Patent Application
20150274333
Embodiments of the present invention relate generally to medication dispensing and replenishment from an automated dispensing system in a healthcare facility. Embodiments may include full or partial automation of the process and may include mechanisms for improving the efficiency and accuracy of medication dispensing.
Medication dispensing and replenishment in healthcare facilities can be a complex and time consuming process. With medication orders changing, and with the significant potential ramifications of dispensing the incorrect medication to a patient, the process of delivering medication from the central pharmacy to the patient can be a high-risk process in a healthcare setting.
Healthcare facilities generally dispense and replenish medications using one or more forms of automation to improve the efficiency of medication distribution. While automation can be implemented in various areas of medication dispensing and replenishment, the accuracy of the dispensing and replenishment of medications must be maintained to avoid potential errors in medication mismanagement. Verification steps must be implemented to ensure the accuracy of medication dispensing and replenishment according to various regulations.
Embodiments of the present invention may provide various apparatuses, systems, and methods for dispensing and replenishment of medication from a dispensing system. In particular, embodiments may provide a method including receiving a first medication order including a first medication type, determining a container size for the first medication order, causing an automated storage device including a plurality of medication types to present the first medication type in an accessible position, and causing a container of the determined container size to be dispensed to a position proximate the accessible position of the first medication type. The first medication order may include an order for one or more articles, wherein at least one article is a medication unit dose of the first medication type, where the container size may be determined based on the cumulative size of the one or more articles. Determining the size based on the cumulative size of the one or more articles may include determining a smallest container available to hold the one or more articles. Determining a container size may further include determining a plurality of container sizes for the first medication order in response to the one or more articles of the first medication order having a cumulative size larger than a single available container size.
According to some embodiments, methods may include receiving an indication of a transfer of a medication unit of the first medication type to the container and advancing the container away from the automated storage device in response to receiving the indication of a transfer. The indication of a transfer of the medication unit of the first medication type may include receiving a barcode scan indicative of the first medication type. The indication of a transfer may further include receiving a barcode scan indicative of the container and associating the medication unit with the container. The first medication type may be visually distinguished from other positions of the automated storage device. The visual distinction may include illumination of a position light. The indication may also include a quantity of the medication type for the first medication order. Causing the container of the determined container size to be dispensed may include causing the container to be dispensed to a conveyor, where the conveyor may be configured to advance the container to the position proximate the automated storage device.
According to some embodiments, methods may include receiving a second medication order including a second medication type, determining a container size for the second medication order, causing the automated storage device to present the second medication in an accessible position, and cause the container for the second medication order to be dispensed to a position proximate the accessible position of the second medication type. Methods may optionally include receiving an indication of a transfer of the second medication type to the container for the second medication order, and advancing the container for the second medication order away from the automated storage device. The automated storage device may include a medication carousel, and causing the automated storage device to present a first medication type in an accessible position may include advancing the medication carousel until a shelf containing the first medication type is presented in the accessible position.
Embodiments of the present invention may provide a system including an automated storage device comprising a plurality of medication types, each medication type arranged in a bulk container at a location within the automated storage device, a container dispenser configured to dispense containers of a plurality of sizes, and a controller. The controller may be configured to receive a first medication order including a first medication type, advance the automated storage device to a position in which a container containing the first medication type is presented in an accessible position, and cause a container to be dispensed from the container dispenser of a first size corresponding to the first medication order. Systems may optionally include a conveyor configured to advance the container of a first size to the automated storage device proximate the accessible position of the first medication type. The controller may optionally be configured to determine a cumulative size of articles in the first medication order and determine a first container size in response to the cumulative size of articles in the first medication order.
According to some embodiments, systems may include a controller configured to receive an indication of a transfer of a medication unit of the first medication type to the container dispensed from the container dispenser and cause the container to be advanced away from the automated storage device in response to receiving the indication of a transfer of the medication unit. The indication of a transfer of a medication unit of the first medication type may include a scanned barcode of the medication unit. The automated storage device may include a medication storage carousel, where advancing the automated storage device to a position in which a container contained in the first medication type is presented in an accessible position may include advancing a plurality of carousel shelves until a carousel shelf containing the container containing the first medication type is presented in an accessible position.
Reference now will be made to the accompanying drawings, which are not necessarily drawn to scale, and wherein:
Embodiments of the present invention may provide various apparatuses, systems, and methods for improving the efficiency of medication dispensing and medication order fulfillment within a healthcare facility. Some embodiments and components of the present invention will now be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments of the invention are shown. Indeed, various embodiments of the invention may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements.
Further, example embodiments of the present invention may provide a method, apparatus, and computer program product which may facilitate the dispensing and replenishment of medication from an automated dispensing or storage system within a healthcare facility to improve the efficiency and accuracy of medication distribution.
While example embodiments described herein may include the distribution and replenishment of medications, embodiments may also facilitate the distribution and replenishment of supplies, such as supplies that may accompany a medication. For example, if a medication is administered intravenously, a syringe may be a required supply to accompany the medication. As such, when the syringe-requiring medication is dispensed or replenished, a syringe may also be dispensed or replenished.
While embodiments of the present invention may be described with respect to healthcare facilities, such as hospitals and long-term care facilities, for example, embodiments of the inventions described herein may be implemented in a variety of types of facilities, not limited to those explicitly described herein.
Healthcare facilities may include a central pharmacy in which medications are stored and dispensed to areas throughout the healthcare facility. Some healthcare facilities may rely on a supplier, distribution center, or remote central pharmacy which stores medications and supplies at a remote location and delivers the medications and supplies on an as needed basis. In such an embodiment, the medications from the supplier, distribution center, or remote central pharmacy may be received by a healthcare facility at a receiving area. While embodiments of the present invention may be described as dispensing medication from an automated storage device, the automated storage device may be located at a central pharmacy of a healthcare facility, or at a remote facility arranged to provide medications to a healthcare facility.
As will be understood from this figure, in one embodiment, the dispensing system controller 100 may include a processor 200 that communicates with other elements within the dispensing system controller 100 via a system interface or bus. The processor 200 may be embodied in a number of different ways. For example, the processor 200 may be embodied as a processing element, processing circuitry, a coprocessor, a controller or various other processing devices including integrated circuits such as, for example, an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), a hardware accelerator, and/or the like.
In an exemplary embodiment, the processor 200 may be configured to execute instructions stored in memory or otherwise accessible to the processor 200. As such, whether configured by hardware or software methods, or by a combination thereof, the processor 200 may represent an entity capable of performing operations according to embodiments of the present invention when configured accordingly. For example, as discussed in more detail below, the dispensing system controller 100 may be configured, among other things, to receive medication or medical supply orders. A user interface 205 may be configured for user input of orders (medication, supplies, etc.) or to otherwise interact with existing orders. The user interface 205 may include a keyboard, a pointing device, or other mechanism for a user to communicate with the processor 200 and interact with the dispensing system controller 100. A display 210 may be configured to present information to a user pertaining to previous orders, current orders, or future orders for medication or supplies. The display 210 may also be configured to present information to a user pertaining to the status of the automated storage device, information regarding inventory, or any information which may be useful to a user of the device. The display 210 may include a touch screen display which may partially or fully comprise the user interface 205.
The dispensing system controller 100 may further include transitory and non-transitory memory device 215, which may include both random access memory (RAM) and read only memory (ROM). The ROM may be used to store a basic input/output system (BIOS) containing the basic routines that help to transfer information to the different elements within the dispensing system controller 100.
In addition, in one embodiment, the dispensing system controller 100 may include at least one storage device 225, such as a hard disk drive, a CD drive, and/or an optical disk drive for storing information on various computer-readable media. The storage device(s) 225 and its associated computer-readable media may provide nonvolatile storage. The computer-readable media described above could be replaced by any other type of computer-readable media, such as embedded or removable multimedia memory cards (MMCs), secure digital (SD) memory cards, Memory Sticks, electrically erasable programmable read-only memory (EEPROM), flash memory, hard disk, and/or the like.
Furthermore, a number of executable instructions, applications, scripts, program modules, and/or the like may be stored by the various storage devices 225 and/or within memory device 215. As discussed in more detail below, these executable instructions, applications, program modules, and/or the like may control certain aspects of the operation of the automated storage device controller 100 with the assistance of the processor 200 and operating system, although their functionality need not be modularized. In addition to the program modules, the automated storage device controller 100 may store or be in communication with one or more databases.
Also located within the dispensing system controller 100, in one embodiment, is a communication interface 220 for interfacing with various computing entities. This communication may be via the same or different wired or wireless networks (or a combination of wired and wireless networks). For instance, the communication may be executed using a wired data transmission protocol, such as fiber distributed data interface (FDDI), digital subscriber line (DSL), Ethernet, asynchronous transfer mode (ATM), frame relay, data over cable service interface specification (DOCSIS), or any other wired transmission protocol. Similarly, the automated storage device controller 100 may be configured to communicate via wireless external communication networks using any of a variety of protocols, such as 802.11, general packet radio service (GPRS), Universal Mobile Telecommunications System (UMTS), Code Division Multiple Access 2000 (CDMA2000), CDMA2000 1X (1xRTT), Wideband Code Division Multiple Access (WCDMA), Time Division-Synchronous Code Division Multiple Access (TD-SCDMA), Long Term Evolution (LTE), Evolved Universal Terrestrial Radio Access Network (E-UTRAN), Evolution-Data Optimized (EVDO), High Speed Packet Access (HSPA), High-Speed Downlink Packet Access (HSDPA), IEEE 802.11 (Wi-Fi), 802.16 (WiMAX), ultra wideband (UWB), infrared (IR) protocols, Bluetooth™ protocols, wireless universal serial bus (USB) protocols, and/or any other wireless protocol.
It will be appreciated that one or more of the dispensing system controller's 100 components may be located remotely from other dispensing system controller 100 components. Furthermore, one or more of the components may be combined and additional components performing functions described herein may be included in the dispensing system controller 100.
In one embodiment, an automated storage device (e.g., 110 of
The shelves 315 of example embodiments of automated storage devices may be arranged on a carousel to rotate between an accessible position, where a shelf 315 is accessible through the opening 320, and an inaccessible position, where a shelf 315 is located away from the opening 320 within the housing 310. The housing 310 may be of any size to accommodate a plurality of storage shelves 315. The opening 320 may provide access to one or more storage shelves 315 at a time; however, not all storage shelves are accessible simultaneously.
While embodiments described above and illustrated include an automated storage device that is in a carousel-like form factor, other embodiments of automated storage devices may be implemented according to examples of the present invention. For example, an automated storage device including a robotic bin retrieval system may receive a medication order including a medication of a first type and the robotic bin retrieval system may retrieve the appropriate bin from an internal storage location to be presented in an accessible position. The robot of example embodiments may be an articulating arm, or an X-Y robot arranged to traverse a matrix of bin locations in order to select and retrieve a bin for presentation to a user. As such, the illustrated embodiment is provided for understanding and clarity and is not to be construed as limiting.
The storage bins 335 of example embodiments may be configured to hold medication or supplies. The quantity of medication or supplies to be stored within an automated storage device may be determined by an inventory management system and may be influenced by the cost of an item (e.g., higher cost inventory items may be stored in lower quantities), size of an item (e.g., larger items may be stored in lower quantities due to space constraints), and/or frequency of use (e.g., frequently used items may be stored in larger quantities in larger bins, or in multiple bins). Storage bins 335 configured to hold small articles, such as individual blister-pack doses of a particular medication, may be configured to hold multiple types of articles, such as three different dosages of a particular medication or multiple articles which are unrelated. Different articles contained in a bin may be similar or dissimilar items.
The controller, which may be the dispensing system controller described above, or a local controller of the automated dispensing device 300 which may be in communication with the dispensing system controller, may be configured to receive a medication order for a particular article (i.e., a medication or medication related supply) and rotate the carousel to present the shelf 315 on which the bin 335 storing the article is located. The specific bin 335 may be identified by indicia displayed on the bin, an identifier presented on the display 325, or a visual flag, such as a light emitting diode (LED) illuminated at the location of the appropriate bin 335. The display 325 may also display the appropriate quantity of the article to be retrieved to fill the order.
The controller may receive orders containing multiple articles of different types (e.g., different supplies or different medications) such that to fill an order, a user must access multiple bins 335. For such an order, the controller may first present the shelf 315 including the bin 335 for the first article, allow the user to retrieve the appropriate quantity of the first article, then rotate the carousel to present the shelf 315 which includes the bin 335 of the next article to be retrieved. If the next article to be retrieved is on the same shelf 315, the carousel may not need to rotate between the retrieval of the articles. However, in some cases, the next article to be retrieved may be disposed in a bin 335 of a shelf 315 that is not close to the opening 320, and the carousel may need to rotate the shelf 315 into the accessible position where the bin 335 is presented to the user. According to some example embodiments, a medication order received that includes more than two articles may be separated into individual articles where the locations of the articles are analyzed. The pick-order of the articles, or the order in which the article bins are presented to a user in an accessible position, may be arranged based upon the location of the article bins 335 in an effort to minimize the time between presentation of bins in accessible positions. This pick-order arrangement may be performed, for example, by the processor 200 of the dispensing system controller 100, or optionally at a processor of a controller local to the automated storage device 300.
Further, the dispensing system controller 100 may buffer a plurality of medication orders that are to be fulfilled. These stored medication orders may be analyzed for their contents and arranged in an order that minimizes the mean time between presentation of bins containing the articles of the medication orders in an accessible position. For example, if a first order contains articles arranged on two shelves, adjacent to one another, a second order contains articles arranged on a shelf five shelves removed from the two shelves of the first order, and a third order includes articles on the same shelves as the first order, the controller may move the third order to be adjacent to the first order in order to minimize the cycle time of the automated storage device moving between shelves, and taking advantage of the accessible position of the shelves. This methodology may be extrapolated to a plurality of orders, such as those to be fulfilled during an entire shift (e.g., 8 hours). Such order arrangement optimization may minimize the duty cycle of the automated storage device while improving the order fulfilling efficiency of the dispensing system.
The one or more articles that are collected from the automated dispensing device 300 to fulfill a particular medication order may be dispensed to a container that is used to transport the medication order through a healthcare facility. Further, while some medication orders may have a very small volume or cumulative size, such as a single unit dose of a tablet form medication, other orders may be relatively large, including items such as 1000 milliliter intravenous bags and related intravenous tubing. Having a single-sized container configured to hold each medication order may result in many small orders being placed in oversized containers. As such, it may be desirable to have multiple sizes of containers to accommodate multiple order sizes.
In order to efficiently and effectively handle the dispensing of medication orders to containers, such as the bins of
Embodiments of a container dispensing device 500 may include an automated container dispensing device that is configured to dispense a container of an appropriate size automatically in response to a determined need for said container. For example, if a dispensing system controller 100 receives a medication order, for example, over a network 105 of a healthcare facility, the dispensing system controller may determine, e.g., via processor 200, a container size that is appropriate for the medication order. The appropriately sized container may then be dispensed from the container dispensing device 500. The container may be dispensed at the location proximate the area from which articles are retrieved, or optionally, as shown in
The size of the container dispensed may be determined based upon a cumulative size of the articles of the medication order. For a medication order including only a single article, the size of the container dispensed may be determined based upon the single article size. According to embodiments in which there are multiple articles in a medication order, the size of each article may be considered in determining the appropriate container size. Further, according to some embodiments, the layout of the articles in the container may be determined in order to maximize the efficiency of container space used. The dispensing system controller may consider whether articles may nest together to conserve space, or whether articles can be arranged in such a way as to fit into a smaller container. Each of these operations may be performed by the dispensing device controller 100, such as with the processor 200. Once the container size is determined for a medication order, a container of that size may be dispensed from the container dispensing device 500. According to some example embodiments, a medication order may be relatively large, and may include a plurality of articles which have a cumulative size too large to fit in the largest container size available. In such an embodiment, the dispensing device controller 100 may cause more than one container to be dispensed. Further, the pick-order of the articles may be arranged such that articles for the first of the dispensed containers are presented in an accessible position first, and subsequently the articles for the second container are presented in an accessible position such that the first container is filled, and the remaining contents are loaded into the second container. Such an embodiment may include any number of containers for a medication order. Further, some medications or supplies may be best suited to a particular container style. For example, there may be a particular container (e.g., one that includes a cold-pack) that is to accommodate medications that require refrigeration. The size of the container with the cold pack may not be selected based on the cumulative size of the medication order, but on the particular needs of an article within the order. Similarly, a narcotic or other controlled substance may require a container of a particular type, such as a lockable container or a high-visibility container. In such an embodiment, the dispensing system controller 100 may dispense the appropriate type of container for a particular article without concern for the overall cumulative size of the medication order.
The container dispensing device 500 of
Example embodiments of a container dispensing device may include a device which can dispense a plurality of containers simultaneously that are associated with one or more orders. For example, a container dispensing device may be configured to pre-load a tray with a plurality of containers, where the sizes of the plurality of containers are selected based on the orders that are to fill the bins. For example, for one or more orders that are best suited to ten small containers and five large containers, ten small containers and five large containers may be pre-loaded to a tray and output from the container dispensing device. The tray may include a unique identifier that is associated with the one or more orders intended for the containers loaded to the tray. Upon arrival of the tray at the automated storage device, the system or a user may scan the identification of the tray. The identified tray may be understood by the controller 100, such as through processor 200, as corresponding to the one or more orders for the ten small and five large containers of the tray, and the controller may cause the automated storage device 300 to begin presenting article storage locations with articles corresponding to the one or more orders. The one or more orders may be associated with one another by the controller 100 based on the locations of the articles that will be used to fulfill the one or more orders. For example, if the controller 100 receives a plurality of orders, and within that plurality of orders, ten small articles and five large articles are each located proximate one another in the automated storage device 300, those orders may be grouped together, and the containers associated with the orders may be pre-loaded to a tray.
According to an example embodiment of the present invention, a medication order may be received at dispensing controller 100 from, for example, a healthcare network. The medication order may be received from a physician, nurse, or other source. The medication order may include one or more articles including a medication of a first medication type to be dispensed. A size of container for the medication order may be determined at the dispensing system controller or at the container dispensing device 500, based upon the cumulative size of the article(s) of the medication order. The automated dispensing system 300 may receive an indication of a first medication type of the medication order. The automated dispensing system 300 may cause the first medication type to be presented in an accessible position. The dispensed container, if not dispensed to a location proximate the accessible position of the first medication type, may be advanced to a position proximate the accessible position of the first medication type by, for example, conveyor 550. A user may retrieve the article of the first medication type for dispensing to the container. However, it may be desirable to include one or more verification steps prior to completing the dispensing.
Upon retrieving an article of a first medication type from the automated storage device 300 for dispensing to a container, a user may identify the article of the first medication type to the dispensing system controller 100. For example, if the article includes a barcode, the user may scan the barcode of the article using a barcode reader in communication with the dispensing system controller 100 via, for example, communication interface 220. If the article includes an Radio Frequency Identification (RFID) tag, the user may cause the RFID tag to be read by an RFID reader. The dispensing device controller 100 may confirm or reject the article in dependence of whether the article matches the anticipated article of the first medication type of the medication order. If the controller confirms that the article is correct, the article may be dispensed by the user to the container. If the medication order includes one or more other articles, the automated storage device 300 may advance to a position in which the next article is presented in an accessible position. The user may again retrieve and identify the article retrieved to the controller for validation. Upon the last article of the medication order, or of the container being filled, being verified by the controller, the container including the medication order may be advanced, such as by conveyor 550, to a location from which the container can be distributed to a patient.
According to some embodiments, during the identification stage in which the article is identified and verified by the dispensing system controller 100, the container may also be identified. Containers may include a unique identification number such that identification of the container and the medication article may pair the medication order and the container. In this manner, a container may be tracked during distribution and the contents of the container can be referenced based on the identity of the container. The container may include a barcode, an RFID tag, etc.
While not all example embodiments may include a conveyor to convey the container from the container dispensing device to the automated storage device, according to the embodiment of
According to some embodiments of the present invention, an indicator of the position of the article to be retrieved may be provided. For example, according to
Accordingly, blocks of the flowchart support combinations of means for performing the specified functions and combinations of operations for performing the specified functions. It will also be understood that one or more blocks of the flowchart, and combinations of blocks in the flowchart, can be implemented by special purpose hardware-based computer systems which perform the specified functions, or combinations of special purpose hardware and computer instructions.
In this regard, a method according to one embodiment of the invention, as shown in
In some embodiments, certain ones of the operations may be modified or further amplified as described below. Moreover, in some embodiments additional operations may also be included. It should be appreciated that each of the modifications, optional additions, or amplifications below may be included with the operations above either alone or in combination with any others among the features described herein. With reference to the method of
In an example embodiment, an apparatus for performing the method of
An example of an apparatus according to an example embodiment may include at least one processor and at least one memory including computer program code. The at least one memory and the computer program code may be configured to, with the at least one processor, cause the apparatus to perform the operations 600-650 (with or without the modifications and amplifications described above in any combination).
An example of a computer program product according to an example embodiment may include at least one computer-readable storage medium having computer-executable program code portions stored therein. The computer-executable program code portions may include program code instructions for performing operations 600-650 (with or without the modifications and amplifications described above in any combination).
Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Moreover, although the foregoing descriptions and the associated drawings describe example embodiments in the context of certain example combinations of elements and/or functions, it should be appreciated that different combinations of elements and/or functions may be provided by alternative embodiments without departing from the scope of the appended claims. In this regard, for example, different combinations of elements and/or functions than those explicitly described above are also contemplated as may be set forth in some of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.
