SYSTEM AND METHOD FOR DYNAMICALLY ADJUSTING PATIENT THERAPY

• US 20140297313A1
• Filed: 06/16/2014
• Published: 10/02/2014
• Est. Priority Date: 08/25/2004
• Status: Active Grant

• Current Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Original Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Inventors: CONDURSO, Joseph, YAMAGA, Cynthia, BUTTERFIELD, Robert, MORLING, Simon, PAIT, Clifton, WEST, Patricia, VANDERVEEN, Timothy W., CRASS, Richard
• Granted Patent: US 9,307,907 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3576 with non implanted data transmission devices, e.g. using external transmitter or receiver
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 5/172 electrical or electronic A61M5/16804, A61M5/16831 take precedence
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 70/00 ICT specially adapted for the handling or processing of medical references
• CPC Class Codes: G16H 70/40 : relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: G16H 70/60 : relating to pathologies

Abstract

A system and method of managing therapy provided to patients in an institution. The system monitors all aspects of the medication delivery to a patient, as well as other information related to the patient, such as values of vital signs, laboratory results and patient factors such as history, diagnosis, allergies and the like. The system includes one or more databases of information, including institutionally developed rules, guidelines and protocol representing the best medical practices of the institution. The system provides alerts and/or recommendations based on the application of the rules to the information being monitored, and alerts care givers accordingly, providing for dynamic adjustment of the patient'"'"'s therapy. The system also monitors the status of the alerts, and if no action is taken in a selected period of time, may escalate the priority of the alert and/or halt the delivery of medication to the patient until the alert is resolved.

Claims

1. A system for managing a therapy provided to a patient, comprising:

a medication delivery device configured for two-way communication with at least one of a monitoring device and an institutional information system, wherein the medication delivery device adjusts the delivery of a drug, medication or fluid to a patient based on institutionally determined rules related to patient specific information.

2. The system of claim 1, wherein the institutional rules comprise at least one of a drug, medication, or fluid dosing parameters and rules, device operating characteristics, or device communication parameters.

3. The system of claim 1, wherein the medication delivery device is in direct communication with the monitoring device.

4. The system of claim 1, further comprising a processor configured to monitor the update of patient specific information and to provide an alert when the delivery of the drug, medication or fluid violates an institutional rule based on new patient specific information, and to transmit instructions to automatically adjust, or direct the adjustment of, the delivery of the drug, medication or fluid to bring delivery of said drug, medication or fluid within the institutional rules.

5. The system of claim 4, wherein the processor is further configured to monitor a status of the alert;

and to increase a priority of the alert when the status of the alert has not changed for a selected period of time.

6. The system of claim 1, wherein the patient specific information comprises at least one of a physiological data, or a laboratory data.

7. A system for managing a therapy to be provided to a patient, comprising:

a memory comprising a database capable of storing and accepting a patient specific data and a configurable database for institutionally determined rules that define dosing parameters as a function of the patient specific data; and

a processor coupled to the memory, the processor configured to execute commands stored in the memory, causing the system to;

select a first dosing regimen for a drug, medication or fluid based on the therapy and a first set of the patient specific data;

accept a second set of patient specific data;

compare the second set of patient specific data with the institutionally determined rules; and

when the first dosing regimen violates an institutionally determined rule based on the second set of patient specific data, to automatically adjust, or direct the adjustment of, the delivery of the drug, medication or fluid to bring delivery of said drug, medication or fluid within the institutionally determined rules.

8. The system of claim 7, wherein the commands stored in the memory further cause the system to receive a recommendation to alter at least one institutionally determined rule.

9. The system of claim 8, wherein the recommendation to alter at least one institutionally determined rule is based on an institution providing the therapy to the patient.

10. The system of claim 7, wherein the commands stored in the memory further cause the system to adjust the therapy to be provided to the patient based on the second set of patient specific data.

11. The system of claim 7, wherein the institutionally determined rules comprise drug dosing parameters, device operating characteristics, device communication parameters, and identification (ID) values for a plurality of patients.

12. The system of claim 7, wherein the institutionally determined rules comprise a model for the first medication concentration as a function of time in a plurality of compartments of a patient'"'"'s body.

13. The system of claim 7, wherein the institutionally determined rules comprise a model that relates a concentration of the drug, medication or fluid with a physiological response of the patient.

14. The system of claim 7, wherein the commands stored in the memory further cause the system to communicate to a medical care device an instruction to monitor a concentration of the drug, medication or fluid in a compartment of the patient'"'"'s body.

15. A method of managing therapy provided to a patient, comprising the steps of:

selecting a first dosing regimen for a drug, medication or fluid based on the therapy and a first set of a patient specific data;

receiving a second set of patient specific data;

comparing the second set of patient specific data with a plurality of institutionally determined rules; and

automatically adjusting, or directing the adjustment of, the first dosing regimen so that the second set of patient specific data is in accordance with the plurality of institutionally determined rules.

16. The method of claim 15, further comprising defining at least one of the plurality of institutionally determined rules according to an institution providing the therapy to the patient.

17. The method of claim 15, wherein comparing the second set of patient specific data with a plurality of institutionally determined rules comprises comparing a concentration of the drug, medication or fluid in a compartment of the patient'"'"'s body with a model.

18. The method of claim 15, further comprising issuing an alert when the second set of patient specific data is not in accordance with the plurality of institutionally determined rules.

19. The method of claim 18, further comprising monitoring a status of the alert, and increasing the priority of the alert when the status of the alert has not changed for a selected period of time.

20. The method of claim 15, further comprising altering at least one institutionally determined rule based on comparing the second set of patient specific data with the plurality of institutionally determined rules.

21. A system for managing a therapy to be provided to a patient, comprising:

a memory comprising a database capable of storing and accepting a patient specific data and a configurable database for institutionally determined rules that define dosing parameters as a function of the patient specific data; and

a processor coupled to the memory, the processor configured to execute commands stored in the memory, causing the system to;

accept a set of patient specific data during delivery of a drug, medication, or fluid according to a first dosing regimen;

compare the set of patient specific data with the institutionally determined rules; and

when the first dosing regimen violates an institutionally determined rule based on the set of patient specific data, to automatically adjust, or direct the adjustment of, the delivery of the drug, medication or fluid to bring delivery of said drug, medication or fluid within the institutionally determined rules.

22. The system of claim 21, wherein the commands stored in the memory further cause the system to receive a recommendation to alter at least one institutionally determined rule.

23. The system of claim 22, wherein the recommendation to alter at least one institutionally determined rule is based on an institution providing the therapy to the patient.

24. The system of claim 21, wherein the commands stored in the memory further cause the system to adjust the therapy to be provided to the patient based on the set of patient specific data.

25. The system of claim 21, wherein the institutionally determined rules comprise drug dosing parameters, device operating characteristics, device communication parameters, and identification (ID) values for a plurality of patients.

26. The system of claim 21, wherein the institutionally determined rules comprise a model for the first medication concentration as a function of time in a plurality of compartments of a patient'"'"'s body.

27. The system of claim 21, wherein the institutionally determined rules comprise a model that relates a concentration of the drug, medication or fluid with a physiological response of the patient.

28. The system of claim 21, wherein the commands stored in the memory further cause the system to communicate to a medical care device an instruction to monitor a concentration of the drug, medication or fluid in a compartment of the patient'"'"'s body.

29. A method of managing therapy provided to a patient, comprising the steps of:

receiving a set of patient specific data during delivery of a drug, medication, or fluid according to a first dosing regimen;

comparing the set of patient specific data with a plurality of institutionally determined rules; and

automatically adjusting, or directing the adjustment of, the dosing regimen so that the set of patient specific data is in accordance with the plurality of institutionally determined rules.

30. The method of claim 29, further comprising defining at least one of the plurality of institutionally determined rules according to an institution providing the therapy to the patient.

31. The method of claim 29, wherein comparing the set of patient specific data with a plurality of institutionally determined rules comprises comparing a concentration of the drug, medication or fluid in a compartment of the patient'"'"'s body with a model.

32. The method of claim 29, further comprising issuing an alert when the set of patient specific data is not in accordance with the plurality of institutionally determined rules.

33. The method of claim 32, further comprising monitoring a status of the alert, and increasing the priority of the alert when the status of the alert has not changed for a selected period of time.

34. The method of claim 29, further comprising altering at least one institutionally determined rule based on comparing the set of patient specific data with the plurality of institutionally determined rules.