Closed loop medication use system and method

• US 20030236683A1
• Filed: 06/19/2003
• Published: 12/25/2003
• Est. Priority Date: 06/21/2002
• Status: Active Grant

• Current Assignee: Harris Dawn Holdings Incorporated
• Original Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Inventors: Tobin, Caren C., Markiewicz, Eugene, Henderson, Dwight, Lunak, Richard
• Granted Patent: US 8,478,604 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A closed loop medication use system and method includes selecting a medication to prescribe to a patient based on patient information, such as laboratory results, radiology results, and patient allergies, healthcare industry practices, patient-care site specific guidelines, and medication information. The selected medication is prescribed on an unverified prescription order that is then transcribed. Transcribing includes performing multiple crosschecks of the prescription order to real-time patient information, healthcare industry practices, and medication information to generate a verified prescription order. After transcribing, the appropriate dispensing method is determined for the prescription order and dispensed. The dispensed medication is administered after confirmation by the administering clinician of the right patient, right medication, right dosage, right route, and right time. The whole process of medication use described above is monitored continuously in real-time. The monitored information is communicated to the prescribing, transcribing, dispensing and administering parts of the system.

Claims

1. A method for use of medication, comprising:

prescribing medication on a prescription order to a patient;

transcribing the prescription order to verify appropriateness of the prescription order, wherein the prescription order is placed in a queue using a scheduling technique, wherein the transcribing generates a verified prescription order;

dispensing the medication from the verified prescription order;

administering the medication to the patient, wherein the administration of the medication is recorded; and

monitoring the patient.

2. The method of claim 1, wherein the steps of prescribing, transcribing, dispensing, administering, and monitoring communicate information over an electronic medium, wherein the electronic medium is a network, World Wide Web, or intranet.

3. The method of claim 2, wherein the step of prescribing medication includes converting a non-electronic prescription order into an electronic prescription order by scanning or faxing the non-electronic prescription.

4. The method of claim 2, wherein information is communicated between the steps of prescribing, transcribing, dispensing, administering and monitoring using a communications protocol.

5. The method of claim 4, wherein the communications protocol is a health level seven messaging protocol.

6. The method of claim 1, wherein the step of prescribing comprises:

receiving information generated from monitoring the patient;

comparing the generated information to medication selection criteria; and

determining at least one recommended medication based on the step of comparing.

7. The method of claim 6, wherein the medication selection criteria is from the group consisting of patient specific information, medication information, laboratory and radiology information, standard of care information, healthcare industry recommended treatment information, verified prescription orders, and alerts.

8. The method of claim 7, wherein the step of comparing comprises:

suggesting a plurality of recommended medications; and

calculating an individual cost for each of the plurality of recommended medications.

9. The method of claim 1, wherein verifying appropriateness of the prescription order in the step of transcribing comprises:

comparing the prescription order to clinical information, wherein clinical information is real-time patient information, medication information, or administering guidelines.

10. The method of claim 9, wherein the medication information includes possible adverse medication interactions.

11. The method of claim 9, further comprising:

modifying the prescription order if comparison of the prescription order produces error; and

sending a message including the modified prescription order to the step of prescribing.

12. The method of claim 11, wherein the message is an alert.

13. The method of claim 1, wherein dispensing the medication comprises:

determining the optimal dispensing approach based on a plurality of dispensing requirements.

14. The method of claim 13, wherein the dispensing requirement includes patient location, type of medication, medication location, or quantity of medication needed.

15. The method of claim 13, wherein the optimal dispensing approach includes a robotic dispensing system, an automated storage and retrieval system, or medication dispensing cabinets.

16. The method of claim 1, wherein the step of dispensing medication comprises electronically verifying the dispensed medication is the correct medication for the patient.

17. The method of claim 1, further comprising dispensing medication from a prescription order, wherein the dispensing of the prescription order generates alerts.

18. The method of claim 1, wherein the step of dispensing medication comprises electronically updating a location'"'"'s on-hand quantity of the dispensed medication.

19. The method of claim 18, wherein the step of electronically updating a location'"'"'s on-hand quantity of the dispensed medication generates alerts.

20. The method of claim 1, wherein administering the medication comprises:

selecting a patient;

identifying the medication to be administered; and

identifying the receiving patient.

21. The method of claim 20, wherein the medication is identified by scanning a medication bar code.

22. The method of claim 20, wherein the medication is identified by selecting medication from a list.

23. The method of claim 20, wherein the patient is identified by scanning a patient bar code.

24. The method of claim 20, wherein the patient is identified by an electronic chip.

25. The method of claim 20, wherein administering the medication further comprises:

performing checks to determine if this is the right patient, right medication, right dosage, right route and right time of administration; and

wherein recording of the administration includes recording observations about the patient, wherein the observations include blood pressure, pain scale, or sugar level.

26. The method of claim 1, wherein monitoring the patient includes continuously analyzing information generated from the steps of prescribing, transcribing, dispensing and administering.

27. The method of claim 26, wherein the information generated is laboratory results, radiology results, unverified prescription order, verified prescription orders, scheduled tests, administered medication, adverse medication reactions, allergies, intravenous infusion rates, patient vital signs, patient observations, or cost of patient'"'"'s treatment.

28. The method of claim 1, wherein monitoring the patient generates information that is communicated to the step of prescribing.

29. The method of claim 28, wherein the information generated is in graph form, chart form, tabular data, or text.

30. The method of claim 1, wherein the scheduling technique includes prioritizing the prescription orders based on the medications scheduled administration time.

31. The method of claim 30, wherein the scheduling technique includes prioritizing the prescription orders based on the location of the medication.

32. An apparatus for medication use, comprising:

a prescribing module, wherein the prescribing module generates a prescription order, wherein the prescription order prescribes medication for a patient;

a transcribing module to verify appropriateness of the prescription order, wherein the prescription order is placed in a queue using a scheduling technique, wherein the transcribing module generates a verified prescription order;

a dispensing module, wherein the dispensing module dispenses the medication from the verified prescription order;

an administering module to administer the medication to the patient, wherein the administration of the medication is recorded; and

a monitoring module to monitor information.

33. The medication use apparatus of claim 32, wherein the prescribing module includes an input device, wherein the input device is a personal digital assistant or computer system.

34. The medication use apparatus of claim 32, wherein the prescribing module, transcribing module, dispensing module, administering module, and monitoring module communicate over an electronic medium, wherein the electronic medium is a network, World Wide Web, or Intranet.

35. The medication use apparatus of claim 34, wherein the prescribing module, transcribing module, dispensing module, administering module and monitoring module communicate using a health level seven messaging protocol.

36. The medication use apparatus of claim 32, wherein the prescribing module:

receives information generated by the monitoring module from monitoring the patient;

compares the generated information to medication selection criteria; and

determines at least one recommended medication based on the comparison.

37. The medication use apparatus of claim 36, wherein the medication selection criteria is from the group consisting of patient specific information, medication information, laboratory and radiology information, standard of care information, healthcare industry recommended treatment information, verified prescription orders, and alerts.

38. The medication use apparatus of claim 32, wherein the transcribing module to verify appropriateness of the prescription order compares the prescription order to clinical information, wherein clinical information is real-time patient information, medication information, or administering guidelines.

39. The medication use apparatus of claim 38, wherein the medication information includes possible adverse medication interactions.

40. The medication use apparatus of claim 38, wherein the transcribing module:

modifies the prescription order if comparison of the prescription order produces error; and

sends a message including the modified prescription order to the prescribing module.

41. The medication use apparatus of claim 40, wherein the message is an alert.

42. The medication use apparatus of claim 32, wherein the dispensing module dispenses the medication by determining the optimal dispensing approach based on a plurality of dispensing requirements.

43. The medication use apparatus of claim 42, wherein the dispensing requirement is patient location, type of medication, or quantity of medication needed.

44. The medication use apparatus of claim 42, wherein the optimal dispensing approach is a robotic dispensing system, an automated storage and retrieval system, or medication dispensing cabinets.

45. The medication use apparatus of claim 32, wherein an administrator using the administering module:

selects a patient;

identifies the medication to be administered; and

identifies the receiving patient.

46. The medication use apparatus of claim 45, wherein the administrator identifies the medication by scanning a medication bar code.

47. The medication use apparatus of claim 45, wherein the administrator identifies the medication by selecting the medication from a list.

48. The medication use apparatus of claim 45, wherein the administrator identifies the patient by scanning a patient bar code.

49. The medication use apparatus of claim 45, wherein the administrator identifies the patient by an electronic chip.

50. The medication use apparatus of claim 45, wherein the administrator using the administering module:

performs checks to determine if this is the right patient, right medication, right dosage, right route and right time of administration; and

wherein recording of the administration includes recording observations about the patient, wherein the observation is blood pressure, pain scale, or sugar level.

51. The medication use apparatus of claim 32, wherein the monitoring module continuously analyzes information generated from the steps of prescribing, transcribing, dispensing and administering.

52. The medication use apparatus of claim 51, wherein the information generated is laboratory results, radiology results, unverified prescription order, verified prescription orders, scheduled tests, administered medication, adverse medication reactions, allergies, intravenous infusion rates, patient vital signs, patient observations, or cost of patient'"'"'s treatment.

53. The medication use apparatus of claim 32, wherein the information is communicated to the prescribing module.

54. The medication use apparatus of claim 53, wherein the information generated is in graph form, chart form, tabular data, or text.

55. The medication use apparatus of claim 32, wherein the monitoring module includes a plurality of monitoring mechanisms, wherein the monitoring mechanisms monitor the information.

56. The medication use apparatus of claim 55, wherein at least one monitoring mechanism is a laboratory system that monitors patient lab results.

57. The medication use apparatus of claim 55, wherein at least one monitoring mechanism is a radiology system that monitors patient X-ray results.

58. A closed loop medication use system for patient care, comprising:

one or more centralized servers coupled to a plurality of databases, the databases stored on one or more storage devices;

a prescribing module coupled to the centralized servers, wherein the prescribing module generates a prescription order;

a transcribing module coupled to the centralized servers, wherein the prescribing module verifies appropriateness of the prescription order, wherein a scheduling technique is used to prioritize the prescription order into a list of pre-existing prescription orders in a queue;

a dispensing module coupled to the centralized servers, wherein the dispensing module dispenses one or more medications prescribed on the prescription order;

an administering module coupled to the centralized servers; and

a monitoring module coupled to the centralized servers, wherein the monitoring module monitors information generated by the closed loop medication use system.

59. The closed loop medication use system of claim 58, wherein the prescribing module sends the prescription order to the centralized servers, wherein the prescription order prescribes the medication for a patient.

60. The closed loop medication use system of claim 59, wherein the centralized server sends the prescription order to the transcribing module to verify appropriateness.

61. The closed loop medication use system of claim 60, wherein the transcribing module sends the verified prescription order to the centralized server, wherein the centralized server informs the dispensing module of the medication to dispense.

62. The closed loop medication use system of claim 61, wherein an administering clinician receives the dispensed medication from the dispensing module, wherein the administering module receives information from the centralized server for administering the medication to a patient.

63. The closed loop medication use system of claim 62, wherein the administering clinician uses the information received by the administering module to check if this is the right patient, right medication, right dosage, right route and right time of administration.

64. The closed loop medication use system of claim 63, wherein after the administering clinician administers the medication, the administering module informs the application server of the medication administration, wherein the administration is recorded.

65. The closed loop medication use system of claim 64, wherein information on the medication administration is communicated from the server to the monitoring module.

66. The closed loop medication use system of claim 65, wherein the prescribing module, transcribing module, dispensing module, administering module and monitoring module communicate using a health level seven messaging protocol.

67. The closed loop medication use system of claim 58, wherein the storage device is an redundant array of inexpensive disks, hard disk drive, compact disc jukebox, or tape drive.

68. The closed loop medication use system of claim 58, wherein the database is a medication information database, radiology database, prescription order database, patient-care site financial database, laboratory database, clinical recommended healthcare industry practices database, standard of care database, patient information database, physician'"'"'s database, or recommended prescribing healthcare industry practices database.

69. The closed loop medication use system of claim 68, wherein one or more database is coupled to the prescribing module through one or more database servers.

70. The closed loop medication use system of claim 68, wherein one or more database is coupled to the transcribing module through one or more database servers.

71. The closed loop medication use system of claim 68, wherein one or more database is coupled to the dispensing module through one or more database servers.

72. The closed loop medication use system of claim 68, wherein one or more database is coupled to the administering module through one or more database servers.

73. The closed loop medication use system of claim 68, wherein one or more database is coupled to the monitoring module through one or more database servers.

74. A system for use of medication, the system comprising:

means for prescribing medication on a prescription order to a patient;

means for transcribing the prescription order to verify appropriateness of the prescription order, wherein a scheduling technique is used to prioritize the prescription order into a list of pre-existing prescription orders;

means for dispensing the medication from the verified prescription order;

means for administering the medication to the patient, wherein the administration of the medication is recorded; and

means for monitoring the patient.

75. The system of claim 74, wherein the means for prescribing, transcribing, dispensing, administering, and monitoring communicate information over a medium.

76. The method of claim 75, wherein information is communicated between the prescribing means, transcribing means, dispensing means, administering means and monitoring means using a health level seven messaging protocol.

77. The system of claim 74, wherein the means for prescribing comprises:

means for receiving information generated from monitoring the patient;

means for comparing the generated information to medication selection criteria; and

means for determining at least one recommended medication based on the comparison.

78. The system of claim 77, wherein the medication selection criteria is from the group consisting of patient specific information, medication information, laboratory and radiology information, standard of care information, healthcare industry recommended treatment information, verified prescription orders, and alerts.

79. The system of claim 77, wherein the means for comparing comprises:

means for suggesting a plurality of recommended medications; and

means for calculating an individual cost for each of the plurality of recommended medications.

80. The system of claim 74, wherein verification of the prescription order in the means for transcribing comprises:

means for comparing the prescription order to clinical information, wherein clinical information is real-time patient information, medication information, or administering guidelines.

81. The system of claim 80, wherein the medication information includes possible adverse medication interactions.

82. The system of claim 80, further comprising:

means for modifying the prescription order if comparison of the prescription order produces error; and

means for sending a message including the modified prescription order to the means for prescribing.

83. The system of claim 82, wherein the message is an alert.

84. The system of claim 74, wherein the means for dispensing comprises:

means for determining the optimal dispensing approach based on a plurality of dispensing requirements.

85. The system of claim 84, wherein the dispensing requirement is patient location, type of medication, or quantity of medication needed.

86. The system of claim 74, wherein means for administering the medication comprises:

means for selecting a patient;

means for identifying the medication to be administered; and

means for identifying the receiving patient.

87. The system of claim 86, wherein the medication is identified by scanning a medication bar code.

88. The system of claim 86, wherein the medication is identified by selecting the medication from a list.

89. The system of claim 86, wherein the patient is identified by scanning a patient bar code.

90. The system of claim 86, wherein the patient is identified by an electronic chip.

91. The system of claim 86, wherein means for administering the medication further comprises:

means for performing checks to determine if this is the right patient, right medication, right dosage, right route and right time of administration; and

wherein recording of the administration includes recording observations about the patient, wherein the observation is blood pressure, pain scale, or sugar level.

92. The system of claim 74, wherein means for monitoring the patient includes continuously analyzing information generated from the means for prescribing, transcribing, dispensing and administering.

93. The system of claim 92, wherein the information generated is laboratory results, radiology results, unverified prescription order, verified prescription orders, scheduled tests, administered medication, adverse medication reactions, allergies, intravenous infusion rates, patient vital signs, patient observations, or cost of patient'"'"'s treatment.

94. The system of claim 74, wherein the means for monitoring the patient generates information that is communicated to the means for prescribing.

95. The method of claim 94, wherein the information generated is in graph form, chart form, tabular data, or text.