Computer systems and methods for providing health care

• US 20050256745A1
• Filed: 05/14/2004
• Published: 11/17/2005
• Est. Priority Date: 05/14/2004
• Status: Active Grant

• Current Assignee: H Lee Moffitt Cancer Center & Research Institute (State University System of Florida)
• Original Assignee: H Lee Moffitt Cancer Center & Research Institute (State University System of Florida)
• Inventors: Dalton, William S.
• Granted Patent: US 8,135,595 B2
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

The invention provides a computer network comprising a first computer and one or more second computers that are in electronic communication with each other. The first computer is associated with a first health care facility and has instructions for retrieving, over a network, one or more data structures for a patient enrolled in a health care program. The one or more data structures for the patient collectively comprise (i) a patient identifier, (ii) a molecular profile from a biological specimen obtained from the patient at the first health care facility; and (iii) a clinical characterization of the patient that was made at the first health care facility. The first computer has instructions for retrieving, over the network connection, one or a plurality of treatment regimens that are deemed suitable for the patient based upon the molecular profile and the clinical characterization of the patient. The one or more second computers are at one or more locations other than the first health care facility and have one or more data structures for each patient in a plurality of patients enrolled in the health care program

Claims

1. A computer program product for use in conjunction with a computer system, the computer program product comprising a computer readable storage medium and a computer program mechanism embedded therein, the computer program mechanism comprising:

(A) one or more data structures associated with each patient in a plurality of patients enrolled in a health care program, the one or more data structures associated with each respective patient in the plurality of patients collectively comprising;

a patient identifier for said respective patient;

a molecular profile from a biological specimen obtained from the respective patient; and

a clinical characterization of the respective patient;

(B) a plurality of treatment regimens; and

(C) a therapeutic determination module comprising;

instructions for identifying a treatment regimen, from among said plurality of treatment regimens, for a patient in said plurality of patients.

2. The computer program product of claim 1 wherein the instructions for identifying a treatment regimen are based at least in part upon at least one of the molecular profile associated with the patient and the clinical characterization associated with the patient.

3. The computer program product of claim 1, the computer program mechanism further comprising a data processing module, the data processing module comprising:

instructions for enrolling a patient in said health care program.

4. The computer program product of claim 3, wherein the instructions for enrolling the patient in the health care program comprise:

instructions for receiving a patient identifier for said patient.

5. The computer program product of claim 3, the data processing module further comprising:

instructions for inputting a diagnosis for said patient into a data structure associated with the patient.

6. The computer program product of claim 3, the data processing module further comprising:

instructions for inputting a detail of a clinical trial in which the patient is enrolled into a data structure associated with the patient.

7. The computer program product of claim 6, the data processing module further comprising:

instructions for inputting a result of said clinical trial in which the patient is enrolled into said data structure associated with the patient.

8. The computer program product of claim 7, the computer program mechanism further comprising:

instructions for using the result of said clinical trial in which the patient is enrolled to define one or more treatment regimens in said plurality of treatment regimens.

9. The computer program product of claim 1 wherein a data structure associated with a patient in the plurality of patients comprises at least one demographic characteristic for the patient.

10. The computer program product of claim 9 wherein the at least one demographic characteristic comprises at least one of:

a gender of said patient;

a marital status of said patient;

an ethnicity of said patient;

a primary language spoken by said patient;

the color of the eyes of said patient;

the hair color of said patient;

the height of the patient;

the weight of the patient;

the social security number of the patient;

the name of the patient;

the date of birth of the patient;

the education status of the patient;

a name of the primary physician for the patient;

a name of a referring physician for the patient;

a referral source for the patient;

an indication as to whether the patient is disabled;

an indication as to whether the patient is a smoker;

an indication as to whether the patient consumes alcohol;

a residential address of the patient;

a telephone number of the patient;

a name of an insurance carrier for an insurance policy held by the patient; and

a member identifier number for an insurance policy held by the patient.

11. The computer program product of claim 1 wherein the molecular profile in a data structure associated with a patient in said plurality of patients comprises abundance values of a plurality of cellular constituents in the biological specimen obtained from the patient.

12. The computer program product of claim 11 wherein each said abundance value is a normalized abundance level measurement for a cellular constituent in said biological sample.

13. The computer program product of claim 11 wherein each said normalized abundance level measurement is obtained by a normalization technique selected from the group consisting of Z-score of intensity, median intensity, log median intensity, Z-score standard deviation log of intensity, Z-score mean absolute deviation of log intensity, calibration DNA gene set, user normalization gene set, ratio median intensity correction, and intensity background correction.

14. The computer program product of claim 11 wherein each said abundance value is determined by measuring an amount of a cellular constituent in said biological specimen.

15. The computer program product of claim 14 wherein said amount of said cellular constituent comprises an abundance of an RNA present in said biological specimen.

16. The computer program product of claim 15 wherein said abundance of said RNA is measured by contacting an array with said RNA from said biological specimen, or with nucleic acid derived from said RNA, wherein said array comprises a positionally addressable surface with attached nucleic acids or nucleic acid mimics, wherein said nucleic acids or nucleic acid mimics are capable of hybridizing with said RNA species, or with nucleic acid derived from said RNA species.

17. The computer program product of claim 12 wherein each said abundance value is an amount of a cellular constituent in said biological specimen, a concentration of a cellular constituent in said biological specimen, a cellular constituent activity level for a cellular constituent in said biological specimen, or a state of modification of a cellular constituent in said biological specimen.

18. The computer program product of claim 1 wherein the biological specimen is a solid tumor, a liquid tumor, blood, or a biopsy from the respective patient.

19. The computer program product of claim 1 wherein the biological specimen is a liver biopsy, a breast biopsy, a kidney biopsy, a large intestine biopsy, an endometrial biopsy, a prostate biopsy, a skin biopsy, a_bone marrow biopsy, a small intestine biopsy, a muscle biopsy, a thyroid nodule biopsy, a heart biopsy, or a nerve biopsy.

20. The computer program product of claim 1 wherein said one or more data structures associated with a patient in said plurality of patients further comprises a diagnosis of said patient.

21. The computer program product of claim 1, the computer program mechanism further comprising a relapse module, the relapse module comprising:

instructions for determining whether a patient has relapsed with respect to a disease.

22. The computer program product of claim 1, the computer program mechanism further comprising a relapse module, the relapse module comprising:

instructions for identifying a clinical regimen when said patient has relapsed.

23. The computer program product of claim 1, the computer program mechanism further comprising a patient risk module comprising:

instructions for identifying a patient in said plurality of patients that is at risk for a disease.

24. The computer program product of claim 23 wherein the instructions for identifying said patient at risk for a disease comprises instructions for using at least one of a genetic factor and a predisposing environmental factor associated with the patient.

25. The computer program product of claim 1, the computer program mechanism further comprising a cost analysis module, the cost analysis module comprising:

instructions for computing a cost for treating a patient in said plurality of patients.

26. The computer program product of claim 1, wherein

the one or more data structures associated with a patient in the plurality of patients further comprises a clinical outcome of the patient;

and

the computer program mechanism further comprises a feedback module for receiving said clinical outcome of the patient.

27. The computer program product of claim 26, the computer program mechanism further comprising:

instructions for using said clinical outcome of said patient to define one or more treatment regimens in said plurality of treatment regimens.

28. The computer program product of claim 1 wherein the clinical characterization in a data structure associated with a patient in the plurality of patients comprises a clinical diagnosis having an ICD-9 code and a date the clinical diagnosis was made by the patient'"'"'s physician.

29. The computer program product of claim 1 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients further comprises at least one of an objective progress assessment for the patient and a subjective progress assessment for the patient.

30. The computer program product of claim 1 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients further comprises a treatment history for said patient.

31. The computer program product of claim 1 wherein a data structure in the one or more data structures associated with said patient further comprises a reference to a clinical trial in which the patient is enrolled.

32. The computer program product of claim 31 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients further comprises a result of the clinical trial.

33. The computer program product of claim 1 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients comprises a Current Procedural Terminology (CPT) code for a procedure performed on the patient and a date the procedure was performed on the patient.

34. The computer program product of claim 1 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients comprises information about a drug prescribed to the patient.

35. The computer program product of claim 34 wherein the information about the drug comprises at least one of a name of the drug prescribed, a strength of the drug prescribed, a quantity of the drug prescribed, and a number of refills of the drug prescribed.

36. The computer program product of claim 2 wherein

a data structure in the one or more data structures associated with a patient in the plurality of patients comprises a family medical history, and

said instructions for identifying a treatment regimen for said patient based upon the molecular profile associated with the patient and the clinical characterization associated with the patient further uses the family medical history for said patient to identify said treatment regimen.

37. The computer program product of claim 1 wherein the therapeutic determination module further comprises:

instructions for determining a diagnosis for said patient based upon the molecular profile associated with the patient and the clinical characterization associated with the patient.

38. The computer program product of claim 37 wherein the instructions for determining a diagnosis for said patient further comprise instructions for determining whether said patient has relapsed based upon the clinical outcome of the patient wherein, when a determination is made that the patient has relapsed, the instructions for identifying a treatment regimen comprise instructions for identifying a different treatment regimen from among said plurality of treatment regimens.

39. The computer program product of claim 37 wherein the diagnosis for a patient in the plurality of patients comprises a type of cancer, a heart disease, an autoimmune disease, a neurodegenerative disorder, or an infectious disease.

40. The computer program product of claim 1 wherein the plurality of patients enrolled in said health care program exceeds 100 patients.

41. The computer program product of claim 3, wherein the instructions for enrolling the patient in the health care program comprise:

instructions for receiving a molecular profile from a biological specimen obtained from said patient.

42. The computer program product of claim 3, wherein the instructions for enrolling the patient in the health care program comprise:

instructions for receiving a clinical characterization of said patient.

43. The computer program product of claim 1, wherein

the one or more data structures associated with each respective patient in the plurality of patients further collectively comprise a clinical outcome of each respective patient in the plurality of patients;

and

the computer program mechanism further comprises instructions for using said clinical outcome of each said respective patient in the plurality of patients to define one or more treatment regimens in said plurality of treatment regimens.

78. The computer of claim 77 wherein said accessing the relapse module is done remotely by a user of the computer of claim 28 over a wide-area network (WAN).

79. The computer of claim 78 the relapse module further comprising instructions for sending said identified clinical regimen over a wide-area network.

44. A computer program product for use in conjunction with a computer system, the computer program product comprising a computer readable storage medium and a computer program mechanism embedded therein, the computer program mechanism comprising:

(A) one or more data structures, said one or more data structures dimensioned and configured to store medical information for a plurality of patients;

(B) a data entry module comprising;

instructions for inputting a patient identifier for a patient in said plurality of patients into a data structure in said one or more data structures;

instructions for inputting a molecular profile from a biological specimen obtained from the patient into a data structure in said one or more data structures; and

instructions for inputting a clinical characterization of the patient into a data structure in said one or more data structures;

(C) a treatment regimen module, comprising;

instructions for receiving a plurality of treatment regimens; and

(D) a therapeutic determination module, comprising;

instructions for identifying a treatment regimen, from among said plurality of treatment regimens, for a patient.

45. The computer program product of claim 44, the data entry module further comprising:

instructions for inputting a diagnosis for the patient into a data structure in said one or more data structures.

46. The computer program product of claim 44, the data entry module further comprising:

instructions for inputting a detail of a clinical trial in which the patient is enrolled into a data structure in said one or more data structures.

47. The computer program product of claim 46, the data entry module further comprising:

instructions for inputting a result of said clinical trial in which the patient is enrolled into a data structure in said one or more data structures.

48. The computer program product of claim 44, the data entry module further comprising:

instructions for inputting at least one demographic characteristic for the patient into a data structure in said one or more data structures.

49. A computer comprising:

a central processing unit; and

a memory, coupled to the central processing unit, the memory storing;

(A) instructions for accessing one or more data structures associated with each patient in a plurality of patients enrolled in a health care program, the one or more data structures associated with each respective patient in the plurality of patients collectively comprising;

a patient identifier for the respective patient;

a molecular profile from a biological specimen obtained from the respective patient; and

a clinical characterization of the respective patient;

(B) instructions for accessing a plurality of treatment regimens; and

(C) instructions for accessing a therapeutic determination module, the therapeutic determination module comprising;

instructions for identifying a treatment regimen, from among said plurality of treatment regimens, for a patient in said plurality of patients.

50. The computer of claim 49 wherein said computer is located at a health care facility.

51. The computer of claim 49 wherein said accessing, in said instructions for accessing said therapeutic module, is over a wide-area network (WAN).

52. The computer of claim 51 wherein the one or more data structures for each respective patient in the plurality of patients are stored in a second computer that is accessible to the computer of claim 51 over said wide-area network (WAN).

53. The computer of claim 52 wherein the WAN is the Internet.

54. The computer of claim 49 wherein the instructions for identifying a treatment regimen, from among said plurality of treatment regimens, for said patient is based at least in part upon at least one of the molecular profile associated with the patient and the clinical characterization associated with the patient.

55. The computer of claim 49 the computer further storing instructions for accessing a data processing module, the data processing module comprising:

instructions for enrolling a patient in said health care program.

56. The computer of claim 55 wherein the instructions for enrolling the patient in the health care program comprise:

instructions for receiving a patient identifier for said patient.

57. The computer of claim 55 wherein the data processing module further comprises:

instructions for receiving a molecular profile from a biological specimen obtained from said patient; and

instructions for receiving a clinical characterization of said patient.

58. The computer of claim 55 wherein the data processing module further comprises:

instructions for receiving a patient identifier for said patient over a wide-area network (WAN);

instructions for receiving a molecular profile from said biological specimen obtained from said patient from a remote computer over the WAN; and

instructions for receiving said clinical characterization of said patient from a remote computer over the WAN.

59. The computer of claim 57 wherein said receiving, in said instructions for receiving said molecular profile, is from one or more computers that are in electrical communication with said computer over said WAN.

60. The computer of claim 56 the data processing module further comprising:

instructions for inputting a diagnosis for said patient into a data structure associated with the patient.

61. The computer of claim 56 the data processing module further comprising:

instructions for inputting a detail of a clinical trial in which the patient is enrolled into a data structure associated with the patient.

62. The computer of claim 61 the data processing module further comprising:

instructions for inputting a result of said clinical trial in which the patient is enrolled into said data structure associated with the patient.

63. The computer of claim 49 wherein a data structure associated with a patient in the plurality of patients comprises at least one demographic characteristic for the patient.

64. The computer of claim 63 wherein the at least one demographic characteristic comprises at least one of:

a gender of said patient;

a marital status of said patient;

an ethnicity of said patient;

a primary language spoken by said patient;

the color of the eyes of said patient;

the hair color of said patient;

the height of the patient;

the weight of the patient;

the social security number of the patient;

the name of the patient;

the date of birth of the patient;

the education status of the patient;

a name of the primary physician for the patient;

a name of a referring physician for the patient;

a referral source for the patient;

an indication as to whether the patient is disabled;

an indication as to whether the patient is a smoker;

an indication as to whether the patient consumes alcohol;

a residential address of the patient;

a telephone number of the patient;

a name of an insurance carrier for an insurance policy held by the patient; and

a member identifier number for an insurance policy held by the patient.

65. The computer of claim 63 the computer further storing instructions for accessing an enrollment module, the enrollment module comprising:

instructions for receiving said at least one demographic characteristic for the patient over a wide-area network.

66. The computer of claim 49 wherein the molecular profile in a data structure associated with a patient in said plurality of patients comprises abundance values of a plurality of cellular constituents in the biological specimen obtained from the patient.

67. The computer of claim 66 wherein each said abundance value is a normalized abundance level measurement for a cellular constituent in said biological sample.

68. The computer of claim 66 wherein each said normalized abundance level measurement is obtained by a normalization technique selected from the group consisting of Z-score of intensity, median intensity, log median intensity, Z-score standard deviation log of intensity, Z-score mean absolute deviation of log intensity, calibration DNA gene set, user normalization gene set, ratio median intensity correction, and intensity background correction.

69. The computer of claim 66 wherein each said abundance value is determined by measuring an amount of a cellular constituent in said biological specimen.

70. The computer of claim 69 wherein said amount of said cellular constituent comprises an abundance of an RNA present in said biological specimen.

71. The computer of claim 70 wherein said abundance of said RNA is measured by contacting a gene transcript array with said RNA from said biological specimen, or with nucleic acid derived from said RNA, wherein said gene transcript array comprises a positionally addressable surface with attached nucleic acids or nucleic acid mimics, wherein said nucleic acids or nucleic acid mimics are capable of hybridizing with said RNA species, or with nucleic acid derived from said RNA species.

72. The computer of claim 66 wherein each said abundance value is an amount of a cellular constituent in said biological specimen, a concentration of a cellular constituent in said biological specimen, a cellular constituent activity level for a cellular constituent in said biological specimen, or a state of modification of a cellular constituent in said biological specimen.

73. The computer of claim 49 wherein the biological specimen is a solid tumor, a liquid tumor, blood, or a biopsy from the respective patient.

74. The computer of claim 49 wherein the biological specimen is a liver biopsy, a breast biopsy, a kidney biopsy, a large intestine biopsy, an endometrial biopsy, a prostate biopsy, a skin biopsy, a bone marrow biopsy, a small intestine biopsy, a muscle biopsy, a thyroid nodule biopsy, a heart biopsy, or a nerve biopsy.

75. The computer of claim 49 wherein said one or more data structures associated with a patient in said plurality of patients further comprises a diagnosis of said patient.

76. The computer of claim 49 the memory further storing instructions for accessing a relapse module, the relapse module comprising:

instructions for determining whether said patient has relapsed with respect to a disease.

77. The computer of claim 49 the memory further storing instructions for accessing a relapse module, the relapse module comprising:

instructions for identifying a clinical regimen when said patient has relapsed.

80. The computer of claim 49 the memory further storing instructions for accessing a patient risk module comprising instructions for identifying a patient at risk for a disease.

81. The computer of claim 80 the patient risk module further comprising instructions for notifying a physician associated with said patient that the patient is at risk for said disease over a wide-area network.

82. The computer of claim 80 wherein the instructions for identifying said patient at risk for a disease comprises instructions for using at least one of a genetic factor and a predisposing environmental factor associated with the patient.

83. The computer of claim 49 the computer memory further storing instructions for accessing a cost analysis module, the cost analysis module comprising:

instructions for computing a cost for treating a patient in said plurality of patients.

84. The computer of claim 49, wherein

the one or more data structures associated with a patient in the plurality of patients further comprises a clinical outcome of the patient;

and

the memory further storing instructions for accessing a feedback module for receiving said clinical outcome of the patient.

85. The computer of claim 84 wherein said clinical outcome associated with said patient is received over a wide-area network.

86. The computer of claim 49 wherein the clinical characterization in a data structure associated with a patient in the plurality of patients comprises a clinical diagnosis having an ICD-9 code and a date the clinical diagnosis was made by the patient'"'"'s physician.

87. The computer of claim 49 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients further comprises at least one of an objective progress assessment for the patient and a subjective progress assessment for the patient.

88. The computer of claim 87 wherein the at least one of the objective progress assessment for the patient and the subjective progress assessment for the patient is received over a wide-area network.

89. The computer of claim 49 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients further comprises a treatment history for said patient.

90. The computer of claim 49 wherein a data structure in the one or more data structures associated with said patient further comprises a reference to a clinical trial in which the patient is enrolled.

91. The computer of claim 90 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients further comprises a result of the clinical trial.

92. The computer of claim 49 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients comprises a Current Procedural Terminology (CPT) code for a procedure performed on the patient and a date the procedure was performed on the patient.

93. The computer of claim 49 wherein a data structure in the one or more data structures associated with a patient in the plurality of patients comprises information about a drug prescribed to the patient.

94. The computer of claim 93 wherein the information about the drug comprises at least one of a name of the drug prescribed, a strength of the drug prescribed, a quantity of the drug prescribed, and a number of refills of the drug prescribed.

95. The computer of claim 49 wherein:

the one or more data structures associated with each respective patient in the plurality of patients further collectively comprise a clinical outcome of each respective patient in the plurality of patients; and

wherein the therapeutic determination module further comprises instructions for using said clinical outcome of each said respective patient in the plurality of patients to define one or more treatment regimens in said plurality of treatment regimens.

96. The computer of claim 49 wherein:

a data structure in the one or more data structures associated with a patient in the plurality of patients comprises a family medical history and

said instructions for identifying a treatment regimen for said patient based upon the molecular profile associated with the patient and the clinical characterization associated with the patient further uses the family medical history for said patient to identify said treatment regimen.

97. The computer of claim 49 wherein the therapeutic determination module further comprises:

instructions for determining a diagnosis for said patient based upon the molecular profile associated with the patient and the clinical characterization associated with the patient.

98. The computer of claim 97 wherein the instructions for determining a diagnosis for said patient further comprise instructions for determining whether said patient has relapsed based upon the clinical outcome of the patient wherein, when a determination is made that the patient has relapsed, the instructions for identifying a treatment regimen comprise instructions for identifying a different treatment regimen from among said plurality of treatment regimens.

99. The computer of claim 98 wherein said different treatment regimen is communicated over a wide-area network to an electronic information device associated with the physician for the patient.

100. The computer of claim 98 wherein the diagnosis for a patient in the plurality of patients comprises a type of cancer, a heart disease, an autoimmune disease, a neurodegenerative disorder, or an infectious disease.

101. The computer of claim 98 wherein the therapeutic determination module further comprises instructions for communicating said diagnosis over a wide-area network (WAN) to said computer.

102. The computer of claim 98 wherein the therapeutic determination module further comprises instructions for communicating said treatment regimen over a wide-area network (WAN) to said computer.

103. A computer for providing health care in accordance with a health care program, the computer comprising:

a central processing unit; and

a memory, coupled to the central processing unit, the memory storing;

(A) one or more data structures, said one or more data structures dimensioned and configured to store medical information for a plurality of patients;

(B) a data entry module comprising;

instructions for inputting a patient identifier for a patient into a data structure in said one or more data structures;

instructions for inputting a molecular profile from a biological specimen obtained from the patient into a data structure in said one or more data structures; and

instructions for inputting a clinical characterization of the patient into a data structure in said one or more data structures;

(C) a treatment regimen module, comprising;

instructions for receiving a plurality of treatment regimens; and

(D) a therapeutic determination module, comprising;

instructions for identifying a treatment regimen, from among said plurality of treatment regimens, for a patient.

104. The computer of claim 103, the data entry module further comprising:

instructions for inputting a diagnosis for a patient into a data structure in said one or more data structures.

105. The computer of claim 103, the data-entry module further comprising:

instructions for inputting a detail of a clinical trial in which a patient is enrolled into a data structure in said one or more data structures.

106. The computer of claim 105, the data entry module further comprising:

instructions for inputting a result of said clinical trial in which the patient is enrolled into a data structure in said one or more data structures.

107. The computer of claim 103, the data entry module further comprising:

instructions for inputting at least one demographic characteristic for a patient into a data structure in said one or more data structures.

108. A method of providing health care in accordance with a health care program, the method comprising:

identifying a treatment regimen, from among a plurality of treatment regimens, for a patient based upon a molecular profile associated with the patient and a clinical characterization associated with the patient, wherein

said patient is one of a plurality of patients enrolled in a health care program and wherein, for each respective patient in a plurality of patients enrolled in said health care program, medical information is stored in one or more data structures associated with the respective patient, the one or more data structures for each respective patient in the plurality of patients collectively comprising;

(i) a patient identifier;

(ii) a molecular profile from a biological specimen obtained from the respective patient; and

(iii) a clinical characterization of the respective patient.

109. The method of claim 108 wherein the molecular profile from one or more of the plurality of patients enrolled in the health care program is used to develop a treatment regimen in said plurality of treatment regimens.

110. The method of claim 108 wherein said identifying is performed by a primary care physician associated with the patient.

111. The method of claim 108 the method further comprising, prior to said identifying,

enrolling a patient in the health care program.

112. The method of claim 108 further comprising further to said identifying:

inputting a patient identifier for the patient into one of said data structures associated with said patient;

inputting a molecular profile from the biological specimen obtained from the patient into one of said data structures associated with said patient; and

inputting the clinical characterization of the patient into one of said data structures associated with said patient.

113. The method of claim 108 the method further comprising, prior to said identifying,

inputting a diagnosis for the patient into one of said data structures associated with said patient.

114. The method of claim 108 the method further comprising:

inputting a detail of a clinical trial in which the patient is enrolled into one of said data structures associated with the patient.

115. The method of claim 114 the method further comprising:

inputting a result of the clinical trial in which the patient is enrolled into one of said data structures associated with the patient.

116. The method of claim 108 wherein a data structure associated with a patient in the plurality of patients comprises at least one demographic characteristic for the patient.

117. The method of claim 116 wherein the at least one demographic characteristic comprises at least one of:

a gender of said patient;

a marital status of said patient;

an ethnicity of said patient;

a primary language spoken by said patient;

the color of the eyes of said patient;

the hair color of said patient;

the height of the patient;

the weight of the patient;

the social security number of the patient;

the name of the patient;

the date of birth of the patient;

the education status of the patient;

a name of the primary physician for the patient;

a name of a referring physician for the patient;

a referral source for the patient;

an indication as to whether the patient is disabled;

an indication as to whether the patient is a smoker;

an indication as to whether the patient consumes alcohol;

a residential address of the patient;

a telephone number of the patient;

a name of an insurance carrier for an insurance policy held by the patient; and

a member identifier number for an insurance policy held by the patient.

118. The method of claim 108 wherein the molecular profile in a data structure associated with a patient in the plurality of patients comprises abundance values of a plurality of cellular constituents in the biological specimen obtained from the patient.

119. The method of claim 118 wherein each said abundance value is a normalized abundance level measurement for a cellular constituent in said biological specimen.

120. The method of claim 118 wherein each said normalized abundance level measurement is obtained by a normalization technique selected from the group consisting of Z-score of intensity, median intensity, log median intensity, Z-score standard deviation log of intensity, Z-score mean absolute deviation of log intensity, calibration DNA gene set, user normalization gene set, ratio median intensity correction, and intensity background correction.

121. The method of claim 118 wherein each said abundance value is determined by measuring an amount of a cellular constituent in said biological specimen.

122. The method of claim 121 wherein said amount of said cellular constituent comprises an abundance of an RNA present in said biological specimen.

123. The method of claim 122 wherein said abundance of said RNA is measured by contacting an array with said RNA from said biological specimen, or with nucleic acid derived from said RNA, wherein said array comprises a positionally addressable surface with attached nucleic acids or nucleic acid mimics, wherein said nucleic acids or nucleic acid mimics are capable of hybridizing with said RNA species, or with nucleic acid derived from said RNA species.

124. The method of claim 118 wherein each said abundance value is an amount of a cellular constituent in said biological specimen, a concentration of a cellular constituent in said biological specimen, a cellular constituent activity level for a cellular constituent in said biological specimen, or a state of modification of a cellular constituent in said biological specimen.

125. The method of claim 108 wherein the biological specimen is a solid tumor, a liquid tumor, blood, or a biopsy from the respective patient.

126. The method of claim 108 wherein the biological specimen is a liver biopsy, a breast biopsy, a kidney biopsy, a large intestine biopsy, an endometrial biopsy, a prostate biopsy, a skin biopsy, a bone marrow biopsy, a small intestine biopsy, a muscle biopsy, a thyroid nodule biopsy, a heart biopsy, or a nerve biopsy.

127. The method of claim 108 wherein said one or more data structures associated with said patient in said plurality of patients further comprises a diagnosis of said patient.

128. The method of claim 108 the method further comprising determining whether said patient has relapsed with respect to a disease.

129. The method of claim 108 the method further comprising identifying a clinical regimen when said patient has relapsed.

130. The method of claim 108 the method further comprising, prior to said step of identifying a treatment regimen, a step of identifying said patient as at risk for a disease.

131. The method of claim 130 wherein the identifying said patient as at risk for a disease comprises using at least one of a genetic factor and a predisposing environmental factor associated with the patient.

132. The method of claim 108 the method further comprising computing a cost for treating said patient.

133. The method of claim 108 wherein the method further comprises inputting a clinical outcome of the patient into one or more data structures associated with the patient.

134. The method of claim 108 wherein the clinical characterization in a data structure associated with said patient comprises a clinical diagnosis having an ICD-9 code and a date the clinical diagnosis was made by said patient'"'"'s physician.

135. The method of claim 108 wherein a data structure in the one or more data structures associated with said patient further comprises at least one of an objective progress assessment for the patient and a subjective progress assessment for the patient.

136. The method of claim 108 wherein a data structure in the one or more data structures associated with said patient further comprises a treatment history for said patient.

137. The method of claim 108 wherein a data structure in the one or more data structures associated with said patient further comprises a reference to a clinical trial in which the patient is enrolled.

138. The method of claim 137 wherein a data structure in the one or more data structures associated with said patient further comprises a result of the clinical trial.

139. The method of claim 108 wherein a data structure in the one or more data structures associated with said patient comprises a Current Procedural Terminology (CPT) code for a procedure performed on the patient and a date the procedure was performed on the patient.

140. The method of claim 108 wherein a data structure in the one or more data structures associated with said patient comprises information about a drug prescribed to the patient.

141. The method of claim 140 wherein the information about the drug comprises at least one of a name of the drug prescribed, a strength of the drug prescribed, a quantity of the drug prescribed, and a number of refills of the drug prescribed.

142. The method of claim 108 wherein

a data structure in the one or more data structures associated with said patient comprises a family medical history and

said instructions for identifying a treatment regimen for said patient based upon the molecular profile associated with the patient and the clinical characterization associated with the patient further uses the family medical history for said patient to identify said treatment regimen.

143. The method of claim 108 the method further comprising determining a diagnosis for said patient based upon the molecular profile associated with the patient and the clinical characterization associated with the patient.

144. The method of claim 143 wherein the determining said diagnosis for said patient further comprises determining whether said patient has relapsed based upon the clinical outcome of the patient wherein, when a determination is made that the patient has relapsed, the method further comprises identifying a different treatment regimen from among said plurality of treatment regimens.

145. The method of claim 143 wherein the diagnosis for a patient in the plurality of patients comprises a type of cancer, a heart disease, an autoimmune disease, a neurodegenerative disorder, or an infectious disease.

146. The method of claim 108 wherein

the one or more data structures associated with each respective patient in the plurality of patients further collectively comprise a clinical outcome of each respective patient in the plurality of patients;

and

the method further comprising, prior to said identifying step,

using said clinical outcome of each said respective patient in the plurality of patients to define one or more treatment regimens in said plurality of treatment regimens.

147. A medical card defined by a base constructed from a substantially flat piece of plastic having a first face and second face, at least one of said first face and said second face comprising indicia placed thereon, said indicia comprising:

an identification of a patient uniquely associated with the medical card; and

a magnetic strip bearing electronic information, the electronic information comprising;

an identification of said patient;

a diagnosis of said patient; and

an identification of a doctor that made the diagnosis.

148. The medical card of claim 147 the electronic information further comprising at least one demographic characteristic describing said patient.

149. The medical card of claim 148 wherein the at least one demographic characteristic comprises at least one of:

a gender of said patient;

a marital status of said patient;

an ethnicity of said patient;

a primary language spoken by said patient;

the color of the eyes of said patient;

the hair color of said patient;

the height of the patient;

the weight of the patient;

the social security number of the patient;

the name of the patient;

the date of birth of the patient;

the education status of the patient;

a name of the primary physician for the patient;

a name of a referring physician for the patient;

a referral source for the patient;

an indication as to whether the patient is disabled;

an indication as to whether the patient is a smoker;

an indication as to whether the patient consumes alcohol;

a residential address of the patient;

a telephone number of the patient;

a name of an insurance carrier for an insurance policy held by the patient; and

a member identifier number for an insurance policy held by the patient.

150. The medical card of claim 147 the electronic information further comprising an analysis of a molecular profile from a biological specimen obtained from said patient.

151. The medical record of claim 150 the electronic information further comprising a clinical characterization of said patient.

152. The medical card of claim 147 wherein the diagnosis is that the patient has a disease.

153. The medical card of claim 152 wherein the disease is a type of cancer, a heart disease, an autoimmune disease, a neurodegenerative disorder, or an infectious disease.

154. The medical card of claim 147 the medical card further comprising an identification of a treatment regimen that has been assigned to said patient.

155. The medical card of claim 151 wherein the clinical characterization comprises a clinical diagnosis having an ICD-9 code and a date the clinical diagnosis was made for the patient.

156. The medical card of claim 147 wherein the electronic information further comprises an objective progress assessment for the patient or a subjective progress assessment for the patient.

157. The medical card of claim 147 wherein the electronic information further comprises a Current Procedural Terminology (CPT) code for a procedure performed on the patient and a date the procedure was performed on the patient.

158. The medical card of claim 147 wherein the electronic information further comprises a detail about a drug prescribed to the patient.

159. The medical card of claim 158 wherein the detail about the drug includes at least one of a name of the drug prescribed, a strength of the drug prescribed, a quantity of the drug prescribed, and a number of refills of the drug prescribed.

160. A method implemented by a computer system coupled to a wide-area network (WAN), the method comprising:

retrieving, over the WAN, one or more data structures for a patient in a plurality of patients enrolled in a health care program, the one or more data structures for the patient collectively comprising;

(i) a patient identifier;

(ii) a molecular profile from a biological specimen, wherein the biological specimen was obtained from the patient at a first health care facility; and

(iii) a clinical characterization of the patient; and

retrieving, over the WAN, one or a plurality of treatment regimens that are deemed suitable for said patient based upon the molecular profile and the clinical characterization.

161. The method of claim 160 wherein the WAN is the Internet.

162. The method of claim 160, wherein the first health care facility has 500 hospital beds or less.

163. The method of claim 160, wherein the first health care facility has 100 hospital beds or less.

164. The method of claim 160, wherein the first health care facility has no hospital beds.

165. The method of claim 160 wherein the molecular profile from said biological specimen is created at a location that is at least a number of miles away from said first health care facility.

166. The method of claim 165 wherein the number of miles is 10 miles.

167. The method of claim 165 wherein the number of miles is 100 miles.

168. The method of claim 160 wherein the molecular profile from said biological specimen is created at a location that is in a state other than the state where the first health care facility is located.

169. The method of claim 160 wherein the molecular profile from said biological specimen is created at a location that is in a country other than the country where the first health care facility is located.

170. A method comprising:

obtaining a signed consent form from a patient at a first health care facility, thereby enrolling a patient in a health care program;

removing a biological specimen from said patient at said first health care facility;

making a clinical characterization of said patient at said first health care facility; and

creating a molecular profile from said biological specimen at a location other than said first health care facility; and

storing, at one or more locations addressable by a wide-area network (WAN) that includes a node at said health care facility, an identification of said patient, said clinical characterization of said patient, and said molecular profile of said patient.

171. The method of claim 170 the method further comprising accessing said identification of said patient, said clinical characterization of said patient, and said molecular profile of said patient from said first health care facility using said WAN.

172. The method of claim 170 wherein said first health care facility has 500 hospital beds or less.

173. The method of claim 170 wherein said first health care facility has 100 hospital beds or less.

174. The method of claim 170 wherein said first health care facility has zero hospital beds.

175. The method of claim 170 the method further comprising retrieving information for a patient enrolled in said health care program over the WAN, the information including an identification of a plurality of treatment regimens that are deemed suitable for said patient based upon the molecular profile and the clinical characterization of the patient.

176. The method of claim 170 wherein said location other than said first health care facility is at least a number of miles away from said first health care facility.

177. The method of claim 176 wherein the number of miles is 10 miles.

178. The method of claim 176 wherein the number of miles is 100 miles.

179. The method of claim 170 wherein said location other than said first health care facility is in a state other than the state where the first health care facility is located.

180. The method of claim 170 wherein the location other than said first health care facility is in a country other than the country where the first health care facility is located.

181. The method of claim 170 wherein said WAN is the Internet.

182. A computer network comprising:

a first computer and one or more second computers, wherein the first computer is in electronic communication with each of one or more second computers over a wide area network (WAN), wherein

the first computer is associated with a first health care facility, the first computer comprising a first memory that comprises;

instructions for retrieving, over the WAN, one or more data structures for a patient in a plurality of patients enrolled in a health care program, the one or more data structures for the patient collectively comprising;

(i) a patient identifier;

(ii) a molecular profile from a biological specimen, wherein the biological specimen was obtained from the patient at said first health care facility; and

(iii) a clinical characterization of the patient that was made at said first health care facility; and

instructions for retrieving, over the WAN, one or a plurality of treatment regimens that are deemed suitable for said patient based upon the molecular profile and the clinical characterization; and

wherein the one or more second computers are at one or more locations other than said first health care facility and wherein the one or more second computers comprise one or more second memories that collectively comprise;

one or more data structures for each patient in a plurality of patients enrolled in said health care program, the one or more data structures for each respective patient in the plurality of patients collectively comprising;

a patient identifier for the respective patient;

a molecular profile from a biological specimen obtained from the respective patient; and

a clinical characterization of the respective patient.

183. The computer network of claim 182 wherein the one or more second memories further collectively comprise a plurality of treatment regimens.

184. The computer network of claim 183 wherein the one or more second memories further collectively comprise:

a therapeutic determination module comprising;

instructions for identifying one or more treatment regimens, from among said plurality of treatment regimens, for a patient based upon a molecular profile associated with the patient and a clinical characterization associated with the patient.

185. The computer network of claim 182 wherein the first health care facility has 500 hospital beds or less.

186. The computer network of claim 182 wherein the first health care facility has 100 hospital beds or less.

187. The computer network of claim 182 wherein the first health care facility has zero hospital beds.

188. The computer network of claim 182 wherein said one or more locations other than said first health care facility are at least a number of miles away from said first health care facility.

189. The computer network of claim 188 wherein the number of miles is 10 miles.

190. The computer network of claim 188 wherein the number of miles is 100 miles.

191. The computer network of claim 182 wherein said one or more locations other than said first health care facility are each in a state other than the state where the first health care facility is located.

192. The computer network of claim 182 wherein said one or more locations other than said first health care facility are each in a country other than the country where the first health care facility is located.

193. The computer network of claim 182 wherein said WAN is the Internet.

194. The computer network of claim 183, wherein

the one or more data structures for each respective patient in the plurality of patients further collectively comprise a clinical outcome of each respective patient in the plurality of patients;

and

the one or more second memories collectively comprise instructions for using said clinical outcome of each said respective patient in the plurality of patients to define one or more treatment regimens in said plurality of treatment regimens.