Patent Application
20140145822
This invention relates to cabinets for storing and dispensing prescription medical items, and is more particularly concerned with a cart or rolling cabinet which can be wheeled into a surgical room and which can provide an anesthesiologist with full access to the contents, but can also provide security in respect to narcotics and other controlled materials contained in the cart. Importantly, the invention is also directed to an anesthesia cart which has the ability to lock automatically when an authorized anesthesiologist is not present or when the anesthesiologist walks away from the cart.
Medications, including narcotics, sedatives, and other controlled substances, are routinely used by an anesthesiologist in the operating room. These substances need to be freely available to the anesthesiologist in an emergency situation where time is of the essence. At the same time, because these controlled substances have high potential for abuse, the compartments that contain these substances have to be secured and locked at any time the anesthesiologist is not present. These two goals are mutually contradictory, where the need to keep these substances secure and locked up interferes with the need to make the materials fully available in an emergency.
The anesthesia carts and other medications carts currently available typically involve a mechanical lock that has to be physically unlocked to obtain access to the contents. These carts need a physical key to unlock the compartments to obtain access. This can be a detriment to the objective of free access if the key cannot be found for some reason, and can be a detriment to security of the controlled materials if the user forgets to re-lock the cart. Also, the key access system does not allow for obtaining the identification of the person opening the cart. Those carts also lack the capability for a sophisticated audit trail, so that it is not possible to determine or record who it was that accessed the cart, when it was opened, when it was locked, and what item(s) have been removed from the cart or cabinet.
Some cabinets and carts permit electronic locking and unlocking, and have the capability of maintaining an audit trail of access. However, these carts depend for security of the contents on the user's affirmative input to lock the cart, or a timer that automatically sets to relock the cart after some fixed time period (e.g., ten minutes) after the cart is accessed and opened or unlocked. The deficiency of the former system is that if the user forgets or neglects to re-lock the cart, then the cart does not secure the contents. The deficiency of the latter system is that the cart may automatically re-lock during a surgical procedure, locking the anesthesiologist out, and delaying the access to emergency drugs, as they become at least temporarily unavailable pending re-logging into the cart and re-entering the anesthesiologist's access or PIN number. The use of an access card may assist in reducing the time needed to re-log in, but even then reaching for the card and swiping it in the cart can waste valuable time in an emergency, and as for narcotics or other controlled materials, security requirements mean that an additional password or code would still need to be entered to resume access.
Accordingly, it is an object of the present invention to provide an anesthesiology cart or similar medical dispensing arrangement that avoids the drawbacks of the prior art.
It is another object to provide an anesthesia cart with a controlled materials compartment in the form, e.g., of one or more pull-out drawers, divided into individual compartments, and each with a locking lid or cover, to limit authorized access to a narcotic or syringe containing a controlled substance, and with access to the locking compartments being limited to the attending anesthesiologist, but permitting access for the duration of the time that the anesthesiologist is actually present. Of course, as used in this description and claims, the term “drawer” should be read broadly to cover any equivalent compartment that can be electrically locked and unlocked.
The anesthesia cart of this invention is based on a medication cart equipped with electronically locking drawers/bins, and operated by a personal computer (PC) or microprocessor board, with an RFID sensor circuit, RFID antennas, and active RFID transponders. The cart may also include an additional proximity type sensor for use with a passive UHF RFID chip as a backup device. The cart may be powered by 110V or 220V AC power, with battery backup, e.g., an uninterruptible power supply or UPS, or alternatively by battery power, with or without the use of a battery charging circuit. In addition to a PC and monitor, the cart may also include a barcode or RFID scanner to identify medications being removed, and include suitable software permitting it to maintain a current inventory.
The use and operation of the anesthesiology cart is as follows—when the anesthesiologist approaches within some radius, e.g. 3 meters of the medication cart, the active transponder he is carrying (typically, the size of a credit card) is sensed by the RFID sensor within the cart, and the drawers containing non-controlled substances are opened automatically by the time the doctor reaches the cart. Manual entry of a narcotics password into the system allows access to the entire contents of the cart (this is done to prevent access to the controlled substances within the cart by someone without authorized access but who happens to find the key card). The cart remains fully unlocked at all times when the anesthesiologist remains within the 3-meters radius of the cabinet. When the anesthesiologist leaves the vicinity of the cart, the RFID signal from the transponder is no longer identified by the sensor, and the cart automatically locks without any further user input. A full audit trail is recorded by the cart, which includes the listing of drawers or bins that have been opened in the cart, and may also include a list of items removed from the cart, when a barcode scanner or additional RFID scanner is included with the system.
In an alternate configuration, there may be two (or more) levels of access to the cart, determined by the RFID chip assigned to the user:
For lower-level access, the anesthesia technician's transceiver may have an RFID code which only allows access to the non-controlled substances and supplies in the cart, all of which may be opened when the technician is in the vicinity of the cart.
For higher-level access, the anesthesiologist's transceiver may have an RFID code which allows full access to everything on the cart, and allows all drawers/bins including the narcotics drawers to be opened and remain open while in the vicinity of the cart. This system also requires the entry of an additional password to access the controlled substances in the cart, or may be alternatively be programmed to omit the need for this additional password.
In either event, the cart remains open for access to the authorized materials while the user is present, but will re-lock automatically when the user walks away (beyond the 3-Meter radius).
Thus, the advantages of this anesthesia cart are:
a.) Quicker access to items in the cart without the need to enter a login name or take out a proximity card;
b.) Automatically relocking the cart without user input;
c.) An audit trail is automatically created, identifying the users and when they had access and what they had access to; and
d.) There is no need for a timed relock of the cart, which can be a safety issue in the middle of a long operation.
RFID readers or sensors within carts in a specific hospital or on a specific floor can all be programmed to accept the specific RFID codes assigned to the individual doctors in the OR, or assigned to the individual nurses on a floor. This programming can be done remotely over a wireless or wired network, or through the use of software contained on the cart or using a USB input on the cart.
In accordance with an aspect of the present invention, the anesthesia cart has a cabinet with a base, a top, and casters or rollers mounted on the base of the cabinet to permit the cabinet to be rolled. A computer control arrangement is mounted on the cabinet and includes a computer processor, a keyboard, a fixed reader or transceiver mounted in the cabinet with the latter being coupled to the computer processor
At least one general use drawer (or equivalent compartment) in the cabinet has an electro-mechanical lock coupled to the computer processor, and at least one controlled-materials drawer (or equivalent locking compartment) in the cabinet has one or more lockable compartments and with an electro-mechanical lock mechanism for locking and unlocking the one or more lockable compartments.
A portable RFID transceiver (an active transceiver carried by e.g., the anesthesiologist or in some cases by the anesthesiology technician or nurse) is capable of transmitting an anesthesia authorization code over a given range, e.g., one to three meters, to the fixed RFID transceiver in the cart. The fixed RFID reader cooperates with the computer control arrangement to communicate with the electro-mechanical lock mechanism of the general use drawer and to communicate with the electro-mechanical lock mechanism of the one or more lockable compartments, and respond to the presence of the anesthesia authorization code to unlock the at least one general use drawer to permit access to such drawer. Where an anesthesia narcotic access code is required, the computer is programmed to await entry of a required authorized pass code on the keyboard or touch-screen. Then, upon entry of the authorized pass code the lockable compartments in the controlled-materials drawer are unlocked to allow the anaesthesiologist full access to the contents.
Upon loss of signal at the fixed RFID reader, i.e., the signal containing the anesthesia authorization code transmitted from the portable active RFID transceiver, the cabinet re-locks the general use drawer(s) and re-locks the lockable compartments of the controlled materials drawer.
The controlled materials drawer may be of a design that includes a pull out drawer slidably supported in the cabinet, with the drawer having a number of storage compartments arranged in at least one row in a given direction across the drawer and an elongated channel portion extending in the same given direction alongside the row of compartments. Each of those storage compartments has a locking lid that is normally locked down but is selectively releasable to permit the lid to open for access to the compartment. In a favorable design, a slide bar disposed in the channel portion is adapted to move for at least a limited distance along the channel portion, and is arranged to slide to one or more unlock positions to unlock the respective ones of the compartment lids. A controlled gearmotor moves the slide bar to the appropriate positions to permit the lid to be lifted open but may lock each of the other compartment lids in said row from opening. This drawer may operate on the principles generally presented in my earlier-filed, copending patent application Ser. No. 13/291,462, filed Nov. 8, 2011, and the disclosure in which is incorporated herein by reference.
The principles of this invention are not limited only to an anesthesia cart of the type described in the preferred embodiment, and need not always include a locked drawer or compartment for narcotics or similar controlled substances. The automatic locking and unlocking feature may also be applied to a cart or cabinet for storing patient medications or medical supply items at a nursing station or elsewhere on a nursing floor. In that case, a nurse (carrying an RFID transceiver) walking up to the cabinet or cart will always find it “open” to him or her and unlocked for use, but the cart or cabinet will automatically re-lock as soon as the nurse walks away beyond the RFID signal radius (of 1 to 3 meters).
The above and many other objects, features, and advantages of this invention will become apparent from the ensuing description of a selected preferred embodiment, which is to be considered in connection with the accompanying Drawing.
With reference to the Drawing, and initially to
The frame 12 of the cart also supports a number of locking slide-out drawers, including a top slide-out drawer 24, here configured as a lockable bin compartment or LBC drawer, which in this embodiment is used for holding controlled materials, e.g., narcotics, for which strict access limits are needed. There are also additional locking drawers including pull-out drawers 26 of generally the same dimension as drawer 24 and somewhat deeper drawers 28, all aligned in a stack on the left side of the cart 10, plus a stack of larger pull-out bins 30. These drawers 26, 28 and 30 can be general-use anesthesia drawers and bins that are intended for materials with a lower need for security than the materials in the drawer 24. These bins are normally kept locked, but are unlocked when the anesthesiologist, carrying a suitably encoded RFID transceiver or transducer, approaches the cart 10. The top drawer 24, i.e., the narcotics drawer, requires the anesthesiologist to enter an access code or PIN to unlock. A key-operated lock may be located on the cart and can serve as a pharmacy over-ride or emergency override.
In one version of the anesthesia cart, there can be two drawers that are LBC drawers, for controlled substances, plus another drawer used for storage of prepared syringes, which may also contain controlled substances. Entry of the pass code enables access to all three drawers, and any bin in the LBC drawer can be selected to open.
A computer unit, i.e., a PC 32 is mounted on the back of the cart 10 (here only a corner of the PC is visible) and is connected with an associated keyboard 34, supported on a shelf 36 on the right side of the cart 10, on which a mouse device 38 is also present, and to a display or monitor 40. The keyboard serves as a data entry device for an authorized person to enter a pass code when needed. Data could be entered in other ways, e.g., on a touch-screen of the monitor 40. An uninterruptible power supply 42 is also supported on a shelf on the right side of the cart 10, and serves as a battery backup for the electronics on the cart 10 including the computer 32 and its peripherals, as well as for the electro-mechanical drawer locks and latches (not shown) within the cart. The power cord for connecting with the hospital AC power is not shown here. Also, mounted within the cart 10 is an RFID reader that is connected with the computer 32.
As shown somewhat schematically in
As mentioned earlier, one or more of the drawers, e.g., drawer 24 is configured for holding narcotics and other materials that need to be safeguarded, but which also need to be freely available to the anesthesiologist during the entire patient procedure, and must be accessible by him or her without delay.
In this embodiment the drawer 24, as shown in
In order to unlock these bins so as to be able to access their contents, the anesthesiologist has to enter a pass code or PIN either on the keyboard 34 or on the monitor 40—if the monitor is an active-screen or touch-screen monitor. Then, once unlocked, the anesthesiologist can access any of the bins or compartments 62, so long as he or she remains present in the operating room, i.e., within the range R of the transceiver 50. If the anesthesiologist leaves the operating room, the cart automatically re-locks, including re-locking the compartments 62 in this drawer 24. Upon return of the anesthesiologist, the cart will again automatically unlock, but the anesthesiologist needs to re-enter the pass code in order to access items in the drawer 24.
The dimensions of the drawer 24 and of the respective compartments 62 may be different from what is shown in this example.
This arrangement may have database control over the exact locations of the medications and supplies. Bar coding and/or RFID coding of the medications or other contents of the cart permit the access to those materials to be recorded and tracked, both as to the person accessing them, and the time of access. Similarly, methods employing RFID identification of individual medications can also be used for security and prevention of medication dispensing errors.
The automated access, i.e., locking and unlocking of the anesthesia cart 10 can be explained with reference to the logic chart of
When the cart 10 is first wheeled into the operating room and plugged in, the cart is in a locked condition, i.e., the drawers 24, 26 etc. are locked, and the electromechanical latches/servos are in the locked position [block 100]. The transceiver in the cart is continuously monitoring for any RFID coded signals, and if an RFID signal is present [block 102] it is decoded [block 104], it is compared with the authorized code or codes stored in the computer [block 106]. If the RFID code matches one of the authorized codes, the computer actuates the servo motors to unlock the drawers [block 108], or otherwise, the cart remains locked or is re-locked [block 100].
The computer also tests the received RFID code to compare with special authorization code or codes for access to the bins 62 of the narcotics drawer 24 [step 110]. If the received RFID code is a proper code for access to the narcotics in that drawer 24, then the computer awaits entry of the anesthesiologist's pass code [block 114], and when that is entered [block 114]. The computer signals the servo motors in the drawer 24 to unlock the bins and permit access [block 116]. The cart, i.e., the computer 32 and fixed RFID reader or transceiver 52 continue to monitor for RFID signals [block 118], and so long as the anesthesiologist is present, and is carrying the portable active RFID transceiver 50 on his or her person, the cart remains unlocked and he or she can continue to access the materials in the cart. When the anesthesiologist moves outside the range of the RFID signals, the cart will automatically relock and reset. As soon as the anesthesiologist returns and approaches the cart, the cart will unlock the drawers, with the exception of the narcotics drawer, but that can be accessed as soon as the anesthesiologist enters his or her pass code or PIN.
As options to over-ride the RFID system, e.g., when the battery dies in the portable RFID transceiver or active transceiver 50, a passive proximity card can be used to unlock the cart, but this card has a very limited range and must be kept in the vicinity of an associated proxmity card reader in order to keep the cart unlocked. Otherwise, the user, e.g., anesthesiologist or nurse, can log in directly to the computer—a step that is eliminated when the RFID transponder is functioning. Another option is to over-ride the lock with the manual lock override to access the cart's contents. Also, the RFID reader may also be capable or reading RFID signals from a short-distance passive RFID chip, as a means for overriding the lock mechanism and unlocking the drawers or compartments of the cart.
In the embodiments of his invention, a significant advantage lies in the cart's feature of automatically and immediately locking out when the RFID signal is no longer detected. As such, the need for a timer is completely eliminated when the RFID transducer is used for access. The cart remains open so long as the RFID signal is present. This eliminates the problem of a cart “timing out” and re-locking during a surgical procedure, such as when the operation lasts longer than the timer's set period.
The same arrangement of using RFID for access can also be applied to locking medical storage cabinets, which may also be joined together using a daisy-chain i2C communications protocol.
While the invention has been described hereinabove with reference to selected preferred embodiments, it should be recognized that the invention is not limited to those precise embodiments. Rather, many modification and variations would present themselves to persons skilled in the art without departing from the scope and spirit of this invention, as defined in the appended claims.
