Management, reporting and benchmarking of medication preparation

• US 8,554,579 B2
• Filed: 01/23/2009
• Issued: 10/08/2013
• Est. Priority Date: 10/13/2008
• Status: Active Grant

• Current Assignee: Baxter Corporation Englewood (Baxter International Inc.)
• Original Assignee: FHT, Inc. (Baxter International Inc.)
• Inventors: Tribble, Dennis, Khan, Abdul Wahid, Schneider, Dennis, Olsen, Gregory T., Bender, Jayson Lee, Padmani, Bhavesh S., Valentine, Matthew A.
• Primary Examiner(s): O'Connor, Gerald J.
• Assistant Examiner(s): Ng, Jonathan K
• Application Number:
  US12/358,574
• Publication Number:
  US 20100094653A1
• Time in Patent Office: 1,719 Days
• Field of Search: 705/2, 700/110, 700/216, 700/245, 700/265
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/08 Logistics, e.g. warehousing, loading or distribution; Inventory or stock management
• 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 20/13 delivered from dispensers
• 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
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A system for preparing and managing patient-specific dose orders includes an order processing server configured to receive the patient-specific dose orders, define a queue of dose orders and distribute the dose orders to at least one dose preparation station. The dose preparation station is in bi-directional communication with the order processing server and has an interface for providing an operator with a protocol associated with each received drug order and specifying a set of steps to fill the drug order. Steps to fill the drug order are captured at the station and a display, positionable independent of the station outputs the dose order queue and metrics concerning activity at the dose preparation station. Systems for preparing patient-specific doses and a method for telepharmacy in which data captured while following the protocol are provided to a remote site for review and approval by a pharmacist.

Claims

1. A method for performing telepharmacy comprising the steps of:

receiving and processing a dose order;

preparing a dose at a medication preparation station based on the dose order including following a recipe, wherein the dose is a reconstituted drug and the recipe having one or more drug preparation steps including using a diluent for reconstitution;

displaying the recipe on an interactive screen that includes prompts that can be highlighted by an operator to receive additional information relative to one particular step and includes areas for entering an input;

capturing one or more images of a plurality of the drug preparation steps, each of the images being captured at, corresponding to, and confirming a performance of one discrete drug preparation step of the recipe, one captured image displaying a result of a discrete isolated event performed in accordance with one drug preparation step, the drug preparation steps including at least one step that is an intermediate step involving the diluent that shows the dose prior to completing the dose preparation and obtaining a completed dose that is in a state that is suitable for delivery to a patient, wherein one input comprises an input that is prompted by the performance of the drug preparation steps;

storing each image associated with the drug preparation steps of the recipe that has been collected together in a data record of a database, thereby allowing the captured image to be later retrieved for inspection;

accessing the data record including the images from a remote site using a portal in communication with the database;

inspecting the data record through the portal;

reviewing the images in the data record in order to verify that each of the captured drug preparation steps was properly completed; and

approving release of the dose to the patient if the reviewing step confirms that each of the captured drug preparation steps was properly completed.

2. The method of claim 1, wherein the steps of preparing the dose and capturing information comprise the steps of:

confirming an identity of a drug product that is used to prepare the dose;

confirming an identity of a diluent that is combined with the drug product in a reconstitution process to form a drug product; and

capturing an image of the completed drug product.

3. The method of claim 2, wherein the step of confirming the identity of the drug product comprises the steps of:

printing and applying a product label to the drug product; and

scanning a label on the drug product to verify contents of the drug product, wherein the step of confirming the identity of the diluents comprises the steps of;

scanning a label on the diluent that is to be combined with the drug product; and

capturing an image of the diluent.

4. The method of claim 2, wherein the completed drug product comprises a drug vial.

5. The method of claim 2, further including the steps of:

applying a label to a dose container that is prepared in view of the dose order;

acquiring a dose volume from the completed drug product;

capturing an image of a product dose transfer in which a dose volume is transferred from the completed drug product to the dose container; and

capturing an image of the completed dose container.

6. The method of claim 5, further including the step of:

scanning a label on the completed dose container.

7. The method of claim 1, wherein the step of capturing information includes the step of using a hands-free device to capture an image with a camera.

14. The system of claim 1, further including

a dose metrics module having access to the drug order preparation data and operative to process the drug order preparation data of at least one local server in accordance with a rule so as to output a performance metric;

and

an output module operative to compare the performance metric of the at least one local server to the performance metric associated with one or more of the plurality of local servers.

15. The system of claim 14, wherein the dose metrics module includes a configuration file and wherein the rule is stored in the configuration file and is associated with the at least one local server.

16. The system of claim 15, wherein the associated rule is selectable by an administrator.

17. The system of claim 14, wherein the central server comprises a processor executing code that is operative to provide the comparative performance metric.

18. The system of claim 14, wherein the central server comprises:

a database connected so as to maintain the drug order preparation data from each local server;

a tabulation module operative to process the drug order preparation data from each local server and to generate billing data as a function of said processing; and

a communications module operative to forward the billing data to the administrator.

19. The system of claim 18, wherein the processing comprises a tally of records uploaded to the central server by each local server.

20. The system of claim 18, wherein the billing data is forwarded by the communications module in the form of an invoice.

21. The method of claim 1, further comprising:

(a) starting a counter, the counter having a value corresponding to a number of the steps that are performed;

(b) incrementing the value of the counter in response to confirmation that one of the steps has been performed;

(c) comparing the value of the counter to a value of a number of steps in the recipe; and

(d) repeating steps (a)-(c) until the value of the counter equals the number of steps in the recipe.

22. The method of claim 1, further including the steps of prompting the operator to identify him or herself and recording and logging the identity of the operator as part of the data record.

8. A system for preparing and managing patient-specific dose orders that have been entered into a first system, comprising:

an order processing server executing software on a processor thereof and connected by a network to the first system and configured to receive the patient-specific dose orders from the first system, the order processing server including a database configured to store the dose orders and images that relate to the dose orders, the order processing server being configured to generate a dose order queue listing all dose orders received by the order processing server;

a dose preparation station for preparing a plurality of doses based on received dose orders, the dose preparation station being in bi-directional communication with the order processing server and having an interface for providing an operator with a protocol associated with each received drug order and specifying a set of drug preparation steps to fill the drug order, the dose preparation station including an interactive screen that includes prompts that can be highlighted by an operator to receive additional information relative to one particular step and includes areas for entering an input;

the dose preparation station being configured to present the protocol and having one or more data input devices to capture images of a plurality of the set of drug preparation steps that are part of the protocol and are followed to fill the drug order, wherein each image associated with the drug preparation steps of the protocol is stored together in a data record of the database, wherein at least one captured image is captured at, corresponds to, and confirms a performance of one discrete drug preparation step in which the dose is not completely prepared and ready for delivery to the patient and wherein each of the steps must be verified as being properly completed before the operator can continue with the other steps of drug preparation process, the captured image displaying a result of a discrete isolated event performed in accordance with one drug preparation step, wherein verifying the steps includes reviewing all of the discrete images in the data record; and

a display communicatively coupled to the order processing server and positionable independently of the dose preparation station, the display outputting the dose order queue and metrics concerning activity at the dose preparation station.

9. The system of claim 8, further comprising a plurality of dose preparation stations.

10. The system of claim 8, wherein the dose preparation station has a printer for printing dose labels of only those dose orders that are received from the order processing server.

11. The system of claim 8, wherein the protocol is based at least in part on information obtained from a National Drug Code (NDC) associated with each drug that is used to fulfill the drug order.

12. The system of claim 11, wherein a product information screen is provided for each drug dose and is configured to include a plurality of input fields, wherein the input fields includes a first NDC code field for entering an 11 digit unformatted NDC code for the drug, a second NDC code field for entering a 10 digit unformatted NDC code and an NDC format field for entering a format of the 10 digit NDC code.

13. The system of claim 12, wherein a product information screen is displayed for entering and storing product information for each drug, the screen including a plurality of product input fields, including a first NDC code field for entering a 10 digit unformatted NDC code for the drug and an NDC format field for entering a format of the 10 digit NDC code, wherein the computer is configured to calculate and store in memory a corresponding 11 digit unformatted NDC code for the drug based on the first NDC code field and the NDC format field.