext link  838  and/or a selectable logout icon or hypertext link  840 . Each of the selectable icons or hypertext links  832 - 840  is usable to change the information displayed in the central display area  710  of the main patient data screen  700 . 
         [0111]    As indicated above, each of the elements  832 - 840  can be a selectable icon or a hypertext link. To simplify the following detailed description, the term icon will be used interchangeably with the terms selectable icon and hypertext link. 
         [0112]    In response to selecting the messages icon  832  of the frame  800 , a messages screen  900  is displayed in the central display area  710  of the main patient data screen  700 . In contrast, selecting the clinical data icon  834  causes various types of clinical information and clinical data to be presented to the patient in the central display area  710  of the main patient data screen  700  using the screens  1500 - 2100  and  6800 . In response to selecting the education icon  836 , the diabetes education screen  2200  shown in  FIG. 29  is displayed in the central display area  710  of the main patient data screen  700 . 
         [0113]    Selecting the contact icon  838  causes one of a number of contact screens to be displayed, such as the diabetes contact screen  2400  shown in  FIG. 31  or a contact screen for the kidney clinic. It should be appreciated that the particular contact screen accessed using the contact icon  838  will depend on a particular chronic illness clinic that the patient is currently visiting. Finally, selecting the logout icon  840  logs the patient out of the currently selected chronic illness clinic and displays the clinic lobby screen  400  or the elevator screen  600 , depending on whether the patient has one or more chronic illnesses, in place of the main patient data screen  700 . 
         [0114]    As shown in  FIG. 10 , in various exemplary embodiments, when the main patient data screen  700  is first displayed during any given session, the messages screen  900  is also automatically displayed in the central display area  710 . The messages screen  900  includes a patient greeting  910 , appropriately addressed and based on the time of day (i.e., “Good Morning,” “Good Afternoon,” or “Good Evening”) followed by the patient&#39;s name, a selectable icon or hypertext link  920  to a screen that displays the latest news, a dropdown list  930  that allows the patient to access archived news items on various subjects, and alerts portion  940 , a messages portion  950  and a reminders portion  960 . 
         [0115]    In various exemplary embodiments, the information presented to the patient concerning the alert portions  940 , the messages portion  950  and/or the reminders portion  960  of the messages screen  900  is automatically extracted or derived from the data stored in the relational database  232  when the patient initially accesses the main patient data screen  700  by analyzing the data stored in the relational database  232  in real time. The information presented to the patient in the alerts portion  940 , the messages  950  and/or the reminders portion  960  of the message screen  900  is the type of information that a healthcare practitioner or other healthcare practitioner would emphasize to a patient during an actual clinic visit. 
         [0116]    When the amount of information to be displayed in any one of the alerts portion  940 , the messages portion  950  or the reminders portion  960 , or in total in the messages screen  900 , exceeds the size of the central display area  710 , a vertical and/or horizontal scroll bar (not shown), as is well known in the art, can be implemented to allow the patient to view any information that could not initially be displayed in the central display area  710 . Of course, it should be appreciated that this technique will be usable for all of the following screens that can be displayed in the central display area  710 . Thus, use of scroll bars will not be further described. 
         [0117]    As shown in  FIG. 10 , the alerts portion  940 , the messages portion  950  and/or the reminders portion  960  of the messages screen  900  may contain medical terms that have embedded hypertext links or graphical user interface widgets, such as the hypertext link or graphical user interface widget  954  shown in  FIG. 10 . These hypertext links or graphical user interface widgets allow the patient to access additional screens, separate windows, and/or windows elements of the graphical user interface that provide information about such medical terms. 
         [0118]    Thus, as shown in  FIG. 11 , when the patient selects or hovers over or otherwise indicates the hypertext link or graphical user interface widget associated with such a medical term, such as the graphical user interface widget or hypertext link  954  associated with the medical term “HbAIC” in  FIG. 10 , contextually relevant information  1000  may be displayed, for example, in a pop-up dialog box  1000 . The information contained within the pop-up dialog box  1000  defines and/or further explains the medical term, symbol or icon associated with the selected or indicated hypertext link or graphical user interface widget. Alternatively, rather than using the pop-up dialog box  1000 , selecting and/or indicating the hypertext link or graphical user interface widget could result in a glossary screen (not shown) being displayed. 
         [0119]    As shown in  FIG. 11 , in various exemplary embodiments that use the pop-up dialog box  1000 , selecting or indicating the graphical user interface widget or hypertext link  954  associated with the medical term “HbAlC” in the messages portion  950  results in the pop-up dialog box  1000  being displayed and containing a contextually relevant message providing a definition for this medical term. Similarly, in various exemplary embodiments, hovering over or indicating, but not selecting, the education icon  836  of  FIG. 10  also causes a contextually relevant message (not shown) to be displayed that may further characterize the education icon  836  as “a diabetes educational site”. 
         [0120]    The messages portion  950  can also optionally include a hypertext link or graphical user interface widget (not shown) that allows a patient to provide comments when the patient has entered new clinical data, such as blood glucose values, into the clinic system  200 . In this case, selecting the hypertext link or graphical user interface widget associated with the newly entered clinical data, such as, for a diabetes patient, blood glucose levels, results, in various exemplary embodiments, in a text entry box (not shown) being displayed to the patient. Alternately, in various other exemplary embodiments, this results in the message screen  900  being replaced with a clinical data comments screen (not shown). In either case, in response to selecting the hypertext link or graphical user interface widget associated with the new clinical data, the patient is able to enter comments about the new clinical data from that patient&#39;s data terminal  120 , 
         [0121]    As shown in  FIG. 12 , when the patient selects the patient&#39;s name icon  820  in the frame  800 , the main patient data screen  700  is replaced with an update patient information screen  1200 . The update patient information screen  1200  may include a number of data entry boxes  1201 - 1206  usable, for example, to update the patient&#39;s personal information, such as the patient&#39;s name, address, telephone numbers, marital status, employment, and/or e-mail or message address. The update patient information screen  1200  can also include a number of data entry boxes  1210 - 1212  usable to update the patient&#39;s medical information, such as the name and/or telephone number of that patient&#39;s primary care healthcare practitioner, and/or that patient&#39;s allergies. Finally, the update patient information screen  1200  can include a number of data entry boxes  1220 - 1223  usable to update the patient&#39;s emergency information such as the name, address, relationship and/or telephone number of that patient&#39;s emergency contact. 
         [0122]    As shown in  FIG. 13 , in response to the patient selecting the hypertext link or graphical user interface widget  920 , the messages screen  900  displayed in the central data area  710  of the main patient data screen  700  is replaced with a news screen  1100 . The news screen  1100  displays one or more recent news articles that are relevant to the particular chronic illness that the patient was managing at the time the hypertext link or graphical user interface widget  920  was selected. As described above with respect to the messages screen  900 , when the news article displayed in the news screen  1100  exceeds the size of the central display area  710 , the entire news article may be viewed by using vertical and/or horizontal scroll bars (not shown). Using the archives news dropdown list box  930  allows archival news to be selected for display in the news screen  1100 . 
         [0123]    As shown in  FIG. 10 , the alerts portion  940  of the messages screen  900  displays information to the patient that is derived from the clinical data supplied, or often, not supplied, by the patient to the clinic system  200  over the patient&#39;s data terminal  120  and the network  110 . For a diabetic patient, the information displayed in the alerts portion  940  is derived from an automated, real-time analysis by the clinic system  200  of the measured blood glucose values that the patient has sent to the clinic system  200  and which has been stored in the relational database  232 _ The alerts portion  940  summarizes those events, and activities and/or inactivities, which may be detrimental to the patient. 
         [0124]    Data is analyzed by the clinic system  200  to inform patients, using the alerts portion  940 , about various clinical parameters that have reached an indicated alert level, In the data illustrated in the exemplary embodiment shown in  FIG. 10 , the latest HbAlC value is greater than the site/patient configurable value. As a result, the value of the patient&#39;s latest HbAlC value is printed in red and an appropriate message is attached and displayed in the alerts portion  940 . Similarly, if the patient&#39;s Average Blood Glucose value over the last 2 weeks is greater than the site/patient configurable value, the patient&#39;s Average Blood Glucose value is printed in red and an appropriate message is attached and displayed in the alerts portion  940 . If the number of hypoglycemic events and/or hyperglycemic events exceeds the corresponding site/patient configurable value, then the stored clinical data is analyzed to show when these hypoglycemic and/or hyperglycemic events occurred. As shown in  FIG. 14 , these hypoglycemic events and/or hyperglycemic can be organized by the day of week in the table portion or tabular chart  1410  and/or by the time of day in a table portion or tabular chart  1412  of an events screen  1400 . Similarly, if more than a site/configurable time period has past since receiving new blood glucose data, then the number of days is printed in red and a message is attached and displayed in the alerts portion  940 . 
         [0125]    Additionally, in the data illustrated in the exemplary embodiment shown in  FIG. 10 , data is analyzed to inform a patient about positive results in the patient&#39;s data in the messages portion  950 . If the patient&#39;s Average Blood Glucose value over the previous two weeks is less than site/patient configurable value, then that value is printed in green, with a smiley face  952  and message attached and displayed in the messages portion  950 . If the patient&#39;s latest HbAlC value is less than site/patient configurable value and has decreased by a site/patient configurable amount, then that value is printed in green, with a smiley face  952  and message attached and displayed in the messages portion  950 . Finally, if a patient has sent new blood glucose data without attaching a comment, the patient is prompted to do so at that time by displaying an appropriate message in the messages portion  950 . Of course, it should be appreciated that the particular alerts and messages displayed in the alerts portion  940  and the messages portion  950  will depend on the particular chronic illness the patient is suffering from 
         [0126]    In the exemplary embodiment illustrated by the data shown in  FIG. 10 , the clinic system  200  has analyzed the blood glucose values submitted by the patient and has determined from the clinical data and/or other information stored in the relational database  232  that this patient has not reported blood glucose data (BO data) in 696 days. In performing its analysis, the clinic system  200  compares the number of days for which blood glucose values were not reported to a threshold value. When this threshold value is exceeded the clinic system  200  causes an appropriate alert message to be displayed in the alerts portion  940 . The number of days a blood glucose value has not been received may also be emphasized to the patient by color coding the number of days, in this case  696 , displayed in the alerts portion  940 , depending on the urgency and/or importance of the message. 
         [0127]    In the exemplary embodiment illustrated by the data shown in  FIG. 10 , the clinic system  200  also summarizes the number of hypoglycemic and hyperglycemic events present in the information and clinical data stored in the relational database  232 . The clinic system  200  causes the generated summary information to be displayed in the alerts portion  940  as well. The clinic system  200  determines these types of events by comparing the clinical data stored in the relational database  232  to one or more threshold values. The threshold values have been entered into the clinic system  200  by a healthcare practitioner via one of the healthcare practitioner data terminals  130 . Each event, or each set of events, is associated with a hypertext link or a graphical user interface widget, as shown in the alerts portion  940 . 
         [0128]    When the patient selects the hypertext link or graphical user interface associated with such an event listed in the alerts portion  940 , the messages screen  900  displayed in the central data portion  710  is replaced with the events screen  1400  shown in  FIG. 14 . As shown in  FIG. 14 , the events screen  1400  shows various organizations of the events associated with the selected hypertext link or graphical user interface widget. For example, when the hypertext link or graphical user interface widget  942  regarding hypoglycemic and/or hyperglycemic events shown in  FIG. 10  is selected, the events screen  1400  shows various hypoglycemic and/or hyperglycemic events associated with that hypertext link or graphical user interface widget organized by day of week in a first tabular chart  1410  and by time of day in a second tabular chart  1412 . 
         [0129]    The information displayed in the messages portion  950  may also be provided by the clinic system  200 . The messages that may be displayed in the messages portion  950  include, for example, that MAX and/or average blood glucose are in target. The real-time analysis by the clinic system  200  of the patient&#39;s blood glucose values that are stored in the relational database  232 , when compared to a clinical target range provides information about the number of times the patient&#39;s blood glucose values either fall below or exceed the normal range. Based on the number of times the patient&#39;s blood glucose values are not normal, the messages displayed in the messages portion may indicate whether the patient is properly managing his or her diabetes. For example, good management of the patient&#39;s diabetes may be indicated by animated yellow smiting faces  952 , while poor management may be indicated by blue frowning faces (not shown). A green blood glucose value or clinical test value in a message may indicate a normal value, indicating good clinical management of the diabetes. Messages are the type of information that a clinician is likely to emphasize to a patient during a clinical visit. 
         [0130]    In  FIG. 10 , the patient&#39;s healthcare practitioners have entered reminders to the patient, for medical tests, exams and visits, into the clinic system  200 , These reminders are stored in the relational database  232 . Data is mined to determine and/or generate reminders of lab tests, clinic visits, etc. for the patient. These reminders are then displayed in the reminders portion  960 . The status of the reminders, such as, whether the patient has properly responded to the reminder, can be color-coded. In various exemplary embodiments, such as that shown in  FIG. 10 , a patient is prompted, at a site/patient configurable time prior to the event, to schedule an appointment. For example, the days past due for an appointment to have been scheduled, or a missed appointment, may be emphasized by setting the appearance of some or all of that text string to red. In the exemplary embodiment shown in  FIG. 10 , the number of days the appointment is past due is displayed in red. 
         [0131]    Selecting the clinical data icon  834  when accessing the diabetes clinic changes the information displayed in the central display area  710  to one of a set of interlinked clinical data screens  1500 - 2100  and a message list screen  6800 . In particular, in the exemplary embodiments shown in  FIG. 15 , the clinical data screen initially displayed upon selecting the clinical data icon  834  is a patient supplied data screen  1500 . However, it should be appreciated that any of the clinical data screens  1500 - 2100  or the messages list screen  6800  could be initially displayed. 
         [0132]    The patient supplied data screen  1500  displays the clinical data that has been submitted to the system by the patient using the medical device  122 , such as, an automated or manual blood glucose meter. For a diabetic patient, the clinical data are the patient&#39;s blood glucose values, displayed as a blood sugar log  1510  in the patient supplied data screen  1500 , as shown in  FIG. 15 . The blood sugar log  1510  is a chart with summary data. An explanatory legend  1512  is located beneath the chart, as shown in  FIG. 15 . 
         [0133]    The patient supplied data screen  1500  also includes a tool bar  1520  that includes a number of icons usable to change the type of graphing used to display the patient supplied data and a tool bar  1501  that includes a number of icons usable to switch between the various clinical data screens  1500 - 2100  and  6800 . It should be appreciated that the patient supplied data screen  1500  can also be accessed through the icon  1503  of the toolbar  1501 . 
         [0134]    The blood sugar log  1510  displays blood glucose (BG) values by date and time of day in the chart. A single row of the chart may display the date, blood glucose values at specific time intervals during the day, the number of blood glucose values obtained in a day (# Readings), and the average value of the blood glucose readings for the day (Avg. Reading). At the bottom of the blood sugar log  1510 , the average values of blood glucose for a specific daily time interval and the average number of readings per time frame (not shown) may be displayed. Additional rows at the bottom of the chart may display the number of hypoglycemic events and hyperglycemic events (not shown) that occur in a specific daily time interval for the displayed dates. 
         [0135]    In the blood sugar log  1510 , a blood glucose value having an associated graphical user interface widget or hypertext link may indicate that more than one blood glucose reading was taken during a time interval. When multiple blood glucose readings occur within a time interval, only the first blood glucose value is displayed in the chart. However, when the graphical user interface widget or hypertext link associated with such a blood glucose value is selected, an on-screen contextual message (not shown) displays all the blood glucose values submitted during that interval. 
         [0136]    Beneath the blood sugar log  1510 , the average blood glucose value for all time intervals over the displayed dates is shown, along with a statistical standard deviation of all the blood glucose values and the range of blood glucose values, indicating maximum and minimum blood glucose values (not shown). Additionally, the legend  1512  beneath the blood sugar log  1510  explains the color coding of the blood glucose values in the chart, which may represent hypoglycemic values in blue, hyperglycemic values in red, and normal blood glucose values in green Hypoglycemic and hyperglycemic values may, alternatively, be displayed with an associated minus sign or plus sign, respectively. 
         [0137]    In particular, in various exemplary embodiments of the systems and methods according to this invention, the values in the log book are color coded and/or are preceded by a + sign or a − sign, depending on their value. If the values in the log book arc greater than a site/patient configurable value, then the values are displayed in red and preceded by a +. If the values in the log book are less than a site/patient configurable value, the values are displayed in blue and preceded by a − If the values in the log book are greater than a site/patient minimum configurable value and less than a site/patient maximum configurable value, the values are displayed in green. Additionally, if multiple readings for a given day and a given time slot are available, the first reading for that day and time slot is displayed, but the other values are available by moving the mouse over the first reading. In response, a pop-up window is displayed that includes some or all of the readings for that day and time slot. 
         [0138]    By selecting the date hypertext link or graphical user interface widget  1514  in the upper left corner of the blood sugar log  1510  of  FIG. 15 , the screen changes to that of a date interval selection screen or window  1570 , as shown in  FIG. 16 . In the date interval selection screen or window  1570 , the patient may select the dates for which the blood sugar log  1510  is to display blood glucose values. The patient may select either the last 14 days entered in the blood sugar log book by an option button  1572  or a “Start Date/End Date” option by selecting a second option button  1574 . If the “Start Date/End Date” option is selected, the patient may enter the start and end dates into, for example, standard data entry input boxes  1576 , as shown in  FIG. 16 . 
         [0139]    The graphing icons in the toolbar  1520  located on the clinical data screen  1500  may change the presentation of the blood sugar log  1510 . For example, if the patient selects the animated line chart icon  1522 , the tabular blood sugar log  1510  is replaced with a linearly plotted graph  1530 , as shown in  FIG. 17 . This linearly plotted graph  1530  plots blood glucose values against time during the date interval that is displayed above the graph. Similarly, selecting the animated “Histograms” icon  1524  displays the data contained in the blood sugar log  1510  as two histograms  1540  and  1542 , shown in  FIG. 18 . The first histogram  1540  plots blood glucose values against days of the week, and the second histogram  1542  plots blood glucose values against the daily time intervals. 
         [0140]    These different data presentations may help the patient to understand any daily or weekly patterns of changes in blood glucose values. Such patterns would usually be discussed in an actual clinic visit to explore activities surrounding the time during which such changes of blood glucose values occur, so as to avoid possible hypoglycemic or hyperglycemic events 
         [0141]    When the pie chart icon  1526  of  FIG. 15  is selected, the data contained in the blood sugar log  1510  is shown as percentages of blood glucose readings above, below and within the target range of clinically desired blood glucose values in a pie chart  1550 , as shown in  FIG. 19 . Sectors of the pie chart may also be color coded to reflect the percentage of blood glucose readings above, below and within a clinical target range as explained in the legend  1552 . For example, a sector of the pie indicating the percentage of blood glucose readings that are above the target blood glucose range may be colored red, while those that are within the target range are colored green and those below the target range are colored blue. Alternatively, various shadings or graphics may be used to distinguish between the pie chart sectors. 
         [0142]    Selecting the multiple pie chart icon  1528  results in a pie chart  1560 - 1564  for each specific daily interval of the blood sugar log  1510 , as shown in  FIG. 20 . Each pie chart  1560 - 1564  indicates the percentage of blood glucose readings that were above, below or within the target blood glucose range for a particular time interval. Again, sectors of each pie may be color coded to reflect the percentage of blood glucose readings above, below and within a clinical target range as explained in the color-coded legend  1566 , or indicated by pluses or minuses (not shown). When no blood glucose readings correspond to a particular daily time interval, a message  1568 , for example, “No data for this timeslot”, may be presented, as shown in  FIG. 20 . The line charts  1530  shown in  FIG. 17 , the histograms  1540  and  1542  shown in  FIG. 18 , and the pie charts shown in FIGS.  19  and  20  are tied to the data range and the data displayed in the blood sugar log  1510 . If the date range is changed in the log book, then the date range on the graphs also changes. 
         [0143]    Selecting the lab results icon  1502  of the toolbar  1501  changes the displayed one of the clinical data screens  1500 - 2100  or  6800  to the laboratory test results screen  1600 .  FIG. 21  shows one exemplary set of such laboratory test results displayed in the laboratory test results screen  1600 . The laboratory test results screen  1600  presents laboratory test results of for example HbAIC, cholesterol, HDL, LDL, triglycerides, and urine microalbumin in a table  1610 , indicating the laboratory test and the month the laboratory test was taken. When any of the laboratory tests having an associated hypertext link or graphical user interface widget is selected, an on-screen contextual message (not shown) may appear to explain what the laboratory test measures, its clinical significance and the acceptable clinical range of test values. 
         [0144]    In  FIG. 21 , the patient has HbA1C test results that fall within the acceptable clinical range for the month of May. In this case, a simple comparison of the laboratory results with acceptable clinical values stored in the relational database  232  by the clinic system  200  is performed in real-time to determine whether the value is acceptable. For example, in various exemplary embodiments, if the HbAlC value is less than a site/patient configurable value, then a text message and/or an audio message is presented to the user in a message portion  1620 . As shown in  FIG. 21 , the illustrated test results are below a site/patient configurable value. As a result, because the test results are acceptable, the clinic system may present in the message portion  1620  a congratulatory comment from the patient&#39;s healthcare practitioner, such as “Great Ale this month-Keep it up”, possibly accompanied by the sound of applause. This message and sound of applause provide motivation to the patient, when the patient has done well in managing his or her blood glucose values and are meant to reflect the feedback a patient would normally receive during a clinic visit from his or her healthcare practitioner. 
         [0145]    Selecting the medication icon  1504  of the toolbar  1501  changes the displayed one of the clinical data screens  1500 - 2100  or  6800  to a medications screen  1700 . The medications screen  1700  shows the medications used by the chronic illness patient. In the particular exemplary embodiment shown in  FIG. 22 , the medications screen  1700  is one that is appropriate for a diabetic patient. It should be appreciated that the contents of the medications screen will change depending on the particular chronic illness, as illustrated by the second exemplary embodiment of the medications screen  3700  shown in  FIG. 37 . 
         [0146]    In the prescription portion  1710 , the date and time of the current prescription for insulin, which has been prescribed by clinic healthcare practitioners, may be displayed. In the prescription portion  1710  of the medication screen  1700  displayed for a diabetic patient, an insulin medication table  1712  may indicate that both long and short acting insulin are currently prescribed for the patient. display the common or trade names of the prescribed insulin, and the dosage values and time of day that the prescribed type of insulin is to be taken. Previous prescription orders for insulin may be viewed by selecting the previous prescription hypertext link or graphical user interface widget  1714 . The previous prescription order date is then displayed above the insulin medication table  1712 , which now contains information about the previous prescription order. After reviewing the previous order, the patient may advance the prescription order to the current prescription date and order by selecting a next prescription graphical user interface widget or hypertext link (not shown), which will be displayed if the currently displayed prescription information is not that for the latest insulin prescription. 
         [0147]    For diabetic patients who have an insulin pump, the insulin prescription information may be presented in a separate table (not shown) that includes, for example, the insulin pump prescription showing time versus basal rate, bolus information by meal including grams of carbohydrate, bolus size, insulin to carbohydrate ratio, prescribed supplemental insulin and information explaining how insulin converts various foods to carbohydrates. 
         [0148]    In an oral medication portion  1720  of the medication screen  1700 , the date of the current prescription of oral prescription drugs other than insulin, which has been prescribed by clinic healthcare practitioners, and an oral medication table  1722  is shown that may indicate the type of oral medication, its name, the dosage and number of tablets per dose, and the frequency with which the medication is to be taken. As described above, previous oral medication prescription orders and information concerning the previous prescription orders may be reviewed by selecting a previous prescription hypertext link or graphical user interface widget  1724  located above the oral medication table. Similarly, after reviewing a previous oral medication prescription order, selecting a next prescription hypertext link or graphical user interface widget (not shown) advances the oral medication prescription date and prescription order. 
         [0149]    In another medication portion  1730  of the medications screen  1700 , non-prescription medications and other prescription medications, prescribed by a non-clinic healthcare practitioner, may be displayed. These other medications are entered into a displayed other medication table  1732  by the patient when he or she selects the add other medication icon  1740 . Selecting the add other medication icon  1740  changes the medications screen  1700  to the add medications screen  1800  shown in  FIG. 23 . As shown in  FIG. 23 , the add medications screen  1800  includes a data entry table  1810  comprising a number of data entry input boxes  1812  and drop down list boxes  1814 , in which the patient enters the information about other medications. The patient enters into the appropriate data entry input box  1812  via the patient data terminal  120 , the name of the medication, when it was taken, its dosage, and the purpose of the medication. The frequency with which the medication is taken may be entered by accessing one of the drop list boxes  1814  that list once, twice and three times per day, or the like. 
         [0150]    Information concerning the various medications taken by the patient may be communicated to other computerized clinical systems that analyze the information for possible adverse drug interactions. If such a system discovers a possible adverse drug interaction, this information may then be communicated to the clinical management system for chronic illnesses for inclusion in, for example, an alert displayed in the alerts portion  940 . Alternatively, such information may be sent to a clinic healthcare practitioner, who in turn informs the patient. 
         [0151]    Selecting the animated exercise log icon  1505  changes the displayed one of the clinical data screens  1500 - 2100  or  6800  to an exercise data screen  1900 . The exercise data screen  1900  includes an exercise log  1910 , as shown in  FIG. 24 , and an exercise event entry portion  1920 . The exercise event entry portion includes a number of drop down list boxes  1922 - 1926  in which the patient may enter the date, type of exercise, and duration of exercise, and a data entry input box  1928  for entering the patient&#39;s comments. Entering the date of a log entry may be facilitated by a set of standard drop down list box  1922  that allows the patient to select a particular month, date, and year. Similarly, a type of exercise drop down list box  1924  may provide for the selection of, for example, biking, jogging or running, swimming, walking or hiking, golfing, arm chair exercising, other sports, gardening, housework, and other activities. The duration of an exercise may be entered by a drop down list box  1926  that provides for the selection of 15, 30, 45 and 60 minutes or an “other” time interval. The data entry input box  1924  permits the patient to enter the patient&#39;s comments, via the patient&#39;s data terminal  120 , which the patient feels will be relevant to the healthcare practitioner or may more fully describe an exercise activity or its duration. Comments from a healthcare practitioner may also be displayed in the exercise data screen  1900 , indicating to the patient that the healthcare practitioner is reviewing and evaluating the level of the patient&#39;s physical activity. 
         [0152]    Selecting the blood pressure icon  1506  of the toolbar  1501  changes the displayed one of the clinical data screens  1500 - 2100  or  6800  to a blood pressure data screen  2000 . The blood pressure data screen  2000  includes a patient blood pressure log  2010 , as shown in  FIG. 25 . The blood pressure log  2010  is a table that displays blood pressure values by date, that are obtained from an automated or manual medical device  122  that the patient may connect to the patient&#39;s data terminal  120  and/or directly to the network  110 . The blood pressure log  2010  allows for patient-entered comments. The blood pressure data screen  2000  also includes a manual entry portion  2020  that includes a number of data entry boxes  2022 - 2028 . The patient may enter the date using drop down list boxes  2022 , while systolic and diastolic blood pressures and comments may be entered into, for example, by the data entry input boxes  2024 ,  2026  and  2028 , respectively. Comments (not shown) from the healthcare practitioner about the patient&#39;s blood pressure may be displayed in the blood pressure data screen  2000 . It should be appreciated that, if the clinic system  200  is able to accept data from an electronic blood pressure device as the medical device  122 , the manual entry portion  2020  may be omitted. 
         [0153]    Selecting the data summary and healthcare practitioner comments icon  1507  changes the displayed one of the clinical data screens  1500 - 2100  or  6800  to the summary screen  2100 . The summary screen  2100  includes a tabular summary  2110 , as shown in  FIG. 26 . In  FIG. 26 , the tabular summary  2110  presents by date, for example, the average blood glucose value, the standard deviation of the blood glucose values, the number of hypoglycemic and hyperglycemic events, the percentage of blood glucose readings within the desired target range, the average number of blood glucose readings per day, and the number of days for which the clinical data is summarized. When reviewing the tabular summary  2110  of  FIG. 26 , the patient may enter comments regarding his or her latest blood glucose values, for example, by a standard data entry box  2120  as shown in  FIG. 27 , to which the healthcare practitioner may reply. 
         [0154]    By selecting the date icon  2112  in the upper left corner of the tabular summary  2110  of  FIG. 26 , a data selection screen or window  2800  is displayed, as shown in  FIG. 28 . The data selection screen or window  2800  shows two options, a “Last 30-Day Summary” option button  2810  or a “Start Date/End Date” second option button  2820 . A “Cancel” button  2840  may cancel the dates&#39; selection screen and return the patient to the summary screen  2100  shown in  FIG. 26 . 
         [0155]    Selecting the patient message list icon  1508  of the toolbar  1501  changes the displayed one of the clinical data screens  1500 - 2100  displayed in the central data area  710  to the patient message list screen shown  6800  in  FIG. 68 . The patient is presented with a list of messages sent by the patient&#39;s healthcare practitioner or by the patient, as shown in  FIG. 68 . Information, such as the date a message was sent. to whom the message was sent, who sent the message, and the subject/title of the message may be presented. In various exemplary embodiment, all unread messages in the list are preceded by a red asterisk. 
         [0156]    When the patient selects one of the underlined subject/titles, the clinical management system retrieves the selected message for the patient, as shown in  FIG. 69 . A message list screen  6900  appears with information such as the date the message was sent, to whom the message is addressed, who sent the message, the subject/title of the message and the message itself. If the entire message does not fit within the message list screen  6900  horizontal and/or vertical scroll bars are presented for the patient to scroll through the message (not shown). At the end of the message there is a reply button  6910  and a close button  6920 . When selected, the reply button  6910  allows the patient to send a response message to whomever sent the message (not shown). The close button  6920  allows the patient to exit the message list screen  6900  and return the patient to the patient message list screen  6800  of  FIG. 68  (not shown). The patient may also exit from the message list screen  6900  by selecting the standard window exit icon (not shown) in the top right hand corner of the message list screen  6900  to return to the patient message list screen  6800 . 
         [0157]    The patient may also create and add a new message to the messages displayed in the patient message list screen  6800 . The patient selects a “Select a CareTeam Member” drop down list box  6810 . The “Select a CareTeam Member” drop down list box  6810  provides a list of the healthcare practitioners in the chronic illness management system  100 . The patient then selects the healthcare practitioner the patient wishes to address the message to (not shown). The patient may also provide a subject/title for the message, but this is not required. The patient does this by simply typing in the subject/title in the “Subject” data entry box  6820  in  FIG. 68 . 
         [0158]    If the patient decides to discard the message, has made an error, or wants to change to whom the message is addressed to and/or the subject/title of the message, the patient can select the reset button  6830 . When selected, the reset button  6830  clears to whom the message is addressed to and clears the “Subject” data entry box  6820  The function of the reset button  6830  can also be accomplished by selecting a different individual from the “Select a CareTeam Member” drop down list box  6810  for whom the message is addressed and by backspacing over the incorrect data entry and then typing the correct data in the “Subject” data entry box  6820 . 
         [0159]    After the patient has selected the healthcare practitioner to whom the message is addressed and typed a subject/title for the message (optional), the patient selects the “Add Message” button  6840 . When the patient selects the “Add Message” button  6840 , the patient message list screen changes to the add message screen shown in  FIG. 70 . The add a message screen  7000  displays the patient&#39;s name as who the message is from, the name of the healthcare practitioner to whom the message is addressed and the subject/title, if provided by the patient. Additionally, there is a message data entry box  7010 , a submit button  7020 , a reset button  7030 , and a cancel button  7040 . The patient then enters his or her message into the message data entry box  7010  by using the keyboard or some other data entry device. Once finished, the patient selects the submit button  7020  to send the message. If the patient is unsatisfied with the inputted message and wishes to discard all of its contents, the patient simply selects the reset button  7030  or backspaces over the undesired portions of the message. However, if the patient wishes to disregard sending a message all together, the patient can select the cancel button  7040 . This returns the patient to the patient message list screen  6800  of  FIG. 68 . 
         [0160]    When a diabetic patient selects the education icon  836  of the main patient data screen  700  shown in  FIG. 10  or included in any other screen having a blue color-coded frame  800 , the screen displayed in the central display area  710  changes to a diabetes education screen  2200 , as shown in  FIG. 29 . The diabetes education screen  2200  includes a number of icons  2210 - 2250  that cause screens providing more detailed information on a particular subject to be displayed. The patient may then select one of the icons  2210 - 2250 , for example, the icon  2210  labeled “What Is Diabetes?”. In response, as shown in  FIG. 30 , a second education screen  2300  for the selected topic will be displayed in the central display area  710 . 
         [0161]    The displayed educational topics may include, for example, hypertext links or graphical user interface widgets associated with various words or phrases  2310 , or Web sites  2320 , as shown in  FIG. 30 . Selecting such a word or phrase  2310  may result in an on-screen contextually relevant message being displayed that explains or identifies the selected word or phrase. Selecting such a Web site  2320  causes the system to access the associated Web site. Upon leaving the accessed Web site, the patient returns to the displayed educational topic. 
         [0162]    When a diabetic patient selects the contacts icon  838  of the main patient data screen  700  shown in  FIG. 10  or included in any other screen having a blue color-coded frame  800 , the screen displayed in the central data area  710  changes to a healthcare practitioner contact screen  2400 . The healthcare practitioner contact screen  2400  includes a graphic and pictorial representation of the clinic&#39;s diabetes treatment and monitoring team, as shown in  FIG. 31 . A hypertext link or graphical user interface widget  2410 - 2440  is associated with each team member. An email access icon  24122442  is also associated with each team member. If the patient selects the hypertext link or graphical user interface widget  2410 - 2440  of a team member, a short biographical sketch (not shown) of the team member is displayed in a separate window or a separate screen. This biographical sketch helps to familiarize the patient with the clinicians handling the patient&#39;s case. If the email access icon  2412 - 2462  is selected, a dialog box containing the corresponding email or message address of the selected team member where that team member can be reached is displayed. if the patient selects the Support Group Message icon (not shown), a dialogue box (not shown) containing the support group&#39;s e-mail or message address where the patient may chat with others having the same chronic illness. By selecting the Technical Support Email icon  2462 , the screen may show a dialogue box (not shown) containing the technical support group&#39;s e-mail or message address to assist the patient with technical problems associated with communicating with the system and using it properly. 
         [0163]    It should be appreciated that the screens shown in  FIGS. 29-31  are the diabetes education screens  2200  and  2300  and the contact screen  2400  as displayed to a healthcare practitioner. The various icons used when displaying these screens to the healthcare practitioner are described in greater detail below with respect to  FIG. 50 . That is, the diabetes education screen  2200  and  2300  and the contact screen  2400  display the same information in the central data area  710  to both patients and to healthcare practitioners. The only significant difference when displaying these screens is that the particular tool bar icons displayed in the frame  800  depends on whether these screen are being displayed to a health care practitioners, as shown in  FIGS. 29-31 , or to a patient. In that later case, the frame  800  shown in  FIGS. 10-28  would be displayed. 
         [0164]    When an authorized kidney disease patient signs on to the clinic system  200  using the clipboard of  FIG. 7 , the screen changes to show the kidney main patient data screen  3200 , shown in  FIG. 32 , that is appropriate for a patient to manage the patient&#39;s kidney disease. The kidney main patient data screen  3200  includes a frame  3202  with upper and left-side borders, and a central display area  3210 , as shown in  FIG. 32 . The background  810  of the upper and left-side borders of the frame  3202  of the main patient data screen  3200  may be colored green to signify a kidney disease patient. The background  810  of the upper border of the frame  3202  includes the underlined patient&#39;s name  3220 , the date of birth  3222 , an icon  3224  linked to another screen of the graphical user interface and a selectable icon or hypertext link  3226  linked to, for example, a Web site for the associated with the clinic. Selecting the underlined patient&#39;s name  3220  changes the screen to the “Patient Information Update” screen, as discussed above and shown in  FIG. 12 . The left border of the frame  3202  may include, for example, icons for “messages”  3232 , “clinical data”  3234 . “education”  3236 , and “contact”  3238  that change the information displayed in the central display area  3210  and a “logout”  3239  icon that accesses the screen for the clinic lobby  400 . Among the icons in the left border of the frame  3202 , only the “education”  3236  icon has changed its appearance from that of the frame  800  shown in  FIG. 10 , showing, instead, a pair of kidneys. By selecting the “education”  3236  icon for the kidney patient, an on-screen contextually relevant message may read “dialysis education site”. 
         [0165]    The initial screen presented to the kidney disease patient upon entering the kidney disease clinic is the main patient data screen  3200  with “ALERTS:”  3250 , “MESSAGES:” (not shown) and “REMINDERS:” (not shown) displayed in the central display area  3210  of  FIG. 32 . In  FIG. 32 , the underlined “What&#39;s New?”  3242  and the drop down list box  3244  labeled “Kidney Disease News Archive” are connected to information stored in the relational database  232  of the clinic system  200  concerning kidney disease. For example, selecting “What&#39;s New?”  3242  displays the latest news concerning kidney disease and peritoneal dialysis, as shown in  FIG. 33 . If the amount of information in the news of  FIG. 33  exceeds the size of the central display area  3210 , a vertical and/or horizontal scroll bar located at the right border of the screen (not shown) allows the patient to view the entire news 
         [0166]    In  FIG. 32 , the information concerning “ALERTS:”  3250  derives from the clinic system&#39;s  200  analysis of quantitative clinical data submitted by the patient using a medical device  122  for at-home peritoneal dialysis, blood pressure and weight measures submitted by the patient, and laboratory test results entered into the clinic system  200  by the patient&#39;s healthcare practitioner. The information presented to the patient concerning “ALERTS:”  3250 , “MESSAGES:” and “REMINDERS:” is automatically analyzed in real-time by the clinic system  200  from data stored in the relational database  232  when the patient initially accesses the main patient data screen shown in  FIG. 32 . The “ALERTS:”  3250  summarize those events and activities, which may be detrimental to the patient and may include, for example, the date of the last PD, that is, peritoneal dialysis data received, weight gain or loss, changes in blood pressure, and clinical laboratory results including creatinine, potassium, albumin, glucose and phosphate levels, and Kt/V, that is, a measure of the quantity of dialysis delivered. In  FIG. 32 , for example, the system has determined that the patient has not submitted PD data, that is, peritoneal dialysis data, for 26 days. The “ALERTS:”  3250  may also emphasize the number of days a peritoneal dialysis datum has not been received by using a red color for the number, corresponding to the color of “ALERTS:”  3250 . Additionally, by selecting underlined laboratory tests or medical terms in “ALERTS:”  3250 , an on-screen contextually relevant message (not shown) may be displayed to further explain the laboratory test or medical term. 
         [0167]    The information concerning “MESSAGES:” for a kidney disease patient in the main patient data screen  3200  may include, for example, that Kt/V or other laboratory test values are in a clinically acceptable range, thus, indicating good management of the kidney disease by the patient. Good and poor management of the patient&#39;s kidney disease may be indicated to the patient by various messages, including animated smiling or frowning faces (not shown) and accompanying sounds. 
         [0168]    The information concerning “REMINDERS:” for a kidney disease patient in the main patient data screen of  3200  may include reminders entered into the clinic system  200  and stored in the relational database  232  by the patient&#39;s healthcare practitioners about upcoming medical visits, medical exams and laboratory tests, and health care tips. 
         [0169]    Selecting the “clinical data” icon  3234  of  FIG. 32  or any other patient screen having a green ft − ante, changes the information displayed to that of  FIG. 34 , showing a peritoneal dialysis prescription  3404  and the clinical data submitted by the patient to the system, that is, the “Automated Cycler Flow Sheet”  3410 . The “Lab Results” icon  3430  and the “Medication” icon  3434  located above the current peritoneal dialysis prescription table  3404  changes the type of information displayed in the central display area  3405  of  FIG. 34 . The “Automated Cycler Flow Sheet”  3432  icon of all patient screens having the green frame displays the “Automated Cycler Flow Sheet”  3410  of  FIG. 34 . In  FIG. 34 , the current peritoneal dialysis prescription shows the date and time of the prescription above a peritoneal dialysis prescription table  3404  including prescription information relating to, for example, therapy time, dwell time, number of cycles, total volume, fill volume, and Last fill volume. The clinical data of the “Automated Cycler Flow Sheet”  3410  are the date and time of the peritoneal dialysis, the percentage concentrations of the dextrose solutions used, the volume of initial drain, the volume of total UF, that is ultrafiltrate, blood pressure, and body weight, as shown in  FIG. 34 . 
         [0170]    Selecting any of the icons  3420  located above the Total UF, BP or WT columns of the “Automated Cycler Flow Sheet” of  FIG. 34  changes the presentation of the clinical data of the column to a linear graph of that column&#39;s variable versus the Automated Cycler Flow Sheet&#39;s time period. For example,  FIG. 35  shows, respectively, the changes in Total Ultrafiltrate, Blood Pressure and Weight over the time period of the Automated Cycler Flow Sheet as linearly plotted graphs. 
         [0171]    Selecting the “Lab Results” icon  3430  of  FIG. 34  or any other patient screen having a green frame  3202  changes the type of clinical data displayed to that of laboratory test results, as shown in  FIG. 36 .  FIG. 36  may present twelve dates on which laboratory test results may be displayed in a table  3610 , with rows corresponding to a particular type of laboratory test and columns corresponding to a test date_ The clinic system  200  may display more than twelve test dates with additional table displays. The laboratory test results displayed may include, but are not limited to, for example, Kt/V, albumin, calcium, creatirune, ferritin, glucose, HGB×3 (Hemoglobin times 3), iron, phosphate, potassium, PT1 − 1 (parathyroid hormone), TIBC (total iron binding capacity), TSH (thyroid stimulation hormone), T3, T4, T7 (thyroid studies), cholesterol, HDL (high density lipids), LDL (low density lipids), triglycerides, HBSAG, HBSAB (hepatitis B surface antigens), 1-{EPCAP (hepatitis C surface antigen) and Hb I AC (hemoglobin A I C) 
         [0172]    When any of the laboratory tests of  FIG. 34  is selected, an on-screen contextual message (not shown) may appear to explain what the laboratory test measures, its clinical significance to managing the illness and the acceptable range of clinical test values. When laboratory test results indicate that the patient is managing his or her illness well, the clinic system  200  may present a congratulatory message above the table  3610  (not shown). Laboratory test results may be color coded to represent values above, below and within acceptable clinical ranges. For example. red values may represent high results, blue values may represent low results and green values may indicate those within a clinically acceptable range. Alternatively, pluses and minuses may indicate high and low values, respectively. 
         [0173]    Selecting the “Medication” icon  3434  of  FIG. 34  or of any other patient screen having a green frame  3202  changes the type of clinical data displayed to that of a “Medications” table  3710  and an “Other Medications” table  3720 , as shown in  FIG. 37 . The medications prescribed by the clinic healthcare practitioners are entered into a “Medications” table  3710  for review by the healthcare practitioner and patient. The “Medications” table  3710  may include, for example, the medication name, its dosage, its units, its frequency taken, its route of administration, the prescription start and stop dates, and instructions to the patient. 
         [0174]    The “Other Medications” table  3720  of  FIG. 37  includes information about non-prescription medications and other prescription medications, prescribed by non-clinic healthcare practitioners for the patient Thus, the “Other Medications” table  3720  of  FIG. 37  provides the patient with a mechanism to enter outside medications the patient may be taking that the healthcare practitioner may not know about. This information is entered into the “Other Medications” table  3720  by the patient when he or she selects the “Add other medication”  3735  icon in the upper right corner of  FIG. 37 . The other medications arc added to the table by the data entry tables discussed above in relation to the diabetic patient, as shown in  FIG. 23 . 
         [0175]    When a kidney disease patient selects the “education” icon  3236  of  FIG. 32  or any other patient screen having a green frame, the upper border of the frame  3202  displays Pager and Clinic telephone numbers, while the central display area  3210  displays the main education page for kidney patients, as shown in  FIG. 38 . In the main education page of  FIG. 38 , the patient may select among the three underlined educational topics for display: “Kidney Disease and YOU”; “PD-Doing It Right!, Plus: Problems and What YOU should know”; and “Daily Life, Food, Fluids, Meds and FUN”. The main education page of  FIG. 38  may also display a “PD News”  3802  icon that when selected displays the latest news about kidney disease and/or peritoneal dialysis. A drop down list box  3804 , labeled “Kidney Disease News Archive”, may allow patients to access archival articles stored in the relational database  232  of the clinic system  200  for display. Additionally, the central display area may display a “Recipes” icon  3806  that when selected displays a current recipe. A drop down list box  3808 , labeled “Recipes”, may allow patients to access other recipes for display in the central display area, as shown in  FIG. 39 . 
         [0176]    Selecting the underlined topic of “Kidney Disease and YOU” in  FIG. 38  changes the screen to that shown in  FIG. 40 . Selecting an underlined word or phrase in the educational article of  FIG. 40  may provide an on-screen contextually relevant message (not shown) that defines the word or phrase. By selecting the underlined, quoted article, “ How the Kidney Works ” of  FIG. 40 , the system accesses a link to a Web site, for example, nephron.com, that explains the workings of the kidney to the patient. Selecting the underlined phrase “Return to Main Education Page” allows the patient to return to the display of  FIG. 38 . 
         [0177]    Selecting the underlined topic of “PD Doing It!, Plus: Problems and What YOU should know” in  FIG. 38  changes the information displayed in the central display area to that shown in  FIGS. 41A and 41B . Selecting an underlined word or phrase in the educational article shown in FIGS.  41 A and  4 IB may provide an on-screen contextually relevant message (not shown) that defines the word or phrase. When other underlined sentences, such as, “Washing AND drying your hands—read about why it&#39;s so important here”, of  FIG. 41A  arc selected, an abstract of the article, “Washing AND drying your hands—read about why it&#39;s so important here”, may be displayed, as shown in  FIG. 42 . 
         [0178]    The section “PD INFORMATION” of  FIG. 41A , entitled “How to do a SAFE EXCHANGE”, may contain a drop down list box  4105 , labeled “Your Unopened Dialysate Bag is”, that provides a checklist  4310  for a patient to follow when checking his or her unopened dialysate bag to assure proper dialysis technique, as shown in  FIG. 43 . Similarly, selecting the drop down list box  4110 , labeled “Your area is”, provides a checklist  4410  for the area the patient selects for his or her peritoneal dialysis, as shown in  FIG. 44 . 
         [0179]    The section of “PD INFORMATION” of  FIG. 41A , entitled “3 Steps to a SAFE Exchange”, shows three underlined terms, that is, “DRAIN”  4120 , &#39;PILL″  4122  and “DWELL”  4124  in a horizontal row. Selecting an underlined term changes the screen to show the information concerning the selected underlined term, as shown for “DRAIN”  4120 , “MU”  4122  and “DWELL”  4124 , in  FIGS. 45A-45C , respectively. After reading any of the “3 Steps to a SAFE Exchange” in  FIGS. 45A-45C , the patient may return to section entitled “3 Steps to a SAFE Exchange” of  FIG. 41A  by selecting the phrase, “Click here to dose window”. 
         [0180]    The section of “PD INFORMATION” of  FIG. 41B , entitled “Problem List”, shows five underlined phrases, that is, “Cloudy Bag”  4150 , “Unclear but not Cloudy Bag”  4152 , “Leaking Equipment”  4154 , “Cramps”  4156  and “Exit Site Infection”  4158  in a horizontal row. Selecting an underlined phrase changes the screen to show the information concerning the underlined phrase, as shown for “Cloudy Bag”  4150 , “Unclear but not Cloudy Bag”  4152 , “Leaking Equipment”  4154 , “Cramps”  4156 , and “Exit Site Infection”  4158 , in  FIGS. 46A-46E , respectively. After reading about any of the problems of peritoneal dialysis, the patient may return to the section entitled “Problem List” of  FIG. 4113  by selecting the phrase, “Click here to close window”. 
         [0181]    Selecting the underlined topic of “Daily Life, Food, Fluids, Meds and FUN” of  FIG. 38  changes the information displayed in the central display area to that shown in  FIGS. 47A-471 . The underlined topics presented under the “Daily Routines” of  FIG. 47A  may include but are not limited to “Fluids”, “What you eat”. “Your weight”, “Blood Pressure”, “Medications”, “Eating Out”, “Exercise”, “Travel”, “Socializing”, and “Learn More”. In  FIG. 47A , selecting any of the underlined topics listed presents an on-screen contextually relevant message between the two columns of under lined topics. For example,  FIG. 48  shows the contextually relevant message of “Here are some Tips”  4810  when the underlined topic of “Eating Out” is selected. Additionally, on-screen contextually relevant messages may be displayed for underlined words and phrases within the displayed texts of the underlined topics, shown in  FIGS. 47A-47L  Links to other web sites, concerning kidney disease, may also be located within the texts of the underlined topics, shown in  FIGS. 47A-471 . At the bottom of the text of each underlined topic, shown in  FIGS. 47A-471  is an underlined phrase “Return to Top” that when selected returns the patient to the top of “Daily Life, Food, Fluids, Meds and FUN” shown in  FIG. 47A . 
         [0182]    When a kidney disease patient selects the “contacts” icon  3238  of  FIG. 32  or any other patient screen having a green frame  3202 , the screen changes to that of a graphic and pictorial representation of the clinic&#39;s kidney disease treatment and monitoring team, as shown in  FIG. 49 . If the patient selects a team member&#39;s picture icon  4920 - 4940 , a short biographical sketch (not shown) of the team member may appear on the screen. This biographical sketch helps to familiarize the patient with the clinicians handling the patient&#39;s case. If the email access icon  4922 - 4942  is selected, a dialog box containing the corresponding email or message address of the selected team member where that team member can be reached is displayed. If the patient selects the “Support Group”  4910  icon, the screen may show a dialogue box (not shown) containing the support group&#39;s e-mail or message address where the patient may chat with others having the same chronic illness. 
         [0183]    When an authorized healthcare practitioner of the clinic signs into the clinic by entering his or her name and a password on the clipboard shown in  FIG. 7 , the screen automatically changes to display information concerning the practitioner&#39;s patient selection in the central display area  5010  of the main practitioner data screen&#39;s  5000 , as shown in  FIG. 50 . Information concerning the practitioner&#39;s patient selection may also be displayed by selecting the animated “alerts and reminders”  5032  icon. The background  810  of the left side border of the frame  5002  may be, for example, blue, indicating that the practitioner&#39;s patient selection is for those patients enrolled in the diabetes clinic, green, indicating that the practitioner&#39;s patient selection is for those patients enrolled in the kidney disease clinic, or another color for some other chronic illness or related clinic. In  FIG. 50 , for the practitioner&#39;s patients within the diabetes clinic, the main practitioner data screen  5000  can include a message list icon  5031 , while the left side border of the frame  5002  may include, for example, icons for “alerts and reminders”  5032 , “register patients or practitioners”  5033 , “enter patient&#39;s lab results”  5034 , “patient reminders”  5035 , “On-line chatroom”  5036 , “education”  5037 , “contacts”  5038 , and “logout”  5039 , that change the information displayed in the central display area of the main practitioner data screen. When selected, each of the icons  5031 - 5039  may be identified by an on-screen contextually relevant message when the on-screen indicator is placed over that icon. Additionally, a cumulative count of new messages for the healthcare practitioner from all of the patients of that healthcare practitioner can be presented on this screen, for example, located on the message list. A link to the messaging screen  7100  is provided by the message list icon  5031  attached to the count. 
         [0184]    The central display area  5010  of the main practitioner data screen  5000  is used by a healthcare practitioner to select a patient whose data the healthcare practitioner would like to review. As shown in  FIG. 50 , there are three lists of patients the healthcare practitioner can select a patient from. A first, an all patients list box  5024  lists all patients. A second, or alerts list box  5020 , lists only those patients to whom alerts have been sent. A third, or new data list box  5022 , lists only those patients that have submitted new data, such as, for example, blood glucose data, peritoneal dialysis data or clinical data from other chronic illness monitor device. 
         [0185]    Selecting a patient&#39;s records for review by the healthcare practitioner may be prioritized by allowing the healthcare practitioner to choose patient records listed in, for example, the alerts list box  5020 , that contains a list of those patients to whom alerts have been sent. For example, in various exemplary embodiments, such as that shown in  FIG. 50 , patients are prioritized based on those requiring attention and among all patients. Those patients requiring higher priority attention include those with active alerts and those with new data. The patients with active alerts and/or new data appear in the alerts list box  5020  or new data box  5022  and the label for the alerts list box  5020  is presented in red. New data, for example, includes blood glucose data (for a diabetic patient) sent in that has not been reviewed by a healthcare practitioner and lab data that has not been reviewed. Selecting a patient from the list contain in the alerts list box  5020  or new data box  5022  brings up the messages screen  5100 , shown in  FIG. 51 , for that patient, displaying the alerts contained in the alerts list box  5020 , any messages, and reminders sent to that patient. This also removes that patient from the list contained in the alerts list box  5020  and the new data box  5022 . 
         [0186]    In various exemplary embodiments, the reasons for alerts may include, for example, one or more of the average blood glucose level being greater than site/patient configurable value, the number of days since receiving new data being greater than site/patient configurable value, the HbAIC value being greater than site/patient configurable value, more than 3 hypoglycemic events having occurred within site/patient configurable time frame, and/or more than 6 hyperglycemic events having occurred within site/patient configurable time frame. 
         [0187]    Additionally, patients are prioritized based on new data and appear in the new data list box  5022  with the label for the box presented in green. Selecting a patient from this list brings up the messages screen  5100 , shown in  FIG. 51A , for that patient. The messages screen  5100  displays that patient&#39;s alerts, messages, and reminders and removes that patient from the alert list box  5020  and the new data list box  5022 . All patients assigned to the healthcare practitioner appear in the all patients list box  5024  and the label for all patients list the box is  5024  presented in blue. Selecting a patient from this list brings up the patient&#39;s log book as the initial screen, but does not remove that patient from the list contained in the alerts list box  5020  or the new data list box  5022  if that patient is contained in that list. 
         [0188]    After selecting a patient&#39;s name from the list of patients contained in the alerts list box  5020  or the new data list box  5022 , information concerning “ALERTS:”  5150 , “MESSAGES:”  5160  and “REMINDERS:”  5170  for the selected patient is displayed. as shown in  FIG. 51A  for a diabetic patient, and for “ALERTS:”  5190 , as shown in Fig. SIB for a kidney disease patient. Alternatively, the healthcare practitioner may select patient records from, for example, the all patients list box  5024 , as shown in Fig SO. 
         [0189]    In  FIG. 51A , the upper border of the frame  5102  for diabetic patients may include a patient&#39;s picture  5101 , the patient&#39;s underlined name  5105 , date of birth  5107 , and icons accessing the diabetic patient&#39;s “Lab Results”  5130  (see  FIG. 21 ), “Blood Sugar Log”  5132  (see  FIG. 15 ), “Medication”  5134  (see  FIG. 22 ), “Blood Pressure Log”  5138  (see  FIG. 25 ), “Exercise Log”  5136  (see  FIG. 24 ), “Data Summary and Healthcare practitioner Comments”  5139  (see  FIG. 26 ) and “Message List”  5140  (see  FIG. 68 ) as described above for information displayed for diabetic patients. In  FIG. 51B , the icons access the kidney patient&#39;s “Lab Results”  5158  (see  FIG. 36 ), “Automated Cycler Flow Sheet”  5152  (see  FIG. 34 ), and “Medications”  5154  (see  FIG. 37 ) and the message list  5156 . Selecting the patient&#39;s picture  5101  automatically presents a screen that allows the healthcare practitioner to send a message to the patient. When the on-screen indicator is placed over the primary care healthcare practitioner&#39;s icon  5170 , the patient&#39;s primary care healthcare practitioner is identified by name. Selecting the primary care healthcare practitioner&#39;s icon  5170  may connect the clinic healthcare practitioner to the patient&#39;s primary care healthcare practitioner by automatically providing a screen which allows the clinic healthcare practitioner to send a message to the patient&#39;s primary care healthcare practitioner. 
         [0190]    Selecting the “Medication” icon  5134  for the diabetic patient of FIG.  5 IA automatically changes the information displayed to an insulin prescription table  5210 , a number of icons located above the insulin prescription table  5210  and the date the medication is being prescribed, as shown in  FIG. 52 . These icons include an insulin medication icon  5235 , an oral medication icon  5237  and an other medications icon  5239 . The date insulin is prescribed and the insulin prescription table  5210  is also displayed by selecting the insulin medication icon  5235 , which is identified by an on-screen message when the on-screen indicator is placed over the insulin medication icon  5235 . The patient&#39;s clinic healthcare practitioner may review previous insulin prescriptions by selecting the left-facing arrow  5215 , which is identified by the on-screen message of “previous prescription” when the on-screen indicator is placed over the arrow  5215 . After reviewing a previous insulin prescription, the healthcare practitioner may advance the prescription date and the insulin prescription table  5210  by selecting a right-facing arrow (not shown), which is identified by the on-screen message of “next prescription” when the on-screen indicator is placed over the right-facing arrow. 
         [0191]    The healthcare practitioner enters a new insulin prescription for the diabetic patient into the insulin prescription table  5210  of  FIG. 52  by entering data into, for example, data input entry boxes  5250 , from the healthcare practitioner&#39;s data terminal  130 . After entering data for a new prescription into the insulin prescription table  5210 , the healthcare practitioner may select the “Update” button  5255  to create the new prescription table, which is automatically dated and timed at the time of the updated entry. 
         [0192]    For diabetic patients having an insulin pump, the information displayed upon selection of the insulin medication icon  5235  automatically shows a basal infusion data table  5310 , a meal/bolus table  5320 , and information relating to supplemental insulin and extra food convergence, as shown in  FIG. 53  The healthcare practitioner enters the new insulin pump prescription data into the basal infusion data table  5310  and meal/bolus table  5320  by, for example, drop down list boxes  5315  or data entry input boxes  5325 , and the data relating to supplemental insulin and extra food convergence into their, for example, data entry boxes  5335 . To create a new insulin pump prescription, the healthcare practitioner may select the “Update”  5355  button at the bottom of the display of  FIG. 53 . 
         [0193]    Selecting the oral medications  5237  icon, for diabetic patients, located above the insulin prescription table  5210  of  FIG. 52 , automatically changes the information displayed to a prescription date for oral medications and an oral medication prescription table  5410 , as shown in  FIG. 54 . The healthcare practitioner may review previously prescribed oral medications by selecting the left-facing arrow  5415  and after review may return to the current oral medication prescription table  5410  by selecting the right-facing arrow (not shown), as described above. Entry of the new oral prescription information may be facilitated by prescribing drugs that are categorized by their function, for example, drugs which enhance insulin secretion, a drug which decreases glucose production by the liver, drugs which slow the absorption of sugars, and glitazones. Entry of data into the oral prescription table  5410  may also be facilitated by allowing the healthcare practitioner to rapidly select a particular drug within a functional category of drugs and to enter prescription information, for example, dosage, tablets per dose and frequency taken into an appropriate, for example, drop down list box  545 , as shown in  FIG. 55  For example, a 500 mg dose of the drug, Glucophage, may be entered into the drop down list box  5450 , as shown in  FIG. 54 . 
         [0194]    Selecting the Medications icon  5154  for kidney disease patients, of  FIG. 5113 , automatically changes the information displayed to a “Medications” table  3710  and “Other Medications” table  3720 , as described above and shown in  FIG. 37 . The healthcare practitioner may enter new prescriptions for medications by entering the appropriate data into the “Medications” table  3710  by, for example, a number of data entry input boxes (not shown), corresponding to the “Medications” table&#39;s  3710  data. The healthcare practitioner may, similarly, view the appropriate data entered by the patient into the “Other Medications” table  3720 . 
         [0195]    Selecting the “Other medications” icon  5239  of  FIG. 52  automatically changes the information displayed to the “Other medications” table  5450 , which corresponds to the diabetic patient&#39;s “Other medications” table  1730  or  1732 , shown in  FIG. 22 , for a practitioner selected diabetic patient and to the kidney disease patient&#39;s “Other medications” table  3720 , shown in  FIG. 37 , for a practitioner selected kidney disease patient. These other medications may be non-prescription medications or they may be medications that have been prescribed by other healthcare practitioners for medical conditions not related to the patient&#39;s chronic illnesses. The clinic healthcare practitioner may wish to review these medications for possible adverse drug interactions with those drugs the healthcare practitioner has prescribed, for possible side effects, or for other medical reasons. 
         [0196]    Selecting the animated “Exercise Log” icon  5136  of  FIG. 51A  for the diabetic patient automatically changes the information displayed to a patient exercise log, as described above and shown in  FIG. 24 . The healthcare practitioner may view comments that the patient may have entered into the exercise log using, for example, a data entry input box, that is displayed above the patient&#39;s Exercise Log  1910  or  1928  of  FIG. 24 . 
         [0197]    Selecting the “Blood Pressure” icon  5138  of  FIG. 51A  for the diabetic patient, automatically changes the information displayed to a patient&#39;s Blood Pressure Log  2010 , as described above and shown in  FIG. 25 . The healthcare practitioner may view comments that the patient may have entered into the blood pressure log using, for example, a data entry input box, that is displayed above the patient&#39;s Blood Pressure Log  2010  of  FIG. 25 . 
         [0198]    Selecting the “Data Summary and Healthcare practitioner Comments” icon  5139  shown in  FIG. 51A  for any data screen of the diabetic clinic portion of the clinic system  200  automatically changes the information displayed to a table  5610 , as shown in  FIG. 56 , corresponding to the patient&#39;s tabular summary  2610  of the blood glucose values for a range of dates, as described above and shown in  FIG. 26 . The clinic healthcare practitioner may enter comments into the “Healthcare practitioner Comments” column of the table  5610  by, for example, a data input entry box  5650 , via the keyboard of the healthcare practitioner data terminal  130 , as shown in  FIG. 56 . In various exemplary embodiments, if a healthcare practitioner writes a comment to the patient in the table  5610 , then the record appears with a yellow background in the healthcare practitioner&#39;s view until the patient views the comment. Such communication between the healthcare practitioner and patient enhances the patient&#39;s compliance in the monitoring program and reflects the type of communication between healthcare practitioner and patient that would occur during an actual clinic visit. 
         [0199]    The healthcare practitioner may also review the data presented in the table  5610  of  FIG. 56  that corresponds to the data of the patient&#39;s blood sugar log  1510  of  FIG. 15 , by selecting the data presentation icons  5620 - 5626  above the table  5610 . 
         [0200]    The “Line Chart” icon  5620  allows the blood sugar log data to be presented as a linear graph; the “Histograms” icon  5622  as histograms; the “Pie Chart” icon  5624  as a pie chart; and the “Multiple pie charts” icon  5626  as multiple pie charts, as described above and shown in  FIGS. 17-20   
         [0201]    Selecting the healthcare practitioner “Message List” icon  5140  of  FIG. 51A  changes the display to the healthcare practitioner message list screen  7100  as shown in  FIG. 71 . The healthcare practitioner is presented with a list of messages sent by the healthcare practitioner&#39;s patients or by the healthcare practitioner, as shown in  FIG. 71 . Information, such as the date a message was sent, to whom the message was sent, who sent the message, and the subject/title of the message may be presented. However, if the healthcare practitioner has selected a particular patient to review that patient&#39;s records using one of the list boxes  5020 - 5024 , only those messages concerning that particular patient are presented in a patient-specific healthcare message list screen  7100 , as shown in  FIG. 73 . Additionally, in various exemplary embodiments, to distinguish unread from read messages, the unread messages in the list can be preceded by an asterisk, which can be color coded to increase its visibility. 
         [0202]    When the healthcare practitioner selects one of the underlined subject/titles, the clinical management system retrieves the selected message for the healthcare practitioner, as shown in  FIG. 72 . A message screen  7210  appears with information such as the date the message was sent, to whom the message is addressed, who sent the message, the subject/title of the message and the message itself. If the entire message does not fit within the message screen  7210 , horizontal and/or vertical scroll bars are presented for the healthcare practitioner to scroll through the message (not shown). At the end of the message there is a “Reply” button  7220  and a “Close” button  7230 . When selected, the “Reply” button  7220  allows the healthcare practitioner to send a response message to whomever sent the message. The “Close” button  7230  allows the healthcare practitioner to exit the message list screen  7210  and return the healthcare practitioner to the healthcare practitioner message list screen  7100  of  FIG. 73 . 
         [0203]    The healthcare practitioner may also create and add a new message using the healthcare practitioner message list screen  7100 . The healthcare practitioner can use this screen to create a message directed to any patient that is assigned to that healthcare practitioner. The healthcare practitioner selects a “Select a Patient” drop down list box  7110 . The “Select a Patient” drop down list box  7110  provides a lists of the patients in the clinical management system for chronic diseases  100  assigned to that healthcare practitioner. The healthcare practitioner then selects the patient that the healthcare practitioner wishes to address the message to using the list box  7110 . However, if the healthcare practitioner has already selected a particular patient using one of the list boxes  5020 - 5024 , the message is automatically addressed to that patient and the patient-specific healthcare practitioner message list screen  7100  is displayed, as shown in  FIG. 73 . The healthcare practitioner does not need to provide this information. Accordingly, the “Select a Patient” drop down list box  7110  does not need to be shown in the patient-specific healthcare practitioner message list screen  7100  shown in  FIGS. 73 and 74 . The healthcare practitioner may also provide a subject/title for the message, but this is not required. The healthcare practitioner does this by simply typing in the subject/title in the “Subject” data entry box  7120 . 
         [0204]    If the healthcare practitioner decides to discard the message, has made an error, or wants to change to whom the message is addressed to and/or the subject/title of the message, the healthcare practitioner can select the “Reset” button  7130 . When selected, the “Reset” button  7130  clears to whom the message is addressed to as selected from the “Select a Patient” drop down list box  7110  and clears the “Subject” data entry box  7120 . The function of the “Reset” button  7130  can also be accomplished by selecting a different individual from the “Select a Patient” drop down list box  7110  for whom the message is addressed and by backspacing over the incorrect data entry and then typing the correct data in the “Subject” data entry box  7120 . 
         [0205]    After the healthcare practitioner has selected the patient to address the message and typed a subject/title for the message (optional), the healthcare practitioner selects the “Add Message” button  7140 . When the healthcare practitioner selects the “Add Message” button  7140 , the display changes to the “Add a Message” screen, which is similar to that shown in  FIG. 70 . The healthcare practitioner&#39;s “Add a Message” screen displays the healthcare practitioner&#39;s name as who the message is from, the name of the patient to whom the message is addressed and the subject/title, if provided by the healthcare practitioner. Additionally, there is a message data entry box  7010 , a “Submit” button  7020 , a “Reset” button  7030 , and a “Cancel” button  7040 . The healthcare practitioner then enters his or her message into the message data entry box  7010  by using the keyboard or some other data entry device. Once finished, the healthcare practitioner selects the “Submit” button  7020  to send the message. If the healthcare practitioner is unsatisfied with the inputted message and wishes to discard all of its contents, the healthcare practitioner simply selects the “Reset” button  7030  or backspaces over the undesired portions of the message. However, if the healthcare practitioner wishes to disregard sending a message all together, the healthcare practitioner can select the “Cancel” button  7040 . This returns the healthcare practitioner to the healthcare practitioner message list screen  7100  shown in  FIGS. 71-74 . 
         [0206]    Selecting the “register patients or practitioners” icon  5033  of  FIG. 50  of the main practitioner data screen automatically changes the display to that shown in  FIG. 57 . When the healthcare practitioner selects the underlined “Practitioners”  5710  of  FIG. 57 , the display automatically changes to a “Practitioner Registration” form, as shown in  FIG. 58 . The “Practitioner Registration” form  5800  may include data entry input boxes  5810  for the entry of, for example, enrollment date, last name, first name, address, city, state, zip code, home and cell phones, pager, and c-mail or message address. The “Practitioner Registration” form  5800  may also include drop down list boxes  5820  for the entry of, for example, the healthcare practitioner&#39;s specialty and the occupation of the healthcare practitioner, for example, healthcare practitioner, nurse, etc. The specialty and the occupation of the healthcare practitioner dictate which patients they will interact with through the system and their permissions, for example, viewing types of patient data, and privileges, for example, entering new prescriptions for medications, on the system. 
         [0207]    When the healthcare practitioner selects the underlined “Patients” icon  5720  shown in  FIG. 57 , the display automatically changes to a “Patient Registration Form”, as shown in  FIG. 59 . The “Patient Registration Form”  5900  may include data entry input boxes  5910  for the entry of, for example, last name, first name, medical record number, address, city, state, zip code, home phone number, work phone number, cell phone number, e-mail or message address, emergency contact, relationship, address. phone number, date of birth, race, gender, educational level, and employment. The “Patient Registration Form”  5900  may also include drop down list boxes  5920  for the entry of, for example, marital status, primary care healthcare practitioner, specialist, nurse, primary disease, comorbidities, and allergies_Selecting the underlined phrases of “Add Physician”, “Add Specialist”, and “Add Nurse” may allow these healthcare practitioners to be added to their respective drop down list boxes  5920  for entry into the “Patient Registration Form”  5900 . A dialogue box  5930  may also be available to add comments. Selection of a specialist dictates which healthcare practitioner and associated healthcare practitioners are responsible for the patient&#39;s care. 
         [0208]    Selecting the “enter patient&#39;s lab results” icon  5034  of  FIG. 50  of the main practitioner data screen  5000  automatically changes the display to that shown in  FIG. 60  for diabetic patients, and to that shown in  FIG. 61  for kidney disease patients. The “Lab Values Entry for Diabetes Patients” screen  6000  shown in  FIG. 60  may include, for example, drop down list boxes  6010 , usable to enter the date for which the lab values are being entered, and usable to select the patient whose lab values are being entered. Additionally, the “Lab Values Entry for Diabetes Patients” display  6000  may include, for example, data entry input boxes  6020 , for the entry of tab values, such as, HbAIC, cholesterol, HDL, LDL, triglyceride and urine microalbumin, as described above in relation to the patient&#39;s “Lab Results” table  2110  shown in  FIG. 21 . 
         [0209]    In the “Lab Values Entry for Dialysis Patients” screen  6100  shown in  FIG. 61 , the healthcare practitioner may also enter the date for which the lab values are being entered using, for example, drop down list boxes  6110 , and may select the patient whose lab values are being entered using, for example, a drop down list box  6120 . Additionally, a first option button  6130  indicates that no hospitalization is required for the test and a second option button  6134  indicates that hospitalization is required for the test. After selecting the “Go” button  6138 , the screen changes to display the continued “Lab Values Entry for Dialysis Patients” screen  6200 . 
         [0210]    As shown in  FIG. 62 , the “Lab Values Entry for Dialysis Patients” screen  6200  shows, for example, multiple data entry input boxes  6210 , by which laboratory test results may be entered by the healthcare practitioner. The entered laboratory test results may include but are not limited to, for example, Kt/V, albumin, calcium, creatinine, ferritin, glucose, HGB×3, iron, phosphate, potassium, PTH, TIBC, TSH, T3 uptake. T4 total, T7/Ffl, cholesterol—FIDL, LDL, triglycerides, HBSAG, HBSAB, HEPCAB, and HgbA1C. The entered laboratory results are then displayed to the kidney disease patient in the “Lab Results” table  3610 , discussed above and shown in  FIG. 36 . 
         [0211]    Selecting the “patient reminders” icon  5035  of  FIG. 50  of the main practitioner data screen  5000  automatically changes to that shown in  FIG. 63  for diabetic patients, and to that shown in  FIG. 64  for kidney disease patients. 
         [0212]    The “Patient Reminders” screen  6300  shown in  FIG. 63  for the diabetic patient may include the current date and data which is to be entered by the healthcare practitioner including, but not limited to, for example, the selected patient, the date of the patient&#39;s visit and when the next visit is scheduled, the date of requested lab work and when the next lab work is scheduled, the date of requested HbAlC test values and when the next HbAlC test is scheduled, the date of a foot exam and the next scheduled foot exam, the date of an eye exam and the next scheduled eye exam. Selecting the patient and entering scheduled dates for visits, tests and exams may be facilitated by, for example, drop down list boxes  6310  that provide selections for the month, date and year, as shown in  FIG. 63 . Selecting the next scheduled date for visits, tests and exams may be facilitated by, for example, option buttons  6340  or data entry input boxes  6320 , as also shown in  FIG. 63 . The entered patient reminders are displayed to the patient in the main patient data screen for diabetic patients  700 , as described above and shown in  FIG. 10 . 
         [0213]    The “Patient Reminders” screen  6400  shown in  FIG. 64  for the kidney disease patient may include the current date and, for example, a drop down list box  6410  for selecting the patient to whom the reminder is to be addressed. After selecting a patient, the main practitioner data screen changes to that shown in  FIG. 65 . The continued “Patient Reminders” screen  6500  shown in  FIG. 65  may include the current date and the selected patient&#39;s name, and a number of, for example, drop down list boxes  6510 , that facilitate entries of month, date and year for various reminders. The reminder dates that are entered for the kidney disease patient may include, but are not limited to a clinic visit, Kt/V test, lab work, chest X-ray, EKG, PPD/TB risk appraisal, a home visit, gynecology/mammogram exam, patient continuing education, medical history and physical, nursing assessment, long term care plan/conference, short term care plan/conference, and transfer set change. The entered patient reminders are displayed to the patient in the main patient data screen  3200  for kidney disease patients, as described above but not shown in  FIG. 32 . 
         [0214]    Selecting the “On-line chatroom” icon  5036  of  FIG. 50  of the main practitioner data screen  5000  automatically changes the screen to that of a message dialogue box (not shown) including the e-mail or message address of the patient support group for the particular chronic illness that the healthcare practitioner is managing. The healthcare practitioner may then interact with the patient support group, offering suggestions for daily living, explaining medical procedures, correcting misunderstandings, etc. 
         [0215]    When a visitor logs on to the system, he or she may enter the clinic lobby  400  of  FIG. 4  and proceed to open the door icon  404  of the public library, as shown in  FIG. 5 . Selecting the door icon  404  changes the screen to that of the main visitor data screen  6600 , as shown in  FIG. 66 . The main visitor data screen  6600  includes, for example, a frame  6602  along its upper and left-side borders that has a light green background  810  and a central display area  6610 . 
         [0216]    The upper border of the frame  6602  may include the name of the project and an icon  6640  that, when selected, connects the visitor to another screen (not shown) that is accessible to visitors. The left side of the border of the frame  6602  may include, for example, icons for “Description”  6630 , “Diabetes”  6631 , “Kidney Disease”  6632 , “News Items”  6633 , “Public”  6634 , and “Main Page”  6635 . The central display area  6610  may include the latest news items concerning the chronic illnesses that the clinic manages. For example, if the underlined “Diabetes News”  6620  is selected, the screen will change to display the latest diabetes news in the central display area  6610 , corresponding to that news displayed in the patient&#39;s education site, as shown in  FIG. 13 . The visitor may also select archival news by selecting the archival article from, for example, a drop down list box  6625 , labeled “Diabetes Archive”. The visitor may similarly access the latest news item and archival news items by selecting the underlined “Kidney Disease News”  6630  or the drop down list box  6635 , labeled “Kidney Disease Archive”. 
         [0217]    Selecting the “Description” icon  6630  of  FIG. 66  changes the screen to display a project description screen  6700 , as shown in  FIGS. 67A-67G . The project description may include multiple pictures  6705  which are sequentially displayed while the project description is displayed. The project description may also include links to other sites within the clinic system  200 , Internet sites or World Wide Web sites for further description of the project. 
         [0218]    Selecting the “Diabetes” icon  6631  of  FIG. 66  changes the screen to display the diabetes education site, as described above and shown in  FIG. 29   
         [0219]    Selecting the “Kidney Disease” icon  6632  of  FIG. 66  changes the screen to display the PD education information, as described above and shown in  FIG. 38 . 
         [0220]    Selecting the “News Item” icon  6633  changes the screen to display the main visitor data screen  6600  of  FIG. 66 . 
         [0221]    By selecting the “Main Page” icon  6635  of  FIG. 66 , the visitor returns to the clinic lobby  400  of  FIG. 4 . 
         [0222]    While this invention has been described in conjunction with the specific embodiments outlined above, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, the preferred embodiments of the invention, as set forth above, are intended to be illustrative, not limiting. Various changes may be made without departing from the spirit and the scope of the invention.

Technology Classification (CPC): 6