Patent Application
20050216310
1. Field of the Invention
The present invention relates to computer-implemented methods and systems for pharmaceutical and medicinal dispensation services and, more specifically, for pharmaceutical and medicinal dispensation services in correctional facilities.
2. Description of the Related Art
Managed healthcare is an important service that is required by law to be provided to all inmates within correctional facilities. Most correctional facilities do not have the internal resources to fully provide efficient managed healthcare services. For this reason, most correctional facilities outsource healthcare to entities that are better suited to handle healthcare on such a large scale.
Often in connection with correctional facilities, data related to inmates, such as demographic information, is maintained to provide the correctional facilities with accurate facility occupancy records and for other administrative purposes. This information has been historically maintained as a computer database on a particular computer system or network.
Correctional facilities have also maintained medical records or medical histories in a separate database on a separate computer system. The medical records have been used to record such events as provider visit results, prescription histories, lab work results, and the like. The medical records typically have been developed and maintained either by the correctional facilities or by a third party that has been providing healthcare services for the correctional facility system.
Even though the databases were created for different, specific purposes, some of the information from each of these databases would be useful in providing administrative healthcare services within the correctional facilities. However, the computer databases have been created separately in incompatible computer protocols. To effectively provide healthcare administrative services, both or more computer systems are needed. The computers need to be able to communicate with each other and provide access to the databases contained within the two separate computer systems.
In addition to the need of each computer system to be able to communicate with each other, federal regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), related to confidentiality and privacy of individual health records, have created an additional feature complicating factor for those involved in dealing with medical records. Medical records are required to be kept confidential and safeguards are required to be taken to protect such records. For example, many providers have a stated policy prohibiting transfer of information related to an individual's medical record by facsimile transmission because they do not deem this to be a secure transmittal method. Security measures are required to be implemented by those providing healthcare services to limit or control access to confidential medical records.
Medicinal administrators within correctional facilities are also required to maintain records associated with the physical administration and dispensation of prescribed medication to inmates. Inmates by law must have proper medical care while in the custody of the correctional facilities. Inmates historically have filed lawsuits against the correctional facilities claiming that they have been denied proper medical care. To provide sufficient evidence that the correctional facilities has exerted its best efforts to provide proper medical care, the correctional facilities have maintained records indicating the time, type, and dosage of medication that was administered to an inmate. A guard has been present during medication administration to ensure that the inmate actually consumed the prescribed medication, unless, as in rare circumstances, the inmate was allowed to keep the medication on his or her person, which is referred to keep-on-person medication. The correctional facility has kept records indicating whether or not the inmate has actually consumed the medication. Many times the records are either paper based or kept on a standalone computer system. To maintain this information efficiently, access to the medical record and demographic databases would be helpful to assist those that provide medication administrative and dispensation services within the correctional facility.
Medication inventory within the correctional facilities has been difficult to manage effectively. The correctional facilities generally have had a central pharmacy that has been responsible for supplying medication to the individual correctional facility units within a correctional facility. The central pharmacy has had a computer system of its own that typically has not been tied into the demographic database maintained by the prison system or the medical record database maintained either by the healthcare providers or by the correctional facility. Maintaining the inventory within the prison units and the central pharmacy and shipment of the medication to the correctional facility units are additional areas that would benefit from access to the data contained within the demographic and medical record databases.
As noted above, several types of data have been required and kept separately by prison and other detention systems, such as demographic information and medical health records. To keep the contents of different databases accurate, duplicate entries were required because much of the data is the same within the different databases. The databases have been created in separate computing environments for different purposes. At present, so far as known, instances have occurred in which data has been needed from each of the separate databases. Communication between the separate databases that were created in different computer environments has not been possible because of the incompatible formats of the separate databases. Maintaining the databases has also been difficult because each prison system has its own procedure for updating its demographic and medical record databases.
The present invention advantageously provides a method for computerized monitoring of inventory of pharmaceuticals for inmates and dispensation of prescribed medication to inmates in correctional facilities. The monitoring of the inventory and dispensation of prescribed medication is performed in conjunction with computerized records including an electronic medical record stored in computer containing information about an inmate to receive the prescribed mediation and the inmate's medical history. The systems and methods of the present invention enable correctional facilities to monitor and track each dose of medication from the time that it enters the pharmacy until an inmate takes the medication.
In order to monitor the inventory of the pharmaceuticals and dispensation of the prescribed medication, the method includes reviewing the electronic medical record to verify that the prescribed medication is suitable for the inmate. The review occurs in two phases. A first phase is performed automatically by a computer upon entry of a prescription into the computer. The automatic review checks for drug—drug interacts and for known allergies. A pharmacist typically performs the second phase of the review. The pharmacist can either perform a manual review or request that the computer perform the automatic computer review again. Once the records are reviewed, authorization for release of the prescribed medication for the inmate can be performed if the prescribed medication has been verified as suitable for the inmate. A pharmacist also typically authorizes the release of the prescribed medication. Once the prescribed medication has been released, a unit packet of the prescribed medication can be labeled for dispensing to the inmate. A pharmacist technician typically performs the task of labeling individual unit packets of the prescribed medication. The unit packet of the prescribed medication can be delivered to a correctional facility unit that houses the inmate.
Upon receipt of the prescribed medication, along with other pharmaceuticals used for a floor stock at the correctional facility, the inventory of pharmaceuticals at the pharmacy from which the pharmaceuticals were sent and the inventory at the correctional facility are adjusted accordingly. Once the prescribed medication is at the correctional facility, the prescribed medication is transferred within the correctional facility unit to administer the prescribed medication to the inmate. The location from which prescribed medication is administered in correctional facilities is often called a “pill window.” At the pill window, a record is formed in the computer verifying the dispensation of the unit packet of the prescribed medication to the inmate, the receipt of the prescribed medication by the inmate, and verifying whether the inmate took the unit packet of the prescribed medication. These records are used as provide verification reports to evidence that the correctional facility at least attempted to provide medical services for the inmate.
As another embodiment of the present invention, a method for computerized monitoring of inventory of pharmaceuticals for inmates in correctional facilities is advantageously provided. This monitoring of the inventory of pharmaceuticals is advantageously provided in conjunction with computer records including an electronic medical record containing information about an inmate to receive prescribed medication and the inmate's medical history. In order to monitor the inventory of pharmaceuticals, the electronic medical record is reviewed to verify that the prescribed medication is suitable for the inmate. The step of reviewing can be performed in two steps, with a first step occurring automatically upon entry of a prescription in the system. A pharmacist typically performs the second step of the review. The step of reviewing compares the prescription with the inmate's electronic medical record to ensure that there will not be a drug—drug interaction or allergic reaction. If the prescribed medication has been verified as being suitable for the inmate, the pharmacist can authorize release of the prescribed medication for the inmate.
Once the pharmacist releases the prescribed medication, a label can be printed for the prescribed medication to place upon a unit packet of the prescribed medication for dispensing to the inmate. A pharmacist technician typically controls the printing and application of labels upon the prescribed medication. The inventory of pharmaceuticals is then adjusted based upon the prescribed medication delivered to the correctional facility for dispensing to the inmate.
To improve the fault tolerance associated with the system, the methods described herein can include the step of caching each electronic medical record for each inmate contained within each wave or shipment scheduled to be shipped within a predefined time period prior to the step of reviewing the electronic medical record. The cache system used in the present invention allows the data needed to perform the reviews for a predetermined time period to be pushed to a pharmacy server where the data remains in local memory until needed. In the event that the network malfunctions, the pharmacist will be able to continue with the review for upcoming shipments without any interruptions in the system during the predetermined time period. Caching can also be used for locally storing data related to each label to be printed for each wave scheduled to be shipped within a predetermined time period prior to printing the label.
Another embodiment of the present invention advantageously includes a program storage device readable by a machine, tangibly embodying a machine readable code of program instructions executable by the machine to perform method steps of monitoring pharmaceutical inventory and monitoring dispensation of prescribed medication to inmates in correctional facilities. The monitoring pharmaceutical inventory and dispensation of prescribed medication is preferably performed in conjunction with an electronic medical record containing information about an inmate to receive the prescribed medication and the inmate's medical history. The machine readable code in the program storage device preferably include instructions for causing review of the electronic medical record, followed by authorizing release of the prescribed medication for the inmate. The machine readable code further includes instructions causing a label for the prescribed medication is then printed to place upon a unit packet of the prescribed medication, and forming a record in the computer for verifying: the dispensation of the unit packet of the prescribed medication to the inmate; the receipt of the prescribed medication by the inmate; and that the inmate took the unit packet of the prescribed medication. The records formed by the computer under control of these instructions are used to provide verification reports to evidence that the correctional facility at least attempted to provide medical services for the inmate.
As another embodiment of the present invention, a computerized system for monitoring of pharmaceutical inventory and dispensation of medication to inmates in correctional facilities in conjunction with an electronic medical record containing information about an inmate to receive prescribed medication and the inmate's medical history is advantageously provided. The system preferably includes a computer memory, and a printer for printing labels for prescribed medication. The system also preferably includes pharmacy databases, a pharmacist review workstation, a pharmacist technician workstation, a medication dispensation workstation, and a communications network.
The pharmacy databases are preferably stored in the computer memory of the pharmacy server and are preferably used for maintaining a drug formulary and a pharmaceutical inventory. The pharmacist review workstation is preferably used to enable a pharmacist to simultaneously review the inmate's electronic medical record and an inmate's prescription in the computer memory and upon review of the inmate's prescription, approve the prescription. The pharmacist technician workstation printer enables pharmacist technicians to print labels for application to the inmate's prescribed medication upon command. The medication dispensation workstation enables data entries concerning the prescribed medication to be dispensed and a medication compliance history, or medical administration record, to be recorded in the computer memory. The communications network electronically interconnects the electronic medical record database, the pharmacy databases, the pharmacist review workstation, the pharmacist technician workstation, the medication dispensation workstation, the printer, and the computer memory to enable the devices to communicate with each other.
As another embodiment of the present invention, a computerized system for monitoring pharmaceutical inventory in correctional facilities in conjunction with an electronic medical record containing information about an inmate to receive prescribed medication and the inmate's medical history is provided. The system preferably includes a computer memory and a printer. The system further includes pharmacy databases, a pharmacist review workstation, and a pharmacist technician workstation.
The pharmacy databases are preferably stored in the computer memory of a pharmacy server for maintaining records related to a drug formulary and a pharmaceuticals inventory. The pharmacist review workstation is preferably used to enable a pharmacist to simultaneously review the inmate's electronic medical record and an inmate's prescription in the computer memory and upon review of the inmate's prescription, approve the prescription. The pharmacist technician workstation is preferably used to enable pharmacist technicians to print labels with the printer for application to the inmate's prescribed medication upon command.
As yet another embodiment of the present invention, a computerized system for monitoring dispensation of medication to inmates in correctional facilities in conjunction with an electronic medical record containing information about an inmate to receive prescribed medication and the inmate's medical history. The system advantageously includes a medication dispensation workstation and a communications network.
The medication dispensation workstation is used to enable medication to be dispensed and a medication compliance history to be recorded. The medication dispensation workstation preferably includes a computer memory in a server for medical administration record, or compliance records, to be recorded. The communications network is used to enable the electronic medical record database, the pharmacy databases, the pharmacist review workstation, the pharmacist technician workstation, and the medication dispensation workstation to communicate with each other.
In all embodiments of the computerized system for monitoring dispensation of medication to inmates in correctional facilities, the system can also include pharmacy databases for maintaining records related to drug formulary and a pharmaceutical inventory.
To better understand the characteristics of the invention, the description herein is attached, as an integral part of the same, with drawings to illustrate, but not limited to that, described as follows.
A better understanding of the present invention can be obtained when the detailed description set forth below is reviewed in conjunction with the accompanying drawings, in which:
To better understand the invention, we shall carry out the detailed description of some of the modalities of the same, shown in the drawings with illustrative but not limited purposes, attached to the description herein. It should be understood that where subject matter or process steps of one of the illustrated embodiments or drawing figures is of a like nature to that shown in another embodiment, like reference numerals are used for each.
In the drawings, a high level flowchart F (
As indicated in the high-level flowchart F (
If the pharmacist P is satisfied with the automatic review results, then the pharmacist P can authorize release of the prescribed medication by utilizing a routine stored on the pharmacy server 89 as indicated in step 22 of
The computerized system 100 (
During the automatic and manual reviews, the electronic medical record 50 for the inmate is reviewed to verify that the inmate is not allergic to any medications, that there will not be a drug—drug interaction based upon all of the prescribed medication that the inmate is taking, and the like, as indicated at step 21 in
The electronic medical record 50 can contain various types of information related to each inmate. For example, the electronic medical record 50 can include demographic information, vital signs, lab work results, x-rays, medical checkup data, allergies, physical exam results, family history, list of current medications, drug formulary, and the like. Example demographic information about each inmate can include information such as height, weight, birth date, inmate number, and last prison unit in which the inmate has been confined. To ensure that each inmate has an electronic medical record 50, the electronic medical record 50 can be electronically interconnected so that the electronic medical record 50 is updated when new inmates are enrolled or admitted at the correctional facility, as shown in
Once the electronic medical record 50 has been reviewed, authorization for release of the prescribed medication for the inmate can be performed if the prescribed medication has been verified as suitable for the inmate, as indicated at step 22 in
As can be seen in
The unit packet of the prescribed medication can be delivered to a correctional facility unit that houses the inmate, as indicated at step 26 in
When the technician T is ready to dispense medications to an inmate, a computer screen showing all of the prescribed medications to be administered to the inmate, such as shown in
Correctional facilities typical have a drug formulary 74, which is a list of drugs that are considered to be safe and effective for patients, as well as cost effective. As shown in
Medication Dispensation Workstation
The method for computerized monitoring of dispensation of prescribed medication can include the steps outlined in the high-level flowchart M shown in
Once the inmate is at the medication dispensation workstation 62 to receive the prescribed medication, the identity of the inmate is verified, as described in step 31 in
All embodiments of the present invention including the method for computerized monitoring of dispensation of prescribed medication to inmates in correctional facilities can include the step of adding inmate information to the computerized inmate record if information related to the inmate is not already present as indicated at step 33 in
To enable pill window technicians to plan better, a time period in which the prescribed medication is to be dispensed to the inmate can be scheduled in the system 100, as indicated by step 29 in
Prior to the pill window technicians forming records of dispensation, receipt, and verification that the inmate took the prescribed medication within the medication administration record 65 as indicated in steps 30, 32, 34 in
Some prescribed medication is not required to be taken at the pill window. These types of prescribed medication are referred to as “keep on person” medications. These “keep on person” medications are often not taken as prescribed by the inmate. Periodically, correctional facility officers go through the units and reclaim any unit packets of prescribed medication that have not been opened or disturbed as shown in
As yet another embodiment of the present invention and as shown in
The medication dispensation workstation 62 is used to enable medication to be dispensed and a medication compliance history or medication administration record 65 to be recorded utilizing computer routines stored on the unit server 80. The medication dispensation workstation 62 preferably includes a computer memory for medical history to be recorded. The communications network 66 is used to enable the electronic medical record 50, the pharmacy database 54, the pharmacist review workstation 56, the pharmacist technician workstation 58, and the medication dispensation workstation 62 to communicate with each other.
Central Pharmacy
As another embodiment of the present invention, a method for computerized monitoring of inventory of pharmaceuticals for inmates in correctional facilities is provided, as described in a high-level flowchart I shown in
The monitoring of the inventory of pharmaceuticals is provided in conjunction with computer records including an electronic medical record 50 containing information about an inmate to receive prescribed medication and the inmate's medical history. In order to monitor the inventory of pharmaceuticals, the electronic medical record 50 is reviewed to verify that the prescribed medication is suitable for the inmate, as indicated as step 20 in
As a part of the pharmacist's manual review process, the system 120 described herein allows pharmacists P to review patient prescriptions after they are entered into the system 120. In addition to the prescriptions entered into the system 120, the pharmacist P can review information related to each inmate, such as a list of pending regular and refill prescriptions for the inmate, a list of medications currently on hold for the inmate, the medication profile for the inmate, the medication history for the inmate, inmate demographic and allergy information, a list of problems associated with each inmate, lab results, records related to compliance or medication administration record 65 with prior prescriptions, and clinical review data for a prescription. Pharmacists P can also view a list of missing medications that are un-reconciled for a particular correctional facility unit or specific shipment. To assist in the prescription process, the pharmacist P also has the ability to request and review prior authorization data for a prescription.
Once the pharmacist P authorizes release of the prescribed medication, a pharmacist technician PT can label the prescribed medication for the inmate. Pharmacist technicians PT can print labels for prescribed medication on printer 60 and fill patient prescriptions that have been reviewed by a pharmacist P, as shown in
The steps of reviewing prescriptions and printing labels for prescribed medication are performed utilizing desktop applications that are performed using the pharmacist workstation 56 and the pharmacist technician workstation 58. The pharmacist P reviewing process can consist of approving, holding, discontinuing, discharging, and re-issuing patient prescriptions. Pharmacists P can also initiate interventions and prior authorizations through the reviewing process. The printing steps are performed on printer 60, which consists of printing and re-printing labels for approved prescribed medication using pharmacist technician workstation 58.
All embodiments of the present invention including the method for computerized monitoring of inventory of pharmaceuticals for inmates in correctional facilities can include the step of sorting the unit packets in accordance with a shipping schedule for delivery of the unit packets to each correctional facility after the prescribed medication has been labeled, as indicated as step 38 of
Delivery of prescribed medication to correctional facility units are made in accordance with a shipping schedule. The units that are included in each shipment can be configured using the methods and systems described herein. A computer screen that enables users to schedule which correctional unit to be included within each shipment can be used, such as shown in
All embodiments of the present invention including the method for computerized monitoring of inventory of pharmaceuticals for inmates in correctional facilities can include the step of updating the inventory of pharmaceuticals at the correctional facility in response to the step of delivering the unit packet of the prescribed medication to a correctional facility unit, as indicated as step 48 in
Once a prescription for prescribed medication has been deemed acceptable by a pharmacist P for a particular inmate, the prescription can be refilled automatically without the need to review the electronic medical record 50 again, as indicated as step 88 in
To ensure that the prescribed medication is ready for delivery to the facility unit, the methods described herein can also include sorting the unit packets in accordance with a shipping schedule for delivery of the unit packets to each correctional facility, as indicated as step 38 in
When the unit packets are shipped to a correctional facility unit, a manifest is included with the unit packets to verify what prescribed medication was shipped to a facility unit. The methods of monitoring pharmaceutical invention can include the step of updating the inventory of pharmaceuticals at the correctional facility, as indicated as step 48 in
To improve the fault tolerance associated with the system, the methods described herein can include the step of caching each electronic medical record 50 for each inmate for each prescribed medication scheduled to be shipped within a predefined time period prior to the step of reviewing the electronic medical record 50 as indicted in step 23 in
To assist in the methods of monitoring the pharmaceutical inventory, prescribed medication can also be reclaimed using the methods and systems described herein. If no record is received of the inmate taking the unit packet of prescribed medication, the prescribed medication can be reclaimed. As described in
According to the present invention, a computer program product 57, associated with one or more services, operating under the sequence of instructions described below causes steps to be performed to monitor pharmaceutical inventory and monitor dispensation of prescribed medication to inmates in correctional facilities. The present invention advantageously includes a program storage device D readable by a machine, tangibly embodying a machine-readable code of program instructions executable by the machine to perform method steps of monitoring pharmaceutical inventory and monitoring of dispensation of prescribed medication to inmates in correctional facilities. The monitoring pharmaceutical inventory and dispensation of prescribed medication is preferably performed in conjunction with the electronic medical record 50 containing information about an inmate to receive prescribed medication and the inmate's medical history. The method steps of the program instructions in the machine-readable code in the program storage device preferably include reviewing the computerized inmate record and the electronic medical record 50. Release of the prescribed medication for the inmate is then authorized following review of the inmate record and the inmate's electronic medical record 50. A label for the prescribed medication is then printed on printer 60 to place upon a unit packet of the prescribed medication. A record is then formed in the computer verifying the dispensation of the unit packet of the prescribed medication to the inmate, the receipt of the prescribed medication by the inmate, and verifying whether the inmate took the unit packet of the prescribed medication. These records are used to provide verification reports to evidence that the correctional facility at least attempted to provide medical services for the inmate.
As another feature of the present invention, a computerized system S for monitoring of pharmaceutical inventory and dispensation of medication to inmates in correctional facilities in conjunction with an electronic medical record 50 containing information about an inmate to receive prescribed medication and the inmate's medical history is advantageously provided. The system 100 preferably includes a computer memory, and a printer 60 for printing labels for prescribed medication. The system 100 also preferably includes a pharmacy database 54, a pharmacist review workstation 56, a pharmacist technician workstation 58, a medication dispensation workstation 62, and a communications network 66.
The pharmacy databases 54 are preferably stored in the pharmacy server 89 and is preferably used for storing records related to an inmate's pharmaceutical history and for storing information related to formulary medications. The pharmacist review workstation 56 is preferably used to enable a pharmacist P to simultaneously review the inmate's electronic medical record 50 and an inmate's prescription in the computer memory and upon review of the inmate's prescription, approve the prescription. The pharmacist technician workstation 58 printer 60 enables pharmacist technicians to print labels with the printer 60 for application to the inmate's prescribed medication upon command. The medication dispensation workstation 62 enables the prescribed medication to be dispensed and a medication compliance history or medication administration record 65 to be recorded in the unit server 80. The communications network 66 electronically interconnects the electronic medical record 50, the pharmacy databases 54, the pharmacist review workstation 56, the pharmacist technician workstation 58, the medication dispensation workstation 62, the printer 60, and the computer memory to enable the devices to communicate with each other.
As a further aspect of the present invention and as shown in
The pharmacy database 54 is preferably stored in the computer memory of the pharmacy server 89 for maintaining records related to a drug formulary 74 and a pharmaceutical inventory 76, as shown in
In all embodiments of the computerized system for monitoring pharmaceutical inventories for inmates in correctional facilities, the system 110 can also include pharmacy databases 54, including a drug formulary 74 and a pharmaceutical inventory 76, as shown in
As used herein, the term correctional facility can be any type of confinement facility, such as state and federal prisons or youth correctional facilities. Examples of correctional facilities include the Texas Youth Commission and the Federal Bureau of Prisons. It is envisioned that the present invention can also be used in other types of facilities, such as nursing homes, that require both medicinal administration and a tracking mechanism to document whether or not patients have been taking their medicine and as evidence to show that the facility has at least attempted to render proper medical care to the patient.
As used herein, the term prescribed medication can be a medication that is prescribed by a provider. The prescribed medication can be either a medication requiring a prescription from a doctor or an over-the-counter medication prescribed by a provider.
The invention has been sufficiently described so that a person with average knowledge in the matter may reproduce and obtain the results mentioned in the invention herein. Nonetheless, any skilled person in the field of technique, subject of the invention herein, may carry out modifications not described in the request herein, to apply these modifications to a determined structure, or in the manufacturing process of the same, requires the claimed matter in the following claims; such structures shall be covered within the scope of the invention.
It should be noted and understood that there can be improvements and modifications made of the present invention described in detail above without departing from the spirit or scope of the invention as set forth in the accompanying claims.
