Patent Application
20110245969
Exemplary embodiments of the present invention relate generally to storing and retrieving unit dose medications.
In a typical hospital, nursing home, or other similar institution, doctors will visit their patients on a routine basis and prescribe various medications for each patient. In turn, each patient will likely be placed on a certain medication treatment plan that requires that he or she take one or more doses of various medications daily. Some medications may require that they be administered only at certain times of the day (e.g., after meals) and/or at intervals of one or more hours each day. In addition, patients may request certain medications on an elective basis for complaints, such as head or body aches. These requests are typically included with the doctor's medication request or prescription that he or she sends to a pharmacy of the hospital for filling.
Medication requests or prescriptions received by the pharmacy will likely be checked by a registered pharmacist and then entered into the pharmacy information system. These requests reflect not only orders that are added to a particular patient's treatment plan, but also changes in a patient's existing treatment plan. The pharmacy information system combines this information with the patient's existing medication schedule and develops a patient medication profile. Using the patient medication profile, a fill list can be created that lists all medications that must be distributed to all patients for a given time period (e.g., a day).
In some instances, this list is printed and used by a pharmacist or pharmacy technician to hand pick each of the drugs needed for each patient (in the form of unit doses) and place those drugs in corresponding patient-specific medication containers (e.g., drawers, boxes, bins or bags). A registered pharmacist then checks the accuracy of the patient order, and, assuming the order was accurate, the individual patient boxes are loaded into a large transport cart and delivered to a nursing unit.
Several drawbacks exist, however, to this method of medication retrieval and distribution. In particular, it is very time consuming and manpower intensive. As a result, systems were created for automating the process of retrieving unit dose medications and distributing them to patients according to their respective medication profiles. One example of such a system is the ROBOT-Rx® system, offered by McKesson Automation Inc. and described in U.S. Pat. Nos. 5,468,110, 5,593,267 and 5,880,443, and other examples are described in U.S. patent application Ser. Nos. 11/382,605, filed May 10, 2006, 11/611,956, filed Dec. 18, 2006 and 11/755,207, filed May 30, 2007, the contents of which are hereby incorporated herein by reference.
The ROBOT-Rx® system, like other similar systems, is a stationary robotic system that automates the drug storing, dispensing, returning, restocking and crediting process by using barcode technology. In particular, single doses of medications are re-packaged, for example in a clear plastic bag, so that each package contains a barcode corresponding to the package contents. The barcode may include the name of the medication, quantity, weight, instructions for use and/or expiration date.
The packaged medications are then stored in a storage area, such as a storage rack having a frame and a plurality of rod supports on which each package can be hung in a manner that provides each with an X, Y coordinate. Using the X, Y coordinates, packages can then be selected by an automated picking means (e.g., a robotic arm capable of moving at least in three, mutually orthogonal directions designated X, Y and Z), for distribution to individual patients.
More specifically, in one instance, a pharmacist or technician may manually enter the identification of a specific medication he or she would like the automated system to retrieve, for example, as a patient's first dose, in an emergency situation. The automated system, and, in particular, a computer associated with the automated system, would then locate the desired medication (i.e., the X, Y and Z coordinates of the medication) and instruct the picking means to retrieve the medication at that location. In another instance, the fill list created based on each patient's medication profile may be communicated to the computer associated with the automated system, providing the automated system with a current list of all patients and their individual medication needs. The computer also maintains a database of all medications stored in the storage area along with their corresponding X, Y and Z coordinates.
Patient-specific containers (e.g., drawers or bins) displaying barcodes that include the corresponding patient's unique identification code are placed on a conveyer belt associated with the automated system. At one point on the belt, a barcode reader reads the barcode displayed on the patient-specific box or container and communicates the patient's identification to the computer. The computer will then retrieve the patient's medication needs from the fill list, and determine the corresponding coordinates for each medication by accessing the database.
The computer can then guide the picking means to select the desired unit dose medications and deposit them in the patient-specific boxes or containers. In particular, the picking means, which also includes a barcode reader, moves to the designated location of a particular medication, as instructed by the computer, scans the barcode displayed on the package containing the medication to identify the medication contained in the package, and provides the identity to the computer.
After the computer confirms that the correct unit dose medication is contained in the package, the picking means will remove the package from the storage area (e.g., using a vacuum generator to produce suction to pull the package off the rod, or other holding means, and hold the package until it can be deposited) and drop it into the patient-specific container.
The process is repeated until the patient's prescription has been filled (i.e., until the patient-specific medication container contains each dose of medication to be taken by the patient in the given time period or, in the instance where the unit dose retrieved the first dose for a new patient, until that first dose has been retrieved). The conveyor belt then moves the patient-specific container to a check station where an operator can use yet another barcode reader to scan the barcode label on the patient-specific container to retrieve and display the patient's prescription, as well as to scan the barcodes on each package in the container to verify that the medications are correct.
As described above, unit dose medications dispensed robotically may be packaged into bags, boxes or a variety of other over-wraps prior to being stored in the storage area. This repackaging effort is performed for several reasons. First, the size and shape of the raw packages vary greatly; therefore, without some commonality in product shape, robotic handling becomes extremely difficult. Second, while robotic systems typically rely on barcodes to identify the products throughout the process, the majority of products originating from various manufacturers do not contain barcodes of any kind or are inconsistent with respect to the information they provide. Accordingly, in these instances, over-wrapping the unit dose with a package containing a barcode may be accomplished for identification purposes.
More recently, efforts have been made to reduce any need for repackaging since, for example, repackaging adds material costs to the final product and requires both additional technician time to perform the packaging as well as additional pharmacist time to validate the content of the package against the description on the label. In addition, repacking by a hospital, or similar institution, shortens the expiration date of the repackaged item based on United States Pharmacopeia/National Formulary (USP/NF) repackaging standards. Moreover, since efforts are being made to ensure that all human drug products have a barcode on the smallest container or package distributed which, in many instances, is the unit dose medication, each unit dose on a unit dose blister card will have a barcode thereon. This includes all human prescription drug products and over-the-counter drugs that are dispensed pursuant to an order in the hospital. The barcode must contain, at a minimum, a National Drug Code (NDC) in a linear barcode, in the Uniform Code Council (UCC) or Health Industry Business Communications Council (HIBCC) format. Following the effective date of this mandate, assuming that the unit dose medications are the smallest container or package used, all unit dose medications will contain barcodes that can be used by robotic dispensing systems, thus eliminating the need to overwrap or repackage merely for identification purposes.
However, even though improvements may be achieved by enhancing the utility of an automated dispensing system in relation to eliminating repackaging or over-wrapping operations, such systems still require a fair amount of manual intervention to prepare the medications for automated dispensing. Additionally, there is no standard shape or configuration for unit dose blister cards, so automatic dispensing of unit doses was a challenge. This challenge was initially met by U.S. patent application Ser. No. 11/382,605, filed May 10, 2006, which provided a robotic device capable of dispensing unit dose blisters automatically. However, even for an automatic or robotic dispensing system, there may be challenges encountered in relation to ensuring proper alignment of medication packages and/or the containers that facilitate handling of the medication packages. For example, if a medication package or container is not properly aligned, the machinery used for automatic handling and dispensing may not be able to function properly. Accordingly, it may be desirable to provide a mechanism by which to improve automatic operation of robotic dispensing equipment.
In general, exemplary embodiments of the present invention provide improvements relating to, among other things, providing a mechanism by which to perform alignment detection functions with respect to a device used to pick medications during automatic medication handling and dispensing. In this regard, for example, some example embodiments may provide enablement for determining a cause for an alignment failure encountered during handling and/or for automatically learning storage locations.
In particular, according to one example embodiment, an apparatus for facilitating storage and/or retrieval of unit dose medications is provided. The apparatus may include a processing circuitry configured for receiving an indication that a medication receptacle is positioned proximate to an alignment pin, determining a position of the alignment pin relative to an alignment guide disposed in the medication receptacle, and providing an output indicative of an alignment state of the medication receptacle based on the position determined.
In another exemplary embodiment, a method for facilitating storage and/or retrieval of unit dose medications is provided. The method may include method for receiving an indication that a medication receptacle is positioned proximate to an alignment pin, determining a position of the alignment pin relative to an alignment guide disposed in the medication receptacle, and providing an output indicative of an alignment state of the medication receptacle based on the position determined.
In another exemplary embodiment, a computer program product for facilitating storage and/or retrieval of unit dose medications is provided. The computer program product may include at least one computer-readable storage medium having computer-executable program code instructions stored therein. The computer-executable program code instructions may include program code portions for receiving an indication that a medication receptacle is positioned proximate to an alignment pin, determining a position of the alignment pin relative to an alignment guide disposed in the medication receptacle, and providing an output indicative of an alignment state of the medication receptacle based on the position determined.
Having thus described the invention in general terms, reference will now be made to the accompanying drawings, which are not necessarily drawn to scale, and wherein:
Some embodiments of the present invention now will be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments of the inventions are shown. Indeed, these inventions may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Like numbers refer to like elements throughout.
In general, exemplary embodiments of the present invention provide a mechanism by which medication (e.g., in unit dose blisters) may be handled and ultimately dispensed either automatically or with minimal manual assistance. Moreover, embodiments of the present invention may provide a mechanism by which to accurately and reliably determine whether an interruption in medication picking is due to an alignment error or due to missing medication. As such, some example embodiments relate to an alignment detection mechanism that may employ optical or other sensing techniques to determine whether alignment errors exist. Accordingly, embodiments of the present invention may provide a mechanism for automatic handling and dispensing of unit dose packages in a repeatable fashion so that they can be selectively retrieved and delivered, for example by one of the automatic retrieval systems discussed above (e.g., the ROBOT-Rx® system or a robot system able to handle blister dispensing such as that described in U.S. patent application Ser. No. 11/382,605, filed May 10, 2006).
The term “unit dose blister” refers to a unit dose medication, or one or more oral solids of the same or different strength, form or type, that has been sealed in a package, such as a vinyl and foil package in which the vinyl conforms to the shape of the medication. The vinyl is typically sealed to a foil that offers a flat surface with medication information printed on the opposite side from the vinyl cavity.
When unit dose medications are packaged into a blister, they are typically packaged with several medications per blister card. Thus, there are a corresponding number of equally-spaced vinyl formed cavities per blister card. These cavities are typically separated by a perforation. During formation of a blister card, several manufacturing stations are encountered, but there is no correlation between the handling techniques employed at each station. Accordingly, a blister card that passes through a station for forming a cavity, labeling of the blister, punching of the blister receptacle, punching out of the card, etc., may not be handled in the same manner at each station as the previous or subsequent blister card. Accordingly, inconsistencies may be created between different blister cards. A singulated blister is one that has been separated from a blister card typically along its perforation.
As one of ordinary skill in the art will recognize, while reference is made throughout to unit dose blisters of the form described above, these unit dose blisters provide just one form in which unit dose medications may be packaged. Use of unit dose blisters in the description of exemplary embodiments included herein should not, therefore, be taken as limiting the scope of the present invention to use with such unit dose packages. In contrast, other unit dose packages may similarly be used in connection with exemplary embodiments without departing from the spirit and scope of the present invention.
Reference is now made to
The system 100 of exemplary embodiments may include a means for storing a plurality of unit dose blisters of various shapes and sizes, referred to herein as a “storage system” 102. As shown, the storage system 102 of one exemplary embodiment, which is also illustrated in
In this regard, the blister mount receptacles 150 of one embodiment shown in
As shown in
The size, shape and depth of the cavities 143 of one exemplary embodiment may be determined to accommodate a large sampling of unit dose blisters of various shapes and sizes. For example, the cavity 143 may be sized to be large enough to receive at least a majority of the unit dose medications packaged in the unit dose blisters of the large sampling. The cavity 143 may also be sized small enough to prevent the majority of unit dose blisters from falling entirely into the cavity. In one example embodiment shown in
According to exemplary embodiments of the present invention, the unit dose blister is able to naturally sit in the unit dose blister mount 140, or storage apparatus, with its medication cavity down. This orientation may position the unit dose blister to lie substantially flat in a plane defined by the unit dose blister mount 140 (e.g., via the carrier 145), such as the horizontal plane, having its identification code and other printed drug information (i.e., the information displayed on the second side of the support panel of the unit dose blister) viewable from above. Due at least in part to this orientation, the unit dose blister may be scanned and perhaps also picked up relatively easily.
In an example embodiment, the unit dose blister mount 140 may include a handle 142 via which the unit dose blister mount 140 may be grabbed, held, moved or otherwise manipulated. In some embodiments, the handle 142 may include an alignment hole 147 (which is an example of an alignment guide). Additionally or alternatively, instances of the alignment hole 147 may be included at other portions of the unit dose blister mount 140 (e.g., in one or more of the carriers 145). According to some example embodiments, perhaps after reading of a barcode on the unit dose blister, the unit dose blister may be stored in the unit dose blister mount 140 or automatically removed from the unit dose blister mount 140 by a picking system.
The Y-Axis component 230 may comprise one or more timing belts driven by a closed-loop motor and configured to move the X and Z-Axis components 220, 240 in the Y-direction (e.g., up and down). The X-Axis component 220 may, likewise, be driven by a closed-loop motor (e.g., a servo motor) to move linearly in the X-direction (e.g., left and right). In embodiments in which the unit dose blister is disposed within a unit dose blister mount while stored within the storage system 102, the X-Axis component 220 may include one or more cantilevered unit dose package (e.g., blister) mount removal mechanisms 224L, 224R (referred to herein as “mount removal mechanisms”), illustrated in
As shown in
The Z-Axis component 240 of the picking system 201, which is shown in more detail in
In one exemplary embodiment, the vacuum generators are capable of generating a local vacuum through the use of one or more diaphragm electric pumps capable of being turned on and off. In particular, rather than requiring the use of compressed air, which can be costly, inefficient and fairly disruptive in terms of the noise and required piping associated with the use of an air compressor, the system of exemplary embodiments of the present invention uses one or more electric vacuum generators to produce a local vacuum, thus eliminating the need for compressed air and enabling the storage, retrieval and delivery system to essentially be moved into a facility and plugged into an electric power outlet in the wall. It should be appreciated that although a vacuum based removal mechanism has been described above, other mechanisms for removing unit dose blisters could alternatively be employed.
In some embodiments, the dispensing system 100 may further include one or more readers 244, including, for example, barcode or radio frequency identification (RFID) tag readers, cameras, or the like, capable of reading the identification code 40 displayed on the unit dose blister located in the unit dose blister mount 140 and communicating the information obtained (e.g., the identity of the unit dose medication, or one or more oral solids, held by the unit dose blister) to a controller associated with the storage, retrieval and delivery system 100, for the purpose of verifying that the correct medication has been selected. As shown in
In some embodiments, if the blister removal mechanism 242 fails to remove medication from the unit dose blister mount 140 during operation, a fault may be sensed. The fault may generally have occurred due to any of a number of reasons. For example, the unit dose blister mount 140 may not be properly aligned to permit the blister removal mechanism 242 to remove the medication (e.g., the unit dose blister) or there may actually not be any medication in the carrier 145 or the cavity 143. An exemplary embodiment of the present invention may provide a solution for determining the reason for failure remove the medication and/or assist in the prevention of failures that may otherwise occur due to improper alignment or positioning of the unit dose blister mount 140.
In this regard, an exemplary embodiment of the present invention may employ an alignment tool 300. The alignment tool 300, an example of which is shown in
As indicated in
In an example embodiment, the alignment tool 300 may include or otherwise operate under the control of processing circuitry. Moreover, in some embodiments the processing circuitry of
An exemplary embodiment will now be described referring to
The processor 400 may be embodied as various processing means such as a processing element, a coprocessor, a controller or various other processing devices including integrated circuits such as, for example, an ASIC (application specific integrated circuit), an FPGA (field programmable gate array), a PLC (programmable logic controller), a hardware accelerator, or the like. The processor 400 may be configured (e.g., via hardcoded instructions or via execution of software instructions) to perform or control the various functions of the processing circuitry. The memory 410 may include volatile and/or non-volatile memory, and typically stores content, data or the like. For example, the memory 410 may be non-transitory memory capable of storing content transmitted from, and/or received by, the processing circuitry. Also for example, the memory 410 may store software applications, instructions or the like for enabling the processor 400 to perform steps associated with operation of the processing circuitry in accordance with embodiments of the present invention. In one exemplary embodiment, the memory 410 stores instructions for directing the processor 400 to control the alignment tool 300 in relation to operations described herein.
In operation, the unit dose blister mount 140 may be presented to the blister removal mechanism 242 (e.g., under direction provided by the processor 400) and the alignment tool 300 (e.g., under direction provided by the processor 400) may control transmission of the signal from the alignment pin 302. Responsive to detection of at least a portion of the signal at the opposite side of the alignment hole 147 from which the side from which the signal is transmitted (or from the same side if a reflected signal is measured instead of measuring a degree of transmissivity presented through the alignment hole 147), the alignment tool 300 may determine an alignment state of the unit dose blister mount 140. In some embodiments, an output regarding the alignment state may be provided to the user (e.g., via the display 430 or audibly). However, regardless of whether the user is informed, an output regarding the alignment of the alignment pin 302 with the alignment hole 147 may be generated, for example, for feedback for use in better alignment or for storing location information as described below.
In some embodiments, the alignment tool 300 may further operate (e.g., under control by the processor 400 and based on instructions and location information stored in the memory 410) to learn proper pick and place locations for a plurality (or perhaps each) of the storage locations that are accessible to the robot. As an example, a technician may manually move the EOAT toward a unit dose blister mount or tray that is being held by the robot and the alignment pin 302 may be aligned with the alignment hole 147 of the unit dose blister mount or tray (e.g., by placing the alignment pin 302 into the alignment hole 147). The position (e.g., in terms of X, Y and Z coordinates) corresponding to this alignment may be recorded (e.g., in the memory 410). From this initial recorded position, the robot may be configured to use the alignment pin 302 to detect a top surface of the unit dose blister mount in order to determine the proper pick and place height for the unit dose blister mount based on known offsets from the top surface of the unit dose blister mount. Thereafter, the robot may be configured to detect edges of the alignment hole 147 by making small lateral movements in the plane of the top surface of the unit dose blister mount in which one or more lateral movements may be followed by a corresponding vertical movement attempting to seat the alignment pin within the alignment hole 147 and thereby learn the best location for picking the unit dose blister mount. A boundary between the alignment hole and the top surface of the unit dose blister mount may be detected by the state of the alignment pin signal. Accordingly, for example, the processor 400 may execute an alignment algorithm to find (at least approximately) edges and perhaps also a center of the alignment hole 147, which may be recorded so that the picking system 201 may be enabled to thereafter select the correct location and height at which to grab the unit dose blister mount based on stored location information generated responsive to alignment of the alignment pin 302 relative to the alignment hole 147. Accordingly, some embodiments of the present invention may provide an ability to self align the alignment tool 300 to pre-stored unit dose blister mount (or other medication receptacle) locations based on feedback signals received regarding alignment of the alignment pin 302 relative to the alignment hole 147.
Accordingly, embodiments of the present invention may provide a mechanism for use in measuring alignment information for medication receptacles. As such, some embodiments may provide alignment detection functions with respect to a device used to pick medications during automated medication handling and dispensing. In this regard, for example, some example embodiments may provide enablement for determining a cause for an alignment failure encountered during handling and/or for automatically learning storage locations to facilitate robotic operation with respect to handling medications.
In this regard, a method of receiving an indication that a medication receptacle (e.g., unit dose blister mount 140 or tray 229) is positioned proximate to an alignment pin at operation 600, determining a position of the alignment pin relative to an alignment guide (e.g., alignment hole 147) disposed at the medication receptacle at operation 610, and providing an output indicative of an alignment state of the medication receptacle based on the position determined at operation 620.
In some embodiments, optional operations may be provided in addition to the operations described above. It should be appreciated that each of the optional operations described below may be included with the operations above either alone or in combination with any others among the features described herein. Accordingly, in some embodiments, the method may further include storing position information indicative of a position of the alignment pin extended into the alignment guide at operation 630 and/or employing an algorithm to measure alignment information responsive to a series of lateral movements of the alignment pin to substantially determine a predetermined position (e.g., a center) of the alignment guide at operation 640. In some embodiments, the method may further include utilizing the position information stored to locate the medication receptacle after storage for subsequent movement of the medication receptacle by an automated device at operation 650.
In some embodiments, the operations described above may be modified. The modifications may be included in any combination and in any order. As such, in some cases, determining the position of the alignment pin may include transmitting a signal from the alignment pin toward the alignment guide and measuring the signal to determine the position based on a result of the measuring. In some cases, transmitting the signal may include transmitting an electrical signal or an optical signal. In some cases, determining the position of the alignment pin may include extending the alignment pin into the alignment guide.
Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Moreover, although the foregoing descriptions and the associated drawings describe exemplary embodiments in the context of certain exemplary combinations of elements and/or functions, it should be appreciated that different combinations of elements and/or functions may be provided by alternative embodiments without departing from the scope of the appended claims. In this regard, for example, different combinations of elements and/or functions other than those explicitly described above are also contemplated as may be set forth in some of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.
