WO2011130735A1

WO2011130735A1 - Collaborative telemedicine application for portable electronic communication devices

Info

Publication number: WO2011130735A1
Application number: PCT/US2011/032883
Authority: WO
Inventors: Cheryl B. Kerr; Lawrence P. Kerr; Lawrence B. Kerr
Original assignee: Kerr Cheryl B; Kerr Lawrence P; Kerr Lawrence B
Priority date: 2010-04-16
Filing date: 2011-04-18
Publication date: 2011-10-20

Abstract

An interactive, wireless, computerized system enabling physicians and other diagnostic healthcare workers to collaborate regarding the physical conditions of a patient and to communicate medical information to at least one other person. Communications and collaboration are facilitated between and among physicians and healthcare professionals, but do not require all parties to be using the system concurrently. Past medical cases, in the form of text files, graphics, X-rays, still photographs, moving video images, sound and any combination thereof can be reviewed and used for patient research and care. Information can be accessed, and updated, and participants can retrieve, assemble and share the information, utilizing portable electronic communication devices. The system allows the creation, replication, and management of a network. The network is constructed by each individual user and is unique to that user. Although the system focuses on individual members of the network and can be constructed by a centrally placed administrator, that is not necessary for this system.

Description

COLLABORATIVE TELEMEDICINE APPLICATION FOR PORTABLE

ELECTRONIC COMMUNICATION DEVICES

Related Applications:

This application is a continuation-in-part application of copending United States Patent Application Serial No. 1 1/239,176 entitled INTERACTIVE SYSTEM FOR

PHYSICIANS AND HEALTHCARE WORKERS, filed September 29, 2005 and incorporated herein in its entirety by reference.

Field of the Invention: The invention pertains to interactive, computerized systems and, more

particularly, to an interactive, computerized system, enabling physicians and other healthcare workers to collaborate and participate on medical cases utilizing smart phones and other portable, wireless electronic communication devices.

BACKGROUND OF THE INVENTION

Traditionally, medical care has been delivered primarily via a generalist or family doctor that cared for patients in a comprehensive, integrated way, simply by virtue of his or her being the only doctor caring for the patient. The drawback of such a delivery system of course is that this doctor could not be omnipresent, nor was he or she omniscient. There were times when the physician was unable to reach the patient and other times when training and experience simply were not specialized enough to handle the problem at hand.

Modern medicine has evolved to create, on one hand, highly skilled specialists who can handle even the most complex problems within the scope of their specialty. On the other hand, modern medicine makes use of home care aides and nurses potentially having limited knowledge but who are able to dedicate significant amounts of time to the patient, frequently in the patient's home. Mid-level providers are increasingly providing health care and need secure and reliable methods of collaboration with supervising physicians. In most ways, the modern medical system functions better than the traditional system, but providers often work in "silos" (i.e., in communicative isolation from one another). This often means that the system as a whole does not provide comprehensive, coordinated care, especially to health disparity populations. These disparities can include social needs, physical disfigurements, living sites and conditions, poverty, immigration, mental illness, and chronic disease. Some patients' care requires the collaboration of multiple providers, ranging from the home care aides that care for the patients on a daily basis to the multiple and diverse specialist physicians who deliver nuanced diagnoses and guidance.

All providers typically have something to contribute, but only rarely can one do the job alone when faced with complex or unusual situations. To ensure quality outcomes in those circumstances, providers must collaborate effectively. Sometimes, health disparities are experienced and created at a critical juncture, for example, when a rural patient, or one who cannot afford to travel, is subjected to inferior or delayed care. At best, delayed, sub-optimal care costs more, results in slower healing, causes more time off from work by the immediate and extended family, requires escort by nurses and aides, and also results in higher transportation costs. At worst, this type of care results in postponement or abandonment of the care plan, sickening of the patient, and, when all falls apart, typically an expensive visit to an emergency room via ambulance with the family, and finally, an admission to a hospital.

The problems created by such fragmented care appear to be most exaggerated in health disparity populations, for example, as with Medicaid beneficiaries. The Public Health Service Policy of 2001 states: "Lack of care coordination can have dire long- range consequences on cost and quality." Two-thirds of Medicare beneficiaries have two or more chronic conditions that account for 95% of all Medicare spending. Those with two chronic conditions see, on average, seven physicians per year. An estimated 0.1 percent of the population have ten chronic conditions. For that 0.1 percent, the number of physician visits escalates to an average of 42 per year. Utilization of multiple providers and sites often leads to fragmented healthcare and over-utilization of pharmaceuticals, an increase in medical errors, and repeated, costly hospitalizations. Improving healthcare coordination provides an opportunity to reverse such costly and adverse outcomes.

The physician applicants pioneered a web-based collaborative telemedicine system to begin to eliminate these health disparities at their source: the moment at which care becomes fragmented. This approach is patient-centric and systems-based. Users of the invention experience cost savings and better outcome metrics, even as the real amelioration of health disparities is seen in the larger health system. To increase the usefulness of the web-based collaborative telemedicine system, a mobile or wireless communications mechanism is herein described.

The existing store-and-forward solution, to which mobile application is a bridge, allows providers to collaborate on cases through a variety of media. Cases are immediately archived for future reference and for medical education. In many ways, this technology enables providers to bring the "medical home" to the patient, empowering general provider, specialist, and patient alike. Instead of a home care aide having to wait days for a consultation, he or she can receive management assistance remotely and quickly. Instead of a pediatrician sending the patient to a specialist, and that specialist sending the patient to yet another doctor, all three providers can collaborate remotely on complex diagnoses and treatments.

It is, therefore, an object of the invention to allow any individual medical provider to self-enroll for his own account and self-organize his own workgroups and referral network that parallel the medical relationships he already has.

It is another object of the invention to allow individual users and organization users to develop networks of particular users with whom they wish to collaborate, regardless of any organizational affiliation.

It is an additional object of the invention to allow providers the ability to grant nonreciprocal coverage to other individuals or groups, the provider granting the ability for a user to see his patient visits, although the first provider will not normally be able to see the visits of the covering provider.

It is a further object of the invention to provide both individual and organization- based users the ability to organize their own coverage relationships as clinically appropriate and to enable administrators to centrally manage these relationships.

It is a still further object of the invention to provide a system to allow users to self- organize HIPAA appropriate relationships that mirror their medical responsibilities.

It is yet another object of the invention to provide a filter option to select predetermined objects that a user prefers.

It is still another object of the invention to allow a provider using favorites to manage a short list of patients that he actively monitors and to allow the provider, once a patient is taken care of, to un-favorite that patient, so the provider sees only his active patients by a single button click.

It is a further object of the invention to provide a deep link in a notification email that contains a string to take the recipient directly to the appropriate visit immediately after login, allowing HIPAA compliance and also providing users with more certainty that they are consulting on the correct visit.

It is yet another object of the invention to provide a family member or a patient himself the ability to view the discussion of his visit. It is also an object of the invention to allow a provider involved in a consultation to invite, by email address, a non-user to log in with a password specific to the proposed visit and to view the collaboration on a readonly basis. Another object of the invention is to provide a log of all actions, including those that occurred at original creation as well as subsequent changes. It is still another object of the invention to allow a user to be able to enter data using voice dictation and recognition and, optionally, to read the text of a visit aloud by a machine.

It is a further object of the invention to provide a system to facilitate the

any human language in the provision of health care.

It is a further object of the invention to place all pertinent clinical data including but not limited to images, video, tests, and text in one place in order to create a rich data milieu in a clean and simplified presentation, promoting better decisions of care.

Discussion of the Related Art: U.S. Patent Nos. 6,779,024 and 6,408,330, issued August 17, 2004 and June 18,

2002, respectively, to DeLaHuerga, both disclose an information system network for remotely gathering information and storing the information at specific network memory locations for easy access. The system includes a remote information collecting device and a network including an input device and a memory storage device. The collecting device remotely gathers information and, based on the information gathered, generates storage addresses and browser configuration information to enable review and modification of collected information and subsequent storage.

U.S. Patent No. 6,283,761 , issued September 4, 2001 to Joao, discloses an apparatus for providing healthcare information. The apparatus has a processor for processing symptom information and condition information corresponding to a patient in conjunction with healthcare information, healthcare theories, healthcare principles, and healthcare research. A processor generates a diagnostic report that contains

information regarding a likely diagnosis and a possible diagnosis.

U.S. Patent Publication No. 2008/0059249 published March 6, 2008 by Joao, discloses an apparatus, including a memory device, for storing a healthcare record or history for an individual, which includes information provided by the individual or a healthcare provider, and information regarding a healthcare insurer or payer. A processing device processes information for storing or updating the information regarding the individual in the healthcare record or history. A request is processed for information and a message or report is generated in response to the request. A transmitter transmits the message or report via, on, or over the Internet.

U.S. Patent Publication No. 2004/0122705 published June 24, 2004 by Sabol, et al., discloses a multilevel network system for exchanging medical-related data. The data may originate from a variety of controllable and prescribable resources, such as at medical institutions. Patient computing devices are also included with the system. An integrated knowledge base may be accessed and compiled by virtue of the network links.

U.S. Patent Publication No. 2004/0122704 also published June 24, 2004 by Sabol, et al., discloses an integrated knowledge base of medical-related data accessed by a variety of users and resources. The integrated knowledge base may be located physically at a range of disparate locations, as may the users and resources. Based upon factors such as the user identification, the user type, the user function, the user environment, and so forth, the system can provide specifically adapted interfaces for interacting with the integrated knowledge base. Similarly, controlled access allow some but not all of the data or functionality of the integrated knowledge base to be offered to the specific user.

U.S. Patent Publication No. US 2003/0208477 published November 6, 2003 by Smirniotopoulos et al., discloses a medical image storage and retrieval system that includes a database with relationally linked tables including a disease factoid table, an image and image caption table, and a patient data table. The system allows for peer review, remote access and maintenance of the stored data, and query searching and retrieval of groups of related multimedia (image and text) case file information. U.S. Patent Publication No. 2002/0032583 published March 14, 2002 by Joao, discloses an apparatus for providing healthcare information. A processor can access, obtain, change, alter, and modify information contained in a patient's healthcare record and healthcare file. The system determines whether a requesting party is authorized to access infornnation contained in the healthcare record and healthcare file. The apparatus also comprises a transmitter for transmitting said notification report.

U.S. Patent Publication No. 2001/0032099 published October 18, 2001 by Joao, discloses an apparatus for providing healthcare information, including a memory device for storing information for performing a healthcare diagnosis, prescribing a treatment for a healthcare diagnosis, and monitoring such treatment. A receiver receives information regarding an individual's symptom, an individual's condition, and an individual's illness. The processor generates a diagnostic report containing information regarding a likely diagnosis, a possible diagnosis, and a list of other, progressively less likely possible diagnoses, and a treatment report containing treatment, drug interaction, information, and treatment interaction information.

None of the aforementioned patents and published patent applications, taken singly, or in any combination, is seen to teach or suggest the novel self-administered relationships that allow users to self-organize HIPAA appropriate relationships that parallel their medical responsibilities. Nor are they suggestive of a network distributed environment as opposed to a centrally controlled hub and spoke environment.

SUMMARY OF THE INVENTION

In accordance with the present invention there is provided a method of contacting medical specialists, allowing collaboration among professionals, and educating participants to retrieve, assemble and share medical information. A user logs on to an information system using a portable electronic communication device and searches for a doctor for collaboration, or for a patient who desires or requires a consulting opinion. The user then selects a person from a list. The communication of information is via the portable electronic communication device allowing professionals and participants to analyze information remotely, for the direct benefit of the patient. BRIEF DESCRIPTION OF THE DRAWINGS

Various objects, features, and attendant advantages of the present invention will become more fully appreciated as the same becomes better understood when considered in conjunction with the accompanying drawings, in which like reference characters designate the same or similar parts throughout the several views, and wherein:

FIGURE 1 is a flow chart of system operations in accordance with the invention;

FIGURE 2 is a flow chart of a remote communication device pathway; FIGURE 3 is a flow chart of a visit option; FIGURE 4 is a flow chart of user network options;

FIGURE 5 is a flow chart of options for provider coverage of the patient; FIGURE 6 is a flow chart of the settings option;

FIGURE 7 is a flow chart of the network stack;

FIGURE 8 is a schematic representation of a systems communication

architecture structure;

FIGURES 9-18, taken together, depict an embodiment of the invention as portrayed on a portable electronic communication device, specifically the Apple iPhone® device; and FIGURES 19-22, taken together, depict an embodiment of the invention as portrayed on a desktop computer web browser. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The present invention provides a method of contacting medical specialists, allowing collaboration among professionals, and educating participants to retrieve, assemble and share medical information. This collaboration technique is accomplished by logging on to an information system using either a portable electronic communication device or a web browser to search for either a doctor for collaboration, or for a patient who requires attention. The user then selects a person from the list presented, if more than one person matches the search criteria. The communication of information is via a portable electronic device, such as a handheld device (e.g., devices sold under the trademarks, iPhone/iPod/iPad, Blackberry, Kindle, etc.) allowing professionals and participants to further analyze medical information remotely. The system can also be accessed through a web browser on a desktop or laptop computer. Referring now to FIGURE 1 , there is shown a flowchart 10 detailing the process required to log on to the inventive system, step 12. The user enters logon information for verification, step 14. After acceptance of credentials, the user is directed to a welcome page, step 16. From the welcome page, the user is taken to the home screen, step 17, or the screen he or she last accessed during the previous session, step 18. The screens available are visit 30, network 40, coverage 50, and settings 60. The first or each time a person enters the system, he or she is presented the aforementioned screens from which to select.

Referring now to FIGURE 2, there is shown a flowchart 20 describing a process to access the collaborative telemedicine application using, for purposes of illustration, an Apple iPhone® device (not shown). Upon successful start up and initialization of the device, the user launches the application, step 22. After successful authentication, step 14, one of two screens appears based upon whether the iPhone was able to access the database, step 16.

If no connection is available, the application defaults to offline, step 26. While offline, step 26, the user may utilize the camera resident to the device to take a still or moving picture, attach freeform text notes with medical descriptions and demographics, and add it to a private photo roll for transmission later, step 28. No further navigation is available to the user as long as the iPhone device is offline, step 26. If a connection is available, the online iPhone device connects to the server 71 (FIGURE 7), step 24, and allows the user access to the welcome page, step 16. Referring now to FIGURE 3, there is shown a schematic view of the visit screen, step 30. After selecting the visit screen, the user has the option to select a consult view screen, step 32, a visit view screen, step 35, and an image detail screen, step 38. The consult view screen 32 opens to allow the user to select an existing patient detail, step 33, or add a new patient, step 34. This and subsequent screens are described in more detail hereinbelow starting at FIGURE 9.

Another selection available on the visit (consults) screen, step 30, is the visit view screen, step 35, that allows the user to see patients needing consults, or patients of the user awaiting a specialist consult. Selecting the new visit screen, step 36, gives the user the option of creating a new visit for a new patient, or creating a new visit for the current date/time that is associated with the presently selected patient. Also available from the visit view, step 35, is a selection to add or take an image, step 37. The user then can take an image, or select a previously taken image, step 28, which is applicable to the current consultation. Both new and existing images of step 37 can be viewed on the screen 38 for further analysis and storage.

Referring now to FIGURE 4, there is shown a schematic view of a healthcare providers' collaboration network, step 40, that encompasses both current invitations, step 41 , and pending invitations, step 42, for consultation and coverage. Current invitations 41 include persons with whom the user has current patient collaborations, while pending invitations 42 have invitations which have been sent by the user and received from other healthcare providers requesting collaboration.

Also available from the current invitations selection, step 41 , is a screen of existing approved providers, step 43, who are available for collaboration. A terminate option, step 44, is available to remove a provider from a patient collaboration, such as when the patient's health has improved, or to remove the provider from the user's local directory, not shown. When an invitation 41 is received, the providers then confirm this request. From that point on, the two users appear in each other's list as a provider who is available for consultation/collaboration. This relationship is reciprocal: if A invites B and B accepts, A becomes a member of B's network and B become a member of A's. This allows both individual users and organizational users to develop networks of particular users with whom they would like to collaborate, regardless of any

organizational affiliation.

Under the pending invitations, step 42, is a screen that provides a record of users needing approval, step 45, and outstanding invitation requests that have been made by the user. Some of the options available to the user to respond to a pending invitation 42 on this screen are to approve, ignore, or block the invitation, step 46. If the user is unsure at this time, the user can cancel the action. While the user is viewing the pending invitation screen 42, the user can select a name from a needing approval screen, step 45, and view the requesting user's detailed profile, step 47. Referring now to FIGURE 5, there is shown a schematic view of the provider coverage, step 50, that defines those which collaborating provider will cover when a second provider is not available, or with whom a user continually shares patient information over a long term, such as a medical group. For the purposes of this discussion, when provider A is said to be covering for provider B, this means that all of the patient visits visible to Provider B will automatically be visible to Provider A, so as to allow Provider A to care for these patients in conjunction with Provider B or in his absence. This is a non-reciprocal (one-way) relationship. This screen specifies the start and stop dates when someone, either the user himself or another provider within user's network, step 40, will cover and the named coverage group to which they belong. The screen lists the providers who are currently providing coverage for the current user while the current user is unavailable, with dates that the covering providers are scheduled to cover, step 51 . The screen moreover has a list of the current user's obligations to cover, step 52, other providers' patients, along with start and stop dates that the user is scheduled to cover. Also provided is a list view screen that provides a simple list (textual list and thumbnail image) for both who is covering for the user, step 53a, and for whom the user is covering, step 53b. From the list of who is covering for the user 53a, the user can add or remove names, step 54, as required to provide proper coverage to the patient. Options available for whom is the user covering for 53b are for the user to approve or cancel the coverage request, step 55, the pending request, step 42. By selecting a provider's name from the covering screens, steps 51 and 52, the user can view the requesting provider's detailed profile, step 47. In addition, providers are able to grant nonreciprocal coverage to other individuals or groups. This nonreciprocal coverage signifies that the first provider grants the ability to the second provider to see the first provider's patient visits. The first provider is not able to see the visits of the covering provider unless the covering provider makes his own coverage request to the first provider.

Referring now to FIGURE 6, there is shown a schematic view of the settings screen, step 60, for the current user and device. The user profile, step 61 , contains information about the user such as the user's name, photo, title, specialties, and contact information. This information is retrieved when a second user selects one of the providers detailed profile screens 47. When user preferences are selected, step 62, a screen opens to allow the setting of user preferences, such as: allowing collaboration requests; the relationship of each provider with one another; user status, such as available/not or auto mail indicating same; and user-specific user interface preferences such as date format, and patient and provider name formats.

Payment options and status, step 63, displays the user payment options that are available for the payment of the provider's subscription cost to the system for use of the service and the status of pending payments. Localization, step 64, allows the user to specify a physical locale for sake of language (English, Spanish, etc) and time zone.

When a provider desires to block another user from his network, the user selects the provider and chooses to block the selected provider, step 46. The current user can view whom they have blocked from their network by utilizing the settings screen 60 that lists names of blocked providers, step 65. An option (not shown) is available to the user to unblock a provider on the blocked provider list, thereby allowing that provider to submit a request, step 45, to join the user's network. A screen is provided for other options, step 66, that fall outside of the settings delineated herein. Referring now to FIGURE 7, there is shown a schematic view of the simplified network stack 70 of the current collaborative telemedicine application. Two branches of the network stack 70 are provided, the first comprising a user utilizing a web browser resident on a standard personal computer 76 connecting over the Internet to, in one embodiment of the application, a Servoy™ or similar web client 75 fed by a headless client server 72 that is resident on the application server 71 , thereby accomplishing the task of proper medical care and billing. This is the way billing has been performed since the dawn of the computer age, when computer terminals were little more than a display device connected by a hardwire to a central computer processor that executed all required processing.

The second branch of the network stack 70 is a focus of this invention, whereby an iPhone user 74 connects to application server 71 utilizing a so-called headless client 73 supplying Java server pages being fed by a headless client server 72. A headless client allows other applications to execute application server-based business rules including making use of them as a web-based wireless capable service. The headless client enables programmers to develop web browser or native mobile applications that access any data hosted by a server. Processing is performed locally on the mobile device (such as off line photo management) and centrally (such as later database management).

Referring now to FIGURE 8, there is shown a schematic conceptual diagram of one embodiment of the collaborative telemedicine application for portable electronic communication devices, generally at reference number 100. A user 102 interacts with a browser 106 through a hardware interface 104. Browser 106 is executed on an electronic communication device 108 connected to the Internet 1 10. While the Internet is used for purposes of disclosure, it will be recognized that the collaborative telemedicine application for portable electronic communication devices may function effectively in any computer environment. Consequently, the invention is not limited to the Internet but is seen to include any and all network topologies or methods. Also for purposes of disclosure, the described electronic communication device 108 is meant to encompass both stationary and portable devices. A server 1 12 hosts at least user data 1 14, application software 1 16 and user preference information 1 18. Server 1 12 has a web server layer 120 containing a Servoy web client 75, and CGI layer 122, which, in turn, interfaces to the Internet 1 10. It should be understood that the Servoy web client 75 is one embodiment of the current web client devices known to those of skill in the art.

Electronic communication device 108 may be selected from among a wide range of computing and communications devices know to those of skill in the art. Electronic communication device 108 may be a laptop, tablet, or notebook computer, a personal data device (PDA), a mobile (e.g., cellular) telephone, other wireless device, an Internet appliance, and the like. Any platform (e.g., electronic communication device 108) may be used, even a device having tiny embedded Linux, for example, as long as the qualifications discussed hereinbelow are met. Electronic communication device 108 must be able to support either a browser- based web client 106 and have a user interface (e.g., a hardware interface 104), or in the exemplary embodiment of the invention, a native smart phone client application that shares data and processing from the server. Typically, electronic communication device 108 has a display screen, not shown, and data input means, not shown. However, it will be recognized by those of skill in the art that hardware interface 104 may consist of many other visual, auditory, or tactile (motor or sensory) devices capable of receiving data from and providing data to a user 102. All user interaction with application software 1 16 and with user data 1 14 or with user preference or security information 1 18 is via hardware interface 104 and browser-based web client/native client 106.

Browser-based web client/native client 106 is typically a web browser based application or a native application that shares data from the server. The collaborative telemedicine application for portable electronic communication devices is designed from the ground up to optimally maintain and protect a user's data. The invention is not limited to the browser or browsers chosen for purposes of disclosure; rather, the invention includes any and all suitable browsers.

It is not necessary for a suitable run time environment 124 to be available within electronic communication device 108, either as a part of browser 106 (e.g., a plug-in, etc.) or elsewhere present within the electronic communication device 108. The exemplary embodiment of the invention uses the AJAX-enhanced Servoy web client, which operates completely within a normal web browser and does not require Java to function on either the electronic communication 108 or browser 106. Assuming that application programs 1 16 are written in Java, run time environment 124 is a Java virtual machine. It will be recognized that other programming languages (e.g., Flash, etc.) may be used to write application software 1 16. Run time environment 124, of course, then must support execution code written in that language. It is assumed that electronic communication device 108 includes network connectivity allowing connection to server 1 12. The inventive system may be used across any network using any suitable interface mechanism and/or communications technology. Such interface mechanisms and communications technologies may include, for example, wireless communications media, wireless communications networks, cellular communications networks, 3G and 4G communications networks, the Internet, intranets, a combination thereof, and the like. More specifically, the communications technology may include, for example, radio frequency (RF) communication, infrared (IR) communication, WAN, Wi-Fi, Point-to-Point Protocol (PPP), Secure Sockets Layer (SSL), transport layer security (TLS), IrDA, global system for mobile communication (GSM), code-division multiple access (CDMA), general packet radio service (GPRS), universal mobile telecommunications system (UMTS), and the like. Consequently, the invention is not limited to the Internet 1 10 chosen for purposes of disclosure. Rather, the invention includes any of the aforementioned network topologies, systems, or methods as well as any other suitable network systems known, or yet to be invented or designed.

In addition, the electronic communication device 108 used with the invention may access the network (e.g., Internet 1 10) on which the invention is being used through any suitable transmission media, including, for example, electromagnetic waves, and the like, such as those generated during RF communications, IR data communications, and the like.

Server 1 12 is equipped with suitable software to implement a common gateway interface (CGI) 122. Implementations of CGI 122 are also well known and are not, therefore, discussed in detail herein. Under suitable conditions, a peer-to-peer network architecture can be established between a plurality of portable electronic communication devices. An application programming interface (API) allows the software portion of the invention to interface with other programs and databases to open, read, and enter data from the system to and from an electronic health record, regional or national information exchange, or demographic and financial management system.

For purposes of disclosure, an Apple iPhone® device is described hereinbelow, and it should be understood that the portrayal embodied herein describes various features specific to the iPhone. Although an Apple iPhone device is described in the preferred embodiment, other portable electronic communication devices can be used. As this is a specific embodiment of the invention, individual figures shown depict the aforementioned iPhone device. Where reference numbers are shown, they refer to similar features detailed hereinabove. This detailed description also includes details of the embodiment that are not shown in the figures, but are capabilities and operations of the complete inventive concept.

Referring now to FIGURE 9, login view 12 appears on launch 22. The username 200 auto-fills based on the registered owner of the iPhone device. The password 202 must be entered via the keyboard. Selecting the log in button 203 completes login 12. Selectable buttons, such as "register as a new user" 204 and "forgot password" 206 are available for self-administered registration and password resets via email. Also on the login view 12 are terms of use and accreditation 207 that a user accepts to have certain sets of privileges within the system. Protected health information is accessed only upon successful completion of a login sequence 12. During login, the user is assigned a specific set of privileges that allows the user to observe and share information pertinent only to a specific patient for whom the patient cares. Various roles are also assigned, such as observation as a lay observer, student, delegate, physician, or administrator. These roles are certifiable by attestation, or assignment by an administrator of an institution. Where appropriate, various licensing considerations such as state license or specialty certification are displayed on the screen here. The privileges and roles are those attributes that determine what a user can see and what they can do within the system. After successful authentication 14, one of two screens appears based upon whether the iPhone device is able to contact the database. If no connection is available, the application defaults to offline 26, wherein the screen reads: "Welcome to ClickCare. Currently you are working offline."

Tapping the camera icon allows a user to take a still or moving picture and add it to a private photo roll for transmission later 28. Limited demographic information and brief medical information are allowed. No further navigation is available to the user as long as the iPhone device is offline 26.

If a connection is available, FIGURE 10 displays the online welcome screen 16:

"Welcome to ClickCare." Done button 210 navigates to home (also referred to as Visit List or Consults List) screen 17. Displayed on the welcome screen 16 are announcements 212 that have current messages 214 listed below, and an option to recall a screen to review older messages 216. The welcome screen 16 provides a general communication mechanism. Communication could be widely disparate and can change as needs dictate. Messages such as disaster, national emergency, and disease outbreaks would notify medical personnel immediately as the application is opened. Trends such as H1 N1 influenza, anthrax, or hurricane formation are provided to the user. Further, expected server outages, notifications of upgrades from the cloud, and advertising messages are placed on the welcome screen 16.

Now referring to FIGURES 1 1 a-d, home view 17 is shown. Home view 17 can be used for both portrait 32a and landscape 32b orientation.

Portrait home screen 32a contains a list of patients 221 and a favorites button 220 that adds a patient to the user's favorites list for easier access to that specific patient at a later time. The landscape home screen 32b displays pictures of various patients that were taken previously and added to the application for review. A user can select a picture 222b in landscape mode 32b or select the view patient detail button 222a in portrait mode 32a to activate FIGURE 1 1 c, patient detail screen 33a, which contains patient name 224, the user who entered patient into system 226, and patient pertinent information 228.

FIGURE 1 1 d is the result of selecting search visits button 223, a button that is contained on many screens, but serves a dedicated function that is dependent on the screen on which it is displayed. Likewise, add new patient button 225 is also located on many screens and serves a dedicated function that is also dependent on the screen on which it is displayed. This will become evident as further descriptions are detailed hereinbelow.

Search visits screen 223a also contains a search field 230 and a keyboard 232 for entering characters in the search field 230. The home view 17 is a central area that provides the user a management screen to view thumbnails of graphics (videos, pictures, icons, images, and any digital document), pertinent demographic information, and health care provider of a patient; an indication of status, such as favorite 220 that allows sorting or selection of specific cases for special attention for such things as teaching, heightened intensity, recall, and recentness; coverage 50 by other providers as to whether a person is covered, recent changes and time of recent change having a color and alpha numeric distinction; consultation or response needed to a request; and geolocalization, whereby a visiting nurse could be directed to a patient needing care by the patient's actual geographic coordinates, much like a GPS system, whereby the patient's location was entered by a provider during a visit to the patient at the patient's domicile. Also, if the need arose for an unscheduled visit, the nearest person to the patient could respond using the application to locate him or her.

The ability of modern geo-location techniques in portable devices allows for further management of workflow for consultation and collaboration. Information about the device's (and by assumption the user's) location can be transmitted back to a central station or to other users' devices. This enhances safety, teamwork and efficiency.

Monitoring of each user's position allows monitoring of activity, allows members of teams to meet at a mutually convenient site or home site, and allows an unscheduled visit to be assigned to the closest team member. Work and transportation can be planned automatically by using an algorithm such as the traveling salesman algorithm. Geo-localization also assists in managing the accountability of users by supervisory personnel.

FIGURES 12a-d and 13a-c depict the visit view (Consults Visit Page) 30.

Depending upon orientation, a user navigates to the visit view 30 by tapping on a record in portrait view 32a or a current image in landscape view 32b of the home view 17. As indicated above, one can also navigate to the visit screen 30 from a list in patient detail 222c. There are both an image 35b and a dialog 35a view for the visit. The current view is controlled by a segmented button having image 250 and dialog 252 segments to toggle between image 35b and dialog 35a screens.

FIGURE 12b depicts a landscape dialog screen 35a, with a menu bar 245 having the following buttons for users to activate in this view: Invite provider to collaborate on visit 240, add a new comment on present visit 242, a view-only invite by email 244, and add a photo, video or other media button 246. Selecting one of these buttons produces the expected result, as shown in FIGURE 12c, wherein selecting invite provider to collaborate on visit 240 button produces the option to invite a provider to collaborate 240, a screen that has a search function 230 and a keyboard 232 to enter a provider's name. Selecting add a new comment on present visit 242 results in FIGURE 12d appearing, again showing keyboard 232 and an entry window 248 so the provider can see what he is typing, and a send button 254 to publish the comment in the patient's file for all collaborating providers to see.

Continuing to refer to FIGURES 13a-c, the image view 35b part of the visit image/dialog screen is shown in portrait and landscape modes. Selecting patient detail button 33 recalls patient detail 33a, represented by FIGURE 13c, allowing the provider to select a clinical category 256 to further define the treatment required for the patient, or to complete or review surveys such as epidemiologic trends. These screens also have a menu bar 245 that allows collaboration and better care to start at the bedside.

FIGURE 14 visually describes the process of collaboration 260 among health care providers utilizing the current invention for the enhanced care of patients. A provider entering the circle at any point allows that provider to manage the collaborative tools in a most effective way, whereby the patient information is available on a mobile handheld device on an as-needed basis. The provider has access to previous visit dialogs, images, supplementary visit detail, billing options, and more. The provider can invite additional specialists to take part in a remote collaboration while the first provider is with the patient, and the provider with whom they are collaborating with is elsewhere.

The visit suite has collection, compilation of data (visual, aural, and text) and the formulation of specific questions. Free and focused discussion of information, the reiterative and compounding actions that constitute collaboration are focused here. While reference and comparison is available, the purpose of this suite of screens is to allow the user to collaborate with one or more colleagues. This management and addition of data and interpretation is combined with other management methods and thus, differentiates this invention from mere reference and databased files, comments, and electronic health/medical records.

FIGURES 15a-b are representative screens from a healthcare provider's collaboration network 40 that encompasses both current invitations 41 and existing approved providers 43 pending invitations 42 for consultation and coverage. Current invitations 41 include persons with whom the user has current patient collaborations, while pending invitations 42 have invitations which have been sent by the user and received from other healthcare providers requesting collaboration. When an invitation 41 is received, the provider then selects either the accept button 270 or the deny button 272 to process the request. After acceptance 270 of an invite, the provider is shown on the approved providers list 43 within the user's network 40. A terminate option 44 is also available to remove a provider from one's approved provider network 43. The network 40 screens described herein also have the search feature 230, favorite button 220, and provider detail view 222 that were described hereinabove.

The network page 40 is a central area that provides the user a management screen for building and self-administrating a network of those individuals with whom a working relationship has been or will be established. This is the area where one manages what are often called friends, those with whom one is involved for consultation and coverage. The page has two views: those potential members 41 who have been invited those whose acceptance by them is in process, and those 43 who have agreed to join the users network. The data presented consists of thumbnails of the photographs of others in the user's network, pertinent demographic and contact information, and an indication of their status, such as a favorite or pending acceptance. Utilizing the favorite button 220 allows sorting and/or selection of specific items for special attention for things such as familiarity, frequency of interaction, recentness. Also provided is a waiting timer 274 that illustrates that an invitation has been made, but acceptance not yet acknowledged.

The view of the network screens can display whether a provider has been invited or has accepted an invitation, a search that allows a search for any person by name, specialty, etc. who is enrolled in the system, the ability to add a new person to join the user's network, further details of the network members' demographic information, a favorites list that allows changing status of favorites, the ability to remove a member of the user's network from their list, acceptance of an invitation from another user to join that person's network, the ability to deny an invitation by another user to join their network, and cancel, which allows the user who had invited another to cancel that invitation.

FIGURES 16a-c are the representative screens from a healthcare provider's coverage and delegates 50. In FIGURE 16a, the pending invitation screen 42 lists invitations from the user or to the user and the status as the user selects either the accept button 270 or the deny button 272 to process the request. A waiting timer 274 illustrates that an invitation has been made, but acceptance has not yet been acknowledged.

In FIGURE 16b, the coverage screen 52 defines who the collaborating provider will cover when a second provider is not available and contains a list of the other provider's patients 53b. An available screen (FIGURE17f) further specifies the start and stop dates when someone, either the user himself or another provider within the user's network 40, will cover and the named coverage group to which they belong. FIGURE 16c shows the screen that lists the providers 51 who are currently providing coverage for the current user while the current user is unavailable, with dates that the covering providers are scheduled to cover. Also provided is a list of names that provides who is covering for the user 53a. From the list of who is covering for the user 53a, the user can add or remove names 225 as required to provide proper coverage to the patient.

The coverage suite allows for relationships to be assigned so that health protected information is accessible to users other than the current user. This assignment is made on a need to know basis. While such relationships, such as a small group of surgeons, are relatively stable, this set of screens allows invitations to be sent, accepted or denied, and even blocked. Further, data that was entered during the user's

enrollment can be accessed within the provider's detailed view 47. This is similarly reflected and administered in the web and browser based form of the invention, hereinbelow described.

On occasion, a user may wish to ask a delegate, such as a nurse or secretary, to retrieve or enter data on the user's behalf. Access to the data, and the recording of actions is entirely under the supervision of the user who selected and enrolled the delegate.

FIGURES 17a-h are views of various settings screens 60 that are available for the current user. The user profile 61 contains the user's name, photo, title, specialties, and contact information 280. This information is retrieved when a second user selects one of the provider's detailed profile screens 47. When user preferences 62 is selected, the screen allows the setting of user preferences, such as collaboration requests, the relationship of each provider with another, user status, such as availability, and the demographics of the provider. Payment options and status 63 displays the user's credit card payment options 63a that are available for payment of the provider's subscription cost to the system for use of the service and the status of pending payments. An optional module, not shown, allows patient billing on behalf of the user. A database is used for documentation of an activity, time spent on the activity, and the role of the user in the activity. This allows the provider to bill the patient correctly and promptly without having to return to a central location to log time and enter billing codes. Localization 64 allows the user to input his local office billing codes and accounting standards that are specific to his or her organization, thereby giving medical groups the flexibility in billing structure. This does not override, but complements payment options 63 in assuring correct billing and accounting of patient interactions.

FIGURES 17e and 17f are representative screens of a healthcare provider's coverage and delegation 50, and further provides a simple list for both who is covering for the user 53a and whom the user is covering for 53b. From the list of who is covering for the user 53a, the user can add or remove names 54 as required to provide proper coverage to the patient and can specify the start and stop dates 284 when someone, either the user himself or another provider within the user's network 40, will cover.

Delegates screen 53a further lists what providers have accepted the user's invitations to provide coverage 286. Referring now to FIGURES 17g and 17h, when a provider desires to block another user from his network, the user selects the provider and chooses to block 46 the selected provider. The current user can view those he has blocked from his network by utilizing the settings screen 60 that lists names of blocked providers 65. An option is available to the user to unblock 282 a provider on the blocked provider list, thereby allowing that provider to submit a request 45 to join the user's network. A separate screen is provided for other options 66 that fall outside of the settings delineated herein.

Referring now to FIGURE 18, there is shown a patient centered collaboration and communication cycle 290. When a patient enters the health care system for treatment, he starts the cycle with the provider having meager information 292 about the patient's past history and current condition. The level of knowledge increases during the initial intake question and answer phase. As more information is gained, decisions on collaboration and coordination of care are achieved through the protected interchange of informational communications among providers and the collaborators they invite to participate within circle of the patient's care. Workflow management, the ability to view disparately collected information, plus the recursive style of communication, allow participants to converge on the proper diagnosis of a patient's injury or ailment by having more specialist filtered information available to make better decisions 294, and builds a skills network 296 that the provider can use in the future for a quicker resolution of a patient's illness.

Continuing to refer to FIGURE 18, utilizing filtered information is meant to keep information overload to a minimum, whereby a general practitioner performing a search on his or her own for symptoms described by the patient may result in a plethora of results, often with conflicting diagnoses. When the patient's family can be incorporated into this care cycle, the support role delivered by the family can be a positive influence on the patient's well being. And as the patient record is being built and care is being delivered, students can learn from the consultations and coordinated care that evolved from the collaborations of providers and specialists, and see the advantage of using available resources to their fullest extent.

FIGURES 19a-f are views of a desk top computer web browser screen related to the selection of settings 60 menu choice. The profile 61 , preferences 62, payment 63, delegates 53a, coverage 53b, and blocked users list 65 are shown. The detailed description of these embodiments is contained in the preceding pages, and is not reiterated here. FIGURES 20a-d are views of a desk top computer web browser screen related to the selection of provider based groups, incorporating organization name 302, who the users 302 within all the organizations are and what group specialties 304 are available for collaboration. A search box 230 (FIGURE 20d) allows the user to look for individual patients or providers, and to view the history log 310 of their relationship within the application.

FIGURES 21 a-b are views of a desk top computer web browser screen related to the selection of coverage 50, whereby providers are inviting or have been invited 41 by others to join the network, and whether the invitees have accepted the invitation. The user may accept, ignore, or block 46 the invitation. If the user is unsure at this time, the user can cancel the action.

FIGURES 22a-c are updated views of a desk top computer web browser screen related to the selection of home view 17. This is the central area that provides the user a management screen to view a list 314 of thumbnail graphics, such as videos, pictures, icons, and images, pertinent demographic information, and the health care provider of a patient. Also displayed are an indication of status such as favorite 220, and consults requested 316 by, and for, the user. The user receives an instant snapshot of the current situation.

The archive view 318 allows the user to review information of present and past cases, and to easily select or sort based on keywords entered into the search field 230. A user can select a record to review, whereby the patient detail screen 222c, which contains patient name 224 and patient pertinent information 228 is displayed. Print selection 320 is available for various reports and can be tailored as needed to allow the physical or electronic printing of a patient's visit or visits. The selection of the desired report for printing is performed by the user. This view is similar to FIGURE 1 1 c, but with increased screen size, more information can be displayed at one time on the screen without clicking through to various screens. This is the trade-off between portability and functionality. The handheld device 108 has all the information available to the user, only not all on one screen. Since other modifications and changes varied to fit particular operating requirements and environments will be apparent to those skilled in the art, the invention is not considered limited to the example chosen for purposes of disclosure, and covers all changes and modifications which do not constitute departures from the true spirit and scope of this invention.

Having thus described the invention, what is desired to be protected by Letters Patent is presented in the subsequently appended claims.

Claims

What is claimed is:

1 . A method of accessing specialists, collaborating among professionals, and educating participants to retrieve, assemble and share information, the steps comprising: a) logging on to an information system by means of a portable electronic communication device; b) searching for an entity having at least one predetermined characteristic and retrieving a result set therefor; c) selecting at least one of a group of entities if said result set is greater than one; and d) communicating said information via said portable electronic communication device to said professionals and participants for further analysis thereof.

2. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , the steps further comprising: e) providing means for an individual to self-enroll in said information system.

3. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , the steps further comprising: e) creating a self-replicating network of users unique to an individual.

4. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 3, the steps further comprising: f) providing non-reciprocal coverage to individuals selected by at least one member of said network.

5. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , the steps further comprising: e) filtering records representative of patients and objects in said information system.

6. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 5, the steps further comprising: f) creating a short list of patients.

7. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 3, the steps further comprising: f) providing HIPAA compliant deep linking ability within a network of users.

8. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , wherein said professionals comprise medical professionals.

9. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , wherein said information can be accessed by a group of professionals and participants, independent of constraints of time and place.

10. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 9, wherein said group of professionals and participants is chosen from the group of: physicians, healthcare workers, nurses, aides, hospital employees, administrators, students, laboratory workers, and

technicians.

1 1 . The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , wherein any language is used for exchanging said information.

12. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 10, wherein said group of professionals can communicate with one another by means of at least one of the group:

videoconferencing, virtual conferencing, real time communication, synchronous communication, and asynchronous communication.

13. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , wherein said communicating step (d) is performed by means of reports generated by one of the group: submitting physicians and consulting physicians.

14. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 13, wherein said generated reports comprise text and photographic images.

15. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 13, wherein said generated reports are printed.

16. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , the steps further comprising: e) logging at least a portion of said information.

17. The method of accessing specialists, collaborating among professionals, and educating participants in accordance with claim 1 , wherein said logging on step (a) further comprises using a peer-to-peer network.

18. A system for accessing specialists, collaborating among professionals, and educating participants to retrieve, assemble and share information, comprising: a) means for storing records representative of entities having at least one predetermined characteristic; b) means for searching for an entity in said means for storing records; and c) means for communicating information relating to said entity to professionals and participants by means of a portable electronic communication device for further comprehension and processing analysis thereof.

19. The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 18, wherein said professionals comprise medical professionals.

20. The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 18, wherein said information can be accessed via portable electronic communication device by a group of professionals and participants.

21 . The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 20, wherein said group of professionals and participants is chosen from the group of: physicians, healthcare workers, nurses, aides, hospital employees, administrators, students, laboratory workers, and

technicians.

22. The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 20, further comprising: d) means for communicating among said professionals and participants, said means comprising at least one of the group: videoconferencing, virtual conferencing, real time communication, synchronous communication, and asynchronous communication.

23. The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 18, wherein said means for

communicating comprises means for generating reports created by one of the group: submitting physicians and consulting physicians.

24. The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 23, wherein said generated reports comprise text and photographic images.

25. The system for accessing specialists, collaborating among professionals, and educating participants in accordance with claim 18, further comprising: d) means for logging at least a portion of said information.

26. A system for accessing specialists, collaborating among professionals, and educating participants to retrieve, assemble and share information, comprising: a) means for storing records representative of entities having at least one predetermined characteristic; b) means for searching for an entity in said means for storing records; c) means for communicating said information to professionals and participants by means of a portable electronic communication device for further analysis thereof; d) means for videoconferencing among said professionals and participants; and e) means for logging at least a portion of said information.

27. The system for accessing specialists, collaborating among professionals, and educating participants to retrieve, assemble and share said information in accordance with claim 26, further comprising: f) a list of consultation visits per user.

28. The system for accessing specialists, collaborating among professionals, and educating participants to retrieve, assemble and share said information in accordance with claim 26, wherein said means for communicating comprises means for generating online/offline reports comprising text and photographic images.