Patent Application
20100168904
Providers of healthcare services, such as clinicians, prescribe various drugs and other chemical agents (collectively, “medications”) to treat ailments or conditions diagnosed in patients. Increasingly, clinicians are utilizing electronic order management systems to enter and manage medications and other orderables for their patients. One example of such an electronic order management system is the POWERORDERS® application available from Cerner Corporation of Kansas City, Mo. For instance, using such an order management system, a physician or other clinician desiring to prescribe a medication for a particular patient may access a profile for the patient and initiate an order for the medication, entering details for the medication order. After initiating the order, the physician may “sign” the order, indicating to the order management system to process the order. Depending on the robustness of the electronic order management system, other features may be provided to assist healthcare providers in the care process. For instance, when a physician enters a medication order, a system may perform dose range checking to determine whether the dosage entered by the physician is appropriate. In addition, a system may determine and/or warn whether the patient has any allergies to the medication, or whether the medication ordered would interact with another medication already prescribed to the patient (e.g., via accessing information in the patient's electronic medical/health record).
In acute care settings, such as hospitals, surgical centers, and the like, the medication order is then submitted for verification by a pharmacist. The pharmacist typically checks to see that the medication prescribed is an appropriate choice for administering to a patient, and that the dosage administration plan is acceptable. Once this is accomplished, the medication is considered verified, such that the orderable can be dispensed to a patient (e.g., by a nurse or other clinician).
Certain situations arise in care settings where a nurse or other clinician needs to administer an “unverified medication” (i.e., a medication that has not be verified by a pharmacist) to a patient they are treating. For instance, a cardiac patient may need an administration of furosemide to treat edema. In this situation, the clinician understands the risks involved in administering a dose of the unverified medication, such as whether any contraindications are present. Despite such risks, the clinician has determined the benefit to the patient far outweighs the potential risks caused by avoiding full verification by the pharmacy (or prescribing physician) in this particular situation. As another example, a patient may have significant discomfort in a postoperative setting, and be in immediate need of a pain reducing medication, such as morphine. The hospital pharmacy may not have time to verify that the medication itself, or its dosage, is appropriate for this patient under such time constraints. Nevertheless, the clinician—being properly trained to be cognizant of any contraindications for the patient—is deemed to have taken appropriate precautions and, according to the healthcare institution policy, is allowed to administer the unverified medication in this situation (e.g., either without further action or after contacting the prescribing physician for confirmation).
Embodiments of the present invention relate to displaying unverified medication orders with verified medication orders. The unverified medication orders are displayed using a visual characteristic that differs from the verified medication orders that allows a user to recognize the unverified status of the unverified medication orders. In some embodiments, the unverified medication orders and verified medication orders are displayed by a computing device used to dispense medications from a medication storage and dispensing apparatus. In further embodiments, an unverified medication order may be selected for dispensing an associated medication from the medication storage and dispensing apparatus.
Accordingly, in one aspect, an embodiment of the present invention is directed to one or more computer-storage media storing computer-useable instructions for causing a computing device to perform a method of displaying verified and unverified medication orders, the computing device being operable to control dispensing of medications from a medication storage and dispensing apparatus. The method includes accessing medication order information associated with a patient. The medication order information includes one or more verified medication orders and one or more unverified medication orders. The method also includes displaying at least a portion of the medication order information, wherein each of the one or more unverified medication orders is displayed using at least one visual characteristic that identifies the one or more unverified orders as having an unverified status.
In another embodiment, an aspect of the invention is directed to one or more computer-storage media storing computer-useable instructions for causing a computing device to perform a method of using an unverified medication order for dispensing a medication, the computing device being operable to control dispensing of medications from a medication storage and dispensing apparatus. The method includes displaying a list of medication orders for a patient, wherein the list of medication orders includes one or more verified medication orders and one or more unverified medication orders, and wherein each of the one or more unverified medication orders is displayed using a visual characteristic that identifies the one or more unverified medication orders as having an unverified status. The method also includes receiving a selection of an unverified medication order from the list of medication orders. The method further includes responsive to the selection, causing a medication associated with the selected unverified medication order to be dispensed from the medication storage and dispensing apparatus.
In a further aspect of the invention, an embodiment is directed to one or more computer-storage media storing computer-useable instructions for presenting one or more user interfaces for displaying a medication profile for a particular patient in a particular healthcare encounter. The one or more user interfaces include an order list including medication orders associated with medications prescribed for the particular patient; and a visual characteristic associated with one or more particular medication orders of the order list to indicate said one or more particular medication orders possesses the status of an unverified order.
This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter.
The present invention is described in detail below with reference to the attached drawing figures, wherein:
The subject matter of the present invention is described with specificity herein to meet statutory requirements. However, the description itself is not intended to limit the scope of this patent. Rather, the inventors have contemplated that the claimed subject matter might also be embodied in other ways, to include different steps or combinations of steps similar to the ones described in this document, in conjunction with other present or future technologies. Moreover, although the terms “step” and/or “block” may be used herein to connote different components of methods employed, the terms should not be interpreted as implying any particular order among or between various steps herein disclosed unless and except when the order of individual steps is explicitly described.
Systems, computer-implemented methods, and computer-storage media provide an unverified order presentation mechanism allowing clinicians to view unverified orders alongside verified orders from a particular patient's medication profile. In embodiments, the unverified orders and verified orders are displayed at a medication dispensing computing device used for dispensing medications from a medication storage and dispensing apparatus, such as a medication storage cabinet. A particular visual characteristic is applied to the listing of the unverified order in a user interface to differentiate such an order from other verified orders displayed. According to an embodiment, rules may also be established to regulate whether a clinician can retrieve a medication dose associated with an unverified order from the medication storage and dispensing apparatus for administration. Furthermore, in an embodiment, selection of a particular unverified order in the medication profile displayed on the user interface initiates a “dispense” activity on the medication storage and dispensing apparatus, thereby allowing a medication dose associated with the selected unverified order to be retrieved from the medication storage and dispensing apparatus for administration to the patient.
With reference to
Server 22 typically includes therein or has access to a variety of computer readable media, for instance, database cluster 24. Computer readable media can be any available media that can be accessed by server 22, and includes both volatile and nonvolatile media, removable and non-removable media. By way of example, and not limitation, computer readable media may comprise computer storage media and communication media. Computer storage media includes volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information, such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVD), or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage, or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by server 22. By way of example, and not limitation, communication media includes wired media, such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media. Combinations of any of the above should also be included within the scope of computer readable media.
The computer storage media, including database cluster 24, discussed above and illustrated in
A user may enter commands and information into server 22 or convey the commands and information to the server 22 via remote computers 28 through input devices, such as keyboards, pointing devices, commonly referred to as a mouse, trackball, or touch pad. Other input devices may include a microphone, scanner, or the like. Server 22 and/or remote computers 28 may have any sort of display device, for instance, a monitor. In addition to a monitor, server 22 and/or computers 28 may also include other peripheral output devices, such as speakers and printers.
Although many other internal components of server 22 and computers 28 are not shown, those of ordinary skill in the art will appreciate that such components and their interconnection are well known. Accordingly, additional details concerning the internal construction of server 22 and computer 28 need not be disclosed in connection with the present invention. Although the method and system are described as being implemented in a LAN operating system, one skilled in the art would recognize that the method and system can be implemented in any system.
As previously mentioned, embodiments of the invention relate to an unverified order presentation mechanism. As used herein, the term “verified order” refers to a clinical order that has undergone a verification process by a pharmacist, physician, or other clinician having a designated role, which may depend on the particular clinical settings, healthcare facility/organization policies, or other pre-established rules or procedures of a healthcare organization. Conversely, the term “unverified order” refers to a clinical order that is intended to undergo but has not yet undergone a verification process by a pharmacist, physician, or other clinician having a designated role, which may depend on the particular clinical settings, healthcare facility/organization policies, or other pre-established rules or procedures of a healthcare organization.
In one embodiment, the unverified order presentation mechanism operates in the context of an exemplary healthcare ordering system 200 illustrated in
In some embodiments, the healthcare ordering system 200 operates within a comprehensive clinical computing system similar to the exemplary medical information system 20 of
In the embodiment shown in
The medication administration record application 204 provides for a display of medications to be administered to the patient at the point of administration, such as the patient's bedside. The verification application 206 tracks the status of medications ordered for a patient to determine if verification by the appropriate entity (e.g., pharmacy, responsible physician, etc) has occurred. Further, the system 200 may include an expert engine 210 or other component/tool to provide guidance to the clinician in the ordering process. For instance, the expert engine 210 may check for adverse drug events (ADE's) for the current order based on the particular patient's medication profile (or other information in the patient's electronic medical/health record), guide the clinician in selecting a particular drug (or drug class) and dosage to provide the desired therapeutic effect for the patient, and perform other similar activities. Although each of the applications 202, 204, 206, and 210 are shown as part of a healthcare ordering system 200, it should be understood that the applications 202, 204, 206, 210 may be part of a comprehensive clinical computing system of a healthcare organization. Additionally, other applications and components not shown in
As shown in
The medication dispensing computing device 212 is configured to display medication order information, including both verified and unverified orders. The unverified orders are displayed using a visual characteristic that differs from the display of verified orders, such that a clinician can readily differentiate unverified orders from verified orders. By way of example only and not limitation, the visual characteristic may include displaying the unverified orders using a different text characteristic (e.g., different font, text size, text color, bolding, italics, etc.), applying highlighting, displaying additional text identifying the unverified status of the unverified orders, including a symbol or icon identifying the orders as being unverified, and/or separating unverified orders from verified orders.
In some embodiments, an unverified order may be used for dispensing medications from the medication storage and dispensing apparatus 214. In particular, the medication dispensing computing device 212 may display an unverified order and allow for selection of the unverified order by a clinician, thereby causing medication associated with the unverified order to be dispensed from the medication storage and dispensing apparatus 214. In some embodiments, rules may be applied to control dispensing of medications for unverified orders. For instance, in some embodiment, the rules may prevent dispensing medications associated with any unverified order. In other embodiments, the rules may prevent medication for some unverified orders from being dispensed while allowing medication for other unverified orders to be dispensed. By way of example only and not limitation, the rules may be based on the type of medication associated with an unverified order, the role of the clinician attempting to access the medication, and the location of the medication storage and dispensing apparatus 214 within a healthcare organization (maternity ward, ICU, etc.). In such embodiments, different visual characteristics may be applied to differentiate unverified orders for which medications can be dispensed (i.e., “dispensable unverified medication orders”) from unverified orders for which medications cannot be dispensed (i.e., “non-dispensable unverified medication orders”).
With reference now to
According to the method, in step 302, a clinician places an order for a particular patient (e.g., using the order application 202 of
In step 308, medication orders for the patient are displayed at a medication dispensing computing device used for controlling the dispensing of medications from a medication storage and dispensing apparatus. The medication orders are displayed on a user interface with a particular visual characteristic applied to the listing of any unverified order to differentiate such an order from other verified orders displayed. By way of example only and not limitation, an exemplary user interface may include a particular label to indicate to the clinician that a particular order is unverified.
As indicated previously, in some embodiments, a clinician may employ an unverified order for selecting a medication to dispense from a medication storage and dispensing apparatus. For instance, as shown at step 310, a clinician or other user designated as authorized to retrieve a particular medication may make a “dispense” selection on an interactive element of the user interface in association with the selected unverified order for the particular patient. For instance, as one example, a particular unverified order on the medication administration record or profile may be selected by any means (e.g., clicked on or scrolled to by the user), and then designated for dispensing by selecting a “remove” button. Whether a “dispense” selection is allowed for an unverified order may depend on various rules established by a healthcare organization in which the healthcare ordering system resides. For instance, the ability to make a dispense selection for medication removal may depend on the particular role of the clinician removing/administering the medication from the unverified order, the type of medication associated with the order (e.g., a controlled substance), or the location within the healthcare organization at which the dispensing is requested (e.g., maternity ward, ICU, etc.). It may also depend on having a witness authorize themselves with the system at the time the clinician making the removal request is attempting to make the “dispense” selection or otherwise is viewing the unverified order.
In some embodiments, as shown at step 312, various order examination tools are engaged (e.g., through expert engine 210 of
Embodiments of the present invention will now be described with reference to
With reference initially to
Turning now to
As discussed previously, in some embodiments, some unverified medication orders may be identified as being “dispensable” (i.e., the order may be selected for dispensing an associated medication) while other orders may be identified as being “non-dispensable” (i.e., the order may not be selected for dispensing an associated medication).
As shown in
Thus, the various embodiments of the invention provide an unverified order presentation mechanism allowing clinicians to view unverified orders alongside verified orders in a particular patient's medication profile. It will be understood that certain features and sub-combinations of utility may be employed without reference to features and sub-combinations and are contemplated within the scope of the claims. Furthermore, the steps performed need not be performed in the order described.
This application claims the benefit of U.S. Provisional Application No. 61/141,958, filed Dec. 31, 2008, which is herein incorporated by reference in its entirety.
| Number | Date | Country | |
|---|---|---|---|
| 61141958 | Dec 2008 | US |
