MXPA00000385A - Therapeutic behavior modification program, compliance monitoring and feedback system - Google Patents

Abstract

A therapeutic behavior modification program,compliance monitoring and feedback system includes a server based relational database, and one or more microprocessors electronically coupled to the server. The system enables development of a therapeutic behavior modification program having a series of milestones for an individual to achieve lifestyle changes necessary to maintain his or her health of recovering from ailments of medical procedures. The program may be modified (1012) by a physician or trained case advisor prior to implementation. The system monitors the individual's compliance (1050) with the program by prompting the individual to enter health-elated data (1030), correlating the individual's entered data with the milestones in the behavior modification program, and generating compliance data indicative of the individual's progress toward achievement of the program milestones. The entire system is designed around a community of support motif including a graphical electronic navigator operable by the individual to control the microprocessor for accessing different parts of the system.

Description

THERAPEUTIC SYSTEM OF PROGRAM OF MODIFICATION OF THE BEHAVIOR, OF VERIFICATION OF THE CONFORMITY AND FEEDBACK FIELD OF THE INVENTION The present invention relates generally to a system implemented by computer to promote well-being and improve health, and more particularly with a therapeutic system of behavior modification program, of verification of compliance and feedback.

BACKGROUND OF THE INVENTION Of the most difficult and expensive care areas of health, education and rehabilitation implies the need for individuals to modify their behavior to prevent or recover from medical ailments. Heart disease, stroke, diabetes, asthma, chronic pain, depression, addiction, cancer and a wide variety of Other discomforts have been clinically shown to respond well to lifestyle modification, including changes in diet, exercise patterns and level of tension. Patients who are recovering from a surgical procedure such as a heart bypass surgery or who are suffering from diabetes, for example, frequently REF .: 88804 What do they need to make changes in their way of life to survive? When individuals are successful in realizing and adhering to positive lifestyle changes, they often require fewer medical visits, go to the hospital less often, and have fewer surgeries. Long-term medical costs also fall accordingly. Currently, many programs to help patients make changes in their lifestyle involve a doctor's visit and the distribution of a brochure that describes the health benefits of behavior modification and lifestyle change. This method is often not effective in behavior modification because there is little or no form of an ongoing support mechanism to help the patient comply with the recommendations, insufficient means to motivate the patient to make the recommended changes, and insufficient means to verify compliance with such recommendations. Participation in an ongoing support program is often effective for patients who have undergone surgery and should make changes in their lifestyle accordingly, but the currently available in-person programs involve expensive medical personnel and facilities. It can also be inconvenient for the patient to move to such programs on a regulated basis. Due to its cost and potential for inconvenience, many support programs last only a limited time, which is often insufficient for the patient to modify their behavior completely and effectively. Another disadvantage of existing lifestyle modification programs is the lack of readily available information to the physician regarding the patient's compliance with the program. The current trend towards reducing costs and still maintaining high-quality health care, a system whereby a physician can easily access information about patient compliance has clear benefits. The development of a therapeutic program that could effectively motivate patients to modify their behavior and change their lifestyle to prevent or recover from discomfort, and that could be reached electronically at home, at work, or while traveling, would be highly desirable It would also be desirable for such a system to allow physicians and their staff to receive frequent feedback regarding patient compliance with their programs. It would also be desirable for such a system to allow revisions of such information by those who pay for the health plan, such as WHO, insurance companies and self-insured large employers, in order to improve the efficiency of the managed health care.

BRIEF DESCRIPTION OF THE INVENTION The present invention therefore provides a therapeutic system of program of behavior modification, verification of compliance and integrated feedback, implemented by computer, which can be delivered electronically to the patient, which supports the designs of programs Therapeutic behavior modification and personalized lifestyle for subscribers; accepts the entry of current health data for those patients; allows the review of those health records by a doctor; allows to make and add revisions of such records by those who pay for the health plan, such as WHO, insurance companies and large self-insured employers; and motivates the patient to comply with the program and make the necessary changes in lifestyle through an integrated system of interactive graphic interfaces. In an exemplary setting, a physician prescribes the parameters and goals of behavioral modification therapy programs to help a patient recover from a discomfort or surgical procedure, and those are fed into the system implemented by computer. Alternatively, one of several established behavioral modeling programs that have been designed for the recovery of patients from particular ailments or procedures may be used. The system provides a novel interface that allows immediate access to the patient to the behavior modification program and helps to verify compliance with the program by encouraging the patient to enter data related to adherence to the program parameters. These parameters can relate, for example, to diet, exercise and other factors relevant to the behavior modification program. The patient, physician, chief or clinical members of the medical team can also feed information related to blood pressure, medication, and the results of medical tests on a computer linked to the system. Using this diet, the system can recommend a plan (also known as a therapeutic program) and goals based on established medical protocols. The doctor can modify the program to personalize this to the patient. Once the patient has begun to follow the program, the system recommends the modifications and updates both the doctor and the patient, correlating the patient's progress with the previously established goals.

The system provides feedback through multiple means (audio, video, and email) in progress to the patient through a user-friendly interface, and novel, designed around a "villa" or interactive "support community" that allows navigate electronically through different parts of the system. The interface provides access to pertinent medical information, in a line that allows the patient to write their feelings on a regular basis, an electronic calendar which integrates the events sent by a program with the patient's daily calendar, group support sessions Interactive online with patients of similar programs, and motivating presentations by multiple means. The system can make diet suggestions and specific exercises based on the total patient program. This data is verified by a professional clinical supervisor in--, a nurse trained in the protocols of the programs and system programming systems - as well as electronically by the protocols of the system itself. The system provides specific medical salt feedback, so that she can modify or update the program as the patient progresses; and it also adds to who pays the health plan to assess the factors of administration and cost. Who pays the health plan can also see the individual records that can be obtained after receiving the appropriate medical release for the patient. By providing several channels of continuous feedback between the patient, the physician, the professional clinical supervisor and who pays the health plan through custom designed interfaces, the system helps improve patient compliance with the behavior modification program. , and can help make the total health care system more efficient.

BRIEF DESCRIPTION OF THE DRAWINGS These and other aspects of the present invention will be more apparent from the following Detailed Description of a preferred embodiment hitherto of the present invention where a set with the drawings and accompanying samples, in which: Figure 1 is a block diagram that illustrates how feedback and verification are used in the current modality of the verification and feedback system in accordance with the therapeutic behavioral modification program. Figure 2 is a form of exemplary prescription for feeding baseline vital factors of the patient; Figure 3 is a graphic representation of a set of files for patients whose recovery programs can be designed or modified; Figure 4 is a graphic representation of an exemplary patient file taken from those depicted in Figure 3; Figure 5 is a graphic representation corresponding to the option of the Program Design of Figure 4. Figure 6 is a graphic representation corresponding to the option of Program Details of Figure 5; Figure 7 is an exemplary report of the patient's progress; Figure 8 is a graphic representation of several interconnection tools, organized around a villa motif available to a patient of a clinical group; Figure 9 is a graphic representation of the Internal Nucleus option of the system; Figure 10 is a graphic representation of the option of a System Agenda; Figure 11 is an expanded graphic representation of the Agenda; Figure 12 is a graphic representation of the System Diary option; Figure 13 is an expanded graphic representation of the Journal; Figure 14 is a graphical representation of the Board Room option of the system; Figure 15 is a graphic representation of the Cafeteria option of the system; Figure 16 is a graphic representation of the Postal Office option of the system; Figure 17 is a graphic representation of the System Notes option; Figure 18 is a graphic representation of the Postal Card option of the system; Figure 19 is a graphic representation of the system Telegram option; Figure 20 is a graphic representation of the option of Electronic Mail with Audio of the system; Figure 21 is a graphic representation of the System Kitchen option; Figure 22 is an expanded graphic representation of the Kitchen option; Figure 23 is a graphic representation of the option of System Recipes; Figure 24 is an expanded graphic representation of a Purchase List option; Figure 25 is an expanded graphic representation of an educational topic available through a descending preview menu of Figure 22; Figure 26 is a graphic representation of the gymnastics option of the system; Figure 27 is a graphic representation of the Training option of Figure 26; Figure 28 is a graphic representation of a Strong Training option of Figure 27; Figure 29 is a graphic representation of the Tranquilizer Park option of the system; Figure 30 is a graphic representation of the System Relaxation option; Figure 31 is a graphic representation of the Yoga option of the system; Figure 32 is a graphic representation of the System Library option; Figure 33 is a graphic representation of the System Items option; Figure 34 is a graphic representation of an access option to the World Wide Web; Figure 35 is a graphic representation of an educational topic available through the descending descending menu in Figure 32; Figure 36 is a graphic representation of the Travel Agency option of the system; Figure 37 is an alternative user interface screen provided by the system; Figure 38 is a graphic representation of a tracking screen for a physician or clinical head according to another aspect of the present invention; Figure 39 is a graphic representation of a main menu available to the physician or the clinical head; Figure 40 is a graphic representation of an exemplary patient file; Figure 41 is a graphic representation of a blood pressure chart for an exemplary patient; Figure 42 is a graphic representation of physical activity charts for an exemplary patient; Figure 43 is a graphic representation of a weight chart for an exemplary patient; Figure 44 is a graphic representation of a cholesterol chart for an exemplary patient; Figure 45 is a graphic representation of the System Behavior option; Figure 46 is a graphic representation of the System Recommendations option; Figure 47 is an expanded graphic representation of the System Communication option; Figure 48 is a graphic representation of the Video Conference option of the system; Figure 49 is a graphic representation of a menu available to who pays the health plan or employer; Figure 50 is a graphic representation of an option of View Conformity Status; Figure 51 is a graphic representation of an option to See Comparative Costs; Figure 52 is a graphic representation through which the system indicates whether the patient has executed a limited confidentiality reluctance; Figure 53 is another graphic representation of an exemplary patient record; Figure 54 is a graphic representation of the option Check System Costs; Figure 55 is a graphic representation of the Use System Results option; Figure 56 is a graphic representation of the option to Perform Performance Review; Figure 57 is a graphic representation of a selection of a group of exemplary physicians of Figure 55; Figure 58 is an expanded graphic representation of a Communicate option of Figure 48; Figure 59 is a block diagram of the compliance and feedback verification system of the therapeutic behavioral modification program; and Figure 60 is a flowchart that illustrates certain aspects of the system of compliance verification and j ^ jgM ^^ feedback of the therapeutic program of behavior modification. To facilitate the description of the present invention, reference is made in numerous cases to the flow chart of Figure 60. For convenience, the blocks in the flow chart are listed beginning at 1000.

DETAILED DESCRIPTION OF THE INVENTION Referring to Figure 1, in a preferred embodiment of the invention so far, patient 10, physician 12, clinical supervisor 14, and who pays the health plan 16 (such as WHO, a self-insured insurance company or employer), provide all input information, and / or receive exit information from the compliance verification and feedback system of the therapeutic behavioral modification program. The clinical supervisor may be a doctor, nurse and / or other trained medical professional experienced in clinical case management practices and protocols. The patient interacts electronically with the system, the clinical supervisor and their doctor through the system interface 18. The behavior modification program is customized to fit the health and recovery needs of individual patients. The system provides at least two separate benefits: it helps the patient to comply with the program ^^^ $ ^ > through a support mechanism implemented electronically; and also helps to verify such compliance. A wide range of individuals can benefit from the system. By way of example only, those individuals include those with chronic discomforts such as coronary artery disease, diabetes, chronic pain, depression, addiction, arthritis, cancer and asthma, as well as patients who are recovering from medical procedures such as Angioplasty or bypass surgery (the "clinical group"). Individuals who simply want to maintain their health and prevent or reduce the risk of such discomforts (the "wellness group") can also benefit from the program. For those individuals, the program can focus on the management of stress, diet, and exercise. The wellness group may also include family members of the clinical group who need support and / or group advice to deal with the chronic illness of the family member. The member of the wellness group may not need all the characteristics available to the members of the clinical group. In addition, access to certain areas within the system may be limited and / or customized to meet the needs of the individual user. However, members of the wellness group may choose to use the clinical case management functions as a "virtual trainer". For example, an individual may wish to have the help of a clinical weight loss supervisor to help the individual change their nutrition, exercise and habits for stress management. The "virtual trainer" or clinical supervisor can provide ongoing feedback and encourage it during the process. Wellness participants can also choose to join an online support group to help them achieve their health and wellness goals. In an exemplary scenario, a doctor diagnoses an individual with discomfort. The doctor can then recommend a maintenance or recovery program of care ±. of health that requires the patient to: take certain medications; participate in a support group; and control risk factors by altering your diet, follow an exercise program, manage stress levels. The doctor can then place the patient in the system to help him make those desirable or necessary modifications in lifestyle and behavior. To subscribe the patient to the system, basal life factors are introduced. Such factors may include readings of blood pressure, heart rate, height, weight and cholesterol levels. Depending on whether the doctor is online (block 1000, Figure 60), the doctor can feed those vital factors into the system directly via his or her personal computer ^^^ ^^^^ ^^^^^^^^ g ^^ íá ^ gaiÉ ^ gg ^^ (block 1002, Figure 60). Alternatively, the doctor may fill out a prescription or prescription form and send the information to a clinical supervisor, who then places the patient in the system (blocks 1004, 1006 and 1008, Figure 60). Referring to Figure 2, an exemplary prescription form 22 contains direct information such as identification and identification of the patient. Using the form, the physician selects a diagnostic category 24 and prescribes a level of recovery program 26. In the exemplary modality, there are eight separate diagnostic categories corresponding to the patient's health status. Category I, for example, includes patients who have suffered a heart attack within the current year, while category VIII includes patients who do not suffer from a particular malaise but who are simply in the plan to promote their well-being. Other categories can also be added if necessary. Depending on the diagnosis, the doctor may recommend that the patient stop smoking or lose a target amount of weight within a certain period by circling the appropriate response in field 30. The doctor may also enter other information, such as patient's medications 32. The doctor then locks in a circle or fills the desired objectives in 3 months 34 related to, among other things, daily caloric intake, percent daily saturated fat intake, maximum heart rate and cholesterol level . Referring to FIGURE 3, the clinical administrator places a new patient based on the information contained in the patient's prescription form or has access to existing patient records through the patient files 40. In this example, Patient files 40 are identified by the name and number of the patient's social security number. To create or modify the program for a particular patient, the administrator creates a new folder or selects a new pre-existing folder 42 that corresponds to the patient in question. Once the physician or clinical administrator introduces the patient to the system, the system or the clinical supervisor recommends a set of default goals based on the patient's needs and existing medical protocols that can be modified by the physician (blocks 1010). and 1012, FIGURE 60). FIGURE 4 illustrates an exemplary patient record after selection of the desired patient file 42 in FIGURE 3. The record includes, among other things, the current status of the patient and the goals of the program. The first column 44 of the record exposes four fields for relevant patient information including the patient's vital signs (eg, weight, cholesterol level, blood pressure), other baseline characteristics (eg, smoking habits of the patient, physical activity , habits of alcohol consumption and 5 food, levels of depression and tension, use of a seatbelt), and information related to any medications used by the patient. The second column 46 of the registry shows the basal values corresponding to the vital signs and characteristics of the patient at the beginning of your participation in the program .. As shown in the third column 48, the record can be updated on an ongoing basis by taking patient data online and from post office visits. Based on the patient's initial evaluation and / or short-term progress, the physician or , clinical supervisor can design a new program ° modify an existing program for the patient by selecting the option of system design 50. Referring to Figure 5, after selecting the option of Design 50 in FIGURE 4, the system suggests to the doctor or clinical supervisor to assign intensity levels 51 that correspond to diet, exercise, tension management, need for group support, anticipated compliance and patient's pharmaceutical requirements. The intensity levels in this example fluctuate from a lower level of 1ahs. * • __- * _ * & «. up to a higher level of 5. Other measurements of intensity of the program can also be included. Based on the information introduced, the system, clinical supervisor or doctor generates a set of 52 goals or milestones for the patient. This is done by correlating patient information such as age, sex, weight and information related to health, life situation and diagnostic categories of the patient to establish medical protocols for that type of patient. Other pertinent information that may be taken into account includes the patient's medication and other health conditions. Based on the correlation, the system suggests a therapeutic program that includes goals related to fat calorie consumption, exercise level, stress management tips, and frequency of compliance management. The physician or clinical supervisor can see details to see how the goals can be implemented by selecting the details option of the system 54 program. Referring to FIGURE 6, after selecting the option of Program Details 54, the record is presented of patient 60 along with the recommended month goals 61 and the final goals 62. The clinician or clinical supervisor can confirm 63 or edit the suggested program to modify the goals by making the appropriate selections (block 1012, FIGURE 60).

The content of patient records and the goals generated vary depending on the diagnostic category of the patient. For example, some of the information shown in the patient record may not be necessary for an individual who belongs to the wellness group. Information related to calories, cholesterol level, blood pressure and seatbelt use, for example, may not belong to a person in the system to get support to help a family member who has a discomfort chronic. Referring to FIGURE 7, the system also sends an exemplary patient status report 70 to the doctor who does not have direct access to the system. The status report may include information related to the patient's current status 66, suggested next steps 67, and objective goals 68. Information may also be included in the status report as desired by the physician. The doctor has the option of agreeing with the following suggested steps 69 or indicating changes to the program. The doctor then sends the report 70 back to the clinical supervisor for modification of the program if necessary. The communication can take place via email, facsimile, or any other means of data transfer.

. * ¿Fa »~ + -,;? «- Once the patient is placed in the system, he is helped to comply with his behavioral modification program (block 1020, FIGURE 60). To use the program, the patient registers in the system network via telephone line, cable modem, cellular connection, satellite link or another method of communication that allows a connection to a network server. Referring to FIGURE 8, in a preferred embodiment of the invention so far, the user interface for patients in the clinical and welfare groups is organized around a villa motif. The user progresses through the system following paths through a city's square to destinations including the gym of villa 71, quiet part 72, post office 74, cafe 76, store 78, library 80, agency 82 travel, as well as the user's own "home" 84. The villa's motif represents the patient with an image of a support community. The whole online community revolves around their recovery and well-being, and this helps to reinforce the patient's confidence and motivation. In addition, the villa's motif provides a representation of the structure of the system that is easy to understand. The patient learns to navigate the system more quickly and easily due to an intuitive distribution of the city.

Another benefit of the villa's motive is its familiarity. A patient afraid of the technology will be reassured through symbolic images of houses and neighbors, streets and warehouses. Finally, the patient may find navigating in an electronic "neighborhood" more satisfying than a system driven by a traditional text menu. Other user interfaces are available, such as those described in conjunction with FIGURE 37. Referring to FIGURE 9, the inner core 86 of the villa provides the user with a. agenda icon 90, a diary icon 94, a meeting room icon 96, a mail icon 98, a rewards icon 92. These give the user access to additional tools that help meet their health program, and also help the clinician or clinical supervisor to verify such compliance. Referring to FIGURE 10, after the selection of the calendar icon 90 of the interface of FIGURE 9, the system presents a graphic representation of a calendar 90A, As shown in FIGURE 11, the agenda presents the user with a list of meetings in which the user can participate via his computer. The list of meetings varies for each user depending on their specific health recovery program. The agenda also presents general information about the meetings, including time 100, date (not shown), and the profile of the meeting ^^^^^ 104, with a notation of how people can register for such a meeting 106. The system also sets a limit on the maximum number of individuals that can register for a meeting. Based on this information, a user can sign up for the meeting that best fits their program. Other factors, such as the city in which other members are located 108 may also influence the user's choice. The user may decide to print a group whose members are located in their own city of residence if they wish to meet those people face to face someday. The system integrates the user's calendar 90A with the calendar of the user's personal electronic diary. For example, after a patient registers for a meeting, the system downloads the day and time of the meeting to the user's calendar. The calendar can be any calendar program or commercial organizer, such as the Organizer ™ available from Lotus Development Corp. In an alternative mode, the user can make an additional request via the phonebook to be sent automated email reminders. Referring again to FIGURE 9, the system also allows the user to access an integrated patient diary 94 from the inner core of the village and self-report their progress and describe their feelings. The selection of a journal icon leads the user to a journal 94A such as that shown in FIGURE 12. After entering the journal 94A, the user has the option to see the 5 personal goals that have been set by the doctor or supervisor clinical. The newspaper also provides a diary used to make a daily record of the relevant information to achieve the user's goals. The 94A journal provides an important tool that allows the patient to express their feelings and. fears in a context different from that of a support group. By recording in a diary, the patient can identify their fears concretely, and in this way begin to solve them. Goal setting is also often more significant 5 when it is described. Instead of just thinking about ambiguous hopes, the patient can define in written form the specific milestones he plans to achieve. These notes can also help remind the patient of the topics they wish to discuss at support group meetings. The system also uses certain notations in the journal to help generate reports for the physician or clinical supervisor related to the patient's progress. As part of its first security measures, the system separates those entries from the diary that the patient wishes to keep private 5 of those that should be used to generate reports. • _, - * »v.

FIGURE 13 exemplifies the type of information that may be contained in the journal. For example, a cardiac patient who belongs to a clinical group may need to check his emotions 100 as well as the exercises he has been doing through the diary. Depending on the patient's program, the system may also suggest to the patient to enter their vital signs 102, such as blood pressure and heart rate, into the diary. This can be done manually or automatically. For example, devices can be connected to the port in. computer series to automatically feed the blood pressure and heart rate to the system. Depending on the particular program, patients may require weighing themselves on a weekly basis and / or measuring their cholesterol level with a household cholesterol kit on a relatively less frequent basis. This information is stored in the database of the system and is accessible to the doctor and clinical supervisor. The type of information required of a person in the welfare group may differ from this. For example, if a user is in the wellness group because a family member suffers from a chronic illness, he does not necessarily have to enter his vital signs in the diary. In addition, you can request information on how you feel emotionally, as well as information on how convinced you are of the support group. The user can also record his personal comments in the diary. This information can only be seen by the individual user, and is not available to the clinical or medical supervisor. The diary is also integrated with the user's diary calendar. The user can, for example, enter information into their exercise program (such as walking 30 minutes on Tuesdays, Thursdays and Saturdays) or the meditation program in the diary. The system then downloads this information to the user's diary calendar. You can also view previous entries in the diary. In addition to allowing the patient to electronically enter their updated health information, the diary also provides the physician or clinical supervisor with means to obtain feedback on the patient's progress. The information recorded in the diary is sent electronically to the clinical supervisor. Alternatively, the clinical supervisor has direct access to portions of the journal stored in the system's database. The doctor or clinical supervisor can use the information provided in the diary to update the program on an ongoing basis.

The system also accepts additional patient data obtained during office visits or directly from the patient via email or other means of communication. The doctor can also feed additional data, such as those derived from laboratory tests, into the system. Accordingly, the system accepts updated patient data directly from the patient and through the data is provided by the physician during office visits (blocks 1030, 1032, and 1034, Figure 60). The system automatically correlates the training defined by the patient with that of the doctor to verify the accuracy. In addition, the system automatically provides the patient with reports of the patient's progress. Depending on the requirements of the patient's plan, the clinical supervisor periodically reviews the information entered by the patient and reported by the physician to verify if the patient is complying with "the parameters of the program and reached the goals (blocks 1036, Figure 60) As part of the feedback process, the system provides an "alarm" option (block 1040, Figure 60) The system compares real data about the patient with the goals and parameters that it receives from the system database and automatically notifies the patient. physician or clinical supervisor via email or facsimile (or pager depending on the severity of the problem), if a health risk is present (block 1042, Figure 60). For example, if the patient's current blood pressure is potentially dangerous, the system will automatically send an alarm to the clinician or clinical supervisor and will require immediate action. If the difference between current data and goals does not present a threatening situation, the system will simply notify the clinician or clinical supervisor that those goals have not been met. For example, if the current data states that the patient has lost 5 pounds instead of 10, the system will notify the physician or clinical supervisor of this fact. This information, although it is not life-threatening, should nevertheless be known by the doctor or clinical supervisor. He or she then has to come in contact with the patient to support him or her and also motivate him or her to achieve the desired goals (block 1044, Figure 60). In addition, the clinician or clinical supervisor may recommend that the program be modified to fit the patient's condition (block 1046, Figure 60). However, if there is an alarm condition, the system periodically correlates the updated patient's health information with the program's goals to determine the patient's progress and compliance with a program (block 1050). If the patient is progressing according to their program, the system informs the physician and / or clinical supervisor (block 1052, Figure 60). The clinician or clinical supervisor can then provide a positive reinforcement to the patient. Depending on the progress of the patient, the clinical supervisor the doctor can also determine if they modify the program by altering the goals or moving the patient to a different diagnostic category. The patient can still be removed from the system if he has reached the goals end of the program (block 1054, 1056, Figure 60). The system also notifies the physician or clinical supervisor if the patient is not progressing toward the goals of the program or if he or she is not using the system (block 1060, Figure 60). The clinical supervisor together with the doctor determine then, whether or not they modify the patient's therapeutic program, providing the patient with additional support, or removing the patient from the system (blocks 1064, 1066 and 1068, Figure 60). The system also allows feedback direct to the individual user. As one of the features of the diary, users can review their levels of compliance, and reach of goals. Patients can not recognize if they are progressing until they are reminded that they have improved so much. Letters and summaries sent by the system, discussed later with respect to Figures 41 or 44, they provide patients with an overview of how far they have come. Referring again to Figure 9, as another tool to reach the patient to meet their programs, the system offers an electronic boardroom interfaces of group support rooms via the boardroom 96 icon through which the patient receives line group support in progress. Placing the patient in contact with people with the same through similar group counseling has clinically proven therapeutic benefits. The system facilitates this process through the use of electronic and online technology. Online group councils solve many of the logical difficulties encountered when putting together, on a regular basis, a large group of people with different programs living in different places. Instead of requiring patients to physically move to a single location, the system allows them to attend group meetings by simply registering with their computers. As the burden on the individual patient decreases, the group's attendance increases, this improves the total therapeutic and practical value of the advice and group support. Online advice also puts the patient in contact with a larger group of people with similar problems, which is what professional counselors do. ____ ^ MMM_MMMMÉMH When desirable or necessary, a group member can withdraw from people in a wide variety of regions, rather than being limited to a single neighborhood. In addition, the relative anonymity of electronic communication benefits patients who are reserved or possibly upset by their situations. These patients can move more freely to share their feelings in an online environment than they would face to face. Patients have access to the boardroom interface via a boardroom icon 96. After the selection of the boardroom 96 icon, patients are presented with the rules and regulations of the meeting. They can then proceed to a pre-scheduled meeting. They will only be allowed to attend those scheduled meetings. The scheduling of the meetings is part of the agenda interface previously explained in conjunction with figures 10 and 11. Referring to Figure 14 each participant 112 may choose to present one or two different weeks in the meeting room. Participant 112 can have their photo scanned electronically to appear in the system. Alternatively, if anonymity is desired, the patient may choose to be represented by a non-photographic icon, or "materialization" accompanied by his own name or a pseudonymous name on the screen. The patient will then be represented £ 5H ^^ a = £ si ^^^^^^^^^^^ m by that materialization in group meetings and private verification sessions. In some cases, patients can choose, design and build their own materializations. A leader or trained, experienced leader, 114 is an important part of those group counseling sessions. It is the responsibility of the leader to guide the discussion and encourage the participation of all members. To improve the beneficial aspects of counseling or group advice, the system allows the leader 114 to selectively access certain portions of the patient's online journals and electronically seat the selected portion anonymously to the online group. The leader can also cut something electronically if he or she says things that are inappropriate. In the preferred embodiment, the participant 112"speaks" during the meeting by entering text at 122. After pressing the start key, this text appears as a "dialogue bubble" 116 above the representation of the participant 112 who enters the corresponding text. In an alternative mode, instead of using a "dialogue bubble" format, each participant 112 can participate in the meetings by talking to a microphone connected to their PC, and listening to the other participants via speakers also connected to the PC. _ ¿.. ^. . ~ ^^ PA. £ - ____ L__I _? ______ A logical window 110 keeps the record running or moving forward during the meeting.

In this way, if a participant 112 stops following the conversation, or wishes to comment on the first one, he has access to enter the reference conversation. During group counseling meetings, a leader can reproduce online media representations that represent other patients or well-known figures who have made positive changes in their lifestyle. In the modality. preferred until now, each patient has access to the presentation of multiple media, such as a short video, via CD-ROM or DVD received by mail on a regularly updated basis. Alternatively, if the user has access to the appropriate programming and physical computing components and programs, and has a sufficient bandwidth connection to the server, the presentation of multiple media can be sent to it over the network. In addition to the CD-ROM, the system can also use a DVD disc, download it to the hard disk of the user's computer, or any other method or medium capable of storing or transmitting audio and video data. When it is time to watch the multi-media presentation, the leader selects, for example, a particular short video from a menu of short videos available on his CD-ROM or DVD. In this way, a signal sends the network to each participating PC. The received signal compares a code on each participating CD-ROM or DVD, which activates the video playback selected by the PC. If the video is stored on the DVD disc or on the hard drive of the user's computer, or some other storage medium, the video could be activated to be played from that medium as well. Participants can not play the video before the meeting because only the leader has access to the code that releases the video. In this way, before a meeting, users can see a list of videos on their CD-ROM, DVD disc, hard drive, or other storage medium, but videos that have not been shown at the meetings will not be accessible. to be seen. Once a video is released by a leader and reproduced for the first time in a meeting, participants can access it at any time later. The administrator or clinical supervisor knows in advance who will be the leader for a meeting and will give you access to the short video to show at that meeting. The multiple media presentations shown at the meetings can present well-known or public figures and other patients have been treated for the same problems that the participants are facing. For example, at a meeting for patients who have had heart attacks, a short video of a celebrity who recovered from a similar problem can be shown. In the short video, the celebrity will talk about his own heart attack, deviant surgery to which he was subjected, and the depression that followed. The celebrity would also describe everything he has had to fight, and how those struggles were overcome during the recovery process. Similarly, brief videos of program participants can also be used to provide motivating examples of success stories, or to express deep-feeling emotions (eg, anger, depression, etc.) that should be dealt with by those individual members or others of the group to be successful in their recovery. Such presentations can act as a source of motivation for the participants, giving them a sense of hope. If someone else was able to overcome the same obstacles, they can also. Presentations can stimulate further discussion during the meeting, and allow participants to open up about the problems and struggles they are facing during their recovery process. Another function provided by the 96A boardroom interface is that of electronic telephone dialing.

Each participant has a telephone icon 118 in front of its materialization. If a participant wishes to speak with any other person at the meeting, they must select the telephone icon and the telephone number so that they are automatically dialed. This allows members to contact each other after meetings to speak further via regular telephone lines if desired. Participants in the conference room also have direct access to an additional private counseling area by selecting a cafeteria icon-76B. System users can also access the private counseling area by selecting the 76 cafeteria in the villa as shown in FIGURE 8. FIGURE 15 is an exemplary illustration of the interior of the 76B cafeteria. The conversation occurs here in a very similar way to what happens in the 96A boardroom, except for the fact that the conversation is not verified and structured by a leader. The text is fed at 132 and appears as dialog bubbles at 134. A record of the conversation is also kept in the logic window 130. In the preferred mode, the system allows a maximum of four people in a single cafeteria at a time. Such a restriction is desirable since the purpose of the cafeteria is one-on-one counseling. In the private installation of a cafeteria, the most experienced individuals can pass their experiences to the less experienced as well as advise on how to overcome the obstacles that can be faced. The support room applications of group 96A and cafeteria 76B are implemented through conversation room applications with a third party such as the Palace, commercially available from The Palace, Inc., Beaverton, Oregon. The chat room applications can be integrated into the system and modified to provide additional functionalities. Activation of multiple media presentations during group meetings and attendance verification are scheduled separately in the system. Through online group meetings and private counseling rooms, the system allows patients to maintain contact with others who have the same or similar problems, all in an entertaining way so that they are encouraged and help the patient to adhere to the parameters of the program and reach the goals. The characteristics of the communications of the system also allow the user to keep in touch with his only, clinical supervisor, or other users of the system. Although the preferred mode of the invention up to now communication is carried out via e-mail, other methods of communication can also be used. For example, it is contemplated that the system will allow sending messages instantaneously, calls, conferences and / or video conferences as alternative means of communication. Referring again to Figure 9, the mail icon 95 gives a user access to the e-mail feature. A user can also access his or her email by selecting the post office of the villa 74 shown in Figure 8. Referring to Figure 16, the system includes four different types of options, e-mail: letters 140, postcards 142, telegrams 144 and email with audio 146. Figure 17 is an example of a letter 140A, which functions as a standard electronic mail. Figure 18 is an example of a postcard 142B, which can be used to send short notes.

For example, postcards can be sent to users to investigate the level of satisfaction with the service provided by the system. The postcard would contain questions about this problem, and ask users to send the postcard back after having answered the questions. Figure 19 is an example of a telegram 144A, which has the highest priority among the types of electronic mail provided by the system. The telegram can be used, for example, to alert a user that he or she did not attend a meeting, or just a short note to encourage the clinical supervisor or group leader for an individual user. Figure 20 is an example of an email notification with audio 146A. After selecting this icon, users can listen to a record of the message sent to them via speakers connected to their PC. The communications functionality can be implemented by integrating any of a conventional email number with the system. As will be more evident from a detailed description of the other interfaces of the system, the system takes a double method for behavioral modification: education and motivation. Entertainment is used as a means to educate and motivate a user to make some difficult changes required for their recovery or even to maintain a healthy lifestyle. Motivation is a method for behavior modification. Education is the way to fulfillment, which is a goal of the system as a whole. The support group and the clinical supervisor described above add a human element to this motivational component. Probably patients respond more positively to ~ _L_ "yff * ^ - ^ words of encouragement from others of what they would do to a program which should be followed by isolation.The system's multi-media capabilities allow it to use graphics, video and music to communicate and educate. These characteristics provide refreshing reinforcements to the patient's efforts to modify their behavior, replacing the learning typically associated with medical and clinical rehabilitation programs.The segments featuring celebrities, medical experts, motivational speakers, and successful program participants give motivating words. and personal testimonials that inspire the user even more, humor is integrated through the system, for example capricious work, entertainment derived from those characteristics of the system is used to spark and maintain the interest of the patient in the development of the drama of his recovery and change of lifestyle.The reward feature is or otivational tool provided by the system. Referring again to Figure 9, the reward "apples" icon 92 allows a user to see information about the reward point of the system and how it works, as well as the control of the user's own personal rewards. Users can earn points for their good participation in the program and reach certain points. For example, the points * » ** «* ¿wF & - ^ S, ^ '^ can be earned by their good attendance at meetings, participation during meetings, losing a certain amount of weight, if this was the goal as it must be fulfilled. The rewards fluctuate from the symbolic type, such as obtaining "golden stars" that are awarded to a user for their progress, reward packages and golden reward villas which can be exchanged for products in a villa's warehouse. or plane tickets from the travel agency of villa 82, respectively. 10 Education is a method of modifying the complementary behavior offered by the system. Education is provided through multiple online, informative presentations, and the interactive areas of the villa dedicated to diet, exercise and tension management. For example, the recipes provided in the village kitchen, discussed later in conjunction with Figures 21-24, are designed to improve the patient's diets without forcing them into impossible austerities or increasing their love of food. 20 The exercise and stress management programs, discussed below in conjunction with Figures 26-31, are designed to allow for variety and fall within the range of capabilities of individual patients. For exercise and an active and interesting healthy diet, the ______ ¡___- Í-_ ____________________ system allows patients to continue with their new lifestyles. The system also provides relevant articles and includes hyperlinks to other Internet sites of proportional cause reputation and health-related medical training, as discussed below in conjunction with Figures 32-35. Referring again to FIGURE 8, the system encompasses a "home" interface 84 as part of the villa's motif. After its selection, a screen shows the interior of "home" of the user 84 followed, as described in FIGURE 21. Once inside his "home" 84, the user can have access to the kitchen by selecting the kitchen icon 150. FIGURE 22 illustrates the interior of the user's kitchen 155. Once in the 150A kitchen, users have the option of obtaining nutritional and dietary information from books for low-fat kitchens 153, or viewing and printing recipes from a book of recipes 154. FIGURE 23 gives an example of a recipe which may be contained in recipe book 154. Referring again to FIGURE 22, users also have the option of preparing and printing a shopping list 156. A user you can choose several recipes from a recipe book 154, and the system can automatically enter the ingredients in the shopping list of the user 156. The user can also manually enter items in the shopping list 156 via the keyboard of his PC. FIGURE 24 gives an example of a user's shopping list. The system can also indicate which recipes are permissible under a particular patient program. For example, the system may recommend certain low-fat items that meet the criteria of a patient's program as well as adequate foods, which he can consider when he eats. The system is also capable of generating weekly shopping lists based on the parameters of the program. According to personal preference, users can choose to substitute certain permissible foods for others. In addition, users have access to a mobile computer menu by selecting the menu icon 152 on the computer. For this computer menu, users can access various educational topics related to food, nutrition and diets. One such topic may, for example, relate to basic food groups and may provide information on the suggested amount of services for each category of food, as shown in FIGURE 25. The option to invite the chef 158 shown in FIGURE 21 also allows users to watch or listen to audios or short videos of a chef or cook showing how to prepare a certain recipe. In the preferred mode so far, these short videos are contained in the user's CD-ROM or DVD, but with the appropriate technology they could be sent via audio or video streams. From the kitchen, a user can substitute food (for example, asparagus for broccoli); access and print food-related articles, view new recipes or articles by selecting the "what's new" button (not shown); gather a discussion group via a bulletin board (not shown). Referring again to FIGURE 8, another part of the villa's motif is the gym at Villa 71, which is used by the system to give recommendations or provide information regarding proper exercise routines. Each exercise program is generated according to the parameters and individualized needs, with the progress being regularly put in a letter by the information entered by the user via the newspaper 94A (FIGURES 12-13). After entering the 71 gym, a user can send the brief videos presented or listen to short audio; do key searches to access and print articles related to exercises; I will read print exercise manuals; or gather a discussion group via a bulletin board. FIGURE 26 illustrates the interior of a gym 71 shown in FIGURE 9. Showing in it various topics of exercises 160 to which a user may have access. For example, selecting the topic of stretching 162 gives the user information about recommended exercises to stretch different muscle groups. FIGURE 27 illustrates one such stretching exercise. Similarly, selecting the strength training topic 164 gives the user information about the recommended exercises to help reinforce several muscle groups. FIGURE 28 illustrates one such force-training exercise. Referring again to FIGURE 9, the quiet park at Villa 72 focuses on stress management strategies, including relaxation techniques, biofeedback, yoga and meditation. After entering park 72, the user can access and print articles on matters related to stress management; watch short videos or listen to short audio about those aspects; and gather discussion groups via a bulletin board. An expanded illustration of the quiet park 72 is shown in FIGURE 29. After selection of the relaxation option 170, an instruction article on the subject is invoked, as shown in FIGURE 30. Similarly, after the Selecting yoga option 172, an instruction article about yoga is invoked, as shown in FIGURE 31. Referring again to FIGURE 8, the system also gives access to a library of villa 80, which allows Users investigate related topics. In this way, patients interested in learning more about their average condition can have access to the 80 library to educate themselves on the topic. FIGURE 32 illustrates the interior of the library 80. From there, a user can select an item option 180 to access an available list of items 186 via his CD-ROM, as shown in FIGURE 33. The type of Articles 186 available to a user will vary depending on the type of user. For example, if the user suffers from a chronic cardiac condition, articles 186 will all relate to such a topic. The list of articles 186 is continually updated to reflect new developments and research on the topic. Users can also be provided hypertext links with other reputable internet sites dedicated to providing medical and health-related information. Those internet sites also H & ^ can be accessed by selecting the World Wide Web option 182 as shown in FIGURE 32. Once linked to an article on the Internet, a user is taken to a separate web browser from which He can surf the net. FIGURE 34 is an example of an internet site to which a user can connect after selecting the World Wide Web option 182 of FIGURE 32. In addition, users have access to a mobile menu by selecting the icon of menu 184. From this menu, users can select various educational topics related to the user's condition. For example, an article available through the mobile menu can teach a user suffering from a chronic heart condition, determine their target heart rate zone, as shown in FIGURE 35. Users can also search for keys to have Access to print articles of interest, to watch short videos or listen to short audio. Referring again to Figure 8, the villa store 78 and the travel agency 82 are two additional interfaces accessible to users. After entering store 78, users are taken to a network site at home or a third party through which they can order relevant items, either online or by phone. . -i. «-" "> i_ae_a.? Users can also investigate the warehouse database and view product information, including tables, descriptions and product prices. In addition, users can see the status of their orders and get in touch with customer services via email or phone. Similarly, when a user enters the travel agency 82, he is linked to a reservation system inspected by a third party. Figure 36 illustrates the interior of the travel agency 82. From there, the user can make online travel reservations by selecting a reservation option 202. A user can also view the frequent bonus miles that they have resorted by selecting a travel option. check reward points 202. As discussed above, a user can earn frequent fly miles for their good participation in the program and reaching certain sites. Although the user interface for the members of the clinical and wellness group has been described in terms of a villa motif, an alternative user interface could incorporate another alternative mode of system interface shown in Figure 37. A screen of Multiple frames which includes: A main navigation area 210; containment area 212; screen area or video messages 214; and an instruction area 216. The screen or message or video control area 214 may be used to display warnings. The instruction area 216 can be used as a "what's new" area or for the bulletin board discussed in a functional manner above for the kitchen interfaces 150A (Figure 22), gym 71 (Figure 26) and quiet park 72 (Figure 29). Figures 38-47 and 49-58 illustrate user interfaces for the clinical supervisor and HMOs, some of which are also accessible to the patient. Unlike the user interface for patients, the navigation of the clinician / clinical supervisor is generally less graphical and more card-oriented. Referring now to Figure 38, a registration screen 220 for the user interface for a clinician / clinician is shown. Screen 220 requires the physician or clinical supervisor to enter its name 222 and corresponding password 224. Screen 220 thus acts as a security measure to ensure that only legitimate users can have access to the system. Referring to Figure 39, an initial screen containing a 230 main menu of the options available to the clinician / clinician follows the registration screen 220. A program design option for patient 232 allows a physician / clinical supervisor create a new program or modify an existing program for a patient, as described above together with Figures 3-6. A second option within main menu 230 is an option to Review Patient Record 234 which allows a clinician / clinician to review the health record of a particular patient. A current patient list (not shown), substantially similar to the list shown in Figure 4 follows the selection of an option to Review Patient Record 234. Referring now to Figure 40, an exemplary patient health record is shown . The registry may provide identification information, including the patient's name 240, subscription ID 242, and social security number 244. In addition, information may be given of the total time the patient has been participating in the program as shown in 246 Column 258 shows the patient's vital signs and other health-related factors, such as blood pressure 250, number of cigarettes smoked per day 252, amount of physical activity 254, weight 256, and cholesterol level 258. Some of those Factors can be verified and reported on a weekly basis, as shown in columns 260-268. Other factors, such as the patient's cholesterol level 258, can be verified and reported on a weekly basis, as shown in columns 260, 264 and 268. The final goal to be reached in each of the specific areas is given in column 272. A list of risk factors that can affect patient recovery can also be noted as shown in 270. Vital signs can be presented graphically by the patient, physician and clinical supervisor. These may include charts or graphs of patient blood pressure 250A (Figure 41), physical activity 254A (Figure 42), weight 256A (Figure 43), cholesterol level 258A (Figure 44). These charts allow the clinician / clinician to review and maintain the patient's progress visually over a period of time, and help determine how the patient is doing in relation to the final goals to be achieved in the areas on the charts. Referring again to Figure 40, a clinician / clinician is also given option 274 to evaluate patient behavior. Upon selection of this option, the system provides a form of behavioral change evaluation 305 such as that shown in Figure 45. This form 305 is used to determine the inclinations of the selected patient toward compliance with the recommended program. In the preferred modality, questionnaires are presented online to patients, ipvárárfolcs to evaluate the intention of their behavior 300, self-efficacy 302 and social support 304. Alternative forms of evaluation can also be used to assess the likelihood of the patient's compliance with the program. The system evaluates the report periodically changes in patient behavior as shown in columns 306 and 308. Desired goals 310 are also listed to verify if the patient is progressing toward them. If the patient continues to have low grades the behavior change evaluation form 305, this may indicate that he is unable to change his lifestyle and leads to the conclusion that the patient should be removed from the system. The system generates reports on the patient's progress based on the data shown in Figures 40-45, as frequently as the physician wishes. These reports can be received via email or facsimile. The frequency of the reports will depend on the needs of the particular patient, and can be filed by the achievement of goals or the appearance of alarm signals as described above. The system can also generate regularly scheduled reports for a doctor's review on a default basis, depending on the patient's needs. For example, patients who are relatively ill may be checked twice a week or more, even if alarming signs do not occur. After receiving feedback from system 5 regarding changes to a patient behavior modification program, a physician or clinical supervisor may wish to make recommendations about the program. FIGURE 46 shows an exemplary feedback screen which follows the selection of a recommendation option 276 of FIGURE 40. If, for example, a patient is initially placed in a walking program 15 minutes three times a week loses 5 pounds (2.3 kilograms) and their blood pressure drops, the system can generate a report for that the doctor recommends an increase in the time it should walk a patient 45 minutes per session as shown in 322. The system can make additional recommendations on the frequency and duration of exercises that reduce stress 328 as well as on other areas of the program as shown in 326. The doctor who reads the report can accept 330 or modify 332 the recommendations. The characteristics of the system report allow a doctor to manage more patients at the same time without diminishing the quality of care. The system also allows the feedback of a patient regardless of their self-verification ability. If he - * - ^ - '- • Á. --- -'- ^ »^ * ^ -» - > - > '^ "patient has a difficult night, for example, can send an email through the system directly to the clinical or medical supervisor via mail interfaces 98 (FIGURES 9, 16-20) or post office 74 (FIGURE 8). 5 Once the clinician / clinician is satisfied with the recommendations, he can electronically communicate the program changes to the user 334. FIGURE 46 also shows an example of a patient who has earned 324 reward points for not having smoked for 60 days. The reward points shown here are effective in the warehouse of the villa 78 shown in FIGURE 8. Referring to FIGURE 47, the system presents a message screen after the selection of a communications option 334 of FIGURE 46. The clinical supervisor can send the recommendation 246 made by the system and reviewed and / or modified by the physician, to the subscriber 340 with a mail message electronic with Annex 344 audio, or alternatively via text or facsimile email. A copy of recommendation 346 and message 344 can also be stored in the system database 342. Clinicians / clinicians can also communicate with patients through conference calls. video. A conference package - video from a third _______ fc __________________ ^ _ & _i_? ¡? ____ ^ existing part can be integrated into the system to allow the video conferencing feature. The minimum requirements for a PC to support the capacity of video conferences are a clock cycle of 90 megahertz, 24 megabytes of random access memory, a color camera, a video capture board, an audio board, a board capture video input, and an ISDN line. The technical specification may change when technological changes affect bandwidth and / or data compression. As shown in FIGURE 47, the video conferencing feature can be accessed after the selection of a video conferencing option 347. A. Video conference manager, such as the one illustrated in FIGURE 48 can then be used to conduct the video conference. Pay a health plan, such as WHO, insurance company or self-insured employer, can also access the system. The information that is provided by a patient can also be sent electronically to who pays the health plan. The information can then be combined with the information of the provider to analyze the individual patients or add results of all the people of the program. The analysis may include, for example, costs per patient, costs per patient in each category or group, use of the doctor. The database of relationships of the system that allows the personalization of the data, depends on the requirements of the health plan. The system can also provide additional reports to who pays the health plan for management review and cost control purposes. Whoever pays for a health plan may be less interested in individual patient records and is more interested in seeing information about the number of subscribers in the system, the cost of keeping subscribers in the system, and how this cost compares with that of patients who are not in the system. At the same time, several layers of electronic security measures ensure the privacy of the individual patient by strictly segregating the type of information available to the different parties that have access to the system. The user interface for who pays the health plan is similar to the user interface used by a clinician / clinician. When the health plan payer subscribes to the system, it presents a main menu screen with a list of available options, as shown in FIGURE 49. From there, whoever pays the plan can choose to see the status of total compliance 350 , carry out a case management review 352, conduct a utilization review 356, review results 354, or communication 358, options each of which is described in more detail later. After selecting an option to view compliance status 350, whoever pays for the health program sees the current compliance status based on predetermined category 360, as shown in FIGURE 50. For each category, information about the total number of patients chosen 364, number of participating patients 366, participating patients who comply with the program 368, participating patients placed on trial due to non-compliance 372, and patients who finished 376. An analysis screen is also invoked comparative costs via the option to see comparative costs 362. FIGURE 51 shows an example of the cost of maintaining patients in the system. The total cost 380 can be compared against the cost incurred by a patient control group that did not subscribe to the 382 system. The comparative savings achieved by the use of the system are shown in column 384. Referring again to FIGURE 49, the menu principal 348 also includes the operation of an option to review case handling 352. A current patient list (not shown) is substantially similar to The list shown in FIGURE 4, follows the selection of this option. Once the patient's file has been selected, a confidential waiver or withdrawal information is presented 390, as shown in FIGURE 52. A patient will be assured of confidentiality and private in the areas where a waiver has not been given. For example, portions of the patient's diary will be kept confidential and not available to whoever pays the plan. health, ensuring that patients. Keep being open and honest by entering information in your journals daily. After the option selection to continue 392, in Figure 40 a similar screen contained in the screen of Figure 53. As with the user interface for physicians / clinical supervisors, indications are given of patient's blood pressure level 404, physical activity 406, weight 408 and cholesterol levels 410 over time. Those can also be represented graphically to who pays the health plan in a manner substantially similar to that of Figures 41, 42, 43 and 44 respectively. Who pays the health plan, however, has an option to review costs 400 which is available to the physician / clinical supervisor. __i _____ ái ___________ _____ MÉ ________ É Figure 54 illustrates an exemplary screen that can be viewed after selecting the option to review costs 400 of Figure 53. There it shows information about the costs incurred at the maintenance date of the selected patient in the system. The costs of system 410, health costs and services 412 and total costs 414 are represented in a bar graph format in this particular example. The costs included by a patient in the control group is not in the system also shown 418. This cost is compared, with the total costs 414 and the amount of savings 416 thus achieved, and is also presented in a graphical format of bars. Referring again to Figure 49, another option provided by main menu 348 is a result review option 354, which provides a screen shown in Figure 55 with information on different patient outcomes, based on several predetermined categories. For example, information is shown on the percentage of compliant subscribers who requested an emergency room ("ER") 420. This information can be compared against visits to the ER made by nonconforming subscribers 422 and patients in the control group who did not subscribe to system 424. Referring again to Figure 49, main menu 348 also provides a revision 356 utilization option. As shown in Figure 56, after making this selection, a screen with information including group name appears. or installation that uses the system, the specialty of the group or facility 432, the number of cases to date 434, the percentage of cases referring to the 436 system, and how this percentage 438 is compared with the percentage of objective use 440. After the selection of a particular group or facility 442, the same type of information can be obtained for the doctors of the selected group or institution 442, co mo is shown in Figure 57. The main menu 348 in Figure 49 further provides a communication option 358 that leads to Figure 58. The health plan payer can send an email with audio 456, text email 458 or fax 460 to the clinical supervisor 450, responsible physician 452, or subscriber 454, as shown here. In this way, there is a proportion, a follow-up cycle of verification and compliance feedback to take the patient to make changes in a difficult lifestyle. Once the patient has reached the desired goals, he or she can continue using the system as a health or wellness maintenance program. The main purpose of the system is to educate and motivate patients to take control of their lives and improve their ^^^ health modifying their behavior and changing their lifestyles. Figure 59 is a block diagram of the system herein. It will be apparent to those skilled in the art that the invention described herein can be implemented on various platforms. In a preferred embodiment, however, patients, physicians, clinical supervisors, and those who pay for the health plan have access to a PC 500 with a Pentium microprocessor. The PC 500 contains 502 audio and CD-ROM capabilities however, a PC 500 can have the capabilities of multiple media and having the capabilities to present or capture video, microphones, etc. The PC 500 is connected to a 504 printer to generate hard copies and any data accessible by the computer. In a preferred embodiment, the operating system, used by a PC 500 is an operating system based on indows. Preferably Windows 95. In a preferred embodiment of the invention, each PC 500 is linked electronically to the server of the network 508 via the Internet 518. Contained on each server 508 is a transaction server 510, meeting server 512, server of "internal circle" 514 , and "open circle" server 516. Transaction server 510 uses to handle secure purchases via store 78 (Figure 9) or travel agency interfaces (Figure 36). The secure meeting server 512 is dedicated to implementing the functions of room 96 and cafeteria discussed with reference to Figures 9, 14, and 15. The "internal circle" server 514 is dedicated to handling sensitive data, such as Medical records. Other servers can be added if necessary. For example, separate media servers can exist to handle the audio and video functionalities of the system. Communication via the Internet 518 is achieved in the preferred embodiment of the invention via telephone lines by means of a high-speed modem 506 connected to the PC 500. Alternatively, satellites, television cable systems, and ISDN lines to access the Internet 518. The TCP / IP standard is used as a protocol to communicate between the 508 servers and a 500 PC via the Internet 518. The 508 network server can be located at the installation of the plan payer of health with an independent third party acting as an Internet Service Provider or elsewhere. The 510-516 servers have access to one or more 522 relationship databases (such as the SQL) that contains all the health plan data, including information fed into the diary's information diary. For example, relevant information from the patient diary will be downloaded to the server and downloaded to the doctor and clinical supervisor. The information provided by the doctor will also be _________ IS_ downloaded to the same server. The data of the system will be downloaded to the supervisor of the case according to the periodic basis for its revision. All the necessary information for a user of a system is located from the databases 522 or CD-ROM or / and DVD distributed to the users on a periodic basis, as technology allows, via audio and video propagation. In the first instance, in the modality preferred until now, the videos and audios available to the leaders 114 to conduct meetings (Figure 14) or via the interfaces of the kitchen (Figures 21, 22), gymnasium (Figure 26), quiet park ( Figure 29), and library (Figure 32) are located on CD-ROM or DVD. However, with the emergence of ISDN, the cable modem, XDSL, and direct satellite distribution, I anticipate that the system will be able to send video and audio propagation over the network. There are three levels of security implementation to help secure data transmission, and 510-516 servers, as well as to ensure that only authorized users can access the 522 databases. Security of use for patients , doctors / clinical supervisors and those who pay for the health plan is ensured a double protection system (user id and password). An example of such a registration screen is shown in Figure 36. r ^^^ A In addition, a code based on "cookie" is used to verify when users enter and exit, and to monitor how each user uses the system. This, for example, will allow the system to maintain attention to group meetings. If a user has missed a group meeting, the clinical supervisor would then be able to track his absence. Referring again to Figure 59, a fire wall 520 is also provided at the server level to protect the confidentiality of the health plan data. In addition, encryption is provided to ensure that communication between the 510-516 servers and the PC 500 is secured. An administrator of the 524 network, who may be the clinical administrator or an independent third party, is also attached to the 508 server. The network administrator subscribes all users to the system except the participants of the clinical or wellness group. Physicians or clinical supervisors are responsible for subscribing clinical members of well-being. The network administrator is also in charge of the maintenance of the system database 522. In the preferred mode, the system was built using the C ++ programming language in conjunction with SQL 6.5, Cold Fusion, commercially available from Alaire g ^ ® ^^^^^^^^^ Company, Visual Basic, commercially available from Microsoft Corporation, HTML. Active X and Java components can also be invoked to handle the multi-media functions of the system. It should be understood that the foregoing is merely illustrative of the principles of the invention, and for those skilled in the art they can make various modifications without departing from the spirit and scope of the invention as defined in the following claims. For example, the system can be programmed in any number of programming languages in addition to the C ++ code to achieve the underlying principles of the present invention. The screens can be given a new format to change their appearance, and many different data sets can be used for several patients with different chronic diseases. It is noted that in relation to this date, the best method known to the applicant to carry out the aforementioned invention, is that which is clear from the present description of the invention. i.á _________------- M _______ f - l

Claims (35)

1. CLAIMS Having described the invention as above, the content of the following claims is claimed as property: 1. A method to verify compliance with a therapeutic program to modify the behavior, the method is characterized in that it comprises the steps of: providing a therapeutic program that modifies a behavior that has a series of milestones for a patient; enter data to the patient at prescribed times; and correlating the patient's data using a microprocessor with the milestones in the therapeutic program to modify the behavior to determine if the patient is complying with the program. The method according to claim 1, characterized in that it also comprises the step of grouping particular data using the microprocessor and linking the data to a remote computer. 3. The method of compliance with the claim 1, characterized in that it also comprises the step of using the microprocessor to provide graphic screens to encourage the patient to comply with the therapeutic program to modify the behavior. 4. The therapeutic system with a program to modify the behavior, verify the compliance and feedback, characterized because it comprises: means, comprising a database of relationships and a microprocessor coupled to the database, to develop a therapeutic program to modify the behavior that has a series of milestones for an individual; means to verify the individual's compliance with the program, which includes: means to suggest to the individual that they enter data related to their health; means to correlate the data entered by the individuals with the milestones in the behavior modification program and generate compliance data indicative of the individual's progress toward achieving the milestones of the program; means, accessible to the database of relationships and the microprocessor, to motivate the individual to comply with the program, which comprises an integrated system of graphical interfaces of the system, the means of motivation include: means to allow the individual to receive the data of accordance; means for providing health information to the individual from a remote source; ^? an electronic calendar integrated with the behavior modification program to indicate the individual to take actions due to the modification program of the opprtration where the calendar has access to the relations databases and have program requirements with the individual's daily program; an electronic journal to allow the individual to enter information related to their personal health; an electronic boardroom to link the individual with a plurality of other individuals who have related behavior modification programs to facilitate support sessions per group to comply with the program; and means to provide motivating media presentations to the individual to encourage the individual to comply with the program; and an electronic graphical navigator operable by the individual to control the microprocessor to have access to different parts of the system. The system according to claim 4, characterized in that the means for developing the therapeutic program of behavior modification comprises: means for introducing preliminary health information related to the individual; means for presenting a plurality of suggested behavioral modification programs containing suggested milestones generated as a function of the preliminary health information; 5 means to select one > of the suggested behavioral modification programs and alter the milestones to generate the individual behavior modification program; and means for loading the behavior modification program into the relationship database. 6. The system according to claim 4, characterized in that it also comprises means for providing presentations of motivational means to individuals in the boardroom15 electronic as part of the group support sessions, thus facilitating the group's interactive discussion about the presentations. 7. The system according to claim 4, characterized in that it also comprises 20 means to allow the individual to select a materialization to be represented in the electronic board room. 8. A method to help an individual comply with a therapeutic program to modify the behavior, The method is characterized in that it comprises the steps of: ______! ______-.? - ^ .- ^ .- ^^^^ -..- ^ .... - »**.« _ *! ___ »_- ,. provide the therapeutic program to modify the behavior that has a series of milestones for the individual; enter health data related to the individual at prescribed times; correlate the individual's health data with the milestones in the behavior modification program using a relationship database and generating compliance milestones indicative of whether the individual is complying with the program; group particular compliance data using a microprocessor and linking the data to a remote computer; and motivate the individual to comply with the behavior modification program by: providing medical information related to the program; present the individual with the compliance data to enable the individual to personally verify compliance with the program; indicate the individual to take, actions according to the program through an electronic interface integrated with the daily program of the individual; promote group support sessions accessible from a distance and means of motivation aimed at encouraging the individual to achieve the milestones of the program; and allow the individual to retrieve medical information, compliance data and programming signals, and participate in group support sessions and see the motivational means through a graphic electronic interface. The method according to claim 8, characterized in that the step of providing remote group support sessions, and motivational means comprises presenting the motivational means during the group support sessions to facilitate the interactive discussion of the group about the presentations. The method according to claim 8, characterized in that it also comprises the step of selecting an embodiment to represent the individual during the group support sessions. 11. A method to help an individual to comply with a program of behavior modification implemented by computer, the method is characterized because it comprises the steps of: providing milestones in a program of behavior modification to be achieved by the individual; verify the conformity of the individual with the program:, obtaining data related to the health of the individual at prescribed times; compare health-related data with milestones to generate compliance data indicative of whether the individual is complying with the program, and encourage the individual to comply with the program if the compliance data indicate lack of compliance; and comparing health-related data against accepted medical protocols and alerting the individual's physician or clinical supervisor when a health risk is present; electronically educate the individual about health topics related to the individual's condition and behavior modification program; and motivating the individual to comply with the behavior modification program: providing group support to the individual by electronically linking the individual with a plurality of other individuals who have related behavior modification programs; provide a reward to the individual when certain milestones are reached; present the individual with compliance data that allows the individual to personally verify compliance with the program; allow the individual to enter comments related to the behavior modification program in a newspaper implemented by computer; and provide presentations by multiple means to encourage the individual to comply with the program. 12. The method in accordance with the claim 11, characterized in that the step of obtaining the data related to health comprises that the user 10 provide the data through a newspaper implemented by computer. 13. The method according to the claim 12, characterized in that portions of the data in the diary are accessible to a physician. 15 14. The method according to the claim 11, characterized in that the step of obtaining health-related data comprises that a doctor obtains the data of office visits by the individual to the doctor. 15. The method according to claim 20 11 wherein the step of providing education includes recipes, strategies stress management, and nutrition information, diet and exercise to the individual. 16. The method according to claim 15, characterized in that the ingredients that appear in the ^^ ¿^^ j ^^ jj ^ m ^^^^ ^^^^^ ET Mamii recipe are automatically downloaded to a shopping list online. The method according to claim 11, characterized in that the group support is provided by a computer-implemented meeting room, where the individual and the plurality of other individuals participate in online group meetings, the meetings comprise: leader to verify the discussion and activate presentations by multiple means; and means to represent • the individual and the plurality of other individuals in group meetings. 18. The method according to claim 17, characterized in that a computer-implemented schedule allows the individual: to view a list of group meetings online; sign up for a particular group meeting from the group meeting list; and request automated reminders to remind the individual of the group meetings to which the individual has enrolled. 19. The method according to claim 17, characterized in that the meetings further comprises means for the individual contact with a plurality of other individuals via telephone directly from the boardroom implemented by computer. ________ 20. The method according to claim 11, characterized in that the support group is provided by an area advisory computer implemented to advise and support to individuals by more experienced individuals. 21. The method according to claim 20, characterized in that no more than a predetermined number of more experienced individuals can be present in the area of counseling at the same time with the individual. 22. The method of compliance with the claim 11, characterized in that the support group is provided via email to facilitate communication with the medical, clinical supervisor, or the plurality of other individuals who have programs related behavior modification. 23. The method according to claim 11, characterized in that the group support is provided through a bulletin board where the individual sends messages and reads messages sent by the other individuals who have related behavior modification programs. 24. The method according to claim 11, characterized in that the reward in reward points that can be exchanged for products, miles of ^^^^^^^^^? fiáij | S ^^^^^^^^^^^^^^^ yy | í ^ i frequent flights, or a symbolic reward that entrusts the individual with a good job. 25. A therapeutic system with a program of behavior modification, verification of conformity and feedback, characterized in that it comprises: means, comprising a database of relations and a microprocessor coupled to the database, to develop the therapeutic program that modifies the behavior that has a series of milestones for an individual; means to subscribe an individual to the behavior modification program; means to verify the conformity of the individual with the program including: means to obtain health data related to the health of the individual at prescribed times to feed them into a relationship database; means to compare health-related data with milestones in the behavior modification program to generate compliance data indicative of whether the individual is complying with the program, and to encourage the individual to comply with the program if the compliance data indicate lack of conformity; Y means for comparing health-related data against accepted medical protocols and alerting the individual's physician or clinical supervisor when a health risk is present; means to educate the individual electronically about health and medical topics related to the condition of the individual and the behavior modification program; means, accessible to the relationship database and the microprocessor, to motivate the individual to comply with the program including: means to provide group assistance to the individual by electronically linking the individual with a plurality of other individuals who have modification programs of related behavior; means to provide a reward to the individual when certain milestones are reached; means to present the individual with compliance data to enable the individual to personally verify compliance with the program; means to allow the individual to introduce personal feelings and comments related to the behavior modification program in a computer-implemented diary; Y _______ _______ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ means to modify the program based on the individual's progress; and a graphical user interface to control the microprocessor to access different parts of the system. 26. The system according to claim 25, characterized in that the means to develop the therapeutic program to modify the behavior comprises: means for introducing preliminary health information related to the individual; means to present a suggested behavioral modification program that contains suggested milestones generated as a function of preliminary health information and accepted medical protocols; means to modify the behavior modification program suggested to generate the program for modifying the behavior of the individual; means for loading the behavior modification program into the relations database; Y j? ^ means to give the individual access to the graphical user interface to control the microprocessor to have access to different parts of the system. 27. The system according to claim 25, characterized in that the means to obtain health-related data comprises means to suggest to the individual to introduce information related to health in the newspaper implemented by computer. 28. The system according to claim 25, characterized in that the means of education comprise means to provide recipes, stress management strategies, and nutritional information, diets and exercise to the individual. 29. The system according to claim 28, characterized in that means for providing recipes includes means for downloading ingredients of recipes implemented to a list of purchases implemented by computer. 30. The system according to claim 25, characterized in that the means for providing group support comprises means for providing online group meetings comprising: means for electronically viewing a list of group meetings available to participate; means to register electronically for a particular group meeting; means for sending automated reminders to remind the individual about a particular group meeting in which the individual is registered; means to provide an electronic boardroom for group meetings; means to verify the discussion during group meetings; means to activate multiple media presentations during group meetings; means to electronically represent individuals and the plurality of other individuals in group meetings; and means for contacting a plurality of other individuals via a telephone directly from the boardroom implemented by computer. The system according to claim 25, characterized in that the means for providing group support comprise means for providing computer-implemented counseling areas to advise and support individuals through other more experienced individuals. 32. The system according to claim 25, characterized in that the means for providing group support comprise electronic mail means to facilitate communication with the plurality of other individuals. 33. The system according to claim 25, characterized in that the means for providing group support comprises bulletin board means for sending messages and reading messages sent by other individuals having related behavioral modification programs. 34. The system according to claim 25, characterized in that it also comprises means for providing security against unauthorized access to the system. 35. The system according to claim 25, characterized in that it also includes means for those who pay for the health plan to verify the use of the system.