The present invention relates generally to dispensing machines, and more particularly to dispensing machines for pharmaceuticals.
Long-term care medical facility settings include assisted living facilities, skilled nursing facilities, group homes, etc. Assisted living and skilled nursing facilities typically have medical staff that are responsible at all times for and oversee the administration of medication to the patients/residents of the facility, as prescribed by the physician or otherwise needed. Group homes may or-may not have live-in or around-the-clock staff that are responsible for all medication administration to the residents; such staff may be available only on a periodic basis (e.g., only during the day time, one or more times per week, etc.) in which case the residents may be responsible for their own medication the majority of the time. Such long-term care facilities are increasingly being asked to handle more and more of the medication storage responsibility that once rested almost totally with the community pharmacy. Long-term care pharmacy providers are typically not located within the actual patient facility; in fact, it is not uncommon for the pharmacy to be several hundred miles away. With new patient admissions occurring at unpredictable times throughout the day and existing patients' medical regimens changing without notice, it is imperative for those facilities without a physical pharmacy on site or access to one in a timely manner, to have non-patient specific medications on site for facility administration to the patients. Historically, facilities have stored medications in various types of non-mechanized containers and tracked drug product additions and removals with manual logs. Mechanized systems have primarily been limited to storage cabinets with a variety of drawers that house specific medications in predetermined locations. The drawer systems typically have secure access features which limit access to authorized users, typically facility staff that have the appropriate credentials, passcode, security pass, etc. to enable unlocking of a drawer to allow access to that user; however, once a user opens a drawer, there are only limited safeguards to prevent the wrong quantity or wrong drug from being removed, as this is a manual selection and removal process by the system user.
In view of the foregoing, it may be desirable to provide improved systems for dispensing medications for patients in long-term care facilities and other medical environments.
As a first aspect, embodiments of the present invention are directed to a system for storing and dispensing discrete doses of pharmaceuticals. The system comprises: a housing with an internal cavity having a front wall with first and second windows; multiple storage locations positioned within the housing; and a carrier assembly positioned and movable within the housing. The carrier assembly is configured to receive a pharmaceutical dose package loaded into either the first or second window and convey the pharmaceutical dose package to one of the storage locations for storage therein, and is further configured to retrieve a pharmaceutical dose package from one of the storage locations and return the pharmaceutical dose package to the first or second window for dispensing'therefrom.
As a second aspect, embodiments of the present invention are directed to a system for storing and dispensing discrete doses of pharmaceuticals, comprising: a housing with an internal cavity having a front wall with a window; multiple storage locations positioned within the housing; a carrier assembly positioned and movable within the housing; and a plurality of bins, each of the bins configured to reside in one of the storage locations. The carrier assembly is configured to receive a bin that contains a pharmaceutical dose package loaded into the window and convey the bin and pharmaceutical dose package to one of the storage locations for storage therein, and is further configured to retrieve a bin that contains a pharmaceutical dose package from one of the storage locations and convey the bin and pharmaceutical dose package to the window for dispensing therefrom.
As a third aspect, embodiments of the present invention are directed to a carrier assembly for a storage and dispensing apparatus, comprising: a base; a pair of jaws, the jaws having facing contact surfaces that are substantially parallel to each other; a first drive unit coupled to the jaws and the base configured to reciprocally drive the jaws toward and away from each other; and a second drive unit coupled to the jaws, the first drive unit and the second drive unit configured to convey the jaws in either direction substantially parallel to the contact surfaces.
As a fourth aspect, embodiments of the present invention are directed to a bin for receiving, storing and dispensing a pharmaceutical dose package, comprising a box having first and second opposed, generally parallel side walls spanned by a floor and a rear wall. The front end of the box is open, and the first side wall includes an open-ended slot.
As a fifth aspect, embodiments of the present invention are directed to a carousel assembly, comprising: first and second sprockets; an endless member having a radially inward surface that engages the first and second sprockets, the endless member defining a generally oblong path; and a plurality of support members attached to the radially inward surface of the endless member and extending generally perpendicular to a plane defined by the oblong path. The first sprocket has a plurality of perimeter pockets, the perimeter pockets being sized and configured to receive the support members as they travel along the oblong path.
The present invention will now be described more fully hereinafter, in which preferred embodiments of the invention are shown. This invention may, however, be embodied in 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 be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. In the drawings, like numbers refer to like elements throughout. Thicknesses and dimensions of some components may be exaggerated for clarity.
Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. As used herein the expression “and/or” includes any and all combinations of one or more of the associated listed items.
In addition, spatially relative terms, such as “under”, “below”, “lower”, “over”, “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
Well-known functions or constructions may not be described in detail for brevity and/or clarity.
The proposed system utilizes a unit dose storage system that allows any medication to be stored in any location of the unit. Unit doses may be prepared in any number of ways; exemplary methods are disclosed in, for example, U.S. Pat. Nos. 6,449,921; 6,585,132; and 7,428,805, the disclosures of which are hereby incorporated herein. An exemplary unit dose package 310 is shown in connection with an automated pharmacy system 300 in
Although the product may be scanned to read the affixed code prior to placement in the specific location, in some embodiments the association of a product to a location only occurs after the product has been loaded into an unoccupied product storage location within the system. Even when the items are scanned prior to placement in a location, the system may still scan each location to ensure that the product was properly placed in the system. Either during loading of an individual product or immediately after a variety of products are loaded in bulk into the system, the system's bar code verification process validates which products are stored in which location by scanning each location. Each system storage location contains only one unique product, although the quantity of that product can vary. Each product packet may hold one or more pills of a given medication, and the system may include different packets having different numbers of pills of the same medication to facilitate different dosing options (e.g., there may be separate packets with one, two, three or four pills of 200 mg ibuprofen to facilitate administration of 200 mg, 400 mg, 600 mg, or 800 mg doses of the medication, depending on a doctor's orders).
Alternatively, as shown in
In some embodiments of the invention, the system may accept totes or other containers capable of large capacity storage; such totes would contain some or all of the inventory to be loaded into the system. Once the tote is deposited inside the unit (via a door or other access method), a robotic arm (i.e., actuator and end effector) inside the unit may remove individual packages from the tote or loading area and place each package in an available storage location within the unit. The robotic arm may include a bar code scanner to automatically scan the indicia on the package prior to placing the package in a storage location. Alternatively, the robotic arm may first move the package to a scanner for scanning prior to placing the package in the storage location.
Upon receipt of a dispense request, the system determines the location of the user selected products and dispenses them by rotating the carousel/bins containing the products to a delivery chute (see
Once the products are released from the carousel/bin, they descend down the delivery chute to the user pick-up slot (the pick-up slot 101 can be seen in
Users access the system 100 via a touch screen 102 (shown in
User interaction with the touch screen 102 also may include selection of the medication to be dispensed, selection of the patient for whom the medication is being dispensed, requests for various types of reports (see below), restocking requests, inventory analysis, etc.
In some embodiments of the invention, various types of records are maintained by the system and reports of such records may be created by the system. Records may include information regarding which users accessed the system and the date and time of the access, which medications were dispensed, which medications were dispensed by each user, the patient for whom each medication was dispensed, etc. Such reports may be created upon request or the system may be programmed to create certain reports automatically (e.g., at the end of a shift, when a patient is discharged or moved from the facility, etc.).
In some embodiments, the system may include a camera (not shown) on the outside of the unit to capture the image of a user when accessing the system. Each picture taken by the camera may be stored in the system and matched against a particular activity such as replenishment of the unit on a specific day at a specific time and with respect to particular items that were stocked in the unit at that time, or a dispensing event of a particular medication or other item for a specific patient. The images may be included in the reports created by the system, as discussed above.
The system may be connected to the supplying pharmacy's pharmacy management system (e.g., its computer system) and may automatically communicate with information stored in the pharmacy management system. Such communications may include information regarding which medications have been dispensed from the system and, therefore, need to be restocked, confirmation that a medication that a user has requested for a particular patient has been approved for administration to that patient, etc. Other embodiments may include a two-way video and/or audio link with the pharmacy to facilitate approval for the removal of certain drugs (narcotics for example) from the unit regardless of patient drug regimens. Through such a link, a system user may request a drug that has not yet been approved for administration to a particular patient and provide the information necessary for review by the pharmacist (change in doctor's order, reason for request for administration to that patient, etc.). The pharmacist may then perform appropriate reviews (drug interactions, insurance adjudication, etc.) and either approve or disapprove the dispensing of the drug from the system for the specified patient.
The system may be connected to a scanner that can be used in the administration of the medication to the patient. Such a scanner may be a wireless portable scanner or may be located in the patient rooms (“bedside scanners”). A bedside scanner may be configured as assigned to a particular patient or either the portable or the bedside scanner may be used to scan a code on the patient's wristband or other form of identification to identify the patient. When the dispensed medication is administered to the patient, the portable or bedside scanner may additionally be used to scan the indicia on the medication package to confirm that the correct medication is being given to the correct patient. Such codes on the package or associated with the patient may be barcode, RFID or other appropriate technology. Via software and a wireless or Ethernet-based connection, the scanner may then communicate with the system to record the administration of the medication to the patient. Additionally, the scanner may be able to be docked on or near the unit to recharge the scanner and/or download information.
Various security features may be included with the system. The unit may be bolted to the floor or wall and may include security doors that are able to withstand attempts at forced entry and are self locking upon manual closure. The system may include an alarm system that is triggered by any movement of the unit, forced entry or other manipulation, power failure after manipulation, etc. In some embodiments, the system may include a sensor to detect if the door is opened. The system may be configured to sound an alarm when the door is opened without proper authorization or if the door remains open for an extended time period. Additionally, the unit may include an internal camera to capture images when the system is opened. The camera may be adapted to run off battery power so that it is able to function even when power is not supplied to the unit as a whole. The alarm system may be tied into facility security and may have the ability to contact local authorities. The alarm system may operate independently of the facility power source and may be able to maintain or bypass internet connectivity if that can also be compromised. A camera on the unit may be activated for image capture if the alarm is triggered.
In some embodiments, the system may include temperature, humidity, and/or other environmental sensors to monitor environmental conditions within the cabinet to ensure proper storage conditions of the items. The sensor may interface to an external monitor or other display so that the temperature/humidity conditions can be evaluated from outside the unit. The environmental sensor(s) may work in conjunction with an alarm system to notify users when environmental conditions within the cabinet are not within acceptable ranges.
The unit may be enabled for user authorization via biometric scanning (i.e., fingerprint, palm print, retinal scan, voice recognition, facial recognition, etc.). Unit security features may also or alternatively include a requirement for scanning of a user badge or entry of a code. User authorization may be performed prior to dispensing or restocking of the unit and authentication information recorded and stored by the unit.
Another embodiment of the present invention is illustrated in
The embodiments described herein may also be applicable in a traditional hospital setting where the administration of medication to patients is overseen by hospital staff and may need to occur on an as-needed basis. By providing access to such a system on hospital floors or in hospital emergency rooms (as well as urgent care centers), access to medications can be provided even when access directly to the pharmacy itself is not feasible.
Another system according to embodiments of the present invention is shown in
Referring to
Turning now to
As can be seen in
Referring to
Referring now to
Referring now to
Vertical rods 710 are mounted to the radially inward surfaces of the upper and lower belts 708, 706 spaced apart several inches from each other. Referring to
On the lower side of the ceiling 526, a motor 720 is mounted between the upper sprockets 702a. The shaft of the motor 720 extends through the ceiling 526 and attaches to a small drive pulley 722 (
Referring now to
The carousel assembly 700 can revolve the shelf units 560 about an oblong path defined generally by the upper and lower belts 708, 706. When the shelf units 560 are to revolve, the controller signals the motor 720, which rotates the drive pulley 722. Rotation of the drive pulley 722 rotates the large pulley 724 via the drive belt 726. Because the drive pulley 724 is fixed to one of the upper sprockets 702a, rotation of the drive pulley 724 rotates that upper sprocket 702a and the remainder of the sprocket unit 701a. Rotation of the upper and lower sprockets 702a, 702b of the sprocket unit 701a causes the sprocket unit 701b to rotate also via the upper and lower belts 708, 706. Rotation of the sprocket units 701a, 701b drives the shelf units 560 around the oblong path noted above (see
As the shelf units 560 revolve, they are maintained on the oblong path via multiple interactions with other components. The wheels 716 capture the rails 718 on the ceiling 526 as the shelf units 560 travel along the straight portions of the oblong path to maintain the shelf units 560 in position on the path (see
A robotic carrier unit 530 is slidably mounted via conventional construction to a vertical rail 531 located near the front of the frame 520 via a slide member 532. A base in the form of a housing 533 is mounted to the slide member 532 and includes a floor 533a and a ceiling 533b. Mounting blocks 534 are mounted to the front and rear edges of the floor 533a and are spanned by two slide rods 535. A carriage 536 is slidably mounted on the slide rods 535 for slidable movement thereon, driven by a motor 537 and a rack-and-pinion arrangement (not shown). The carriage 536 includes two upwardly-extending flanges 538 on which are mounted two slide rods 539. A lead screw 540 is mounted parallel to the slide rods 539 and extends through one of the flanges 538 to attached to a motor 541 mounted thereon. Two jaw blocks 542a, 542b are mounted on the slide rods 539 and the lead screw 540. A jaw 544 is mounted on each jaw block 542a, 542b and extends upwardly therefrom through an opening 545 in the ceiling 533b of the housing 533 with contact surfaces 544a of the jaws 544 being parallel and facing each other. A bar code reader 550a is mounted on a pedestal attached to the side wall of the housing 533, and an opposing bar code reader 550b is mounted on the opposite side wall of the housing 533.
The robotic carrier unit 530 has the ability to open and close the jaws 544 and to move them forwardly and rearwardly relative to the housing 533. Actuation of the motor 537 causes the rack-and-pinion mechanism to drive the carriage 536 along the slide rods 535, which in turn moves the jaws 544 forwardly or rearwardly also. Actuation of the motor 541 turns the lead screw 540, which in turn draws the jaws together or apart as desired. The controller can activate either of the motors 537, 541 as needed.
Referring now to
To load the system 500 with single dose pharmaceutical package, a user activates the system 500 by inputting a loading command into the controller via the display screen 514. The controller locates an empty bin (either a small bin 570 or a large bin 578—for the purposes of this example, a small bin 570 will be discussed) on one of the shelves 562 of a shelf unit 560. In some embodiments, the bins in the rows closest to the small and large windows 510, 512 are kept empty whenever possible to facilitate rapid loading. If the small bin 570 selected by the controller (which could be any empty small bin 570) is not aligned already with the jaws 544 of the carrier unit 530, the controller signals the carousel drive assembly 700 to revolve the shelf units 560 until the selected bin 570 is aligned with and rearward of the jaws 544.
Once the bin 570 is in place, the controller signals the carrier assembly 530 to move vertically on the rail 531 to the correct height to retrieve the bin 570. As shown in
Once in position adjacent the small window 510, the door opens, the jaws 544 move forwardly, separate, move rearwardly, close on the small bin 570, and move forwardly again (
The operator may scan the package with the bar code scanner 516 prior to loading the package into the small bin 570, or may place the package directly into the small bin 570. As described above, the package is generally vertically disposed in the small bin 570; if the package is a blister-pack, the “blister” resides in the slot 576 in the manner shown in
After the small bin 570 is loaded with the pharmaceutical package, the controller signals the system 500 to reverse the steps described above in connection with the presentation of the small bin 570. More specifically, the drive roller 600 rotates to draw the small bin 570 back through the small dispensing window 510 until locating sensors in the jaws 544 detect the presence of the small bin 570 in position between the jaws 544. The jaws 544 close to grasp the bin 570 and move rearwardly to “inch” the package rearwardly. The jaws 544 then separate, move forwardly to center the jaws 544 on the bin 570, and close to grasp the bin 570. The carrier assembly 530 then moves vertically on the rail 531 to position the bin 570 at the proper height for loading onto the selected shelf 562. Under most circumstances, the carrier assembly 530 will simply return the small bin 570 to the location on the shelf 562 that it just vacated prior to loading; however, another storage location may be selected, in which case the controller activates the carousel assembly 700 to rotate the shelf unit 560 having the selected shelf 562 to a position in line with the jaws 544:
When the carrier assembly 530 and the shelf 562 are both in position, the controller signals the carrier assembly 530 to load the bin 570 into the selected storage location. The jaws 544 move rearwardly, separate, move forwardly, close onto the bin 570, and move rearwardly with the bin 570. This process is repeated until the carrier assembly locating sensors have been deactivated (with the bin 570 resting on either the ceiling 533b of the housing 533 or the shelf 562, depending on how far rearwardly the bin 570 has moved) to “inch” the bin 570 into place in the selected location on the shelf 562. The small bin 570 is retained in place by the interaction between the ridge 564 of the shelf and the recess 573a of the small bin 570.
One additional step that may be performed during loading of the pharmaceutical package onto a storage location on a shelf 562 is reading of the bar code on the package by one of the bar code readers 550a, 550b. The bar code, which may be one- or two-dimensional, typically includes information about the pharmaceutical in the package, such as the NDC number, dosage or the like, that enables the system 500 to track the type of pharmaceutical being stored in a particular storage location.
To dispense a desired pharmaceutical, the controller simply identifies a storage location that contains the package of interest, then moves the carousel assembly 580 and the carrier assembly 530 as described above to move the bin 570 and carrier assembly 530 to a position in which the carrier assembly can retrieve the bin 570. The carrier assembly 530 then moves the bin 570 to the dispensing window 510 in the manner described above in connection with
A similar sequence of steps would be followed for the loading, storage, and dispensing of pharmaceutical items in a large bin 578, with the exceptions that (a) the large bin 578 would be presented to and withdrawn from the large dispensing window 512, and (b) in some cases the form of the package will not make it possible for the bar code scanner 550a, 550b to read the bar code on the package, so identification and confirmation of the package contents is typically performed at the bar code reader 516.
The system 500 typically stores data associated with the storage and dispensing of pharmaceutical packages therein. As a result, the system 500 can provide reports (either on the display screen 514 or in hard-copy form) of inventory, dispensing, timing, and the like as described in some detail above in connection with the systems 100, 300 and 400.
Those skilled in this art will appreciate that the system 500 may take various other forms. For example, the motors and slide rods of the carrier assembly that control movement of the jaws 544 may be replaced with different varieties of drive units such as belt drives, conveyors, roller assemblies cam drives, and the like. Also, the rollers 600, 602, 610, 612 may be omitted, or in some embodiments may be incorporated into the carrier assembly.
Some embodiments of the system may have only one dispensing window, or may have more than two dispensing windows. In single window embodiments, the window may be of a single permanent size, or may be configured to expand or contract between multiple sizes based on the size of the bin being used for storage or dispensing.
Similarly, the shelf units 560 may have only one size of shelf, or may have more than two sizes. Moreover, the shelf units may be deployed such that one or more shelf units includes shelves intended to house only one size of bin, and one or more other shelf units includes shelves intended to house only a different size of bin. Rather than the passive bin retaining system provided by the recesses in the bins and the ridges in the shelves, the shelf units may employ an active retaining system that includes springs, latches, magnets, doors, locks, clips or the like. In addition, the carousel assembly may be constructed differently, with sprockets that lack perimeter pockets (e.g., the rods may be mounted on the outer surface of the upper and lower belts), or with a path that is defined differently (including round). Other variations may also be suitable for use with the system.
Also, although blister-packs and pouches are shown herein as pharmaceutical dose packages, other forms of packaging may also be used, including envelopes, boxes, jars, vials, “bingo cards” (blister pack cards), and the like.
Those skilled in this art will also appreciate that features described above in connection with the systems 100, 300 and 400, such as refrigeration, security, and the like, may also be employed with the system 500.
The foregoing embodiments are illustrative of the present invention, and are not to be construed as limiting thereof. Although exemplary embodiments of this invention have been described, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the novel teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention.
The present application claims priority from U.S. Provisional Patent Application Nos. 61/364,038, filed Jul. 14, 2010; 61/394,828, filed Oct. 20, 2010; and 61/424,161, filed Dec. 17, 2010, the disclosure of each of which is hereby incorporated herein in its entirety.
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