Medical condition sensing system

Abstract

This invention discloses a medical condition sensing system including a multiplicity of general purpose computers disposed in user locations and being connected via a computer network to at least one controller computer remote from at least one of the user locations, personal parameter measuring software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for measuring at least one personal parameter of at least one user, personal parameter reference generating software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for establishing a reference for the at least one personal parameter, and personal parameter comparison software resident on at least one of said multiplicity of general purpose computers and the at least one controller computer for comparing at least one currently measured personal parameter with a corresponding reference and providing a comparison output. A method for medical condition sensing is also disclosed.

Claims

What is claimed is:

1. A medical condition sensing system comprising:

a multiplicity of general purpose computers disposed in user locations and being connectable via an on-line connection with a computer network to at least one controller computer remote from at least one of said user locations;

personal parameter measuring software resident on at least one of said multiplicity of general purpose computers fur measuring at least one personal parameter of at least one user;

personal parameter reference generating software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for establishing a reference for said at least one personal parameter; and

personal parameter comparison software resident on at least one of said multiplicity of general purpose computers for comparing at least one currently measured personal parameter with a corresponding reference and providing a comparison output without an on-line connection to said controller.

2. A medical condition sensing system according to claim 1 and also comprising alert indication software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for providing a generally real time alert indication to said user based at least partially on said comparison output.

3. A medical condition sensing system according to claim 2 and wherein said alert indication software is resident on said multiplicity of general purpose computers.

4. A medical condition sensing system according to claim 1 and wherein said reference is a personal parameter baseline constructed from pre-real time measurements of said personal parameter.

5. A medical condition sensing system according to claim 1 and wherein said reference is a calibration reference employing a measurement of a personal parameter based on a calibration input.

6. A medical condition sensing system according to claim 1 and wherein said reference is a calibration reference based on a calibration input.

7. A medical condition sensing system according to claim 1 and wherein said reference is a calibration reference based on a calibration input supplied from another computer via said computer network.

8. A medical condition sensing system according to claim 1 and wherein said reference is a calibration reference employing a measurement of a personal parameter based on a calibration input supplied from another computer via said computer network.

9. A medical condition sensing system according to claim 8 and wherein said personal parameter comparison software is operative to compare at least one currently measured personal parameter with said calibration reference.

10. A medical condition sensing system according to claim 1 and also comprising notification software resident on at least one of said multiplicity of general purpose computers and said at least one controller for transmitting a notification from one of said at multiplicity of general purpose computers to at least one other computer based on said comparison output.

11. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a heart function parameter.

12. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a blood parameter.

13. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a electrocardiogram parameter.

14. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a hearing function parameter.

15. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a skin appearance parameter.

16. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a tissue appearance parameter.

17. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises an optically sensible parameter.

18. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises an electrically sensible parameter.

19. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises an thermally sensible parameter.

20. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises an audibly sensible parameter.

21. A medical condition sensing system according to claim 1 and wherein said personal parameter comprises a chemically sensible parameter.

22. A medical condition sensing system according to claim 1 and wherein said personal parameter comparison software is operative to compare optical images of at least one body region.

23. A medical condition sensing system according to claim 1 and wherein said personal parameter measuring software is operative to measure at least one personal parameter of at least one user in response to an input supplied to the user.

24. A medical condition sensing system according to claim 23 and wherein said personal parameter measuring software includes feedback software for calibrating the input supplied to the user.

25. A medical condition sensing system according to claim 23 and also comprising feedback circuitry for calibrating the input supplied to the user.

26. A medical condition sensing system according to claim 24 and wherein said feedback software is operative to communicate between a general purpose computer and said controller computer over said computer network.

27. A medical condition sensing system according to claim 25 and wherein said feedback circuitry is operative to communicate between a general purpose computer and said controller computer over said computer network.

28. A medical condition sensing method according to claim 23 and wherein said personal parameter measuring software includes feedback software for calibrating the input supplied to the user.

29. A medical condition sensing method according to claim 28 and also comprising employing feedback circuitry for calibrating the input supplied to the user.

30. A medical condition sensing method according to claim 29 and wherein said feedback software is operative to communicate between a general purpose computer and said controller computer over said computer network.

31. A medical condition sensing method according to claim 30 and wherein said feedback circuitry is operative to communicate between a general purpose computer and said controller computer over said computer network.

32. A medical condition sensing system according to claim 1 and also comprising software utilizing the output of at least one of said personal parameter measuring software, said personal parameter reference generating software, and said personal parameter comparison software for providing at least one of recommendations and indications to a user.

33. A medical condition sensing system according to claim 32 and also comprising a manned center accessible at least via said computer network for receiving at least some of said output of at least one of said personal parameter measuring software, said personal parameter reference generating software said personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

34. A medical condition sensing system according to claim 33 and wherein at least one of said recommendations and indications as well as the criteria therefor is determinable by a user's health professional by transmitting instructions to at least one of said controller computer and said general purpose computer via said computer network.

35. A medical condition sensing system according to claim 1 and also comprising a manned center accessible at least via said computer network for receiving at least some of said output of at least one of said personal parameter measuring software, said personal parameter reference generating software said personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

36. A medical condition sensing system according to claim 35 and wherein at least one of said recommendations and indications as well as the criteria therefor is determinable by a user's health professional by transmitting instructions to at least one of said controller computer and said general purpose computer via said computer network.

37. A medical condition sensing system according to claim 35 and wherein said manned center employs a personal physician of the user and communicates with him via through at least one of telephone and data links via at least one of wired and wireless communication media.

38. A medical condition sensing system according to claim 1 and also comprising personal parameter analysis software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for analyzing said at least one personal parameter of at least one user.

39. A medical condition sensing system according to claim 38 and wherein analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at said at least one controller computer.

40. A medical condition sensing system according to claim 38 and wherein analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of said at least one personal parameter is carried out at said at least one controller computer.

41. A medical condition sensing system according to claim 38 and wherein at least one of said general purpose computer and said at least one controller computer serves as a backup for another one of said general purpose computer and said at least one controller computer.

42. A medical condition sensing system according to claim 1 and wherein said personal parameter measuring software includes feedback software for calibrating a measured personal parameter of a user.

43. A medical condition sensing system according to claim 42 and wherein said feedback software is operative to communicate between a general purpose computer and said controller computer over said computer network.

44. A medical condition sensing system according to claim 1 and also comprising feedback circuitry for calibrating a measured personal parameter of a user.

45. A medical condition sensing system according to claim 44 and wherein said feedback circuitry is operative to communicate between a general purpose computer and said controller computer over said computer network.

46. Apparatus for collecting medical data comprising:

a user station connected to at least one computer remote from said user station via a computer network;

a user interface connected to said user station, said user interface being for interfacing for gathering medical data for remote processing; and

a calibration system at said computer remote from said user station operable to calibrate said user interface which employs communication via said at least one computer network, said calibration being for calibrating said gathering of medical data for said remote processing.

47. Apparatus for collecting medical data according to claim 46 and wherein said calibration system operates automatically without operator intervention.

48. Apparatus for collecting medical data according to claim 46 and also comprising personal parameter analysis software resident on at least one of said user station and said at least one computer for analyzing said at least one personal parameter of at least one user.

49. Apparatus for collecting medical data according to claim 48 and wherein analysis of at least one personal parameter of at least one user takes place partially at said user station and partially at said at least one computer.

50. Apparatus for collecting medical data according to claim 48 and wherein analysis of at least one personal parameter of at least one user provides an analysis output which determines whether further analysis of said at least one personal parameter is carried out at said at least one computer.

51. Apparatus for collecting medical data according to claim 48 and wherein at least one of said user station and said at least one computer serves as a backup for another one of said user station and said at least one computer.

52. A medical condition sensing system comprising:

a multiplicity of general purpose computers disposed in user locations and being connectable via an on-line connection with a computer network to at least one controller computer remote from at least one of said user locations;

personal parameter measuring software resident on at least one of said multiplicity of general purpose computers for measuring at least one personal parameter of at least one user; and

personal parameter analysis software resident on at least one of said multiplicity of general purpose computers for analyzing said at least one personal parameter of at least one user and for producing an output corresponding to said analysis without an on-line connection to said controller.

53. A medical condition sensing system according to claim 52 and wherein analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at said at least one controller computer.

54. A medical condition sensing system according to claim 52 and wherein analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of said at least one personal parameter is carried out at said at least one controller computer.

55. A medical condition sensing system according to claim 52 and wherein at least one of said general purpose computer and said at least one controller computer serves as a backup for another one of said general purpose computer and said at least one controller computer.

56. A medical condition sensing method comprising:

connecting a multiplicity of general purpose computers disposed in user locations via an on-line connection with a computer network to at least one controller computer remote from at least one of said user locations;

employing personal parameter measuring software resident on at least one of said multiplicity of general purpose computers for measuring at least one personal parameter of at least one user;

employing personal parameter reference generating software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for establishing a reference for said at least one personal parameter; and

employing person parameter comparison software resident on at least one of said multiplicity of general purpose computers for comparing at least one currently measured personal parameter with a corresponding reference and for providing a comparison output without an on-line connection to said controller.

57. A medical condition sensing method according to claim 56 and also comprising utilizing alert indication software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for providing a generally real time alert indication to said user based at least partially on said comparison output.

58. A medical condition sensing method according to claim 57 and wherein said alert indication software is resident on said multiplicity of general purpose computers.

59. A medical condition sensing method according to claim 56 and wherein said reference is a personal parameter baseline constructed from pre-real time measurements of said personal parameter.

60. A medical condition sensing method according to claim 56 and wherein said reference is a calibration reference employing a measurement of a personal parameter based on a calibration input.

61. A medical condition sensing method according to claim 56 and wherein said reference is a calibration reference based on a calibration input.

62. A medical condition sensing method according to claim 56 and wherein said reference is a calibration reference based on a calibration input supplied from another computer via said computer network.

63. A medical condition sensing method according to claim 56 and wherein said reference is a calibration reference employing a measurement of a personal parameter based on a calibration input supplied from another computer via said computer network.

64. A medical condition sensing method according to claim 63 and wherein said personal parameter comparison software is operative to compare at least one currently measured personal parameter with said calibration reference.

65. A medical condition sensing method according to claim 56 and also comprising employing notification software resident on at least one of said multiplicity of general purpose computers and said at least one controller for transmitting a notification from one of said at multiplicity of general purpose computers to at least one other computer based on said comparison output.

66. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a heart function parameter.

67. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a blood parameter.

68. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a electrocardiogram parameter.

69. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a hearing function parameter.

70. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a skin appearance parameter.

71. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a tissue appearance parameter.

72. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises an optically sensible parameter.

73. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises an electrically sensible parameter.

74. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises an thermally sensible parameter.

75. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises an audibly sensible parameter.

76. A medical condition sensing method according to claim 56 and wherein said personal parameter comprises a chemically sensible parameter.

77. A medical condition sensing method according to claim 56 and wherein said personal parameter comparison software is operative to compare optical images of at least one body region.

78. A medical condition sensing method according to claim 56 and wherein said personal parameter measuring software is operative to measure at least one personal parameter of at least one user in response to an input supplied to the user.

79. A medical condition sensing method according to claim 56 and wherein said personal parameter measuring software includes feedback software for calibrating a measured personal parameter of a user.

80. A medical condition sensing method according to claim 56 and also comprising employing feedback circuitry for calibrating a measured personal parameter of a user.

81. A medical condition sensing method according to claim 80 and wherein said feedback software is operative to communicate between a general purpose computer and said controller computer over said computer network.

82. A medical condition sensing method according to claim 81 and wherein said feedback circuitry is operative to communicate between a general purpose computer and said controller computer over said computer network.

83. A medical condition sensing method according to claim 56 and also comprising employing software utilizing the output of at least one of said personal parameter measuring software, said personal parameter reference generating software, and said personal parameter comparison software for providing at least one of recommendations and indications to a user.

84. A medical condition sensing method according to claim 56 and also comprising accessing a manned center at least via said computer network for receiving at least some of said output of at least one of said personal parameter measuring software, said personal parameter reference generating software, said personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

85. A medical condition sensing method according to claim 84 and also comprising accessing a manned center at least via said computer network for receiving at least some of said output of at least one of said personal parameter measuring software, said personal parameter reference generating software, said personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

86. A medical condition sensing method according to claim 85 and wherein at least one of said recommendations and indications as well as the criteria therefor is determinable by a user s health professional by transmitting instructions to at least one of said controller computer and said general purpose computer via said computer network.

87. A medical condition sensing method according to claim 86 and wherein at least one of said recommendations and indications as well as the criteria therefor is determinable by a user's health professional by transmitting instructions to at least one of said controller computer and said general purpose computer via said computer network.

88. A medical condition sensing method according to claim 85 and wherein said manned center employs a personal physician of the user and communicates with him via through at least one of telephone and data links via at least one of wired and wireless communication media.

89. A medical condition sensing method according to claim 88 and wherein analysis of at least one personal parameter of at least one user at a general purpose computer at at least one use location provides an analysis output which determines whether further analysis of said at least one personal parameter is carried out at said at least one controller computer.

90. A medical condition sensing method according to claim 88 and wherein at least one of said general purpose computer and said at least one controller computer serves as a backup for another one of said general purpose computer and said at least one controller computer.

91. A medical condition sensing method according to claim 56 and also comprising employing personal parameter analysis software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for analyzing said at least one personal parameter of at least one user.

92. A medical condition sensing method according to claim 91 and wherein analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at said at least one controller computer.

93. Apparatus for collecting medical data comprising:

a general purpose computer;

a user interface connected to said computer;

a recording and storage facility for recording and storing at least one baseline result received by said user station using said user interface from at least a first test taken at least a first time; and

a comparison facility for receiving at least one subsequent result received by said user station using said user interface from at least a second test, similar to said first test, taken at at least a second time, later than said first time, comparing said at least second test with said at least first test, applying a threshold to a comparison result and providing an indication in response to exceedance of said threshold.

94. A user interface assembly suitable for use in apparatus for collecting medical data including a general purpose computer, the user interface assembly comprising:

a user interface coupled to said user station for use in collecting medical data from a subject;

software usable by said general purpose computer and providing at least the following functionality:

a recording and storage functionality for recording and storing at least one baseline result received by said general purpose computer via said user interface from at least a first test taken at at least a first time; and

a comparison facility for receiving at least one subsequent result received by said general purpose computer using said user interface from at least a second test, similar to said first test, taken at at least a second time, later than said first time, comparing said at least second test with said at least first test, applying a threshold to a comparison result, said threshold being selected based on said first test, and providing an indication in response to exceedance of said threshold.

95. A user interface method suitable for use in apparatus for collecting medical data including a general purpose computer, the user interface method comprising:

coupling a user interface to said user station for collecting medical data from a subject;

employing software providing at least the following functionality:

recording and storing at least one baseline result received by said general purpose computer via said user interface from at least a first test taken at at least a first time; and

receiving at last one subsequent result using said user interface from at least a second test, similar to said fist test, taken at at least a second time, later than said fist time, comparing said at least second test with said at least first test, applying a threshold to a comparison result, said threshold being selected based on said first test, and proving an indication in response to exceedance of said threshold.

96. A user interface method suitable for use in apparatus for collecting medical data for remote processing including a user station connected to at least one computer remote from said user station via a computer network, said user interface method comprising:

coupling a user interface to said user station for use in collecting medical data from a subject; and

employing software to control the operation of said user interface and to communicate via said computer network with said at least one computer remote from said user station, said software being further operable to:

communicate data required for calibration of said medical data collecting, from said user station to said remote computer via said network and

to support calibration of said medical data collecting at said user station from said remote computer via said network.

97. A method for collecting medical data for remote processing comprising:

connecting a user station to at least one computer remote from said user station via a computer network;

connecting a user interface to said user station, said user interface being for collecting medical data at said user station for said remote processing; and

calibrating said user interface at said user station from said remote computer by employing communication via said at least one computer network, thereby to obtain calibrated data for said remote processing.

98. A method for collecting medical data according to claim 97 and wherein said calibrating step operates automatically without operator intervention.

99. A method for collecting medical data according to claim 97 and also comprising employing personal parameter analysis software resident on at least one of said user station and said at least one computer for analyzing said at least one personal parameter of at least one user.

100. A method for collecting medical data according to claim 99 and wherein analysis of at least one personal parameter of at least one user provides an analysis output which determines whether further analysis of said at least one personal parameter is carried out at said at least one computer.

101. A method for collecting medical data according to claim 99 and wherein analysis of at least one personal parameter of at least one user takes place partially at said user station and partially at said at least one computer.

102. A method for collecting medical data according to claim 99 and wherein at least one of said user station and said at least one computer serves as a backup for another one of said user station and said at least one computer.

103. A method for collecting medical data comprising:

providing a general purpose computer;

connecting a user interface to said computer;

recording and storing at least one baseline result received by said user station using said user interface from at least a first test taken at least a first time; and

receiving at least one subsequent result received by said user station using said user interface from at least a second test, similar to said first test, taken at at least a second time, later than said first time, comparing said at least second test with said at least first test, applying a threshold to a comparison result and providing an indication in response to exceedance of said threshold.

104. A medical condition sensing method comprising:

connecting a multiplicity of general purpose computers disposed in user locations via an on-line connection with a computer network to at least one controller computer remote from at least one of said user locations;

employing personal parameter measuring software resident on at least one of said multiplicity of general purpose computers for measuring at least one personal parameter of at least one user; and

employing personal parameter analysis software resident oil at least one of said multiplicity of general purpose computers for analyzing said at least one personal parameter of at least one user and for producing an output corresponding to said analysis without an on-line connection to said controller.

105. A medical condition sensing method according to claim 104 and wherein analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of said at least one personal parameter is carried out at said at least one controller computer.

106. A medical condition sensing method according to claim 104 and wherein at least one of said general purpose computer and said at least one controller computer serves as a backup for another one of said general purpose computer and said at least controller computer.

107. A medical condition sensing method according to claim 104 and wherein analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one use location and partially at said at least one controller computer.

108. A user interface assembly suitable for use in apparatus for collecting medical data including a user station connected to at least one computer remote from said user station via a computer network, said user interface assembly comprising:

a user interface coupled to said user station for use in collecting medical data from a subject;

software usable by said user station to control the operation of said user interface and to communicate via said computer network with said at least one computer remote from said user station; and wherein said software is useful at least to communicate data required for calibration of at least one of said user interface and said user station.

Description

FIELD OF THE INVENTION

The present invention to medical condition sensing and evaluation and more particularly to medical condition sensing and evaluation over computer networks.

BACKGROUND OF THE INVENTION

There exist in the patent literature various proposals for medical sensing and evaluation over computer networks. The following U.S. Patents are believed to represent the state of the art: U.S. Pat. Nos. 5,907,291; 5,906,208; 5,902,234; 5,897,493; 5,895,354; 5,892,570; 5,879,292; 5,873,369; 5,868,669; 5,868,135; 5,868,134; 5,865,733; 5,855,550; 5,848,975; 5,842,977; 5,842,975; 5,840,018; 5,827,180; 5,811,681; 5,79.1,908; 5,791,342; 5,769,074; 5,758,652; 5,677,979; 5,619,991.

SUMMARY OF THE INVENTION

The present invention seeks to provide a highly effective computer network based system for medical sensing and evaluation as well as interface elements useful in the system.

There is thus provided in accordance with a preferred embodiment of the present invention a medical condition sensing system including a multiplicity of general purpose computers disposed in user locations and being connected via a computer network to at least one controller computer remote from at least one of the user locations, personal parameter measuring software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for measuring at least one personal parameter of at least one user, personal parameter reference generating software resident on at least one of said multiplicity of general purpose computers and said at least one controller computer for establishing a reference for the at least one personal parameter, and personal parameter comparison software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for comparing at least one currently measured personal parameter with a corresponding reference and providing a comparison output.

Further in accordance with a preferred embodiment of the present invention the medical condition sensing system also includes alert indication software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for providing a generally real time alert indication to the user based at least partially on the comparison output. Preferably, the alert indication software is resident on the multiplicity of general purpose computers.

Still further in accordance with a preferred embodiment of the present invention the reference may be a personal parameter baseline constructed from pre-real time measurements of the personal parameter, a calibration reference employing a measurement of a personal parameter based on a calibration input, a calibration reference based on a calibration input, a calibration reference based on a calibration input supplied from another computer via the computer network, and/or a calibration reference employing a measurement of a personal parameter based on a calibration input supplied from another computer via the computer network. Preferably, the personal parameter comparison software is operative to compare at least one currently measured personal parameter with the calibration reference.

Additionally in accordance with a preferred embodiment of the present invention, the medical condition sensing system also includes notification software resident on at least one of the multiplicity of general purpose computers and the at least one controller for transmitting a notification from one of the at multiplicity of general purpose computers to at least one other computer based on the comparison output.

Further in accordance with a preferred embodiment of the present invention, the personal parameter includes a heart function parameter, a blood parameter, a electrocardiogram parameter, a hearing function parameter, a skin appearance parameter, a tissue appearance parameter, an optically sensible parameter, an electrically sensible parameter, a thermally sensible parameter, an audibly sensible parameter, and/or a chemically sensible parameter.

Still further in accordance with a preferred embodiment of the present invention the personal parameter comparison software is operative to compare optical images of at least one body region.

Additionally in accordance with a preferred embodiment of the present invention the personal parameter measuring software is operative to measure at least one personal parameter of at least one user in response to an input supplied to the user. The personal parameter measuring software also includes feedback software and feedback circuitry for calibrating the input supplied to the user. Preferably, the feedback software is operative to communicate between a general purpose computer and the controller computer over the computer network.

Additionally or alternatively the feedback circuitry is operative to communicate between a general purpose computer and the controller computer over the computer network.

Still further in accordance with a preferred embodiment of the present invention the personal parameter measuring software also includes feedback software for calibrating a measured personal parameter of a user.

Furthermore in accordance with a preferred embodiment of the present invention the medical condition sensing system also includes feedback circuitry for calibrating a measured personal parameter of a user. Additionally or alternatively the feedback software is operative to communicate between a general purpose computer and the controller computer over the computer network.

Moreover the feedback circuitry is operative to communicate between a general purpose computer and the controller computer over the computer network.

Further in accordance with a preferred embodiment of the present invention the medical condition sensing system also includes software utilizing the output of at least one of the personal parameter measuring software, the personal parameter reference generating software, and the personal parameter comparison software for providing at least one of recommendations and indications to a user.

Still further in accordance with a preferred embodiment of the present invention the medical condition sensing system also includes a manned center accessible at least via the computer network for receiving at least some of the output of at least one of the personal parameter measuring software, the personal parameter reference generating software the personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

Preferably, the manned center is accessible at least via the computer network for receiving at least some of the output of at least one of the personal parameter measuring software, the personal parameter reference generating software the personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

Additionally or preferably at least one of the recommendations and indications as well as the criteria therefor is determinable by a user's health professional by transmitting instructions to at least one of the controller computer and the general purpose computer via the computer network. Furthermore, at least one of the recommendations and indications as well as the criteria therefor is determinable by a user's health professional by transmitting instructions to at least one of the controller computer and the general purpose computer via the computer network.

Still further in accordance with a preferred embodiment of the present invention the manned center employs a personal physician of the user and communicates with him via through at least one of telephone and data links via at least one of wired and wireless communication media.

Moreover in accordance with a preferred embodiment of the present invention, the medical condition sensing system also includes personal parameter analysis software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for analyzing the at least one personal parameter of at least one user. The analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at the at least one controller computer.

Additionally or alternatively the analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of the at least one personal parameter is carried out at the at least one controller computer.

Still further in accordance with a preferred embodiment of the present invention, the at least one of the general purpose computer and the at least one controller computer serves as a backup for another one of the general purpose computer and the at least one controller computer.

There is also provided in accordance with yet another preferred embodiment of the present invention apparatus for collecting medical data including a user station connected to at least one computer remote from the user station via a computer network, a user interface connected to the user station, and a calibration system operative to calibrate the user interface which employs communication via the at least one computer network.

Further in accordance with a preferred embodiment of the present invention the said calibration system operates automatically without operator intervention.

Still further in accordance with a preferred embodiment of the present invention the apparatus for collecting medical data also includes personal parameter analysis software resident on at least one of the user station and the at least one computer for analyzing the at least one personal parameter of at least one user.

Preferably, analysis of at least one personal parameter of at least one user takes place partially at said user station and partially at the at least one computer.

The analysis of at least one personal parameter of at least one user provides an analysis output which determines whether further analysis of the at least one personal parameter is carried out at the at least one computer.

Additionally in accordance with a preferred embodiment of the present invention, the at least one of the user stations and the at least one computer serves as a backup for another one of the user stations and the at least one computer.

There is also provided in accordance with yet another preferred embodiment of the present invention apparatus for collecting medical data including a general purpose computer, a user interface connected to said computer, a recording and storage facility for recording and storing at least one baseline result received by the user station using the user interface from at least a first test taken at least a first time, and a comparison facility for receiving at least one subsequent result received by the user station using the user interface from at least a second test, similar to the first test, taken at at least a second time, later than the first time, comparing the at least second test with the at least first test, applying a threshold to a comparison result and providing an indication in response to exceedance of the threshold.

There is further provided in accordance with another preferred embodiment of the present invention a user interface assembly suitable for use in apparatus for collecting medical data including a user station connected to at least one computer remote from said user station via a computer network, the user interface assembly includes a user interface coupled to said user station for use in collecting medical data from a subject, software usable by the user station to control the operation of the user interface and to communicate via the computer network with the at least one computer remote from the user station.

Further in accordance with a preferred embodiment of the present invention the software is useful at least to communicate data required for calibration of at least one of the user interface and the user station.

There is provided in accordance with yet another preferred embodiment of the present invention a user interface assembly suitable for use in apparatus for collecting medical data including a general purpose computer, the user interface assembly includes a user interface coupled to the user station for use in collecting medical data from a subject, software usable by the general purpose computer and providing at least the following functionality a recording and storage functionality for recording and storing at least one baseline result received by the general purpose computer via the user interface from at least a first test taken at at least a first time, and a comparison facility for receiving at least one subsequent result received by the general purpose computer using the user interface from at least a second test, similar to the first test, taken at at least a second time, later than the first time, comparing the at least second test with the at least first test, applying a threshold to a comparison result and providing an indication in response to exceedance of the threshold.

There is further provided in accordance with yet another preferred embodiment of the present invention a medical condition sensing system including a multiplicity of general purpose computers disposed in user locations and being connected via a computer network to at least one controller computer remote from at least one of the user locations, personal parameter measuring software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for measuring at least one personal parameter of at least one user, personal parameter analysis software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for analyzing the at least one personal parameter of at least one user.

Further in accordance with a preferred embodiment of the present invention the analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at the at least one controller computer.

Still further in accordance with a preferred embodiment of the present invention the analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of the at least one personal parameter is carried out at the at least one controller computer.

Additionally in accordance with a preferred embodiment of the present invention at least one of the general purpose computer and the at least one controller computer serves as a backup for another one of the general purpose computer and the at least one controller computer.

There is also provided in accordance with a preferred embodiment of the present invention a medical condition sensing method including:

connecting a multiplicity of general purpose computers disposed in user locations via a computer network to at least one controller computer remote from at least one of the user locations;

employing personal parameter measuring software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for measuring at least one personal parameter of at least one user;

employing personal parameter reference generating software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for establishing a reference for the at least one personal parameter; and

employing personal parameter comparison software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for comparing at least one currently measured personal parameter with a corresponding reference and providing a comparison output.

Preferably, the method also includes utilizing alert indication software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for providing a generally real time alert indication to the user based at least partially on the comparison output.

In accordance with a preferred embodiment of the present invention, the alert indication software is resident on the multiplicity of general purpose computers.

Preferably, the reference is a personal parameter baseline constructed from pre-real time measurements of the personal parameter.

Alternatively, the reference is a calibration reference employing a measurement of a personal parameter based on a calibration input.

In accordance with a preferred embodiment of the present invention, the reference is a calibration reference based on a calibration input.

In accordance with a preferred embodiment of the present invention the reference is a calibration reference based on a calibration input supplied from another computer via the computer network.

Preferably, the reference is a calibration reference employing a measurement of a personal parameter based on a calibration input supplied from another computer via the computer network.

In accordance with a preferred embodiment of the present invention the personal parameter comparison software is operative to compare at least one currently measured personal parameter with the calibration reference.

Preferably, the method includes comprising employing notification software resident on at least one of the multiplicity of general purpose computers and the at least one controller for transmitting a notification from one of the at multiplicity of general purpose computers to at least one other computer based on the comparison output.

In accordance with a preferred embodiment of the present invention the personal parameter comprises a heart function parameter.

In accordance with another preferred embodiment of the present invention the personal parameter comprises a blood parameter.

In accordance with yet another preferred embodiment of the present invention the personal parameter comprises a electrocardiogram parameter.

In accordance with still another preferred embodiment of the present invention the personal parameter comprises a hearing function parameter.

Alternatively the personal parameter comprises a skin appearance parameter, a tissue appearance parameter, an optically sensible parameter, an electrically sensible parameter, an thermally sensible parameter, an audibly sensible parameter, a chemically sensible parameter,

Preferably, the personal parameter comparison software is operative to compare optical images of at least one body region.

In accordance with another preferred embodiment of the present invention the personal parameter measuring software is operative to measure at least one personal parameter of at least one user in response to an input supplied to the user.

Preferably, the personal parameter measuring software includes feedback software for calibrating the input supplied to the user.

In accordance with another preferred embodiment of the present invention the method includes employing feedback circuitry for calibrating the input supplied to the user.

Preferably, the feedback software is operative to communicate between a general purpose computer and the controller computer over the computer network.

Alternatively, the feedback circuitry is operative to communicate between a general purpose computer and the controller computer over the computer network.

Preferably, the personal parameter measuring software includes feedback software for calibrating a measured personal parameter of a user.

In accordance with another preferred embodiment of the present invention calibrating a measured personal parameter of a user.

Preferably, the method employs feedback software which is operative to communicate between a general purpose computer and the controller computer over the computer network.

In accordance with another preferred embodiment of the present invention, the feedback circuitry is operative to communicate between a general purpose computer and the controller computer over the computer network.

Preferably, the method employing software utilizing the output of at least one of the personal parameter measuring software, the personal parameter reference generating software, and the personal parameter comparison software for providing at least one of recommendations and indications to a user.

In accordance with another preferred embodiment of the present invention the method includes accessing a manned center at least via the computer network for receiving at least some of the output of at least one of the personal parameter measuring software, the personal parameter reference generating software, the personal parameter comparison software and at least one of recommendations and indications to a user and providing health professional interaction with the user.

Preferably, at least one of the recommendations and indications as well as the criteria therefor is determinable by a users health professional by transmitting instructions to at least one of the controller computer and the general purpose computer via the computer network.

In accordance with another preferred embodiment of the present invention, the manned center employs a personal physician of the user and communicates with him via through at least one of telephone and data links via at least one of wired and wireless communication media.

Preferably, the method employs personal parameter analysis software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for analyzing the at least one personal parameter of at least one user.

In accordance with another preferred embodiment of the present invention analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at the at least one controller computer.

Preferably, analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of the at least one personal parameter is carried out at the at least one controller computer.

In accordance with another preferred embodiment of the present invention at least one of the general purpose computer and the at least one controller computer serves as a backup for another one of the general purpose computer and the at least one controller computer.

There is additionally provided in accordance with a preferred embodiment of the present invention a method for collecting medical data including:

connecting a user station to at least one computer remote from the user station via a computer network;

connecting a user interface to the user station; and

calibrating the user interface by employing communication via the at least one computer network.

Preferably, the calibrating step operates automatically without operator intervention.

The method preferably employs personal parameter analysis software resident on at least one of the user station and the at least one computer for analyzing the at least one personal parameter of at least one user.

In accordance with another preferred embodiment of the present invention, analysis of at least one personal parameter of at least one user takes place partially at the user station and partially at the at least one computer.

Preferably, analysis of at least one personal parameter of at least one user provides an analysis output which determines whether further analysis of the at least one personal parameter is carried out at the at least one computer.

In accordance with another preferred embodiment of the present invention at least one of the user station and the at least one computer serves as a backup for another one of the user station and the at least one computer.

There is additionally provided in accordance with a preferred embodiment of the present invention a method for collecting medical data including:

providing a general purpose computer;

connecting a user interface to the computer;

recording and storing at least one baseline result received by the user station using the user interface from at least a first test taken at least a first time; and

receiving at least one subsequent result received by the user station using the user interface from at least a second test, similar to the first test, taken at at least a second time, later than the first time, comparing the at least second test with the at least first test, applying a threshold to a comparison result and providing an indication in response to exceedance of the threshold.

There is also provided in accordance with a preferred embodiment of the present invention a user interface method suitable for use in apparatus for collecting medical data including a user station connected to at least one computer remote from the user station via a computer network, the user interface method comprising:

coupling a user interface to the user station for use in collecting medical data from a subject;

employing software to control the operation of the user interface and to communicate via the computer network with the at least one computer remote from the user station.

Preferably, the software is useful at least to communicate data required for calibration of at least one of the user interface and the user station.

There is additionally provided in accordance with a preferred embodiment of the present invention a user interface method suitable for use in apparatus for collecting medical data including a general purpose computer, the user interface method comprising:

coupling a user interface to the user station for collecting medical data from a subject;

employing software providing at least the following functionality:

recording and storing at least one baseline result received by the general purpose computer via the user interface from at least a first test taken at at least a first time; and

receiving at least one subsequent result using the user interface from at least a second test, similar to the first test, taken at at least a second time, later than the first time, comparing the at least second test with the at least first test, on at least one of multiplicity of general rose computers and the at least one controller computer for analyzing the at least one personal parameter of at least one user.

Preferably, analysis of at least one personal parameter of at least one user takes place partially at a general purpose computer at at least one user location and partially at the at least one controller computer.

In accordance with another preferred embodiment of the present invention analysis of at least one personal parameter of at least one user at a general purpose computer at at least one user location provides an analysis output which determines whether further analysis of the at least one personal parameter is carried out at the at least one controller computer.

Preferably, at least one of the general purpose computer and the at least one controller computer serves as a backup for another one of the general purpose computer and the at least one controller computer.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be understood and appreciated more fully from the following detailed description, taken in conjunction with the drawings in which:

FIG. 1 is a simplified partially pictorial, partially block diagram illustration of a medical condition sensing system constructed and operative in accordance with a preferred embodiment of the present invention.

FIG. 2 is a simplified functional block diagram illustration of the general functionality of a general purpose computer and of a personal parameter transmitting interface, both forming part of the system of FIG. 1;

FIG. 3 is a simplified functional block diagram illustration of the general functionality of a controller computer forming part of the system of FIG. 1;

FIG. 4 is a simplified flow chart illustration of the general functionality of the controller computer forming part of the system of FIG. 1;

FIG. 5A is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for lung sounds condition sensing;

FIG. 5B is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for lung function condition sensing;

FIG. 5C is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for electrocardiogram sensing;

FIG. 5D is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for cardiac rhythm monitoring;

FIG. 5E is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for cardiac output condition sensing;

FIG. 5F is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for hearing condition sensing;

FIG. 5G is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for acute and chronic skin lesion monitoring sensing;

FIG. 5H is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for vision testing;

FIG. 6A is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5A;

FIG. 6B is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5B;

FIG. 6C is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5C;

FIG. 6D is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5D;

FIG. 6E is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5E;

FIG. 6F is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5F;

FIG. 6G is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5G;

FIG. 6H is a simplified functional block diagram of the system of FIG. 1 having the functionality shown in FIG. 5H;

FIG. 7A is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5A and 6A;

FIG. 7B is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5B and 6B;

FIG. 7C is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5C and 6C;

FIG. 7D is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5D and 6D;

FIG. 7E is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5E and 6E;

FIG. 7F is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5F and 6F;

FIG. 7G is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5G and 6G;

FIG. 7H is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5H and 6H;

FIG. 8A is an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5A;

FIG. 8B is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5B;

FIG. 8C is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5C;

FIG. 8D is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5D;

FIG. 8E is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5E;

FIG. 8F is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5F;

FIG. 8G is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5G;

FIG. 8H is a an illustration of application of part of an exemplary decision table to personal parameters of a given person in the operative environment of FIG. 5H;

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Reference is now made to FIG. 1, which is a simplified partially pictorial, partially block diagram illustration of a medical condition sensing system constructed and operative in accordance with a preferred embodiment of the present invention.

As seen in FIG. 1, the medical sensing system of the present invention comprises a multiplicity of general purpose computers 10, such as personal computers or communicators, disposed in user locations and connected via suitable wired or wireless connections 12 to a network 14, such as the Internet or other wide area network and via network 14 to at least one controller computer 16 remote from at least one of the user locations.

In accordance with a preferred embodiment of the invention, personal parameter measuring software 20 is resident on at least one of the general purpose computers 10 and/or on at least one controller computer 16 for measuring at least one personal parameter of at least one user of one of the general purpose computers. The personal parameters may be any suitable medical parameter, such as, for example, parameters relating to heart function, lung function, hearing, vision, alertness, physical appearance and perception as well as conventional medical indications such as weight, height, age, blood pressure, blood sugar level and other body fluid parameters, as well as various combinations of the foregoing.

Personal parameter measuring software 20 cooperates with personal parameter measuring equipment 22 which is preferably adapted to measure each type of personal parameter in association with a general purpose computer 10. Various types of personal parameter measuring equipment 22 may be provided to users of the system. For example, a stethoscope transducer 24 and lung sounds interface 26 may be provided for sensing lung sounds, electrocardiogram electrodes 27 and an electrocardiogram interface 28 may be provided for electrocardiogram measurements, and a hearing testing headset 32 and headset calibrator 34 may be provided for hearing testing.

It is appreciated that various calibration functionalities, which may be embodied in hardware, software or combinations thereof, may be provided as part of personal parameter measuring equipment 22 or for use therewith. The calibration functionalities may or may not involve communication with the controller computer 16 via the network 14. A given calibration functionality may operate automatically without operator intervention. Alternatively, a calibration functionality may require operator activity.

It is further appreciated that at every appropriate stage of operation, suitable instruction is provided to the user by the general purpose computer of the user. This instruction may be presented to the user in textual, audio or multi-media form and may be unidirectional or interactive. Preferably, suitable instruction is provided prior to calibration of personal parameter measuring equipment 22, prior to establishment of a baseline and prior to each test.

In accordance with a preferred embodiment of the present invention the medical condition sensing system of the present invention includes personal parameter reference generating software 33 resident on at least one of the general purpose computers or on at least one controller computer for establishing a reference for the at least one personal parameter. In this preferred embodiment, personal parameter comparison software, resident on at least one of the multiplicity of general purpose computers 10 and/or on at least one controller computer 16, compares at least one currently measured personal parameter with a corresponding reference and provides a comparison output.

The comparison output may be provided to the user by the general purpose computer 10 together with an action recommendation. Alternatively or additionally, it may be provided to a controller computer 16 for comparison with reference data stored on a central database 34 in order to provide additional information and recommendations to the user.

A manned center 36 may be associated with the controller computer 16 for providing a human interface and/or input as required. The manned center 36, which is preferably staffed by physicians or other health professionals, may be in direct telephone and preferably videophone contact with the user. To this end video cameras 38 are preferably provided both at the manned center 36 and at various user locations. Communication of outputs of the video cameras 38 may be effected via network connections 12 or alternatively in any other manner.

In accordance with a preferred embodiment of the present invention, acceptable ranges of values for various medical parameters used in present invention may be established by medical personnel in the manned center 36 in accordance with the personal characteristics of each given patient.

In accordance with one embodiment of the present invention, initial feedback to the user may be provided under certain conditions by a general purpose computer 10 without accessing the network 14 or the controller computer 16. In accordance with a preferred embodiment of the present invention, communication via the network 14 with the controller computer 16 may be actuated automatically by the system, for example in response to a sensed personal parameter or to the comparison output being beyond a certain threshold. Communication via the network with the controller computer 16 may also be initiated by a user, at the user's initiative.

In accordance with another preferred embodiment of the present invention, communication with the manned center may be actuated automatically by the system, for example in response to a sensed personal parameter or to the comparison output being beyond a given threshold. Communication with the manned center may also be initiated by a user, at the user's initiative. Communication between the user and the manned center may be via the network 14 and/or via conventional telephone or video-conference facilities.

Further in accordance with a preferred embodiment of the present invention, there is provided a recording and storage facility 40 for recording and storing sensed personal parameters. Facility 40 may be provided both at general purpose computers 10 and at controller computer 16.

There may also be provided for operation in the general purpose computer 10 or in the controller computer 16, software 42 providing a comparison facility for comparing personal parameters and a threshold facility for applying a threshold to a comparison result and providing an indication in response to exceedance of the threshold. Software 42 may include signal processing functionality, where appropriate.

Additionally in accordance with a preferred embodiment of the present invention, there is provided software 44 which controls measurement of the personal parameters and which may communicate via the network 14 with at least one remote computer. Software 44, which may reside both at general purpose computers 10 and at controller computer 16, preferably provides encryption encoding of information communicated between general purpose computers 10 and controller computer 16.

Preferably there is associated with each general purpose computer 10, at least one of a display 50, a printer 52 and an audio input/output transducer 54, as well as a user graphics interface such as a mouse 56 and an IP telephone 58. A conventional telephone 59 is preferably available at each user location.

In accordance with a preferred embodiment of the present invention communication between a general purpose computer 10 via the network 14 with another general purpose computer 10 or with a controller computer 16 is encoded or encrypted using conventional technology suitable for this purpose.

Preferably, the controller computer 16 is provided with access to medical databases which provide reference material for presentation to user as well as information which can be used by the controller computer 16 to evaluate measured personal parameters and to determine suitable courses of treatment therefor.

In accordance with a preferred embodiment of the present invention, the medical condition sensing system of the present invention includes:

a multiplicity of general purpose computers disposed in user locations and being connected via a computer network to at least one controller computer remote from at least one of the user locations;

personal parameter measuring software resident on at least one of the multiplicity of general purpose computers and at least one controller computer for measuring at least one personal parameter of at least one user; and

personal parameter analysis software resident on at least one of the multiplicity of general purpose computers and the at least one controller computer for analyzing at least one personal parameter of at least one user.

The distributed processing thus provided has a number of advantages, including reduced communication load and increased speed of response. Furthermore, such processing enables medical confidentiality to be readily maintained in communications over the computer network.

Preferably, at least one of the general purpose computer and the at least one controller computer serves as a backup for another one of the general purpose computer and the at least one controller computer.

This backup functionality preferably enables the system to overcome computer failures at either a general purpose computer at a user location or a controller computer, by transferring computing functionality to another computer connected thereto via the computer network. This is extremely important for emergency situations. Should a network failure occur, but the general purpose computer at the user location is functioning, the user nevertheless can receive basic information as well as indications and recommendations as described hereinbelow from the general purpose computer. Additionally a bypass telephone connection may be employed to provide necessary communication with a user.

Reference is now made to FIG. 2, which is a simplified functional block diagram illustration of the general functionality of a general purpose computer and of an optional personal parameter transmitting interface, both forming part of the system of FIG. 1. It is appreciated that the personal parameter transmitting interface typically forms part of personal parameter measuring equipment 22 (FIG. 1) and may have different configurations depending on the personal parameter which is sought to be measured and, in certain cases, may be obviated. Examples of personal parameter transmitting interfaces that do include hardware are interfaces 26 and 28 shown in FIG. 1. An example where the interface may be obviated is the hearing testing equipment employing the headset 32 shown in FIG. 1, which may be connected directly to the general purpose computer and may employ the sound card thereof.

As seen in FIG. 2, personal parameter measurement equipment 100, such as stethoscope transducer 24 (FIG. 1), electrocardiogram electrodes 27 and headset 32, indicated generally at reference numeral 22 in FIG. 1, is coupled to optional personal parameter interface circuitry, designated generally by reference numeral 102. Circuitry 102 typically includes one or more of the following components: a filter 104, an amplifier 106, a memory 108, a microprocessor 110, a power supply 112, a wireless communications interface 114 and a wired communication interface 116. Where a memory 108 or a wireless interface 114 is provided, the interface circuitry 102 may be portable and thus particularly useful for emergency applications.

Typically the personal parameter interface circuitry 102 is coupled to a suitable port of a general purpose computer 10 (FIG. 1), such as a serial port, a sound or game port or a universal port and permits outputs to be supplied to the general purpose computer 10 for processing thereat.

Recording and storage facility 40 (FIG. 1) is provided preferably at general purpose computer 10 for recording and storing parameters received by the general purpose computer 10 during at least one test. Preferably, the recording and storage facility 40 comprises signal receipt and storage facility 120, a signal processing facility 122, a signal analysis facility 122 and an information storage facility 124. Optionally, any one or more of the foregoing functionalities may be obviated.

Software 42 (FIG. 1), which is preferably resident in general purpose computer 10, provides appropriate signal processing and comparison of parameters received by the general purpose computer 10 and may apply a threshold to a comparison result. Software 42 typically provides via the general purpose computer 10 an indication of exceedance or non-exceedance of the threshold along with suitable description of the situation which may be accompanied by recommendations for action.

Software 42 typically comprises a comparison functionality 130 which may receive information representing a stored baseline and/or a test and which may provide an output to a threshold functionality 132. A condition description functionality 134 preferably receives information relating to at least one of the stored baseline and the test and may also receive outputs of the comparison and threshold functionalities 130 and 132. The condition description functionality preferably provides outputs to one or more of output devices 50, 52 and 54 (FIG. 1) as well as optionally via network 14 to controller computer 16 and/or to manned center 36.

The condition description functionality may also provide an output to recommendation functionality 136, which preferably also receives inputs from comparison functionality 130 and threshold functionality 132.

In accordance with a preferred embodiment of the present invention the general purpose computer 10 may communicate with a remote computer, such as a controller computer 16 (FIG. 1), for obtaining additional reference data and possibly carrying out a comparison between the test data and reference data, thereby to provide further information to the user. Such further information may include a more detailed or precise description of the condition indicated by the test results which may be accompanied by a more detailed or precise recommendation for action. Information received via the network may be employed by the recommendation functionality 136 as well as by the condition description functionality 134.

Communication with a remote computer, such as a controller computer 16 may be initiated automatically by the general purpose computer 10 via the network 14, for example in response to a sensed personal parameter or a comparison output beyond a certain threshold. Communication via the network 14 with the controller computer may also be initiated by a user, at the user's initiative.

Software 42 preferably also includes a standard personal parameter database 138 which stores normal values of personal parameters for a given user or users. The information stored in database 138 is preferably employed by one or more of functionalities 130, 132, 134 and 136.

Condition description functionality 134 and recommendation functionality 136 preferably operate in association with a database 140 cm which stores acceptable ranges of outputs of comparison functionality 130, normalized for age, weight, height, sex and possibly other characteristics. This database may be used for normalizing sensed personal parameters as well as for determining whether a baseline value indicates a need for evaluation or even urgent medical attention. Database 140 is preferably employed to enable condition description functionality 134 and recommendation functionality 136 to take into account the variation in acceptable changes in various personal parameters due to variations in age, weight, height, sex and possibly other characteristics.

It is appreciated that any one or more of the functionalities and databases described hereinabove in the context of software 42 may be obviated in a given application.

Communication with a remote computer, such as a controller computer 16 (FIG. 1) via the network 14 may be actuated automatically in response to the output of comparison functionality 130, threshold functionality 132, condition description functionality 134 or recommendation functionality 136. Thus, when a sensed personal parameter or the comparison output lies beyond a certain threshold which may indicate either an emergency situation or a situation requiring controller intervention, communication is established immediately between the user's general purpose computer 10 and the controller computer 16 via the network.

Communication between the user and the manned center may be via the network 14 and/or via conventional telephone or video-conference facilities.

Reference is now made to FIG. 3, which is a simplified functional block diagram illustration of the general functionality of a controller computer forming part of the system of FIG. 1. The controller computer, such as controller computer 16 (FIG. 1) preferably includes a communications facility 200 which enables it to communicate with a user's general purpose computer 10 (FIG. 1) via the network 14 (FIG. 1). This communication may include receiving information from a user as to which parameter measurement functionality the user is implementing and downloading to the user suitable operating, reference and calibration software to carry out that functionality.

The controller computer also preferably includes a user records database 202, which interfaces with the communications facility 200 and maintains all relevant records of user information, and a medical information database 204 which stores medical reference information useful in making comparisons and recommendations. The user records database 202 stores personal details of each user, general medical information regarding each user and results of tests conducted by the user, using the medical condition sensing kits, which are transmitted to the controller computer 16. Normally, the personal details, general medical information and results of the tests conducted on the patient, which are stored in the user records database 202, are also stored in the personal database 138 of the user's general purpose computer 10.

The controller computer also preferably includes decision functionality 206 which enables it to make decisions based on patient parameter, comparison and threshold information received from a user's general purpose computer 10 via network 14, using an analysis algorithm 208, such may be specific to each medical information sensing functionality provided by the system. The decisions made by functionality 206 may include decisions whether to automatically connect the user to a manned center 36 (FIG. 1) and whether to automatically summon emergency assistance for the user.

As indicated above, the controller computer also stores software to be downloaded to a user's general purpose computer 10 in a software storage facility 212. The controller computer also preferably includes a recording facility 210 for recording all communications with a user.

Reference is now made to FIG. 4, which is a simplified flow chart illustration of the general functionality of a controller computer forming part of the system of FIG. 1 and having the general structure described hereinabove with reference to FIG. 3.

Initial communication between a user's general purpose computer 10 (FIG. 1) and a controller computer, such as controller computer 16 (FIG. 1) preferably includes a user communicating with a web site of the controller computer 16, using communications functionality 200 (FIG. 3). In the course of this communications, the user may obtain demonstrations of various functionalities of system of the present invention and explanations regarding use of the system. The site may include transactional software enabling various medical condition sensing kits to be purchased by a user. Each such kit preferably includes all interfaces to be connected to the user's general purpose computer 10 and all necessary software to be installed by the user in the user's general purpose computer 10.

Alternatively or additionally the software may be downloaded by the user via the Internet or any other modality and the kit may be purchased or otherwise obtained not only from the web site but also from conventional retail sources.

Irrespective of the manner in which the kit is obtained by the user and the software is installed in the user's general purpose computer, the user is required to register with the user records database 202 (FIG. 3). As noted above, the user records database stores personal details of each user, general medical information regarding each user and results of tests conducted by the user, using the medical condition sensing kits, which are transmitted to the controller computer.

When the user wishes to use the medical condition sensing kit in communication with the controller computer, following current use registration, in many cases an appropriate calibration protocol is followed, preferably using software installed at the controller computer. Following calibration, as and when appropriate, a baseline determination is carried out, as needed.

Once any and all calibration and baseline determination steps have been followed, a test may be conducted using the medical condition sensing kit in cooperation with the user's general purpose computer 10 which is in communication with the controller computer 16. In the course of the test or thereafter, the test results may be processed by decision functionality 206 in accordance with an analysis algorithm 208, which is typically kit specific. The processing typically employs stored in the user records database 202, such as calibration data and baseline data, and may also employ general (i.e. not patient specific) medical data stored in the medical information database 204.

Following processing of the test results as described hereinabove, decisions and recommendations are preferably provided to the user, preferably via the web site and the Internet. Additionally or alternatively, responsive to the test results and their relationship with established thresholds for the specific patient or for the type of test generally, an automatic connection may be established between the user and the manned center 36 (FIG. 1), via the web site of the controller computer and/or other media such as a telephone or video conference connection. Additionally, where appropriate, emergency assistance may be summoned to the user automatically or with human intervention. Preferably, all communications with the user and other parties as well as the entire decision making record are recorded for archival purposes.

Reference is now made to FIG. 5A, which is a pictorial illustration of part of the medical condition sensing system of FIG. 1 being employed for lung sounds condition sensing. FIG. 5A shows two stages in lung sounds condition sensing, a first stage, indicated by designation I, at which a baseline reference is generated, and a second stage, indicated by designation II, at which an actual test is conducted. The context of FIG. 5A is typically a situation wherein a person, such as a child, has a possible respiration condition which is evidenced in lung sounds emitted during breathing.

In the environment of FIG. 5A, a user interface is provided which preferably includes a stethoscope transducer 310, such as transducer commercially available from Karmel Medical Acoustic Technologies Ltd. of Yokneam Illit, Israel. The stethoscope transducer 310 provides an electrical output typically via interface circuitry 312 to a suitable interface of a general purpose computer 10 (FIG. 1), here designated by reference numeral 314.

A recording and storage facility 40 (FIG. 1), here designated by reference numeral 316, at general purpose computer 314 is operative for recording and storing at least one baseline plot of lung sounds received by the general purpose computer 314 from stethoscope transducer 310 during at least one first test taken at least a first time, such as on Jun. 30, 1999. This first test is preferably carried out when the child is in apparent good health and shows no symptoms of respiratory distress and is employed to establish a baseline. The baseline result may be visualized by the waveform 317.

Software 42 (FIG. 1) here designated by reference numeral 318, which is preferably resident in general purpose computer 314, provides appropriate signal processing and comparison of lung sounds received by the general purpose computer 314 from stethoscope transducer 310 during a subsequent test taken at a a subsequent time, such as on Aug. 15, 1999. This second test is preferably carried out when the person shows symptoms of respiratory distress and may require attention. It is seen that waveform 319 differs from baseline waveform 317.

Software 318 compares the lung sounds received during the second test with the baseline established by at least one earlier test and may apply a threshold to the comparison result. Software 318 typically provides via the general purpose computer 314 an indication of exceedance or non-exceedance of the threshold along with suitable description of the situation which may be accompanied by recommendations for action.

Software 318 typically compares various breathing parameters such as the slope of the waveform, the area under the waveform and the relationship between various portions of the waveform.

A controller computer 16 (FIG. 1), here designated by reference numeral 320, preferably communicates, via the network 14 (FIG. 1), with software 318 for assisting in providing recommendations for action. Where a manned center 36 (FIG. 1) is provided, a human interface or human evaluation of the lung sounds may also be provided to the user. To enhance the efficacy of interface between the user and personnel in the manned center 36 (FIG. 1) a video camera 38 (FIG. 1), here designated by reference numeral 322, may be located at the user location to enable personnel in the manned center 36 to view the patient who is experiencing apparent breathing distress.

In accordance with another preferred embodiment of the present invention, communication with the manned center may be actuated automatically by the system, normally through the action of the controller computer 320, for example in response to lung sounds of a certain type or the output of a comparison of the currently sensed lung sounds with a baseline or with a standard reference which exceeds a threshold indicating a possibly critical condition or possibly improper use of the kit.

Reference is now made to FIG. 6A, which is a simplified functional block diagram of the system of FIG. 1 having the functionality of FIG. 5A, namely lung sounds condition sensing, typically in an environment wherein a person, such as a child, has a possible respiration condition which is evidenced in the lung sounds emitted during breathing.

In the environment of FIG. 5A, as illustrated in FIG. 6A, stethoscope transducer 310 provides a lung sounds waveform via interface circuitry 312 (FIG. 5A) to recording and storage facility 316 (FIG. 5A) of general purpose computer 314 (FIG. 5A). As noted above with reference to FIG. 5A, preferably a baseline is initially established by a test conducted in an environment wherein a person, such as a child, is apparently breathing normally. Thereafter, a further test may be conducted when the person has a possible respiration condition which is evidenced in the lung sounds emitted during breathing. In both cases, the resulting waveform received from stethoscope transducer 310 is processed using the functionality described hereinabove with reference to FIGS. 2, 3 and 4.

In the embodiment of FIG. 6A, interface circuitry 312 is preferably portable'so as to be readily brought to the location of the patient and preferably employs a band pass filter 344 which filters out sounds picked up by the stethoscope transducer 310 outside a desired band, typically 80-4000 Hz, which includes both lung sounds and wheezing noises. The output of filter 344 is amplified by an amplifier 346 and preferably supplied to a memory 348. A portable power supply 352 preferably supplies power to the foregoing components as well as to a wireless communication interface 354 and/or a wired communication interface 356 which output to general purpose computer 314 (FIG. 5A).

In the embodiment of FIG. 6A, preferably, the recording and storage facility 316 stores both a baseline lung sounds waveform and an actual test lung sounds waveform. A lung sounds signal receipt and storage facility 360 receives and stores the signal received from interface 312. A signal processing facility 362 removes unwanted signal artifacts, such as wheezing signals having a duration less than 150 msecs, and generally prepares the signal for analysis.

A signal analysis functionality 364 preferably performs the following functions on the lung sounds signals:

Determination of the breathing rate;

Determination of the time relationship between durations of inhalation and exhalation;

Derivation of the slopes of the waveform at various stages during inhalation and exhalation;

Sensing the frequency pattern of the lung sounds;

Determination of the percentage of the duration of both inhalation and exhalation that wheezing occurs;

Sensing the presence of noises and other characteristic sound patterns in the lung sounds;

Normalization of the above parameters for the age and height of the patient, using patient data from a personal database, typically forming part of software 318.

The outputs of the signal analysis functionality 364 for the signal is preferably stored in storage facility 366.

The above-described functionality provided by software 316 is applied initially to a baseline signal and thereafter to an actual test signal. The stored results for both the baseline signal and for the test signal are supplied to software 318.

Comparison functionality 130 (FIG. 2), here designated by reference numeral 370, which is included in software 318 (FIG. 5A), compares the lung sounds waveform and analysis data relating thereto stored by recording and storage facility 316 with a baseline lung sounds waveform and analysis data relating thereto, also stored by facility 316. Comparison functionality 370 preferably applies sensed differences therebetween to thresholding functionality 132 (FIG. 2), here designated by reference numeral 372, which may apply a threshold to the comparison result indicating whether the currently sensed lung sounds substantially different from the baseline. Threshold functionality may employ data received from a personal database 374, which may also provide data to signal analysis functionality 364 of software 316 for use in normalizing analysis data for given patient parameters.

Outputs of comparison functionality 370 and thresholding functionality 372 are preferably provided to condition description functionality 134 (FIG. 2) here designated by reference numeral 375, which provides a description of the sensed respiratory condition via an output device, such as a display 50, printer 52 and audio transducer 54 (FIG. 1). Outputs provided by comparison functionality 370, thresholding functionality 372 and condition description functionality 375 may be further processed by recommendation functionality 136 (FIG. 2) here designated by reference numeral 376, which may provide indications/recommendations to the user via any one or more of display 50, printer 52 or transducer 54.

Preferably, both condition description functionality 375 and recommendation functionality 376 receive reference data from a database 140 (FIG. 2), designated by reference numeral 380, which stores acceptable ranges of outputs of comparison functionality 370, normalized for age, weight, height, sex and possibly other characteristics. Database 380 is preferably employed to enable condition description functionality 375 and recommendation functionality 376 to take into account the variation in acceptable changes in various personal parameters due to variations in age, weight, height, sex and possibly other characteristics.

Communication with a remote computer, such as a controller computer 16 (FIG. 1) may be initiated automatically by the general purpose computer 314 via the network 14, for example in response to the output of comparison functionality 370, threshold functionality 372, condition description functionality 375 or recommendation functionality 376, indicating, for example a possibly acute respiratory condition or a suspected misuse of the kit.

Thus, when a sensed personal parameter or the comparison output lies beyond a certain threshold which may indicate either an emergency situation or a situation requiring controller intervention, communication is established immediately between the user's general purpose computer 314 and the controller computer 16 (FIG. 1) via the network 14 (FIG. 1). As noted above, communication via the network 14 with the controller computer 16 may also be initiated by a user, at the user's initiative.

Reference is now made to FIG. 7A, which is a simplified flowchart illustrating the operation of the system of FIG. 1 in the operative environment of FIGS. 5A and 6A.

Initially the user accesses a system web site and carries out the initial communications and actions described hereinabove with respect to FIG. 4, which include the acquisition of a lung sound test kit including a stethoscope transducer and download of operating baseline establishment software to the user's general purpose computer 314 (FIG. 5A) from the controller computer 320 (FIG. 5A) or otherwise. The user registers with the user records database 202 of the controller computer (FIG. 3). As noted above, the user records database stores personal details of each patient for which the lung sounds sensing kit is to be used as well as general medical information regarding each such patient and results of tests conducted on that patient, using the lung sounds sensing kit, to the extent that such results are transmitted to the controller computer. Preferably, the information entered by the user into the user records database 202 of the controller computer 320. Thus, the personal details, general medical information and the results of the tests conducted on the patient, which are stored in the user records database 202, are also stored in the personal database 374 of the user's general purpose computer 314.

When the user is ready to perform a baseline establishing lung sounds test, following current use registration, a baseline determination is carried out typically in the following manner:

The lung sounds waveform is recorded at the user's general purpose computer 314.

The breathing rate is derived at the user's general purpose computer 314.

The time relationship between durations of inhalation and exhalation is derived at the user's general purpose computer 314.

The slopes of the waveform at various stages during inhalation and exhalation are derived at the user's general purpose computer 314.

The frequency pattern of the lung sounds is sensed at the user's general purpose computer 314.

The presence of noises and other characteristic sound patterns in the lung sounds is sensed at the user's general purpose computer 314. These noises and other characteristic sound patterns are preferably analyzed automatically to provide an output indication of frequency and amplitude.

Some of the above parameters are preferably normalized for the age and height of the patient.

It is appreciated that should one or more baseline values differ from expected values to a medically significant extent, such as that described hereinbelow with reference to FIG. 8A, appropriate indications/recommendations may be provided immediately to the user and the controller computer and the manned center may be employed as appropriate.

At a later time, when a test is carried out on the same patient who may be experiencing apparent respiratory distress, preferably all of the above listed parameters are measured and analyses are performed. Some of the above parameters are preferably normalized for the age and height of the patient.

At least some of the foregoing parameters as well as possibly other parameters are employed by operating software installed at the user's general purpose computer 314. Some or all of the parameters are preferably stored both at the user's general purpose computer 314 and in user records database 202 at the controller computer 320.

The general purpose computer 314 preferably determines the differences between the baseline values and the current test values for the various parameters and analysis results and preferably indicates both the absolute difference and the percentage difference.

Based on the calculated differences between the baseline and the current test results, and using the information contained in databases 374 and 380, the operating software installed at the user's general purpose computer 314 is preferably operative to provide a condition description and recommendations to the user via the user's general purpose computer. The user's general purpose computer 314 may also employ inputs from the controller computer 320 in providing the condition description and recommendations to the user.

Depending on the comparison results and the recommendations, the user's computer may provide to the controller computer 320 the comparison results and possibly some or all of the test and baseline information.

The controller computer may analyze the comparison results and possibly some or all of the test and baseline information and provide results of the analysis to the user via the user's general purpose computer.

Preferably, the controller computer 320 makes a determination as to whether to contact a manned center 36. The user may make an independent determination whether to contact the manned center 36. A user's decision to utilize the services of the manned center which is not supported by the decision of the controller computer 320 may incur an additional charge, depending on the financial arrangements with the user.

Preferably, the condition description and recommendations are provided in accordance with a decision table, an example of which is provided in FIG. 8A.

The decision table of FIG. 8A is merely exemplary and illustrates the application of typical decision and recommendation functionality to a typical patient, a 10 year child of height 140 cm.

As noted above, based on the application of the decision and indication/recommendations functionality, an indication/recommendations such as "INSIGNIFICANT CHANGE IN LUNG SOUNDS/NO ACTION REQUIRED", "POSSIBLY SIGNIFICANT CHANGE IN LUNG SOUNDS/CONTACT PHYSICIAN/REPEAT TEST", "SIGNIFICANT CHANGE IN LUNG SOUNDS I IMMEDIATELY INITIATE PHYSICIAN ORDERED TREATMENT/CONTACT PHYSICIAN IMMEDIATELY" and "HIGHLY SIGNIFICANT CHANGE IN LUNG SOUNDS/OBTAIN EMERGENCY TREATMENT IMMEDIATELY" may be made. In certain cases where the computer is unable to provide a reliable indication/recommendation due to technical difficulties with the test, an indication such as "BECAUSE OF TECHNICAL PROBLEMS RECOMMENDATION UNAVAILABLE/CONTACT YOUR PHYSICIAN/REPEAT TEST" may be provided.

Additionally or alternatively, an automatic connection may be made to the controller computer 320 which may apply decision functionality similar to that used by the user's general purpose computer, but preferably including additional informational resources, such as breathing pattern analysis and lung noise analysis. The controller computer may also make any of the above-listed recommendations to the user. Alternatively or additionally, an automatic connection may be made to the manned center 36 (FIG. 1) wherein a human operator, such as a physician may review all of the personal parameters, analyses thereof and additional available medical information and make appropriate recommendations for action.

As noted above, complete records of all communications between the user and both the controller computer 120 and the manned center are maintained at the controller computer for future reference.

Turning to FIG. 8A, it is seen that for each of a plurality of relevant parameters, such as breathing rate, the ratio of durations of inhalation and exhalation, the percentage of the duration of inhalation at which wheezing noises are heard and the percentage of the duration of exhalation at which wheezing noises are heard, predicted, baseline and current test values are provided. Ratios and differences are calculated, as well as the ratio of the difference between the current test and the baseline to the baseline (D/B). Additionally or alternatively, the differences between a current test and previous tests and/or predicted values, as from databases 138 and 140 (FIG. 2), for the same patient may be determined and used.

The differences are preferably categorized as to their significance and the number of parameters falling within each category are noted. It is appreciated that various parameters may be given different weighting. All of the relevant parameters are taken into account with their respective weighting and a total, suitably weighted, value is used to determine which indications/recommendations are provided to the user and whether to utilize the analysis of the controller computer 320 and/or to engage the services of the manned center 36 (FIG. 1).

In the specific example shown in FIG. 8A, four categories, each having a different weighting, are defined. Category A includes parameters having a current to baseline difference or (D/B) ratio less than 15% and is given a weight of 0. Category B includes parameters having a current to baseline difference or (D/B) ration between 15% and 30% and is given a weight of 1. Category C includes parameters having a current to baseline difference or (D/B) ratio of between 30% and 40% and is given a weight of 2. Category D includes parameters having a current to baseline difference or (D/B) ratio exceeding 40% and is given a weight of 4.

It is appreciated that differences in different parameters may be measured in different ways, as most appropriate. For example in FIG. 8A, the differences in the breathing rate and the inhalation/exhalation duration ratio are measured as the ratio of current to baseline values. The differences in the wheezing percentage during both inhalation and exhalation are measured by subtracting the baseline value from the current value.

Thus it is seen in FIG. 8A that one parameter, namely wheezing percentage during inhalation, falls within Category A and one parameter, namely wheezing percentage during exhalation, falls within Category B. No parameters fall within Category C. Two parameters, breathing rate and inhalation/exhalation duration ratio fall within Category D. The resulting total weighted score is thus 9.

The relationship between weighted scores and indications/recommendations for the example shown in FIG. BA, is typically as follows:

    Weighted
      Score   Indication/Recommendation
       0-2    "INSIGNIFICANT CHANGE IN LUNG SOUNDS/
              NO ACTION REQUIRED"
       3-4    "POSSIBLY SIGNIFICANT CHANGE IN LUNG SOUNDS/
              CONTACT PHYSICIAN/REPEAT TEST"
       5-8    "SIGNIFICANT CHANGE IN LUNG SOUNDS/
              IMMEDIATELY INITIATE PHYSICIAN ORDERED
              TREATMENT/CONTACT PHYSICIAN IMMEDIATELY"
       9+     "HIGHLY SIGNIFICANT CHANGE IN LUNG SOUNDS/
              OBTAIN EMERGENCY TREATMENT IMMEDIATELY"