Patent Document

CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application is a U.S. national phase application filed under 35 U.S.C. § 371 of International Patent Application No. PCT/US2010/020269, entitled “INGESTION-RELATED BIOFEEDBACK AND PERSONALIZED MEDICAL THERAPY METHOD AND SYSTEM,” filed Jan. 6, 2010, which application claims the benefit of both U.S. Provisional Patent Application No. 61/142,869, filed on Jan. 6, 2009, titled “INGESTION-RELATED BIOFEEDBACK METHOD AND SYSTEM”; and U.S. Provisional Patent Application No. 61/260,325, filed on Nov. 11, 2009, titled “METHOD AND SYSTEM FOR PERSONALIZED MEDICAL THERAPY”, the entire disclosures of which are hereby incorporated by reference herein. 
    
    
     INTRODUCTION 
     The present invention relates generally to medical therapy systems, devices, and methods. More specifically, the invention relates to systems, devices, and methods for applying information related to an ingestion by a patient of a device, medication or substance. 
     Proper adjustment of medical treatment is an important factor in the success of medical therapies. Although some conclusions regarding the efficacy of treatment may be drawn from analysis of the patient&#39;s direct sensory symptoms during treatment and used as a modification indicator, many conditions exist where the patient has little direct sensory awareness. Hypertension is one such disease state. Patient adherence is another important factor in the success of medical therapies. Reliable adherence information may be used to inform efficacy and modification determinations. Lack of reliable adherence information, however, may be an issue. Adherence information may not be available. Further, adherence information may be faulty, inaccurate, or inadequate. Poorly informed medical treatment decisions, for example, those made in the absence of comprehensive, adherence information, may result in suboptimal therapy programs. Such programs may result in loss of quality of life, loss in health, and/or loss of life span. 
     Biofeedback is one technique that can be used to adjust medical treatment and to encourage patient adherence to medical therapy. Biofeedback may be defined as the technique of revealing certain selected internal physiologic indicators of physical health by presenting verbal, textual, visual and/or auditory signals to a monitored person in order to help the monitored person to manipulate these otherwise involuntary, unfelt and/or little felt vital processes (such as blood pressure, heart beat and respiration rate and intensity). Biofeedback techniques can enable a person to modify a monitored physiologic indicator to achieve, or more consistently maintain, a healthy condition. Achieving such health management goals typically requires voluntary cooperation on the part of the subject. 
     The management of certain chronic diseases or ongoing health conditions, hypertension for example, can be supported by monitoring and controlling one or more vital aspects of a patient. Examples of these disease control parameters include blood glucose of diabetes patients, respiratory flow of asthma sufferers, blood pressure of hypertensive patients, cholesterol of cardiovascular disease victims, body weight of eating disorder patients, T-cell or viral count of HIV bearers, and frequency or timing of undesirable episodes of depression of mental health patients. Because of the continuous nature of these diseases, clinicians can gain valuable information by monitoring one or more vital health processes on a regular basis outside of a clinical care facility. 
     A patient may monitor and control one or more vital health parameters in clinician assisted self-care or outpatient treatment programs. The term “health parameter” refers to any parameter associated with health, e.g., the health of a patient, athlete, or other living being. In these treatment programs, patients are responsible for performing self-care actions which impact the control parameter. Patients are also responsible for measuring the control parameter to determine the success of the self-care actions and the need for further adjustments. The successful implementation of such a treatment program requires a high degree of motivation, training, and understanding on the part of the patients to select and perform the appropriate self-care actions. When reliable, useful guidance is provided to the patient in a timely manner, the patient&#39;s confidence may increase in the health improvement program. With an increase in confidence, the patient may be more likely to adhere to the health improvement program. Adherence, in turn, increases the likelihood of success of the health improvement program. 
     Further, ingestible pharmaceutical agents, for example, prescription and non-prescription medicines and substances can be an important aspect of a therapeutic regime prescribed to a given patient. Reliable monitoring of adherence to scheduled dosages of pharmaceutical agents is desirable to optimize biofeedback effectiveness. 
     There is a long-felt need to provide behavioral guidance developed in view of various physiologic parameters and longitudinal monitoring of vital health aspects of the patient. 
     SUMMARY 
     The present disclosure seeks to address at least some of the previously discussed problems. The present disclosure includes methods and systems for acquiring information useful to support a patient in implementing and adhering to a medically prescribed therapy plan. The therapy may incorporate biofeedback methods and/or personalized therapy aspects. 
     A method includes steps of acquiring biometric information associated with an ingestible event marker; analyzing, by a computing device having a microprocessor configured to perform a biometric information analysis, the biometric information; and determining a therapeutic recommendation at least partly on the basis of the analysis. The method further optionally includes integrating biofeedback techniques into patient therapy and/or activity. 
     A system includes a biometric information module to acquire information associated with an ingestible event marker; an analysis module to analyze the information; and a determination module to optionally determine and communicate a therapeutic recommendation to a patient at least partly on the basis of the analysis of the information. 
     INCORPORATION BY REFERENCE 
     All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. 
     Such incorporations include United States Patent Application Publication No. 20080284599 published on Nov. 20, 2008 titled “Pharma-Informatics System”; United States Patent Application Publication No. 20090135886 titled “Transbody Communication Systems Employing Communication Channels”, United States Patent Application No. 20090082645, published on Mar. 26, 2009 titled “In-Body Device With Virtual Dipole Signal Amplification”; U.S. patent application Ser. No. 12/546,017 filed Sep. 21, 2009 titled, “Communication System With Partial Power Source”; U.S. Provisional Patent Application No. 61/251,088 filed Oct. 13, 2009 titled “Receiver and Method”; and U.S. Provisional Patent Application No. 61/034,085, filed Mar. 5, 2008. 
     Such incorporations further include patent applications filed under the Patent Cooperation Treaty (“PCT”), to include PCT Patent Application Serial No. PCT/US2006/016370, filed Apr. 28, 2006; PCT Patent Application Serial No. PCT/US07/82563, filed Oct. 17, 2007; PCT Patent Application Serial No. PCT/US2008/52845 filed Feb. 1, 2008; PCT Patent Application Serial No. PCT/US2006/016370 published as WO/2006/116718; PCT Patent Application Serial No. PCT/US2007/082563 published as WO/2008/052136; PCT Patent Application Serial No. PCT/US2007/024225 published as WO/2008/063626; PCT Patent Application Serial No. PCT/US2007/022257 published as WO/2008/066617; PCT Patent Application Serial No. PCT/US2008/053999 published as WO/2008/101107; PCT Patent Application Serial No. PCT/US2008/056296 published as WO/2008/112577; PCT Patent Application Serial No. PCT/US2008/056299 published as WO/2008/112578; and PCT Patent Application Serial No. PCT/US2008/077753. 
     The publications discussed or mentioned herein are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Furthermore, the dates of publication provided herein may differ from the actual publication dates which may need to be independently confirmed. 
    
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
       These, and further features of various aspects of the present invention, may be better understood with reference to the accompanying specification, wherein: 
         FIG. 1  is a schematic of an electronic communications network communicatively coupled with an IEMD, a patient management data system and one or more vital parameter sensors. 
         FIG. 2  is a schematic of the patient management data system of  FIG. 1   
         FIG. 3  is a schematic diagram of a system software of the patient management data system of  FIGS. 1 and 2 . 
         FIG. 4A  is an illustration of a representative first patient record as stored in the patient management data system or elsewhere in the network of  FIG. 1 . 
         FIG. 4B  is an illustration of a representative first medication record as stored in the patient management data system or elsewhere in the network of  FIG. 1 . 
         FIG. 4C  is an illustration of a representative first behavior recommendation record as stored in the patient management data system or elsewhere in the network of  FIG. 1 . 
         FIG. 4D  is an illustration of a representative patient history data of the first patient record of  FIG. 4A . 
         FIG. 5  is an illustration of additional aspects of the method of the present invention, wherein a patient is treated for a health condition by means of the electronic communications network, the IEMD, the patient management data system and one or more vital parameter sensors of  FIGS. 1 and 2 . 
         FIG. 6  is an illustration of other aspects of the method of the present invention, wherein certain behaviors of the patient and interaction of the patient with the patient management data system of  FIGS. 1 and 2  is denoted. 
         FIG. 7  is an illustration of a process implemented by the patient management data system of  FIGS. 1, 2 and 3  in communication with the network, IEMD and sensors of  FIG. 1 . 
         FIG. 8  is a process chart of a method in which a clinician or an expert system monitors a vital parameter of the patient and suggest via the network of  FIG. 1  a therapeutic behavior intended to improve the health of the patient. 
         FIG. 9  is a process chart of a method of the patient management data system to determine if and when to send a text or audio message to the patient transceiver and/or the patient input device of  FIG. 1 . 
         FIG. 10  is another process chart of a method of the patient management data system to determine if and when to send a text or audio message to the patient transceiver and/or the patient input device of  FIG. 1 . 
         FIG. 11  shows an exemplary process flow. 
         FIG. 12  is a schematic of a patient coupled with a plurality of biometric sensors and in communication with a cellular telephone, other mobile computational devices and information technology networks. 
         FIG. 13  is an illustration of a display screen of the cellular telephone of  FIG. 12  displaying icons. 
         FIG. 14  is a schematic diagram of the cellular telephone of  FIGS. 12 and 13 . 
         FIG. 15  is a schematic diagram of a mobile phone system software of the cellular telephone of  FIGS. 12, 13 and 14 . 
         FIG. 16  illustrates a first disclosed exemplary additional or alternate process, wherein the cellular telephone of  FIG. 12-15  displays one or more icons of  FIG. 13 . 
         FIG. 17A  is an illustration of an exemplary record that includes an icon identifier relating to an icon of  FIG. 13 . 
         FIG. 17B  is an illustration of log event data that contain biometric information generated and transmitted by a biometric sensor of  FIG. 12 . 
         FIG. 18  illustrates a graph  114  wherein a plurality of event log data of  FIG. 6A  and a plurality of biometric data of  FIG. 17B  are displayed on a display screen of  FIGS. 12, 13 and 14 . 
         FIG. 19  is an illustration of an additional or alternate method wherein the cellular telephone of  FIGS. 12-15  transmits information via the network to the data base system and/or the diagnostic system of  FIG. 12 . 
         FIG. 20  is an illustration of an additional or alternate method, wherein the cellular telephone of  FIGS. 12-15  receives information via the network from the data base system and/or the diagnostic system of  FIG. 12 . 
         FIG. 21  illustrates a still other additional or alternate method, wherein global positioning data (hereinafter “GPS data”) collected from the cellular telephone of  FIGS. 12-15  of the patient of  FIG. 12  are used to determine the current and relative level of social interaction in which the patient is engaging. 
         FIG. 22  illustrates yet another additional or alternate method, wherein a diagnostician applies an activity monitor logic of the diagnostic system of  FIG. 12 . 
         FIG. 23  is a schematic of a diagnostic system software of the diagnostic system of  FIG. 12 . 
         FIGS. 24A, 24B and 24C  are schematics of information stored in the diagnostic system of  FIGS. 12 and 23 . 
         FIG. 25  illustrates a still other additional or alternate method, wherein GPS data collected from the cellular telephone of  FIGS. 12-15  of the patient of  FIG. 12  are used to determine the current and relative level of social interaction in which the patient is engaging. 
         FIG. 26  is an illustration of yet another additional or alternate method, wherein a diagnostician applies a mobility monitor logic of the diagnostic system of  FIGS. 12 and 23  to generate a GPS data baseline (hereinafter “GPS baseline”). 
         FIG. 27  is a process chart of an even other additional or alternate method, wherein the cellular telephone of  FIGS. 12-15  is programmed to render a distinctive ringtone, alarm tone, audio message, and/or text message to alert the patient of  FIG. 1  to take a medication, engage in a medically recommended behavior, or cease a behavior. 
         FIG. 28  illustrates a still further additional or alternate method, wherein the phone of  FIGS. 12-15  is programmed to remind the patient of  FIG. 12  to take, e.g., ingest, inhale, insert, or topically apply, one or more medications of  FIG. 12 . 
         FIG. 29  is a schematic of a first exemplary patient record selected from a plurality of patient records that are stored in the cellular telephone of  FIGS. 12-15 , the DB computer of  FIG. 12 , and/or the diagnostic system of  FIGS. 12 and 23 . 
         FIG. 30  illustrates an even other additional or alternate method, wherein a patient record is applied by the phone of  FIGS. 12-15  to record biometric data received from one or more sensors of  FIG. 1  and to send reminding alerts to encourage the patient of  FIG. 1  to perform meditative exercises, relaxation exercises, or other therapeutic or prescribed behaviors. 
         FIG. 31  describes another additional or alternate method, wherein high stress events that occur routinely in the routine life of the patient are identified and the phone of  FIGS. 12-15  is programmed to encourage the patient of  FIG. 12  to take therapeutic steps to reduce the harmful impact of the stress inducing events. 
         FIG. 32  is a schematic of an exemplary patient activity log. 
         FIG. 33  describes a yet other alternate or additional method, wherein the diagnostician analyzes information about diagnostic test results, genetic test results, patient records, patient activity logs, and other information to develop and prescribe therapy. 
         FIG. 34  is a schematic of an exemplary first diagnostic test record that includes a patient identifier, a phone identifier, and a plurality of diagnostic test notes. 
         FIG. 35  is a schematic of an exemplary first genetic test record that includes the patient identifier of  FIG. 34 , the phone identifier, and a plurality of genetic test notes. 
         FIG. 36  is a schematic illustrating the diagnostic system software as containing patient records, diagnostic records and genetic records. 
         FIG. 37  is a schematic of the patient of  FIG. 12  being monitored by additional sensors. 
         FIG. 38  is a schematic diagram of the exemplary heart rate sensor of  FIG. 12 . 
         FIG. 39  illustrates another still additional or alternate method, wherein a diagnostician receives and analyzes information and advises the patient of  FIGS. 12-15 and 37  with therapeutic guidance. 
         FIG. 40  illustrates another even additional or alternate method, wherein the patient of  FIGS. 12 and 37  is encouraged by yet other engagement modalities to adhere to a prescribed ingestion of the medicine of  FIG. 12 . 
         FIG. 41  illustrates another even additional process wherein the patch receiver of  FIG. 12  is attached or coupled to the patient of  FIG. 12  and monitored over two separate time periods. 
         FIG. 42  illustrates a system to facilitate adherence to a treatment plan. 
         FIG. 43  illustrates a system to facilitate adherence to a treatment plan including a patient management system communicatively coupled with all other parts via a communications bus. 
     
    
    
     DETAILED DESCRIPTION 
     While the present invention has been described with reference to specific methods, devices and systems, it should be understood by those skilled in the art that various changes may be made and equivalents may be substituted without departing from the true spirit and scope of the invention. In addition, many modifications may be made to adapt a particular situation, material, composition of matter, process, process step or steps, to the objective, spirit and scope of the present invention. All such modifications are intended to be within the scope of the claims appended hereto. 
     Methods recited herein may be carried out in any order of the recited events which is logically possible, as well as the recited order of events. 
     Where a range of values is provided herein, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range and any other stated or intervening value in that stated range, is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges and are also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits ranges excluding either or both of those included limits are also included in the invention. 
     Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can also be used in the practice or testing of the present invention, the methods and materials are now described. 
     It must be noted that as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely,” “only” and the like in connection with the recitation of claim elements, or use of a “negative” limitation. 
     Referring now generally to the Figures and particularly to  FIG. 1 ,  FIG. 1  is a schematic of an electronic communications network  2  communicatively coupled with an ingestible device  4  (hereinafter “IEMD”  4 ) wherein the IEMD  4  has been ingested within a patient&#39;s body  6 . A patient transceiver  8  is configured to receive a wireless transmission from the IEMD  4  that includes an ingestible event datum M, or “IEM M”. Alternatively, the patient transceiver  8  may be configured to acquire communicated information comprising an IEM M, or a datum of an IEM M, via the electronic communications network  2  or an aspect device or source  6 - 24  communicatively coupled with or comprised within the electronic communications network  2 . 
     The IEMD  4  gathers, collects, and/or generates ingestion data via various methods, e.g., ingestion timing, contact with alimentary system substances, sampling, etc. Further, various ingestible event marker data source devices IEMD  4  communicate the IEM M data via various methods, e.g., wireless methods, conductive methods via body tissue, etc. The following are examples of the ingestible devices  300   a.    
     A pharma-informatics system described in PCT/US2006/016370, filed Apr. 28, 2006, includes compositions, systems and methods that allow for the detection of the actual physical delivery of a pharmaceutical agent to the body  6  are provided. Embodiments of the compositions include an identifier and an active agent. 
     A system described in PCT/US2008/52845, filed Feb. 1, 2008, includes an IEMD  4  referred to therein as an ingestible event marker IEM and patient transceiver  8  referred to therein as a personal signal receiver. Aspects of data transmitted from the IEMD  4  may include an identifier, which may or may not be present in a physiologically acceptable carrier. The identifier is characterized by being activated upon contact with a target internal physiological site of the body  6 , such as digestive tract internal target site. The patient transceiver  8  may be configured to be associated with a physiological location, e.g., inside of or on the body  6 , and to receive a signal from the IEMD  4 . During use, the IEMD  4  broadcasts a signal which is received by the patient transceiver  8 . 
     The ingestion data associated with the electronic communications network  2  (hereinafter “network”  2 ) include personal patient data, e.g., physiologic data generated by the IEMD  4 . Examples are derived metrics, e.g., processed physical data to derive various metrics such as time of ingestion data; combined metrics, e.g., derived metrics combined with other derived metric data such as time of ingestion data combined with data identifying the ingested substance; and patient data, e.g., derived metrics and/or combined metrics aggregated with various physiologic data such as time of ingestion data combined with data identifying the ingested substance and physiologic data such as ECG data, temperature, etc. 
     Embodiments of activation component based on battery completion formats employ a battery that includes, when completed, a cathode, an anode, and an electrolyte, where the electrolyte is made up, at least in part, by fluid present at the target physiologic site (stomach fluid present in the stomach, where the stomach is the target physiological site). For example, when a stomach fluid activated IEM is ingested, it travels through the esophagus and proceeds to enter the stomach. The cathode and anode provided on the IEM do not constitute a full battery. However, when the cathode and anode are exposed to stomach fluid, the stomach fluid acts as the electrolyte component of the battery and completes the battery. Therefore, as the IEM contacts the target site, a power source is provided which activates the identifier. The data signal is then transmitted. 
     In certain embodiments, the IEMD is dimensioned to be orally ingestible, e.g., either by itself or upon combination with a physiologically acceptable carrier component of the composition so as to produce a composition that can be readily administered to a subject in need thereof. As such, in certain embodiments, the identifier element is dimensioned to have a width ranging from about 0.05 to about 2 or more mm, e.g., from about 0.05 mm to about 1 mm, such as from about 0.1 mm to about 0.2 mm; a length ranging from about 0.05 to about 2 or more mm, e.g., from about 0.05 mm to about 1 mm, such as from about 0.1 mm to about 0.2 mm and a height ranging from about 0.05 to about 2 or more mm, e.g., from about 0.1 mm to about 1 mm, such as from about 0.05 mm to about 0.3 mm, including from about 0.1 mm to about 0.2 mm. In certain embodiments the identifier is 1 mm3 or smaller, such as 0.1 mm3 or smaller, including 0.2 mm3 or smaller. The identifier element may take a variety of different configurations, such as but not limited to: a chip configuration, a cylinder configuration, a spherical configuration, a disc configuration, etc., where a particular configuration may be selected based on intended application, method of manufacture, etc. 
     A controlled activation ingestible identifier described in PCT Patent Application PCT/US07/82563, filed Oct. 17, 2007, includes ingestible compositions such as pharma-informatics enabled compositions. The controlled activation ingestible identifiers include a controlled activation element that provides for activation of the identifier in response to the presence of a predetermined stimulus at a target site of interest. 
     A life cycle pharma informatics system described in U.S. Patent Provisional Application Ser. No. 61/034,085, filed Mar. 5, 2008 includes RFID and conductive communications technology combined with medication and/or medication packaging such that the medication can be tracked for the duration of its existence. The system further allows in-body data transmissions while addressing the potential privacy and signal degradation concerns associated with RFID technology. 
     Additional examples of ingestible identifiers of interest include those described in Examples of different types of identifiers of interest include, but are not limited to, those identifiers described in PCT application serial no. PCT/US2006/016370 published as WO/2006/116718; PCT Patent Application Serial No. PCT/US2007/082563 published as WO/2008/052136; PCT Patent Application Serial No. PCT/US2007/024225 published as WO/2008/063626; PCT Patent Application Serial No. PCT/US2007/022257 published as WO/2008/066617; PCT Patent Application Serial No. PCT/US2008/052845 published as WO/2008/095183; PCT Patent Application Serial No. PCT/US2008/053999 published as WO/2008/101107; PCT Patent Application Serial No. PCT/US2008/056296 published as WO/2008/112577; PCT Patent Application Serial No. PCT/US2008/056299 published as WO/2008/112578; and PCT Patent Application Serial No. PCT/US2008/077753; the disclosures of which are herein incorporated by reference. 
     The patient transceiver  8  may be or comprise an electronic communications device configured for receipt of wireless transmissions from the IEMD  4  and optionally comprising, for example, (a.) an information appliance; (b.) a television set-top box; (c.) a VAIO FS8900™ notebook computer marketed by Sony Corporation of America, of New York City, N.Y., (d.) a SUN SPARCSERVER™ computer workstation marketed by Sun Microsystems of Santa Clara, Calif. and running a LINUX™ or a UNIX™ operating system; (e.) a wireless communications enabled personal computer configured for running WINDOWS XP™ or VISTA™ operating system marketed by Microsoft Corporation of Redmond, Wash.; (f.) a PowerBook G4™ personal computer as marketed by Apple Computer of Cupertino, Calif.; (g.) an iPhone™ cellular telephone as marketed by Apple Computer of Cupertino, Calif.; and/or (h.) a personal digital assistant enabled for wireless communications. 
     The electronic communications network  2  may be or comprise, for example, in whole or in part, a telephony network  2 A, a wireless communications network, a computer network, and/or the Internet  2 B. 
     The patient transceiver  8  is communicatively coupled with a patient management data system  10  (hereinafter, “PMDS”  10 ) via the electronics communications network  2 . The patient transceiver  8  may be communicatively coupled with the electronics communications network  2  (hereinafter, “the network”  2 ) by a hard wire connection and/or a wireless communications mode with a first network transceiver  12 , wherein the first network transceiver  12  is communicatively coupled with the network  2  by a hard wire connection. 
     A patient messaging module  14  is additionally coupled with the network  2 , wherein the patient messaging module  14  enables a clinician or an automated information system (not shown) to transmit recommendations to the patient regarding medicinal ingestion, patient behavior and therapeutic activity. The patient messaging module  14  and/or the PDMS transceiver  8  may be communicatively coupled with the network  2  by means of a hard wire connection and/or a wireless communications mode with a second network transceiver  16 , wherein the first network transceiver  12  is communicatively coupled with the network  2  by a hard wire connection. 
     It is understood that the patient messaging module  14  may be comprised within the PMDS  10 , and that the patient messaging module  14  and/or the PMDS  10  may comprise or be comprised within a unified or distributed electronic information technology system configured for communication via the network  2  and optionally comprising, for example, (a.) an information appliance; (b.) a television set-top box; (c.) a VAIO FS8900™ notebook computer marketed by Sony Corporation of America, of New York City, N.Y., (d.) a SUN SPARCSERVER™ computer workstation marketed by Sun Microsystems of Santa Clara, Calif. and running a LINUX™ or a UNIX™ operating system; (e.) a wireless communications enabled personal computer configured for running WINDOWS XP™ or VISTA™ operating system marketed by Microsoft Corporation of Redmond, Wash.; (f.) a PowerBook G4™ personal computer as marketed by Apple Computer of Cupertino, Calif.; (g.) a mobile or cellular digital telephone; (h.) an iPhone™ cellular telephone as marketed by Apple Computer of Cupertino, Calif.; and/or (i.) a personal digital assistant enabled for wireless communications. 
     A patient input device  18  is additionally coupled with the network  2 , wherein the patient input device  18  enables a patient or caregiver (not shown) to transmit reports and information regarding patient adherence or non-adherence to recommended therapy; patient behavior; patient physical, mental, or emotional condition; risk taking or risk seeking behavior by the patient; and therapeutic activity of the patient. The patient input device  18  may be included within the patient transceiver  8 , and/or may comprise or be comprised within an electronic communications device, or a unified or distributed electronic information technology system configured for communication via the network  2  and optionally comprising, for example, (a.) an information appliance; (b.) a television set-top box; (c.) a VAIO FS8900™ notebook computer marketed by Sony Corporation of America, of New York City, N.Y., (d.) a SUN SPARCSERVER™ computer workstation marketed by Sun Microsystems of Santa Clara, Calif. and running a LINUX™ or a UNIX™ operating system; (e.) a wireless communications enabled personal computer configured for running WINDOWS XP™ or VISTA™ operating system marketed by Microsoft Corporation of Redmond, Wash.; (f.) a PowerBook G4™ personal computer as marketed by Apple Computer of Cupertino, Calif.; (g.) an iPhone™ cellular telephone as marketed by Apple Computer of Cupertino, Calif.; (h.) an iPhone™ cellular telephone as marketed by Apple Computer of Cupertino, Calif.; and/or (i.) a personal digital assistant enabled for wireless communications. 
     A first vital parameter monitor  20 , or “first sensor”  20 , is coupled with the patient&#39;s body  6  and may be or comprise, for example, a motion detector, a heart rate monitor, a blood pressure monitor, a respiration monitor, and/or a patient skin electrical current conductivity monitor. A second vital parameter monitor  22 , or “second sensor”  22 , is coupled with the patient&#39;s body  6  and may additionally be or comprise, for example, a motion detector  23 , a heart rate monitor, a blood pressure monitor, a respiration monitor, and/or a patient skin electrical current conductivity monitor. 
     The motion detector  23  is communicatively coupled to the analysis module and the PMDS  10  whereby the PMDS  10  incorporates a patient motion datum generated by and communicated from the motion detector  23  in an analysis of at least one health parameter of a patient. The motion detector  23  may be, comprise, or comprised within, for example, a cellular telephone, an accelerometer and/or a global positioning signal device. 
     A third vital parameter monitor  24  is positioned remotely from the patient&#39;s body  6 , and is configured to monitor a vital parameter of the patient&#39;s body  6  by remote sensing, for example, sound detection, air pressure variation, light energy reflection, and/or heat detection. The third sensor  24  may be or comprise a motion detector, for example, a heart rate monitor, a blood pressure monitor, a respiration monitor, and/or a patient skin electrical current conductivity monitor. 
     A system described in PCT/US2008/52845, filed Feb. 1, 2008, includes an IEMD  4  referred to therein as an ingestible event marker IEMD  4  and patient transceiver  8  referred to therein as a personal signal receiver. Aspects of IEM M data transmitted from the IEMD  4  and/or sensors  20 ,  22 ,  23  and  24  may include an identifier (sometimes, for example, referred to herein as an “ingestible event marker”, an “ionic emission module”, and/or an “IEM”), which may or may not be present in a physiologically acceptable carrier. The identifier is characterized by being activated upon contact with a target internal physiological site of a body, such as digestive tract internal target site. The patient transceiver  8  may be configured to be associated with a physiological location, e.g., inside of or on the body, and to receive a signal from the IEMD  4  and/or sensors  20 ,  22 ,  23  and  24 . During use, the IEMD  4  and/or sensors  20 ,  22 ,  23  and  24  broadcasts signals that are received by the patient transceiver  8 . 
     The ingestion data associated with the network  2  include personal data, e.g., physiologic data generated by the IEMD  4  and/or sensors  20 ,  22 ,  23  and  24 . Examples are derived metrics, e.g., processed physical data to derive various metrics such as time of ingestion data; combined metrics, e.g., derived metrics combined with other derived metric data such as time of ingestion data combined with data identifying the ingested substance; and patient data, e.g., derived metrics and/or combined metrics aggregated with various physiologic data such as time of ingestion data combined with data identifying the ingested substance and physiologic data such as ECG data, temperature, etc. 
     A controlled activation ingestible identifier described in PCT/US07/82563, filed Oct. 17, 2007, includes ingestible compositions such as pharma-informatics enabled compositions. The controlled activation ingestible identifiers include a controlled activation element that provides for activation of the identifier in response to the presence of a predetermined stimulus at a target site of interest. 
     A life cycle pharma informatics system described in U.S. Patent Application Ser. No. 61/034,085, filed Mar. 5, 2008 includes RFID and conductive communications technology combined with medication and/or medication packaging such that the medication can be tracked for the duration of its existence. The system further allows in-body data transmissions while addressing the potential privacy and signal degradation concerns associated with RFID technology. 
     The computer architecture shown in  FIG. 2  illustrates the aspects of the PMDS  10 , including a central processing unit  26  (hereinafter, “CPU”), a system memory  28 , including a random access memory  30  (hereinafter, “RAM”) and a read-only memory (hereinafter, “ROM”)  32 , and a power and communications system bus  34  that couples the system memory  28  to the CPU  26 . A basic input/output system  36  containing the basic software-encoded instructions and routines that help to transfer information between elements within the PMDS  10 , such as during startup, is stored in the ROM  20 . The PMDS  10  further includes a system software  38  and a database management system  40  (hereinafter “DBMS”  40 ), which will be described in greater detail below, stored in the system memory  28  and/or a computer-readable medium  42 . 
     A media writer/reader  44  is bi-directionally communicatively coupled to the CPU  26  through the power and communications system bus  34  (hereinafter “the bus”  34 ). The media writer/reader  44  and the associated computer-readable media  42  are selected and configure to provide non-volatile storage for the PMDS  10 . Although the description of computer-readable media  42  contained herein refers to a mass storage device, such as a hard disk or CD-ROM drive, it should be appreciated by those skilled in the art that computer-readable media can be any available media that can be accessed by the PMDS  10 . 
     By way of example, and not limitation, computer-readable media  42  may comprise computer storage media and communication media. Computer storage media includes volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer-readable instructions, data structures, program modules or other data. Computer storage media includes, for example, but is not limited to, RAM, ROM, EPROM, EEPROM, flash memory or other solid state memory technology, CD-ROM, digital versatile disks (“DVD”), or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by the PMDS  10 . 
     The computer-readable medium  42  may comprise machine-readable instructions which when executed by the PMDS  10  to cause the PMDS  10  to perform one or more steps as described in the Figures and enabled by the present disclosure. The bus  34  further bi-directionally communicatively couples a network interface  46 , a user input interface  48 , a user audio input interface  50 , and a video screen interface  52  with the CPU  26  and the system memory  28 . The video screen interface  52  directs visual presentations of data on a visual display screen  54  and bi-directionally communicatively couples the visual display screen  54  with the CPU  26  via the communications bus  34 . The user input interface  48  couples a user input device  56 , for example, an electronic keyboard, a computer mouse, a computer trackball, or a computer mouse pad, with the CPU  26  via the communications bus  34  and enables the clinician to input icon selections, commands and data to the PMDS  10 . The icon selections may be chosen from images presented on the visual display screen  54 . 
     The audio input interface  50  couples a user audio input device  58 , for example an audio microphone, with the CPU  26  via the communications bus  34  and enables the clinician to input vocal input that communicates icon selections, commands and data to the PMDS  10 , and/or digitized representations of verbal expressions. The digitized representations of verbal expressions may be transmitted via the network interface  46  to enable VoIP communications with the patient input device  18  and/or the patient transceiver  8 . 
     An audio output interface  60  communicatively coupled with the communications bus  34  receives digitized verbal information, for example, VoIP messages, from the network  2  via the network interface  46  and drives the audio output device  62  to audibly output verbal message derived from the digitized verbal communications. 
     An audio/text converter module  64  (1.) converts digitized audio data into textual data for storage in a patient record R. 0 ; and (b.) converts text data into audio data representative of vocalizations of the source text data. The converted text data may be received via the bus  34  and from the system memory  28  or the network  2 , or generated by the CPU  26 . 
     A wireless interface  66  enables bi-directional communication between the bus  34  and a wireless transceiver  68 , whereby the PMDS  10  may communicate via the wireless and/or hard wired telephony network  2 A with an element  8 - 16  to the network  2 . 
     It is understood that the additional elements  8  and  12 - 16  of the network  2  may include one, several or all of the aspects  26 - 68  of the PMDS  10 . It is further understood that the PMDS  10  may optionally, additionally or alternatively be configured to acquire a communicated information comprising an IEM M, or a datum of an IEM M, via the electronic communications network  2  or an aspect device or source  6 - 24  communicatively coupled with or comprised within the electronic communications network  2 . 
       FIG. 3  is an illustration of the system software  38  of the PMDS  10  of  FIGS. 1 and 2 . An operating system  70  enables a VoIP client software module  72  to provide voice data to the network  2  by directing the audio input driver  74  to digitize acoustic signals detected by the audio input device  58  to form a digitized voice record and transmit the digitized voice record to the patient transceiver  8  and or the patient input device  18  via the network  2 . It is understood that the first network transceiver  12  and/or the second network transceiver  16  may facilitate the transmission of voice communications between the PMDS  10  and the patient transceiver  8  and/or the patient input device  18 . An audio output driver  76  processes digitized acoustic signals received from the network  2  and directs the audio output interface  60  and the audio output device  62  to derive and broadcast acoustic signals from the received digitized acoustic signals for hearing by the clinician. 
     A display driver  78  directs the video interface  52  and the video screen  54  to visually present information received from, or derived from inputs derived from the network  2 , the patient transceiver  8 , the patient input device  18 , the first network transceiver  12 , the second network transceiver  16 , a graphical user interface driver  80  of the PMDS  10 , the audio input device  58  and/or the input device  56 . A web browser  82  may enable the PMDS  10  to visually display information received from the Internet  2 B. The user record R. 0  and a plurality of user records R. 1 -R.N are stored in a patient database  84  of the DBMS  40 . 
     A text editor  86  and an email client  87  separately or in combination enable the clinician to, for example, prepare text messages, and/or to include reminder messages for medication ingestion, for transmission via the network  2  and to the patient transceiver  8  and or the patient input device  18 . It is understood that the first network transceiver  12  and/or the second network transceiver  16  may facilitate the transmission of text messages between the PMDS  10  and the patient transceiver  8  and/or the patient input device  18 . 
     It is understood that the additional elements  8  and  12 - 16  of the network  2  may include one, several or all of the software aspects  70 - 86  of the PMDS  10 . 
     Referring now generally to the Figures and particularly to  FIG. 4A ,  FIG. 4A  is an illustration of the representative first patient record R. 0  the format of which may be followed in whole or in part by one or more of the remaining patient records R. 1 -R.N. A first record identifier R. 0 .ID uniquely identifies the first record R. 0  within the PMDS  10  and a patient identifier R. 0 .PID identifies the patient associated with the first record R. 0 . A network patient address R. 0 .ADDR identifies a network address of the patient transceiver  8  and/or the patient input device  18  to which electronic messages, for example, email messages, may be sent. A patient telephone number R. 0 .ADDR.T identifies a telephone number used to establish a telephonic communications session during which a text message or a voice communication maybe accomplished. One or more medication records R. 0 .MR. 0 -R. 0 .MR.N specify one or more medicines prescribed to the patient. A medication reminder flag R. 0 .FM indicates whether the patient is to be reminded by the PMDS  10  to ingest or otherwise apply a medication. One or more behavior records R. 0 .BHR. 0 -R. 0 .BHR.N specify one or more behaviors prescribed to the patient. A behavior remind flag R. 0 .FB indicates whether the patient is to be reminded by the PMDS  10  to engage in (or to avoid) a specified behavior. A patient history data retains information associated with the patient and may include records of receipt of attestations from the patient and receipt of ingestible event data IEM M. A patient activity data R.ACT retains information describing expected types of patient activities and expected times of the patients may be engaging in each expected activities. 
     Referring now generally to the Figures and particularly to  FIG. 4B ,  FIG. 4B  is an illustration of the representative first medication record R. 0 .MR. 0 . A first medication record identifier RM.ID uniquely identifies the first medication record R. 0 .MR. 0  within the PMDS  10 , and the patient identifier R. 0 .PID identifies the patient associated with the first medication record R. 0 .MR. 0 . A medication identifier MED.ID identifies the medication and dosage thereof associated with the first medication record R. 0 .MR. 0 . A dosage data MED.D indicates what dosage of the identified medication is to be ingested or applied. 
     An application schedule MED.S indicates when the associated medication is prescribed to be ingested or otherwise applied. A first remind flag FLAG 1  indicates if the patient shall be reminded to apply or ingest the associated medication before the next prescribed time, wherein the reminder may be sent at approximately a first remind time period TR 1  before the next prescribed time. A first remind medication text TXT 1  (hereinafter, “first remind text” TR 1 ) is a prerecorded text message that may be sent prior to the scheduled time of ingestion or application as a reminder message to the patient to encourage ingesting or applying the associated medication. 
     A second remind flag FLAG 2  indicates if the patient shall be reminded to ingest the medication associated with the first medication record R. 0 .MR. 0  in the event that an ingestion event datum IEM M has not been received by the network  2  within a second remind TR 2  time after a prescribed ingestion time has passed. A second remind text TXT 2  is a prerecorded text message that may be sent after a scheduled time as a reminder message to the patient to encourage ingesting or applying the associated medication identified by the medication identifier MED. 0 . 
     Referring now generally to the Figures and particularly to  FIG. 4C ,  FIG. 4C  is an illustration of the representative first behavior record R. 0 .BHR. 0 . A first behavior record identifier R.BHR.ID uniquely identifies the first behavior record R. 0 .BHR. 0  within the PMDS  10 , and the patient identifier R. 0 .PID identifies the patient associated with the first behavior record R. 0 .BHR. 0 . A behavior identifier BHR.ID identifies the behavior associated with the first behavior record R. 0 .BHR. 0 . A behavior description text BHR.D includes a textual description of a behavior recommended to be engaged in or avoided. A behavior application schedule BHR.S indicates when the associated behavior is prescribed to be ingested or otherwise applied. A first behavior remind flag BFLG 1  indicates if the patient shall be reminded to perform or avoid the associated behavior before the next prescribed time, wherein the reminder may be sent at approximately a TRB 1  time period before the next prescribed time. A first behavior text TXT 1 B is a prerecorded text message that may be sent prior to the scheduled time of ingestion or application as a reminder message to the patient to encourage performing, or alternatively avoided, the behavior identified by the behavior identifier BHR.ID. 
     A second behavior remind flag BFLG 2  indicates if the patient shall be reminded to perform, or alternatively avoid, the behavior associated with the first behavior record R. 0 .BHR. 0  if an attestation by the patient has not been received by the network  2  within a time after a prescribed time of performance has passed. A second behavior text TXT 2 B is a prerecorded text message that may be sent, for example, after a scheduled time of behavior performance, or alternatively, a behavior avoidance, as a reminder message to the patient to encourage performing, or alternatively avoid performing, the associated behavior identified by the behavior identifier BHR.ID. 
     Referring now generally to the Figures and particularly to  FIG. 4D ,  FIG. 4D  is an illustration of the representative patient history data H.D of the first record R. 0 . The patient history data H.D includes, for example, (a.) a plurality of marker record H.M 0 -H.MN of previously received ingestion markers IEM M, (b.) a plurality of attestation records H.PA 0 -H.PAN containing notations of attestations received from the patient, and (c.) a plurality of text message records H.T 0 -H.TN of previously transmitted text messages sent to the patient transceiver  8  and/or the patient input device  18 . The received patient attestation records H.PA 0 -H.PAN may include, for example, notations of attestations of performed behaviors, attestations of applications or ingestions of medicines, and/or attestations of avoided behaviors. 
     Referring now generally to the Figures and particularly to  FIG. 5 ,  FIG. 5  is an illustration of additional aspects of the method of the present invention, wherein a patient is treated for a health condition. In step  502  a database record R. 0  is initiated in the PMDS  10  identifying the patient. The patient is evaluated in step  504  and diagnosed in step  506 . A patient activity model is generated in step  508  wherein the daily activity of the patient is included in a software-encoded portion of the database record R. 0 . Medications and behaviors are prescribed in step  510  and the prescribed medications and behaviors are stored in the database record R. 0 . The patient is counseled and advised of the prescribed medications and behaviors as stored in the database record R in step  514 . 
     The receipt of ingestion markers IEM M transmitted from one or more IEMD&#39;s  4  and measurements and transmissions of the sensors  20 ,  22 ,  23  and  24  are received by the patient transceiver  8  and transmitted to the PMDS  10  via the network  2  and the patient record R. 0  is updated with the received parametric data in step  516 . Attestations by the patient, for example, of (a.) changes in patient activity varying from the activity model of step  508 ; (b.) adherence and non-adherence to prescribed medication ingestion schedule by the patient; and (c.) performance and non-performance of prescribed patient behaviors are received via the patient input device  18  and by the PMDS  10  via the network  2  in step  518 . 
     The information received in steps  516  and  518  are evaluated by a clinician or an expert information technology system (not shown) in step  520  in view of other information included in the patient record R. 0 . The clinician or the expert information technology system may update the patient diagnosis in step  522 , and may further determine in step  524  whether to cease treatment of the patient. When the clinician or expert system determines in step  824  that the current treatment cycle of the patient shall cease, the patient is informed of the cessation of treatment, and the database record R. 0  is updated with a notice of treatment termination, in step  526 . The treatment is ended in step  528 . 
     When the clinician or expert system determines in step  524  that the current treatment cycle of the patient shall continue, the clinician or expert system determines by analysis of the patient record R. 0 , or one or more additional patient records R. 0 -R.N and optionally in consultation with the patient, determines in step  530  whether to increase or decrease medication dosage or frequency. When the clinician or expert system determines in step  530  to increase or decrease medication dosage or frequency, the patient is informed of the prescription change and the pharmacy is updated in step  534 . 
     The clinician or expert system determines by analysis of the patient record R. 0 , and optionally in consultation with the patient determines in step  536  whether to alter prescribed or recommended behaviors. The patient is informed in step  538  of any alterations or additions of prescribed or recommended behaviors. 
     The PMDS  10  determines by analysis of the patient record R. 0 , in step  542  whether to remind the patient to, for example, ingest or apply a medication, or engage in a prescribed or recommended behavior, and the patient is reminded in step  542  to, for example, ingest or apply a medicine, or engage in a prescribed or recommended behavior. 
     Referring now generally to the Figures and particularly to  FIG. 6 ,  FIG. 6  is an illustration of other aspects of the method of the present invention, wherein certain behavior of the patient is denoted. In step  602  the patient receives a prescription of medications and behaviors. It is understood that a prescription of medication may include both the medication to be ingested and a schedule for ingesting the prescribed medications. The patient reports a schedule of expected activities via the patient input device  18  to the PMDS  10  in step  604 . The schedule of expected activities, for example, may include work sessions, such as manual labor, expense report authoring, staff meetings, customer interaction periods, negotiations sessions, employee review meetings, sales forecast development, and presentations. The expected activities reported by the patient in step  604  are integrated into a patient record R. 0  of the patient database  84  by means of the patient input device  18  and the network  2 . The patient positions one or more sensors  20 ,  22 ,  23  and  24  in step  606  to enable the sensors  20 ,  22 ,  23  and  24  to detect one or more vital parameters of the patient. The patient ingests an IEMD  4  wherein the IEMD  4  transmits an ingestion report with a marker datum IEM M in step  608 . The patient may further adhere to behaviors in step  612  as suggested in the prescription received in step  602 , and report adherence in step  612  with suggested behaviors, to include one or more ingestions of an IEMD  4 . 
     The patient may elect to cease following medical advice in step  614 , and for example, to cease ingesting IEMD&#39;s  4 , may proceed on to report cessation of adherence to the PMDS  10  by means of the patient input device  18  and the network  2  in step  616 . The patient may cease implementing the prescriptive behaviors in step  618 . Alternatively, the patient may determine to proceed from step  614  to step  620  and to query the PMDS  10  to determine whether the prescription assigned by the PMDS  10  has been modified. When the patient determines in step  620  that the assigned prescription has not been modified, the patient proceeds from step  620  back to step  608 . When the patient determines in step  620  that the assigned prescription has been modified, the patient proceeds from step  620  back to step  602  to receive and review the modified assigned prescription. 
     Referring now generally to the Figures and particularly to  FIG. 7 ,  FIG. 7  describes a process implemented by the PMDS  10  in communication with the network  2 , the sensors  20 ,  22 ,  23  and  24  and the IEMD  4 . In step  702 , the PMDS  10  receives a marker datum IEM M of an ingestion report transmitted from the IEMD  4 . In step  704 , the PMDS  10  compares the medicine identified by the marker datum IEM M and the time of receipt of the marker datum IEM M with the medication records R. 0 .MR. 0 -R. 0 .MR.N. The PMDS  10  determines in step  7 . 06  whether the marker datum IEM M received step  7 . 02  is compliant with a medication record R. 0 .MR. 0 -R. 0 .MR.N. When the PMDS  10  determines in step  7 . 06  that receipt of the marker datum IEM M of step  7 . 02  is noncompliant with a medication record R. 0 .MR. 0 -R. 0 .MR.N, the PMDS  10  records the instant receipt of the marker datum IEM M in the patient history data H.D as a noncompliant event and issues and transmits a patient notice of nonadherence in step  710  to the patient transceiver  8  and/or the patient input device  18 . When the PMDS  10  determines in step  7 . 06  that receipt of the marker datum IEM M of step  7 . 02  is compliant with a medication record R. 0 .MR. 0 -R. 0 .MR.N, the PMDS  10  updates patient history data H.D in step  712  with a notation of adherence. The PMDS  10  proceeds from either step  710  or  712  to step  714  and to perform alternate computational operations. 
     Referring now generally to the Figures and particularly to  FIG. 8 ,  FIG. 8  is a process chart of a method in which a clinician or an expert system monitors a vital parameter of the patient and suggest via the network  2  a therapeutic behavior intended to improve the health of the patient. In step  802  the PMDS  10  receives vital parameter data from one or more sensors  20 ,  22 ,  23  and  24 . In step  804  the PMDS  10  compares the vital parameter data received in step  802  with a range of healthy values of the instant vital parameter, for example, heart rate, blood pressure, respiration rate, respiration intensity, and electrical skin conductivity. The PMDS  10  determines in step  806  whether the vital data received in step  802  falls within the healthy range of the instant vital parameter as stored in the PMDS  10  or elsewhere in the network  2 . When the PMDS  10  determines in step  806  that the vital data received in step  802  does not falls within the healthy range of the instant vital parameter, the PMDS  10  proceeds from step  806  to step  808  and correlates the time of the receipt of the vital parameter data with the activity schedule of patient activity data R.ACT of one or more patient records R. 0 -R.N associated with the patient. In step  810  the PMDS  10  selects a therapeutic behavior intended to encourage the patient to maintain the vital parameter referenced in step  802  within the healthy range selected in step  802 . The therapeutic behavior selected in step  810  may be provided by a clinician by input to the PMDS  10  or by means of the patient-messaging module  14 . When the vital parameter referenced in step  802  is hypertension of the cardiovascular system, the selected therapeutic behavior may be or include, for example, listening to calming music, performing meditation, and/or physical exercise. In step  812  the therapeutic behavior is prescribed to the patient in view of a patient activity associated in the patient activity data R.ACT with the time of the receipt of the vital parameter data received in step  802 . A patient behavior suggestion is transmitted from the PMDS  10  and/or the patient messaging module  14  in step  814 , wherein the suggestion advises the patient to engage in the therapeutic behaviors selected in step  810  at times correlated with patient behavior correlated in step  808  and reported in the patient activity data R.ACT. The PMDS  10  proceeds from step  816  and to perform alternate or additional computational operations. 
     Referring now generally to the Figures and particularly to  FIG. 9 ,  FIG. 9  is a process chart of a method of the PMDS  10  to determine if and when to send a text or audio message to the patient transceiver  8  and/or the patient input device  18 . In step  902  the PMDS accesses one or more patient records R. 0 -R.N. The PMDS  10  determines in step  904  whether an ingestion of a medicine has been prescribed to the patient. When the PMDS determines in step  904  that the patient has not been prescribed to ingest a medication, the PMDS  10  proceeds on from step  904  to step  906  and to perform alternate or additional computational operations. 
     When the PMDS determines in step  904  that the patient has been prescribed in a medication record R. 0 .MR. 0 -R. 0 .MR.N of a patient record R. 0 -R.N to ingest an IEMD  4  containing a medication, the PMDS  10  proceeds on from step  904  to step  908 , and to examine the first remind flag FLAG 1  of the instant medication record R. 0 .MR. 0 -R. 0 .MR.N. When the first remind flag FLAG 1  indicates an instruction to remind the patient of a recommended medication ingestions. When the first remind flag FLAG 1  indicates an instruction to remind the patient of prescribed medicine ingestion recommendations, the PMDS  10  proceeds from step  908  to step  910 . The PMDS  10  calculates the next scheduled time for an IEMD  4  ingestion in step  910  by analyzing information of the application schedule MED.S and calculates the next scheduled ingestion time TNEXT. The PMDS  10  reads the first remind time period TR 1  from the medication record R. 0 .MR. 0 -R. 0 .MR.N accessed in step  908 . The PMDS  10  accesses the real time clock  27  determines the current real time TACTUAL in step  914 , and calculates the time difference TDELTA between the current time TACTUAL and the next scheduled ingestion time TNEXT. The PMDS  10  determines in step  918  whether the time difference TDELTA is less than the first remind time period TR 1 . When the PMDS  10  determines in step  918  that the time difference TDELTA is not less than the first remind time period TR 1 , the PMDS  10  proceeds from step  918  to step  906 . When the PMDS  10  determines in step  918  that the time difference TDELTA is less than the first remind time period TR 1 , the PMDS  10  proceeds from step  918  to step  920  and selects the first remind text TXT 1  from the medication record R. 0 .MR. 0 -R. 0 .MR.N accessed in step  908 , and transmits the first remind text TXT 1  to the patient transceiver  8  and/or the patient input device  18  in step  922 . 
     The PMDS  10  proceeds from either step  922  or step  906  to step  924  and to determine whether to cease monitoring for transmissions of markers IEM M from the IEMD  4  and the sensors  20 ,  22 ,  23  and  24 . When the PMDS  10  determines to continue monitoring the sensors  20 ,  22 ,  23  and  24  and for transmissions of markers IEM M from the IEMD  4 , the PMDS  10  proceeds from step  924  to step  902 . When the PMDS  10  determines to cease monitoring the sensors  20 ,  22 ,  23  and  24  and for transmissions of markers IEM M from the IEMD  4 , the PMDS  10  proceeds from step  924  to step  926  perform alternate or additional computational operations. 
     Referring now generally to the Figures and particularly to  FIG. 10 ,  FIG. 10  is a process chart of a method of the PMDS  10  to determine if and when to send a text or audio message to the patient transceiver  8  and/or the patient input device  18  when an ingestion marker datum IEM M is not received approximately when a marker datum IEM M would be received when the IEMD  4  is ingested prescribed. In step  1002  the PMDS accesses one or more patient records R. 0 -R.N. The PMDS  10  determines in step  1004  whether an ingestion of a medicine has been prescribed to the patient. When the PMDS determines in step  1004  that the patient has not been prescribed to ingest a medication, the PMDS  10  proceeds on from step  1004  to step  1006  and to perform alternate or additional computational operations. 
     When the PMDS determines in step  1004  that the patient has been prescribed in a medication record R. 0 .MR. 0 -R. 0 .MR.N of a patient record R. 0 -R.N to ingest an IEMD  4  containing a medication, the PMDS  10  proceeds on from step  1004  to step  1008 , and to examine the second remind flag FLAG 2  of the instant medication record R. 0 .MR. 0 -R. 0 .MR.N. When the second remind flag FLAG 2  indicates an instruction to remind the patient of a recommended medication ingestion when an ingestible event marker datum IEM M has not been received as would be when an IEMD  4  had been ingested as directed by the medication record R. 0 .MR. 0 -R. 0 .MR.N of step  1004 . When the second remind flag FLAG 2  indicates an instruction to remind the patient of a tardiness in following prescribed medicine ingestion as prescribed, the PMDS  10  proceeds from step  1008  to step  1010 . The PMDS  10  calculates the next scheduled time for an IEMD  4  ingestion in step  1010  by analyzing information of the application schedule MED.S and calculates the next scheduled ingestion time TNEXT. The PMDS  10  accesses the real time clock  27  determines the current real time TACTUAL in step  1012 , and calculates the time difference TOVER between the current time TACTUAL and the scheduled ingestion time TNEXT IN STEP  1014 . 
     The PMDS  10  reads the second remind time period TR 2  in step  1016  from the medication record R. 0 .MR. 0 -R. 0 .MR.N accessed in step  1008 . The PMDS  10  determines in step  1018  whether the time difference TOVER calculated in step  1014  is less than the second remind time TR 2  of step  1016 . When the PMDS  10  determines in step  1018  that the time difference TOVER is less than the second remind time TR 2 , the PMDS  10  proceeds from step  1018  to step  1006 . When the PMDS  10  determines in step  1018  that the time difference TDELTA is not less than the second remind time TR 2 , the PMDS  10  proceeds from step  1018  to step  1020  and selects the second remind text TXT 2  from the medication record R. 0 .MR. 0 -R. 0 .MR.N accessed in step  1008 , and transmits the second remind text TXT 2  to the patient transceiver  8  and/or the patient input device  18  in step  1022 . 
     The PMDS  10  proceeds from either step  1022  or step  1006  to step  1024  and to determine whether to cease monitoring for transmissions of markers M from the IEMD  4  and the sensors  20 ,  22 ,  23  and  24 . When the PMDS  10  determines to continue monitoring the sensors  20 ,  22 ,  23  and  24  and for transmissions of markers M from the IEMD  4 , the PMDS  10  proceeds from step  1024  to step  1002 . When the PMDS  10  determines to cease monitoring the sensors  20 ,  22 ,  23  and  24  and for transmissions of markers M from the IEMD  4 , the PMDS  10  proceeds from step  1024  to step  1026  perform alternate or additional computational operations. 
     Referring now generally to the Figures and particularly to  FIGS. 2, 4A, 4B, 4C, and 4D , the audio/text converter module  64  is configured to convert digitized audio data received from the patient transceiver  8 , the patient input device  18 , the patient messaging module  14 , the first network transceiver  12  and/or the second network transceiver  16  into textual data for storage in a patient record R. 0 , for example in the patient history data H.D, the patient activity data R.ACT, the first remind text TXT 1 , the second remind text TXT 2 , the first behavior remind text TXT 1 B and the second behavior remind text TXT 2 B, and/or the behavior description text BHR.D. 
     The audio/text converter module  64  is further configured to convert text data into digitized audio data representative of vocalizations of the source text data from the PMDS  10  and/or the patient messaging module  14  and for transmission of the digitized audio data representations to the patient transceiver  8  and/or the patient input module  18 . The text data and the digitized audio data may be received via the bus  34  and from the system memory  28  or the network  102 , or generated by the CPU  26 . 
     Referring now generally to the Figures and particularly to  FIG. 12 ,  FIG. 12  is a schematic of a patient coupled with a plurality of biometric sensors and in communication with a cellular telephone, other mobile computational devices and information technology networks. In one example, it is a schematic of a patient  88  with a blood pressure sensor  90  wrapped around a right arm  92 , a wireless heart rate sensor  94  in contact with a right leg  96 , a wireless body temperature sensor  98  positioned within a left ear canal  100 , and a respiration monitor  102  positioned at a patient&#39;s mouth and nose area  104 . These sensors are bi-directionally communicatively coupled to a first network computer  106 . To illustrate, biometric data may include body related data, e.g., temperature, ph factor, pulse rate, and ingestion data may include event and/or medication related data, e.g., nature, type of medication, dosage, time at which ingestion took place, adherence to prescription, level of adherence to prescription, etc., communicated to a wireless communications device or receiver, e.g., computer, patch receiver, etc. The biometric data may include, for example, a unique identifier which may be compared to various data, e.g., genetic profile data, emotional data, and other data. Such data may be associated with one or more of a variety of devices, e.g., cellular phone, wireless computer, PDA, and wireless comms system or receiver for validation purposes. 
     A database computer  108 , or “DB computer”  108 , and a medical diagnostic computational system  110  (hereinafter, “diagnostic system”  110 ) are bi-directionally communicatively coupled with the network  2 . A software-encoded database may be associated with the database computer  108  and may include current and historical data pertaining to the patient  88 . The historical data includes, for example, medical record(s), health record(s), or medical chart(s) which are systematic documentation of a patient&#39;s medical history and care. The term “medical record” is used both for the physical information for the patient and for the body of information which comprises the total of each patient&#39;s health history. The network  2  is bi-directionally and communicatively coupled with a telephonic network, represented by telephony network  2 A and with other forms of telecommunication devices, e.g., fax etc, represented by, telecommunications network  112  (hereinafter “TELCO”  112 ). 
     Communication devices, for example, a digital cellular telephone  114 , a wireless enabled network computer  116  and a wireless enabled personal digital assistant (PDA)  118  are further bi-directionally communicatively coupled with the network  2  via a wireless communications system  120  (hereinafter “wireless comms system”  120 ). It is understood that the definition of the term “computer” as used in the present disclosures includes, for example, digital cellular telephones, personal digital assistants, network computer, computer workstations, automated database systems, servers, and web servers. 
     In another aspect, one or more sensors  20 ,  22 ,  23 ,  24 ,  94 ,  98 , and/or  102  may be conductively or communicatively coupled to a patch receiver  122 , positioned on the skin or subcutaneously or as a wristband or any such wearable device. The patch receiver  122  in turn may be communicatively coupled to the first network computer  106 . The first network computer  106  is bi-directionally communicatively coupled to electronics communications network  2 . The network  2  may further facilitate a two-way communication with the Internet  2 B. 
     An IEMD  4  optionally includes a medicine  126 . The IEMD  4  is an in-body device as disclosed herein. Examples of in-body devices include, but are not limited to: implantable devices, e.g., implantable therapeutic devices, such as but not limited to stents, drug delivery devices, orthopedic implants, implantable diagnostic devices, e.g., sensors, biomarker recorders, etc.; ingestible devices such as the IEMD  4  described in the preceding references; etc. 
     In various aspects, the biometric data may be communicated to and/or from one or more receiving devices (not shown), for example, a biometric data receiver such as the computer  106 , etc. The biometric receiver  106 ,  114 ,  116 ,  118  and  120  may be embodied in various ways, for example, as the cellular telephone  114 , the wireless computer  116 , the personal digital assistant  118 , and/or a personal receiver such as an implantable receiver, a semi-implantable receiver, and an externally applied device such as the personal signal patch receiver  122 . The patch receiver is a personal receiver that may be removably affixed to the person&#39;s person, apparel, or personal equipment, for example, by an adhesive, a clip, a fabric, or other suitable attachment means known in the art. 
     To illustrate one exemplary application of the method of the present invention, a patient  88  may ingest the IEMD  4  integrated with medicine  126 . The IEMD  4  may communicate data that includes biometric data and ingestion data. The biometric data may include body related data, for example, temperature, pH factor, pulse rate, and ingestion data may include event and/or medication related data, for example, nature, type of medication, dosage, time at which ingestion took place, adherence to prescription, level of adherence to prescription, etc., communicated to a wireless communications device  114 ,  116 ,  118 , and  120 , or receiver, for example, computer  106 , patch receiver, etc. The biometric data may include, for example, a unique identifier which may be compared to various data, for example, genetic profile data, emotional data, and other data. Such data may be associated with one or more of a variety of devices, for example, the cellular phone  114 , the wireless computer  116 , PDA  118 , and the wireless comms system  120  or receiver for validation purposes. 
     The biometric data reception may be affected or effected by one or more receiving devices, for example, personal signal receivers such as patch receivers that are removably attachable externally to the patient  88  or a non-human body; or comprised within a subcutaneous device, an implantable devices, and/or various external devices, for example, devices which are or are not designed for attachment or other permanent or semi-permanent contact with the body, for example, the cellular telephone  114 . An ingestible event marker system is described in the Patent Application PCT/US2008/52845 and includes an IEMD  4  and a personal patch signal receiver  122 . The patch receiver  122  includes, for example, devices capable of at least receiving data and/or signals, etc. Patch receivers  122  may be attachable, for example, permanently or removably attachable externally to a human body or a non-human body. For example, the patch receiver  122  may include the receiver and an adhesive layer to provide for attachment to and removal from the patient  88 . Alternatively, the patch receiver  122  may be implantable or semi-implantable, for example, subcutaneous implantation. 
     The wireless communications system  120 , the cellular telephone  114 , the wireless computer  116 , and/or the personal digital assistant  118 , may include systems, subsystems, devices, and/or components that receive, transmit, and/or relay the biometric data. In various aspects, the wireless communications system  120  communicably interoperates with a receiver  37  such as the patch receiver  120  and a communications network  2  such as the Internet  2 B. Examples of wireless comms systems  120  are computers, for example, servers, personal computers, desktop computers, laptop computers, intelligent devices/appliances, etc., as heretofore discussed. 
     In various aspects, the wireless communications system  120  may be embodied as an integrated unit or as distributed components, for example, a desktop computer and a mobile telephone in communication with one another and in communication with a patch receiver and the Internet  2 B. 
     Further, various aspects of the network include combinations of devices. For example, one such combination is a receiver  122  such as the patch receiver  122  in communication with the portable digital assistant  118  or the mobile telephone  114 . Thus, for example, the patch receiver  122  wirelessly transmits biometric data received from the IEMD  4  to the cellular telephone  114  having a receiver and a software agent available thereon. The cellular telephone  114  receives the biometric data transmitted by the IEMD  4 . In one scenario, the patient  88  ingests prescription medication  126  in conjunction with an IEMD  4 . The IEMD  4  identifies various information, for example, the medication type and dosage and transmits this information in a biometric data transmission via, for example, a conductive transmission to the patch receiver  120 , which may be removably attached to the patient  88 . The patch receiver  122  transmits the biometric data to, for example, the cellular telephone  114 , the wireless computer  116 , the personal digital assistant  118 , and/or the wireless comms device  120  as the case may be. 
     For ease of description, the in-body devices of the invention will now be further described in terms of configurations having current path extender capabilities such as those provided by a skirt (not shown) where the skirt is part of the IEMD  4 , for example, the wireless IEMD  4 . One or more IEMD  4  may be or comprise a composition that includes in certain configurations a vehicle, where the vehicle may or may not include an active agent such as the medicine  126 . 
     IEMDs  4  of interest include those described in PCT Application No. PCT/US2006/016370 filed on Apr. 28, 2006 titled “Pharma-Informatics System”; PCT Application No. PCT/US2007/022257 filed on Oct. 17, 2007 titled “In-vivo Low Voltage Oscillator for Medical Devices”; PCT Application No. PCT/US2007/82563 filed on Oct. 25, 2007 titled “Controlled Activation Ingestible Identifier”; U.S. patent application Ser. No. 11/776,480 filed Jul. 11, 2007 titled “Acoustic Pharma Informatics System”; PCT/US2008/52845 filed on Feb. 1, 2008 titled “Ingestible Event Marker Systems”; Patent Application No. PCT/US08/53999 filed Feb. 14, 2008 titled “In-Body Power Source Having High Surface Area Electrode”; U.S. patent application Ser. No. 12/238,345 filed Sep. 25, 2008 titled “In-Body Device With Virtual Dipole Signal Amplification, the disclosures of which applications are herein incorporated by reference. 
     The IEMD  4  communicates, e.g., generates, alters, produces, emits, etc., a communication upon contact of the IEMD  4  with a target physiological location (or locations) depending on the particular configuration of the IEMD  4 . The IEMD  4  of the present compositions may vary depending on the particular configuration and intended application of the composition. 
     As such, variations of IEMDs  4  may communicate, for example, communicate a unique identifier, when activated at a target site, for example, when the instant IEMD  4  contacts a target surface or area within the patient&#39;s body  6 , for example, a physiological, site and/or alters a current when in contact with a conducting fluid, for example, gastric acid in the stomach. Depending on the configuration, the target physiological site or location may vary, where representative target physiological sites of interest include, for example, but are not limited to: a location in the alimentary system, such as the mouth, esophagus, stomach, small intestine, large intestine, etc. 
     In certain configurations, the IEMD  4  is configured to be activated upon contact with fluid at the target site, for example, stomach fluid, regardless of the particular composition of the target site. In some configurations, the IEMD  4  is configured to be activated by interrogation, following contact of the composition with a target physiological site. In some configurations, the IEMD  4  is configured to be activated at a target site, wherein the target site is reached after a specified period of time. 
     Depending on the needs of a particular application, the communication of an ingestible event marker datum IEM M associated with the event marker IEMD  4 , for example, altered current, an RFID signal, etc., may be generic such as a communication that merely identifies that the composition has contacted the target site, or may be unique, for example, a communication which in some way uniquely identifies that a particular event marker datum IEM M from a group or plurality of different markers M in a batch has contacted a target physiological site. 
     As such, the IEMD  4  may be one that, when employed with a batch of unit dosages, for example, a batch of tablets, is associated with a communication which cannot be distinguished from the signal emitted by the IEMD  4  of any other unit dosage member of the batch. In yet other configurations, each member of the batch has an IEMD  4  that is associated with a unique communication, at least with respect to all the other ingestible event markers of the members of the batch. For example, each wireless ingestible device IEMD  4  of the batch emits a signal that uniquely identifies that particular wireless ingestible device in the batch, at least relative to all the other ingestible event markers M of the batch and/or relative to a universe of ingestible event markers M. In one configuration, the communication may either directly convey information about a given event, or provide an identifying code, which may be used to retrieve information about the event from a database, for example, a database linking identifying codes with compositions. 
     The IEMD  4  may generate a variety of different types of signals as a marker datum IEM M, including, for example, but not limited to: RF signals, magnetic signals, conductive (near field) signals, acoustic signals, etc. Of interest in certain configurations are the specific signals described in the PCT application serial no. PCT/US2006/16370 filed on Apr. 28, 2006; the disclosures of various types of signals in this application being specifically incorporated herein by reference. The transmission time of the IEMD  4  may vary, where in certain configurations the transmission time may range from about 0.1 microsecond to about 48 hours or longer, for example, from about 0.1 microsecond to about 24 hours or longer, for example from about 0.1 microsecond to about 4 hours or longer, for example from about 1 sec to about 4 hours, including from about 1 minute to about 10 minutes. Depending on the given configuration, the IEMD  4  may transmit a given signal once. Alternatively, the IEMD  4  may be configured to transmit a signal with the same information, for example, identical signals, two or more times, where the collection of discrete identical signals may be collectively referred to as a redundant signal. 
     Various configurations of elements are possible, e.g., dissimilar materials  124 A,  124 B. When in contact with a conducting fluid, a current is generated. A control device  124 C may alter the current. The altered current may be detectable, for example, by a receiving device, etc., and associated with a communication providing a unique IEM, etc., as previously discussed. The dissimilar materials making up the electrodes can be made of any two materials appropriate to the environment in which the identifier will be operating. The dissimilar materials are any pair of materials with different electrochemical potentials. For example, in some configurations where the ionic solution comprises stomach acids, electrodes may be made of a noble metal, e.g., gold, silver, platinum, palladium or the like, so that they do not corrode prematurely. Alternatively, for example, the electrodes can be fabricated of aluminum or any other conductive material whose survival time in the applicable ionic solution is long enough to allow the identifier to perform its intended function. Suitable materials are not restricted to metals, and in certain configurations the paired materials are chosen from metals and non-metals, for example, a pair made up of a metal (such as Mg) and a salt. With respect to the active electrode materials, any pairing of substances, for example, metals, salts, or intercalation compounds, that have suitably different electrochemical potentials (voltage) and low interfacial resistance are suitable. 
     Various other configurations may include other communication-related components, for example, an RFID signal generator, etc. 
     In various aspects, the IEMD  4  communicates an ingestion alert when the medicine  126  is dissolved within a gastrointestinal pathway of the patient  88 . The IEMD  4  is configured to transmit the ingestion alert as a wireless transmission that is detectable by, for example, the cellular telephone  114 , the wireless enabled network computer  116 , the wireless enabled personal digital assistant  118 , and/or the wireless comms system  120 . In addition, the wireless heart rate sensor  94 , the wireless body temperature sensor  98 , and/or the respiration monitor  16  are optionally configured to transmit biometric measurements in a wireless transmission that is detectable by, for example, the cellular telephone  114 , the wireless enabled network computer  116 , the wireless enabled personal digital assistant  118  and/or the wireless comms system  120 . The wireless transmissions, for example, of the IEMD  4 , the wireless heart rate sensor  94 , the wireless body temperature sensor  98 , and/or the respiration monitor  102  alternately or additionally are or comprise radio frequency wave or pulse transmissions and/or light wave or pulse transmissions. 
     Information regarding alternate configurations of the pharmaceutical composition  40  and the IEMD  4  are disclosed in United States Patent Application Publication No. 20080284599, published on Nov. 20, 2008 titled “Pharma-Informatics System”, which is incorporated by reference in its entirety and for all purposes in this document. 
     Referring now generally to the Figures and particularly to  FIG. 13 ,  FIG. 13  is an illustration of a display screen  128  of the cellular telephone  114 , the wireless enabled network computer  116  and/or the wireless enabled personal digital assistant  118  wherein a plurality of icons  129 - 136  are available for user selection. In one configuration, the display screen  128  is a touch screen and the icons  129 - 136  are selected by the application of the patient  88  of finger pressure or body heat. In other configurations, alternately or additionally the patient  88  may select one or more icon by positioning a cursor  138  over an icon  129 - 136  and selecting the icon  129 - 136  over which the cursor  138  is positioned by means of an input device  140  of, for example, the cellular telephone  114 , the wireless enabled network computer  116  and/or the wireless enabled personal digital assistant  118 . The medicine cursor  138  is selected by the patient  88  to indicate a taking of the medicine  126 , for example by an oral or nasal ingestion of one or more pharmaceutical compositions  122 , a topical application of the medicine  126 , or injection or other introduction of the medicine  126  to the patient  88 . Accomplishment icon  130  is selected by the patient  88  to indicate an achievement or an engagement in an activity, for example an athletic session, exercise or event, a hobby, a meditation session, a therapeutic practice or exercise, a leisure activity, a recreational activity, a rehabilitative activity, a period of sleep, a meal consumption, a liquid ingestion, an erotic thought, erotic act, or an occurrence of an aspect of menstruation. 
     Each emotion icon  129 - 136  is selected by the patient  88  to indicate a perception of an associated emotion or a psychological state by the user, for example an emotion or psychological state of happiness, appreciation, kindness, love, joy, fondness, bliss, anger, fear, dread, loathing, anxiety, jealousy, envy, contempt, resentment, perceived pain, perceived pleasure, confidence, insecurity, optimism, pessimism, patience, impatience, attraction, repulsion, clarity, confusion, encouragement, discouragement, a romantic sensation, a sexual arousal, or an erotic sensation. Each sad icon  134 - 135  is selected by the patient  88  to report an occurrence of an undesirable event or condition, for example nausea, diarrhea, anxiety, physical pain, bleeding, or a loss of balance. An external icon  136  may be selected by the patient  88  to indicate a perception of an event or condition external to the patient  88 , for example an inbound phone call or a visit from a friend. It is understood that each icon  129 - 136  may be individually associated with a single emotion, perception, event, process or condition. 
     Referring now generally to the Figures and particularly to  FIG. 14 ,  FIG. 14  is a schematic diagram of the cellular telephone  114 . It is understood that the network computer  106 , the wireless enabled network computer  116 , the wireless enabled personal digital assistant  118  and the wireless comms system  120  may comprise one or all of the elements of the cellular telephone  114 . 
     The cellular telephone  114  includes a central processing unit  142 , or “CPU”  142  and a firmware  144 . The firmware  144  further includes a set of software-encoded instructions comprising a mobile basic input output system  146  used to boot-up the cellular telephone  114 . A power and communications bus  148  (or “mobile bus”  148 ) bi-directionally communicatively couples the CPU  142 , the firmware  144 , a display device interface  150 , the input device  140 , a telephone audio output module  152 , a wireless network interface  154 , a global positioning system module  156 , a telephone system memory  158 , a telephone media writer/reader  160 , a date time circuit stamp  162 , a telephone audio input module  164 , a telephone mechanical vibration module  166 , a small message service module  168 , and an accelerometer  170 . 
     The display interface  150  bi-directionally communicatively couples a display module  172  comprising a telephone display screen  174  with the communications bus  148 . The telephone audio output module  152  accepts digitized information from the bus  148  and derives and generates an audible sound wave output therefrom. 
     An electrical power battery  176  provides energy to the elements  142 - 174  of the cellular telephone  114  via the mobile bus  148 . 
     The wireless network interface  154  bi-directionally communicatively couples the electronics communications bus  146  and the network  2 . The system memory  158  is a random only access memory wherein a mobile telephone system software  178  is maintained and optionally edited or modified by deletion, addition or update of software-encoded instructions. 
     The global positioning system module GPS (hereinafter “GPS module”  156 ) is a communications device that communicates with a global positioning system that comprises earth-orbiting satellites and allows the GPS module  156  to determine coordinates of the location of the GPS module  156  on the earth&#39;s surface. 
     The date/time circuit  162  is bi-directionally communicatively coupled with the communications bus  148  and provides a digitized date time stamp data when polled by the telephone CPU  142 . The date/time circuit  162  further generates time pulses and synchronizing signals that the telephone CPU  142  and the cellular telephone  114  generally, apply to measure the passage of time, time period durations, and to schedule alarms and alerts. 
     The telephone media writer/reader  160  is configured to read, and optionally write, machine readable, computer executable software encoded instructions from a computer program product  180 . The telephone media writer/reader  160  and the associated computer program product  180  are selected and configured to provide non-volatile storage for the cellular telephone  114 . Although the description of computer program product  180  contained herein refers to a mass storage device, for example a hard disk or CD-ROM drive, it should be appreciated by those skilled in the art that computer program product  160  can be any available media that can be accessed by the digital telephone  114 . 
     By way of example, and not limitation, computer program product  180  may be or comprise computer operable storage medium  182  and communication media. Computer operable storage media  182  include, for example, volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer-readable instructions, data structures, program modules or other data. Computer operable storage media include, for example, but are not limited to, RAM, ROM, EPROM, EEPROM, flash memory or other solid state memory technology, CD-ROM, digital versatile disks (“DVD”), or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by the cellular telephone  144 . 
     The computer program product  180  may comprise machine-readable instructions within a computer operable storage medium which when executed by the computer to cause the computer to perform one or more steps as described in the Figures and enabled by the present disclosure, and/or generate, update, maintain and apply one or more data structures. 
     The input device  140  may be or comprise a character input keypad  184  and/or a mouse  186 , or other point and click selection or data input device known in the art. 
     Referring now generally to the Figures and particularly to  FIG. 15 ,  FIG. 15  is a schematic diagram of the mobile telephone system software  178  of the cellular telephone  114 . A mobile device operating system  188  acts as a control layer between the hardware elements  142 - 186  of the cellular telephone  114  and the mobile system software  178  of the cellular telephone  114 . A network communications software  190  enables the wireless network interface  154  to bi-directionally couple the network  2  with internal communications bus  148  and the CPU  142 . A mobile display device driver  192  enables the CPU  142  to direct the state of the telephone display screen  128  to include the rendering of the icons  129 - 136 . A mobile input device driver  194  enables the CPU  142  to accept, execute and interpret commands, instructions, data and selections from the input device  140 . A mobile reader driver  196  enables the CPU  140  to accept, execute and interpret software encoded programs, commands, instructions, data and selections from the computer program product  180 . A graphical user interface driver  198 , or “mobile GUI”  198 , enables the cellular telephone  114  to visually render data, for example, to render the icons  129 - 136 . 
     The mobile telephone system software  178  further includes a data base management system  98  (hereinafter, “mobile DBMS”  200 ) storing a plurality of records  202 .A- 202 .N. and a plurality of logged event data  204 .A- 204 .N (hereinafter, “log”  204 .A- 205 .N). The system software  178  further comprises a plurality of software applications  206 .A- 206 .N. 
     Referring now generally to the Figures and particularly to  FIG. 16 ,  FIG. 16  illustrates a first aspect of a method wherein an exemplary process is represented. In the process of  FIG. 16 , the cellular telephone  114  powers up in step  1600  and displays one or more icons  129 - 136  in step  1602 . The computer determines in step  1604  whether the patient  88  has selected an icon  129 - 136 . When the cellular telephone  114  determines in step  1604  that the patient  88  has selected an icon  129 - 136 , the cellular telephone  114  proceeds on to step  1606  to form an exemplary record  202 .A and store the record  202 .A in the DBMS  188 , wherein the record  202 .A includes an icon identifier and a date/time stamp data generated by the date time circuit  162  and related to the time of selection of the icon  129 - 136 . 
     The cellular telephone  114  determines in step  1608  whether or not to display the information contained or associated with the exemplary record  202 .A in a graphical representation on the display screen  128 . The cellular telephone  114  renders information of the record  202 .A in a visually presented temporal relationship with information contained within or associated with the plurality of logged event data  204 .A- 204 .N. The cellular telephone  114  alternately displays the graphical representation, such as an exemplary graph  181  of  FIG. 18 , in step  1610 , or proceeds on to step  1612 . The cellular telephone  114  determines in step  1612  to return or continue to display the icons  129 - 136  in step  1602 , or to proceed on to step  1614  and cease displaying the icons  129 - 136  in step  1612  and to continue on to perform alternate computational processes. 
     Referring now generally to the Figures and particularly to  FIGS. 17A and 17B ,  FIG. 17A  is an illustration of the exemplary record  202 .A that includes an icon identifier  202 .A. 1 . The date time stamp  202 .A. 2  is generated by the date time circuit  162 . The icon identifier  202 .A. 1  associates the exemplary record  202 .A with an icon  29 - 36 .  FIG. 17B  is an illustration of the exemplary log event data  204 .A that includes a biometric identifier  204 .A. 1 , a measured biometric value  204 .A. 2  and an event date time stamp  204 .A. 3  related to the time of recordation of the event biometric value  204 .A. 2 . In certain exemplary methods, the biometric identifier  204 .A. 1  may associate the exemplary log data  204 .A. with a measurement, for example, of a heart rate, a blood pressure, a body temperature, and/or a respiration, wherein the measured biometric value  204 .A. 2  may be a numeric value of the biometric parameter identified by the biometric identifier  204 .A. 1  of the exemplary log data  204 .A. An optional record information  202 .A. 3  includes additional information provided by the patient  88  via the input module  140 , by uploading from a computer program product  180  and/or by downloading from the network  2 . The record information  202 .A. 3  may include textual information entered from a computer keyboard  184  or mouse  186 . According to even other additional or alternate methods, the record information  202 .A. 3  may optionally be input to the cellular telephone  114  via an audio input module  164  that accepts sound waves and generates digitized recordings therefrom, wherein the digitized recordings may be stored as audio data in the record information  202 .A. 3 . In addition, the audio input and/or a textual interpretation of sound waves received by the audio input module  122  and thereupon stored as text data in the record information  202 .A. 1 . 
     When the icon identifier  202 .A. 1  indicates that the identified icon  132 - 136  specifies an accomplishment, or the record information  202 .A. 3  indicates that that the comprising exemplary record  202 .A identifies an accomplishment, the exemplary record  202 .A is defined as an accomplishment record  202 .A, and the exemplary record information  202 .A. 3  is defined as an accomplishment information  202 .A. 3 . 
     Referring now generally to the Figures and particularly to  FIG. 18 ,  FIG. 18  illustrates a graph  206  wherein a plurality of event log data  204 .A- 204 .N that each datum includes a beats per minute measurement value as the biometric value  204 .A. 2 - 204 .N. 2 . Each biometric value  204 .A. 2 - 204 .N. 2  is plotted within the graph  206  according to its value along a heart rate axis  208 .A and the value of the date time stamp  204 .A. 3 - 204 .N. 3  of the same event log data  204 .A- 204 .N along a time axis  208 .B. In addition, one or more records  202 .A- 202 .N are plotted as events along the same time axis  208 .B, wherein the quality associated with each displayed record  202 .A- 202 -N is presented along the time axis  208 .B. The patient  88  may thus review the graph  206  and observe the temporal relationship between each event documented by a record  202 .A- 202 .N and the biometric data measurement values  204 .A. 2 - 204 .N. 2  contained in the plurality of event log data  204 .A- 204 .N. 
     Referring now generally to the Figures and particularly to  FIG. 19 ,  FIG. 19  is an illustration of an additional or alternate method, wherein the cellular telephone  114  transmits in step  1902  the exemplary record  202 .A via the network  2  to the data base system  108  and/or the diagnostic system  110 . In step  1904  the cellular telephone  114  receives a digitized message that includes a medical advice content via the network  2 . The cellular telephone  114  displays the medical guidance content in the display screen  128  in step  1906 . In a yet other aspect of the method of the  FIG. 19 , the medical guidance content is rendered as an audible signal output through the audio output module  152 . 
     Referring now generally to the Figures and particularly to  FIG. 20 ,  FIG. 20  is an illustration of a still additional or alternate aspect of the method of the of  FIG. 20  wherein the cellular telephone  114  receives one or more event logs  204 .A- 204 .N in step  2002  via the network  2 . The cellular telephone  114  then stores the one or more event logs  204 .A- 204 .N in the mobile DBMS  200  in step  2004 . The one or more event logs  204 .A- 204 .N received in step  2002  will then be included in the next calculation of the graph  206  in the next execution of step  1610 . It is understood that the one or more event logs  204 .A- 204 .N received in step  2002  may include biometric measurement values  204 .A. 2 - 204 .N. 2  that are measures, for example, of heart rate, blood pressure, respiration or body temperature. 
     Referring now generally to the Figures and particularly to  FIGS. 3 and 21 ,  FIG. 21  illustrates a still other additional or alternate method, wherein GPS data collected from the cellular telephone  114  of the patient  88  are used to determine the current and relative level of social interaction in which the patient  88  is engaging. In step  2102  the cellular telephone  114  is associated with the patient  88 . In step  2104  the communications traffic of the cellular telephone  114  is monitored and each phone call is recorded in a session record  210 .A- 210 .N of the patient database  40  of the PMDS  10 . The monitoring of the use of the cellular phone  114  may be accomplished by a telecommunications carrier from whom the patient  88  receives a communications enabling service and/or by monitoring by the wireless comms system  120 . The session records  210 .A- 210 .N and the patient database are transmitted to, stored in, and made accessible for review to a diagnostician at the diagnostic system  110  and/or the data base computer  108  in step  2106 . The diagnostician determines in step  2108  that the level of social interaction indicates an increased risk of degradation in the state of mental health of the patient  88 , the diagnostician then determines in step  2110  whether or not to issue an alarm to alert the patient  88  or third parties of a potential decline in mental health. An alarm is transmitted to and rendered in step  2112  by the cellular telephone  114  in optional step  1012 . Additionally or alternatively, the diagnostician may in step  2114  generate a therapeutic recommendation, e.g., a diagnosis of, study of, analysis of, determination of or a prescription regarding, one or more health issues of the patient  88  in step  2114 , and optionally the medical advice generated in step  2114  is transmitted to and rendered by the cellular telephone  114  in step  2116 . It is understood that either or both the alarm transmitted and rendered in step  2112  and the advice transmitted and rendered in step  2116  may optionally, alternatively or additionally be sent to and rendered by the cellular telephone  114 , the first network computer  106 , the wireless-communications enabled network computer  116  and/or the wireless-communication enabled personal digital assistant  118  in whole or in part. 
     Referring to  FIGS. 14, 15 and 21 , it is understood that the cellular telephone  114  may have a plurality of pre-recorded ringtone records  212 . The alarm of step  2112  may be rendered by the cellular telephone  114  generating a sound energy as derived from a digitized alarm tone record  214 , wherein the sound generated is distinctive to the patient  88  from the sounds generated by the cellular telephone by rendering from one of the ringtones records  212 . Alternatively or additionally, the alarm of step  2112  may direct the cellular telephone  114  to energize the vibration module  166  with the aim to attract the attention of the patient  88 . 
     The medical advice transmitted and received by the cellular telephone  114  in step  2116  may be included in whole or in part in an audio message  216  that may be rendered by audible output module  152  for the patient  88  to listen to, and/or by a textual message  218  that the patient  88  may read from the display screen  128 . 
     Additionally or alternatively, the textual message  218 , some or all of the therapeutic advice of step  2116 , and/or the alarm  2112  may be transmitted to the cellular telephone  114  by means of a text messaging service or a small message service as received and rendered by the SMS module  168  of the cellular telephone  114  and enabled via the TELCO  112  by a telephone services provider, for example, AT&amp;T™ text messaging service or small message service provider. 
     Referring now generally to the Figures and particularly to the  FIGS. 3 and 22 , in yet another alternate or additional method, the diagnostician applies in the process of  FIG. 22  an activity monitor process of the diagnostic system  110  to generate a communications activity baseline  220  of telephone communications and compares the baseline with a calculation of recent telephone communications to generate a current communications frequency to determine if the current telephone use of the patient  88  is indicative of an increased risk of the patient entering into a declining state of mental health, for example, in certain circumstances, decreased sociability may be an early indicator of declining mental state or other conditions. In step  2202  the diagnostic system  110  counts the number of phone calls C 1  placed by the patient  88  over a first length of time T 1 , for example, over the preceding three months. In step  2204  the diagnostic system  110  calculates a baseline ratio R 1  of placed phone calls C 1  as divided the first length of time T 1 . The baseline ratio R 1  is thus one instantiation of the communications activity baseline  220 . 
     In step  2206  the diagnostic system  110  determines the number of telephone calls C 2  placed by the patient  88  over a shorter and more recent second period of time T 2 , for example, over the most recent five-day period. In step  2208  the diagnostic system then calculates a current ratio R 2  equal to the number of more recently placed phone calls C 1  as divided the second length of time T 2 . 
     In step  2210  the diagnostic system  110  divides the current ratio R 2  by the baseline ratio R 1  and determines whether the result of this division is less than a first indicator value V 1  of, for example, 0.70. In one exemplary application of the process of  FIG. 22 , the first indicator value V 1  is 0.70, the first ratio R 1  indicates the number of telephone calls placed by the patient  88  via the cellular telephone  114  per unit time during the most recent three months, and the second ratio R 2  indicates the number of telephone calls placed by the patient  88  via the cellular telephone  114  per unit time during the most recent five day period, whereby if the frequency of phone call placed by the patient  88  dips below 70% of the frequency of telephone calls exhibited by the patient  88  in the most recent three month period, the diagnostic system  110  issues an alert to patient  88  in step  2212  as described above in the process of  FIG. 21 . It is understood that the alert of step  2212  may be issued by either direction of the diagnostician or by an automatic activity monitor logic  223  of the diagnostic system  110 . It is further understood that the activity monitor logic  223  may calculate C 1  and/or C 2  by calculated number of telephone calls placed from the cellular telephone  114  summed with the number of telephone calls received through the cellular telephone  114 . It is further understood that the activity monitor logic  223  may calculate C 1  and/or C 2  by including the number of attempted telephone calls placed from the cellular telephone  114 . It is further understood that the activity monitor logic  223  may calculate C 1  and/or C 2  by additionally or alternately by counting the number of text messages sent to and/or from the cellular telephone  114 . 
     It is further understood that the diagnostician may provide therapeutic guidance to the patient  88  as an element of the transmitted alarm of step  2212  in steps  2210  through  2216 , as per steps  2112  through  2116  of  FIG. 21 . 
     Referring now generally to the Figures and particularly to  FIG. 23 ,  FIG. 23  is a schematic of a diagnostic system software  222  of the diagnostic system  110 . The diagnostic system software  222  includes a diagnostic system operating system  224  and the patient DBMS  40  that stores a plurality digitized software encoded records of one or more ringtones records  212 , alarm tone records  214 , audio message records  216 , and/or text messages  218  that may be transmitted via the network  2  to the cellular telephone  114 . The patient DBMS  40  may include a plurality of call records  226 .A- 226 .N, a plurality of GPS records  228 .A- 228 .N, a plurality of text messages records  230 .A- 230 .N and the GPS baseline data  220 . The plurality of call records  226 .A- 226 .N, plurality of GPS records  228 .A- 228 .N and plurality of text message records  218  may be provided to the diagnostic system  110  via the network  2  by the TELCO  112  and/or the telecommunications network services provider. 
     Referring now generally to the Figures and particularly to  FIGS. 24A, 24B and 24C ,  FIG. 24A  is a schematic diagram of an exemplary first phone call record  224 .A selected from the plurality of call records  226 .A- 226 .N provided by or the via the TELCO  112  by the telephone services provider. Each phone call record  226 .A- 226 .N contains information related to an individual communication session that is enabled by the network  2 . It is understood that a communication session may be enabled by the Internet  2 B by voice over Internet Protocol technology and/or by the telephony network  2 B. The information contained within the plurality of phone call records  226 .A- 226 .N may be provided by or via the TELCO  112  by the telephone services provider in whole or in part. 
     The exemplary first call record  226 .A relates to a first communications session, for example, an “instant communications session”. A phone identifier  226 .A. 1  identifies the cellular telephone  114 . The phone identifier  226 .A. 1  may be, for example, a telephone number or a network address, or may be another telephone (not shown) or a network address of a computer  106 ,  116 . A second phone identifier  226 .A. 2  identifies a second telephone (not shown) or a computer  106  or  116 . It is understood that the second phone identifier  226 .A. 2  may be a telephone number or a network address, or may be a reference number to the second telephone or a computer  106  or  116  that is issued to protect the privacy of another party. An origin flag  226 .A. 3  indicates whether the instant communications session was initiated by the means of either (a.) the cellular telephone  114 , or (b.) the computer  106  or other computer  116 . A call start data  226 .A. 4  identifies the start time of the instant communications session. A call duration data  226 .A. 5  documents the length of time of the instant communications session. A GPS data  226 .A. 6  includes a global position system data that indicates the location of the cellular telephone  114  at the start time of the instant communications session or at a moment during the duration of the instant communications session. The GPS data  226 .A. 6  may be generated by the GPS module  156  of the cellular telephone  114  in concert with information received from a global positioning system. 
     Referring now generally to the Figures and particularly to  FIG. 24B ,  FIG. 24B  is a schematic diagram of an exemplary first GPS record  228 .A. A phone identifier  228 .A. 1  identifies the cellular telephone  114 . A GPS sampling data  228 .A. 2  includes a global position system data that indicates the location of the cellular telephone  114 . A GPS time data  228 .A. 3  indicates a time and date that the GPS sampling data  228 .A. 2  was acquired by the cellular telephone  114 . 
     Referring now generally to the Figures and particularly to  FIG. 24C ,  FIG. 24C  is a schematic diagram of an exemplary first text message record  228 .A selected from the plurality of text session records  230 .A- 230 .N. Each text record  230 .A- 230 .N contains information related to an individual texting session that is enabled by the network  2 . It is understood that a communications session may be enabled by the Internet  2 B by various technologies, for example, Voice Over Internet Protocol (VoIP) technology, the telephony network  2 A, etc. The information contained within the plurality of text records  230 .A- 230 .N may be provided by or via the TELCO  112  by the telephone services provider in whole or in part. 
     The exemplary text session record  230 .A relates to a first text session, i.e., an “instant text session”. A phone identifier  230 .A. 1  identifies the cellular telephone  114 . A second phone identifier  230 .A. 2  identifies a second telephone (not shown) or a computer  106  or  116  that participated in the instant text message. A text time data  230 .A. 3  identifies a time of initiation or completion of the instant text message session. An origin flag  230 .A. 4  indicates whether the instant communications session was initiated by the means of either, for example, (a.) the cellular telephone  114 , or (b.) the computer  106  or other computer  116 . 
     Referring now generally to the Figures and particularly to  FIG. 25 ,  FIG. 25  illustrates a still other additional or alternate method, wherein GPS data collected from the cellular telephone  114  of the patient  88  is used to determine the current and relative level of social interaction in which the patient  88  is engaging. In step  2502  the cellular telephone  114  is associated with the patient  88  and monitored. The GPS module  156  of the cellular telephone  114  is periodically sampled and each sampled GPS datum is recorded in an individual GPS record  228 .A- 228 .N of the patient DBMS  40 . The monitoring of the use of the cellular phone  114  may be provided by or via the TELCO  112  by the telephone services provider in whole or in part, for example, in step  2504  during a phone session, from which the patient  88  receives a text enabling service and/or by monitoring by the wireless comms system  120 , etc. The GPS records  228 .A- 228 .N and the patient database  40  are transmitted to, stored in, and made accessible for review to a diagnostician at the diagnostic system  110  and/or the data base computer  108 . The diagnostician determines in step  2508  that the level of social interaction indicates an increased risk of degradation in the state of mental health of the patient  88 , the diagnostician then determines in step  2510  whether or not to issue an alarm to alert the patient  88  or third parties of a potential decline in mental health. An alarm is transmitted to and rendered in step  2512  by the cellular telephone  114  in optional step  2512 . Additionally or alternatively, the diagnostician may in step  2514  generate a therapeutic recommendation, for example, a diagnosis of, or a prescription regarding, one or more health issues of the patient  88  in step  2514 , and optionally the medical advice generated in step  2516  is transmitted to and rendered by the cellular telephone  114 . It is understood that either or both the alarm transmitted and rendered in step  2512  and the advice transmitted and rendered in step  2516  may optionally, alternatively or additionally be sent to and rendered by the cellular telephone  114 , the first network computer  106 , the wireless-communications enabled network computer  116  and/or the wireless-communication enabled personal digital assistant  118  in whole or in part. 
     It is understood that the cellular telephone  114  may have a plurality of pre-recorded standard ringtones records  212 . The alarm of step  2112  may be rendered by the cellular telephone  114  generating a sound energy as derived from an alarm tone record  212 , wherein the sound generated is distinctive to the patient  88  from the sounds generated by the cellular telephone  114  by rendering from one of the ringtones records  214 . Alternatively or additionally, the alarm of step  2512  may direct the cellular telephone  114  to energize the vibration module  166  with the aim to attract the attention of the patient  88 . 
     The medical advice transmitted and received by the cellular telephone  114  in step  2516  may be included in whole or in part in an audio message record  216  that may be rendered by audible output module  152  for the patient  88  to listen to, and/or by a textual message record  230  that the patient  88  may read from the display screen  128 . 
     Additionally or alternatively, the textual message  230 , some or all of the therapeutic advice of step  2116 , and/or the alarm  2112  may be transmitted to the cellular telephone  114  by means of a text messaging service or a small message service as received and rendered by an SMS module  168  of the cellular telephone  114  and may be provided in whole or in part by or via the TELCO  112  by the telephone services provider. 
     Referring now generally to the Figures and particularly to the  FIG. 26 , in yet another additional or alternate method, the diagnostician applies a mobility monitor logic  232  of the diagnostic system  110  to generate the GPS baseline  220  derived from the telephone GPS information of the plurality of GPS records  226 .A- 226 .N and compares the GPS baseline  220  with a more recent plurality of GPS readings to determine if the mobility of the patient  88  is indicative of an increased risk of the patient entering into a reduced state of mental health. In step  2602  the diagnostic system  110  examines the GPS records  228 .A- 228 .N containing GPS information collected over an extended length of time T 3 , for example, over the preceding three months. In step  2604  the diagnostic system  110  calculates the GPS mobility baseline  220  indicative of the movement presented by the patient  88  during the extended time C 3 , for example, an extended mobility value M 1 . 
     In one alternate aspect of the method of  FIG. 26 , the mobility baseline  220  is automatically calculated by (a.) selecting a plurality of GPS records  228 .A- 228 .N; (b.) ordering the GPS records  228 .A- 228 .N in order of the GPS time data  228 .A. 3 - 228 .N. 3 ; (c.) calculating the distance between each ordered GPS records  228 .A- 228 .N by straight line measurements between succeeding each ordered GPS location data  228 .A. 2 - 228 .N. 2 ; (d.) summing the distances measured in the previous step; and dividing the distance measurement by a length time measured between the earliest GPS time data  228 .A. 3 - 228 .N. 3  and the most recent GPS time data  228 .A. 3 - 228 .N. 3  of the selected plurality of GPS records  228 .A- 228 .N. 
     In step  2604  the diagnostic system  110  examines the GPS records  228 .A- 228 .N containing GPS information collected over a shorter and recent mobility period of time T 4 , for example, over the most recent five day period, and calculates a recent mobility value M 1  in step  2604 . In step  2606  the diagnostic system  110  examines the GPS records  228 .A- 228 .N containing GPS information collected over a greater period of time and calculates an extended time period mobility value M 2   
     In step  2608  the diagnostic system  110  calculates a current mobility ratio R 3  equal to the recent mobility value M 1  divided by the extended mobility value M 2 . 
     In step  2610  the diagnostic system  110  compares the current mobility ratio R 3  to a level L. In one exemplary application of the measurement of the patient&#39;s recent mobility dips below 70% the patient&#39;s estimated mobility as expressed by the mobility baseline  220 , the diagnostic system  110  issues an alert to patient  88  in step  2612  as described above in the process of  FIG. 25 . It is understood that the alert of step  2612  may be issued by either direction of the diagnostician or by the mobility monitor logic  232 . It is further understood that the diagnostician may provide therapeutic guidance to the patient  88  as an element of the transmitted alarm of step  2612  in steps  2620  through  2216 , and as per steps  2512  through  2520  of  FIG. 25 . 
     Referring now generally to the Figures and particularly to  FIG. 27 ,  FIG. 27  is a process chart of an even other additional or alternate method, wherein the cellular telephone  114  is programmed to render a distinctive ringtone record  212 , alarm tone record  214 , audio message record  216 , and/or text message record  218  to alert the patient  88  to take a medication, engage in a medically recommended behavior, or cease a behavior. In step  2702  the cellular telephone  114  determines if a programmer, for example, the patient  88 , the diagnostician, a health care provider, or other party, has input a command to place the cellular phone  114  into an alert programming mode. When the cellular telephone  114  determines in step  2702  that the programmer has input a programming command, the cellular telephone  114  proceeds to step  2704  and accepts a selection of an alert selection from the programmer, where the alert selection may be indicated from a group including for example, but not limited to, a distinctive ringtone record  212 , alarm tone record  214 , audio message record  216 , and/or text message record  218 . In step  2706  the cellular telephone  114  accepts an alert time from the programmer which indicates at which time the cellular telephone  114  is to render the selected alert. The cellular telephone  114  proceeds from step  2706  to step  2708  to access the date/time circuit  162  and in step  1610  to determine whether the alert time has passed. When the cellular telephone  114  determines in step  2710  that the alert time has occurred, the cellular telephone  114  proceeds on to step  712  and renders the selected alarm, wherein such rendering may include an excitation of, for example, the vibration module  166 , a sound generated from ringtone record  212 , alarm tone record  214 , and/or audio message record  216  by means of the audio output module  152 , and/or text message record  218  by means of the display device  156 . The cellular telephone  114  proceeds from either step  2710  or step  2712  to determine whether to cease the alert cycle in step  2714 . When the cellular telephone  114  determines in step  2714  to cease the alert cycle of steps  2708  and  2710 , the cellular telephone  114  proceeds on to step  2716  and performs additional or alternate computational operations, which may include a return to step  2702  at a later time. When the cellular telephone  114  determines in step  2714  to continue to execute the alert cycle of steps  2708  through  2714 , the cellular telephone  114  proceeds on to step  2718  and performs additional or alternate computational operations before performing another comparison of the programmed alert time of step  2710  with the real time as indicated by a current output of the date/time circuit  162  execution of step  2708 . 
     It is understood that the alert rendered in step  2710  may encourage the patient to inhale a second medication  240  or to apply a topical medication  242  to a skin area  244  of the patient  88 . 
     Referring now generally to the Figures and particularly to  FIG. 28 ,  FIG. 28  illustrates a still further alternate additional or alternate method, wherein the cellular phone  114  is programmed to remind the patient  88  to take, for example, ingest, inhale, insert or topically apply, etc., one or more medications  126 . The phone  114  initializes a resting time variable TD to a current date and time reading received from the date/time circuit  162  in step  2802 . The phone  114  then proceeds to step  2804  to perform alternate computational operations, and periodically returns to step  2806  to determine whether to query the accelerometer  170  to determine whether the accelerometer  170  has detected motion since the most recent execution of step  2802 . When the phone  114  determines in step  2806  that the accelerometer  170  indicates motion of the phone  114  since the most recent execution of step  2802 , the phone  114  proceeds on to step  2808  to determine whether the time elapsed between the current value of the resting time variable TD and a newer and actual date and time reading TA received from the date/time circuit  162  is greater than a sleep time value TS, for example, wherein the sleep time value is a value preferably between the time durations of four hours and eight hours. When the phone  114  determines in step  2808  that the accelerometer  170  has not detected motion for a period of time greater than the sleep time value TS, the phone  114  proceeds on to step  2810  and to render an alert to encourage the patient  88  to take one or more medications, e.g., medicine  126 ,  240  and  242 . 
     It is understood that the motion detector  23  of  FIG. 1  may be, include, or be comprised within, an accelerometer  170 , a GPS module  156 , or a cellular telephone  114 . 
     When the cellular telephone  114  determines in step  2808  that the alert time has occurred, the cellular telephone  114  proceeds on to step  2810  and renders the selected alarm, wherein such rendering may include, for example, an excitation of the vibration module  166 , a sound generated from ringtone record  212 , alarm tone record  214 , and/or audio message record  216  by means of the audio output module  152 , and/or text message record  218  by means of the display device  156 . 
     The cellular telephone  114  proceeds from either step  2810  or step  2812  to determine whether to cease the alert cycle of steps  2800  through  2812 . When the cellular telephone  114  determines in step  2812  to cease the alert cycle of steps  2800  through  2812 , the cellular telephone  114  proceeds on to step  2814  and performs additional or alternate computational operations, which may include a return to step  2802  at a later time. 
     Referring now generally to the Figures and particularly  FIG. 29 ,  FIG. 29  is a schematic of a first exemplary patient record  232 .A selected from a plurality of patient records  232 .A. 1 - 232 .A.N that are stored in the patient DBMS  40  and/or the mobile DBMS  200  as stored in the cellular telephone  114 , the DB computer  108 , and/or the diagnostic system  110 . The first exemplary patient record  232 .A includes a patient identifier  232 .A. 1 , a phone identifier  232 .A. 2 , a biometric data field  232 .A. 3 , an ingestion record  232 .A. 4 , a patient reminder instructions data field  232 .A. 5 , and a behavior data field  232 .A. 6 . The patient identifier  232 .A. 1  uniquely identifies the patient  88  to the DBMS  178  and  206 .The phone identifier  232 .A. 2  uniquely identifies the phone  114  to the DBMS  178  and  206 . The biometric data field  232 .A. 3  includes biometric data received from the sensors  20 - 23  and  98 - 104  with associated time date stamps generated by the time/date circuit  162  wherein each date time stamp individually identifies the time of generation of an associated biometric datum. The ingestion record  232 .A. 4  includes data identifying medicines taken, for example, inhaled, applied, inserted, ingested, etc., with associated time date stamps generated by the time/date circuit  162  wherein each date time stamp individually identifies the time of generation of a comprising ingestion record. The patient reminder instructions data field  232 .A. 5  includes instructions directing the phone  114  to when and how to render an alert to encourage the patient  88  to perform a specified meditative practice, a relaxation practice, and/or a therapeutic behavior. The behavior data field  232 .A. 6  includes data noting a performance of a meditative practice, a relaxation practice, a therapeutic behavior, and/or other practice or behavior of the patient  88 , with associated time date stamps generated by the time/date circuit  162  wherein each date time stamp individually identifies the time of the referenced performance or behavior. 
     Referring now generally to the Figures and particularly to  FIG. 30 ,  FIG. 30  illustrates an even additional or alternate method, wherein a patient record  232 .A- 232 .N is applied by the phone  114  to record biometric data received from one or more sensors  20 - 23  and  98 - 104  and to send alerts to encourage the patient  88  to perform meditative exercises, relaxation exercises, or other therapeutic behaviors. In step  3002  the phone  114  receives notice of a taking of a medication, e.g., medicine  126 ,  240  or  242 , and records the medicine application datum with an associated time date stamp in the ingestion records data field  232 .A. 4  of the exemplary first patient record  232 .A. In step  3004  the phone  114  issues an alert to the patient in accordance with information stored in the reminder message instructions  232 .A. 5 . In step  3006  the phone  114  receives a biometric datum received from one or more sensors  20 - 23  and  98 - 104 , and records the received biometric datum with an associated time date stamp in the biometric data field  232 .A. 3 . It is understood that the biometric datum might be (a.) a measure of blood pressure or hypertension generated by and received from the blood pressure sensor  90 ; (b.) a measure of heart rate generated by and received from the heart rate sensor  94 ; (c.) a measure of body temperature generated by and received from the temperature sensor  98 ; and/or (d.) a measure of respiration generated by and received from the respiration sensor  102 . 
     In step  3008 , the data stored in the exemplary first patient data record  232 .A is visually presented to the patient  88  via the display screen  128  by the GUI driver  198  and optionally as described in reference to  FIG. 18 . This presentation of step  3008  is executed with the intent to provide feedback to the patient  88  of the effect that the behavior of the patient  88  is having on the physiological state of the patient  88 , whereby the patient  88  is encouraged to follow the practices. e.g., making a pause, avoiding a situation, taking a pill, etc., to achieve a prescribed behavior, e.g., cool, calm, composed, etc., and behavior specified by the reminder message instructions  232 .A. 5 . 
     The phone  114  determines in step  3010  whether to continue performing the cycle of steps  3000  through  3008 , or to proceed on to alternate computational processes of step  3014 . When the phone  114  determines in step  3010  to continue performing the cycle of steps  3000  through  3008 , the phone proceeds on to step  3012  and to determine whether instructions to the patient  88  of a dosage of a medicine  126 ,  240  and  242 , a schedule of taking a medicine  126 ,  240  and  242 , or a recommended patient practice or behavior. When a therapeutic alteration is determined in step  3012 , the phone  114  proceeds on to step  3016  and to alter information stored in the reminder message instructions  232 .A. 5 . The phone  114  then proceeds from step  3016  on to step  3002 . 
     It is understood that the biometric datum received in one or more executions of step  3006  may be received by (a.) wireless transmissions from the wireless comms system  120 , and/or a wireless enabled sensor  20 - 23 ,  90 ,  94 ,  98  and  102 ; and/or (b.) a hardwired connection with the network  2 . It is further understood that a notice of an ingestion of the composition device  122  may be received by the phone  114  as transmitted wirelessly from the IEMD  4  and/or the wireless comms system  120 . 
     It is additionally understood that the alteration of information stored in the reminder message instructions  232 .A. 5  as performed in step  3016  may be directed and provided by a health care professional as input from the DB computer  108  and/or the diagnostic system  110 . 
     Referring now generally to the Figures and particularly to  FIG. 31 ,  FIG. 31  describes another additional or alternate method, wherein high stress events that occur routinely in the life of the patient are identified and the phone  114  is programmed to encourage the patient  88  to follow or perform therapeutic or prescribed steps or instructions to reduce the harmful impact of the stress inducing events. In step  3102  a plurality of patient records  232 .A- 232 .N are formed by observing and storing the readings of the sensors  20 - 23 ,  90 ,  94 ,  98  and  102 . In step  3104  patient activity logs  168  are formed and populated with data, wherein the patient  88  records time and dates and descriptions of daily events experienced by the patient  88 . The patient activity logs  168  may be populated from inputs by the patient  88  to the phone  114 , the PDA  118 , and/or the wireless computer  116 . The diagnostician or other health care professional analyzes the plurality of patient logs  232 A- 232 N in comparison with the patient records  232 .A- 232 .N to isolate and find patterns between sensory indications of physiological stress experienced by the patient  88  and predictable events in the life of the patient, e.g., meetings with supervisors, subordinates, or family members. The diagnostician or health care professional then determines those events that can be anticipated and lead to high stress conditions for the patient  88  in step  3108 . The diagnostician then programs the phone  114  to issue a message to the patient prior to one or more anticipated stress-inducing event. The diagnostician or health care professional programs the phone  114  in step  3110  via the diagnostic system  110  and the network  2 . The diagnostician or health care professional determines in step  3112  whether to continue the loop of steps  3102  to  3112  or to proceed on to alternate processes of step  3114 . 
       FIG. 29  is a schematic of an exemplary patient activity log  232 A that includes the patient ID  232 .A. 1 , the phone ID  232 .A. 2 , and a plurality of activity notes  232 A. 1 - 232 A.N. Each activity note  232 A. 1 - 232 A.N contains a notation by the patient  88  of the date, time and nature of an activity experienced by the patient  88 , e.g., arrival at work, commuting experiences, physical exercise, social interactions, and work related behavior. 
     Referring now generally to the Figures and particularly to  FIG. 32 ,  FIG. 32  describes a yet additional or alternate method, wherein the diagnostician analyzes information about diagnostic test results, genetic test results, patient records  232 .A- 232 .N, patient activity logs  232 A- 232 N, and other information to develop and prescribe therapy. One or more diagnostic tests are performed in step  3202 . The results of these diagnostic tests are stored in the diagnostic system  110  in step  3204  in one or more diagnostic test records  236 .A- 236 .N. One or more genetic tests are performed in step  3206 . The results of these genetic tests are stored in the diagnostic system  110  in step  3208  in one or more genetic test records  252 .A- 252 .N. The diagnostician then analyzes the diagnostic test records  236 .A- 236 .N, the genetic test records  252 .A- 252 .N, the patient records  232 .A- 232 .N, the patient activity logs  232 A- 232 N, and other information in step  3210  by means of the diagnostic system  110 . The diagnostician then updates a therapeutic plan in step  3212 , and programs the cell  114  to transmit alerts and alarms to the patient  88  in step  3314  that are designed to encourage the patient  88  to comply with the prescribed therapy of step  3312 . 
     The diagnostician or health care professional determines in step  3316  whether to continue the loop of steps  3302  to  3316  or to proceed on to alternate processes of step  3318 . 
       FIG. 34  is a schematic of an exemplary first diagnostic test record  236 .A that includes the patient ID  232 .A. 1 , the phone ID  232 .A. 2 , and a plurality of diagnostic test notes  236 .A. 1 - 236 .A.N. Each diagnostic test note  236 .A. 1 - 236 .N contains information identifying a diagnostic test, a time and date of the diagnostic test, and the results of the diagnostic test. 
       FIG. 35  is a schematic of an exemplary first genetic test record  238 .A that includes the patient ID  232 .A. 1 , the phone ID  232 .A. 2 , and a plurality of genetic test notes  238 .A. 1 - 238 .A.N. Each genetic test note  238 .A. 1 - 238 .N contains information identifying a genetic test, a time and date of a performance of the genetic test, and the results of the genetic test. 
       FIG. 36  is a schematic illustrating the diagnostic system software  222  as containing the patient records  232 .A- 232 .N, the patient activity logs  234 .A- 234 .N, the diagnostic records  236 .A- 236 .N and the genetic records  238 .A- 238 .N. 
       FIG. 37  is a schematic of the patient  88  being monitored by additional sensors  240  and  242 . An impedance sensor  240  is in contact with a second skin area  244  of the patient. The impedance sensor  240  is configured and positioned to detect variations in dermal impedance of the patient  88  that are generally determined by sweat forming on the second skin area  244 . An electrocardiograph sensor  242  (or “ECG sensor”  242 ) is configured and positioned relative to the patient  88  to measure the electrical activity of the heart  246  of the patient  88 . 
       FIG. 38  is a schematic diagram of the exemplary heart rate sensor  94 . The heart rate sensor  94  includes a biometric detector  94 A, a logic circuit  94 B, a wireless interface  94 C, a signal emitter  94 D, and a battery  94 E that are all mounted onto a flexible band  94 F. The biometric sensor  94 A monitors and measures the heart rate of the patient  88  and communicates the heart rate measurement to the logic circuit  94 B. The logic circuit  94 B formats and populates a biometric data message and directs the wireless interface  94 C to transmit the biometric message in a wireless transmission via the emitter  94 D. It is understood that the emitter  94 D may be a radio wave antenna or a light pulse emitter. The emitter  94 D is configured to transmit the biometric message for successful reception by the phone  114 , the wireless computer  116 , the PDA  118  and/or the wireless comms system  120 . The battery  94 E provides electrical power to the biometric detector  94 A, the logic circuit  94 B, the wireless interface  94 C and the signal emitter  94 D. 
     A first strap  94 G and a second strap  94 H are each separately coupled with the flexible band and enable the heart rate sensor to be detachably coupled to the patient  88 . A first hook and loop fabric strip  941  and a second hook and loop fabric strip are positioned to detachably engage and hold the flexible band  94 E against a skin area  163  and  176  of the patient  88 . Alternatively or additionally an adhesive strip  94 L of the flexible band  94 F is configured and positioned to enable detachable placement of the flexible band against a skin area  163  and  164  of the patient  88 . 
     It is understood that the illustration of the heart sensor  94  of  FIG. 37  is exemplary and is descriptive in part of other sensors  20 - 23 ,  94 ,  98 ,  102 ,  240  and  242 . 
     Referring now generally to the Figures and particularly to  FIG. 39 ,  FIG. 39  illustrates another still additional or alternate method, wherein the diagnostician receives and analyzes information and advises the patient  88  with therapeutic guidance. In step  3902  the phone  114  receives accelerometer data from the accelerometer  170 . The phone  114  transmits the received accelerometer data to the diagnostic system  110  in step  3904 , wherein the accelerometer data is stored in a movement record  248 .A- 248 .N. The diagnostic system  110  calculates a walking gait of the patient  88  by analyzing a plurality of movement records  248 .A- 248 .N and stores the gait calculation in step  3906 . The phone  114  receives skin impedance data from the impedance sensor  240  and transmits the received impedance data to the diagnostic system  110  in step  3908 . The phone  114  receives electrocardiograph data from the ECG sensor  242  and transmits the received electrocardiograph data to the diagnostic system  110  in step  3910 . The phone  114  receives body temperature data from the temperature sensor  98  and transmits the received body temperature data to the diagnostic system  110  in step  3912 . 
     The diagnostic system  110  displays the gait calculated and the data received in steps  3904 , and  3908 - 3912  to the diagnostician in step  3914  on the display screen  128  as rendered by the GUI driver  176 . The diagnostician analyzes the displayed information and communicates diagnostic information, prognostic information, and therapeutic guidance to the patient in step  3916  via the network  2 . 
     The diagnostician determines in step  3918  whether to continue the loop of steps  3902  through  3918  or to proceed on to alternate activities of step  3920 . 
     Referring now generally to the Figures and particularly to  FIGS. 22 and 40 ,  FIG. 40  illustrates another even additional aspect of a method, wherein the patient is encouraged by yet other engagement modalities to adhere to a prescribed ingestion of the medicine  126 . In step  4002  the phone  114  determines whether the IEMD  4  has emitted an ingestion signal. When the phone  114  determines in step  4002  that the IEMD  4  has emitted an ingestion signal, the phone  114  informs the DB computer  108  via the network  2  in step  4004  an ingestion signal has been received. The DB computer  108  then updates a virtual pet status in step  4006  in accordance with the information transmitted in step  4004 . The virtual pet status is an aspect of a virtual pet personality software  254  is maintained by a virtual world web service  256  that is hosted on a virtual world services server  258 . The virtual world services server  258  is accessible to the phone  114  through the network  2 , and the virtual pet personality software  254  maintains status and conditions on the basis of instructions from the virtual world web service  256  and from the patient  88  and the DB computer  108  as delivered via the network  2  to the virtual world services server  256 . 
     The DB computer  108  further determines in step  4008  whether with the information transmitted in step  4004  in combination with additional information related to the patient and stored in the patient data base  40  indicates that the patient  88  has earned a reward or achieved a new reward state or level. When the DB computer  108  determines in step  4008  that the patient  88  has earned a reward, the reward is issued in step  4010 . The reward of step  4010  may be as modest as directing the phone  114  to vibrate, visually display a congratulations message, and/or render a pleasant audible tone or musical tune. The reward of step  4010  may also include making provisions for delivery of a physical coin, medallion, or crystal. The reward of step  4010  may alternatively or additionally include (a.) providing the patient  88  with a ringtone data or file; (b.) rewarding the patient  88  with a music download service at no extra charge; and/or (c.) a delivery of a hard copy note of congratulations. In various aspects, the rewards may be provided by, or otherwise associated with, one or more reward/incentive sources. Such sources may include, for example, proprietary reward systems, e.g., developed in conjunction with or for aspects of the invention, and existing reward systems, e.g., commercial incentive or reward systems such as point systems, coupon systems, etc., associated with one or more independent providers. 
     In optional step  4012  the DB computer  108  informs an online community of the achievement and/or status of the patient  88  via the network  2 . The DB computer  108  in step  4014  whether to continue the loop of steps  4002  through  4014  or to proceed on to perform alternate computational activities of step  4016 . 
     Referring now generally to the Figures and particularly to  FIG. 41 ,  FIG. 41  illustrates another even additional process wherein the patch receiver  122  is attached or coupled to the patient  88 , or clothing or personal equipment of the patient  88  in step  4102 . The biometric data received by the patch receiver  122  is monitored during a first time period T 1  in step  4104 . The biometric data received in step  4104  is stored in the patient database  40  in step  4106 . The biometric data received by the receiver patch  122  is then monitored during a second time period T 2  in step  4108 . In step  4110  the biometric data received by the path receiver  122  e.g., from the one or more IEMD  4 , during the first time period T 1  and second time period T 2  is compared by a diagnostician and/or the activity monitor logic  223 . The diagnostician and/or the activity monitor logic  223  then determines in step  4112  whether a predetermined action shall be taken at least partly on the basis of the comparison of step  4112  of the behavior of the one or more IEMD  4  that transmit an ingestible event marker datum IEM M during the first time period T 1  and the second time period T 2 . The predetermined action, such as transmitting an alert to the patient  88  via the cellular telephone  114  or informing a healthcare provider of the state of the patient  88 , is affected in step  4114 . 
     In various aspects, a system is provided, for example and as illustrated in  FIG. 42 , a system  4200  may include a biometric information module  4202  to receive biometric information associated with an ingestible event marker datum IEM M; an analysis module  4204  to analyze the biometric information; and a determination module  4206  to determine a therapeutic recommendation at least partly on the basis of the analysis. Biometric information includes any data and/or information associated with living being, e.g., physiologic information such as heart rate, blood pressure, etc.; subA skilled artisan will recognize that the modules may be standalone or integrated in various combinations. Further, one or more modules may be implemented as software modules, as hardware, as circuitry, etc. 
       FIG. 43  illustrates a unified system  4300  to facilitate adherence to a treatment plan which may include a biometric information module  4202  to receive biometric information associated or contained within an ingestible event marker datum IEM M; an analysis module  4204  to analyze the biometric information; and the determination module  4206  to determine a therapeutic recommendation at least partly on the basis of the analysis. The patient management data system  10  is optionally comprised within the unified system  4300  and may be communicatively coupled with all other parts of the unified system  4300  via a communications bus  4302 . Further, one or more modules  4202 ,  4204 ,  4206  and PMDS  10  may be implemented as software modules, as hardware, as circuitry, etc. Referring now to  FIG. 2 , in certain alternate configurations, the unified system  4300  may be, in whole or in part, comprised within the PMDS  10 . 
     In addition, one or more modules may be associated with one or more devices. To illustrate, a receiver or computer may be associated with the biometric information module  4202  of the unified system  4300 . One or more modules  4202 ,  4202 ,  4206  and PMDS  10  may be associated with a computer, a network, the internet  2 B, the telephony network  2 A, a database computer  108 , a database  40 , an ingestible event device IEMD  4 , an ingestible event marker datum IEM M, a receiver, e.g., a receiver associated with an IEMD  4  or other device, a wireless computer  116 ; a temperature sensor, a respiration sensor, a pressure sensor, a heart sensor, and/or other devices and systems. 
     While the present invention has been described with reference to specific methods, devices and systems, it should be understood by those skilled in the art that various changes may be made and equivalents may be substituted without departing from the true spirit and scope of the invention. In addition, many modifications may be made to adapt a particular situation, material, composition of matter, process, process step or steps, to the objective, spirit and scope of the present invention. All such modifications are intended to be within the scope of the claims appended hereto. 
     The foregoing disclosures and statements are illustrative only of the present invention, and are not intended to limit or define the scope of the present invention. The above description is intended to be illustrative, and not restrictive. Although the examples given include many specificities, they are intended as illustrative and not limiting. Those skilled in the art will appreciate that various adaptations and modifications of the just-described systems and methods can be configured without departing from the scope and spirit of the present invention. Therefore, it is to be understood that the present invention may be practiced other than as specifically described herein. The scope of the present invention as disclosed and claimed should, therefore, be determined with reference to the knowledge of one skilled in the art and in light of the disclosures presented above.

Technology Category: 1