Computer-implemented system and method for electronic medication administration records

• US 8,086,471 B2
• Filed: 04/24/2009
• Issued: 12/27/2011
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Emissary Technologies, LLC
• Original Assignee: Emissary Technologies, LLC
• Inventors: Gamboa, Mona, Renz, Timothy W., Van Baalen, Jeffrey, Gamboa, Ruben
• Primary Examiner(s): O'Connor, Gerald J.
• Assistant Examiner(s): Patel, Neha
• Application Number:
  US12/429,907
• Publication Number:
  US 20100274587A1
• Time in Patent Office: 977 Days
• Field of Search: 705/2, 705/3
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/0637 Strategic management or analysis, e.g. setting a goal or target of an organisation; Planning actions based on goals; Analysis or evaluation of effectiveness of goals
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 10/1095 Meeting or appointment
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients

Abstract

A system for electronic medication administration records comprising a cart station located at a skilled nursing facility, administration web pages, and a healthcare server not located at the skilled nursing facility. The cart station utilizes a plan builder algorithm to build a plan for each patient based on data contained in the cart station database. The plan comprises a list of the patient'"'"'s procedures for a given day and information indicating whether such procedures have been completed. The cart station utilizes a plan runner algorithm to maintain and update the plan for each patient. The administration web pages allow an administrator to manage utilization of the system. The healthcare server and the cart station utilize a synchronization algorithm to maintain accurate and timely data for all of the skilled nursing facilities that use the system. A method of maintaining electronic medication administration records using the system described above.

Claims

1. A system for electronic medication administration records comprising:

(a) a cart station with a cart station database;

(b) administration web pages; and

(c) a healthcare server with a healthcare server database;

wherein the cart station is located in a skilled nursing facility with patients, wherein the cart station utilizes a plan builder algorithm to build a plan for each patient based on data contained in the cart station database, and wherein the plan comprises a list of the patient'"'"'s procedures for a given day and information indicating whether such procedures have been completed;

wherein the plan builder algorithm accounts for completed or missed procedure applications for a specified period prior to current time;

wherein the plan builder algorithm reads from the cart station database a list of each patient'"'"'s procedure applications, historical data indicating whether or not the procedure application has been performed on a given day, and selected data about procedures previously performed; and

wherein the plan builder algorithm also reads from the cart station database data associated with each procedure application, including type of procedure, start date, end date, hold date, frequency of application, prescribing physician, days of week on which the procedure should be performed, whether or not the procedure is active, prerequisite procedures of the procedure, type-specific attributes, and times of day or periods of day when the procedure is to be performed;

wherein the cart station utilizes a plan runner algorithm to maintain and update the plan for each patient;

wherein the plan runner algorithm ensures that no procedure is given before an allowed time;

wherein the plan runner algorithm ensures that no procedure is performed before its prerequisites are performed;

wherein the plan runner algorithm adds a subsequent application of a QH (Quaque Hora) procedure to the plan when a QH application is completed;

wherein the plan runner algorithm adds required dynamic procedures to the plan;

wherein the plan runner algorithm records all action on all procedure applications;

wherein the plan runner algorithm allows a procedure to be recorded as not given or done;

wherein the plan runner algorithm allows a procedure to be postponed and records when postponed procedures are next due;

wherein the plan runner algorithm records errors associated with procedures with period frequency that were due but not completed in a required period, procedures with QH frequencies that are overdue by more than a predefined period, prerequisites of procedures that are not completed, and follow-ups that are overdue by more than a predefined period; and

wherein the plan runner algorithm notifies a user of pending application procedure errors;

wherein the administration web pages allow an administrator to manage utilization of the system;

wherein the healthcare server is not located at the skilled nursing facility, and wherein one or more skilled nursing facilities use the system; and

wherein the healthcare server and the cart station utilize a synchronization algorithm to maintain accurate and timely data for all of the skilled nursing facilities that use the system;

wherein each cart station is assigned a unique ID, the cart station database contains data tables, the data tables contain records, each record is assigned a unique ID, and each record has a timestamp;

wherein the synchronization algorithm identifies records in the data tables and any associated data tables to be sent to the healthcare server from the cart station database;

where the identified records are sent by the cart station to the healthcare server;

wherein the healthcare server maintains a global timestamp;

wherein the synchronization algorithm determines whether a record received from the cart station database is already contained within the healthcare server database to determine whether it is a new or existing record;

wherein if the record is a new record, then it is added to the healthcare server database, and the timestamp for the record is set to the global timestamp;

wherein if the record is an existing record, then it is updated on the healthcare server to match the record received from the cart station, and the timestamp for the record is set to the global timestamp;

wherein if custom processing steps apply to a new or existing record, the synchronization algorithm performs the custom processing steps on the record;

wherein the global timestamp is incremented to a new value; and

wherein the healthcare server sends to the cart station records that are relevant to patients assigned to the cart station based on the cart station ID and that have been modified as a result of synchronization, as determined by comparing the timestamp on the modified records to the timestamp of the records sent by the cart station.

2. The system of claim 1, wherein the cart station comprises a user display, and the plan runner ensures that the user display is accurate and accounts for events that occur in a given day;

wherein the plan runner ensures that no procedure is performed before its allowed time;

wherein a procedure may have one or more prerequisites, and the plan runner ensures that no procedure is performed before its prerequisites have been performed;

wherein when a procedure with a defined interval between applications of the procedure has been performed, the plan runner adds the next application of the procedure to the plan;

wherein the plan runner records when postponed procedures are due;

wherein the plan runner adds required dynamic procedures to the plan;

wherein the plan runner notifies a user of pending procedure application errors; and

wherein the plan runner records actions on procedure applications.

3. The system of claim 1, wherein data is input into the cart station database from a pharmacy, through the administration web pages, or from the cart station itself;

wherein the cart station database comprises tables of records, each table has a timestamp that is an integer that encodes a date on which the table was last synchronized with the healthcare server, and each record has a timestamp that is an integer that encodes a date on which the record was last synchronized with the healthcare server; and

wherein the cart station ensures that each record in a table in the cart station database has been updated with data received from the healthcare server up to the date of the timestamp for that table.

4. The system of claim 3, wherein the system undergoes a series of synchronization sequences over a period of time;

wherein the cart station sends to the healthcare server all new records, all records containing data that has been updated since the last synchronization sequence, and all records that are related to said new or updated records;

wherein the healthcare server maintains a global timestamp that is used as an official notation of time for synchronization purposes for the healthcare server and all cart stations;

wherein the healthcare server receives the records sent from the cart station;

wherein if a record received by the healthcare server is a new record, the healthcare server adds the record to the healthcare server database and ascribes a timestamp to it;

wherein if a record received by the healthcare server is an existing record, the healthcare server updates the record in the healthcare server database to match the record from the cart station and ascribes a timestamp to the updated record;

wherein the healthcare server increments the global timestamp;

wherein the healthcare server sends back to the cart station only those records comprising data that has been modified since the last synchronization sequence;

wherein each record has a globally unique ID that is used by the cart station to determine whether the record is a new record or an updated record;

wherein the cart station stores the new and/or updated records in the cart station database; and

wherein the timestamp associated with each new or updated record is updated to match the global timestamp ascribed to the record by the healthcare server.

5. The system of claim 4, wherein a synchronization sequence occurs whenever the care provider logs into or out of the cart station, whenever the care provider clicks on a synchronization button on the cart station, and/or whenever the cart station is idle for a pre-defined period of time.

6. The system of claim 1, wherein the plan builder algorithm is invoked after each login to a cart station.

7. The system of claim 1, further comprising a pharmacy server that transmits data to the healthcare server;

wherein the data transmitted from the pharmacy server to the healthcare server is downloaded to a cart station in connection with a synchronization sequence.

8. The system of claim 1, wherein the cart station is located on a medication cart at the skilled nursing facility.

9. The system of claim 1, wherein the cart station generates a medication administration record report that describes all activities performed on a patient over a specified period of time.

10. The system of claim 1, wherein the cart station generates an activity report that describes all activities performed on patients at the skilled nursing facility over a specified period of time.

11. The system of claim 1, wherein the cart station generates a medical doctor report that includes prescribed medications, most recent vital signs taken, and medications given for a particular patient.

12. A method for maintaining electronic medication administration records comprising:

(a) providing a cart station with a cart station database, wherein the cart station is located in a skilled nursing facility with patients, wherein the cart station utilizes a plan builder algorithm to build a plan for each patient based on data contained in the cart station database, wherein the plan comprises a list of the patient'"'"'s procedures for a given day and information indicating whether such procedures have been completed, and wherein the cart station utilizes a plan runner algorithm to maintain and update the plan for each patient;

wherein the plan builder algorithm accounts for completed or missed procedure applications for a specified period prior to current time;

wherein the plan builder algorithm reads from the cart station database a list of each patient'"'"'s procedure applications, historical data indicating whether or not the procedure application has been performed on a given day, and selected data about procedures previously performed;

wherein the plan builder algorithm also reads from the cart station database data associated with each procedure application, including type of procedure, start date, end date, hold date, frequency of application, prescribing physician, days of week on which the procedure should be performed, whether or not the procedure is active, prerequisite procedures of the procedure, type-specific attributes, and times of day or periods of day when the procedure is to be performed;

wherein the plan runner algorithm ensures that no procedure is given before an allowed time;

wherein the plan runner algorithm ensures that no procedure is performed before its prerequisites are performed;

wherein the plan runner algorithm adds a subsequent application of a QH (quaque hora) procedure to the plan when a QH application is completed;

wherein the plan runner algorithm adds required dynamic procedures to the plan;

wherein the plan runner algorithm records all action on all procedure applications;

wherein the plan runner algorithm allows a procedure to be recorded as not given or done;

wherein the plan runner algorithm allows a procedure to be postponed and records when postponed procedures are next due;

wherein the plan runner algorithm records errors associated with procedures with period frequency that were due but not completed in a required period, procedures with QH frequencies that are overdue by more than a predefined period, prerequisites of procedures that are not completed, and follow-ups that are overdue by more than a predefined period; and

wherein the plan runner algorithm notifies a user of pending application procedure errors;

(b) providing administration web pages that allow an administrator to manage utilization of the method; and

(c) providing a healthcare server with a healthcare database, wherein the healthcare server is not located at the skilled nursing facility, and wherein one or more skilled nursing facilities use the method;

wherein the healthcare server and the cart station utilize a synchronization algorithm to maintain accurate and timely data for all of the skilled nursing facilities that use the method;

wherein each cart station is assigned a unique ID, the cart station database contains data tables, the data tables contain records, each record is assigned a unique ID, and each record has a timestamp;

wherein the synchronization algorithm identifies records in the data tables and any associated data tables to be sent to the healthcare server from the cart station database;

where the identified records are sent by the cart station to the healthcare server;

wherein the healthcare server maintains a global timestamp;

wherein the synchronization algorithm determines whether a record received from the cart station database is already contained within the healthcare server database to determine whether it is a new or existing record;

wherein if the record is a new record, then it is added to the healthcare server database, and the timestamp for the record is set to the global timestamp;

wherein if the record is an existing record, then it is updated on the healthcare server to match the record received from the cart station, and the timestamp for the record is set to the global timestamp;

wherein if custom processing steps apply to a new or existing record, the synchronization algorithm performs the custom processing steps on the record;

wherein the global timestamp is incremented to a new value; and

wherein the healthcare server sends to the cart station records that are relevant to patients assigned to the cart station based on the cart station ID and that have been modified as a result of synchronization, as determined by comparing the timestamp on the modified records to the timestamp of the records sent by the cart station.

13. The method of claim 12, wherein the cart station comprises a user display, and the plan runner ensures that the user display is accurate and accounts for events that occur in a given day;

wherein the plan runner ensures that no procedure is performed before its allowed time;

wherein a procedure may have one or more prerequisites, and the plan runner ensures that no procedure is performed before its prerequisites have been performed;

wherein when a procedure with a defined interval between applications of the procedure has been performed, the plan runner adds the next application of the procedure to the plan;

wherein the plan runner records when postponed procedures are due;

wherein the plan runner adds required dynamic procedures to the plan;

wherein the plan runner notifies a user of pending procedure application errors; and

wherein the plan runner records actions on procedure applications.

14. The method of claim 12, wherein data is input into the cart station database from a pharmacy, through the administration web pages, or from the cart station itself;

wherein the cart station database comprises tables of records, each table has a timestamp that is an integer that encodes a date on which the table was last synchronized with the healthcare server, and each record has a timestamp that is an integer that encodes a date on which the record was last synchronized with the healthcare server; and

wherein the cart station ensures that each record in a table in the cart station database has been updated with data received from the healthcare server up to the date of the timestamp for that table.

15. The method of claim 14, wherein the cart station database and healthcare server database undergo a series of synchronization sequences over a period of time;

wherein the cart station sends to the healthcare server all new records, all records containing data that has been updated since the last synchronization sequence, and all records that are related to said new or updated records;

wherein the healthcare server maintains a global timestamp that is used as an official notation of time for synchronization purposes for the healthcare server and all cart stations;

wherein the healthcare server receives the records sent from the cart station;

wherein if a record received by the healthcare server is a new record, the healthcare server adds the record to the healthcare server database and ascribes a timestamp to it;

wherein if a record received by the healthcare server is an existing record, the healthcare server updates the record in the healthcare server database to match the record from the cart station and ascribes a timestamp to the updated record;

wherein the healthcare server increments the global timestamp;

wherein the healthcare server sends back to the cart station only those records comprising data that has been modified since the last synchronization sequence;

wherein each record has a globally unique ID that is used by the cart station to determine whether the record is a new record or an updated record;

wherein the cart station stores the new and/or updated records in the cart station database; and

wherein the timestamp associated with each new or updated record is updated to match the global timestamp ascribed to the record by the healthcare server.

16. The method of claim 15, wherein a synchronization sequence occurs whenever the care provider logs into or out of the cart station, whenever the care provider clicks on a synchronization button on the cart station, and/or whenever the cart station is idle for a pre-defined period of time.

17. The method of claim 12, wherein the plan builder algorithm is invoked after each login to a cart station.

18. The method of claim 12, further comprising a pharmacy server that transmits data to the healthcare server;

wherein the data transmitted from the pharmacy server to the healthcare server is downloaded to a cart station in connection with a synchronization sequence.

19. The method of claim 12, wherein the cart station is located on a medication cart at the skilled nursing facility.

20. The method of claim 12, wherein the cart station generates a medication administration record report that describes all activities performed on a patient over a specified period of time.

21. The method of claim 12, wherein the cart station generates an activity report that describes all activities performed on patients at the skilled nursing facility over a specified period of time.

22. The method of claim 12, wherein the cart station generates a medical doctor report that includes prescribed medications, most recent vital signs taken, and medications given for a particular patient.