WO2011143326A1

WO2011143326A1 - Providing remote healthcare monitoring

Info

Publication number: WO2011143326A1
Application number: PCT/US2011/036093
Authority: WO
Inventors: Ajit Pendse
Original assignee: pomdevices, LLC
Priority date: 2010-05-11
Filing date: 2011-05-11
Publication date: 2011-11-17

Abstract

In one example, a system provides remote healthcare monitoring. A portable device operated by a patient remotely from a caregiver can provide numerous functions, such as aided construction of SMS status messages to caregivers and trend detection and notification.

Description

PROVIDING REMOTE HEALTHCARE MONITORING

[0001] Background of the Invention

[0002] SMS (sometimes known as "short message service" or "text messaging") is a common technique for communication of short messages in a networked environment, for example among mobile phone devices. Simple and convenient, text messaging is seen as a new standard by many for sending status, proximity, and other types of one-way information. Indeed, billions of text messages are now sent monthly in the United States alone.

[0003] Most text messaging devices, however, present technological hurdles to the older adult. Navigating complex menus, interacting with small screens and keyboards, and understanding the underlying technology involved in SMS messaging can lead to a lack of participation in the older population. The disclosure that follows solves this and other problems.

[0004] In circumstances of remote care-giving, responsible parties often are not able to easily track daily activities. For example, family members cannot easily monitor the daily activites of an older, infirm or handicapped parent who may be living alone. Changes in even the simplest activities such as walking and talking may indicate that health is declining or is in a sub-optimal state. Without regular access to this information, however, individuals are unable to get a large- scale picture of behavior over time, making timely detection of healthcare problems more difficult.

[0005] Current methods for tracking daily activity include pencil and paper tracking, persistent phone calls, and basic tools (such as spreadsheets) for getting daily snapshots of individuals. More technical solutions, such as Georgia Institute of Technology's "Aware Home" project, track

1 Attorney Docket No. 7395-0042 motion and other activity through expensive devices such as force load tiles and video cameras. The disclosure that follows solves this and other problems.

[0006] Summary of the Invention

[0007] In one example, a portable device displays a first subset of a set of predefined text statements, and receives a user selection of one of the displayed text statements over an input interface of the portable device. Conditionally based on which one of the displayed text statements is identified by the user selection, the portable device displays a second subset of the set of predefined text statements on the display of the portable device. The portable device then generates a text message with user data containing text taken from at least a particular one of the set of predefined text statements according to the received user selection(s).

[0008] Patient activities are detected or monitored by a variety of electronic input sources. Data representing the activities are transmitted to a central device where the data are archived, i.e., accumulated over time. A software process analyzes the input data from a given source, and detects changes over time, for example by use of a moving average or other statistical metrics. Significant results or changes in those metrics trigger notification to a caregiver or other designated party. In another embodiment, the input data from multiple sources and analyzed against previous data.

[0009] In one example, a process includes receiving a plurality of first communications and a plurality of second communications, each first communication capturing activity of a patient using a first device at a different time and each second communication capturing activity of the patient using a second device at a different time. The process includes identifying a macro trend for all monitored activity of the patient based on data taken from the first and second

2 Attorney Docket No. 7395-0042 communications. The process includes comparing data taken from a new communication from at least one of the first and second devices to the identified macro trend. A caregiver may be notified according to the comparison.

[0010] In this application and the claims, we use the term "patient" broadly to mean any individual person whose activities are monitored consistent with the present disclosure. We use the term "caregiver" broadly to mean any person who receives notifications related to patient activities consistent with the present disclosure. "Caregiver" thus may include but is not limited to a doctor, nurse, other healthcare professional, friend, neighbor, family member, etc.

[0011] Brief Description of the Drawings

[0012] FIG. 1 illustrates a system for aided construction of SMS status messages to caregivers.

[0013] FIG. 2A illustrates a timeline of an example operation of the portable device of FIG. 1.

[0014] FIG. 2B illustrates example screens displayed by the portable device during the example operation of FIG. 2A.

[0015] FIG. 3 illustrates an example method for using the portable device illustrated in FIG. 1.

[0016] FIG. 4 illustrates an example method for using the caregiver computing device illustrated in FIG. 1.

[0017] FIG. 5 illustrates a system for activity trend detection and notification to caregivers.

[0018] FIG. 6 illustrates an example method for using the caregiver computing device and/or the patient computing device shown in FIG. 5.

[0019] Detailed Description of Preferred Embodiments

[0020] FIG. 1 illustrates a system for aided construction of SMS status messages to caregivers.

3 Attorney Docket No. 7395-0042 [0021] The system 100 includes a caregiver computing device 6 and a portable device 8 to be used by a patient or other monitored user. The computing device 6 and the portable device 8 include specially configured processing devices 21 and 11, respectively, which will be described later in greater detail.

[0022] The system 100 can include conventional networked devices 7 including, but not limited to, a personal portable device (cell phone, PDA, etc.), a laptop, a desktop workstation, etc. The processing device 11 is configured for aided construction of SMS messages addressed to the networked devices 7 and/or the caregiver computing device 6.

[0023] The portable patient computing device 8 includes a memory 19 containing a plurality of predefined text statements 20. In one example, the predefined text statements 20 include at least four predefined text statements, namely a first predefined text statement that recites a first status of a patient or other monitored user, a second predefined text statement that recites a second different status of the monitored user, a third predefined text statement that recites a first need of the monitored user, and a fourth predefined text statement that recites a second different need of the monitored user. The at least first and second predefined text statements could include "feel good", "feel OK", "not so good", or any other status indications providing alternative statuses. The at least third and fourth predefined text statements could include a need such as an item, e.g. "groceries" or "medicine", or a need such as a request for contact with alternative urgencies such as "please call me today" or "please call me when you get a chance".

[0024] In some examples, the particular combination of the predefined text statements 20 stored in the memory 19 corresponds to one of the predefined text statement sets 1 stored in the memory 22 of the remote device 6. In such examples, the processing device 21 can obtain information regarding a characteristic of the operator (patient or other monitored user) of the

4 Attorney Docket No. 7395-0042 portable device 8 from any source such as via a communication from the processing device 11 or via an input over a local user interface 15 (a touch screen, a keyboard, a microphone in the case of a voice recognition system, etc.) of the caregiver computing device 6. The characteristic can be any information taken from a profile of the operator, such as a level of care needed by the operator in one example. The processing device 21 selects a particular one of the sets 1 based on the obtained information. The selection by the processing device 21 controls which of the predefined text statements 20 are available to the processing device 11 for displaying to the operator.

[0025] The portable patient computing device 8 may contain persistent storage 25 for retaining data 28 related to a history of transmitted SMS messages containing the predefined text statements. For example, the data 28 can contain send times of previously transmitted text messages with predefined text statement(s) 20 included therein and an indication of which ones of the predefined text statement(s) 20 were included in each text message.

[0026] The processing device 11 is configured to analyze the data 28 at times. The processing device 11 is configured to use a result of the analysis to adjust aided construction of future text messages (illustrated as feedback 29). For example, according to the analysis the processing device 11 may identify a trend such as a plurality of text messages containing the same one or ones of the predefined text statements 20 sent at regular intervals. The processing device 11 is configured to then schedule a proposed text message based on the identified statements to be displayed based on a display 16 of the device 8 at the next occurrence of the regular interval with a request for confirmation to send the proposed message, or in some examples the processing device 11 can be configured to automatically (without manual user intervention) send the system generated text message at the scheduled time.

5 Attorney Docket No. 7395-0042 [0027] Having described various components of the system 100, an example operation will now be discussed with reference to FIG. 2A (a timeline for the example operation of the portable device of FIG. 1) and FIG. 2B (example screens displayed on the portable device of FIG. 1) for purposes of further describing these components.

[0028] Referring to FIG. 2 A, at time 50 the user actuates a "send text" button, which can be a physical user interface component on a surface of the portable device shell or any other user interface component. At time 51, the portable device displays a plurality of destinations for the text message. At time 52, the user selects at least one of the destinations.

[0029] At time 53, the portable device displays an initial subset of the predefined text statements. Referring to FIG. 2B, an example image 34 for this displaying is shown. The example image 34 includes a query field 30 to elicit selection of one of the three displayed predefined text statements 41-43. The user can select any one of the three displayed predefined text statements 41-43 using any known user interface such as a touch screen.

[0030] Referring again to FIG. 2A, at time 54 the user selects one of the predefined text statements of the initial subset. At time 55, the portable device analyzes the received selection and displays an additional subset of the predefined text statements according to the analysis. For example, referring to FIG. 2B, if the user selects either statement 41 or 42 (but not statement 43), then the display image 31 is shown. The display image 31 has a query field 40 and statements 45-47 of the additional subset. Selection of statement 43 might cause a different subset than statements 45-47 to be displayed in the image 31.

[0031] Referring again to FIG. 2A, at time 56 the user selects one of the predefined text statements of the additional subset. This could include activating a touch input interface such as a button or speaking a selection such as "choose one", "choose two", or "choose three" in the

6 Attorney Docket No. 7395-0042 case of a voice recognition option. The times 55 and 56 are intended to represent some number N cycles of displaying additional predefined text statements and obtaining a user selection, where N can be 0, 1, 2, 3, etc. depending on the initial selection.

[0032] At time 57, once all the statement selections are received, the portable device displays a proposed text message including the selected predefined text statements as shown in FIG. 2B, image 32. The image 32 includes the proposed text message 48 and a send message soft button 49. The proposed text message 48 includes the terms "feel good" and "need groceries/medicine" as shown if the user selected statements 41 and 45. The user can manually edit the proposed message to include, for example, other inputs before and/or after the predefined text statements.

[0033] At time 58, a user can submit any edits to the proposed text message before sending a confirmation by, for example, actuating a soft button (49 in FIG. 2B) or re-actuating the physical "send text" button (14 in FIG. 1). At time 59, the portable device transmits the text message containing the selected predefined text statement(s) to the selected destination(s).

[0034] FIG. 3 illustrates an example method for using the portable device illustrated in FIG. 1. 100351 In block 300, the portable device displays a plurality of destinations for a guided creation text message. In block 301, the portable device receives a destination selection and displays an initial subset of predefined text statements.

[0036] In block 302, the portable device selects an initial subset of the predefined text statements such as a default initial subset or a subset based on a characteristic of the operator and/or the destination selection, and displays the selected subset. In block 303, the portable device receives a statement selection. In block 304, the portable device determines if an additional subset of the predefined text statements can be displayed based on the most recent statement selection.

7 Attorney Docket No. 7395-0042 [0037] If an additional subset can be displayed (diamond 305), then in block 306 the portable device selects an additional subset of predefined text statements based on the most recent statement selection, and displays the selected subset. The process returns to block 303.

[0038] Otherwise, if no additional subset can be displayed (diamond 305), then in block 307 the portable device displays a draft text message containing the user selected predefined text statements. In block 308, the portable device receives confirmation and any user edits and transmits the text message to the selected destination(s). In block 309, the portable device stores a record of the transmitted text message including an indication of the selected destination(s) and an indication of the included predefined text statements. In block 310, the portable device can optionally schedule any automatic initiations of guided text message creation based on a history including the record and/or modify statement subset(s) based on the history.

[0039] FIG. 4 illustrates an example method for using the caregiver computing device illustrated in FIG. 1.

[0040] In block 400, the caregiver computing device receives a message or input indicating a characteristic of an operator of a portable device. In block 401 , the caregiver computing device selects from different sets of predefined text statements based on the indicated characteristic. In block 402, the caregiver computing device transmits a message to the portable device to provide the predefined text statements of the selected set(s) to the portable device.

[0041] In block 403, the caregiver computing device receives a text message from the portable device, the text message containing at least one of the provided text statements. In block 404, the caregiver computing device stores a record of the transmitted text message including an indication of the destination(s) and an indication of the included predefined text statements. In block 405, the caregiver computing device can optionally schedule any automatic initiations of

8 Attorney Docket No. 7395-0042 guided text message creation by the portable device based on a history including the record and/or modify statement set(s) based on the history.

[0042] FIG. 5 illustrates a system for activity trend detection and notification to caregivers. The system 900 includes a portable computing device 908 including a processing device 911 for activity trend detection and notification to a caregiver. The system 900 also includes one or more of the other networked device(s) 907B-N that are communicatively coupled to the processing device 908 over at least one network. The other networked devices 907B-N can include, but are not limited to, a TV (networked type), a gaming console (networked type), a database storing gaming results (typically any such databases are networked), a DVR (networked type), a set top box (networked type), a cell phone, a camera such as a wall or ceiling mounted camera, a microphone such as a wall or ceiling mounted microphone, etc. The portable computing device 908 is configured to aggregate user inputs collected by user interface 907A and/or the other devices 907B-N and identify a macro trend 920 based on the aggregated data. The processing device 911 stores the macro trend in a memory 919 for use in analyzing newly received data.

[0043] In the system 900, the sources of the data aggregated by the processing device 908 can be categorized into two broad categories as follows. One category includes devices which a patient actively controls via a user interface of the networked device. This category includes the personal portable device 908 (which the patient can actively interact with by sending text messages to friends and family in one example), online databases of gaming results (which represents active interaction with a gaming console), networked televisions (a patient actively interacts by selecting a channel and causing the TV to remain tuned to that channel for a particular time period), networked DVRs, networked set top boxes, networked gaming consoles,

9 Attorney Docket No. 7395-0042 etc. and other multimedia devices. The source of the data can be the specific user input interface that the patient is actively interacting with, or in some cases a different user input interface of the same device, i.e. in the case of the portable device 908, the patient may be recorded via a microphone/camera user input interface of the portable device 908. Activity data may be collected when the user is interacting over another user input interface of the portable device 908 such as an attached keyboard or touch screen.

[0044] The "active device" category can be contrasted with another category of devices characterized by devices such as wall and ceiling mounted cameras, microphones or motion sensors distributed through a living area, which the patient does not actively interact with (these devices merely passively observe the patient). In these cases, the patient is not actively interacting with the device that is the source of the data aggregated by the processing device 908.

[0045] In some examples, the processing device 908 aggregates data exclusively from source devices in the "active device" category. In other examples, the processing device 908 aggregates data from at least one source device in the "active device" category and at least one source device in the "passive device" category, e.g. from the networked TV 907B and a camera mounted on a wall/ceiling of a living area in one example.

[0046] The processing device 911 is configured to obtain information from a patient in direct and indirect ways. For example, the processing device 911 can be configured to display inquiries soliciting information from the patient (direct). The processing device 911 can also be configured to gather activity information indirectly, for example, by capturing motion and sound of the patient when the patient interacts with the computing device 908 and/or information from remote sources 907B-N (indirect).

10 Attorney Docket No. 7395-0042 [0047] The processing device 911 can be configured to, at various times, extract information from the networked devices 907B-N over one or more networks. The extracted information can include, but is not limited to, game information such as score/results, frequency of play, and duration of play; meta data from text communications sent via SMS or other similar protocols; and media viewing information such as information from a TV 907B, a set top box 907E, or a DVR 907C concerning viewing patterns. The various times for extraction could be scheduled or requested ad hoc by a caregiver computing device 906. In other embodiments, networked devices may initiate a communication, or "push" data when they have activity to report. For example, a gaming console may report a score at the conclusion of a game.

[0048] The processing device 911 is further configured to control the interface 907 A (such as touch screen, motion detector, audio-in processing, etc.) to obtain motion and sound information of the patient. For example, the processing device 911 can obtain a captured motion of the patient and a captured speech of the patient when the patient is interacting with, for example text messaging, or a remote device. The processing device 911 may be further configured to control the graphical display on the output 916 to display graphics that solicit generation and

transmission of text messages to a remote device, or to control an audio output to audibly solicit generation and transmission of text messages to a remote device.

[0049] Once the processing device 911 has the obtained the raw information from devices 907 A- N as described above, in the present example the processing device 911 processes the

information to identify a macro trend 920 for all monitored activity of the patient based on the raw information from devices 907A-N. The processing device 911 can identify the macro trend 920 by analyzing the raw information directly, or by first determining an average of the data per- device and then analyzing the averages, or any combinations thereof. It should be apparent that

11 Attorney Docket No. 7395-0042 any known form of trend analysis can be used. Even in examples where the processing device 911 identifies the macro trend 920 by analyzing the raw information directly, the processing device 911 may also determining an average of the data per-device and store such averages (not shown) in the memory 919. In the present example, the macro trend 920 is stored in the memory 919 of the portable device 908 for later use by the processing device 91 1.

[0050] Having identified a macro trend 920, the processing device 91 1 can compare new information extracted from one of the devices 907A-N to the stored macro trend 920. If the new information varies from the macro trend 920 by a predetermined threshold, the processing device 911 transmits a certain type of notification (a health alert) to a caregiver. The transmitted notification can use SMS/text messaging, email, and/or other forms of communication. If the new information does not vary from the macro trend 920 by the predetermined threshold, the processing device 911 can still transmit a result of the trend analysis to the caregiver, although this would not be a health alert type notification.

[0051] The content of the uploaded notification can include results of the trend analysis to be used by the caregiver in monitoring cognitive health (or for that matter any form of health) of the particular user. In some examples, the notification be configured to highlight new deviations from existing trends and/or to characterize such new deviations by associating at least some of the trends with symptoms and characterize symptoms.

[0052] The processing device 911 may update the stored macro trend 920 from time to time. An update can occur at a scheduled time no matter how much or how little new information is available, or may occur in response to receiving a certain amount of new information.

[0053] Having now described the portable patient computing device 908 and the processing device 911 in one example of the system 900, it is noted that other examples can include a

12 Attorney Docket No. 7395-0042 caregiver computing device 6 containing processing device 922. Some or all of the functions described above by the processing device 911 can be performed by the processing device 922 as part of a distributed scheme.

[0054] For example, in one distributed scheme the processing device 911 can upload the raw information extracted from the devices 907A-N as it is obtained via SMS/text messaging, email, and/or other forms of communication. At times, the processing device 922 determines a macro trend 920 based on all of the raw information currently available on the computing device 906. The processing device 922 stores the macro trend 920 in the memory 921. Then, as the portable patient computing device 908 feeds new raw information to the computing device 906, the processing device 922 can compare the new raw information to the locally stored macro trend 920. According to the comparison, the processing device 922 can notify a caregiver, which may include displaying a message on a display attached to the computing device 906.

[0055] It should be apparent that the above example is just one example of distributing functions between the processing device 91 1 and the processing device 922. In other examples the functions can be distributed in specific ways.

[0056] The present disclosure includes daily (or other period) activity monitoring such as motion and sound through, for example, an audio recorder and a motion detector. The system then builds a database of information over time. The database can then be analyzed for trends and deviations from those trends, and the results could be communicated to appropriate parties such as caregivers or medical facilities.

[0057] Trends can be determined through a moving average algorithm such that both acute and longitudinal changes can be detected. Some specific embodiments would not only provide status and alerts, but could include recommended actions for both the caregiver and the patient.

13 Attorney Docket No. 7395-0042 [0058] FIG. 6 illustrates an example method for using the caregiver computing device and/or the patient computing device shown in FIG. 5.

[0059] Referring to FIG. 6, a flowchart for a particular system is shown. In process 1001, the processing device 911 (FIG. 5) gathers data originating from local or remote inputs. The data can be the audio/video files themselves, or data characterizing the audio/video files, or any other data gathered directly from the source or derived from data gathered directly from the source. In process 1002, processing device 911 stores the gathered data.

[0060] In process 1003, the processing device 911 identifies a moving average of each data group, e.g. a moving average for data gathered from a first source, a moving average for data gathered from a second source, and a moving average for data gathered from a third source, etc.

[0061] In process 1004, the processing device 911 compares new data from a particular input source to the moving average for that particular input source. For example, new data from a first input source is compared to the moving average for that input source. If the comparison indicates a difference exceeding a preset threshold, then in 1005 A the processing device 911 generates and transmits a notification (and possibly a recommendation) over a network to alert a caregiver. The processing device 911 could also output locally, using a display of the portable device 908, a recommended course of action for the patient (which may or may not be different from any recommendation sent to the caregiver). Any remote notification 1005 A or local output may be held until the completion of processes 1005B/1006 (next paragraph), so that the notification 1005 A is sent only if the process reaches 1007.

[0062] In process 1005B, the processing device 911 aggregates data from all sources and generates a macro trend based on an analysis of the aggregation. In process 1006, the processing device 911 compares new data aggregated from more than one input source (or possibly new

14 Attorney Docket No. 7395-0042 data from a single input source) to the macro trend. If the comparison indicates a variation from the macro trend, then in process 1007 the processing device 91 1 generates and transmits a notification over the network to alert a caregiver. It should be apparent that the processing device 911 can be configured to transmit an alert type notification (and possibly a

recommendation) only if the variation exceeds a preset threshold. The processing device 911 could also generate a local notification for the patient instead of or in addition to the remote notification.

[0063] The macro trend analysis may also check a variance in the input data from one source and correlate that variance with other sources, and based on this comparison, determine whether or not a threshold limit has been reached. In real life this could mean that a person who normally spends most of the day in the living room may occasionally spend more time in the bedroom for that day watching TV. This lower activity detected in the living room might be compensated by the activity in the bedroom resulting in no notification, for example. Or, perhaps input from another source indicates more time spent in the bathroom, which would mean that the notification does get sent despite the living room time being compensated for by bedroom time.

[0064] It should be apparent that some example systems include a portable device configured to provide any one or ones of the functions described with respect to the portable device of FIGS. 1-4 and any one or ones of the functions described with respect to the portable device of FIGS. 5-6 (in fact in some examples a portable device is configured with all of the portable device functions described herein). It should also be apparent that some examples include a remote caregiver computer configured to provide any one or ones of the functions described with respect to the remote caregiver computer of FIGS. 1-4 and any one or ones of the functions described

15 Attorney Docket No. 7395-0042 with respect to the remote caregiver computer of FIGS. 5-6 (in fact in some examples a remote caregiver computer is configured with all of the portable device functions described herein).

[0065] It will be apparent to those having skill in the art that many changes may be made to the details of the above-described embodiments without departing from the underlying principles of the invention. For example, the scope of the present invention should, therefore, be determined only by the following claims.

[0066] Most of the equipment discussed above comprises hardware and associated

software. For example, the typical portable device is likely to include one or more processors and software executable on those processors to cany out the operations described. We use the term software herein in its commonly understood sense to refer to programs or routines

(subroutines, objects, plug-ins, etc.), as well as data, usable by a machine or processor. As is well known, computer programs generally comprise instructions that are stored in machine- readable or computer-readable storage media. Some embodiments of the present invention may include executable programs or instructions that are stored in machine-readable or computer- readable storage media, such as a digital memory. We do not imply that a "computer" in the conventional sense is required in any particular embodiment. For example, various processors, embedded or otherwise, may be used in equipment such as the components described herein.

[0067] Memory for storing software again is well known. In some embodiments, memory associated with a given processor may be stored in the same physical device as the processor ("on-board" memory); for example, RAM or FLASH memory disposed within an integrated circuit microprocessor or the like. In other examples, the memory comprises an independent device, such as an external disk drive, storage array, or portable FLASH key fob. In such cases, the memory becomes "associated" with the digital processor when the two are operatively

16 Attorney Docket No. 7395-0042 coupled together, or in communication with each other, for example by an I/O port, network connection, etc. such that the processor can read a file stored on the memory. Associated memory may be "read only" by design (ROM) or by virtue of permission settings, or not. Other examples include but are not limited to WORM, EPROM, EEPROM, FLASH, etc. Those technologies often are implemented in solid state semiconductor devices. Other memories may comprise moving parts, such as a conventional rotating disk drive. All such memories are "machine readable" or "computer-readable" and may be used to store executable instructions for implementing the functions described herein.

[0068] A "software product" refers to a memory device in which a series of executable instructions are stored in a machine-readable form so that a suitable machine or processor, with appropriate access to the software product, can execute the instructions to carry out a process implemented by the instructions. Software products are sometimes used to distribute

software. Any type of machine-readable memory, including without limitation those

summarized above, may be used to make a software product. That said, it is also known that software can be distributed via electronic transmission ("download"), in which case there typically will be a corresponding software product at the transmitting end of the transmission, or the receiving end, or both.

[0069] Having described and illustrated the principles of the invention in a preferred

embodiment thereof, it should be apparent that the invention may be modified in arrangement and detail without departing from such principles. We claim all modifications and variations coming within the spirit and scope of the following claims.

17 Attorney Docket No. 7395-0042

Claims

Claims:

1. A portable device, comprising:

a memory storing a plurality of predefined text statements, wherein a first predefined text statement recites a first status of a patient or other monitored user, a second predefined text statement recites a second different status of the monitored user, a third predefined text statement recites a first need of the monitored user, and a fourth predefined text statement recites a second different need of the monitored user; and

a processing device coupled to the memory, the processing device configured to:

display at least the first and second predefined text statements on a display of the portable device;

receive a user selection of one of the displayed text statements;

conditionally based on which one of the displayed text statements is identified by the user selection, display the third predefined text statement and the fourth predefined text statement on the display of the portable device;

if the third predefined text statement and the fourth predefined text statement are displayed on the display of the portable device, receive an additional user selection; and

generate a text message with user data containing text taken from at least a particular one of the predefined text statements stored in the memory according to the received user

selection(s).

2. The portable device of claim 1, wherein the processing device is further configured to:

18 Attorney Docket No. 7395-0042 display the text for the user data of the text message on the display of the portable device; modify the text of the user data according to any received user edits; and

transmit the generated text message.

3. The portable device of claim 1 , wherein the processing device is further configured to:

identify a characteristic of the monitored user; and

select which one of a plurality of sets of predefined text statements available on a remote server are stored in the memory according to the identified user characteristic.

4. The portable device of claim 1, wherein the processing device is further configured to:

identify a characteristic of the monitored user; and

select which ones of the predefined text statements from the memory are conditionally displayed according to the characteristic of the monitored user.

5. The portable device of claim 1, wherein the processing device is further configured to:

transmit the text message;

store information relating to the transmitted text message and information relating to previously transmitted guided-creation text messages to form a history of guided-creation text messages;

analyze the stored history of guided-creation text messages; and

19 Attorney Docket No. 7395-0042 automatically display at least the first and second predefined text statements on the display of the portable device at a time selected according to the analysis.

6. The portable device of claim 1 , wherein the processing device is further configured to:

transmit the text message;

analyze the stored history of guided-creation text messages; and

automatically display a proposed new text message, wherein the proposed new text message includes a particular combination of predefined text statements identified according to the analysis.

7. The portable device of claim 6, wherein the processing device is further configured to automatically display the proposed new text message at a time selected according to the analysis.

8. The portable device of claim 1 , further comprising a physical user interface dedicated for guided text message generation, wherein the processing device is further configured to display at least the first and second predefined text statements on the display of the portable device responsive to actuation of the physical user interface.

20 Attorney Docket No. 7395-0042

9. The portable device of claim 8, wherein the physical user interface is a button.

10. The portable device of claim 1 , wherein the processing device is further configured to:

display a plurality of destinations for the text message; and

in response to receiving a destination selection over a user input interface, control which ones of the predefined text statements stored in the memory are displayed based at least in part on the destination selection.

11. A system, comprising: a portable device including a network interface to communicate over a network and a user interface to capture a motion or sound of an operator of the portable device; and a processing device coupled to the portable device, the processing device configured to: capture a plurality of motions or sounds of the operator using the user interface of the portable device at different times; receive a plurality of communications over the network interface of the portable device, each communication capturing activity of the operator at different times; determine a first average based on data of the captured motions or sounds; determine a second average based on data of the communications; identify a macro trend for all monitored activity of the patient based on the determined averages or based on the data from the captured motions or sounds and the communications;

21 Attorney Docket No. 7395-0042 compare, to the identified macro trend, data taken from a newly captured motion or sound of the operator using the user interface of the portable device or data taken from a new communication received over the network interface; and transmit a notification addressed to a caregiver over the network using the network interface based on a result of the comparison.

12. The system of claim 11, further comprising a remote device, wherein the remote device is a multimedia device, and wherein each of the communications captures an activity of the operator operating the multimedia device.

13. A system, comprising: a processing device configured to: receive a plurality of first communications, each first communication including data indicative of activity of a patient using a first device that was captured at a corresponding time; receive a plurality of second communications, each second communication including data indicative of activity of a patient using a second device that was captured at a corresponding time; determine a first average based on the data of the first communications; determine a second average based on the data of the second communications;

22 Attorney Docket No. 7395-0042 identify a macro trend for all monitored activity of the patient based on the determined averages; analyze data received in a new communication from at least one of the first and second devices based on the identified macro trend; and transmit a notification to a caregiver responsive to results of the analysis.

14. The system of claim 13, and further comprising: a first device communicatively coupled to the processing device and configured to transmit a communication to the processing device wherein the communication includes first data indicative of an activity of a patient; a second device communicatively coupled to the processing device and configured to transmit a communication to the processing device wherein the communication includes second data indicative of an activity of a patient; wherein at least one of the first and second devices is a user interface of a personal portable device operated by the patient.

15. The system device of claim 14, wherein at least one of the first and second devices is a microphone or a camera of the personal portable device.

23 Attorney Docket No. 7395-0042

16. The system of claim 13, wherein at least one of the first and second devices is a user interface of a remote entertainment device.

17. The system of claim 13, wherein at least one of the first and second devices is a component of a television or a gaming console.

18. The system of claim 13, wherein the processing device is further configured to: receive a new communication from the first device; determine a difference between data taken from the new communication to a

corresponding one of the first and second averages; and transmit a message if the difference exceeds a preset threshold.

19. The system of claim 13, wherein at least one of the first and second devices is a component of a media playing device.

20. The system of claim 13, wherein at least one of the first and second devices is a component of a messaging device.

24 Attorney Docket No. 7395-0042