Infusion therapy bar coding system and method

• US 20030140929A1
• Filed: 05/31/2002
• Published: 07/31/2003
• Est. Priority Date: 01/29/2002
• Status: Abandoned Application

• Current Assignee: Baxter International Inc.
• Original Assignee: Baxter International Inc.
• Inventors: Hoffman, Jack, Armentrout, Lary, Stephens, Carole, Kland, Michele, Wilkes, Gordon J., Acharya, Meetali, Paul, Eric S., Radpay, Sayeh, Talachian, Kaivan
• Application Number:
  US10/160,429
• Publication Number:
  US 20030140929A1
• Time in Patent Office: Days
• US Class Current: 128/898
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A system and method for verifying that the right medication is efficiently provided to the right patient, in the right dose, at the right time, and via the right route. The invention also relates to efficiently coordinating infusion therapy with patient care system billing and inventory subsystems.

Claims

1. A system for administering a medication, the medication being in a container, the container having a medication label, the label including a bar code, the system comprising:

a first computer, the first computer having data defining a first flow rate, the first computer having data defining a first flow rate tolerance;

a central time source;

an infusion pump;

a second computer, the second computer designed to accept information from a bar code reader, the second computer designed to provide a first signal to the first computer, the first signal including data identifying the medication, the second computer designed to provide a second signal to the first computer, the second signal including data identifying a second flow rate, the second computer designed to provide a third signal to the first computer, the third signal including data identifying the volume of medication in the medication container,

where the first computer authorizes the second flow rate if the second flow rate is within the first flow rate tolerance,

where the infusion pump receives new operating parameters to implement the second flow rate if the first computer authorizes the second flow rate, and

where the first computer documents the initiation of the second flow rate using the central time source.

2. The system of claim 1,

where the first computer includes a first flow rate tolerance override, and the first computer includes a database identifying acceptable reasons for overriding the first flow rate tolerance, where the second computer is designed to provide a fourth signal to the first computer, the fourth signal including data identifying a first reason for overriding the first flow rate tolerance, where the second flow rate is outside of the first flow rate tolerance, where the infusion pump receives new operating parameters if the first reason is an acceptable reason for overriding the first flow rate tolerance.

3. The system of claim 1,

where the medication has an expiry, and the first computer confirms the second flow rate does not exceed the expiry prior to authorizing the second flow rate.

4. The system of claim 1, where the first computer includes data defining a first infusion order, the first infusion order including an order flow rate tolerance, where the first computer authorizes the second flow rate if the second flow rate is within the order flow rate tolerance.

5. The system of claim 1, where a message is sent to a pharmacy if the first computer authorizes the second flow rate.

6. The system of claim 1, where a message is sent to a physician if the first computer authorizes the second flow rate.

7. The system of claim 1, where the first computer includes a database identifying clinician authority levels, where a first plurality of clinicians are identified in the database as having the authority to override the first flow rate tolerance and a second plurality of clinicians are identified in the database as not having the authority to override the first flow rate tolerance,

where the second computer is designed to provide a fourth signal to the first computer, the fourth signal including data identifying a clinician,

where the second flow rate is outside of the first flow rate tolerance, and

where the infusion pump receives new operating parameters if the clinician is in the first plurality.

8. The system of claim 1, where the second computer is designed to provide a display, the display relating the second flow rate to a drip rate.

9. The system of claim 1, where a message is sent to the pharmacy if the second flow rate requires a new infusion bag.

10. The system of claim 1, where the second computer is designed to provide the administering clinician with the option of recalculating an infusion schedule.

11. A method for administering a medication, the medication being in a container, the container having a medication label, the label including a bar code, the method comprising the steps of:

using a bar code scanner to provide a first signal to a first computer, the first signal including data identifying the medication, the first computer having data defining a first flow rate, the first computer having data defining a first flow rate tolerance, the first computer using a central time source;

using the bar code scanner to provide a second signal to the first computer, the second signal including data identifying a second flow rate;

using the bar code scanner to provide a third signal to the first computer, the third signal including data identifying the volume of medication in the medication container,

where the first computer authorizes the second flow rate if the second flow rate is within the first flow rate tolerance,

where the infusion pump receives new operating parameters to implement the second flow rate if the first computer authorizes the second flow rate, and

where the first computer documents the initiation of the second flow rate using the central time source.

12. The method of claim 11, further comprising the step of:

providing a fourth signal to the first computer, the fourth signal including data identifying a first reason for overriding the first flow rate tolerance,

where the first computer includes a first flow rate tolerance override, and the first computer includes a database identifying acceptable reasons for overriding the first flow rate tolerance,

where the second flow rate is outside of the first flow rate tolerance, and where the infusion pump receives new operating parameters if the first reason is an acceptable reason for overriding the first flow rate tolerance.

13. The method of claim 11,

where the medication has an expiry, and the first computer confirms the second flow rate does not exceed the expiry prior to authorizing the second flow rate.

14. The method of claim 11,

where the first computer includes data defining a first infusion order, the first infusion order including an order flow rate tolerance, and

where the first computer authorizes the second flow rate if the second flow rate is within the order flow rate tolerance.

15. The method of claim 11, further comprising the step of:

sending a message to a pharmacy if the first computer authorizes the second flow rate.

16. The method of claim 11, further comprising the step of:

sending a message to a physician if the first computer authorizes the second flow rate.

17. The method of claim 11, further comprising the step of:

providing a fourth signal to the first computer, the fourth signal including data identifying a clinician,

where the first computer includes a database identifying clinician authority levels, where a first plurality of clinicians are identified in the database as having the authority to override the first flow rate tolerance and a second plurality of clinicians are identified in the database as not having the authority to override the first flow rate tolerance,

where the second flow rate is outside of the first flow rate tolerance, and

where the infusion pump receives new operating parameters if the clinician is in the first plurality.

18. The method of claim 11, further comprising the step of:

providing a display if the first computer authorizes the second flow rate.

19. The method of claim 11, further comprising the step of:

sending a message to a pharmacy if the second flow rate requires a new infusion bag.

20. The method of claim 11,

recalculating an infusion schedule if the first computer authorizes the second flow rate.

21. A computer readable medium for administering a medication, the medication being in a container, the container having a medication label, the label including a bar code, the medium comprising logic for:

using a bar code scanner to provide a first signal to a first computer, the first signal including data identifying the medication, the first computer having data defining a first flow rate, the first computer having data defining a first flow rate tolerance, the first computer using a central time source;

using the bar code scanner to provide a second signal to the first computer, the second signal including data identifying a second flow rate;

using the bar code scanner to provide a third signal to the first computer, the third signal including data identifying the volume of medication in the medication container,

where the first computer authorizes the second flow rate if the second flow rate is within the first flow rate tolerance,

where the infusion pump receives new operating parameters to implement the second flow rate if the first computer authorizes the second flow rate, and

where the first computer documents the initiation of the second flow rate using the central time source.

22. The computer readable medium of claim 21, further comprising logic for:

providing a fourth signal to the first computer, the fourth signal including data identifying a first reason for overriding the first flow rate tolerance,

where the first computer includes a first flow rate tolerance override, and the first computer includes a database identifying acceptable reasons for overriding the first flow rate tolerance,

where the second flow rate is outside of the first flow rate tolerance, and

where the infusion pump receives new operating parameters if the first reason is an acceptable reason for overriding the first flow rate tolerance.

23. The computer readable medium of claim 21,

where the medication has an expiry, and the first computer confirms the second flow rate does not exceed the expiry prior to authorizing the second flow rate.

24. The computer readable medium of claim 21,

where the first computer includes data defining a first infusion order, the first infusion order including an order flow rate tolerance, and

where the first computer authorizes the second flow rate if the second flow rate is within the order flow rate tolerance.

25. The computer readable medium of claim 21, further comprising logic for:

sending a message to a pharmacy if the first computer authorizes the second flow rate.

26. The computer readable medium of claim 21, further comprising logic for:

sending a message to a physician if the first computer authorizes the second flow rate.

27. The computer readable medium of claim 21, further comprising logic for:

providing a fourth signal to the first computer, the fourth signal including data identifying a clinician,

where the first computer includes a database identifying clinician authority levels, where a first plurality of clinicians are identified in the database as having the authority to override the first flow rate tolerance and a second plurality of clinicians are identified in the database as not having the authority to override the first flow rate tolerance,

where the second flow rate is outside of the first flow rate tolerance, and

where the infusion pump receives new operating parameters if the clinician is in the first plurality.

28. The computer readable medium of claim 21, further comprising logic for:

providing a display if the first computer authorizes the second flow rate.

29. The computer readable medium of claim 21, further comprising logic for:

sending a message to a pharmacy if the second flow rate requires a new infusion bag.

30. The computer readable medium of claim 21, further comprising logic for:

recalculating an infusion schedule if the first computer authorizes the second flow rate.

31. A system for administering a medication, the medication being packaged in a plurality of medication containers, the system comprising:

a first computer, the first computer having data defining an infusion order, the infusion order including a first flow rate;

an infusion schedule, the infusion schedule including a preparation schedule for the plurality of medication containers, the preparation schedule based on the first flow rate;

an infusion pump;

a second computer, the second computer designed to provide a first signal to the first computer, the first signal including data identifying a second flow rate,

where the infusion pump receives new operating parameters to implement the second flow rate if the first computer authorizes the second flow rate, and

where the preparation schedule is revised based on the second flow rate if the first computer authorizes the second flow rate.

32. The system of claim 31, where medication labels are printed based on the second flow rate if the first computer authorizes the second flow rate.

33. The system of claim 31,

where the medication has an expiry, and the first computer confirms the second flow rate does not cause the medication to exceed the expiry prior to authorizing the second flow rate.

34. The system of claim 31,

where the first flow rate is stopped prior to the authorization of a second flow rate,

where the medication has an expiry, and

where the first computer confirms the second flow rate does not cause the medication to exceed the expiry prior to authorizing the second flow rate.

35. The system of claim 31,

where the second flow rate results in a medication container not being used, and

where the first computer triggers a billing program to credit a patient for the unused medication.

36. A method for administering a medication with an infusion pump, the medication being packaged in a plurality of medication containers, the method comprising the steps of:

providing a first signal to a first computer, the first signal including data identifying a second flow rate, where the first computer has data defining a first infusion order, the infusion order including a first flow rate, where the plurality of medication containers are prepared according to a first preparation schedule, where the infusion pump receives new operating parameters to implement the second flow rate if the first computer authorizes the second flow rate; and

providing a second signal to the first computer, the second signal triggering a revision of the preparation schedule based on the second flow rate if the first computer authorizes the second flow rate.

37. The method of claim 36, further comprising the step of:

printing medication labels based on the second flow rate if the first computer authorizes the second flow rate.

38. The method of claim 36,

where the medication has an expiry, and the first computer confirms the second flow rate does not cause the medication to exceed the expiry prior to authorizing the second flow rate.

39. The method of claim 36,

where the first flow rate is stopped prior to the authorization of a second flow rate,

where the medication has an expiry, and

where the first computer confirms the second flow rate does not cause the medication to exceed the expiry prior to authorizing the second flow rate.

40. The method of claim 36,

where the second flow rate results in a medication container not being used, and

where the first computer triggers a billing program to credit a patient for the unused medication.

41. A computer readable medium for administering a medication with an infusion pump, the medication being packaged in a plurality of medication containers, the medium comprising logic for:

providing a first signal to a first computer, the first signal including data identifying a second flow rate, where the first computer has data defining a first infusion order, the infusion order including a first flow rate, where the plurality of medication containers are prepared according to a first preparation schedule, where the infusion pump receives new operating parameters to implement the second flow rate if the first computer authorizes the second flow rate; and

providing a second signal to the first computer, the second signal triggering a revision of the preparation schedule based on the second flow rate if the first computer authorizes the second flow rate.

42. The computer readable medium of claim 41, further comprising logic for:

printing medication labels based on the second flow rate if the first computer authorizes the second flow rate.

43. The computer readable medium of claim 41,

where the medication has an expiry, and the first computer confirms the second flow rate does not cause the medication to exceed the expiry prior to authorizing the second flow rate.

44. The computer readable medium of claim 41,

where the first flow rate is stopped prior to the authorization of a second flow rate, where the medication has an expiry, and

where the first computer confirms the second flow rate does not cause the medication to exceed the expiry prior to authorizing the second flow rate.

45. The computer readable medium of claim 41,

where the second flow rate results in a medication container not being used, and

where the first computer triggers a billing program to credit a patient for the unused medication.

46. A system for creating infusion orders, the system comprising:

a first computer screen, the first computer screen offering a plurality of main infusion order types, the main infusion order types including a single dose infusion, a continuous infusion;

a sequencing infusion, and an alternating infusion, where the selection of the continuous infusion allows defining of a titrating dose;

a second computer screen, where the second computer screen is provided after a main infusion order type is identified in the first computer screen, the second computer screen designed to offer an infusion order subtype, the infusion order subtype being one of the group of infusion order subtypes consisting of TPN, chemotherapy, piggyback, and large volume parental.

47. The system of claim 46, where the infusion order subtypes are designed to be sortable and filterable.

48. The system of claim 46, further comprising:

a plurality of medication label formats, where the plurality of medication label formats includes a distinct format for each of the infusion order subtypes.

49. The system of claim 46, where the first computer screen includes a medication information area, and where selection of a medication from the medication information area triggers the identification of the main infusion order type.

50. The system of claim 46, where the first computer screen includes a medication information area, and where selection of a medication from the medication information area opens the second computer screen and the triggers the selection of an infusion order subtype.

51. A method for creating infusion orders, the method comprising the steps of:

identifying a main infusion order type in a first computer screen, the first computer screen offering a plurality of main infusion order types, the main infusion order types including a single dose infusion, a continuous infusion;

a sequencing infusion, and an alternating infusion, where the selection of the continuous infusion allows defining of a titrating dose;

identifying an infusion order subtype in a second computer screen, the infusion order subtype being one of the group of infusion order subtypes consisting of TPN, chemotherapy, piggyback, and large volume parental.

52. The method of claim 51, where the infusion order subtypes are sortable and filterable.

53. The method claim 51, further comprising the step of:

printing a plurality of medication label formats, where the plurality of medication label formats includes a distinct format for each of the infusion order subtypes.

54. The method of claim 51, where the first computer screen includes a medication information area, and where selection of a medication from the medication information area triggers the identification of the main infusion order type.

55. The method of claim 51, where the first computer screen includes a medication information area, and where selection of a medication from the medication information area opens the second computer screen and the triggers the selection of an infusion order subtype.

56. A computer readable medium for creating infusion orders, the medium comprising logic for:

identifying a main infusion order type in a first computer screen, the first computer screen offering a plurality of main infusion order types, the main infusion order types including a single dose infusion, a continuous infusion;

a sequencing infusion, and an alternating infusion, where the selection of the continuous infusion allows defining of a titrating dose;

identifying an infusion order subtype in a second computer screen, the infusion order subtype being one of the group of infusion order subtypes consisting of TPN, chemotherapy, piggyback, and large volume parental.

57. The computer readable medium of claim 56, where the infusion order subtypes are sortable and filterable.

58. The computer readable medium of claim 56, further comprising logic for:

printing a plurality of medication label formats, where the plurality of medication label formats includes a distinct format for each of the infusion order subtypes.

59. The computer readable medium of claim 56, where the first computer screen includes a medication information area, and where selection of a medication from the medication information area triggers the identification of the main infusion order type.

60. The computer readable medium of claim 56, where the first computer screen includes a medication information area, and where selection of a medication from the medication information area opens the second computer screen and the triggers the selection of an infusion order subtype.

61. A system for configuring medical devices in a patient care system, the system comprising:

a central computer;

a first plurality of remote medical devices, the operation of the remote medical devices being determined by a plurality of patient care system configuration parameters and a plurality of operating parameters,

where the plurality of patient care system configuration parameters are definable at the central computer.

62. The system of claim 61, where the remote medical devices are infusion pumps.

63. The system of claim 61, where the plurality of patient care system configuration parameters are default parameters, and where the default parameters may be overridden by subsystem configuration parameters.

64. The system of claim 61, further comprising:

subsystem configuration parameters,

where the patient care system includes a first subsystem and a second subsystem, where the subsystem configuration parameters are defined to apply to a second plurality of remote medical devices within the first subsystem

where the second plurality of remote medical devices are configured with the subsystem configuration parameters.

65. The system of claim 61, where a message is sent to the central computer if a system configuration parameter is overridden.

66. The system of claim 61, where a first portion of the patient care system operating parameters are associated with a patient attributes, where the first portion of patient care system operating parameters are provided to a portion of the remote medical devices that are being used to treat patients with the attribute.

67. The system of claim 61, where a medical device may be added to the first plurality of remote medical devices by providing the central computer with the address of the medical device.

68. The system of claim 61, where the patient care system verifies the receipt of the correct system configuration parameters by the sending a copy of the system operating parameters back to the central computer and comparing the copy to the original system operating parameters.

69. The system of claim 61, where the central computer polls the plurality of remote medical devices to determine whether the remote medical devices are operating according to the system configuration parameters.

70. The system of claim 61, where the central computer provides a system configuration parameters to the first plurality of remote medical devices when the system configuration parameters is modified in the central computer.