Patent Grant
12079742
The present disclosure generally relates to medication distribution, and, in particular, relates to systems and methods for managing preparation, delivery, and recycling of a medication in a healthcare facility through harmonized integration of previously incompatible systems.
A hospital pharmacy must manage and keep track of numerous medication orders to fit the needs of its patients. The various phases or steps of providing medication to patients are often carried out by various machines or personnel spread across various locations throughout the hospital.
In cases of patients admitted to a healthcare facility, one or more medications for a patient or infusions to be administered to the patient are prescribed by the patient's physician. A pharmacy, generally located within the patient's hospital or healthcare facility, prepares the medication according to the physician's prescription, for example, in a cleanroom (e.g., an environment having a controlled level of contamination that is specified by a number of particles per cubic meter at a specified particle size). In cases where the medication is an infusion solution, a compounder, such as a fully automatic or robotic compounder requiring minimal human operation, a partially-robotic or semi-robotic compounder requiring some human operation, or a manual compounder requiring a human operator, can be used to prepare the medication. After preparation, an appropriately trained and credentialed pharmacist places the infusion solution in a bag, bottle, syringe, or other container and labels the container.
The infusion solution is then staged in a pickup location, such as a bin-sorting area. A sorting person is then responsible for placing each prepared medication into bins or delivery carts that correspond to the locations where the medications will be delivered, such as an Intensive Care Unit (ICU). A delivery person retrieves the medications from the bins that correspond to areas of the healthcare facility to which that delivery person delivers. The delivery person then delivers the medications to the appropriate locations of the healthcare facility.
The medication is then delivered to the patient's location, and if the medication is an infusion solution, a clinician such as a nurse or other clinician hangs the infusion solution from a rack. The nurse connects a tube between the infusion solution and an infusion pumping system and inserts a cannula at the end of the tube into the vessel of the patient for delivery of the infusion solution to the patient.
According to certain implementations of the present disclosure, a method of managing medications comprises interfacing with (i) a medication preparation component configured to fulfill a plurality of medication orders based on a first set of parameters, (ii) an inventory management component configured to stock an inventory based on a second set of parameters, (iii) a delivery management component configured to deliver medications based on a third set of parameters, and (iv) a medication recycling management component configured to retrieve unused medications based on a fourth set of parameters. The method further comprises providing the medication preparation component the first set of parameters based on the second, third, and fourth set of parameters, wherein the medication preparation component cannot interface directly with the second, third, and fourth set of parameters.
In another implementation of the present disclosure, a method of managing medications comprises receiving a plurality of medication orders for a plurality of medications, each of the plurality of medication orders having a preparation status, identifying an unused medication and a current location of the unused medication, identifying a component medication in an inventory, providing a preparation instruction to prepare a medication for at least one of the plurality of medication orders using the component medication when the at least one of the plurality of medication orders cannot be fulfilled by the unused medication, providing delivery instructions for delivering the medication based on the preparation status of each of the plurality of medication orders, and receiving a delivery verification of the medication.
In yet another implementation of the present disclosure, a non-transitory machine-readable medium contains machine-readable instructions for causing a processor to execute a method for managing medications. The method comprises receiving a plurality of medication orders for a plurality of medications, each of the plurality of medication orders having a preparation status, identifying an unused medication and a current location of the unused medication, identifying a component medication in an inventory, providing a preparation instruction to prepare a medication for at least one of the plurality of medication orders using the component medication when the at least one of the plurality of medication orders cannot be fulfilled by the unused medication, providing delivery instructions for delivering the medication based on the preparation status of each of the plurality of medication orders, and receiving a delivery verification of the medication.
At the various stages of medication preparation and delivery, verification of proper steps and/or procedures may be required. However, verification may be a complex procedure particularly when the various devices operate within proprietary parameters which may be incompatible with other devices in the workflow.
Examples of the various component systems and methods are described in U.S. patent application Ser. No. 13/901,501 entitled “Medication Preparation Queue,” filed May 23, 2013, U.S. patent application Ser. No. 13/901,497, entitled “Component Based Aggregation of Medication Orders.” filed May 23, 2013, , U.S. patent application Ser. No. 13/900,482, entitled “Medication Delivery Management,” filed May 22, 2013, U.S. patent application Ser. No. 13/900,502, entitled “Medication Retrieval Optimization,” filed May 22, 2013, and U.S. patent application Ser. No. 13/900,493, entitled “Managing Re-Use of Returned Medications,” filed May 22, 2013, the entire contents of which are incorporated by reference herein.
It is understood that other configurations of the subject technology will become readily apparent to those skilled in the art from the following detailed description, wherein various configurations of the subject technology are shown and described by way of illustration. As will be realized, the subject technology is capable of other and different configurations and its several details are capable of modification in various other respects, all without departing from the scope of the subject technology. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not as restrictive.
The accompanying drawings, which are included to provide further understanding and are incorporated in and constitute a part of this specification, illustrate disclosed embodiments and together with the description serve to explain the principles of the disclosed embodiments. In the drawings:
In the following detailed description, numerous specific details are set forth to provide a full understanding of the present disclosure. It will be apparent, however, to one ordinarily skilled in the art that the embodiments of the present disclosure may be practiced without some of these specific details. In other instances, well-known structures and techniques have not been shown in detail so as not to obscure the disclosure.
The disclosed methods provide a process for managing the various devices and procedures throughout a medication workflow. For example, various components, such as a medication preparation component, and a delivery component, may operate independently of each other without being aware of each other. By providing an interface between the two, which my require reconciling incompatible data parameters, the workflow may be made more efficient. The interface may further reduce time necessary in actively managing the different data parameters, such as inconsistent identification (ID) parameters.
The interfacing of the various components provides for efficiency in the workflow. For instance, medication orders are taken from an electronic data feed such as a Health Level 7 (HL7) feed. Data from the feed is processed in order to identify various aspects of each order to add to the virtual queue. The system then determines whether the order for the medication can be filled with an already prepared medication item or a returned or retrievable unused medication item, or whether the order should be filled by preparing a medication item from components available in storage. Appropriate instructions for filling the order are provided for display in the queue based on how the order can be filled. In certain instances, a notification or preferred retrieval route may be provided to a delivery person to retrieve a medication item if the retrievable medication item can be used to fill the order.
The electronic data feed is monitored to update, in real-time, an order for a medication in the queue if, for example, a patient is discharged and the order for the patient is no longer needed. The queue will continually update based on changes from the electronic data feed. Thus, if an order is changed or discontinued, the entry for the order will be immediately updated in the queue. This will result in preventing a compound medication from being made that is no longer needed at that point in time, thereby preventing or reducing waste. This will also result in preventing or limiting dispensing of a product out for delivery or finalized and ready for delivery that may no longer be needed by a patient. This will further result in decreasing inefficient use of labor, and keeping a prepared medication on hand to potentially be used for a new order.
Each order for a medication is placed at a position in the virtual queue based on various factors including, for example, an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. Two or more medication orders that require the same or similar medication components may be grouped together in the queue, for example, to avoid unnecessary wasting of the component. The disclosed system is also configured to capture images or barcode readings of each component used to prepare the medication for the order, and the images or barcode readings may be provided to a local or remote pharmacist or other authorized inspector for verification that the medication for the order has been prepared with the appropriate components. Upon verification, the virtual queue is updated to reflect that the order has been filled and that the prepared medication for the order may be retrieved for delivery to a patient.
The disclosed system determines, upon a delivery person identifying (e.g., by scanning) a medication, such as an infusion solution, to be delivered, whether there are any other prepared or almost prepared medications that need to be delivered to the area of the hospital to which the delivery person is delivering the identified medication. If another medication is available or almost prepared for delivery, and it would be preferable to deliver the other medication during the same delivery as the identified medication, such as based on an urgency of the other medication or an expiration or delivery time of either medication, then a notification is provided to the delivery person to wait for the other medication to arrive for the appropriate bin prior to leaving to deliver the identified medication. The notification can be provided as an alert on a display of a device at or near the bin-sorting area, and/or may be sent to a device of the delivery person, such as the delivery person's mobile device. If another medication is available or almost prepared for delivery, but it is not preferable to deliver the other medication during the same delivery as the identified medication, then either no notification is provided to the delivery person, or a notification is provided to the delivery person to proceed with delivering the identified medication.
In this manner, the disclosed system provides the delivery person with insight into the medication preparation process by determining whether the delivery person should request (for delivery to the appropriate bin) a prepared medication that is sitting in the bin-sorting area from a sorting person, or whether the delivery person should wait for an medication to finish being prepared. The disclosed system may determine how urgently the medications identified (e.g., scanned) for delivery need to be delivered by the delivery person, and how long the delivery person will need to wait to obtain any other medication for which the preparation is almost complete. The disclosed system may notify (e.g., by a visible or audible alert, such as a text message or notification window) the delivery person of an medication that is almost prepared if the system determines that the delivery person has sufficient time to wait for the preparation of the medication to complete, (e.g., based on an estimated amount of time required to complete the preparation of the medication), the times that the identified medications need to be delivered by, and an estimated amount of time required to deliver the identified medications.
In addition, the disclosed system provides a delivery person who is delivering infusion solutions to a particular area of a healthcare facility with a list of discontinued infusion solutions and their location in the area to which the delivery person is delivering. The delivery person may then retrieve the discontinued infusion solutions and return them to a pharmacy location providing services within a facility. The discontinued infusion solutions may be scanned upon their return to the pharmacy and listed in an inventory of available infusion solutions. In certain aspects, the discontinued infusion solutions may be scanned when initially retrieved by the delivery person and also be listed in the inventory of available solutions. If the discontinued infusion solutions have passed their expiration date, or are not within a threshold time duration of their expiration date, (e.g., exceeding the amount of time required to deliver to and administer the infusion solution at another location), then the discontinued infusion solutions are discarded. However, if the discontinued infusion solutions are not within the threshold time duration of their expiration date, the discontinued infusion solutions are re-entered into inventory for possible re-use. In certain aspects, the expiration date of an infusion solution can be automatically determined based on the stability and sterility of the medication.
When a new order for an infusion solution is received, the disclosed system first checks whether the discontinued infusion solution that has been re-entered into inventory can be used to fill the new order. If the order can be filled with the discontinued infusion solution, then the discontinued infusion solution is used for the order. However, if the order cannot be filled with the discontinued infusion solution, then the order is placed in an infusion solution preparation queue for preparation by a technician or pharmacist.
In certain aspects, the disclosed system may determine one or more metrics regarding the number of discontinued infusion solutions that are re-entered into inventory and/or the number of discontinued infusion solutions that are discarded. The disclosed system may, for example, utilize the one or more metrics to adjust a suggested number of infusion solutions that are prepared without any corresponding orders on a daily basis, (e.g., the number of fast mover pre-pack infusion solutions that are prepared on a daily basis). For example, if a large number of discontinued orders for a particular fast mover pre-pack infusion solution is being re-entered into inventory on a daily basis, and the fast mover pre-pack infusion solutions subsequently expire before they can be administered to a patient, the disclosed system may reduce the suggested number of the fast mover pre-packs that should be prepared on a daily basis.
The example hospital network environment 100 includes a network 105, a physician order entry (POE) system 110, a server 115, a pharmacy information system (PIS) 120, one or more healthcare devices 130A-F, an electronic device 140A that is located in a medication storage area, and an electronic device 140B that is located in a medication preparation area. In one or more implementations, the medication storage area may be an area w % here a medication inventory of a healthcare facility is stored, and the medication preparation area may be an IV workroom or compounding station, such as a clean workroom, a sterile workroom, and/or a non-sterile workroom. Other types of medication storage areas and/or medication preparation areas are also possible, such as nurse stations.
The POE system 110, PIS 120, healthcare devices 130A-F, and/or electronic devices 140A-B may be communicatively coupled to one another, such as by the network 105. In one or more embodiments, one or more of the POE system 110, the PIS 120, the healthcare devices 130A-F, or the electronic devices 140A-B may be directly coupled to one another. In addition, there may be a number of other devices connected to the network 105, such as a control system, additional healthcare systems, (e.g., a hospital information system (HIS), a laboratory information system (LIS), or other clinical and/or logistical systems), additional healthcare devices, additional electronic devices, external systems, computing devices, mobile devices, etc. The POE system 110, the PIS 120, one or more of the healthcare devices 130A-F, and/or one or more of the electronic devices 140A-B may be, or may include all or part of, the electronic system that is discussed further below with respect to
The network 105 may be a communication network, such as a public communication network (such as the Internet, cellular data network, dialup modems over a telephone network), a private communications network (such as private local area network (“LAN”), leased lines), etc. The network 105 may also include, but is not limited to, any one or more of the following network topologies, including a bus network, a star network, a ring network, a mesh network, a star-bus network, a tree or hierarchical network, and the like. The connections of the network 105 may be wired or wireless. For example, one or more of the POE system 110, the server 115, the PIS 120, the healthcare devices 130A-F, and/or the electronic devices 140A-B may transmit wireless signals over the network 105, such as wireless Ethernet signals, radio frequency (RF) signals, infrared (IR) signals, Bluetooth signals, or any other means capable of carrying information in a wireless manner between devices having appropriate transmitters and/or receivers.
The POE system 110, the server 115, and/or the PIS 120 may be single computing devices, such as computer servers. Alternatively, the POE system 110, the server 115 and/or the PIS 120 may represent one or more computing devices (such as a cloud of computers and/or a distributed system) that are communicatively coupled, such as communicatively coupled over the network 105, and that collectively, or individually, perform one or more functions that can be performed server-side, such as receiving messages, transmitting messages, storing messaging, receiving control commands, providing user interfaces, transmitting notifications, etc. The POE system 110, the server 115, and/or the PIS 120 may be coupled with various databases, such as data stores, storage services, or other computing devices.
The server 115 may be a system or interface engine configured to interface with the other devices, including the POE system 110, the PIS 120, the healthcare devices 130A-F, and/or the electronic devices 140A-B (collectively referred to as the other devices). For example, the server 115 may be able to interface with each of the other devices and further provide an interface between each of the other devices even if normally one or more of the other devices are incompatible, or otherwise operate on unique or proprietary parameters. The server 115 may provide feedback on the operation of one or more of the other devices, and may further automate the medication workflow by providing instructions to one of more of the other devices based on feedback. The server 115 may act as an interface engine which reconciles the various systems of the other devices without requiring real-time mapping across multiple systems. The server 115 may also be configured to support additional devices such that the addition of one or more devices provides seamless integration with the other devices already in use.
The POE system 110, the server 115, and/or the PIS 120 may be systems that facilitate with providing healthcare, and/or provide healthcare. The POE system 110 may be used, for example, by physicians to enter orders for patients, such as orders for medications to be administered to patients. The orders for medications may be transmitted to the PIS 120 for preparation. The PIS 120 may store, for example, information pertaining to a pharmacy of a healthcare facility, such as outstanding orders, filled orders, medication inventory, patient medical profiles/histories, etc. For example, the PIS 120 may be coupled to a database that stores, for example, an inventory of the medications that are stored in the medication storage area and/or medications that are temporarily stored in one or more medication preparation areas.
The healthcare devices 130A-F may include infusion devices, such as infusion pumps, drug delivery devices, dispensing devices, such as automated dispensing machines, monitoring devices, respiratory devices, such as ventilators, waste devices, such as drug disposal devices, or generally any device that may facilitate with providing healthcare and/or may provide healthcare. One or more of the healthcare devices 130A-F may include a processor and/or a memory. Alternatively, or in addition, one or more of the healthcare devices 130A-F may be communicatively coupled to a device that includes a processor and a memory, such as via a serial port.
For example, the healthcare devices 130A-F may include automated dispensing machines (ADM), such as Pyxis Medstations™, which store and dispense medications at nurse's stations, thereby providing distributed access to medications. The healthcare devices 130A-F may further include infusion devices, such as infusion pumps, that assist with administering medications to patients. The healthcare devices 130A-F may also include waste devices that accept and store wasted medications, for example, excess medications, from healthcare professionals and track the amount of medications wasted by healthcare professionals. One or more of the healthcare devices 130A-F that provide medications, (e.g., that provide access to medications or that administer medications), may transmit signals, such as replenishment signals, to the PIS 120 when the medications need to be replenished. For example, an intravenous (IV) pump may transmit a replenishment signal when an IV bag that is being administered to a patient needs to be replenished. Similarly, an automated dispensing machine may transmit a replenishment signal when one or more of the medications distributed by the automated dispensing machine are running low. The server 115 may facilitate the transmission of these signals to the appropriate device in the appropriate format.
The electronic devices 140A-B may be any electronic devices such as laptop or desktop computers, mobile phones, personal digital assistants (“PDAs”), tablet computers, televisions or other displays, or other appropriate computing devices that can be used to display user interfaces that facilitate with, for example, picking component medications for ordered medications and/or preparing ordered medications. For instance, the electronic device 140A that is located in the medication storage area may display a queue to facilitate with retrieving, or picking, medications from inventory for received orders in a manner that substantially minimizes waste, while the electronic device 140B that is located in the medication preparation area may display a queue to facilitate with preparing ordered medications in a manner that substantially minimizes waste.
In the example of
For explanatory purposes, the electronic device 140A is described herein as being located in a medication storage area and the electronic device 140B is described herein as being located in a medication preparation area; however, the electronic devices 140A-B may be portable devices, (e.g., a tablet device or a mobile phone), that a healthcare professional may carry in and out of the medication storage area and/or the medication preparation area. The medication storage area and/or the medication preparation area may be located within a pharmacy of a healthcare facility. Alternatively, or in addition, the medication storage area and the medication preparation area may be disparately located within, or outside of, the healthcare facility. In one or more implementations, the healthcare facility may include multiple medication storage areas, one or more of which may include the electronic device 140A, and/or multiple medication preparation areas, one or more of which may include the electronic device 140B.
In operation, one or more orders for medications may be received by the PIS 120, such as from the POE system 110, or from one of the healthcare devices 130A-F, for example, in the form of a replenishment signal. An order may indicate at least one component medication, such as cefazolin, vancomycin, norepinephrine, saline solution, etc., along with an amount of the component medication to be used to prepare the medications. In one or more embodiments, the orders for medications may include orders for IV bags. The PIS 120 may transmit the orders to the electronic device 140A that is located in the medication storage area, such that the component medications of the orders can be picked or retrieved from the medication storage area by a healthcare professional, for instance. The server 115 may help facilitate the transmission of the orders and other related data.
In one or more embodiments, the healthcare facility may utilize anticipatory batching for fast moving compounds or components. For example, a determined amount of a medication that includes a particular compound or component may be prepared as an anticipatory batch, irrespective of whether any orders have been received for the medication. The anticipatory batch of the medication may be associated with one or more periodic automatic replenishment (PAR) levels. If the prepared amount of the medication from the anticipatory batch falls below a PAR level, a system, such as the PIS 120 or the server 115, may generate one or more orders for the medication, (e.g., an “auto-reorder”), based on the PAR levels set, and the one or more orders may be provided to the PIS 120 along with orders received from the POE 110 and/or from one or more of the healthcare devices 130A-F.
The electronic device 140A that is located in the medication storage area may aggregate the received orders into batches, or groups, for example, based on the component medications that are indicated by each order. For instance, the electronic device 140A may batch the orders such that orders that have a common (e.g., the same) component medication are picked together. After batching the orders, for example based on the component medications, the electronic device 140A may select the first batch of orders and determine the containers from inventory that should be picked to prepare the first batch of orders in a manner that minimizes wasted component medications. The containers may include vials, bags, bottles, packages, or generally any container that can store a component medication. In one or more embodiments, the steps of batching the orders and determining the containers to be retrieved from inventory to prepare a batch of orders may be performed by the PIS 120, and/or another server system. The PIS 120 may then transmit the batches, along with the amount of component medications to be retrieved for each batch and/or the containers to be retrieved from inventory for each batch, to the electronic device 140A.
The electronic device 140A may determine a first batch of orders and may provide an indication of the component medications needed to prepare the first batch, the amount of the component medications that needs to be retrieved for the first batch, and the containers from inventory that should be retrieved for the first batch. For example, the electronic device 140A may display a user interface to facilitate the healthcare professional with picking the component medications for the first batch. The healthcare professional may retrieve the containers from the inventory of the medication storage area for preparing the first batch. For example, the healthcare professional may identify each container that is retrieved from inventory, for instance by scanning the containers with a bar code scanner. The electronic device 140A may transmit indications of the scanned containers to the PIS 120 and the PIS 120 may store an indication that the containers are being removed from the inventory of the medication storage area and being delivered to a temporary inventory of a medication preparation area. The server 115 may be an intermediary to facilitate the transmittal of identifiers, such that any proprietary or otherwise incompatible identifying system of any of the devices becomes compatible with the PIS 120 and other devices. The containers may then be delivered to the medication preparation area for preparation of the first batch of orders.
Once the containers containing the component medications for the first batch of orders are delivered to the medication preparation area, the electronic device 140B (that is located in the medication preparation area) receives an indication of the first batch of orders. The electronic device 140B may display, for example, to a healthcare professional who will be preparing the first batch of orders, a user interface that includes a queue that lists the first batch of orders. In one or more implementations, the electronic device 140B may order the queue such that the orders that will be prepared with a common component medication are displayed adjacently in the queue.
The electronic device 140B may receive an indication that the healthcare professional has initiated preparation of an order listed in the queue, and/or that the healthcare professional has selected an order listed in the queue. Upon receiving the indication, the electronic device 140B determines whether there are any other orders listed in the queue that will be prepared using the component medication of the order that is currently being prepared. If the electronic device 140B determines that any such orders are listed in the queue, the electronic device 140B may notify the healthcare professional of the orders and/or the electronic device 140B may re-order the queue, if necessary, such that the orders are listed in the queue adjacent to the order currently being prepared. In this manner, orders that are prepared using the same component medication can be prepared together, thereby minimizing any excess amount of component medication that is wasted.
Turning now to the drawings,
The architecture 100 includes a pharmacy 1 having a medication storage area 10, a fill and/or preparation (fill/prep) area 20, and a delivery pickup area 30 (e.g., bin-sorting area). The medication storage area 10 includes a plurality of medications and supplies including, for example, an anesthetic drug (e.g., bupivacaine or chloroprocaine) and an appropriate fluid for the anesthetic drug. The anesthetic drug and the fluid are taken from the medication storage area 10 to the prep/fill area 20 where they are mixed together to produce the anesthetic IV solution. A patient/medication ID device 72, such as a barcode label or a radio frequency identification (RFID) tag, is provided on (e.g., affixed to) a package 70 (e.g., IV bag) containing the IV solution at the prep/fill area 20. The patient/medication ID device 72 includes patient/medication ID information indicative of the medication and the patient to whom the medication is prescribed. The package 70 is then taken by a technician at the pharmacy 1 to the delivery pickup area 30. The technician determines an appropriate bin or delivery cart 90 into which to place the package 70, and then loads the package 70 onto the appropriate delivery cart 90 for delivery to a scheduled delivery/drop location 60 (e.g., a patient room) by a delivery person 2 (e.g., a person assigned the task of delivering medications, or a machine such as a robot configured to perform such task).
In the illustrated implementation, the prep/fill area 20 has a barcode reader 24 provided therein that the technician at the pharmacy 1 can use to read the patient/medication ID device 72 (a barcode label in the illustrated example) before the package 70 is taken to the delivery pickup area 30. The prep/fill area 20 may also have an image recording device 25, such as a camera, for recording preparation of the package 70. The delivery pickup area 30 has a barcode reader 34 connected to a client 112 provided therein that the technician at the pharmacy 1 can use to read the patient/medication ID device 72 once the package 70 is taken to the delivery pickup area 30. The delivery cart 90 may also be provided with a location barcode label reader. The delivery person 2 can use the barcode reader 34 to scan the package 70 to indicate the delivery person 2 will begin delivery of the package 70. A notification of delivery may be sent to a server 135.
The pharmacy 1 includes the server 135 (e.g., pharmacy server) that may correspond to (e.g., perform one or more functions of) the server 115, and includes a processor 40. The server 135 is coupled to an output device 134, such as a display, and an input device 136, such as a keyboard. The server 135 can be any device having an appropriate processor, memory, and communications capability for running a preparation tracking application and receiving, processing, and sending information associated with a medication database 45 and prepared medications. The processor 40 is coupled to the medication database 45 that is configured to store a variety of information. The medication database 45 can include information such as, but not limited to: the patient's name or ID, the medication name or ID, the scheduled delivery location 60, the scheduled delivery time, an expiration date or time for a prepared medication, an estimated administration time for the prepared medication, an urgency of delivery of the prepared medication, a current location of the prepared medication, an order status of the prepared medication, a return status of the prepared medication, one or more read locations where the medication/patient ID information and/or the location ID information was read by a barcode scanner 84, a time when the information was read, and the name or ID of the delivery person 2. The medication database 45 is configured to electronically provide and receive the information according to various interoperability standards or parameters, such as the HL7 standard, which can include data received from various medical devices such as an infusion pump. The electronic data feed providing the HL7 standardized data is different than a printer feed in which data is not provided for exchange, integration, sharing, and retrieval of electronic health information as with the HL7 standardized data. For example, the electronic data feed can include data formatted for the HL7 standard that indicates a current or past status of an infusion pump, respiratory device, dispensing machine, or other medical device. However, certain devices or machines, such as compounders or other devices in the prep/fill area 20, may not be compatible with or able to directly interface with the interoperability standards or parameters, due to, for example, being configured for a proprietary or custom-built data parameters. The processor 40 may reconcile the incompatibilities between various data standards or parameters. For example, before or while storing data in the database 45, the processor 40 may convert, using a look-up table, a hash table, or other appropriate algorithm, non-standard data into standardized data. Alternatively, the database 45 may store the non-standardized data, and may convert the data before or during its retrieval.
The processor 40 of the server 135 at the pharmacy 1 is configured to electronically receive information or data from the medication database 45 according to an interoperable standard such as the HL7 standard and process the information to identify one or many orders to be prepared in the prep/fill area 20 of the pharmacy 1. In certain implementations, one or more devices may require data in a non-standard format or parameters. The processor 40 may either receive data and convert into a compatible parameter or format, or alternatively may specifically request and receive non-standard data from the database 45. The processor 40 then determines whether each order can be filled using an available medication that has already been prepared (e.g., in the medication storage area 10), a retrieved or retrievable medication that will no longer be needed by another patient, or whether the order must be filled by preparing anew medication. As such, the processor 40 is configured to make the determinations in “real-time,” namely, substantially immediately in response to corresponding data from the medication database 45. In addition, the start or completion of the various tasks described herein may send a corresponding notification or verification to the server 135, through being scanned, for instance.
A medication order may be prepared by a physician 3 (e.g., a doctor, other authorized personnel, or machine such as a robot assigned the task of determining prescriptions for patients). The physician 3 may send medication orders through a POE (not shown in
A medication may be retrieved by the delivery person 2 and returned to the pharmacy 1. The retrieved medication may be scanned upon its return to the pharmacy 1 and listed in an inventory of available retrieved medications. In certain aspects, the retrieved medication may be scanned when initially retrieved (e.g., but not yet returned to the pharmacy 1) by the delivery person 2 and also be listed in the inventory of available solutions. If the retrieved medication has passed its expiration date, or is not within a threshold time duration of its expiration date, (e.g., exceeding the amount of time required to deliver to and administer the retrieved medication at another location), then the retrieved medication is discarded. However, if the retrieved medication is not within the threshold time duration of its expiration date, the retrieved medication is re-entered into inventory for possible re-use.
The processor 40 of the server 135 at the pharmacy 1 provides appropriate notifications to an output device 134 based on the determination whether each order can be filled using an available medication that has already been prepared, a retrieved or retrievable medication that will no longer be needed by another patient, or whether the order must be filled by preparing a new medication, including, for example, how the order should be filled, and a location of a retrievable medication that can be used to fill the order. For example, a notification can be displayed on the output device 134 indicating that a retrieved medication for bupivacaine IV solution and be used to fill a new order for bupivacaine IV solution. In determining whether retrieved or retrievable medication can be used to fill the order, the processor 40 is configured to calculate the expiration date of the retrieved or retrievable medication. The expiration date of the retrieved or retrievable medication is used to determine whether the retrieved or retrievable medication can be used to fill the order.
The processor 40 is configured to determine an expiration date for a returned package 70 based on, for example, the stability and sterility of the returned package 70. Information indicative of the stability and sterility of the returned package 70 may be obtained from the medication database 45. For example, the stability of the returned package 70, which indicates a length of time a drug in the returned package 70 retains its properties without loss of potency (i.e., “shelf life”) can initially be entered by a pharmacist or other health care provider when the returned package 70 is first prepared. The sterility of the returned package, which indicates the conditions in which the package 70 was prepared (e.g., an environment particle count), can be determined based on a known location in which the package 70 was prepared as stored in the medication database 45. For instance, if the package returned package 70 is prepared in a sterile zone, it may be given a longer expiration time frame than if the returned package 70 were not prepared in a sterile zone. The processor 40, based on a stability date entered by a pharmacist and a sterility indicator calculated based on the known location in which the package 70 was prepared, can then generate an expiration date for the returned package 70.
In certain aspects where a retrieved or retrievable medication can be used to fill the order, an identification of the retrievable medication and of the retrieval location 50 can be provided to a client 112 in or associated with the delivery pickup area 30 for display on an output device 114 at or near the delivery pickup area 30 instructing the delivery person 2 to retrieve the retrievable medication from the retrieval location 50. A route for retrieving the retrievable medication from the retrieval location 50 (e.g., a patient room) may also be provided to the client 112 based on, for example, current deliveries being made by the delivery person 2. The client 112 can be, for example, a computer system associated with the delivery pickup area 30 such as a desktop computer or mobile computer. The client 112 can also be, for example, a tablet computer, mobile device (e.g., a smartphone or PDA), or any other device having appropriate processor, memory, and communications capabilities. A client 112 that is a mobile device may, for example, be associated with the delivery person 2.
Upon determining how the order from the medication database 45 can be filled, the processor 40 of the server 135 in the pharmacy 1 provides an entry for the order for display on the output device 134 of the server 135 and in a virtual queue of orders to be filled by the pharmacy 1. The entry for the order is listed at an appropriate position in the queue among any other order(s) in the queue. The position of each order for a medication in the queue as determined by the processor 40 may be based on, for example, an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to the delivery/drop location 60, an estimated time at which the medication will be needed for administration to a patient at the delivery/drop location 60, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. Two or more medication orders that require the same or similar medication components may be grouped together in the queue, for example, to avoid unnecessary wasting of the component used to prepare the medication.
Records of the preparation of the medication for the order using one or more components is recorded and stored in the medication database 45 for later verification by a pharmacist or other inspector responsible for authorizing the prepared medication as being ready for delivery to a patient. The records can include, for example, images or video recorded by the image recording device 25 or barcodes for the component(s) read by the barcode reader 24. The records may then be provided to the pharmacist for verification. Upon verification, the package 70 prepared for the order is identified as prepared in the queue and ready for delivery to the delivery/drop location 60 by the delivery person 2. At any time, if the medication database 45 indicates that the order has changed, such as due to a status change of the patient for whom the order is written, the queue is automatically updated to modify or remove the listing for the order in the queue based on the change to the order indicated by the medication database 45.
The delivery location 60 and/or the retrieval location 50 can include, for example, patient rooms having an infusion device for providing an IV infusion from a package to a patient. In the illustrated example, the retrieval location 50 and the delivery location 60 are provided with location barcode label 52 and location barcode label 62, respectively. Each of the location barcode labels 52, 62 includes unique location ID information indicative of the respective location 50, 60 where the corresponding barcode label is provided. As described above, the package 70 (e.g., IV bag) containing the medication (e.g., IV solution) is provided with a patient/medication identification (ID) device 72. In the illustrated example, the patient/medication ID device 72 is a barcode label that includes patient/medication information indicative of the patient (e.g., “Jane Smith”) and the medication (e.g., “bupivacaine IV solution”). The patient/medication information may also contain other drug or patient related information such as the patient's medical conditions (e.g., allergies), name of the drug (e.g., bupivacaine), the drug dosage, the drug concentration, the drug administration schedules, and the drug administration rate.
Also depicted in the architecture 200 of
The location ID devices 52, 62, 92 and/or the patient/medication ID device 72 may be passive ID devices, meaning that certain action (e.g., scanning) has to be taken by the participant (e.g., a pharmacy technician or the delivery person 2) to retrieve information therefrom. In other implementations, the ID devices can be active ID devices, such as an active tracking device 157, meaning that the information retrieval from the ID devices occur automatically without an action taken by the participant. In some implementations, the active ID devices can actively transmit signals containing the relevant information to the reader device 72 through a wireless link. The wireless link can use a variety of technologies including Bluetooth, ZigBee, wireless USB, and proprietary systems. In other implementations, the active ID devices do not themselves transmit signals, but respond to query signals generated by a reader device (e.g., by altering impedance of an RF circuit therein) as the reader device passes by the ID devices in close proximity.
In the illustrated example, each time the barcode scanner 84 scans an ID device (e.g., patient/medication ID device or location ID device), the information read thereby is provided to the medication database 45 via wireless transmission 101 to a wireless bridge 50 that receives the information. The bridge 50 is in data communication with the processor 40 via a hospital network 150. The network 150 can include, for example, any one or more of a personal area network (PAN), a local area network (LAN), a campus area network (CAN), a metropolitan area network (MAN), a wide area network (WAN), a broadband network (BBN), the Internet. and the like. Further, the network 150 can include, but is not limited to, any one or more of the following network topologies, including a bus network, a star network, a ring network, a mesh network, a star-bus network, tree or hierarchical network, and the like. The network 150 may correspond to the network 105 in
The processor 40 is configured to receive medication/patient ID information and/or location ID information read by the barcode scanner 84, generate location, use, and re-use information therefrom. The processor 40 is configured to store the information in the medication database 45.
The architecture 100 further comprises tracking devices 122, 152 that allow a care provider 4 (e.g., a nurse assigned the task of administering the patient-specific medication to the patient, or a machine such as a robot configured to perform such tasks) to monitor the progress of the delivery of the medication. Each of the tracking devices 122, 152 is configured to receive a tracking request by the care provider 4, access the medication database 45, either directly or via the processor 40, retrieve the delivery progress information stored in the database 45, and indicate a delivery progress of the medication to the care provider 4 based on the delivery progress information. In the illustrated example, the tracking device 122 is an automated dispensing machine having a processor (not shown), a display 121, and a keyboard 123; and the tracking device 152 is a mobile communication device 155 (e.g., a cell phone, personal digital assistant (PDA), or pager) having a processor (not shown), a display 151, and a keyboard 153, and may be connected to the server 135 through a wireless connection 102. The delivery progress information can inform the care provider 4 of a last-known read location and time of the last reading. Based on such information, the care provider 4 can decide, for example, whether to wait for the delivery at the delivery location 60, go to the delivery location later at an expected delivery time, or go to the last-known location to retrieve the medication from the cart 90.
The client 112 includes a processor 212, the communications module 218, and a memory 220 that includes a notification application 222. The client 112 is further connected to the barcode reader 34, the input device 116, and the output device 114.
The server 135 includes a processor 40, a communications module 238, and a memory 232 that includes the medication database 45, an application 234, and an interface engine 335. The processor 40 of the server 135 is configured to execute instructions, such as instructions physically coded into the processor 40, instructions received from software in memory 232, or a combination of both. For example, the processor 40 of the server 135 executes instructions from the application 234 to receive information indicative of an order for medication for a patient from an electronic data feed (e.g., medication database 45) and determine whether the order can be filled with an available prepared medication or a returned medication.
A determination whether an available prepared or returned medication can be used to fill the order can be based on, for example, a comparison between at least two of an expiration time of the available prepared or returned medication, an estimated amount of time for delivering the available prepared or returned medication to the delivery/drop location 60, an estimated time at which the available prepared or returned medication w-ill be administered to a patient at the delivery/drop location 60, and a delivery deadline for the available prepared or returned medication.
For example, if a returned medication is estimated to expire in ten minutes, and it is estimated to take thirty minutes to deliver the returned medication to the delivery/drop location 60, then the determination may indicate that the returned medication cannot be used for completing the order of the other medication. As another example, if the order must be delivered to the delivery/drop location 60 within two hours, and the estimated time to deliver an available prepared medication to the delivery/drop location 60 is one hour, then the determination may indicate that the available prepared medication should be used for completing the order. As yet another example, if a returned medication is estimated to expire in one hour, it is estimated to take thirty minutes to deliver the returned medication to the delivery/drop location 60, and the order must be delivered to the delivery/drop location 60 within forty-five minutes, then the determination may indicate that the returned medication can be used for completing the order of the other medication.
When the processor 40 determines the order can be filled with an available prepared medication or a returned medication, the processor 40 is configured to provide a notification to fill the order with the available prepared medication or returned medication. The notification can include, for example, an instruction to assist with preparation of the order using the prepared or returned medication. For instance, the notification can indicate that a returned medication should be combined with another returned medication to fill the order, and further indicate a pickup location (e.g., retrieval location 50) at which the medication can be retrieved if it is not yet retrieved. As an example, if two returned medications are each for Cefazolin (2 gm/NS 50 ml), and a new order for Cefazolin (4 gm/NS 100 ml) is received by the processor 40, then the processor 40 can send a notification (e.g., to output device 134) indicating that the two returned medications of Cefazolin (2 gm/NS 50 ml) should be combined to fill the new order for Cefazolin (4 gm/NS 100 ml).
Similarly, the processor 40 may be configured to provide a notification indicating to proceed with completing the order when the determination indicates that a prepared or returned medication is not available for completing the order. For example, if the order for the medication must be delivered to the delivery/drop location 60 within thirty minutes, and the estimated time to deliver a returned medication to the delivery/drop location 60 is one hour, then a notification on the output device 134 can indicate that the returned medication cannot be used for completing the order of the other medication. In certain aspects, the same notification or another notification can be provided by the processor 40 indicating the returned medication is expired, or the returned medication will expire within a threshold time period. The threshold time period may be based on an expiration time of the returned medication and an estimated amount of time for delivering the returned medication to the delivery/drop location 60.
The processor 40 is further configured to place the order in a virtual queue of orders to be filled. The order for medication from the medication database 45 is placed in a position in the virtual queue determined based on various factors. The factors affecting the position of an order for medication in the virtual queue include, for example, an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location (e.g., delivery/drop location 50), an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication.
The order may be listed by the processor 40 at a position among other orders in the virtual queue where the order is provided with other orders of the same type (e.g., the same type of medication) or having a shared component. For instance, a new order for medication that requires a particular medication component for formulation can be grouped with other orders in the virtual queue that require the same particular medication component for formulation.
Such component based aggregation of medication orders may allow a healthcare facility, such as a hospital, to substantially minimize the amount of medication that is wasted when component medications are picked, or retrieved, by a healthcare professional, for the purposes of preparing ordered medications. For example, the processor 40 may provide, to a healthcare professional and for display on the output device 134, an indication of a container, or a set of containers, which provides a sufficient amount of the component medication to prepare the orders while minimizing any excess amount of the component medication, such as any amount of the component medication that is left unused after the ordered medications are prepared. The processor 40 thus minimizes the amount of component medications that is wasted when ordered medications are prepared. For example, the processor 40 may aggregate medication orders based on common component medications such that a healthcare professional can sequentially prepare ordered medications that have a common component medication. In this manner, the likelihood of any component medication being wasted, or expiring, is substantially minimized.
Accordingly, the processor 40 is configured to aggregate received orders into batches, or groups, for instance, based on the component medications that are indicated by each order for display in the queue. For example, the processor 40 may batch the orders such that orders that have a common (e.g., the same) component medication are picked together. After batching the orders, (e.g., based on the component medications), the processor 40 may select the first batch of orders and determine the containers from inventory (e.g., in the medication storage area 10) that should be picked to prepare the first batch of orders in a manner that minimizes wasted component medications. The containers may include vials, bags, bottles, packages, or generally any container that can store a component medication.
The processor 40 of the server 135 is further configured to execute instructions from the application 234 to determine a first batch of orders and provide an indication of the component medications needed to prepare the first batch, the amount of the component medications that needs to be retrieved for the first batch, and the containers from inventory that should be retrieved for the first batch. For example, the processor 40 may provide a user interface for display on the output device 134 to assist a healthcare professional with picking the component medications for the first batch. The healthcare professional may retrieve the containers from the inventory of the medication storage area 10 for preparing the first batch. For example, the healthcare professional may identify each container that is retrieved from inventory, (e.g., by scanning the containers with a bar code scanner 24). The processor 40 may transmit indications of the scanned containers to medication database 45, and the medication database 45 may store an indication that the containers are being removed from the inventory of the medication storage area 10 and being delivered to a temporary inventory of the preparation/fill area 20. The containers may then be delivered to the preparation/fill area 20 for preparation of the first batch of orders.
The processor 40 of the server 135 is further configured to execute instructions from the application 234 to receive an image or barcode identifying a component used to formulate the medication, and provide the image or barcode to a person, such as the pharmacist, responsible for verifying the medication is filled using the component. For example, during preparation of the package 70, a technician may place each component medication used to formulate the package 70 into a capture area of the prep/fill area 20 where the image recording device 25 or barcode reader 24 can capture a record (e.g., image or barcode reading) of each component medication being used. The processor 40 is configured to receive an input indicating the person has verified the medication has been filled using the component, and provide an indication that the order for the medication is ready for delivery to the patient. For example, the image or barcode reading of each component medication used to formulate the package 70 can be provided to a pharmacist in the pharmacy 1 or remote from the pharmacy 1 for review (e.g., as displayed on output device 134) and verification (e.g., using an input device 136 of the server 135) that the appropriate component medications were used to prepare the package 70. Upon verification by the pharmacist, the processor 40 indicates that the order is complete and that the package 70 for the order is ready for delivery.
In addition, once a medication is delivered, the processor 40 is further configured to receive notification or verification of whether the delivered medication is administered (or currently being administered) or unused. For example, the barcode of the medication may be scanned before being placed in an IV pump attached to a patient. An unused medication may be flagged or otherwise noted for relocation and possible reuse, as described herein.
The determination of the order in which to retrieve the unused package 70 can be based on various factors. For example, the determination can be based on an expiration date of the unused package 70. For instance, if the unused package will not expire for several days, then the determination may indicate that the unused package 70 may be retrieved towards the end of the ordered list. The determination can also be based on an estimated amount of time to retrieve the unused package 70. For instance, if it is estimated that it will take at least 15 minutes to retrieve the unused package 70, and the unused package 70 is set to expire within an hour, then the determination may indicate that the unused package 70 should be retrieved towards the beginning of the ordered list. The determination can further be based on a degree of urgency associated with the unused package 70. For instance, if the unused package 70 is listed as being required for delivery immediately (“stat” or “photostat”), then the determination may indicate that the unused package 70 should also be retrieved immediately.
The determination can also be based on a cost associated with the unused package 70. For instance, if the unused package 70 is very expensive to produce, and the expiration date of the unused package 70 is approaching, then the determination may indicate that the unused package 70 should also be retrieved immediately. The determination can yet further be based on an estimated distance to retrieve the unused package 70. The estimated distance can be calculated, for instance, based on a current location of a client 112, such as a mobile device client 112 carries by a delivery person 2. For instance, if two unused packages are to be retrieved, and a first unused package is closer to a current location of a mobile device client 112 of a delivery person 2 than a second unused package, then the determination can indicate that the first unused package should be retrieved first.
The determination can further be based on a likelihood of reuse of the unused package 70 or receipt of a new order for a medication that can be filled using the unused package 70. For instance, if the unused package 70 is for a frequently received order or can be used to fill a new order received at the pharmacy 1, then the determination can indicate that the unused package 70 should be retrieved.
In certain aspects, the determination is indicated by associating a priority value to each of the factors discussed above. As a result, various factors can be taken into consideration when generating a sum priority value indicating a priority in which to retrieve the unused package 70. The priority value can be based on the expiration date of the unused package 70, the estimated amount of time to retrieve of the unused package 70, the degree of urgency associated with the unused package 70, the cost associated with the unused package 70, and the estimated distance to retrieve of the unused package 70. For example, if the unused package expires in the next hour, this first factor may be assigned a high priority value, and if the estimated amount of time to retrieve the unused package is thirty minutes, then this second factor may also be assigned a high priority, thereby generating an even higher sum total priority value for retrieval of the unused package 70. The order of retrieving the unused packages can be sorted according to the priority values such that, for example, an unused package 70 having a higher priority value is retrieved prior to another unused package having a lower priority value.
The processor 40 of the server 135 also executes instructions from the application 234 to provide, for display, a listing of the unused medications based on the determined order for retrieving the unused medications. The listing can be displayed, for example, on a client 112. This may occur where, for example, the processor 40 of the server 135 sends over the network 150 instructions to a notification application 222 in a memory 220 of the client 112, and the notification application 222 instructs the processor 212 of the client 112 to display the listing on an output device 114 of the client 112. As an unused package 70 is retrieved, a barcode 72 of the unused package 70 can be scanned using the bar code reader 34 of the client 112, and a user can confirm that the unused package 70 has been retrieved using an input device 116 of the client. In certain aspects, the displayed listing can include a route to follow within the institution in order to retrieve each unused package 70 and return them to the delivery pickup area 30. The route can be provided, for example, via text instructions or via a visualization of a map of the institution. The visualization, which may be displayed on a mobile device client 112, can be updated based on a current location of the mobile device client 112.
In certain aspects, processor 40 of the server 135 also executes instructions from the application 234 to receive an identification of a first medication to be delivered to a first location and determine a route by which to deliver the first medication to the first location and retrieve at least one second medication at a second location. In certain aspects, the second location may be the same as the first location. The route is determined based on the first location, the second location, and at least one of an expiration date of the first or second medication, an estimated amount of time to deliver the first medication, an estimated amount of time to retrieve the second medication, a degree of urgency associated with each of the first and second medication, a cost associated with each of the first or second medication, and an estimated distance to retrieve each of the first and second medication. The processor 40 of the server 135 can provide, for display, the route for display on the client 112, such as a visualization on a mobile device client 112.
The processor 40 of the server 135 is also configured to execute instructions from the interface engine 335. The processor 40 is configured to interface with various devices, such as the electronic devices 130A-130F, as described herein, to reconcile incompatibility between the various data and parameters used by the electronic devices 130A-130F. By interfacing with the various electronic devices 130A-130F, the processor may better determine an efficient workflow by leveraging all available data, (e.g., inputs and outputs of each connected device). Although
At 404, providing the medication preparation component the first set of parameters based on the second, third, and fourth set of parameters, wherein the medication preparation component cannot interface directly with the second, third, and fourth set of parameters. For example, the inventory management component, delivery management component, and the medication recycling management component may be configured to utilize standardized data parameters as described herein. The compounder may utilize proprietary data parameters, which may not be compatible with the standardized parameters. The interface engine may reconcile the incompatibility, as described herein.
At 458, the interface engine provides a preparation instruction to prepare a medication for at least one of the plurality of medication orders using the component medication when the at least one of the plurality of medication orders cannot be fulfilled by the unused medication. For example, the interface engine may determine whether the unused medication can be used to fulfill the medication order by determining the expiration date of the unused medication, and whether the unused medication can be delivered and administered before the expiration date. The interface engine may further determine whether the unused medication can be used with a component medication or another unused medication to fulfill the medication order. The interface engine may further determine, based on delivery schedules and other related data, the availability of the unused medication, and may further determine whether a needed component medication is available in inventory or must be restocked. The interface engine may order additional component medications as needed, and factor in the delivery times of the additional component medications when determining availability. The interface engine may determine an efficient queue of preparation instructions based on such availability data. By interfacing with the various components or devices, the interface engine may utilize information which would normally not be available to each individual component.
At 460, the interface engine provides delivery instructions for delivering the medication based on the preparation status of each of the plurality of medication orders. At 462, the interface engine receives a delivery verification of the medication. The interface engine may perform the process through one or more devices, as described herein.
Computer system 500 (e.g., client 112 and server 135) includes a bus 508 or other communication mechanism for communicating information, and a processor 502 (e.g., processor 212 and 40) coupled with bus 508 for processing information. By way of example, the computer system 500 may be implemented with one or more processors 502. Processor 502 may be a general-purpose microprocessor, a microcontroller, a Digital Signal Processor (DSP), an Application Specific Integrated Circuit (ASIC), a Field Programmable Gate Array (FPGA), a Programmable Logic Device (PLD), a controller, a state machine, gated logic, discrete hardware components, or any other suitable entity that can perform calculations or other manipulations of information.
Computer system 500 can include, in addition to hardware, code that creates an execution environment for the computer program in question, such as code that constitutes processor firmware, a protocol stack, a database management system, an operating system, or a combination of one or more of them stored in an included memory 504 (e.g., memory 220 and 232), such as a Random Access Memory (RAM), a flash memory, a Read Only Memory (ROM), a Programmable Read-Only Memory (PROM), an Erasable PROM (EPROM), registers, a hard disk, a removable disk, a CD-ROM, a DVD, or any other suitable storage device, coupled to bus 508 for storing information and instructions to be executed by processor 502. The processor 502 and the memory 504 can be supplemented by, or incorporated in, special purpose logic circuitry.
The instructions may be stored in the memory 504 and implemented in one or more computer program products, i.e., one or more modules of computer program instructions encoded on a computer readable medium for execution by, or to control the operation of, the computer system 500, and according to any method well known to those of skill in the art, including, but not limited to, computer languages such as data-oriented languages (e.g., SQL, dBase), system languages (e.g., C. Objective-C, C++, Assembly), architectural languages (e.g., Java, .NET), and application languages (e.g., PHP, Ruby, Perl, Python). Instructions may also be implemented in computer languages such as array languages, aspect-oriented languages, assembly languages, authoring languages, command line interface languages, compiled languages, concurrent languages, curly-bracket languages, dataflow languages, data-structured languages, declarative languages, esoteric languages, extension languages, fourth-generation languages, functional languages, interactive mode languages, interpreted languages, iterative languages, list-based languages, little languages, logic-based languages, machine languages, macro languages, metaprogramming languages, multiparadigm languages, numerical analysis, non-English-based languages, object-oriented class-based languages, object-oriented prototype-based languages, off-side rule languages, procedural languages, reflective languages, rule-based languages, scripting languages, stack-based languages, synchronous languages, syntax handling languages, visual languages, wirth languages, embeddable languages, and xml-based languages. Memory 504 may also be used for storing temporary variable or other intermediate information during execution of instructions to be executed by processor 502.
A computer program as discussed herein does not necessarily correspond to a file in a file system. A program can be stored in a portion of a file that holds other programs or data (e.g., one or more scripts stored in a markup language document), in a single file dedicated to the program in question, or in multiple coordinated files (e.g., files that store one or more modules, subprograms, or portions of code). A computer program can be deployed to be executed on one computer or on multiple computers that are located at one site or distributed across multiple sites and interconnected by a communication network. The processes and logic flows described in this specification can be performed by one or more programmable processors executing one or more computer programs to perform functions by operating on input data and generating output.
Computer system 500 further includes a data storage device 506 such as a magnetic disk or optical disk, coupled to bus 508 for storing information and instructions. Computer system 500 may be coupled via input/output module 510 to various devices (e.g., barcode reader 34 and 24). The input/output module 510 can be any input/output module. Example input/output modules 510 include data ports such as USB ports. The input/output module 510 is configured to connect to a communications module 512. Example communications modules 512 (e.g., communications module 218 and 238) include networking interface cards, such as Ethernet cards and modems. In certain aspects, the input/output module 510 is configured to connect to a plurality of devices, such as an input device 514 (e.g., input device 116 and 136) and/or an output device 516 (e.g., output device 114 and 134). Example input devices 514 include a keyboard and a pointing device, (e.g., a mouse or a trackball), by which a user can provide input to the computer system 500. Other kinds of input devices 514 can be used to provide for interaction with a user as well, such as a tactile input device, visual input device, audio input device, or brain-computer interface device. For example, feedback provided to the user can be any form of sensory feedback, (e.g., visual feedback, auditory feedback, or tactile feedback); and input from the user can be received in any form, including acoustic, speech, tactile, or brain wave input. Example output devices 516 include display devices, such as a LED (light emitting diode), CRT (cathode ray tube), or LCD (liquid crystal display) screen, for displaying information to the user.
According to one aspect of the present disclosure, the client 112 and server 135 can be implemented using a computer system 500 in response to processor 502 executing one or more sequences of one or more instructions contained in memory 504. Such instructions may be read into memory 504 from another machine-readable medium, such as data storage device 506. Execution of the sequences of instructions contained in main memory 504 causes processor 502 to perform the process steps described herein. One or more processors in a multi-processing arrangement may also be employed to execute the sequences of instructions contained in memory 504. In alternative aspects, hard-wired circuitry may be used in place of or in combination with software instructions to implement various aspects of the present disclosure. Thus, aspects of the present disclosure are not limited to any specific combination of hardware circuitry and software.
Various aspects of the subject matter described in this specification can be implemented in a computing system that includes a back end component, (e.g., as a data server), or that includes a middleware component, (e.g., an application server), or that includes a front end component, such as a client computer having a graphical user interface or a Web browser through which a user can interact with an implementation of the subject matter described in this specification, or any combination of one or more such back end, middleware, or front end components. The components of the system can be interconnected by any form or medium of digital data communication, (e.g., a communication network). The communication network (e.g., network 150) can include, for example, any one or more of a personal area network (PAN), a local area network (LAN), a campus area network (CAN), a metropolitan area network (MAN), a wide area network (WAN), a broadband network (BBN), the Internet, and the like. Further, the communication network can include, but is not limited to, for example, any one or more of the following network topologies, including a bus network, a star network, a ring network, a mesh network, a star-bus network, tree or hierarchical network, or the like. The communications modules can be, for example, modems or Ethernet cards.
Computing system 500 can include clients and servers. A client and server are generally remote from each other and typically interact through a communication network. The relationship of client and server arises by virtue of computer programs running on the respective computers and having a client-server relationship to each other. Computer system 500 can be, for example, and without limitation, a desktop computer, laptop computer, or tablet computer. Computer system 500 can also be embedded in another device, for example, and without limitation, a mobile telephone, a personal digital assistant (PDA), a mobile audio player, a Global Positioning System (GPS) receiver, a video game console, and/or a television set top box.
The term “machine-readable storage medium” or “computer readable medium” as used herein refers to any medium or media that participates in providing instructions or data to processor 502 for execution. Such a medium may take many forms, including, but not limited to, non-volatile media, volatile media, and transmission media. Non-volatile media include, for example, optical disks, magnetic disks, or flash memory, such as data storage device 506. Volatile media include dynamic memory, such as memory 504. Transmission media include coaxial cables, copper wire, and fiber optics, including the wires that comprise bus 508. Common forms of machine-readable media include, for example, floppy disk, a flexible disk, hard disk, magnetic tape, any other magnetic medium, a CD-ROM, DVD, any other optical medium, punch cards, paper tape, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM, a FLASH EPROM, any other memory chip or cartridge, or any other medium from which a computer can read. The machine-readable storage medium can be a machine-readable storage device, a machine-readable storage substrate, a memory device, a composition of matter effecting a machine-readable propagated signal, or a combination of one or more of them.
As used herein, the phrase “at least one of” preceding a series of items, with the terms “and” or “or” to separate any of the items, modifies the list as a whole, rather than each member of the list (i.e., each item). The phrase “at least one of” does not require selection of at least one item; rather, the phrase allows a meaning that includes at least one of any one of the items, and/or at least one of any combination of the items, and/or at least one of each of the items. By way of example, the phrases “at least one of A, B, and C” or “at least one of A, B, or C” each refer to only A, only B, or only C; any combination of A. B. and C; and/or at least one of each of A, B, and C.
Furthermore, to the extent that the term “include,” “have,” or the like is used in the description or the claims, such term is intended to be inclusive in a manner similar to the term “comprise” as “comprise” is interpreted when employed as a transitional word in a claim.
A reference to an element in the singular is not intended to mean “one and only one” unless specifically stated, but rather “one or more.” The term “some” refers to one or more. Underlined and/or italicized headings and subheadings are used for convenience only, do not limit the subject technology, and are not referred to in connection with the interpretation of the description of the subject technology. All structural and functional equivalents to the elements of the various configurations described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and intended to be encompassed by the subject technology. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the above description.
While this specification contains many specifics, these should not be construed as limitations on the scope of what may be claimed, but rather as descriptions of particular implementations of the subject matter. Certain features that are described in this specification in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a subcombination or variation of a subcombination.
Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In certain circumstances, multitasking and parallel processing may be advantageous. Moreover, the separation of various system components in the aspects described above should not be understood as requiring such separation in all aspects, and it should be understood that the described program components and systems can generally be integrated together in a single software product or packaged into multiple software products.
This specification describes example aspects of the subject technology, which may include at least the following concepts:
Concept 1: A method of managing medications comprising: interfacing with (i) a medication preparation component configured to fulfill a plurality of medication orders based on a first set of parameters, (ii) an inventory management component configured to stock an inventory based on a second set of parameters, (iii) a delivery management component configured to deliver medications based on a third set of parameters, and (iv) a medication recycling management component configured to retrieve unused medications based on a fourth set of parameters; and providing the medication preparation component the first set of parameters based on the second, third, and fourth set of parameters, wherein the medication preparation component cannot interface directly with the second, third, and fourth set of parameters.
Concept 2: The method described in concept 1, wherein the medication preparation component comprises a compounder configured to prepare an intravenous (IV) medication.
Concept 3: The method described in concept 1, further comprising determining a common set of parameters corresponding to similar information of the first, second, third, and fourth sets of parameters.
Concept 4: The method described in concept 3, wherein the similar information corresponds to medication identification information.
Concept 5: The method described in concept 3, wherein the similar information corresponds to patient identification information.
Concept 6: The method described in concept 3, wherein the similar information corresponds to medication order identification information.
Concept 7: The method described in concept 3, wherein the medication preparation component directly interfaces with the common set of parameters.
Concept 8: The method described in concept 1, further comprising interfacing with an additional component based on a fifth set of parameters, wherein the medication preparation component cannot interface directly with the fifth set of parameters.
Concept 9; A method of managing medications comprising: receiving a plurality of medication orders for a plurality of medications, each of the plurality of medication orders having a preparation status; identifying an unused medication and a current location of the unused medication; identifying a component medication in an inventory; providing a preparation instruction to prepare a medication for at least one of the plurality of medication orders using the component medication when the at least one of the plurality of medication orders cannot be fulfilled by the unused medication; providing delivery instructions for delivering the medication based on the preparation status of each of the plurality of medication orders; and receiving a delivery verification of the medication.
Concept 10: The method described in concept 9, further comprising receiving a notification of whether the delivered medication is administered or unused.
Concept 11: The method described in concept 10, further comprising providing a return instruction for the unused delivered medication.
Concept 12: The method described in concept 11, further comprising: determining whether the unused delivered medication is reusable; identifying the unused delivered medication as another unused medication when it is determined to be reusable; and identifying the unused delivered medication as waste when it is determined not to be reusable.
Concept 13: The method described in concept 12, further comprising receiving a restock verification indicating the another unused medication is reusable.
Concept 14: The method described in concept 9, wherein providing the delivery instructions further comprises providing the delivery instructions based on a delivery deadline of each of the plurality of medication orders.
Concept 15: A non-transitory machine-readable medium containing machine-readable instructions for causing a processor to execute a method for managing medications, the method comprising: receiving a plurality of medication orders for a plurality of medications, each of the plurality of medication orders having a preparation status; identifying an unused medication and a current location of the unused medication; identifying a component medication in an inventory; providing a preparation instruction to prepare a medication for at least one of the plurality of medication orders using the component medication when the at least one of the plurality of medication orders cannot be fulfilled by the unused medication; providing delivery instructions for delivering the medication based on the preparation status of each of the plurality of medication orders; and receiving a delivery verification of the medication.
Concept 16: The method described in concept 15, further comprising receiving a notification of whether the delivered medication is administered or unused.
Concept 17: The method described in concept 16, further comprising providing a return instruction for the unused delivered medication.
Concept 18: The method described in concept 17, further comprising: determining whether the unused delivered medication is reusable; identifying the unused delivered medication as another unused medication when it is determined to be reusable; and identifying the unused delivered medication as waste when the it is determined not to be reusable.
Concept 19: The method described in concept 18, further comprising receiving a restock verification indicating the another unused medication is reusable.
Concept 20: The method described in concept 15, wherein providing the delivery instructions further comprises providing the delivery instructions based on a delivery deadline of each of the plurality of medication orders.
The subject matter of this specification has been described in terms of particular aspects, but other aspects can be implemented and are within the scope of the following claims. For example, the actions recited in the claims can be performed in a different order and still achieve desirable results. As one example, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In certain implementations, multitasking and parallel processing may be advantageous. These and other implementations are within the scope of the following claims and contemplated in the disclosure herein.
This application is a continuation application of U.S. application Ser. No. 14/891,962 entitled “MEDICATION WORKFLOW MANAGEMENT,” filed on Nov. 17, 2015, now U.S. Pat. No. 11,182,728, which is a national stage entry application of International Application No. PCT/US2014/039228, entitled “MEDICATION WORKFLOW MANAGEMENT,” filed on May 22, 2014, which is a continuation application of U.S. application Ser. No. 13/931,746, entitled “AUTOMATED UTILIZATION DRIVEN INVENTORY MANAGEMENT,” filed on Jun. 28, 2013, now U.S. Pat. No. 10,650,925, which is a nonprovisional application of U.S. Application Ser. No. 61/827,419 entitled “AUTOMATED UTILIZATION DRIVEN INVENTORY MANAGEMENT,” filed on May 24, 2013. International Application No. PCT/US2014/039228 is a continuation application of U.S. application Ser. No. 13/901,497 entitled “COMPONENT BASED AGGREGATION OF MEDICATION ORDERS,” filed on May 23, 2013, now U.S. Pat. No. 9,076,115. International Application No. PCT/US2014/039228 is a continuation application of U.S. application Ser. No. 13/901,504 entitled “MEDICATION PREPARATION QUEUE,” filed on May 23, 2013. International Application No. PCT/US2014/039228 is a continuation application of U.S. application Ser. No. 13/901,501 entitled “MEDICATION PREPARATION QUEUE,” filed on May 23, 2013, now U.S. Pat. No. 10,430,554. International Application No. PCT/US2014/039228 is a continuation application of U.S. application Ser. No. 13/900,482 entitled “MEDICATION DELIVERY MANAGEMENT.” filed on May 22, 2013, now U.S. Pat. No. 10,380,326. International Application No. PCT/US2014/039228 is a continuation application of U.S. application Ser. No. 13/900,493 entitled “MANAGING RE-USE OF RETURNED MEDICATIONS,” filed on May 22, 2013, now U.S. Pat. No. 10,372,880. International Application No. PCT/US2014/039228 is a continuation application of U.S. application Ser. No. 13/900,502 entitled “MEDICATION RETRIEVAL OPTIMIZATION.” filed on May 22, 2013, the entirety of each of which is incorporated herein by reference.
| Number | Name | Date | Kind |
|---|---|---|---|
| 2141006 | Marinsky | Dec 1938 | A |
| 3724455 | Unger | Apr 1973 | A |
| 3831006 | Chaffin, III et al. | Aug 1974 | A |
| 3848112 | Weichselbaum et al. | Nov 1974 | A |
| 3872448 | Mitchell, Jr. | Mar 1975 | A |
| 3898984 | Mandel et al. | Aug 1975 | A |
| 3910260 | Sarnoff et al. | Oct 1975 | A |
| 3921196 | Patterson | Nov 1975 | A |
| 3970996 | Yasaka et al. | Jul 1976 | A |
| 4051522 | Healy et al. | Sep 1977 | A |
| 4135241 | Stanis et al. | Jan 1979 | A |
| 4164320 | Irazoqui et al. | Aug 1979 | A |
| 4216462 | McGrath et al. | Aug 1980 | A |
| 4237344 | Moore | Dec 1980 | A |
| 4315309 | Coli | Feb 1982 | A |
| 4321461 | Walter, Jr. et al. | Mar 1982 | A |
| 4360125 | Martindale et al. | Nov 1982 | A |
| 4373527 | Fischell | Feb 1983 | A |
| 4476381 | Rubin | Oct 1984 | A |
| 4604847 | Moulding, Jr. et al. | Aug 1986 | A |
| 4636950 | Caswell et al. | Jan 1987 | A |
| 4674652 | Aten et al. | Jun 1987 | A |
| 4676776 | Howson | Jun 1987 | A |
| 4688026 | Scribner et al. | Aug 1987 | A |
| 4695954 | Rose et al. | Sep 1987 | A |
| 4696671 | Epstein et al. | Sep 1987 | A |
| 4731726 | Allen, III | Mar 1988 | A |
| 4733364 | Yamagata | Mar 1988 | A |
| 4741732 | Crankshaw et al. | May 1988 | A |
| 4756706 | Kems et al. | Jul 1988 | A |
| 4785969 | McLaughlin | Nov 1988 | A |
| 4803625 | Fu et al. | Feb 1989 | A |
| 4810243 | Howson | Mar 1989 | A |
| 4828545 | Epstein et al. | May 1989 | A |
| 4831562 | McIntosh et al. | May 1989 | A |
| 4835372 | Gombrich et al. | May 1989 | A |
| 4839806 | Goldfischer et al. | Jun 1989 | A |
| 4847764 | Halvorson | Jul 1989 | A |
| 4850009 | Zook et al. | Jul 1989 | A |
| 4853521 | Claeys et al. | Aug 1989 | A |
| 4855909 | Vincent et al. | Aug 1989 | A |
| 4857713 | Brown | Aug 1989 | A |
| 4857716 | Gombrich et al. | Aug 1989 | A |
| 4865584 | Epstein et al. | Sep 1989 | A |
| 4882575 | Kawahara | Nov 1989 | A |
| 4899839 | Dessertine et al. | Feb 1990 | A |
| 4916441 | Gombrich et al. | Apr 1990 | A |
| 4918604 | Baum | Apr 1990 | A |
| 4925444 | Orkin et al. | May 1990 | A |
| 4942544 | McIntosh et al. | Jul 1990 | A |
| 4950246 | Muller | Aug 1990 | A |
| 4967928 | Carter | Nov 1990 | A |
| 4970669 | McIntosh et al. | Nov 1990 | A |
| 4978335 | Arthur, III | Dec 1990 | A |
| 5001630 | Wiltfong | Mar 1991 | A |
| 5006699 | Felkner et al. | Apr 1991 | A |
| 5036462 | Kaufman et al. | Jul 1991 | A |
| 5036852 | Leishman | Aug 1991 | A |
| 5041086 | Koenig et al. | Aug 1991 | A |
| 5072383 | Brimm et al. | Dec 1991 | A |
| 5077666 | Brimm et al. | Dec 1991 | A |
| 5078683 | Sancoff et al. | Jan 1992 | A |
| 5088056 | McIntosh et al. | Feb 1992 | A |
| 5088981 | Howson et al. | Feb 1992 | A |
| 5100380 | Epstein et al. | Mar 1992 | A |
| 5126957 | Kaufman et al. | Jun 1992 | A |
| 5142484 | Kaufman et al. | Aug 1992 | A |
| 5153416 | Neeley | Oct 1992 | A |
| 5153827 | Coutre et al. | Oct 1992 | A |
| 5164575 | Neeley et al. | Nov 1992 | A |
| 5166498 | Neeley | Nov 1992 | A |
| 5171977 | Morrison | Dec 1992 | A |
| 5181910 | Scanlon | Jan 1993 | A |
| 5190522 | Wojcicki et al. | Mar 1993 | A |
| 5207642 | Orkin et al. | May 1993 | A |
| 5208762 | Charhut | May 1993 | A |
| 5235507 | Sackler et al. | Aug 1993 | A |
| 5256157 | Samlotes et al. | Oct 1993 | A |
| 5258906 | Kroll et al. | Nov 1993 | A |
| 5265010 | Evans-Paganelli et al. | Nov 1993 | A |
| 5267174 | Kaufman et al. | Nov 1993 | A |
| 5291399 | Chaco | Mar 1994 | A |
| 5292029 | Pearson | Mar 1994 | A |
| 5307263 | Brown | Apr 1994 | A |
| 5312334 | Hara et al. | May 1994 | A |
| 5314243 | McDonald et al. | May 1994 | A |
| 5315505 | Pratt et al. | May 1994 | A |
| 5317506 | Coutre et al. | May 1994 | A |
| H1324 | Dalke et al. | Jun 1994 | H |
| 5331547 | Laszlo | Jul 1994 | A |
| 5356378 | Doan | Oct 1994 | A |
| 5367555 | Isoyama | Nov 1994 | A |
| 5368554 | Nazarian et al. | Nov 1994 | A |
| 5371692 | Draeger et al. | Dec 1994 | A |
| 5374813 | Shipp | Dec 1994 | A |
| 5376070 | Purvis et al. | Dec 1994 | A |
| 5378231 | Johnson et al. | Jan 1995 | A |
| 5382232 | Hague et al. | Jan 1995 | A |
| 5390238 | Kirk et al. | Feb 1995 | A |
| 5401059 | Ferrario | Mar 1995 | A |
| 5404384 | Colburn et al. | Apr 1995 | A |
| 5408443 | Weinberger | Apr 1995 | A |
| 5412372 | Parkhurst et al. | May 1995 | A |
| 5412564 | Ecer | May 1995 | A |
| 5416695 | Stutman et al. | May 1995 | A |
| 5456691 | Snell | Oct 1995 | A |
| 5460605 | Tuttle et al. | Oct 1995 | A |
| 5465082 | Chaco | Nov 1995 | A |
| 5472614 | Rossi | Dec 1995 | A |
| 5502944 | Kraft et al. | Apr 1996 | A |
| 5515426 | Yacenda et al. | May 1996 | A |
| 5522798 | Johnson et al. | Jun 1996 | A |
| 5533079 | Colburn et al. | Jul 1996 | A |
| 5536084 | Curtis et al. | Jul 1996 | A |
| 5538006 | Heim et al. | Jul 1996 | A |
| 5542420 | Goldman et al. | Aug 1996 | A |
| 5544649 | David et al. | Aug 1996 | A |
| 5544661 | Davis et al. | Aug 1996 | A |
| 5547470 | Johnson et al. | Aug 1996 | A |
| 5561412 | Novak et al. | Oct 1996 | A |
| 5562232 | Pearson | Oct 1996 | A |
| 5564803 | McDonald et al. | Oct 1996 | A |
| 5573506 | Vasko | Nov 1996 | A |
| 5582593 | Hultman | Dec 1996 | A |
| 5583758 | McIlroy et al. | Dec 1996 | A |
| 5592374 | Fellagara et al. | Jan 1997 | A |
| 5593267 | McDonald et al. | Jan 1997 | A |
| 5594786 | Chaco | Jan 1997 | A |
| 5597995 | Williams et al. | Jan 1997 | A |
| 5601445 | Schipper et al. | Feb 1997 | A |
| 5622429 | Heinze | Apr 1997 | A |
| 5628309 | Brown | May 1997 | A |
| 5630710 | Tune et al. | May 1997 | A |
| 5633910 | Cohen | May 1997 | A |
| 5643212 | Coutre et al. | Jul 1997 | A |
| 5644778 | Burks et al. | Jul 1997 | A |
| 5645531 | Thompson et al. | Jul 1997 | A |
| 5651775 | Walker et al. | Jul 1997 | A |
| 5655118 | Heindel et al. | Aug 1997 | A |
| 5657236 | Conkright | Aug 1997 | A |
| 5658250 | Blomquist et al. | Aug 1997 | A |
| 5672154 | Sillen et al. | Sep 1997 | A |
| 5681285 | Ford et al. | Oct 1997 | A |
| 5683367 | Jordan et al. | Nov 1997 | A |
| 5685844 | Marttila | Nov 1997 | A |
| 5689229 | Chaco et al. | Nov 1997 | A |
| 5692640 | Caulfield et al. | Dec 1997 | A |
| 5699038 | Ulrich et al. | Dec 1997 | A |
| 5700998 | Palti | Dec 1997 | A |
| 5703786 | Conkright | Dec 1997 | A |
| 5704352 | Tremblay et al. | Jan 1998 | A |
| 5710551 | Ridgeway | Jan 1998 | A |
| 5712913 | Chaum | Jan 1998 | A |
| 5713856 | Eggers | Feb 1998 | A |
| 5721913 | Ackroff et al. | Feb 1998 | A |
| 5733259 | Valcke et al. | Mar 1998 | A |
| 5737539 | Edelson et al. | Apr 1998 | A |
| 5738102 | Lemelson | Apr 1998 | A |
| 5752235 | Kehr et al. | May 1998 | A |
| 5758095 | Albaum et al. | May 1998 | A |
| 5758096 | Barsky et al. | May 1998 | A |
| 5760704 | Barton et al. | Jun 1998 | A |
| 5764034 | Bowman et al. | Jun 1998 | A |
| 5772585 | Lavin et al. | Jun 1998 | A |
| 5774865 | Glynn | Jun 1998 | A |
| 5781442 | Engelson et al. | Jul 1998 | A |
| 5790409 | Fedor et al. | Aug 1998 | A |
| 5795327 | Wilson et al. | Aug 1998 | A |
| 5803906 | Pratt et al. | Sep 1998 | A |
| 5807321 | Stoker et al. | Sep 1998 | A |
| 5807336 | Russo et al. | Sep 1998 | A |
| 5819229 | Boppe | Oct 1998 | A |
| 5822418 | Yacenda et al. | Oct 1998 | A |
| 5822544 | Chaco et al. | Oct 1998 | A |
| 5832488 | Eberhardt | Nov 1998 | A |
| 5833599 | Schrier et al. | Nov 1998 | A |
| 5842173 | Strum et al. | Nov 1998 | A |
| 5842976 | Williamson | Dec 1998 | A |
| 5845253 | Rensimer et al. | Dec 1998 | A |
| 5845254 | Lockwood et al. | Dec 1998 | A |
| 5845255 | Mayaud | Dec 1998 | A |
| 5845264 | Nellhaus | Dec 1998 | A |
| 5848593 | McGrady et al. | Dec 1998 | A |
| 5850344 | Conkright | Dec 1998 | A |
| 5852408 | Christiansen et al. | Dec 1998 | A |
| 5855550 | Lai et al. | Jan 1999 | A |
| 5867821 | Ballantyne et al. | Feb 1999 | A |
| 5871465 | Vasko | Feb 1999 | A |
| 5883806 | Meador et al. | Mar 1999 | A |
| 5885245 | Lynch et al. | Mar 1999 | A |
| 5894273 | Meador et al. | Apr 1999 | A |
| 5895371 | Levitas et al. | Apr 1999 | A |
| 5899998 | McGauley et al. | May 1999 | A |
| 5903211 | Flego et al. | May 1999 | A |
| 5905653 | Higham et al. | May 1999 | A |
| 5907490 | Oliver | May 1999 | A |
| 5911132 | Sloane | Jun 1999 | A |
| 5911687 | Sato et al. | Jun 1999 | A |
| 5912818 | McGrady et al. | Jun 1999 | A |
| 5920054 | Uber, III | Jul 1999 | A |
| 5920263 | Huttenhoff et al. | Jul 1999 | A |
| 5928329 | Clark et al. | Jul 1999 | A |
| 5930145 | Yuyama et al. | Jul 1999 | A |
| 5935099 | Peterson et al. | Aug 1999 | A |
| 5941710 | Lampotang et al. | Aug 1999 | A |
| 5942986 | Shabot et al. | Aug 1999 | A |
| 5950630 | Portwood et al. | Sep 1999 | A |
| 5950632 | Reber et al. | Sep 1999 | A |
| 5953099 | Walach | Sep 1999 | A |
| 5954641 | Kehr et al. | Sep 1999 | A |
| 5957885 | Bollish et al. | Sep 1999 | A |
| 5961036 | Michael et al. | Oct 1999 | A |
| 5961446 | Beller et al. | Oct 1999 | A |
| 5971593 | McGrady | Oct 1999 | A |
| 5985371 | Fujioka et al. | Nov 1999 | A |
| 5995077 | Wilcox et al. | Nov 1999 | A |
| 5995937 | DeBusk et al. | Nov 1999 | A |
| 6000828 | Leet | Dec 1999 | A |
| 6003006 | Colella et al. | Dec 1999 | A |
| 6009333 | Chaco | Dec 1999 | A |
| 6017318 | Gauthier et al. | Jan 2000 | A |
| 6021392 | Lester et al. | Feb 2000 | A |
| 6024699 | Surwit et al. | Feb 2000 | A |
| 6032155 | de la Huerga | Feb 2000 | A |
| 6039251 | Holowko et al. | Mar 2000 | A |
| 6047203 | Sackner et al. | Apr 2000 | A |
| 6048087 | Laurent et al. | Apr 2000 | A |
| 6053887 | Levitas et al. | Apr 2000 | A |
| 6063026 | Schauss et al. | May 2000 | A |
| 6082776 | Feinberg | Jul 2000 | A |
| 6112182 | Akers et al. | Aug 2000 | A |
| RE36871 | Epstein et al. | Sep 2000 | E |
| 6112502 | Frederick et al. | Sep 2000 | A |
| 6134582 | Kennedy | Oct 2000 | A |
| 6135949 | Russo et al. | Oct 2000 | A |
| 6202923 | Boyer et al. | Mar 2001 | B1 |
| 6228057 | Vasko | May 2001 | B1 |
| 6241704 | Peterson et al. | Jun 2001 | B1 |
| 6269340 | Ford et al. | Jul 2001 | B1 |
| 6282441 | Raymond et al. | Aug 2001 | B1 |
| 6290681 | Brown | Sep 2001 | B1 |
| 6292698 | Duffin et al. | Sep 2001 | B1 |
| 6302844 | Walker et al. | Oct 2001 | B1 |
| 6312378 | Bardy | Nov 2001 | B1 |
| 6314556 | DeBusk et al. | Nov 2001 | B1 |
| 6319200 | Lai et al. | Nov 2001 | B1 |
| 6322502 | Schoenberg et al. | Nov 2001 | B1 |
| 6338007 | Broadfield et al. | Jan 2002 | B1 |
| 6339732 | Phoon et al. | Jan 2002 | B1 |
| 6406426 | Reuss et al. | Jun 2002 | B1 |
| 6409684 | Wilk | Jun 2002 | B1 |
| 6421650 | Goetz et al. | Jul 2002 | B1 |
| 6493747 | Simmon et al. | Dec 2002 | B2 |
| 6519569 | White et al. | Feb 2003 | B1 |
| 6529892 | Lambert | Mar 2003 | B1 |
| 6540672 | Simonsen et al. | Apr 2003 | B1 |
| 6558352 | Hogan | May 2003 | B1 |
| 6571128 | Lebel et al. | May 2003 | B2 |
| 6581606 | Kutzko et al. | Jun 2003 | B2 |
| 6671563 | Engelson et al. | Dec 2003 | B1 |
| 6745764 | Hickle | Jun 2004 | B2 |
| 6757898 | Ilsen et al. | Jul 2004 | B1 |
| 6785589 | Eggenberger et al. | Aug 2004 | B2 |
| 6796956 | Hartlaub et al. | Sep 2004 | B2 |
| 6799149 | Hartlaub | Sep 2004 | B2 |
| 6847861 | Lunak et al. | Jan 2005 | B2 |
| 6856247 | Wallace | Feb 2005 | B1 |
| 6873268 | Lebel et al. | Mar 2005 | B2 |
| 6993402 | Klass et al. | Jan 2006 | B2 |
| 7034691 | Rapaport et al. | Apr 2006 | B1 |
| 7054844 | Fletcher et al. | May 2006 | B2 |
| 7060059 | Keith et al. | Jun 2006 | B2 |
| 7096072 | Engleson et al. | Aug 2006 | B2 |
| 7201734 | Hickle | Apr 2007 | B2 |
| 7204823 | Estes et al. | Apr 2007 | B2 |
| 7215991 | Besson et al. | May 2007 | B2 |
| 7229430 | Hickle et al. | Jun 2007 | B2 |
| 7230529 | Ketcherside, Jr. et al. | Jun 2007 | B2 |
| 7256708 | Rosenfeld et al. | Aug 2007 | B2 |
| 7263492 | Suresh et al. | Aug 2007 | B1 |
| 7379885 | Zakim | May 2008 | B1 |
| 7384420 | Dycus et al. | Jun 2008 | B2 |
| 7398183 | Holland et al. | Jul 2008 | B2 |
| 7421709 | Watson et al. | Sep 2008 | B2 |
| 7433853 | Brockway et al. | Oct 2008 | B2 |
| 7443303 | Spear et al. | Oct 2008 | B2 |
| 7471994 | Ford et al. | Dec 2008 | B2 |
| 7526769 | Watts, Jr. et al. | Apr 2009 | B2 |
| 7587415 | Guarav et al. | Sep 2009 | B2 |
| 7612679 | Fackler et al. | Nov 2009 | B1 |
| 7649454 | Singh et al. | Jan 2010 | B2 |
| 7693697 | Westenskow et al. | Apr 2010 | B2 |
| 7734478 | Goodall et al. | Jun 2010 | B2 |
| 7769601 | Bleser et al. | Aug 2010 | B1 |
| 7771385 | Eggers et al. | Aug 2010 | B2 |
| 7771386 | Eggers et al. | Aug 2010 | B2 |
| 7776031 | Hartlaub et al. | Aug 2010 | B2 |
| 7787946 | Stahmann et al. | Aug 2010 | B2 |
| 7796045 | Spear et al. | Sep 2010 | B2 |
| 7835927 | Schlotterbeck et al. | Nov 2010 | B2 |
| 7847970 | McGrady | Dec 2010 | B1 |
| 7860583 | Condurso et al. | Dec 2010 | B2 |
| 7860724 | Chudy et al. | Dec 2010 | B2 |
| 7962544 | Torok et al. | Jun 2011 | B2 |
| 7970550 | Arakelyan et al. | Jun 2011 | B2 |
| 7983995 | Murphy et al. | Jul 2011 | B2 |
| 8005688 | Coffman et al. | Aug 2011 | B2 |
| 8024200 | Jennings et al. | Sep 2011 | B2 |
| 8027749 | Vahlberg et al. | Sep 2011 | B2 |
| 8160895 | Schmitt et al. | Apr 2012 | B2 |
| 8197437 | Kalafut et al. | Jun 2012 | B2 |
| 8239062 | Vahlberg et al. | Aug 2012 | B2 |
| 8244594 | Barron | Aug 2012 | B2 |
| 8284059 | Ross | Oct 2012 | B2 |
| 8291337 | Gannin et al. | Oct 2012 | B2 |
| 8321236 | Goodall et al. | Nov 2012 | B2 |
| 8340792 | Condurso et al. | Dec 2012 | B2 |
| 8606596 | Bochenko | Dec 2013 | B1 |
| 8655751 | Renz | Feb 2014 | B2 |
| 8666774 | Gonzales, Jr. et al. | Mar 2014 | B1 |
| 8689008 | Rangadass et al. | Apr 2014 | B2 |
| 10192193 | Glass | Jan 2019 | B1 |
| 10335953 | Davey | Jul 2019 | B2 |
| 10417758 | Alexander | Sep 2019 | B1 |
| 10692207 | Sandmann et al. | Jun 2020 | B2 |
| 20010037083 | Hartlaub et al. | Nov 2001 | A1 |
| 20010044731 | Coffman et al. | Nov 2001 | A1 |
| 20020010679 | Felsher | Jan 2002 | A1 |
| 20020013640 | Phoon et al. | Jan 2002 | A1 |
| 20020016568 | Lebel et al. | Feb 2002 | A1 |
| 20020016923 | Knaus et al. | Feb 2002 | A1 |
| 20020022973 | Sun et al. | Feb 2002 | A1 |
| 20020026223 | Riff et al. | Feb 2002 | A1 |
| 20020032582 | Feeney et al. | Mar 2002 | A1 |
| 20020035484 | McCormick | Mar 2002 | A1 |
| 20020038392 | De La Huerga | Mar 2002 | A1 |
| 20020042636 | Koshiol et al. | Apr 2002 | A1 |
| 20020046346 | Evans | Apr 2002 | A1 |
| 20020077849 | Baruch et al. | Jun 2002 | A1 |
| 20020087114 | Hartlaub | Jul 2002 | A1 |
| 20020116509 | De La Huerga | Aug 2002 | A1 |
| 20020120350 | Klass et al. | Aug 2002 | A1 |
| 20020169636 | Eggers et al. | Nov 2002 | A1 |
| 20020198624 | Greenwald et al. | Dec 2002 | A1 |
| 20030009244 | Engleson et al. | Jan 2003 | A1 |
| 20030018495 | Sussman | Jan 2003 | A1 |
| 20030036683 | Kehr et al. | Feb 2003 | A1 |
| 20030036966 | Amra et al. | Feb 2003 | A1 |
| 20030045858 | Struys et al. | Mar 2003 | A1 |
| 20030051737 | Hickle et al. | Mar 2003 | A1 |
| 20030063524 | Niemiec et al. | Apr 2003 | A1 |
| 20030069481 | Hervy et al. | Apr 2003 | A1 |
| 20030098991 | Laverty et al. | May 2003 | A1 |
| 20030105389 | Noonan et al. | Jun 2003 | A1 |
| 20030105555 | Lunak et al. | Jun 2003 | A1 |
| 20030106553 | Vanderveen | Jun 2003 | A1 |
| 20030114836 | Estes et al. | Jun 2003 | A1 |
| 20030121517 | McFarland | Jul 2003 | A1 |
| 20030129578 | Mault | Jul 2003 | A1 |
| 20030135087 | Hickle et al. | Jul 2003 | A1 |
| 20030135388 | Martucci et al. | Jul 2003 | A1 |
| 20030139701 | White et al. | Jul 2003 | A1 |
| 20030140928 | Bui et al. | Jul 2003 | A1 |
| 20030140929 | Wilkes et al. | Jul 2003 | A1 |
| 20030149599 | Goodall et al. | Aug 2003 | A1 |
| 20030156143 | Westenskow et al. | Aug 2003 | A1 |
| 20030158746 | Forrester | Aug 2003 | A1 |
| 20030163223 | Blomquist | Aug 2003 | A1 |
| 20030205897 | Kaufman | Nov 2003 | A1 |
| 20030236683 | Henderson et al. | Dec 2003 | A1 |
| 20040046020 | Andreasson et al. | Mar 2004 | A1 |
| 20040068229 | Jansen et al. | Apr 2004 | A1 |
| 20040073329 | Engleson et al. | Apr 2004 | A1 |
| 20040088187 | Chudy et al. | May 2004 | A1 |
| 20040107118 | Harnsberger et al. | Jun 2004 | A1 |
| 20040122702 | Sabol et al. | Jun 2004 | A1 |
| 20040122705 | Sabol et al. | Jun 2004 | A1 |
| 20040122719 | Sabol et al. | Jun 2004 | A1 |
| 20040122790 | Walker et al. | Jun 2004 | A1 |
| 20040128162 | Schlotterbeck et al. | Jul 2004 | A1 |
| 20040152622 | Keith et al. | Aug 2004 | A1 |
| 20040167465 | Mihai et al. | Aug 2004 | A1 |
| 20040167804 | Simpson et al. | Aug 2004 | A1 |
| 20040172283 | Vanderveen et al. | Sep 2004 | A1 |
| 20040172300 | Mihai et al. | Sep 2004 | A1 |
| 20040172302 | Martucci et al. | Sep 2004 | A1 |
| 20040176297 | Cheung et al. | Sep 2004 | A1 |
| 20040188998 | Henthorn | Sep 2004 | A1 |
| 20040193325 | Bonderud et al. | Sep 2004 | A1 |
| 20040193446 | Mayer et al. | Sep 2004 | A1 |
| 20040260478 | Schwamm | Dec 2004 | A1 |
| 20050010166 | Hickle | Jan 2005 | A1 |
| 20050010269 | Lebel et al. | Jan 2005 | A1 |
| 20050020996 | Hartlaub et al. | Jan 2005 | A1 |
| 20050021297 | Hartlaub | Jan 2005 | A1 |
| 20050022274 | Campbell et al. | Jan 2005 | A1 |
| 20050033606 | Miller | Feb 2005 | A1 |
| 20050049179 | Davidson et al. | Mar 2005 | A1 |
| 20050055242 | Bello et al. | Mar 2005 | A1 |
| 20050088296 | Lee | Apr 2005 | A1 |
| 20050096941 | Tong | May 2005 | A1 |
| 20050097566 | Watts et al. | May 2005 | A1 |
| 20050107914 | Engleson et al. | May 2005 | A1 |
| 20050108057 | Cohen et al. | May 2005 | A1 |
| 20050113945 | Engleson et al. | May 2005 | A1 |
| 20050119788 | Engleson et al. | Jun 2005 | A1 |
| 20050144043 | Holland et al. | Jun 2005 | A1 |
| 20050145010 | Vanderveen et al. | Jul 2005 | A1 |
| 20050148890 | Hastings | Jul 2005 | A1 |
| 20050171815 | Vanderveen | Aug 2005 | A1 |
| 20050224083 | Crass et al. | Oct 2005 | A1 |
| 20050278194 | Holland et al. | Dec 2005 | A1 |
| 20060026205 | Butterfield | Feb 2006 | A1 |
| 20060047538 | Condurso et al. | Mar 2006 | A1 |
| 20060053036 | Coffman et al. | Mar 2006 | A1 |
| 20060079831 | Gilbert | Apr 2006 | A1 |
| 20060101072 | Busche et al. | May 2006 | A1 |
| 20060122481 | Sievenpiper et al. | Jun 2006 | A1 |
| 20060122729 | Murphy et al. | Jun 2006 | A1 |
| 20060149416 | Mohapatra et al. | Jul 2006 | A1 |
| 20060178812 | Affleck et al. | Aug 2006 | A1 |
| 20060190302 | Eggers et al. | Aug 2006 | A1 |
| 20060200369 | Batch et al. | Sep 2006 | A1 |
| 20060206356 | Vanderveen | Sep 2006 | A1 |
| 20060217628 | Huiku | Sep 2006 | A1 |
| 20060218015 | Walker et al. | Sep 2006 | A1 |
| 20060229551 | Martinez et al. | Oct 2006 | A1 |
| 20060249423 | Reijonen | Nov 2006 | A1 |
| 20060271401 | Lassetter et al. | Nov 2006 | A1 |
| 20060287890 | Stead et al. | Dec 2006 | A1 |
| 20070015972 | Wang et al. | Jan 2007 | A1 |
| 20070043767 | Osborne et al. | Feb 2007 | A1 |
| 20070061266 | Moore et al. | Mar 2007 | A1 |
| 20070061393 | Moore | Mar 2007 | A1 |
| 20070083389 | Dyer et al. | Apr 2007 | A1 |
| 20070106457 | Rosenberg | May 2007 | A1 |
| 20070106753 | Moore | May 2007 | A1 |
| 20070106754 | Moore | May 2007 | A1 |
| 20070129647 | Lynn | Jun 2007 | A1 |
| 20070156452 | Batch | Jul 2007 | A1 |
| 20070156860 | Nedelcu et al. | Jul 2007 | A1 |
| 20070168301 | Eisner et al. | Jul 2007 | A1 |
| 20070185615 | Bossi et al. | Aug 2007 | A1 |
| 20070208454 | Forrester et al. | Sep 2007 | A1 |
| 20070210157 | Miller | Sep 2007 | A1 |
| 20070286466 | Heffernan et al. | Dec 2007 | A1 |
| 20070293843 | Ireland et al. | Dec 2007 | A1 |
| 20080015549 | Maughan | Jan 2008 | A1 |
| 20080025230 | Patel et al. | Jan 2008 | A1 |
| 20080034323 | Blomquist | Feb 2008 | A1 |
| 20080040151 | Moore | Feb 2008 | A1 |
| 20080046292 | Myers et al. | Feb 2008 | A1 |
| 20080141272 | Borgendale et al. | Jun 2008 | A1 |
| 20080162254 | Herger et al. | Jul 2008 | A1 |
| 20080164998 | Scherpbier et al. | Jul 2008 | A1 |
| 20080169045 | Tribble et al. | Jul 2008 | A1 |
| 20080195246 | Tribble et al. | Aug 2008 | A1 |
| 20080195416 | Tribble et al. | Aug 2008 | A1 |
| 20080272138 | Ross et al. | Nov 2008 | A1 |
| 20080317672 | Viertio-Oja | Dec 2008 | A1 |
| 20080319795 | Poteet et al. | Dec 2008 | A1 |
| 20090012812 | Rausch et al. | Jan 2009 | A1 |
| 20090012813 | Berzansky et al. | Jan 2009 | A1 |
| 20090043253 | Podaima | Feb 2009 | A1 |
| 20090043611 | Nadas et al. | Feb 2009 | A1 |
| 20090054754 | McMahon et al. | Feb 2009 | A1 |
| 20090099867 | Newman | Apr 2009 | A1 |
| 20090112333 | Sahal | Apr 2009 | A1 |
| 20090125335 | Manetta et al. | May 2009 | A1 |
| 20090144078 | Bajars et al. | Jun 2009 | A1 |
| 20090150484 | Roberts | Jun 2009 | A1 |
| 20090210252 | Silver | Aug 2009 | A1 |
| 20090240651 | Fletcher et al. | Sep 2009 | A1 |
| 20090272677 | Mallett et al. | Nov 2009 | A1 |
| 20090306585 | Pang et al. | Dec 2009 | A1 |
| 20090306944 | Willmann et al. | Dec 2009 | A1 |
| 20090319623 | Srinivasan et al. | Dec 2009 | A1 |
| 20100037067 | Rangadass et al. | Feb 2010 | A1 |
| 20100042437 | Levy et al. | Feb 2010 | A1 |
| 20100082458 | Godlewski | Apr 2010 | A1 |
| 20100094653 | Tribble et al. | Apr 2010 | A1 |
| 20100121654 | Portnoy et al. | May 2010 | A1 |
| 20100161113 | Tribble et al. | Jun 2010 | A1 |
| 20100169120 | Herbst et al. | Jul 2010 | A1 |
| 20100169771 | Pelegrin et al. | Jul 2010 | A1 |
| 20100174552 | Hawkes et al. | Jul 2010 | A1 |
| 20100174553 | Kaufman et al. | Jul 2010 | A1 |
| 20100179825 | Hanov et al. | Jul 2010 | A1 |
| 20100241453 | Malec | Sep 2010 | A1 |
| 20100241456 | Miller et al. | Sep 2010 | A1 |
| 20100271218 | Hoag et al. | Oct 2010 | A1 |
| 20100280840 | Fukushi et al. | Nov 2010 | A1 |
| 20100323397 | Reavy et al. | Dec 2010 | A1 |
| 20110015941 | Backhaus | Jan 2011 | A1 |
| 20110046975 | Hoffman | Feb 2011 | A1 |
| 20110060758 | Schlotterbeck et al. | Mar 2011 | A1 |
| 20110078608 | Gannon et al. | Mar 2011 | A1 |
| 20110119612 | Gannon et al. | May 2011 | A1 |
| 20110179405 | Dicks et al. | Jul 2011 | A1 |
| 20110202495 | Gawlick | Aug 2011 | A1 |
| 20110257991 | Shukla | Oct 2011 | A1 |
| 20110282691 | Coffman et al. | Nov 2011 | A1 |
| 20110288882 | Halow | Nov 2011 | A1 |
| 20110313787 | Rangadass et al. | Dec 2011 | A1 |
| 20120011253 | Friedman et al. | Jan 2012 | A1 |
| 20120016215 | Condurso et al. | Jan 2012 | A1 |
| 20120041775 | Cosentino et al. | Feb 2012 | A1 |
| 20120053533 | Butterfield et al. | Mar 2012 | A1 |
| 20120075060 | Connor | Mar 2012 | A1 |
| 20120075061 | Barnes | Mar 2012 | A1 |
| 20120136673 | Presley et al. | May 2012 | A1 |
| 20120173254 | Korhnak et al. | Jul 2012 | A1 |
| 20120173264 | Brush et al. | Jul 2012 | A1 |
| 20120173391 | Korhnak et al. | Jul 2012 | A1 |
| 20120179006 | Jansen et al. | Jul 2012 | A1 |
| 20120182939 | Rajan et al. | Jul 2012 | A1 |
| 20120185267 | Kamen et al. | Jul 2012 | A1 |
| 20120185277 | Tribble et al. | Jul 2012 | A1 |
| 20120191052 | Rao | Jul 2012 | A1 |
| 20120205441 | Utech et al. | Aug 2012 | A1 |
| 20120239422 | Chudy et al. | Sep 2012 | A1 |
| 20120239824 | Nguyen et al. | Sep 2012 | A1 |
| 20120241043 | Perazzo | Sep 2012 | A1 |
| 20120247480 | Varga | Oct 2012 | A1 |
| 20120253835 | Tracy et al. | Oct 2012 | A1 |
| 20120265549 | Virolainen | Oct 2012 | A1 |
| 20130006652 | Vahlberg et al. | Jan 2013 | A1 |
| 20130018356 | Prince et al. | Jan 2013 | A1 |
| 20130085771 | Ghanbari et al. | Apr 2013 | A1 |
| 20130096444 | Condurso et al. | Apr 2013 | A1 |
| 20130197927 | Vanderveen et al. | Aug 2013 | A1 |
| 20130197928 | Vanderveen et al. | Aug 2013 | A1 |
| 20130197929 | Vanderveen et al. | Aug 2013 | A1 |
| 20130197930 | Garibaldi et al. | Aug 2013 | A1 |
| 20130197931 | Gupta et al. | Aug 2013 | A1 |
| 20130204433 | Gupta et al. | Aug 2013 | A1 |
| 20130204637 | Vanderveen et al. | Aug 2013 | A1 |
| 20130226600 | Barfield | Aug 2013 | A1 |
| 20130262138 | Jaskela et al. | Oct 2013 | A1 |
| 20130282401 | Summers | Oct 2013 | A1 |
| 20140028464 | Garibaldi | Jan 2014 | A1 |
| 20140100868 | Condurso et al. | Apr 2014 | A1 |
| 20140108028 | Braun | Apr 2014 | A1 |
| 20140278466 | Simmons et al. | Sep 2014 | A1 |
| 20140297313 | Condurso et al. | Oct 2014 | A1 |
| 20140350950 | Jaskela et al. | Nov 2014 | A1 |
| 20150250948 | Gupta et al. | Sep 2015 | A1 |
| 20160000997 | Batch et al. | Jan 2016 | A1 |
| 20160114925 | Yuyama | Apr 2016 | A1 |
| Number | Date | Country |
|---|---|---|
| 2472098 | Jul 2003 | CA |
| 2554903 | Apr 2005 | CA |
| 1421810 | Jun 2003 | CN |
| 1650317 | Aug 2005 | CN |
| 1759398 | Apr 2006 | CN |
| 101116077 | Jan 2008 | CN |
| 101146055 | Mar 2008 | CN |
| 201110955 | Sep 2008 | CN |
| 101331491 | Dec 2008 | CN |
| 101689320 | Mar 2010 | CN |
| 101890193 | Nov 2010 | CN |
| 102068725 | May 2011 | CN |
| 102508877 | Jun 2012 | CN |
| 102521394 | Jun 2012 | CN |
| 102688532 | Sep 2012 | CN |
| 102799783 | Nov 2012 | CN |
| 4023785 | Jan 1992 | DE |
| 0192786 | Sep 1986 | EP |
| 0384155 | Aug 1990 | EP |
| 0595474 | May 1994 | EP |
| 0649316 | Apr 1995 | EP |
| 0652528 | May 1995 | EP |
| 0784283 | Jul 1997 | EP |
| 0921488 | Jun 1999 | EP |
| 1003121 | May 2000 | EP |
| 1018347 | Jul 2000 | EP |
| 1237113 | Sep 2002 | EP |
| 1750573 | Feb 2007 | EP |
| 2141006 | Dec 1984 | GB |
| 62114562 | May 1987 | JP |
| S82114562 | May 1987 | JP |
| 5168708 | Jul 1993 | JP |
| 11505352 | May 1999 | JP |
| H11505352 | May 1999 | JP |
| 2002520718 | Jul 2002 | JP |
| 2003085283 | Mar 2003 | JP |
| 2004287616 | Oct 2004 | JP |
| 2005165442 | Jun 2005 | JP |
| 2005296428 | Oct 2005 | JP |
| 2006155070 | Jun 2006 | JP |
| 2006521183 | Sep 2006 | JP |
| 2008508616 | Mar 2008 | JP |
| 2008516303 | May 2008 | JP |
| 2011501311 | Jan 2011 | JP |
| 2012200430 | Oct 2012 | JP |
| 20070045611 | May 2007 | KR |
| 1020070045611 | May 2007 | KR |
| 10073826381 | Jul 2007 | KR |
| 20080013129 | Feb 2008 | KR |
| 1020080013129 | Feb 2008 | KR |
| 100847397 | Jul 2008 | KR |
| 20100049549 | May 2010 | KR |
| 1020100049549 | May 2010 | KR |
| 20100125972 | Dec 2010 | KR |
| 1020100125972 | Dec 2010 | KR |
| 20110070824 | Jun 2011 | KR |
| 1020110070824 | Jun 2011 | KR |
| 20120070045 | Jun 2012 | KR |
| 20120076615 | Jul 2012 | KR |
| 20120078635 | Jul 2012 | KR |
| 1020120076615 | Jul 2012 | KR |
| 1020120076635 | Jul 2012 | KR |
| 522631 | Jul 2004 | NZ |
| WO-1993022735 | Nov 1993 | WO |
| WO-1994005344 | Mar 1994 | WO |
| WO-1994008647 | Apr 1994 | WO |
| WO-1994013250 | Jun 1994 | WO |
| WO-1995023378 | Aug 1995 | WO |
| WO-1996020745 | Jul 1996 | WO |
| WO-1996025214 | Aug 1996 | WO |
| WO-1996036923 | Nov 1996 | WO |
| WO-1997004712 | Feb 1997 | WO |
| WO-1998013783 | Apr 1998 | WO |
| WO-1998028676 | Jul 1998 | WO |
| WO-1999009505 | Feb 1999 | WO |
| WO-1999010829 | Mar 1999 | WO |
| WO-1999010830 | Mar 1999 | WO |
| WO-1999035588 | Jul 1999 | WO |
| WO-1999044167 | Sep 1999 | WO |
| WO-1999045490 | Sep 1999 | WO |
| WO-1999046718 | Sep 1999 | WO |
| WO-1999067732 | Dec 1999 | WO |
| WO-2000003344 | Jan 2000 | WO |
| WO-2000004521 | Jan 2000 | WO |
| WO-2000018449 | Apr 2000 | WO |
| WO-2000032088 | Jun 2000 | WO |
| WO-2000032098 | Jun 2000 | WO |
| WO-2001039874 | Jun 2001 | WO |
| WO-2001086506 | Nov 2001 | WO |
| WO-2001088828 | Nov 2001 | WO |
| WO-2002036044 | May 2002 | WO |
| WO-2002053209 | Jul 2002 | WO |
| WO-2002069099 | Sep 2002 | WO |
| WO-2003038566 | May 2003 | WO |
| WO-2003053503 | Jul 2003 | WO |
| WO-2003092769 | Nov 2003 | WO |
| WO-2003094091 | Nov 2003 | WO |
| WO-2004060443 | Jul 2004 | WO |
| WO-2004061745 | Jul 2004 | WO |
| WO-2005110208 | Nov 2005 | WO |
| WO-2006055515 | May 2006 | WO |
| WO-2008087982 | Jul 2008 | WO |
| WO-2008112731 | Sep 2008 | WO |
| WO-2010124016 | Oct 2010 | WO |
| WO-2010124137 | Oct 2010 | WO |
| WO-2010124328 | Nov 2010 | WO |
| WO-2011064712 | May 2011 | WO |
| WO-2012095829 | Jul 2012 | WO |
| WO-2014159280 | Oct 2014 | WO |
| Entry |
|---|
| Optimising workflow processes in an advanced medication dispensary by Amanda Y. Leong, Mary Pederson, Science Direct, ElSevier, vol. 14, Issue 11, pp. 1072-1079, Nov. 2018 (Year: 2018). |
| Brazilian Office Action for Application No. BR112015029135-0, issued Aug. 30, 2022, 10 pages including translation. |
| Canadian Office Action for Application No. 2901024, dated Jul. 20, 2022, 5 pages. |
| Chinese Office Action for Application No. 202111564727.9, dated Aug. 17, 2022, 14 pages including translation. |
| “General-Purpose Infusion Pumps,” Evaluation—Health Devices, Oct. 2002, pp. 353-387, vol. 31 (10), ECRI Institute. |
| “Infusion Pump Technology,” Health Devices, Apr.-May 1998, pp. 150-170, vol. 27(4-5), ECRI Institute. |
| “Infusion Pumps, General Purpose,” Healthcare Product Comparison System, 2007, pp. 1-54, ECRI Institute. |
| “Infusion Pumps, Large-Volume,” Healthcare Product Comparison System, 2010, pp. 1-51, ECRI Institute. |
| “Smart Infusion Pumps Join CPOE and Bar Coding as Important Ways to Prevent Medication Errors,” ISMP—Medication Safety Alert, Feb. 7, 2002, 2 pgs., Institute for Safe Medication Practices. |
| “Pandora Analytics”, Pandora Healthcare Data Analytics by Omnicell, retrieved from , retrieved Jul. 10, 2013, pp. 1-4, Omnicell, Inc. |
| “Welcome to Medacist Solutions Group, LLC”, Medacist—The Key to Healthcare Automation, retrieved from , retrieved Jul. 10, 2013, 1 page, Medacist Solutions Group, LLC. |
| Amanda Y. Leong, Mary Pederson, Optimising workflow processes in an advanced medication dispensary, Nov. 2018, Research in Social and Administrative Pharmacy, ScienceDirect, ELSEVIER, vol. 14, issue 11, pp. 1072-1079 (Year: 2017). |
| Anonymous, “Pyxis MedStation™ 4000 System. Console User Guide” In: “Part No. 127157-06”, Nov. 1, 2010, Cardinal Health, XP2055121062, pp. 1-228. p. 21-22. p. 38-61, p. 123-125, p. 157-166, p. 200, p. 216. |
| Anonymous, Guardrails® Safety Software—Medley TM Medication Safety System, Alaris Medical Systems XP-00234431; 2002 Alaris Medical Systems Inc. Nov. 2002, SSM @2159C. |
| Australia Office Action for Application No. 2014268828, dated Jul. 3, 2020, 5 pages. |
| Australian Decision Issued for Application No. 2014268828, dated Feb. 26, 2021, 30 pages. |
| Australian Examination Report No. 1 for Application No. 2016216550, dated Sep. 20, 2017, 3 pages. |
| Australian Office Action for Application No. 2014241019, dated Aug. 12, 2019, 4 pages. |
| Australian Office Action for Application No. 2014241019, dated Dec. 5, 2019, 5 pages. |
| Australian Office Action for Application No. 2014241019, dated Feb. 6, 2019, 3 pages. |
| Australian Office Action for Application No. 2014241022, dated Feb. 7, 2019, 4 pages. |
| Australian Office Action for Application No. 2014241022, dated Jun. 25, 2019, 3 pages. |
| Australian Office Action for Application No. 2020203449, dated May 26, 2021, 5 pages. |
| Baldauf-Sobez et al., “How Siemens' Computerized Physician Order Entry Helps Prevent the Human Errors,” electromedica, vol. 71, No. 1, 2003, pp. 2-10. |
| Brazil Office Action for Application No. BR112015019758-2, dated Feb. 20, 2020, 5 pages. |
| Brazil Office Action for Application No. BR112015029135-0, dated Feb. 12, 2020, 5 pages. |
| Calabrese, et al., “Medication administration errors in adult patients in the ICU,” Intensive Care Med, 2001, pp. 1592-1598, vol. 27, Springer-Verlag. |
| Canada Office Action for Application No. 2900564, dated Jan. 28, 2020, 4 pages. |
| Canadian Office Action for Application No. 2512991, dated Jan. 10, 2018, 4 pages. |
| Canadian Office Action for Application No. 2512991, dated Mar. 2, 2017, 4 pages. |
| Canadian Office Action for Application No. 2551903, dated Aug. 18, 2020, 3 pages. |
| Canadian Office Action for Application No. 2551903, dated Mar. 28, 2017, 7 pages. |
| Canadian Office Action for Application No. 2551903, dated Mar. 5, 2018, 8 pages. |
| Canadian Office Action for Application No. 2828898, dated Aug. 25, 2021, 5 pages. |
| Canadian Office Action for Application No. 2828898, dated Dec. 3, 2019, 6 pages. |
| Canadian Office Action for Application No. 2828898, dated Dec. 7, 2018, 5 pages. |
| Canadian Office Action for Application No. 2828898, dated Jan. 11, 2018, 8 pages. |
| Canadian Office Action for Application No. 2828898, dated Oct. 7, 2020, 7 pages. |
| Canadian Office Action for Application No. 2900564, dated Nov. 19, 2020, 4 pages. |
| Canadian Office Action for Application No. 2901024, dated Aug. 25, 2021, 6 pages. |
| Canadian Office Action for Application No. 2901024, dated Jan. 27, 2020, 5 pages. |
| Canadian Office Action for Application No. 2901024, dated Nov. 20, 2020, 6 pages. |
| Canadian Office Action for Application No. 2912792, dated Mar. 1, 2021, 7 pages. |
| Chinese Notice of Reexamination for Application No. 201480015025.7, dated Aug. 20, 2021, 29 pages including translation. |
| Chinese Notice of Reexamination for Application No. 201480015036.5, dated Jul. 29, 2021, 32 pages including machine translation. |
| Chinese Office Action for Application No. 2 1480041362.3, dated Oct. 18, 2018, 13 pages. |
| Chinese Office Action for Application No. 201480015025.7, dated Jan. 23, 2018, 11 pages excluding English summary. |
| Chinese Office Action for Application No. 201480015025.7, dated Jun. 24, 2019, 25 pages. |
| Chinese Office Action for Application No. 201480015025.7, dated Nov. 12, 2019, 20 pages. |
| Chinese Office Action for Application No. 201480015025.7, dated Oct. 9, 2018, 27 pages. |
| Chinese Office Action for Application No. 201480015036.5, dated Jan. 23, 2018, 13 pages excluding English translation. |
| Chinese Office Action for Application No. 201480015036.5, dated Jun. 24, 2019, 20 pages. |
| Chinese Office Action for Application No. 201480015036.5, dated Nov. 5, 2019, 12 pages. |
| Chinese Office Action for Application No. 201480015036.5, dated Sep. 29, 2018, 20 pages. |
| Chinese Office Action for Application No. 201480015093.3, dated Apr. 25, 2019, 18 pages. |
| Chinese Office Action for Application No. 201480015093.3, dated Dec. 4, 2019, 17 pages. |
| Chinese Office Action for Application No. 201480015147.6, dated Mar. 10, 2017, 10 pages excluding translation. |
| Chinese Office Action for Application No. 201480015147.6, dated May 3, 2018, 6 pages. |
| Chinese Office Action for Application No. 201480015147.6, dated Nov. 16, 2017, 8 pages. |
| Chinese Office Action for Application No. 201480041362.3 dated Apr. 4, 2019, 19 pages. |
| Chinese Office Action for Application No. 201480041362.3, dated Aug. 5, 2019, 13 pages. |
| Chinese Office Action for Application No. 201480041362.3, dated Oct. 18, 2018, 13 pages. |
| Chinese Office Action for Application No. 201480041985.0, dated Apr. 3, 2019, 12 pages. |
| Chinese Office Action for Application No. 201480041985.0, dated Jun. 2, 2021, 4 pages including translation. |
| Chinese Office Action for Application No. 201480041985.0, dated May 15, 2020, 23 pages. |
| Chinese Office Action for Application No. 201480041985.0, dated Sep. 23, 2019, 24 pages. |
| Chinese Office Action for Application No. 201480041985.0, dated Sep. 3, 2020, 38 pages. |
| Eskew, James et al., Using Innovative Technologies to Set New Safety Standards For the Infusion of Intravenous Medications, Hospital Pharmacy, vol. 37, No. 11, pp. 1179-1189, 2002, Facts and Comparisons. |
| European Communication for Application No. 14779655.1, dated Oct. 2, 2019, 12 pages. |
| European Communication of the Board of Appeal for Application No. 05791269.3, dated Nov. 10, 2017, 7 pages. |
| European Office Action for Application No. 12756903.6, dated Apr. 19, 2017, 5 pages. |
| European Office Action for Application No. 14772937.0, dated Apr. 19, 2018, 9 pages. |
| European Office Action for Application No. 14775918.7, dated Dec. 20, 2017, 8 pages. |
| European Office Action for Application No. 14779655.1, dated Jul. 28, 2017, 6 pages. |
| European Office Action for Application No. 14779655.1, dated Mar. 8, 2018, 7 pages. |
| European Office Action for Application No. 14801713.0, dated Dec. 11, 2019, 6 pages. |
| European Office Action for Application No. 14801726.2, dated Nov. 19, 2019, 7 pages. |
| European Office Action for Application No. 20191537.8, dated Aug. 18, 2021, 10 pages. |
| European Summons to attend oral proceedings pursuant to Rule 115(1) EPC for Application No. 14772937.0, dated Jul. 17, 2019, 12 pages. |
| Evans, R. S. et al., “Enhanced notification of infusion pump programming errors”, Studies in health technology and informatics, Jan. 1, 2010, pp. 734-738, XP055305644, Netherlands DOI: 10.3233/978-1-60750-588-4-734 Retrieved from the Internet: URL:http://booksonline.iospress.nl/Extern/EnterMedLine.aspx?ISSN=0926-9630&Volume=160&SPage=734 [retrieved on Sep. 26, 2016]. |
| Extended European Search Report and Written Opinion for Application No. 14772937.0, dated Oct. 10, 2016, 9 pages. |
| Extended European Search Report and Written Opinion for Application No. 14775918.7, dated Sep. 13, 2016, 10 pages. |
| Extended European Search Report and Written Opinion for Application No. 14779139.6, dated Nov. 7, 2016, 7 pages. |
| Extended European Search Report for Application No. 14779655.1, dated Jul. 14, 2016, 8 pages. |
| Extended European Search Report for Application No. 14780320.9, dated Jul. 1, 2016, 7 pages. |
| Extended European Search Report for Application No. 14801713.0, dated Jan. 16, 2017, 8 pages. |
| Extended European Search Report for Application No. 14801726.2, dated Jan. 5, 2017, 8 pages. |
| Extended European Search Report for Application No. 20191537.8, dated Dec. 17, 2020, 9 pages. |
| India Office Action for Application No. 2625/KOLNP/2015, dated Jul. 8, 2020, 7 pages. |
| India Office Action for Application No. 4041/KOLNP/2015, dated Jul. 8, 2020, 8 pages. |
| India Office Action for Application No. 7050/CHENP/2013, dated Sep. 18, 2019, 7 pages. |
| International Search Report and Written Opinion for PCT Application No. PCT/US2014/022830, dated Jun. 19, 2014, 6 pages. |
| International Search Report and Written Opinion for PCT Application No. PCT/US2014/022832, dated Jun. 24, 2014, 5 pages. |
| International Search Report and Written Opinion for PCT Application No. PCT/US2014/022835. |
| International Search Report and Written Opinion for PCT Application No. PCT/US2014/022837, dated Jun. 18, 2014. |
| International Search Report and Written Opinion for PCT Application No. PCT/US2014/022840, dated Jun. 19, 2014, 5 pages. |
| International Search Report and Written Opinion for PCT Application No. PCT/US2014/037577 dated Sep. 5, 2014. |
| International Search Report and Written Opinion in International Patent Application No. PCT/US2014/012594 dated Jun. 11, 2014, 16 pages. |
| International Seaach Report and Written Opinion in PCT Application No. PCT/US2014/038498 dated Sep. 17, 2014. |
| International Search Report and Written Opinion in PCT Application No. PCT/US2014/038654 dated Oct. 7, 2014, 12 pages. |
| International Search Report and Written Opinion in PCT Application No. PCT/US2014/039228 dated Aug. 22, 2014, 11 pgs. |
| International Search Report and Written Opinion of the International Searching Authority for PCT Application No. PCT/US2014/038658, dated Oct. 7, 2014. |
| International Search Report for Application No. PCT/US2014/038497, dated Oct. 23, 2014, 3 pages. |
| Japanese Office Action for Application No. 2016-501081, dated May 7, 2019, 4 pages. |
| Japanese Office Action for Application No. 2016501081, dated Nov. 12, 2019, 6 pages. |
| Japanese Office Action for Application No. 2016-501081, dated Nov. 2, 2018, 6 pages. |
| Japanese Office Action for Application No. 2019-030891, dated Aug. 24, 2021, 4 pages including translation. |
| Japanese Office Action for Application No. 2019-030891, dated May 27, 2020, 8 pages. |
| Japanese Office Action for Application No. 2019-030891, dated Nov. 26, 2020, 5 pages including English translation. |
| Japanese Office Action in Application No. 2016-501081, dated Feb. 9, 2018, 4 pages. |
| Kohn, et al., “To Err is Human—Building a Safer Health System,” National Academy Press, 2002, pp. i-287, National Academy of Sciences. |
| Lesar, “Recommendations for Reducing Medication Errors,” Medscape Pharmacists, posted Jul. 24, 2000, 10 pgs, vol. 1(2), Medscape Pharmacists, <http://www.medscape.com>. |
| Meier, “Hospital Products Get Seal of Approval at a Price,” The New York Times, Apr. 23, 2002, 5 pgs. |
| Memo concerning Mexican Office Action for Application No. MX/a/2015/015959, mailed Sep. 21, 2017, 4 pages. |
| Memo concerning Mexican Office Action for Application No. MX/a/2015/015959, memo mailed Mar. 2, 2018, 1 page. |
| Memo concerning Mexican Office Action for Application No. MX/a/2015/016104, memo dated May 4, 2018, 3 pages. |
| Office Action for United Arab Emirates Application No. UAE/P/0962/2013, mailed Apr. 17, 2017, 18 pages. |
| Queensland Health. Use of returned or unused dispensed medicines, Jan. 5, 2005, Queensland Government. pp. 1-2. |
| Shabot et al., “Wireless clinical alerts for critical medication, laboratory and physiologic data,” System Sciences 2000. Proceedings of the 33rd Annual Conference on Jan. 4-7, 2000, Piscataway, NJ, IEEE, Jan. 4, 2000. |
| U.S. Appl. No. 90/009,912, filed Aug. 12, 2013, Schlotterbeck et al. |
| U.S. Appl. No. 90/011,697, filed Aug. 12, 2013, Schlotterbeck et al. |
| United Arab Emirates Office Action from KIPO for Application No. UAE/P/1554/2015, first received Nov. 21, 2019, 11 pages. |
| Williams, et al., “Reducing the Risk of User Error with Infusion Pumps,” Professional Nurse—Safe Practice—Infusion Devices, Mar. 2000, pp. 382-384, vol. 15(6). |
| Yokoi, “Prevention of Errors in Injection/Drip Infusion—No excuse for ignorance!—Essential Points of Accident Prevention, IV Infusion Pump, Syringe-pump Accident Prevention,” JIN Special, Igaku Shoin K.K., Dec. 1, 2001, pp. 109-120, No. 70. |
| Australian Office Action for Application No. 2020200812, dated Nov. 18, 2021, 4 pages. |
| Australian Office Action for Application No. 2020203449, dated Nov. 24, 2021, 3 pages. |
| Australian Office Action for Application No. 2020210162, dated Sep. 22, 2021, 6 pages. |
| Canadian Office Action for Application No. 2912792, dated Dec. 30, 2021, 9 pages. |
| Chinese Office Action for Application No. 201480015036.5, dated Sep. 24, 2021, 52 pages including translation. |
| Chinese Office Action for Application No. 201480015093.3, dated Nov. 1, 2021, 36 pages including translation. |
| Brazilian Office Action for Application No. BR112015029135-0, dated Mar. 8, 2022, 8 pages including translation. |
| Chinese Office Action for Application No. 201480015093.3, dated Mar. 3, 2022, 42 pages including translation. |
| European Summons to attend oral proceedings pursuant to Rule 115(1) EPC for Application No. 14801726.2, dated Nov. 17, 2022, 10 pages. |
| Australian Office Action for Application No. 2022201089, dated Mar. 17, 2023, 3 pages. |
| Chinese Office Action for Application No. 202111564727.9, dated Mar. 19, 2023, 14 pages including translation. |
| Extended European Search Report for Application No. 22205566.7, dated Mar. 13, 2023, 12 pages. |
| India Hearing Notice for Application No. 4041/KOLNP/2015, dated Apr. 6, 2023, 5 pages. |
| Chinese Office Action for Application No. 202111564727.9, dated Aug. 2, 2023, 12 pages including translation. |
| European Decision to Refuse for Patent Application No. 14801713.0, dated Sep. 25, 2023, 21 pages. |
| United Arab Emirates Office Action from KIPO for Application No. P962/2013, 5 pages. |
| European Decision to Refuse for Patent Application No. 14801726.2, dated Oct. 23, 2023, 20 pages. |
| Australian Office Action for Application No. 2022201089, dated Jan. 31, 2024, 3 pages. |
| Indian Hearing Notice for Application No. 7050/CHENP/2013, dated Dec. 1, 2023, 3 pages. |
| Australian Office Action for Application No. 2022201089, dated Mar. 15, 2024, 4 pages. |
| Number | Date | Country | |
|---|---|---|---|
| 20220083953 A1 | Mar 2022 | US |
| Number | Date | Country | |
|---|---|---|---|
| 61827419 | May 2013 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 14891962 | US | |
| Child | 17531653 | US | |
| Parent | 13931746 | Jun 2013 | US |
| Child | 14891962 | US | |
| Parent | 13901501 | May 2013 | US |
| Child | 14891962 | US | |
| Parent | 13901504 | May 2013 | US |
| Child | 14891962 | US | |
| Parent | 13901497 | May 2013 | US |
| Child | 14891962 | US | |
| Parent | 13900482 | May 2013 | US |
| Child | 14891962 | US | |
| Parent | 13900502 | May 2013 | US |
| Child | 14891962 | US | |
| Parent | 13900493 | May 2013 | US |
| Child | 14891962 | US |
