Note: Descriptions are shown in the official language in which they were submitted.
CA 02833710 2013-11-19
SYSTEMS AND METHODS FOR DISPENSING MEDICAL PRODUCTS
BACKGROUND OF THE INVENTION
Automated pharmaceutical delivery systems have been in use for over
thirty years. The initial purpose of such systems was to reduce the high rates
of medication errors associated with manual distribution. In modern times,
automated systems present more sophisticated advantages. These include:
further reduction of errors, lower costs associated with pharmaceutical
distribution, reduction of personnel, inventory control, substance control,
automated documentation, and relieving professional pharmacists of many
tasks.
The current state of the art of automated pharmaceutical delivery
systems, otherwise known as medication management devices generally fall
under three categories: automated devices in the central pharmacy area;
automated devices in the patient care unit; and point-of-care information
systems.
The primary goal of centrally-located devices is to replace or improve
the current manual process for filling unit dose carts. These devices offer
the
advantage of a single, centralized inventory and a lower overall inventory.
Disadvantages of such devices include their large size, high cost, and
reliance
on efficient delivery systems.
Patient care unit-based devices replace the traditional manual unit dose
cart filling and delivery system and provide increased control over floor
stock.
Advantages of such systems include their smaller size and lower cost relative
to centrally-located devices, immediate access to medications, and automated
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documentation of medication administration. Disadvantages include application
to unit
dose levels only, increased costs due to the maintenance of multiple
inventories in multiple
units, additional time required to restock multiple devices, and larger
inventory.
Point-of-care systems are designed to enable immediate exchange of patient
data at
the bedside. Such systems allow for rapid access to patient information, fast
documentation, integration of hospital information systems, and immediate
verification of
drug administration. Primary disadvantages of point-of-care systems include
high cost
associated with placing hardware in each room, networking the system, and
security issues
associated with personal data access.
The above-described systems offer solutions for medication management in large
hospitals where the large expense associated with large centrally-located
pharmacy
systems, decentralized patient care units, and point-of-care systems at the
bedside are
justifiable for unit-dose dispensing and verification. These systems fail to
address efficient
and economical medication management at medium size facilities, for example
health
maintenance organizations which cannot justify the expenses associated with
the large and
costly aforementioned systems. Furthermore, while the above systems provide a
solution
for unit-dose dispensing for individual patients, they fail to address the
issue of filling weekly
or monthly prescriptions in a cost-effective manner.
SUMMARY OF THE INVENTION
The present invention relates to a method for remote dispensing of
pharmaceuticals
or other medical products using a distributed, interoperable, packet switched
network such
as the Internet and to a system that combines computer hardware and software,
including a
computer network, a telecommunications capability, and a medical products
dispensing
cabinet to form a complete drug dispensing system. The medical products may
include, but
are not limited to, packaged or non-packaged pharmaceuticals or prescription
or non-
prescription pharmaceuticals including drug samples, individual pills,
caplets, tablets, liquids,
or suspensions. This enables drug prescription dispensing in volume by a
physician,
pharmacist, or other licensed practitioner directly to the patient at a
clinic, group practice,
or other location outside a pharmacy or a hospital. The system
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provides a convenient, safe, automated, and low cost drug delivery system for
the
patient.
A preferred embodiment of the present invention is directed to an apparatus
and method for automated dispensing of packaged and non-packaged
pharmaceuticals. The remote control dispenser system of the invention includes
a
centralized computer network in conjunction with product release at a remote
location. The centralized network communicates with the remote distribution
point
using standard Internet Protocols (IP) or higher level application protocols
such as
Hypertext Transport Protocol (HTTP). In another preferred embodiment, a web
browser can be employed as a tool to provide for the controlled remote
dispensing of
packaged and non-packaged pharmaceuticals. In another preferred embodiment a
customized web server can be employed as a tool to provide for the controlled
remote dispensing of packaged and non-packaged pharmaceuticals. The systems
and
methods of the present invention provide for the efficient remote dispensing
of
medical products using widely available communications network technology
while
preserving the confidentiality of patient information and the safety of users
based on
restricted access to controlled substances.
A preferred system and method for remote dispensing of a medical product,
such as, for example, a prescription pharmaceutical includes an authorization
node, a
dispensing node to distribute the authorized medical product, a controlling
node that
interfaces with the authorization node and the dispensing node and a
transmission
medium between the nodes. The authorization node can include a controller and
appropriate software used by a pharmacist or a licensed physician. The
dispensing
node can include a housing having a plurality of bins which store encoded
packages
of medical products and a dispenser controller. The controlling node, which
may be
co-located with the authorization node, includes a customized web server to
control
the flow of information between the authorization and dispensing node.
A preferred embodiment of the present invention relates to systems and
methods of dispensing samples of drugs or other medical products. Samples are
often given to patients by physicians at clinics, offices, or hospitals. These
samples
are provided free of charge to physicians or institutions for distribution to
patients.
At present, there are no systematic procedures for controlling the
distribution of
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samples and there are increasing requirements by regulatory and accrediting
institutions to provide such controls.
Samples are usually packaged as unit doses in small foil and/or plastic
containers with labels intended to identify a particular brand name or
manufacturer
so that the patient will then associate the particular medication with a
particular
source.
Thus, the packaging for different samples from different sources tend to be
varied in
size and shape.
Thus, a system for containing and monitoring distribution in accordance with
the present invention includes a number of trays or drawers in which the
samples are
stored, a control system that opens and closes the system to provide access to
the
user and secures the system to restrict unauthorized access.
A user identification system can be included that serves to identify those
gaining access to the dispensing system. This system can include a computer
containing a catalog of medications dispensed using the system as well as
patient
data, or alternatively, accessing such information using a communication
network as
described herein.
Another preferred embodiment of the present invention provides a system for
dispensing non-prescription medications or other medical products that do not
require a licensed physician or pharmacist to be involved in the transaction.
Such a
system can include a secure storage housing that dispenses individual packages
based on credit card, debit card, cash, or other smart card transactions. The
system
can utilize features of the communications network, code reader, and
dispensing
systems described herein to provide for the distribution of "over the counter"
medical products.
The systems and methods to dispense medical products in the preferred
embodiments have an information display device for retrieving and caching
information from a communication network during periodically established
communication sessions. The display device includes a graphical display
device, a
communication transceiver connectable to a communication network that receives
display data. The network can include the Internet or other local and wide
area
networks. The device also includes a microprocessor and a memory device that
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stores display data, at least one display template, and program information.
The
display templates include variable field identifiers. Further the program
information
comprises a display generator providing a modified template by replacing the
variable field identifiers with corresponding display data, and displaying the
modified template on the graphical display device. The microprocessor and the
memory device record at least one dispensing operation value for a subset of
data
that are subsequently sent to the communication network. The display device
formats textual data and graphical data for display on the touch screen.
In accordance with a preferred embodiment, a system for dispensing a
medical product, includes a dispensing node to distribute the medical product
at a
location, the dispensing node is connected to a touch activated graphical
display to
initiate an express method for dispensing the medical product. The dispensing
node
verifies the presence of a unique transaction identifier affixed to the
medical product.
The system also includes a controlling node which interfaces with the
dispensing
node, the controlling node generating the unique transaction identifier. The
system
further includes a transmission medium between the nodes. The transmission
medium includes a network, for example, the Internet, a telephone system, a
satellite
system, a pager, and/or a wireless system. The dispensing node includes a
dispenser
controller and a housing having a plurality of bins wherein each bin stores an
encoded plurality of packages of medical products. A code reader is coupled to
the
controller for reading a code of a dispensed medical product. The dispensing
system
of the medical product further comprises a drug utilization review and
verification
process. The system prevents against dispensing the medical product a multiple
of
times using the unique transaction identifier.
In accordance with the present invention a method for dispensing of a
medical product includes selecting an expedited dispense function using a
graphical
user interface, scanning a pharmacy prescription label, dispensing the medical
product from a dispenser housing at the second location, the dispenser housing
including a touch activated graphical display, the dispenser having a
plurality of bins
and a code reader; and scanning in a transaction identifier affixed on the
medical
product. The method further comprising authorizing the dispensing of the
medical
product at a first location, transmitting the authorization via a transmission
medium
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to a second location. The transmission medium includes a packet switched
network such as
the Internet. The transaction identifier further includes one of patient
identifier, script date,
and national drug code. The method further includes parsing the pharmacy
prescription
label to generate the transaction identifier.
Further, a preferred embodiment includes a computer network formed of a
communication channel and a plurality of digital data processors coupled to
the
communication channel for communication thereon and a computer apparatus
dispensing a
medical product including an authorizing data processor at a first location
which includes a
database configured to store authorized user information, a plurality of
dispensing data
processors at a plurality of locations, each dispensing data processor being
connected to a
housing having a plurality of medical products and in communication with a
server; an
environmental control unit in the housing for controlling temperature inside
the housing; a
controlling data processor which is in communication with the authorizing and
dispensing
data processors configured to receive user information and send an
authorization request
including the user information to the authorization data processor; and a
laser which is
adapted to project a beam toward the medical product moved to the dispensing
location
and generate an image associated with medical product. The system also
comprises an
interface data processor is in communication with the controlling data
processor and parse
communications from the authorizing data processor. The processors communicate
via a
network and are further operative with a set of executable instructions to
authorize and
dispense the medical product.
Another preferred embodiment of the present invention includes a system for
automated dispensing of pharmaceuticals including a housing having a plurality
of
dispensers for moving packages of pharmaceuticals to the dispensing location
in response to
a dispense signal, a computer that controls dispensing of packages, an
electronic controller
within the housing that generates a dispense signal in response to a request
signal from the
computer and an environmental control unit in the housing for controlling at
least the
temperature of packages in the dispensers. Each dispenser includes a helical
dispenser. Each
dispenser further includes a ramp for gravity feeding of packages and a
rotating dispenser
actuated by the dispensing data processor, such that a single package is
dispensed per
request. The environmental control unit includes a heat exchanger for cooling
water and a
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chiller plate carried in proximity to the plurality of dispensers and
receiving water from the
heat exchanger for maintaining the temperature of packages at a temperature
below
ambient temperature. The environmental control unit routes conditioned air
through the
interior of the packages to control the temperature and humidity inside the
packages.
Furthermore, the environmental control unit comprises an evaporator in the
heat exchanger
and a plurality of condenser coils, a compressor and at least one fan for a
closed system for
cooling the water in the heat exchanger.
Another preferred embodiment of the present invention includes a computer-
readable data transmission medium between a plurality of computers having a
first subset
of data which includes authorization for dispensing a medical product; and a
second subset
of data which includes the data for a medical product label that accompanies
the dispensed
medical product. The processing of the first and second subset of data is
communicated at
their respective dispensing computers.
The foregoing and other object and features and advantages of the invention
will be
apparent from the following more particular description of preferred
embodiments of the
invention, as illustrated in the accompanying drawings in which
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-7-
like reference characters refer to the same parts throughout the different
views. The
drawing are not necessarily to scale, emphasis instead being place upon
illustrating
the principles of the invention.
=
BRIEF DESCRIPTION OF THE DRAWINGS
Figure lA is a diagram of a preferred embodiment of an automated drug
dispensing system in accordance with the present invention.
Figure 1B is a perspective illustration of a rack of columns in accordance
with the present invention.
Figure 1C is a perspective illustration of drawers of helix dispensers.
Figure 1D is a perspective illustration of a system including helix and
column dispensers in accordance with the present invention.
Figure lE illustrates a dispensing unit having a plurality of workstations in
accordance with the present invention.
Figure IF illustrates a kiosk system in accordance with the present invention.
Figure 2 is a flow diagram representing the processes performed by the
pharmacy technician at a Remote Control Dispenser (RCD) in a remote dispense
location and a registered pharmacist, R.Ph., at a remote control location in
accordance with the present invention.
Figure 3 is a schematic block diagram illustrating the drug dispensing system
in accordance with the present invention.
Figure 4A is a schematic block diagram illustrating a drag dispensing system
having a host system in one city and a remote drug dispensing system in
different
cities in accordance with the present invention.
Figures 4B - 4C are schematic block diagrRms illustrating the transfer of
information between the host system and the dispensing system in accordance
with
the present invention.
Figures 5A-5C are schematic block diagrams illustrating the sequence of the
transfer of information between a host system and a remote drug dispensing
system,
using the Internet, in accordance with the present invention.
Figures 6A and 6B are flowcharts illustrating the process to dispense
medications in accordance with the present invention.
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Figure 7 is a schematic block diagram illustrating a drug dispensing system
having an integrated touchscreen computer and print module in accordance with
the
present invention.
Figures 8A and 8B are schematic block diagrams illustrating a remote control
dispensing system which uses a server to control drug dispensing in accordance
with
the present invention.
Figure 9A(1) and Figure 9A(2), collectively referred to as Figure 9A
hereinafter, is a schematic block diagram illustrating a preferred embodiment
of the
remote control dispensing system which uses an internal data socket network
configuration in accordance with the present invention.
Figures 9B and 9C are flow charts illustrating the process to dispense
medications using the preferred embodiment of the present invention
illustrated in
Figure 9A.
Figure 10A(1) and Figure 10A(2), collectively referred to as Figure 10A
hereinafter, is a schematic block diagram of a preferred embodiment of the
remote
control dispensing system using the intemet and host pharmacy system network
configuration.
Figures 10B-10D are flow charts illustrating the process to dispense
medications using the preferred embodiment of the present invention
illustrated in
Figure 10A.
Figure 11A is a schematic block diagram of a preferred embodiment of the
remote control dispensing system using the internet network configuration.
Figures 11B-11D are flowcharts illustrating the process to dispense
medications using the preferred embodiment of the present invention
illustrated in
Figure 11A.
Figures 12A and 12B are schematic block diagrams illustrating the use of a
telephone network in a drug dispensing; system in accordance with the present
invention.
Figure 13A is a schematic block diagram of a preferred embodiment of the
remote control dispensing system using a telephone network direct dial
configuration.
=
CA 02833710 2013-11-19
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Figures 13B and 13C are flow charts illustrating the process to dispense
medications using the preferred embodiments of the present invention
illustrated in
Figure 13A.
Figures 14A and 14B are schematic block diagrams illustrating the use of a
pager service in a drug dispensing system in accordance with the present
invention.
Figures 15A and 15B are schematic block diagrams illustrating the use of a
satellite system to transfer information in a remote control drug dispensing
system in
accordance with the present invention.
Figures 16A-16E illustrate views of the display screen that a user interfaces
with during a dispense process to dispense a drug sample in accordance with a
preferred embodiment of the present invention.
Figures 17A-17C illustrate views of the display screen that a user interfaces
with during a maintenance process including loading medications in accordance
with
a preferred embodiment of the present invention which includes dispensing of
drug
samples.
Figures 18A-18D illustrate views of the display screen that a user interfaces
with during a maintenance process including an inventory process in accordance
with a preferred embodiment of the present invention which includes dispensing
of
drag samples.
Figures 19A-19C illustrate views of the display screen that a user interfaces
with including a prescriber process in accordance with a preferred embodiment
of
the present invention which includes dispensing of drug samples.
Figures 20A and 20B illustrate views of the display screen that a user
interfaces with during a transaction process in accordance with a preferred
embodiment of the present invention which includes dispensing of drug samples.
Figure 21 illustrates views of the display screen that a user interfaces with
during a history loading process in accordance with a preferred embodiment of
the
present invention which includes dispensing of drug samples.
Figure 22 illustrates views of the display screen that a user interfaces with
during a report process in accordance with a preferred embodiment of the
present
invention which includes dispensing of drug samples.
CA 02833710 2013-11-19
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Figures 23A and 23B illustrate views of the drag sample dispenser in
accordance with the present invention.
Figures 24A and 24B illustrate views of a computer chassis located within
the dispenser illustrated in Figures 23A and 23B.
Figure 25 illustrates a view of a computer mounted on the chassis located
within the dispenser illustrated in Figures 23A and 23B.
Figures 26A and 26B illustrate views of a motion control system located
within the dispenser illustrated in Figures 23A and 23B.
Figures 27A-27D illustrate views of an embodiment of a bin located within
the dispenser illustrated in Figures 23A and 23B.
Figure 28 illustrates a view of an introductory display screen that a user
interfaces with to dispense a non-prescription drug in accordance with a
preferred
embodiment of the present invention.
Figure 29 illustrates a view of a display screen showing in particular a drug
category selection screen that a user interfaces with to dispense a non-
prescription
drug in accordance with a preferred embodiment of the present invention.
Figure 30 illustrates a view of a display screen showing in particular a drug
availability screen that a user interfaces with to dispense a non-prescription
drug in
accordance with a preferred embodiment of the present invention.
Figure 31 illustrates a view of a display screen showing in particular a drug
list screen that a user interfaces with to dispense a non-prescription drug in
accordance with a preferred embodiment of the present invention.
Figure 32 illustrates a view of a display screen showing in particular a user
identification screen that a user interfaces with to dispense a non-
prescription drug in
accordance with a preferred embodiment of the present invention.
Figure 33 illustrates a view of a display screen showing in particular a ready-
to-dispense screen that a user interfaces with to dispense a non-prescription
drug in
accordance with a preferred embodiment of the present invention.
Figure 34 illustrates a view of a display screen showing in particular an
ending screen that a user interfaces with to dispense a non-prescription drug
in
accordance with a preferred embodiment of the present invention.
CA 02833710 2013-11-19
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Figure 35 illustrates a detailed view of the preferred embodiment of the non-
prescription drug dispenser in accordance with the present invention.
Figure 36 illustrates a view of an embodiment of the helix trays of the non-
prescription drug dispenser in accordance with the present invention.
Figure 37 illustrates a view of the details of an embodiment of a door
installed in a preferred embodiment of the non-prescription drug dispenser in
accordance with the present invention.
Figure 38 illustrates a view of a display screen of a user interface showing a
main screen used to dispense a prescription medical product in accordance with
a
preferred embodiment of the present invention.
Figure 39 illustrates a view of a display screen of a user interface
illustrating
use of a dispense function interface such as a button in accordance with a
preferred
embodiment of the present invention.
Figure 40 illustrates a view of a display screen of a user interface
illustrating
a dispense queue in accordance with a preferred embodiment of the present
invention.
Figure 41 illustrates a view of a display screen of a user interface showing a
review of patient script information in accordance with a preferred embodiment
of
the present invention.
Figure 42 illustrates a view of a display screen of a user interface showing
the prompt for scanning a barcode on a medical product in accordance with a
preferred embodiment of the present invention.
Figure 43 illustrates a view of a display screen of a user interface showing
the ba.rcode check information in accordance with a preferred embodiment of
the
present invention.
Figure 44 illustrates a view of a display screen of a user interface showing
the access of the resources function by interacting with the "Resources"
button in
accordance with a preferred embodiment of the present invention.
Figure 45 illustrates a view of a display screen of a user interface showing
the details of the resources function in accordance with a preferred
embodiment of
the present invention.
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712-
Figure 46 illustrates a view of a display screen of a user interface showing
the method of selecting the drug that needs to be accessed and edited in
accordance
with a preferred embodiment of the present invention.
Figures 47A and 47B illustrate a preferred embodiment of a remote control
dispensing system, the resources of which are being managed by the user
interface
described with respect to Figure 45 and Figure 46 in accordance with the
present
invention.
Figure 48 illustrates a view of a display screen of a user interface showing
the access of the reporting function by the use of the "reports" button in
accordance
with a preferred embodiment of the present invention.
Figure 49 illustrates a view of a display screen of a user interface showing
the selections of reports available in accordance with a preferred embodiment
of the
present invention.
Figure 50 illustrates a view of a display screen of a user interface showing
the access to an "Assign User" functionality by the use of a particular button
in
accordance with a preferred embodiment of the present invention.
Figure 51 illustrates a view of a display screen of a user interface showing
the method used to add a new user to the system in accordance with a preferred
embodiment of the present invention.
Figure 52 illustrates a view of a display screen of a user interface showing
the method to edit user privileges in accordance with a preferred embodiment
of the
present invention.
Figure 53 illustrates a view of a display screen of a user interface showing
the use of the "New Rx" interface button in accordance with a preferred
embodiment
of the present invention.
Figure 54 illustrates a view of a display screen of a user interface showing
the method used to select the patient in the "New Rx" option in accordance
with a
preferred embodiment of the present invention.
Figure 55 illustrates a view of a display screen of a user interface showing
the next step in the method to select the patient in accordance with a
preferred
embodiment of the present invention.
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Figure 56 illustrates a view of a display screen of a user interface showing a
method to select a prescriber in accordance with a preferred embodiment of the
present invention.
Figure 57 illustrates a view of a display screen of a user interface showing a
subsequent step in the method used to select the prescriber in accordance with
a
preferred embodiment of the present invention.
Figure 58 and Figure 59 illustrate views of a display screen of a user
interface showing steps in a method to select a drug in accordance with a
preferred
embodiment of the present invention.
Figure 60 illustrates a view of a display screen of a user interface showing
the information fields that can be edited pertaining to a drug in accordance
with a
preferred embodiment of the present invention.
Figure 61 illustrates a view of a display screen of a user interface showing
the required fields that need to be entered in accordance with a preferred
embodiment of the present invention.
Figure 62 illustrates a view of a display screen of a user interface showing
the reload inventory function interface, in particular a button, in accordance
with a
preferred embodiment of the present invention.
Figure 63 illustrates a view of a display screen of a user interface showing a
prompts to scan a barcode of a medical product to be reloaded into inventory
in
accordance with a preferred embodiment of the present invention.
Figure 64 illustrates a view of a display screen of a user interface showing
the selection of the drug and the related information in accordance with a
preferred
embodiment of the present invention.
Figure 65 illustrates a view of a display screen of a user interface showing
the use of the save interface (button) after restocking a particular medical
product in
accordance with a preferred embodiment of the present invention.
Figure 66 illustrates a view of a display screen of a user interface showing
the use of the add/edit patient interface button in accordance with a
preferred
embodiment of the present invention.
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Figure 67 illustrates a view of a display screen of a user interface showing
the subsequent step in the method to add the patient in accordance with a
preferred
embodiment of the present invention.
Figure 68 illustrates a view of a display screen of a user interface showing a
plurality of fields that need to be filled to add a patient in accordance with
a
preferred embodiment of the present invention.
Figure 69 illustrates a view of a display screen of a user interface showing
the use of the add/edit prescriber interface button in accordance with a
preferred
embodiment of the present invention.
Figure 70 illustrates a view of a display screen of a user interface showing a
subsequent step in the method to add a prescriber in accordance with a
preferred
embodiment of the present invention.
Figure 71 illustrates a view of a display screen of a user interface showing
the fields that are required to be filled to add a prescriber in accordance
with a
preferred embodiment of the present invention.
Figure 72 illustrates a view of a display screen of a user interface showing
the start of an adjudication method in accordance with a preferred embodiment
of
the present invention.
Figure 73 illustrates a view of a display screen of a user interface showing a
dispense queue in the adjudication method in accordance with a preferred
embodiment of the present invention.
Figure 74 illustrates a view of a display screen of a user interface showing
drug utilization review (DUR) alerts in an adjudication method in accordance
with a
preferred embodiment of the present invention.
Figure 75 illustrates a view of a display screen of a user interface showing
script information in the DUR alert described with respect to Figure 74 in
accordance with a preferred embodiment of the present invention.
Figure 76 illustrates a view of a display screen of a user interface showing
the patient transaction history in an adjudication method in accordance with a
preferred embodiment of the present invention.
Figure 77 illustrates a view of a display screen of a user interface showing
= the patient script information to be reviewed after an override or a
returned claim
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during the adjudication process in accordance with a preferred embodiment of
the
present invention.
Figure 78 illustrates a view of a display screen of a user interface showing
the fmal portion of the dispense process that includes the scanning of
barcodes as
part of the adjudication process in accordance with a preferred embodiment of
the
present invention.
Figure 79 illustrates a view of a display screen of a user interface showing
the reason for rejection as part of the adjudication process in accordance
with a
preferred embodiment of the present invention.
Figure 80 illustrates a view of a display screen of a user interface showing a
subsequent step indicating unresolved issues as part of the adjudication
process in
accordance with a preferred embodiment of the present invention.
Figure 81 illustrates a view of a display screen of a user interface showing a
rejection correction form as part of the adjudication process in accordance
with a
preferred embodiment of the present invention.
Figure 82 illustrates a view of a display screen of a user interface showing a
claim pending adjudication after being resubmitted as part of the adjudication
method in accordance with a preferred embodiment of the present invention.
Figure 83 illustrates a view of a display screen of a user interface showing a
DUR alert removal form as part of the adjudication method in accordance with a
preferred embodiment of the present invention.
Figure 84 illustrates a view of a display screen of a user interface showing a
returned claim as a result of the adjudication process in accordance with a
preferred
embodiment of the present invention.
Figure 85 illustrates a view of a display screen of a user interface showing
an
access users screen for dispensing, tracking and returning of particular
classes of
drugs such as, for example, controlled drugs like narcotics in accordance with
a
preferred embodiment of the present invention.
Figure 86 illustrates a view of a display screen of a user interface showing
an
access level field for adding and editing medical products into a system for
dispensing medical products in accordance with a preferred embodiment of the
present invention.
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Figure 87 illustrates a view of a display screen of a user interface showing
the denial of access to dispense a medical product in accordance with a
preferred
embodiment of the present invention.
Figure 88 illustrates a view of a display screen of a user interface showing
an
inventory count required field for an access level field in accordance with a
preferred
embodiment of the present invention.
Figure 89 illustrates a view of a display screen of a user interface showing a
response to an incorrect entry made into an inventory count for an access
level field
in accordance with a preferred embodiment of the present invention.
Figure 90 illustrates a view of a display screen of a user interface showing a
discrepancy report generated in response to denial of access in accordance
with a
preferred embodiment of the present invention.
Figure 91 illustrates a view of a display screen of a user interface showing a
"return/wasted" interface button in accordance with a preferred embodiment of
the
present invention.
Figure 92 illustrates a view of a display screen of a user interface showing
return/wasted information generated in accordance with a preferred embodiment
of
the present invention.
Figure 93 illustrates a view of a display screen of a user interface showing
the details of the selected transactions for an access level user in
accordance with a
preferred embodiment of the present invention.
Figures 94A-94D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing displays for
dispense
summaries in accordance with a preferred embodiment of the present invention.
Figures 95A-95G illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the methods of
entering
medical products to an inventory in accordance with a preferred embodiment of
the
present invention.
Figures 96A-96D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the methods for re-
entering or editing medical products to an inventory in accordance with a
preferred
embodiment of the present invention.
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Figures 97A-97D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the steps of the
method
associated with the databases functions to include a prescriber name in
accordance
with a preferred embodiment of the present invention.
Figures 98A-98C illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the methods for
viewing
a transaction or loading databases in accordance with a preferred embodiment
of the
present invention.
Figures 99A-99D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the method to view
multiple reports in accordance with a preferred embodiment of the present
invention.
Figures 100A-100C illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing the method to
determine the software version of the medical products in accordance with a
preferred embodiment of the present invention.
Figures 101A-101B illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing the method to
access a desktop computing processor in accordance with a preferred embodiment
of
the present invention.
Figure 102 illustrates warning screen in a user interface that is used in a
system for dispensing samples of medical products in accordance with a
preferred
embodiment of the present invention.
Figure 103 illustrates an initial screen in a system for dispensing samples of
medical products in accordance with a preferred embodiment of the present
invention.
Figure 104 illustrates a maintenance screen in a system for dispensing
samples of medical products in accordance with a preferred embodiment of the
present invention.
Figures 105A-105C illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing a method used
for
delaying the closing of a cabinet in accordance with a preferred embodiment of
the
present invention.
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Figures 106A-106D illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing a method used
for
registering fingerprints in accordance with a preferred embodiment of the
present
invention.
Figures 107A-107G illustrate display screens in a user interface that is used
in a system for dispensing medical products showing a method for an express
sequence for logging into the system for dispensing the medical products in
accordance with a preferred embodiment of the present invention.
Figures 108A-108E illustrate display screens in a user interface that is used
in a system for dispensing medical products showing a method for verifying the
bar
code of a medical product in accordance with a preferred embodiment of the
present
invention.
Figures 109A-109Q illustrate display screens in a user interface that is used
in a system for dispensing medical products showing a method for creating and
accessing reports, in particular customized reports, in accordance with a
preferred
embodiment of the present invention.
Figures 110A-1-110D are schematic diagrams illustrating preferred
embodiments that can include web-based dispensing ability in accordance with
the
present invention.
Figure 111 is a perspective view of a remote control dispenser (RCD) cabinet
in accordance with a preferred embodiment of the present invention.
Figure 112 is a sectional view of the remote control dispenser (RCD) cabinet
of Figure 111 in accordance with a preferred embodiment of the present
invention.
Figure 113A is a perspective view of a dispenser in accordance with a
preferred embodiment of the present invention.
Figure 1133 is a side sectional view of a roller dispenser in accordance with
a preferred embodiment of the present invention.
Figure 114A is a perspective view of an alternative dispenser in accordance
with a preferred embodiment of the present invention.
Figure 114B is a side view of a modified embodiment of the dispenser of
Figure 114A in accordance with a preferred embodiment of the present
invention.
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Figure 115 is a diagram of an automated drug dispensing system with a label
writer unit in accordance with a preferred embodiment of the present
invention.
Figure 116A is a schematic view of components of the label writer unit in
accordance with a preferred embodiment of the present invention.
Figure 116B is a perspective view of a package with a label in accordance
with a preferred embodiment of the present invention; and
Figure 117 is a sectional view of a remote control dispenser (RCD) cabinet
with a label writer unit in accordance with a preferred embodiment of the
present
invention.
DETAILED DESCRIPTION OF THE INVENTION
The present invention relates to systems and methods for the remote
dispensing of packaged and non-packaged medical products including the methods
for controlling a drug dispensing system described in U. S. Patent No.
6,068,156
issued May 30, 2002 which was filed as U.S. Patent Application No. 09/058,524
on
April 10, 1998, which is a continuation of PCT/US96/16758, filed October 18,
1996,
Publication No. WO 97/14393, which is a continuation-in-part of U.S. Patent
Application No. 08/642,484 filed on May 3, 1996, now U.S. Patent No. 5,797,515
which issued August 25, 1998, which is a continuation-in-part of U.S. Patent
Application No. 08/544,623 filed on October 18, 1995, now U.S. Patent No.
5,713,485 which issued February 3, 1998.
The present invention provides safe pharmaceutical prescription dispensing
directly by physicians, pharmacists, and other trained or licensed
practitioners
operating in small to medium size locations in a cost-effective manner. The
dispensing locations can be remote from the location of a licensed
practitioner such
as, for example, a pharmacist. Prepackaged pharmaceuticals are stocked at
nearby
municipal service centers and distributed to the health care locations as
needed. The
inventory is continually and automatically monitored by a host computer at the
location, and/or off-site on a central server. Inventory is ordered on a just-
in-time
basis by the computer. In this manner, prepackaged multiple-dose
pharmaceuticals
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are available to practitioners at the health-care facility for immediate
filling of
patient prescriptions.
The present invention offers significant advantages to physician group
practices. The system improves customer service and enhances the image of the
group practice. Drug theft is prevented by securing the pharmaceuticals in a
closed
system on hand and inventory is kept low. The system meets state pharmacy,
safety,
and regulatory compliance laws, whereas many manual dispensing systems do not.
A pharmaceutical distributor can handle all inventory planning, financing,
maintenance, and ordering with minimal interaction with group practitioners.
Disruptive telephone calls to the physician from pharmacists are minimized.
Further, physicians can gain immediate access to a patient's pharmacy records
currently unavailable to him.
Managed care providers, for example, Health Maintenance Organizations and
Pharmacy Benefits Managers also realize significant advantages from the
present
invention. The invention increases the likelihood that a patient will receive
the
required treatment, because the pharmacy is available at the doctor's office.
Labor
costs for in-house pharmacies are reduced, allowing staff reductions or
reassignments. In-house drug dispensing can be extended to physician-staffed
satellite clinics and other locations not suitable economically for
conventional
pharmacies. The system enables automated patient compliance enhancing
programs,
drug utilization analysis, and the use of other emerging pharmacy management
opportunities to reduce costs and improve patient compliance and wellness.
Drug
costs are reduced by formulary control, thereby encouraging generic
substitution of
name brand drugs. Inventory is tracked automatically by the drug distributor
headquarters, thus preserving professional time for patient care.
The present invention also offers significant advantages to the patients.
Drugs are provided immediately at the physician's office, avoiding an
inconvenient
trip to a pharmacy. This is particularly important to mobility-impaired
patients and
eliminates a major source of drug non-compliance. Electronic third-party payor
cards such as smart cards can be used for drug purchases at the doctor's
office. The
patient can obtain prescription drags at prices competitive with retail
discounters.
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The physicians are able to track prescription compliance which can result in
faster
recovery.
The apparatus of a preferred embodiment of the invention will now be
described. Figure lA is a diagram of an automated drug dispensing system in
accordance with the present invention. The primary components of the system
include a remote control dispenser (RCD) cabinet 20, a host computer 46, a
modem
52, a document printer 56, and a label printer 54. The cabinet 20 includes a
rack 24
comprising a plurality of bins, preferably in the shape of columns 34.
Packages 32
such as drug bottles, containing pharmaceuticals of various types are
distributed
among -the columns 34, each column 34 containing a separate type of
pharmaceutical, or multiple columns 34 containing the same pharmaceutical to
help
prevent stock outs on more frequently dispensed pharmaceuticals. A plurality
of
racks, for example, four racks 24 are enclosed in the cabinet 20 chamber, two
in the
main cabinet 20 and two on the doors 22. The doors are secured by locks 28.
A licensed user, for example, a doctor, pharmacist, nurse, or other medical
practitioner qualified to fill patient prescriptions, operates the system at
the host
computer 46, using a keyboard 50 and mouse 66 for input and receiving visual
feedback at a monitor 48. In an alternative preferred embodiment, a touch
screen
can be used for input. Using the keyboard 50, a user enters a, command to
request
dispensing of a particular packaged pharmaceutical variety 32 for a particular
patient. The computer 46 transmits the request via an interface 70 to a
controller 42
located on the RCD cabinet 20. The controller 42 interprets the command sent
from
the computer 46 and enables a dispensing actuator 68 in the appropriate column
34.
The lowest package 32 in the appropriate column 34 is released from the column
34
and ejected onto a ramp 30. The released package 74 slides down the ramp 30
into
an opening 26, where the released package 74 is made available to the
dispensing
party for transfer to the patient. A barcode reader 40, located near the
dispensing
opening 26, reads a code 98 on the dispensed package 74 and transmits the
barcode
information to the computer 46, which informs the user whether the code 98 on
the
dispensed package 74 matches that which was requested by the user. The barcode
98 can be disposed on the side, top, ancVor bottom of the package 32. In an
alternative embodiment, a semiconductor chip can be embedded in the dispensed
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package which, when passed through an RF field, charges a capacitor. When the
capacitor reaches an appropriate level, a weak RF signal is emitted. The
signal can
include approximately a 12 digit number. The semiconductor chip can also be
used
to uniquely identify a dispensed item.
In an automated embodiment of the system, sensors 36 located on each
column 34 monitor the dispensing process and notify the controller 42 of any
package jams. The sensors 36 also monitor inventory of the columns 34 and
notify
the computer 46 through controller 42 that a particular column is empty or
near
empty.
Alternatively, the prescription can be dispensed directly to the patient. A
card reader 38, mounted directly on or near the cabinet, is adapted to receive
a card
39 from a patient. The card is programmed with patient information that is
stored in
an electronic memory on the card by a licensed practitioner. The- patient
inserts the
card 39 in the card reader 38 and receives his medication automatically from
the
cabinet. The medication bottle 32 may be filled with a single dose of
medication for
a particular patient, or can include weekly or monthly doses. This embodiment
is
especially useful in large institutions, such as prisons, where many
individuals
require medication on a regular basis.
Upon validating the barcode 98 or the unique electronic signature of the
dispensed package 74, the computer generates a label 58 containing
prescription
information at a label printer 54 to be placed on the package, and generates a
document 60 at a document printer 56 containing additional instructions for
the
patient or practitioner. A modem 52 enables periodic or continuous
communication
between the host computer 46 and other computers in the network so that a
complete
inventory and status of each remote control dispenser cabinet is available at
all
times. Several remote control dispenser cabinets 20 can be integrated into a
single
installation operated by a single computer 46. The cabinets 20 can each be
individually connected to the host computer 46, or may be daisy-chained, with
only
one cabinet 20 in the chain connected to the host 46.
The RCD controller 42 receives commands from and transmits status
information to the host computer 46 via the controller interface 70. A request
command sent from the host computer 46 identifies the pharmaceutical package
32
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to be dispensed. In response, the RCD controller 42 activates the appropriate
dispenser 68, thereby releasing a single package of the variety requested. A
parallel
or serial I/O interface 62 at the host computer 46 provides a sufficient
communication channel. The simplest interface is a unidirectional channel from
the
host computer 46 to the controller 42. A full duplex implementation allows the
controller 42 to transfer status information back to the host 46. Status
information
may include errors such as package jams, empty columns, or other cabinet
status.
Availability of such information prevents inconsistencies in the database and
provides the operator with recovery procedures. This would require adequate
sensors 36 to be mounted in appropriate positions on the RCD cabinet 20.
The barcode reader 40 or an electronic digital signal reader can be mounted
directly on the unit or can comprise a hand-held unit 41. It verifies proper
loading of
the RCD cabinet 20 and proper dispensing of each pharmaceutical package 32.
Before a column 34 is loaded with packages 32, the column barcode label 76 is
compared with the barcode label 98 of each package 32 inserted into the column
34.
Each time a package 74 is dispensed from the cabinet 20, the package barcode
label
98 is scanned by the barcode reader 40 to verify that the correct
pharmaceutical has
been dispensed. The barcode reader 40 is interfaced to the host computer 46,
through a standard keyboard wedge 64. The wedge 64 makes the barcode reader 40
input via the barcode interface 72 appears to be coming from the keyboard 50.
Such
an interface is a simple and reliable interface to the pharmacy software
operating on
the computer 46. The barcode reader 40 must be highly reliable and provide a
high
first read rate. Label printing on the pharmaceutical packages 32 must be of
high
quality to accommodate this. The electronic digital signal reader interfaces
with a
communications port (comm port), a network interface card (NIC), or is in
direct
communication with the computer bus. During loading, the bottles are loaded
into
each column up to a certain height. The highest bottle in the column is
positioned
adjacent a barcoded column label 75 running along each column. Thus, the
number
of bottles in each column can be recorded at loading and tracked during use.
The host computer 46 runs the pharmacy software, provides a user interface,
and supports the RCD controller 42, barcode reader 40, printer, electronic
digital
signal reader, and modem 52. A standard off-the-shelf personal computer and
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operating system are sufficient to meet these requirements. As described
above, the
keyboard 50 and mouse 66 receive input from the user and the monitor 48
provides
visual feedback. The document printer 56 prints documentation 60 such as
detailed
instructions and a label printer 54 prints package labels 58, for example,
prescription
information 59 for adherence to the dispensed package 74. Using a combination
label stock form, a single printer can be used to provide both the patient
label and
patient education material. The prescription label 58 may also include a
printed
picture of the pharmaceutical 57 contained on the bottle to provide additional
safety.
The modem 52 provides a communication link between the municipal
service center (MSC) 106 and the remote control dispenser 108. Through this
link,
inventory of each RCD cabinet 20 is automatically monitored and updated in the
MSC 106 computer. The modem link also serves as a medium to issue restock
orders, update pharmacy software running on the host computer 46, and provide
remote diagnostics. The modem can be compatible with standard telephone lines
and can be capable of transferring data at sufficient rates.
The pharmacy software operating on the host computer 46 is a standard
commercial software package which provides standard administrative and
accounting capabilities. The pharmacy software also supports the unique
features of
the remote control dispenser system. These include: data communication with
the
RCD controller 42 via parallel or serial 1/0 interface 62; network interface
card
(NIC); data communication with the barcode reader 40 via keyboard wedge 64;
data
communication with the municipal service center via modem 52; printing of
labels
58 with the label printer 54 and printing of documentation 60 with the
document
printer 56.
The cabinet 20 and rack 24 are preferably fabricated from aluminum,
stainless steel, or plastic to be fully compatible with a clinical setting.
The rack 34
can be modified to provide for a diversity of packages including various box
and
bottle sizes, unit-of-use packaging, liquids, syringes, and various non-
prescription
products, for example, medical supplies.
The computer 46 can comprise a portable terminal, a notebook computer, or
a hand-held personal digital assistant. Voice recognition or voice prompted
software
can be employed using a telephone or wireless local area network. Voice
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recognition systems can use a generic or a user-customized system and can
include
voice signatures. The objective is to maximize system flexibility and ease of
use for
the doctor and staff without compromising safety. The remote control dispenser
system can be utilized as a free-standing system, as a local network
integrated with
physician office computers, or as a centralized network in conjunction with
product
release at a remote location.
Figure 1B is a perspective illustration of a rack 110 of columns 112. Each
column 112 includes a corresponding roller assembly 114, which is individually
addressable by the controller to dispense a bottle 116 as shown. After
dispensing, a
pusher 118 pushes the dispensed bottle forward into an off-center tilt tray
121 and
returns to its original position. The tilt tray 121 rotates in the direction
shown by
arrow 123 for removal of the dispensed bottle by the operator. Either a return
spring
or gravity returns the tilt tray 121 to its closed position. Note that the
tilt tray 121
when opened by the operator prevents entry of the operator's hand or other
objects
into the rack area 110 to avoid pilferage.
To load the columns 112, each rack 110 of columns slides out in the
direction shown by arrow 124. Each rack preferably includes a key lock at the
top
with a keying mechanism which retains the key until the rack is returned to
its
position, preventing loss of the key. After the columns are filled, the rack
is returned
to its normal position and the key is removed.
Figure IC is a perspective illustration of an alternative embodiment of the
present invention. In this embodiment, drawers 120 of helix dispensers 122 are
contained in a cabinet 124. The helix dispensers 122, when activated, rotate
in a
single direction. As the helix 122 rotates, any pharmaceutical packages
disposed on
the helix are pushed forward toward the front of the cabinet 124. One full
rotation of
the helix 122 will cause the outermost package to be released, causing the
package to
fall into the bin 126. After the package drops into the bin 126, an operator
slides
open the bin 126 and removes the package. While the bin is open, a door blocks
the
opening between the bin 126 and the dispensing area to prevent pilferage. The
helix-dispensing unit described above is particularly suitable for packages of
various
non-standard sizes, for example boxes, bags, and kits. Larger-sized helixes
122 may
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=
be used for smaller packages. The helixes 122 are each individually driven by
a
stepper motor located in the rear of each tray.
Figure 1D is a remote control dispenser embodiment well-suited for use in a
doctor's office or in a small clinic. The top unit 130 includes a column
dispenser as
shown in Figure 1B. The bottom unit 132 includes a helix dispenser as shown in
Figure 1C. This combination of dispensers covers a range of package styles for
controlled substances, toolkits, and bandages for a typical clinic.
Figure lE is an illustration of an alternative dispensing unit. The unit
includes a plurality of workstations 178, each workstation having a
corresponding
dispensing port 180. The unit further includes a cabinet 182 for storing a
variety of
pharmaceuticals and a conveyer means 184 for conveying a dispensed
pharmaceutical from the cabinet area 182 and for distributing it to the
appropriate
dispensing port 180. Each workstation 178 also includes a printer for printing
labels
and instructions as described herein and a barcode reader for verifying that
proper
dispensing has occurred.
The workstation can alternatively be configured with integrated voice
response software and hardware to penult external initiation of a refill
order. In such
a configuration, a patient telephones the workstation, enters a secret code
and
initiates refill dispensing. After dispensing has occurred, the workstation
verifies
such to the patient indicates a time for pick up. At the next opportunity, the
operator
of the workstation prepares the bottle label and instructions, and verifies
that proper
dispensing has occurred.
In a kiosk configuration as shown in Figure 1F, a cabinet 186 encloses a
carousel-type rotatable cabinet 188 containing a plurality of individually
addressable
locations 190. Upon receiving a dispensing signal, the carousel 188 rotates to
align
the correct column 190 with the dispenser 192. The dispenser 192 includes a
grabber 194 which removes the bottle from its storage location 196. The
grabber
194 conveys the pharmaceutical downward to dispensing drawer 198 and rotates
to
place the pharmaceutical in the drawer 198. The operator removes the
pharmaceutical from the drawer and completes the dispensing process.
Figure 2 is a flow diagram representing the processes performed by the
pharmacy technician at an RCD and a registered pharmacist at the RPH
workstation
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in accordance with the present invention. Initially, a patient presents a
prescription
to a technician at an RCD unit 270. The technician determines whether the drug
is
stocked in the RCD unit 271. If the pharmaceutical is not stocked, then the
technician decides whether to electronically transfer via facsimile, email, or
otherwise, the prescription to in affiliate 272. If the prescription is
transferred to the
affiliated pharmacy, 273, the patient may travel to that pharmacy to receive
the
pharmaceutical. Otherwise, the prescription is returned to the patient 274 to
be filled
at another RCD unit or by another pharmacist of the patient's choosing.
lithe drug is stocked at the RCI unit, then patient data is retrieved 275, the
drug is selected 276, the prescription signa is selected 277 and additional
scripts may
be entered 278. Following this, the identification number of the prescriber is
entered
279 and all data is transmitted to the RPH workstation 280. At the RPH
workstation, the pharmacist verifies the prescription 281 and performs a drug
utilization review 282. If issues arise during the review, the pharmacist is
immediately made aware of the conflict and given an opportunity to review and,
if
appropriate, override 283 the contra-indications 284. If the pharmacist
decides at
this point to discontinue the dispensing 285, the process is aborted 294. If
the
pharmacist decides to continue the dispensing anyway 284 or there were no
contra-
indications 283 in the first place, then claim adjudication is performed 286.
During
adjudication 286, a patient's insurance information is automatically verified
to
determine whether the insurer will pay for the prescription, and if so, if any
co-
payment is required from the patient. If a negative response is received 287,
drug
dispensing is aborted 291. Otherwise, the drug is dispensed and verified with
a
barcode reader 288. If an improper drug was dispensed, the technician is
notified to
abort the process as a system failure has occurred 292. Upon system failure
electronic notification is performed. Distribution headquarters or a regional
dispensing location or agent can be notified by the RCD system of an incorrect
dispense is shown. Electronic notification can take the form of a fax, email,
file
transfer, pager notification, or any other electronic transfer protocol, If
verification
is positive, a label is printed and affixed to the bottle 290. The technician
then must
scan an additional barcode that is created at the time of the printing. This
barcode is
located on the patient label now affixed to the dispensed item. If
verification of this
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last barcode is positive, the prescription is dispensed to the patient by the
technician
293.
Referring to Figure 3, the drug dispensing system 310 of the present
invention includes computers attached to a computer network system, for
example,
the Internet 320. Three of the systems are RCD workstations 322 which control
the
RCD hardware or dispensers 324. A computer system, represented by the laptop
graphic, is the "Controlling Pharmacist" computer 326. Another computer 328 is
a
server running typical website type software.
The operating system of the workstations 322 is preferably a Windows
basedsystem, for example, Windows NT systems with access to the Internet via
a
modem or via a connection to a Local Area Network (LAN), which has access to
the
Internet. Each workstation 322 uses a browser (for example, Microsoft
Internet
Explorer) to interact with the server 328. The interaction entails getting
patient
information entered, drug information, etc. Instead of a local executable, the
Internet
and a browser are used. The server 328 sends permission to each workstation
322
via the browser. The permission protocol is discussed in further details
hereinafter.
In a particular embodiment, the server 328 runs Microsoft NT, Microsoft
Internet Information Server (US) 4.0, ColdFusionTM and is connected to the
Internet
320 via a static Internet Protocol (IP) address. A static or dynamic IP or a
unique
domain name can be used.
The server 328 contains and maintains all the information necessary to
dispense a drug. It effectively functions as a "mainframe."
Once the dispense is appropriate that is there are no drug issues, and the
patient can pay for the medication, the server 328 passes to the client
browser the
necessary codes to cause the RCD 324 to dispense the drug requested.
The pharmacy controller 326 is shown as a laptop to indicate pictorially that
there is no attached hardware RCD's, etc. This system also requires access to
the
Internet 320 via a modem or LAN, and uses a browser to interact with the
server 328
and the workstations 322.
The drug dispensing method of the present invention is predicated on the fact
that most everybody has access to the Internet 320. When one logs onto the
Internet
320 one gets an IP address, which uniquely identifies a user. Access to the
Internet
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can be through an existing connection LAN, or using a Microsoft utility for
example, dial-up networking. The workstation 322 using a bookmark, or Internet
Explorer Favorites, or entering the domain name or IP address, connects to the
server 328. The server 328, for example, WebDirectRx.com has a password gate;
to
control access and to establish which databases the workstation 322 has access
to.
This reduces any confusion regarding the inventory and dispense queues of
networks, for example, in Utah, and Florida. The workstation 322 gets access
from
its user ID and password, plus a cookie that uniquely identifies the
installation, to the
correct databases. Examples are the inventory database, patient database,
transaction
database, and the dispense queue database.
The workstation 322 types into WebDirectRx.com the demographics of a
new patient, or selects an existing patient. Another preferred embodiment has
a host
pharmacy or hospital network share access to patient records within its own
nodes,
or dispense sites. The workstation 322 selects and enters the Rx information.
Rx
Information is the data needed to process a drug Rx. It includes at least an
account
number, Rx#, Rx date, patient name, prescriber name, SIG, dosage, and
insurance
information. This information is placed into a queue database that is
accessible for
read only by the workstation 322. The Rx information is then available to a
pharmacy controller account, who has READ/WRITE access to the queue. The
pharmacy controller 326 uses a browser, and has gone through a password gate.
The
queue available to the pharmacy controller 326 is based upon the user ID
entered to
keep the different dispensing networks from sharing or intercepting data not
pertinent unto itself.
The pharmacy controller 326 reviews the Rx information in the queue,
processes the information through a Drug Utilization Review (DUR) Process, and
performs adjudication as needed. Once these services are completed the
pharmacy
controller 326 places into a dispense queue the Rx information for the sending
workstation 322. The sending workstation 322 in turn, sees it has an item in
its
queue, and dispenses that item using one of the methods to dispense a drug
from
hardware using the network as will be discussed later.
In a particular embodiment, the actual signal sent to the RCD 324 is triggered
by the pharmacy controller 326, assuming the RCD is in a ready state to
receive such
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a signal. Some states require the signal to be controlled by the pharmacy
controller
326, versus the caregiver in front of the dispenser. The pharmacy controller
can
control quite a large network of workstations 322.
Figures 4A-4C schematically illustrates a host pharmacy system in city 1
connected to a remote dispensing system 340 in city 2 and city 3. The
dispensing
systems 340 are connected to a host interface controller 342 which acts as a
gateway
and passes control to the host pharmacy workstation 344. The information
required
to process a medication prescription for example, patient information, patient
allergies, disease, and medication profile, is sent by the dispense interface
central
processing unit (CPU) 340 to the host interface CPU 342. The information is
processed by the host pharmacy server 346 then is sent to a pharmacy label
printer
348 which in turn prints out a pharmacy label for the requested medication.
The
pharmacist at the host pharmacy workstation 344 is sent the physician's
prescription
or a copy thereof. The physicians prescription can be in a variety of forms
for
example, a physician's called in instructions, an electronic version, a
scanned in
version from a scanner co-located with the remote dispensing RCD system 324.
The
pharmacist interprets the physician's prescription instructions against the
label
printed out by the printer 348. If acceptable, the pharmacist redirects the
label to the
host interface CPU 342 which now effectively acts as a network printer. The
host
interface CPU 342 parses the output based on a set of instructions and
extracts out
the prescription information, for example, the patients name, the name of the
drug,
SIGNA etc. The host interface CPU 342 then sends a signal, or dispense
information, to the dispense interface CPU 340 in either city 2 or city 3 via
the
Internet 320. Upon receiving the signal, the dispense interface CPU 340
dispenses
the appropriate medication from the RCD 324. In the alternative, the dispense
interface reconstructs the information and presents it for dispensing from the
RCD
324 by the co-located caregiver. As described previously with the dispense
interface
CPU 340 with respect to Figure 2, the dispensed drug's barcode is scanned
along
with the printed label and provided to an end user.
Figures 5A-5C schematically illustrate the sequence followed to transfer
information between a host pharmacy system in one city and remote dispensing
systems in a different city. As illustrated in Figure 5A, a connection is
first
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established between the host pharmacy system and a remote dispensing system
using
a remote access engine 350. Each location publishes the dynamically assigned
EP
address to an Internet website 352.
As illustrated in Figure 5B, the dispense system in city 3 queries the
Internet
website 352 for the dynamically assigned IP address of the host pharmacy
system.
The dispense system then begins remote control 354 of the host pharmacy system
to
create a medication prescription.
=
As illustrated in Figure 5C, the host pharmacy system queries the Internet
website 352 for the dynamically assigned IP address of the dispense system
using a
data socket 356. The host pharmacy system then sends the medication
prescription
release information to the dispense system using the IP address given by the
Internet
website 352.
Figures 6A and 6B are flow charts illustrating the process to dispense
medications using a remote controlled dispense system. The prescriber, for
example,
a physician creates a prescription on paper or via electronic means per step
360. The
prescription is then given to the patient or electronically delivered to a
technician
who is co-located at a dispense interface CPU 340 per step 362. If the
prescription
was given to a patient, the patient carries the Rx to a dispense interface CPU
340
location per step 364. The prescription is presented to the technician in step
366.
The technician then faxes, or forwards the electronically generated
prescription to a
host pharmacy location per step 368. The technician uses the Internet 320 to
connect
to the host interface CPU 342 per step 370.
The host interface CPU 342 also connects to the Internet 320 per step 372.
The technician enters patient demographics and prescription information in a
host
pharmacy software over a link per step 374. A drug utilization review (DUR)
process is then conducted by the pharmacist per step 376. This is followed by
an
adjudication process per step 378 if required. A prescription (Rx) label is
printed in
the host pharmacy software on the pharmacy label printer 348 per step 380. The
host pharmacy then interprets the faxed or electronically generated
prescription with
the output from the pharmacy label printer per step 382. The host pharmacy
then
sends the prescription information to the host interface CPU 342 per step 384.
The
host interface CPU 342 sends the prescription information to the dispense
interface
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CPU 340 via the Internet 320 per step 386. The prescription is then placed
into a =
queue for the technician who is co-located with the dispense interface CPU 340
per
step 388. The technician then selects the prescription to be dispensed per
step 390.
The technician enters their unique user ID per step 392. Upon being queried
for a
password, per step 394, the technician enters a valid password. If the
password is
accepted the item is dispensed from the RCD 324 per step 396. The item's
barcode
is read to check if the correct item has been dispensed per step 398. If the
barcode is
accurate, as decided per step 400, a label containing the monograph and
patient
material is printed per step 402. The patient label barcode is then read for
accuracy
per step 404. A counsel request is made to the patient per step 406. If a
counsel is
required per step 408, then a telepharmacy connection is made between the
dispense
location 340 and the host pharmacy location per step 410. Once the patient is
counseled per step 412 the dispensing procedure is completed. If however, it
is
decided in step 408 that a counsel is not required then the procedure for
dispensing
the medication is completed then.
Figure 7 illustrates a particular embodiment of a remote control dispenser
324 having an integrated touch screen 420 and a print module 422. This
embodiment does away with the need for a workstation co-located with an RCD
324.
Figures 8A and 8B illustrate a particular embodiment of the remote control
dispense system which relies on a web server such as an Internet server 430 as
illustrated in Figure 8A, or a customized web server 432 as illustrated in
Figure 8B.
A browser 434 is used to control the dispensing of the medication or package
from
the RCD 324. The Internet server 430 and the web server 432 effectively
function as
the host interface CPU 342.
The drug dispensing method in accordance with the present invention
includes at least one of the following different methods to dispense a drug
from
hardware such as the RCD 324 using a computer network such as the Internet. A
first method includes having the web browser which causes a local executable
to
launch which communicates with the communications port (COIVEVI PORT) of a
workstation 340 and thereby the electronics in the RCD 324. This activates
automatically in an unattended fashion, effectively like a batch file running.
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A second method to dispense a drug from the RCD 324 using the Internet
includes direct communications between the browser and the COMM PORT. An
ADD-ON element is built for the browser that is downloaded each time a
dispense
signal is to occur, or only once (the first time) and it is called when
needed.
A third method to dispense a drug from the RCD 324 hardware using the
Internet is via a customized software application such as, for example, a JAVA
APPLET downloaded as part of the permission to dispense. The applet activates
the
COMM PORT and causes the dispense cycle.
Another method to dispense a drug is to have a local executable which is
"WebEnabled" by having built into it a hypertext transfer protocol (http) or
file
transfer protocol (ftp) service which frequently scans a table on the server
328 for
the needed codes to dispense an item.
Another method to dispense a drug includes PCAnywhere. Both systems are
connected to the Internet, one runs pcAnywhere HOST, the other pcAnywhere
REMOTE. The remote, via the Internet 320, controls a local executable - the
dispense software just by entering the host IP address, or searches a sub-net
for any
connected system running HOST. The dispense protocol remains the same as
described herein before.
It should be noted that the software the technician interacts with can exist
on
an attached and co-located external computer configuration, or as an
integrated
computer using TouchScreen components built directly into the RCD.
Referring to Figure 9A, in this embodiment of the dispensing system an
existing host pharmacy software system 470 with a co-located interface
application
server 476, and a remotely installed dispense location interact to provide
pharmaceutical dispensing across a wide geographic region. This preferred
embodiment uses the Internet 482 to communicate Rx dispense information. The
host pharmacy software system 470, via the interface application server 476,
sends
Rx dispense information onto the dispense location workstation 486. At the
dispense location workstation 486 the local user, for example, a technician,
is
presented with a queue of processed prescriptions received from the host
pharmacy
software system 470.
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The dispense location workstation 486 contains local executable program(s)
that manage the connection to the intemet 482, internet data socket
communications,
data acceptance, inventory management, and visually prepares the Rx
information
received from the interface application server 476 in an easy to read queue
for the
local caregiver, typically a technician. In addition the dispense location
workstation
486 communicates with the co-located Remote Control Dispenser(RCD) 490 to
dispense packaged pharmaceuticals, a printer 472, such as a laser jet or color
jet
printer to provide patient and record keeping materials, as well as, a barcode
scanner
for doing quality checks during a dispense. The dispense location needs access
to a
telephone system to get a "dial tone", or a LAN based Internet connection, in
order to
receive and send communications.
The host pharmacy software 470 is maintained or run at the pharmacy control
location. Typically these are small networks of pharmacy workstations where a
retail or hospital pharmacy team interacts with insurers computers to create
the order
that leads to the filling of a drug to be handed to the patient.
The interface application server 476 is a computer that is co-located with the
host pharmacy software system 470. It is used to collect information (the Rx
data)
for a dispense from the host pharmacy system and then forwards that
information to
the dispense location workstation 486 via the Internet 482.
Referring to Figures 9B and 9C, a typical workflow of the embodiment
illustrated in Figure 9A includes the following sequence of steps. An Rx is
generated by a Physician or caregiver using a paperless method such as a PDA
or
TouchScreen or by usual methods using pen and paper, fax and scanners in step
504.
The Rx information typically contains the patient name, prescriber name and
Drug
Enforcement Agency identifiers, instructions for the administration of the
drug,
drug; name, and quantity to be given to the patient. The Rx is transmitted to
different locations per step 506, for example, if the Rx is transmitted to a
pharmacy
control location via fax or an electronic means, the authorized dispenser,
typically a
pharmacist, interprets the transmitted information. Alternatively, if the Rx
is
transmitted to a dispense location electronically or physically delivered, a
user,
typically a technician can take authorized action.
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Once entered into the host pharmacy system per step 516, the Rx is
manipulated into the host pharmacy software system per step 518 either by an
authorized dispenser interpreting the Rx information transmitted directly to
his/her
location and then manually or through an electronic interface transfers the Rx
information into the host pharmacy software, or the technician has an option
to
transmit the information to the authorized dispenser, pharmacist, for the
pharmacist
to manipulate as described hereinbefore or to remotely connect to the host
pharmacy
software via a variety of interfaces to transfer the Rx information into the
host
pharmacy software system either manually or via an electronic interface. The
connection interfaces can be, but are not limited to, Symantec pcAnywhere
directly,
Symantec pcAnywhere via the: Internet, or by a co-located WAN connection
provided with the host pharmacy software.
Once the information is transcribed or transferred into the host pharmacy
software system a number of typical processes are applied to the Rx
information.
The processes can be a Drug Utilization Review; which entails scanning the
drug to
be dispensed against the patient profile contained within the host pharmacy
software
system to determine if any pharmaceutical contra-indications for dispensing
exist.
An example of a DUR can be a drug-to-drug interaction test, or a patient drug
allergy test. A second typical process is an Adjudication process whereby the
host
pharmacy Software system communicates with a pharmacy benefit management
computer to determine the patient's insurance coverage and payment amounts, if
any.
The Rx information, having been processed by the host pharmacy software
system can generally then be determined to be a valid Rx; which can be
processed by
the pharmacist. In a retail setting, the pharmacist then triggers patient drug
labeling
to be produced by the host pharmacy software system and takes a large bottle
of
medications from the shelf and counts and places into a smaller bottle,
typically
called a vial, the number of tablets, caplets, or milliliter's called for by
the physician.
The pharmacist then applies labeling and hands the drug to the patient. When
the
dispense is processed in conjunction with the remote dispensing system, the
pharmacist or authorized dispenser triggers a patient drug label to be
produced by the
host pharmacy software system, however, instead of the label being processed
by a
CA 02833710 2013-11-19
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co-located printer (laser jet or dot matrix) the output is directed to the
interface
application server. The interface application server accepts the Rx
information as a
printer stream per step 520, or through a direct electronic interface to the
host
pharmacy software system network constructs.
Per step 522, an application, such as, for example, Parse Engine, parses the
output received by the host pharmacy software system.into discreet data
elements.
Once the parsing is completed, the data is then encrypted and is uniquely
identified
for transmission to the dispense location workstation via the Internet.
The information is received by the dispense location workstation, decrypted
and is placed into a work in process queue that is accessed by local
executable
programs run by the technician per step 508.
The technician at the dispense location selects the Rx-Drug-Patient to be
dispensed from a list of one or more possible to be displayed per step 510.
The
selections are shown as mouse selectable lines. Each line represents a
different Rx-
Drug-Patient to be processed by the technician.
Upon selecting the Rx-Drug-Patient to dispense the technician at the
dispense location is queried if this is in fact the Rx-Drug-Patient per step
524. If the
answer to the query is no, the technician is returned to the entire queue list
as
described above per step 512. If the answer to the query is in the
affirmative, the
local executable program resident on the dispense location workstation
examines a
local inventory file that contains data specific to the drug requested to be
dispensed
per step 526. The drug contains a profile which includes but is not limited to
current
stock level, suggested restock levels, and coordinate position within a single
or
plurality of RCD's.
The RCD receives a technician coordinate type communication from the
locally resident executable. The X,Y coordinate represents &location within a
single
or plurality of RCD's where the requested pharmaceutical is stored for
dispensing.
The X,Y coordinate is determined by examining an inventory profile of the drug
to
be dispensed. Upon receiving the dispense signal from the dispense location
workstation the RCD presents a drug to the technician per step 528.
As a result of the dispense occurring, the technician is presented with an
additional screen which requires the input of barcode data embedded onto the
label
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of the dispensed drug. A barcode reader co-located at the Dispense Location is
used
to read the barcode of the item dispensed from the RCD per step 530. The
technician reads the barcode into the screen to be examined by the resident
dispensing software.
The barcode of the item dispensed is read into the resident dispensing
software and is compared with the value of the barcode expected from the drug
inventory profile. If the values match per step 532 what the resident
dispensing
software is expecting, a patient education monograph, patient labeling,
graphic
representation of the drug expected, and picture of drug expected are
generated per
step 536 and delivered to the co-located printer. If the values do not match
what the
resident dispensing software is expecting, the user has three attempts with
which to
scan or enter the expected values per step 534. If three failed attempts are
made, the
transaction is terminated with warnings sent to appropriate parties like the
authorized dispenser, technician, system operator, and pharmacy consultant via
pager and email. Appropriate drug disposal and storage is maintained via
training of
the technician and an additional lock storage box within the RCD.
The technician at the dispense location is presented with one additional
barcode on the patient label that is to be affixed to the item dispensed. The
technician is required to perform one more barcode read by scanning the
patient
label after it is affixed to the item dispensed per step 538. The barcode of
the item
dispensed is read into the resident dispensing software and is compared with
the a
value of the barcode expected, the Rx number. If the values do not match what
is
expected, then the user has three attempts to scan the correct label before an
error
condition is reported per step 542. If the values do match per step 540, then
the
dispense is complete and the local technician is returned to the view of the
queue
show work in process, if any.
If the patient, who has been remotely administered medications has any
questions an authorized pharmacist is available for consultation using a
variety of
telephannacy systems, including, but not limited to, a telephone system audio
visual
connection 488, a networked audio visual connection, and an internet connected
audio visual connection.
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Referring to Figure 10A, in another preferred embodiment of the present
invention an existing host pharmacy software system 560 with a co-located
interface
application server 566, and a designed web server 574 work in-conjunction to
provide a third location, the dispense location, with prescription information
enough
to identify and then dispense a pharmaceutical.
The dispense location uses a web browser, such as, for example, Microsoft
Internet Explorer 5.0, instead of a locally installed executable. The web
browser
then interacts with data on a Web Server 574. The web server 574 gets its data
from
the interface application server 566 which is co-located with a customers
Pharmacy
software system 560.
The dispense location is where the RCD cabinet 582 is located, along with a
personal computer 580, a printer 562 such as a laser jet printer, and a
barcode
scanner. This site has connectivity through a network or telephone system to
the
internet 576.
The pharmacy control location is where the host pharmacy software is
maintained or run. Typically these are small networks of pharmacy workstations
where a retail or hospital pharmacy team interacts with insurers computers to
create
the order that leads to the filling of a drug to be handed to the patient. The
wholesalers have discovered a method to keep distribution by supplying retail
outlets
with pharmacy software that automatically places reorders with the wholesalers
computers based upon use and an inventory threshold stockout level. An example
of
pharmacy software that can be used, but is not limited to, with the present
invention
is McKesson HBOC Pharmaserve software.
The interface application server 566 is a computer that is co-located with the
pharmacy software system 560. It is used to collect information such as, for
example, the Rx data for a dispense from the host pharmacy system and then
forwards that information to the web server 574 in accordance with the present
invention. The web server 574, runs ColdFusionTM with a Structured Query
Language (SQL) 6.5+ database. The web server stores data sent to it, and
displays
that data in an easy to understand point and click format. The web server 574
is
connected to the internet 576 at a static EP address using a Universal
Resource
Locator (URL) such as, for example, StarNetLite.COM. The web server 574
CA 02833710 2013-11-19
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handles secure transmission of the data as well as the segmentation of data
based
upon a user log-in id/profile.
Referring to Figures 10B-10D, a typical workflow, illustrated as a flow chart,
includes the following sequence of steps. Per step 604, an Rx is generated by
a
physician or caregiver using a paperless method such as a personal data
assistant(PDA), such as, for example, a palm pilot, or TouchScreen or by usual
methods using pen and paper, fax and scanners. The Rx information typically
contains the patient name, prescriber name and Drug Enforcement Agency
identifiers, instructions for the administration of the drug, drug name, and
quantity to
be given to the patient. Per step 606, the Rx can be transmitted to different
locations. For example, if the Rx is transmitted to the web server 574
directly, then
the image or Rx data is stored to an appropriate table on the web server for
retrieval
by a user authorized to dispense medications, typically a pharmacist. In the
alternative, if the Rx is transmitted to a pharmacy control location via fax
or other
electronic means, the authorized dispenser, typically a pharmacist, interprets
the
transmitted information. If the Rx is transmitted to a dispense location
electronically
or is physically delivered, a user, typically a technician can take the
authorized action
upon the Rx.
Once the Rx is entered into the host pharmacy system per step 610, the Rx is
manipulated into the host pharmacy software per step 612 using different
methods.
For example, an authorized dispenser reviews the web server 574 captured Rx
information in a 10 browser, and then, transfers that Rx information manually
or
through an electronic interface into the host pharmacy software.
Alternatively, an
authorized dispenser interprets the Rx information transmitted directly to
his/her
location and then manually or through an electronic interface transfers the Rx
information into the host pharmacy software. The technician has an option, to
either
transmit the information to the authorized dispenser, pharmacist, for the
pharmacist
to manipulate as described hereinbefore, or to remotely connect to the host
pharmacy
software via a variety of interfaces to transfer the Rx information into the
host
pharmacy software system either manually or via an electronic interface. The
connection interfaces can be, but are not limited to, Symantec pcAnwhere
directly,
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Symantec pcAnywhere via the Internet, and by a co-located wide area network
(WAN) connection provided with the host pharmacy software.
Once the information is transcribed or transferred into the host pharmacy
software system, a number of typical processes are applied to the Rx
information.
The processes can be, for example, a Drug Utilization Review (DUR) which
entails
scanning the drug to be dispensed against the patient profile contained within
the
host phannacy software system to determine if any pharmaceutical contra-
indications for dispensing exist. An example of a DUR can be a drug-to-drug
Interaction test, or a patient drug allergy test. A second typical process is
an
Adjudication process whereby the host pharmacy Software system communicates
with a pharmacy benefit management computer to determine the patients
insurance
coverage and payment amounts, if any.
The Rx information, having been processed by the host pharmacy software
system can generally then be determined to be a valid Rx; which can be
processed by
the pharmacist. In a retail setting, the pharmacist then triggers patient drug
labeling
to be produced by the host pharmacy software system and takes a large bottle
of
medications from the shelf and counts and places into a smaller bottle,
typically
called a vial, the number of tablets, caplets, or milliliter's called for by
the physician.
The pharmacist then applies labeling and hands the drug to the patient. When
the
dispense is processed in conjunction with the web server, the pharmacist or
authorized dispenser triggers a patient drug label to be produced by the host
pharmacy software system, however, instead of the label being processed by a
co-
located printer (for example, a laser jet or dot matrix printer) the output is
directed to
the interface application server.
The interface application server accepts the Rx information as a printer
stream per step 614, or through a direct electronic interface to the host
pharmacy
software system network constructs. An application, such as, for example,
Parse
Engine, parses the output received by the host pharmacy software system into
discreet data elements per step 616. The parse engine, having completed
parsing the
data, then encrypts the data and uniquely identifies the data for transmission
to the
web server 574 via a network or dial-up Internet connection per step 616.
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The information is received by the web server and placed into a work in
process dispense queue/SQL database with flags identifying the dispense
information as "belonging" to a particular dispense location per step 624.
This is a
method designed to permit many simultaneous dispense locations to use the same
SQL database.
The dispense locations then have access to the data in the work in process
table presented as an HTML document (web page). Only data designated as
belonging to a dispense location is available to a dispense location.
The technician at the dispense location selects the Rx-Drug-Patient to be
dispensed from a list of one or more possibilities to be displayed per steps
640, 642.
The selections are shown as HTTP "hyperlinks".
Upon selecting the Rx-Drug-Patient to dispense, the technician at the
dispense location is shown a dispense detail Page. The dispense detail page
presents
to the technician additional information about the Rx, not practically visible
above.
The technician has a choice of deleting the Rx-Drug-Patient selection, or the
"GO
BACK" to earlier step and select another, or to dispense the drug from the co-
located
Remote Control Dispenser (RCD)582. The Rx-Drug-Patient selection delete causes
an early termination event which is communicated to the pharmacist via an
email as
an option, and is captured to the correct early termination database for
review later or
in real-time by the pharmacist or authorized dispenser. The "GO BACK:" step
prompts the technician to return to the previous list of available dispenses
in the
work in process table represented by displaying them as a queue on a web page.
The
selection to dispense the drug from the co-located RCD continues the process
by
requesting final dispense authority from the web server.
Final dispense authority is received from the web server in the form of a
single web page, HTML document, that expires quickly so that repeat requests
for
the same drug can not be made by reversing the browser using its imbedded back
button. The web server 574 completes one more check to determine if the drug
requested is still in the local RCD inventory and the location of the drug
within the
RCD per step 632. Each RCD contains an Identifier, for example, from 0 to 9
(10
total) and from 00-27, or 00-59 columns, depending upon the configuration, As
part
of the final dispense authorization the web server returns the exact position
of the
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drug desired within a single or plurality of RCD's. The user clicks a button
or link
and a series of different options can occur. For example, a JAVA APPLET
communicates with the RCD passing the RCD the data culled from the web server.
In the alternative, a browser ADDAN communicates with the RCD passing the RCD
the data culled from the web server. In another embodiment, a local one-time
use
executable is downloaded that communicates with the RCD passing the RCD data
culled from the web server. Alternatively, a local executable is launched
which
passes the needed variables and communicates with the RCD 582 passing the RCD
data culled from the web server 574. In yet another embodiment, an alpha
numeric
page is sent to an integrated pager reception unit placed within the RCD,
which
passes the needed variables and communicates with the RCD passing the RCD data
culled from the web server.
As a result of the dispense occurring, the technician is presented with an
additional web page which requires the input of barcode data embedded onto the
label of the dispensed drug. A barcode reader co-located at the dispense
location is
used to read the barcode of the item dispensed from the RCD per step 652. The
technician reads the barcode into the browser and clicks a test hyperlink, or
in some
instances the barcode reader can interact with the browser directly and select
the test
hyperlink directly.
The barcode of the item dispensed is read into the browser and is compared
with the value of the barcode expected. If the values match what the web
server 574
is expecting, a patient education monograph, patient labeling, graphic
representation
of the drug expected, and picture of drug expected are generated and delivered
to the
technicians' browser for subsequent printing to a co-located printer per step
658.
However, if the values do not match what the web server is expecting, the user
has
three attempts with which to scan or enter the expected values per step 674.
If three
failed attempts are made, the transaction is terminated with warnings sent to
appropriate parties like the authorized dispenser, technician, system
operator, and
pharmacy consultant via pager and email. Appropriate drug disposal and storage
is
maintained via training of the technician and an additional lock storage box
within
the RCD.
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The technician at the dispense location is presented with one additional
barcode on the patient label that is to be affixed to the item dispenses. The
technician is required to perform one more barcode read by scanning the
patient
label after it is affixed to the item dispensed per step 664. The barcode of
the item
dispensed is read into the browser and is compared with the a value of the
barcode
expected, the Rx number. If the values do not match what is expected, then the
user
has three attempts to scan the correct label before an error condition is
reported per
step 672. If the values do match per step 668, then the dispense is complete
and the
local technician is returned to the view of the queue show work in process, if
any.
Referring to Figure 11A, in this embodiment of a dispense system the
majority of the features and functions use a web server 706 on the Internet
708.
Thus, no longer does a local EXE (executable program) reside on the computer
at
the dispense location (where the RCD 714 is co-located to dispense drugs).
Instead
the dispense location CPU 710 uses an Internet browser 712 to interact with
the web
server 706 to access patient information, drug selection, inventory control,
and
dispense permission.
Referring to Figures 11B-11D, a flow chart of a typical workflow of the
referred embodiment shown in Figure 11A includes the following sequence of
steps.
An Rx is generated by a physician using a paperless method such as a personal
data
assistant(PDA), or by usual methods using pen and paper per step 724.
The Rx is transmitted to a pharmacy control location per step 726 whether by
an electronic means for a PDA device, or fax for pen and paper method.
The pharmacy control location's pharmacists (Rph) or designated pharmacy
technician, is logged onto the Internet, or logs onto the Internet using a
local Internet
Service Provider (1SP) per step 728. This device can be a PDA, a laptop, a
cell
phone with browser ability, or even a typical personal computer. Any device
that is
compatible with, but not limited to, HTML or XHTML or similar emerging
protocol,
=
can be used.
Using a device, for example, a laptop computer, the RPh or technician enters
a URL (web address) such as, for example, WebDirectRx.com or gets this URL
from
her favorites List on the browser per step 730.
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The RPh then enters her user id and password per step 732. This user name
and password carries with it a profile. This, profile then permits different
functionality on the web server 706 available to the person logging in. A RPh
gets a
functionality not available to others; like Rx generation, and the ability to
see
multiple dispensing queues across the network of dispensers.
If the patient is new, the RPh needs to enter patient demographics, insurance
information, allergies, disease states, drug profile, et al., before beginning
to generate
an Rx per step 734.
The RPh then generates the Rx per step 736 by selecting the patient, drug,
prescriber, SIG, tity, refills, ICD-9 (a disease code if known), etc.
The generated Rx is then run through a process called DUR (Drug Utilization
Review) per step 746 to examine the drug for contra-indications against the
patient
profile. For example, allergies, and drug to drub; interactions are examined
here. In
this embodiment, the process is executed on the server 706. The RPH or
technician
then approves the results of the DUR per step 748 or cancels the Rx or picks a
more
appropriate therapy.
The RPH or technician then runs an Adjudication on the patient to determine
if the patient is insured through a pharmacy benefit management company per
step
752. This process returns a status of, for example, PAID per step 754,
REJECTED,
etc. A copay amount, among other items, is returned with a PAID claim.
The Rx is then placed into a queue per step 758 which the dispense location
can see using its own browser. The dispense location caregiver, for example, a
nurse, doctor, technician, also needs to be logged onto the Internet. This
user/caregiver logs onto the web server at, for example, WebDirectRx.com with
a
user id and password per step 760. This user id and password carries with it a
user
profile per step 764. The user profile indicates that this person is a
dispenser, and
can only view the queue for his/her location per step 766. The user/caregiver
sees
his/her Rx - the one communicated to the RPh earlier and can now act upon that
Rx
as it has been approved per step 768.
The user/caregiver then clicks on the item to be dispensed. This triggers the
web server to double check inventory per step 770 and acquire the location of
the
drug in the co-located RCD. When completed, the web server returns a page that
the
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user can click on again to cause the computer to send a dispense signal to an
RCD
per step 776. The signals, as described hereinbefore, can be sent using
different
options, such as, but not limited to, Java Applet, browser add-ins, and
launching
local executables.
The RCD then dispenses the item. Whilst doing that, the web server 706
presents to the user a screen whereby the user can barcode scan the dispensed
items'
barcode per step 780. Upon entry of the barcode a test per step 790 is made to
see if
the item is a repackaged item or a manufacturers packaged item per step 786.
If it is
a manufacturers packaged item, then the web browser presents the user with
places
to enter a lot number and expiration date per step 794. The repackaged item
has
built into the barcode a lot number and expiry date. If the barcode of the
item
entered is what the web server, for example, WebDirectRx.com is expecting,
then
the web server presents the user/caregiver with a completed patient label,
patient
education monograph, receipts, and image of pill, tablet, capsule etc., that
is then to
be directed to a co-located laser jet printer per step 796. Once printed per
step 798,
' the patient label, which contains a second barcode, is also scanned into
a page
presented to the user per step 800. The transaction details are written to a
database
on the web server, and the user/caregiver is returned to the queue view from
where
= this process started initially.
If the patient, who has been remotely administered medications has any
questions, an authorized pharmacist is available for consultation using a
variety of
telepharmacy systems. Including, but not limited to, a telephone service audio
visual
connection, a networked audio visual connection, and an Internet connected
audio
visual connection.
Figures 12A and 12B illustrate the use of a telephone network 440 in the
drug dispensing system in accordance with the present invention. The telephone
network 440 transfers information between the host interface CPU 342 and the
RCD
324. A wireless phone 442 can be integrated with the RCD. The telephone
network
440 takes the place of or is used in conjunction with the Internet as a
mechanism to
transfer information between the host pharmacy system represented by the host
interface CPU 342 and the host pharmacy workstation 344 and the remote
dispensing system represented by the RCD. The wireless phone device acts as
the
CA 02833710 2013-11-19
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trigger mechanism to dispense pharmaceuticals or medical products out of the
RCD.
The wireless phone device can communicate with an integrated circuit within
the
RCD transferring the RCD information obtained during a wireless connection.
It should be noted that previous preferred embodiments are disclosed with
respect to using a communications cable or link between a controlling CPU and
the
RCD to transfer a dispense message. The communications cable can be replaced
with a wireless phone device thus, facilitating dispensing via a wireless
connection.
Figure 12B illustrates a dispense interface CPU 340 and a laser printer 444
co-located with the RCD 324. The remotely controlled dispense session can be
managed entirely without land lines. The wireless phone connection can be
integrated into the RCD or in the alternative, as an attachment to, the
dispense CPU.
The wireless phone connection serves as the connectivity media instead of the
intemet connection.
Further, as described hereinbefore, the software the technician interacts with
can exist on an attached and co-located external computer configuration, or as
an
integrated computer using TouchScreen components built directly into the RCD.
Referring to Figure 13A, in this embodiment of a dispensing system an
existing host pharmacy software system 850 with a co-located interface
application
server 856, and a remotely installed dispense location interact to provide
pharmaceutical dispensing across a wide geographic region. This preferred
embodiment uses the existing local telephone service available. The interface
application server 856 and the dispense location workstation 868 connect and
exchange Rx information directly with one another.
The dispense location workstation 868 contains local executable program(s)
that manage the call pickup, data acceptance, inventory management, and
visually
prepares the Rx information received from the interface application server in
an easy
to read queue for the local caregiver, typically a technician. In addition,
the dispense
location workstation 868 communicates with the co-located Remote Control
Dispenser (RCD) 872 to dispense pharmaceuticals, a printer 870, for example, a
laser jet or color jet printer to provide patient and record keeping
materials, as well
as, a barcode scanner for doing quality checks during a dispense. The dispense
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location needs access to the telephone service 864 to get a "dial tone" in
order to
receive and send communications.
The pharmacy control location is where the host pharmacy software is
maintained or run. Typically these are small networks of pharmacy workstations
where a retail or hospital pharmacy team interacts with insurers computers to
create
the order that leads to the filling of a drug to be handed to the patient.
The interface application server 856 is a computer that is co-located with the
host pharmacy software system. It is used to collect information (the Rx data)
for a
dispense from the host pharmacy system and then forwards that information to
the
dispense location workstation 868 via the telephone service, or the telephone
network 864.
Referring to Figures 13B and 13C, a typical workflow includes the sequence
of steps illustrated. An Rx is generated by a physician or caregiver using a
paperless
method such as a PDA or TouchScreen or by usual methods using pen and paper,
fax
and scanners per step 902. The Rx information typically contains the patient
name,
prescriber name and Drug Enforcement Agency identifiers, instructions for the
administration of the drug, drug name, and quantity to be given to the
patient.
The Rx is transmitted to different locations per step 904. If the Rx is
transmitted to a pharmacy control location via fax or an electronic means, the
authorized dispenser, typically a pharmacist, interprets the transmitted
infatuation.
If the Rx is transmitted to a dispense location electronically or physically
delivered, a
user, typically a technician can take authorized action.
The Rx is manipulated into the host pharmacy software system per step 914
either by an authorized dispenser who interprets the Rx information
transmitted
directly to his/her location and then manually or through am electronic
interface
transfers the Rx information into the host pharmacy software or by the
technician
who has an option to transmit the information to the authorized dispenser,
pharmacist, for the pharmacist to manipulate or to remotely connect to the
host
pharmacy software via a variety of interfaces to transfer the Rx information
into the
host pharmacy software system either manually or via an electronic interface.
The
connection interfaces can be, but are not limited to, Symantec pcAnywhere
directly,
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Symantec pcAnywhere via the Internet, by a co-located WAN connection provided
with the host pharmacy software.
Once the information is transcribed or transferred into the host pharmacy
software system a number of typical processes are applied to the Rx
information.
The processes can be a Drug Utilization Review or an Adjudication process as
described hereinbefore.
The Rx information, having been processed by the host pharmacy software
system can generally then be determined to be a valid Rx; which can be
processed by
the pharmacist.
In a retail setting the pharmacist then triggers patient drug labeling to be
produced by the host pharmacy software system and takes a large bottle of
medications from the shelf and counts and places into a smaller bottle,
typically
called a vial, the number of tablets, caplets, or milliliter's called for by
the physician.
The pharmacist then applies labeling and. hands the drug to the patient.
When the dispense is processed in conjunction with telepharmacy systems,
the pharmacist or authorized dispenser triggers a patient drug label to be
produced by
the host pharmacy software system 850, however, instead of the label being
processed by a co-located printer 852(laser jet or dot matrix) the output is
directed to
the interface application Server 856.
The interface application server accepts the Rx information as a printer
stream per step 916, or through a direct electronic :interface to the host
pharmacy
software system network constructs. An application, Parse Engine (PE), parses
the
output received by the host pharmacy software system into discreet data
elements.
Once the parsing is completed, the data is encrypted and is uniquely
identified for
transmission to the dispense location workstation via telephone service per
step 918.
The information is received by the dispense location workstation decrypted
and placed into a work in process queue that is accessed by local executable
programs run by the technician per step 906.
The technician at the dispense location selects the Rx-Drug-Patient to be
dispensed from a list of one or more possible to be displayed per step 908.
The
selections are shown as mouse selectable lines. Each line represents a
different Rx-
Drag-Patient to be processed by the technician. Upon selecting the Rx-Drug-
Patient
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to dispense the technician at the dispense location is queried if this is in
fact the Rx-
Drug-Patient per step 920.
If the answer to the query is no, the technician is returned to the entire
queue
list as described above per step 922. If the answer to the query is in the
affirmative,
the local executable program resident on the dispense location workstation
examines
a local inventory file that contains data specific to the drug requested to be
dispensed
per step 924. The drug contains a profile which includes, but is not limited
to,
current stock level, suggested restock levels, and coordinate position within
a single
or plurality of RCD's.
, The Remote Controlled Dispenser (RCD) receives a X,Y coordinate type
communication from the locally resident executable. The X,Y coordinate
represents
a location within a single or plurality of BCD's where the requested
pharmaceutical
is stored for dispensing. The X,Y coordinate is determined by examining an
inventory profile of the drug to be dispensed. Upon receiving the dispense
signal
from the dispense location workstation the RCD presents a drug to the
technician per
step 926.
As a result of the dispense occurring, the technician is presented with an
additional screen which requires the input of barcode data embedded onto the
label
of the dispensed drug. A barcode reader co-located at the dispense Location is
used
to read the barcode of the item dispensed from the RCD per step 928. The
technician reads the barcode into the screen to be examined by the resident
dispensing software.
The barcode of the item dispensed is read into the resident dispensing
software and is compared with the value of the barcode expected from the drug
inventory profile. If the values match what resident dispensing software is
expecting
per step 930, a patient education monograph, patient labeling, graphic
representation
of the drug expected, and picture of drug expected are generated and delivered
to the
co-located printer per step 934. If the values do not match what the resident
dispensing software is expecting, the user hasthree attempts with which to
scan or
enter the expected values per step 932. If three failed attempts are made, the
transaction is terminated with warnings sent to appropriate parties like the
authorized dispenser, technician, system operator, and pharmacy consultant via
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pager and email. Appropriate drug disposal and storage is maintained via
training of
the technician and an additional lock storage box within the RCD.
The technician at the dispense location is presented with one additional
barcode on the patient label that is to be affixed to the item dispensed. The
technician is required to perform one more barcode read by scanning the
patient
label after it is affixed to the item dispensed per step 936. The barcode of
the item
dispensed is read into the resident dispensing software and is compared with
the a
value of the barcode expected, the Rx number. If the values do not match what
is
expected, then the user has three attempts to scan the correct label before an
error
condition is reported per step 940. If the values do match then the dispense
is
complete per step 942 and the local technician is returned to the view of the
queue
showing work in process, if any.
If the patient, who has been remotely administered medications has any
questions an authorized Pharmacist is available for consultation using a
variety of
telephannacy systems, including, but not limited, to a telephone service audio
visual
connection, a networked audio visual connection, and an internet connected
audio
visual connection.
Figures 14A and 14B illustrate the use of a pager service 450 in combination
with the Internet 320 to dispense medication from a remote location. The pager
service 450 interacts with the Internet 320 to transfer information between
the host
pharmacy system represented by the host interface CPU 342 and the host
pharmacy
workstation 344 and the remote dispensing system 324. A receive/send pager 452
interfaces with the RCD 324 and transfers information regarding the dispensing
of
medication. A print module 454 can be integrated with the RCD. Figure 14B
illustrates an embodiment having a dispense interface CPU 340 and a laser
printer
444 co-located with the RCD 324.
In a preferred embodiment, a pager service can forward dispense information
via an alphanumeric page. A computer, such as, for example, but not limited
to, an
Aqcess Technologies Qbe Personal Computing Tablet, can be integrated with the
RCD. In another preferred embodiment, the computing function can be
accomplished using a combination of an external and integrated computer.
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Figures 15A and 15B illustrate a preferred embodiment which uses a satellite
system 460 to transfer information between a host pharmacy interface CPU 342
and
a remote dispensing system or RCD 324. The Internet 320 transfers information
from host interface CPU 342 to a satellite 460 via a satellite dish 462. The
satellite
in turn using a satellite send or receive module 464 transfers information to
the
dispense interface CPU 340 at a remote location from the host pharmacy system.
The dispense interface CPU then directs the dispensing of medication from the
RCID 324. As illustrated in Figure 15B a touch screen computer 466 and a print
module 468 can be integrated with the RCD which eliminates the need for a
dispense interface CPU 340.
In a preferred embodiment, the remote dispensing location is sent Rx
dispense information via a satellite network, such as, for example, the
Iridium
paging or telephone network. The dispensing workflow remains the same, only
the
connectivity to the RCD 324 changes.
According to another embodiment, a method of managing samples is a
necessity in the highly regulated and cost control environment that exists in
healthcare today. The current haphazard approach to sampling is both costly
and
inefficient for all parties concerned and provides little useful information
to any
party.
The Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) is citing healthcare institutions for failure to document and manage
pharmaceutical samples. Drug cost control is a critical factor and formulary
management, via the sampling process, is an important component in that
overall
process, especially in outpatient and independent practitioner settings.
The Joint Commission is citing hospitals and integrated delivery networks
(IDNs) for failure to properly manage physician samples. The impact of a
negative
Joint Commission finding can be severe. Nonadherence with state and federal
laws
puts prescriber's licenses at risk, and violation of JCAHO-specified criteria
in the
drug sampling area can lead to a Type 1 citation and endanger the healthcare
organization's accreditation status. Many insurance companies and government
programs, such as Medicare/Medicaid require JCAHO accreditation before they
will
reimburse that institution for medical care of its patients.
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JCAHO requires the institutions to have a policy on drug samples and
requires a control system that tracks the receipt and distribution of each
drug sample.
Further, the samples have to be properly labeled for patient use (including
any
auxiliary cautionary statements and expiration dates). The pharmacy department
has
to include drug samples in its process for responding to drug recalls and in
its
monthly inspection routine. This is the reason for tracking lot numbers and
expiration dates. Drugs need to be stored so that unauthorized individuals do
not
have access to them, such as, for example, by using a locked cabinetry or
room.
ICAHO also requires the institution to keep a drug sample receiving log that
tracks
date, drug name, strength, form, lot number, manufacturer, received amount,
expiration date of drug, and location of storage. In addition, ICAHO also
requires
either a drug dispensing log or a drug sample dispensing database that
includes the
following information: date dispensed, patient name, drug name/strength/form,
lot
number, manufacturer, amount dispensed, directions for use, and physician
name.
The physician/pharmacist has to provide medication counseling per certain
congressional regulations. This could be in the form of a drug monograph with
the
following information: name of medication, length of therapy, possible side
effects
of the medication, and expiration date and proper storage of the medication.
Uncontrolled sampling is driving up costs for physicians, patients and payers
of all kinds. Drug companies need alternatives which give them information,
reduce
costs and retain access to prescribing physicians.
There are differing regulatory schemes in different jurisdictions that exist
for
drug samples and the dispensing thereof. The regulatory schemes address issues
such as, for example, drug control license patient's chart or clinical record
to include
record of drugs dispensed; delegating authority to dispense drugs; storage of
drugs;
containers; labels; complimentary starter dose drug; information;
inspection of
locations; limitation on delegation; and receipt of complimentary starter dose
drugs
pharmacist. Further, the regulatory boards periodically inspect locations from
which
prescription drugs are dispensed.
Under some regulatory schemes, a prescriber who wishes to dispense
prescription drugs obtains from a board a drug control license for each
location in
which the storage and dispensing of prescription drugs occur. A drug control
license
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is not necessary if the dispensing occurs in the emergency department,
emergency
room, or trauma center of a hospital or if the dispensing involves only the
issuance
of complimentary starter dose drugs.
Per regulations, a dispensing prescriber can dispense prescription drugs only
to his or her own patients. A dispensing prescriber has to include in a
patient's chart
or clinical record a complete record, including prescription drug names,
dosages, and
quantities, of all prescription drugs dispensed directly by the dispensing
prescriber or
indirectly under his or her delegatory authority. If prescription drugs are
dispensed
under the prescriber's, delegatory authority, the delegatee who dispenses the
prescription drugs has to initial the patient's chart, clinical record, or log
of
prescription drugs dispensed. In a patient's chart or clinical record, a
dispensing
prescriber has to distinguish between prescription drugs dispensed to the
patient and
prescription drugs prescribed for the patient. A dispensing prescriber has to
retain
information required for not less than, for example, five years after the
information
is entered in the patient's chart or clinical record.
Regulations further include that a dispensing prescriber has to store
prescription drugs under conditions that maintain their stability, integrity,
and
effectiveness and assure that the prescription drugs are free of
contamination,
deterioration, and adulteration. A dispensing prescriber has to store
prescription
drugs in a substantially constructed, securely lockable cabinet. Access to the
cabinet: has to be limited to individuals authorized to dispense prescription
drugs in
compliance with the regulatory schemes.
Unless otherwise requested by a patient, a dispensing prescriber dispenses a
prescription drag in a safety closure container that complies with the poison
prevention packaging act, for example, of 1970, Public Law 91-601, 84 Stat.
1670.
Further, a dispensing prescriber has to dispense a drug in a container that
bears a label containing all of the following information: the name and
address of the
location from which the prescription drug is dispensed, the patient's name and
record
number, the date the prescription drug was dispensed, the prescriber's name,
the
directions for use, the name and strength of the prescription drug, the
quantity
dispensed, the expiration date of the prescription drug, or the statement
required per
regulations.
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Additionally, per the regulations, a dispensing prescriber who dispenses a
complimentary starter dose drug to a patient has to give the patient at least
all of the
following information, either by dispensing the complimentary starter dose
drug to
the patient in a container that bears a label containing the information or by
giving
the patient a written document which may include, but is not limited to, a
preprinted
insert that comes with the complimentary starter dose drug, that contains the
information: the name and strength of the complimentary starter dose drug,
directions for the patient's use of the complimentary starter dose drug, and
the
expiration date of the complimentary starter dose drug.
Per some regulations, a supervising physician may delegate in writing to a
pharmacist practicing in a hospital pharmacy with a hospital licensed the
receipt of
complimentary starter dose drugs other than controlled substances. When the
delegated receipt of complimentary starter dose drugs occurs, both the
pharmacist's
name and the supervising physician's name has to be used, recorded, or other
wise
indicated in connection with each receipt. A pharmacist may dispense a
prescription
for complimentary starter dose drugs written or transmitted by other means of
communication by a prescriber.
Per the regulations, "complimentary starter dose" means a prescription drug
packaged, dispensed, and distributed in accordance with state and federal law
that is
provided to a dispensing prescriber free; of charge by a manufacturer or
distributor
and dispensed free of charge by the dispensing prescriber to his or her
patients.
Referring to Figures 16A-27D, a preferred embodiment of the present
invention includes a way to manage the sampling process and provide solutions
to
the persistent regulatory compliance issues and escalating pharmaceutical
costs. The
embodiment fully documents the sample process and addresses all the JCAHO
standards. The preferred embodiment also plays a significant role in better
formulary management via information captured through the sampling process.
The
cost savings realized through this process benefit all constituents of the
healthcare
industry - patients, providers, and payers. Following are two examples of the
preferred embodiment's contribution to controlling drug costs.
Firstly, generic drug sampling can greatly reduce an overall pharmacy drug
budget. A recent study, conducted by Scott & White Prescription Services,
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evaluated the cost savings achieved after implementation of a generic drug
sampling
program. Results showed savings per antibiotic prescription of over 10% of
total
prescription drug cost for antibiotics. Greater savings were shown for
nonsteroidal
anti-inflammatory medications. Drug sampling of nonsteroidal anti-
inflammatories
(NSAIDS) resulted in over 30% savings per prescription cost in this
therapeutic
category. Among the general conclusions of the study, generic drug sampling
helped
increase usage of generic medications and decrease average health plan cost
per
prescription, while allowing for opportunities to influence prescription
habits.
Secondly, drug sampling can selectively reduce medication costs for
economically disadvantaged. In a study conducted al the University of Arizona
Department of Pharmacy Practice and Science, it was determined that Medicare
managed care beneficiaries adopted predictable behaviors to cope with capped
prescription drug benefits. The findings suggest that a considerable
proportion of
Medicare managed care enrollees take steps (i.e. obtain a medication sample,
take
less than the prescribed amount of medication, and using an over-the-counter
product to replace the prescribed medication) to avoid facing the full
financial
impact of their prescription drug costs.
There are several benefits of the- preferred embodiment in accordance with
the present invention. The benefits are gained by physicians and
pharmaceutical
companies. For example, the pharmaceutical companies can get specific
information about the prescriber, demographics on the patient without
identification,
competitive usage factors and site specific information using the preferred
embodiment.
Further, the distribution costs are lowered using the preferred embodiment of
the present invention, enabling better use of the marketing representatives of
the
pharmaceutical companies. Lower wastage of samples due to strict controls over
access and usage are realized with the preferred embodiment. Additionally,
continued access to physicians is gained because the institution is able to
meet
accreditation standards. The preferred embodiment also provides the ability to
get
national rollout virtually overnight through information dissemination
directly to
users of sites employing the preferred embodiment. The preferred sample
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dispensing, is embodied by two components. A hardware component comprising
uniquely designed cabinetry, and a touch screen software component.
In the preferred embodiment, the software, for example, is written for
Microsoft Windows 98 and Microsoft Windows NT, using Visual Basic 6.0 and
Visual C++, and runs on a typical Intel/Pentium based personal computer.
Although
disclosed with respect to being written for Microsoft Windows , the software
may
be written for any computer operating systems, for example, JAVA platforms,
UNIX
system, Windows CE, and IBM OS operating systems. The operating
requirements, imposed upon the personal computer are minimal, permitting the
purchase of less expensive, though proven, computer components. Printers such
as,
for example, a Laser Jet or Color Ink Jet printer which provides a patient
specific
education monograph and labels with each dispense are used with the computer.
The laser jet printer can also be used to print reports locally. Typical
components
include, for example, but are not limited to, ASUS motherboards, Intel Pentium
II
CPU's, 3COM 3C90X network interface cards, digital hard drives of between four
and six gigabytes capacity, internal or external 3COM US Robotics modems, and
MicroTouch touch screens.
The software is used by a nurse, physician, or medical office staff, depending
upon state laws and regulations. The functionality of the software breaks down
into
five main categories, namely, dispensing function, loading function,
maintenance,
reports, and communications.
All information transmitted, whether through the internet or a direct
connection, is encrypted. An encryption program that is used, but not limited
to, is
for example, "Blowfish." In addition, the key bit exceeds 128-bits for sites
located
within the United States. Any sites located outside of the borders of the
United
States will use key bit encryption strength approved by the US government,
such as
for example, 56-bit key lengths. According to some public safety regulations a
key
of 128-bit meets or exceeds the level deemed necessary to transmit information
over
the intemet or other electronic means.
All information generated by the users input is captured in a transaction
database for transmittal via the intemet, or direct modem dial out, to a
server.
Inventory is maintained perpetually with increases to the stocking level
managed via
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the load process, and decreases in inventory managed by the dispense process.
Inventory stock levels are also communicated to a server, with special
attention to
stockout threshold levels to trigger additional communications with clinic
managers,
chiefs of pharmacy, manufacturers, and any others involved in the sample
dispensing
value chain. =
All information captured is aggregated in the server. The communications
function of the samples dispensing software manages the aggregation process.
At
present time, throughout a 24 hour period, the communication module can
deliver
the days activity of an individual sample dispensing location to the server.
This
information is accumulated and is available for redistribution using a variety
of ways
and methods.
Distribution of each sample dispensing location's information occurs in at
least one of two ways, depending upon the available information
infrastructure.
Where telephone access is available the sample dispensing locations can call,
using
an 800 number, a server, setup for receipt of up to 24 simultaneous
connections.
This type of server is commonly referred to as a Remote Access Server (RAS).
The
RAS can be set up with 24 ports or more capable of 56K connections using a T-1
data line. Additional simultaneous connections are available in groups of 24,
36,
128, or higher. If toll free access is not acceptable, the sample dispensing
location
can call a local Internet Service Provider access number, and then negotiate a
session
with the server also connected to the internet.
If modem access is not possible, then an existing hospital network running a
protocol such as, for example, TCP/IP is used if that hospital can access the
internet.
The sample dispensing location is connected to the hospital network to
transmit
daily activity logs through the hospital network, out onto the internet,
thence onto
the server. The data is encrypted, and compressed so as to minimize the
bandwidth
necessary for each session. This reduction in bandwidth usage is important to
many
clinics, so that a drain on hospital networking resources is minimized, or as
in the
case of the information generated by the samples dispensing locations using
modems
is none.
Methods of redistribution of samples include, but are not limited to, email,
fax, website, and a planned integrated voice response(IVR)system. The server
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aggregates the information into a series of larger databases, while keeping
information accessible that is unique to an installation by using a unique key
for each
individual location. In this manner, access to the information can be attained
as an
aggregate of a market, or as an individual dispensing location, depending upon
the
need. For example, Microsoft SQL 6.5 acts as the main database repository
engine.
In a particular, preferred embodiment, for the server processes, Allaire's
ColdFusionTM web site database management and development solution can be
used. Allaire is a web site development language and solution company with
tools
for data management over the Internet. Other database management and
development solutions can be used. Each customer is offered a unique view of
the
aggregated data based upon the customers buying level.
Using password access, the preferred embodiment offers a user nearly real
time sample dispensing information. In addition, based upon buying levels,
daily,
weekly, or monthly reports via email are provided.
In another preferred embodiment, a process that can be broken up into a
series of questions that can be responded to using a telephone keypad is
programmed
using an IVR. A follow-on device can be provided for patients to interact with
regard to their prescriptions. Medications used for treating various mental
incapacities have a history of side effects ranging from mild to severe. These
medications are typically quite expensive. In cases of severe side effects,
the
patient's entire prescription is destroyed and another new and different
prescription is
generated. The destroyed medications are a complete loss to the dispensing
institution and the patients' insurer. Using samples, and an IVR system, a
complete
costly prescription is not given to a patient until the patient has completed
a duration
of free samples to determine if side effects are severe enough to warrant a
different
therapy approach.
A patient can query a prearranged I'VR number to indicate that side effects
are, or are not, present in his or her currently selected therapy regime. If
the patient
can tolerate the tested samples, then the NR can trigger the hospital
pharmacy, an
online pharmacy company like, for example, PlanetRx.com, or redirect the Rx to
a
mail order facility, a complete therapy cycle based upon the norms of the
institution.
Where an expensive prescription might have been wasted the patient can test a
free
CA 02833710 2013-11-19
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sample of the medication before determining if a complete cycle of therapy
would be
effective without severe side effects.
A user, instead of dialing an IVR system, launches their favorite web browser
using an Internet service such as, for example, AmericaOnLine or any other
Internet
access provider, and complete a series of simple questions about the sample of
medicine, before being issued a complete therapy cycle. The therapy cycle can
be
redirected to many different locations, including, again the originating
hospital
outpatient pharmacy, a mail order house, etc.
Figures 16A through 22 illustrate embodiments of screens of the software
component of the sample dispensing. The screens can be displayed by a monitor
of
a drug dispenser. In a preferred embodiment, the monitor is a touch screen.
Therefore, it is possible for a user to interact with the dispenser by using
the monitor
and the screens shown in Figures 16A through 22 to provide commands to the
dispenser 1500. To use the touchscreen monitor, the user must press the tip of
a
capacitive item, such as a fmger against the screen. Non-capacitive items,
such, as
fingernails or pointed objects, will not work. In another embodiment, the user
can
also use a mouse or a keyboard to interact with the commands and options
presented
on the screens.
Figures 16A through 16E illustrate a method of dispensing drug samples
from the sample dispenser 1500 and embodiments of screens associated with
dispensing samples. Figure 16A shows an introduction screen 1400 having a
dispense command 1402 and a maintenance command 1404. To engage the
dispenser to dispense drugs, the user can select the dispense command 1406.
The
user can then be presented with a subscriber name screen 1408, as shown in
Figure
16B. The user can select the first initial of the prescriber's last name 1410
using
letter keys 1412. The user can then select the prescriber name 1414 from the
screen
1408. Next, the user types in the patient name 1416 in a patient name area.
Theuser
can then proceed 1420 by selecting; a next command 1426.
Figure 16C shows a medication screen 1422 which can follow the subscriber
name screen 1408. A user can select the first letter of a medication 1424 he
wishes
= to receive using the letter buttons 1412 provided. A list of medications
can then be
listed on the screen 1422. The user can select the medication 1428 he requires
by
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touching the portion of the screen corresponding to his drug choice. The user
can
select the number of packages he requires 1430 using the package quantity
buttons
1432. The number of packages is not equivalent to the number of doses needed
for a
patient, since one package can have multiple doses of medication. The user can
then
proceed 1434 by selecting the next command 1426.
Figure 16D shows a SIGS screen 1442 which can follow the medication
screen 1422. The user can select one of the provided SIGS or use he space at
the
bottom to create a custom SIG 1436. The user can edit both the lot number and
expiration date 1438 of the medication. The user can then proceed 1440 by
selecting
a next command 1426. The user can then be presented with a dispense summary
screen 1442, shown in Figure 16E. The user can then review all entries to make
sure
they are comet 1/1/1/1. The user can also check the printer to ensure that
paper is
available 1444. The user can chose to give the same patient additional
medications
1446, restart the process 1448 or select a finish command to print labels and
monographs for the patient 1450.
Figures 17A through 17C illustrate a method of loading medications into a
dispenser. The user can first be presented with an introduction screen 1400
having a
maintenance command 1404, shown in Figure I7A. The user can select the
maintenance command 1446 to proceed with the loading of medications. The user
can then be presented with a menu screen 1448 having a load command 1450, a
databases command 1452, a reports command 1454 and a return to introduction
screen command 1458. The user can select the load command 1458 to proceed. The
user can then be presented with a user identification screen 1460 where the
user can
enter his name and his company's name before proceeding. After the data has
been
entered, the user can select a next command 1462 to continue.
Figure 17B illustrates a medication screen 1464, which follows the user
identification screen 1460. The user can select the first letter of the
medication to be
loaded 1466 from the letter buttons 1412. The user can then be presented with
a list
of drugs having names starting with the chosen letter. The user cart then
select the
medication to be loaded 1468 from the screen 1464. The user can proceed by
selecting a next command 170, which brings him to a medication data screen
1472,
shown in Figure 17C. In the medication data screen 1472, the user can enter
the lot
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number, the expiration date and the quantity of the medication added 1474 to
the
dispenser. The medication data screen 1472 includes a save command 1476 and a
quit - no save command 1478. After entering the data and hitting the tab key
to
move through the screens, the user can check his entries and execute the save
command if they are correct or execute a the quit - no save command if they
are
incorrect 1480.
Figures 18A through 18D illustrate a method to view or edit inventory within
the dispenser. The user can first be presented with an introduction screen
1400
having a maintenance command 1404, shown in Figure 18A. The user can select
the
maintenance command 1446 to proceed with the loading of medications. The user
can then be presented with a menu screen 1448 having a load command 1450, a
databases command 1452, a reports command 1454 and a return to introduction
screen command 1458. The user can select the databases command 1482 to
proceed.
A database screen 1484 can then be presented to the user as illustrated in
Figure
18B.
The database screen 1484 can include an inventory command 1486, a
prescriber command 1487, a transactions command 1488 and a load command 1489.
To view or edit inventory in the dispenser, a user can select the inventory
command
1490 and select a medication 1492 shown on the screen 1484. The screen 1484
can
present manufacturer and barcode information of the medications, in addition
to
medication names. The user can then manipulate the inventory database 1494 by
either editing or deleting the database selection. When editing the 'database
selection, an inventory database editor screen 1495 can appear, as shown in
Figure
I8C. On this screen 1495, the user can edit items or add new items to the
database
1496. To add new items to the database, the user can select the inventory
command
1486, select the edit command 1330 and select a medication from the screen
1484.
Any medication can be selected since it will immediately be changed. The user
can
then select the clear all fields command 1332, enter data into the blank
fields shown
on the screen 1495 and select the save command 1334.
The user can opt to get new GCN number and apply the new GCN number
1498 from the inventory database editor screen 1495. A GCN num' ber is
assigned to
drugs that belong in the same class and can be used to create a monograph that
the
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patient receives in the dispense process. If the use chooses to get and apply
a new
GNC, the user can be presented with a GCN screen 1300, shown in Figure 18D.
From this screen, the user can select a new GCN number by picking the actual
medication or its closest therapeutic equivalent from the screen 1300.
Whichever
item is selected will have its GCN number added to the NEW GCN textbox 1306 on
the inventory database editor screen 1495. The user can return to the
inventory
database editor screen 1308 and choose to save the new data or restore the
previous
data 1310.
Figures 19A through 19C show a method to view or edit a prescriber within
the database of the dispenser. The user can first be presented with an
introduction
screen 1400 having a maintenance command 1404, shown in Figure 19A. The user
can select the maintenance command 1446 to proceed with the loading of
medications. The user can then be presented with a menu screen 1448 having a
load
command 1450, a databases command 1452, a reports command 1454 and a return
to introduction screen command 1458. The user can select the databases command
1482 to proceed. A database screen 1484 can then be presented to the user as
illustrated in Figure 19B.
The database screen 1484 can include an inventory command 1486, a
prescriber command 1487, a transactions command 1488 and a load command 1489.
To view or edit a prescriber in a database interfaced with the dispenser, a
user can
select the prescriber command 1310 and select a prescriber 1312 shown on the
screen 1484. The user can then remove the selected prescriber from the
database or
edit the prescriber information to add him to the database 1314. If the user
chooses
to add a new prescriber, he can be presented with a prescriber database editor
screen
1316, shown in Figure 19C. The user can enter a new prescriber name and return
to
the database screen 1318.
Figures 20A and 20B illustrate a method to view a transaction made with the
dispenser. The user can first be presented with an introduction screen 1400
having a
maintenance command 1404, shown in Figure 20A. The user can select the
maintenance command 1446 to proceed with the loading of medications. The user
can then be presented with a menu screen 1448 having a load command 1450, a
databases command 1452, a reports command 1454 and a return to introduction
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screen command 1458. The user can select the databases command 1482 to
proceed.
A database screen 1484 can then be presented to the user as illustrated in
Figure
20B.
The database screen 1484 can include an inventory command 1486, a
prescriber command 1487, a transactions command 1488 and a load command 1489.
To view the transactions made with the sample dispenser 1500, a user can
select the
transaction command 1320. The transaction database can be used for viewing
purposes only. The user can view the transactions by transaction number or by
transaction date, for example.
Figure 21 illustrates a method viewing the load history of the dispenser. The
user can first be presented with an introduction screen 1400 having a
maintenance
command 1404. The user can select the maintenance command 1446 to proceed
with the loading of medications. The user can then be presented with a menu
screen
1448 having a load command 1450, a databases command 1452, a reports command
1454 and a return to introduction screen command 1458. The user can select the
databases command 1482 to proceed. A database screen 1484 can then be
presented
to the user.
The database screen 1484 can include an inventory command 1486, a
prescriber command 1487, a transactions command 1488 and a load command 1489.
To view the database showing the medications loaded into the dispenser, a user
can
select the load.command 1322. The database showing; the medications loaded can
be used for viewing purposes only. The database screen 1484 can show various
types of load data, including load date, drug potency, and quantity.
Figure 22 illustrates a method of viewing reports of the database of the
dispenser. The user can first be presented with an introduction screen 1400
having a
maintenance command 1404. The user can select the maintenance command 1446
to proceed with the viewing of reports. The user can then be presented with a
menu
screen 1448 having a load command 1450, a databases command 1452, a reports
command 1454 and a return to introduction screen command 1458. The user can
select the reports command 1324 to proceed. A reports screen 1326 can then be
presented to the user. The user can then select a report 1328 from the screen
1326
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that lie wishes to view. For example, an inventory report can be chosen and
viewed
by the user.
Figures 23A and 23B show a preferred embodiment of a sample dispenser
1500 the hardware system of sample dispensing. The dispenser 1500 can have a
computer 1560 located within a computer housing 150.2, a monitor 1504, a
printer
1506 and a control system 1518 located within a control system housing 1546.
The
dispenser 1500 can also have doors 1508 holding a plurality of bins 1510, a
camera
1512 and a user identification system 1514. Figure 23A shows a door 1508 of
the
dispenser 1500 in an open position. Figure 16B shows a door 1508 of the
dispenser
1500 in a closed position.
Figures 24A and 24B illustrate an embodiment of the computer housing 1502
in an open and a closed position, respectively. The computer housing 1502 can
be
opened and closed in order to allow restricted access to the computer for
rebooting
or servicing. The computer housing 1502 can have a stationary portion 1562 and
a
moveable portion 1564. The stationary 1562 and moveable 1564, portions can be
attached by at least one hinge 1566. In a preferred embodiment, two hinges
1566
connect the stationary 1562 and moveable 1564 portions of the housing 1502.
The
moveable portion 1564 of the housing 1502 can include side rails 1568 and the
stationary portion 1562 of the housing 1502 can have side walls 1570. The
rails
1568 and walls 1570 can limit the motion of the moveable portion 1564 and the
computer 1560 as the moveable portion 1564 is opened by a user. When the
moveable portion 1564 is opened, the side rails 1568 can engage side walls
1570 of
the stationary portion 1562 of the housing 1502, thereby preventing further
rotation
of the moveable portion 1564 of the housing 1502. Opening the computer housing
1502 can allow user access to the computer 1560.
Figure 25 shows a computer 1560 mounted on a moveable portion 1564 of a
housing 1502. In one embodiment, the housing 1502 can have pistons 1570 or
dampeners mounted between the moveable portion 1564 and the stationary portion
1562. In the embodiment shown, the pistons 1570 can be mounted between
movable portion brackets 1574 and stationary portion brackets 1576. The
pistons
1570 can help to control the speed at which the moveable portion 1564 travels
when
the computer housing 1502 is opened.
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The computer housing 1502 can have a computer 560 which can include a
motherboard, a CPU, a network interface card, a hard drive and a modem. In a
preferred embodiment, the computer housing 1502 can include an Asus
motherboard, an Intel PentiumTM 11 CPU, a 3Com 3C90X network interface card, a
Western Digital hard drive and a 3Com U.S. Robotics modem. The hard drive can
have between a 4 and 6 gigabyte capacity, for example. The modem can be either
an
internal or an external modem. The monitor 1504, in a preferred embodiment, is
a
touch screen such as, for example, a MicroTouch screen which allows users to
enter
commands into the computer. The computer can also include a keyboard to allow
commands to be entered into the computer. The printer 1506 can be a laser jet
or a
color ink jet, for example.
A camera 1512 can be mounted to the dispenser 1500, as shown in Figures
23A and 23B, and can be used to create a photographic record of all users of
the
sample dispenser 1500. Such a record can be used for security at the sample
dispenser 1500 and to discourage tampering at the dispenser 1500. The camera
1512
can be triggered by some predetermined event to automatically take a picture
of the
area surrounding the dispenser. In one embodiment, a proximity sensor can be
electronically coupled to the camera 1512 and can cause the camera 1512 to
snap a
picture based upon some external event. For example, if a user were to move
within
a certain distance of the dispenser 1500, the proximity sensor detects such a
motion
and causes the camera 1512 to automatically capture an image of an area
surrounding the dispenser 1500. In another embodiment, the camera 1512 can be
coupled with the user identification system 1514 such that engaging the system
1514
causes the camera 1512 to take a picture. For example, if a user were to
attempt to
use the identification system 1514, either successfully or unsuccessfully,
such an
attempt triggers the camera 1512 to snap a photograph. In another embodiment,
the
camera 1512 can be connected with the doors 1508 of the dispenser 1500 such
that
opening the doors 1508 causes the camera 1512 to snap a picture of an area
surrounding the dispenser 1500. The camera 1512 can have a control system
which
can be a computer. The computer which controls the camera 1512 can be separate
from the computer which controls the dispenser 1500 or integrated with it.
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The sample dispenser 1500 can also have a user idenfification system 1514 to
protect against unauthorized access. The user identification system 1514 can
be
used as a security device to permit authorized user access to the medications
dispensed by the dispenser. In this system 1514, a user would be required to
provide
some paper form of identification to the system 1514 before the doors 1508 of
the
dispenser 1500 could be opened. The user identification system 1514 can be
used in
conjunction with a locking mechanism to provide security for the dispenser
1500. In
one embodiment, the user identification system 1514 operates by identifying a
fingerprint of a user. In a preferred embodiment, the user identification
system 1514
operates by identifying a thumb print of a user. To access the dispenser 1500,
a user
places a finger or a thumb against the user identification system 1514. If the
user's
fingerprint was recognized by the user identification system 1514, a locking
mechanism in the dispenser 1500 is released and the doors 1508 opened. If the
user's fingerprint was not recognized by the user identification system 1514,
the
locking mechanism in the dispenser is not be released, thereby preventing
access to
the samples in the dispenser 1500. The user identification system 1514 can
have a
control system which can be a computer. The computer which controls the user
identification system 1514 can be separate from the computer which controls
the
dispenser 1500 or integrated with it. It should be noted that the user
identification
system can include, but is not limited to, hospital identification cards,
credit card,
debit card, other identification paperwork, keyword or password access using a
keypad.
The sample dispenser 1500 can also have doors 1508. The doors 1508 can
house a plurality of bins 1510 which can be used to contain or organize
samples
within the dispenser 1500. Each door 1508 can be connected to the dispenser by
a
hinge 1516.
Figure 26A shows a control system 1518 for the doors 1508. The control
system 1518 can include a belt 1520 having at least one block 1524 attached
therein
and having a set of rollers 1522 to control the motion of the belt 1520. In
one
embodiment, the blocks 1524 are bolted to the belt 1520. In another
embodiment,
the belt 520 is a chain drive. In one embodiment, the rollers 1522 can be
gears. The
rollers 1522 can be connected to a control system which can control the motion
of
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the rollers 1522, thereby providing automatic opening and closing of the doors
1508.
The control system can include a computer.
Each door 1508 can be connected to a first end 1532 of a rod 1530 at a pivot
1528 on the door 1508. A second end 1534 of each rod 1530 can be attached to a
pivot 1526 on each block 1524. The rods 1530 connect the doors 1508 to the
motion
control system 1518. The pivots 1528 on the doors 1508 allow the doors 1508 to
rotate about their hinges 1516 without impingement from the rods 1530.
Similarly,
the pivots 1526 on the blocks 1526 allow the rods 1530 to follow the
rotational
motion of the doors 1508 without impinging this motion.
Figure 26A also shows the control system 1518 in various stages of
operation. The control system 1518 can control the positioning of the doors
1508.
In a first stage 1536, the doors 1508 are in a closed position, with a side
door portion
1544 forming a zero degree angle with a centerline 1542. The blocks 1524 are
located on the belt 1520 near the centerline 1542 of the control system 1518.
The
belt 1520 causes the rods 1530 to create a force on each door 1508 directed
toward
the centerline 1542, thereby holding the doors 1508 in a closed position. In a
second
silage 1538, the doors 1508 are half-opened, with a side door portion 1544
forming a
forty-five degree angle with the centerline 1542. In this position 1538, each
block
1524 is forced to move away from the centerline 1542 of the system 1518 by the
belt
1520, in an opening motion, or forced to move toward the centerline 1542 of
the
system 1518 by the belt 1520, in a closing motion. In an opening motion, the
belt
1520 causes each rod 1530 to create a force against each respective door 1508,
directed away from the centerline 1542, thereby forcing the doors 1508 in a
partially
open position. In a closing motion, the belt 1520 can cause each rod 1530 to
create a
force on each respective door 1508, directed toward the centerline 1542,
thereby
forcing the doors 1508 in a partially open position. In a third stage 1540,
the doors
are fully opened, with a side door portion 1544 forming a ninety degree angle
with a
centerline 1542. In this position 1540, each block 1524, again, has been
forced to
move away from the centerline 1542 of the system 1518 by the belt 1520. The
motion of the belt 1520 to this position 1540 further causes each rod 530 to
create a
force against each respective door 1508, directed away from the centerline
1542,
thereby, forcing the doors 1508 into a fully open position.
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The motion system 1518 can be operated automatically. Such operations can
provide security for the dispenser 1500 and can limit user access to the
device 1500.
When operated, the control system 1518 can cause the doors 1508 to expand or
contract to an open or closed position, respectively. Automatic operation of
the
control system 1518 can be triggered by some predefined event. For example, in
one
embodiment, the doors 1508 can be programmed to be opened by the motion
control
system 1518 only when the user provides positive identification. Also, the
doors
1508 can be programmed to automatically close after a set time period has
elapsed.
In another embodiment, the doors 1508 can also be caused to close when the
user
moves away from a proximity sensor located on the dispenser 1500. For
automatic
operation of the control system 1518, the system 1518 can be controlled by a
computer. The computer which controls the system 1518 can be separate from the
computer which controls the dispenser 1500 or integrated with it.
The sample dispenser 1500 can also include a barcode reader, or an
electronic reader in an alternate embodiment. The samples held by the
plurality of
bins 1510 can include barcodes. The inclusion of a barcode reader on the
sample
dispenser 1500 can allow a user to quickly and accurately create a record of
the
samples removed from the sample dispenser 1500 and the dates and times of
removal, for example.
Figure 26B illustrates a detailed, overhead view of the control system 1518
shown in Figure 26A. The control system 1518 can have a housing 1550 to which
the belt 1520, rollers 1522 and blocks 1524 are mounted. The housing 1550 can
also
hold and secure these components 1520, 1522 and 1524 to the motion control
system
housing 1546. The housing 1550 can have flanged portions 1552 which allow for
attachment of the housing 1550 to the control system housing 1546. The control
system 1518 can also have a shank 1554 attached to the housing 1550. Each
block
1524 can have a groove formed therein such that the groove in each block 1524
mates with the shank 1554. The blocks 1524 can be mounted on the shank 1554
such that the blocks 1524 can slide along the length of the shank 1554. In a
preferred embodiment, the shank 1554 is a raised steel rod.
Figures 27A through 27D illustrate an embodiment of a bin 1608 for a
sample dispenser 1500. The bins 1608 can be used to store and organize drugs
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within the dispenser 1500. In the embodiment shown, the bin 1608 have a
housing
1614 with a front end 1610 and a back end 1612. The housing 1614 includes a
handle 1620, a pushing device 1616 and a continuous torsion spring 1618. The
handle 1620 is used to aid in removing the bin 1608 10 from the dispenser
1500.
When the bin 1608 is empty, the pushing device 1616 is forced to the front end
1610
of the bin 1608 by the continuous torsion spring 1618. A user can then load
medicines or drug packages into the bin 1608 by moving the pushing device 1616
to
the back end 1612 of the bin 1608. Such motion provides storage space for the
medicine and extend the continuous torsion spring 1618. As drug packages are
removed from the bin 1608, the pushing device 1616 is forced toward the front
end
1610 of the bin 1608 by the contracting continuous torsion spring 1618. In
this
embodiment, the user can know immediately whether a bin 1608 is empty or full.
Incrementing a second drug package to the front end 1610 of the bin 1608 when
a
first drug package is removed ensures that a package will always be readily
available. Such a unit can save the user time in guessing whether a bin is
entirely
empty or contains a package "hidden" in the back of a bin.
In another preferred embodiment, a drug dispenser dispense non-prescription,
over-the-counter drugs to patients who can positively identify themselves to
the drug
dispenser system. Figures 28 through 34 illustrate embodiments of user
interactive
touch screens which can be used with such a system. The screens can provide a
way
for a user to interact with the software at the non-prescription dispenser.
Figure 28 shows an introduction screen 1560 for a touch screen monitor of a
non-prescription drug dispenser. The introduction screen 1560 can include a
start
command 1562, language option command 1564 and a demonstration command
1566. The start command 1562 can allow a user to progress through subsequent
screens and choose the non-prescription drugs they wish to receive. The
language
option command 1564 allow a user the choice of language for subsequent display
screens. The demonstration command 1566 can provide a demonstration of how the
drug dispenser works. The introduction screen 1560, and all subsequent
screens, can
include an end command 1568 which allows a user to exit the screens at any
point.
Figure 29 illustrates a drug category selection screen 1570 having drug
category selections 1572 and a reset command 1574. The drug category
selections
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1572 allows a user to select the drug categories from which they would like to
receive products. The drug categories can include medications for allergies,
antacids, cold/flu, creams/lotions, hemorrhoids, laxatives, pain relievers and
vitamins, for example. The reset command 1574 allows the user to start over or
cancel his selection, if the wrong selection had been made.
Figure 30 illustrates a drug availability screen 1576 showing the availability
of different dugs within a selected category. If a user selected Pain
Relievers as a
drug category, the screen shown in Figure 30 can provide the user with a list
of the
types of pain relievers available. For example, under the pain relievers
category, a
user can choose from aspirin, children's aspirin, acetaminophen, ibuprofen or
non-
aspirin acetaminophen. The user can choose the drugs he wishes to receive,
using
the drug selection commands 1578. Each drug selection command 1528 can be
associated with a particular drug. The drug availability screen 1576 can also
have a
drug list command 1580 which, when activated, can show the user a list of all
of the
drugs he has selected.
Figure 31 shows a drug list screen 1582 which lists the user's selection of
drugs 1588. The drug list screen 1582 can include drug selection commands 1598
which allow a user to delete certain drug choices from the list. In one
embodiment,
to delete a drug choice, a user can touch a drug selection commands 1598
corresponding to the drug to be removed from the list. The drug list screen
1582
also shows a "continue" command 1584 and a "done command 1586. The
"continue" command 1584 allows the user to make further drug selections. The
"done" command 1586 allows the user to exit the drug selection screens and
receive
the drugs he has chosen.
Figure 32 illustrates a user identification screen 1590. This screen 1590
instructs the user to identify himself to the drug dispensing system, in order
for the
drugs to be dispensed. In one embodiment, the user can be instructed to swipe
his
Veteran's Administration card through a card reader. The information on the
user's
card can then be compared to information within the system's database to
determine
the user's eligibility to receive the requested drugs. The user identification
screen
1590 can also include user identification indicator buttons 1592. The buttons
1592
can include a positive identification button 1594, which indicates the user's
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identification as valid, or a negative identification button 1596, which
indicates the
user's identification as invalid.
Figure 33 shows a ready-to-dispense screen 1600 which can indicate the
drugs the user has selected and will be dispensed. The ready-to-dispense
screen
1600 can also include drug selection commands 1602 which allow a user to
delete
certain drug choices from the list. In one embodiment, to delete a drug
choice, a
user can touch a portion of the touch screen corresponding to a drug selection
command 1602 which, in turn, corresponds to the drug to be removed from the
list.
The ready-to-dispense screen 1600 can also have a drug dispense command 1604.
When a user is satisfied with his drug request, he can touch this button to
begin the
drug dispensing procedure.
Figure 34 shows an ending screen 1606. The ending screen 1606 can provide
instructions to the user involving picking up drugs from the dispenser tray
and taking
information from the printer. The ending screen 34 can also indicate to the
user that
the request is being processed and delivered.
Figures 35 and 36 illustrate an embodiment of an over-the-counter (OTC)
medication dispenser 1650. The OTC medication dispenser 1650 can have a
housing 1684 which includes a door 1652, drug storage trays 1654, a labeling
device
1656, electronics 1658, a user identification system 1660, a computer 1666, a
security monitoring device 1668, a magnetic card reader 1672 and a pickup
location
1674. The computer 1666 can include a display 1662 and a printer 1664 having a
paper pickup location 1674. The display 1662 can be a touch screen display.
The
display screen can display materials such as, for example, advertisement
material
pertinent to the non-prescription drugs or related educational material. The
door
1652 is shown in an open position to better illustrate the drug storage trays
1654 of
the medication dispenser 1650.
Both the user identification system 1660 and the magnetic card reader 1672
can be used to either permit or prevent a user's access to the medication
dispenser
1650. The user identification system 1660 can be a fingerprint reader and,
preferably, is a thumb print reader. However, other user identification
systems can
be incorporated, such as, for example, but not limited to, credit card, debit
card, and
smart card reader systems. The user identification system 1660 can compare the
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user's fingerprint data against fingerprint data contained in a database
interfaced with
the dispenser 1650. The magnetic card reader 1672 can read information from a
user's medication dispenser card, such as a Veteran's Administration card, and
compare the information to that within a database interfaced with the
dispenser
1650. In either the user identification system 1660 or the magnetic card
reader 1672,
if the user's information is present in the database, the user will be allowed
to
proceed and can receive his requested medication. Conversely, if the user's
information is not located in the database, the user will not be able to
proceed within
the system or receive any medication. A dispenser 1650 can include either the
user
identification system 1660 or the magnetic card reader 1672, on both,
depending
upon the level of security required by the customer. For example, a dispenser
1650
located in a doctor's office can require a different level of security than a
dispenser
1650 located in a methadone clinic. For customer's requiring a high level of
security, the dispenser 1650 can include both the user identification system
1660 and
the magnetic card reader 1672.
The electronics 1658 can include a camera, speakers or a microphone. The
speakers or microphone can allow for user interaction with the computer 1666
with
the presence of a voice recognition system. The camera can be connected to the
security monitoring device 1668. The security monitoring device 1.668 can
detect
tampering of the dispenser 1650. In one embodiment, the security monitoring
device
1668 can be an infrared detector. In another embodiment, the security
monitoring
device 1668 can be a vibration recorder. Tithe dispenser 1650 was tampered,
the
security monitoring device could cause the camera to create a photographic
record of
the area surrounding the dispenser 1650, for example. In one embodiment, the
photographic record could be a digital image which could then be transferred
to a
monitoring station, byway of modem technology, for example.
The drug storage trays 1654, as shown in Figure 36, can include a dispensing
device. In a preferred embodiment, the dispensing device can include helix
coils
1680. In a preferred embodiment, the helix coils 1680 are motor driven and
allow
the dispensing of medications to a user. When a user selects a medication to
be
dispensed from the dispenser 1650, the helix coil 1680 corresponding to the
chosen
medication can be forced to rotate, thereby causing the medication to move
toward
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the door 1652 of the dispenser 1650 and into a collection tray 1676 located on
the
door 1652. The drug storage trays 1654 can also include dividers 1682. The
dividers 1682 can be adjustable within the trays 1654 such that the trays 1654
can
accommodate medication packages of varying sizes or shapes. The rotation of
the
helix coils 1680 can be controlled by some control system, such as a computer
for
example.
The door 1652 can be used to secure the drug storage trays 1654 and the
medications within the housing 1684 of the OTC medication dispenser 1650. The
door 1652 can include lifting mechanisms 1678, which are shown without the
door
1652 in Figure 37. The door 1652 can also include a collection tray 1676, a
pushing
device 1686 and a pushing device control 1688.
In a preferred embodiment, the lifting mechanisms 1678 are S-rail lifting
screws. The S-rail lifting screws can be threaded through the collection tray
1676
and can rotate about a central axis, either in a clockwise or a
counterclockwise
direction, thereby causing the collection tray 1686 to translate in an upward
or
downward direction. The S-rail lift screws can also be Teflon coated to
provide for
smooth translation of the collection tray 1676.
The collection tray 1676 can be used to collect medicine packages from the
drug storage trays 1654 and deliver the packages to the labeling device 1656.
By
allowing for the collection tray 1676 to translate upwards and downwards, the
tray
1676 can collect medicine packages from drug storage trays 1654 located along
the
entire height of the dispenser 1650. Positioning the collection tray 1676 at a
particular drug storage tray 1654 from which a package is being dispensed
prevents
the medicine in the package from being damaged by an impact after being
dispensed.
The positioning at the collection tray 1676 can be controlled by a control
system,
such as a computer, for example.
The collection tray 1676 can include a pushing device 1686 which can be
used to move medical samples from the collection tray 1676 into the labeling
device
1656. The pushing device 1686 can include a pushing device controller 1688
which
controls the positioning of the pushing device 1686. In one embodiment, the
pushing device controller 1688 is an S-rail screw. In another embodiment, a
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conveyor can be used as the pushing device controller 1688. The pushing device
controller 1688 can be driven by a control system, such as a computer, for
example.
When a user wishes to retrieve drugs from the OTC medication dispenser
1650, he can first be prompted to provide his identification, either by
utilizing the
user identification system 1660 or the magnetic card reader 1672, or both and
can
then enter his medication choices into the computer 1666. In another
embodiment,
the user can first be prompted to enter his drug choices and then be required
to
provide his identification to the dispenser 1650. Next, the collection tray
1676 can
be forced to move, in either an upward or downward direction, to the drug
storage
trays 1654 which contain the requested medication. The helix coils 1680 can
then be
forced to rotate in the drug storage trays 1654 so as to advance the selected
medication into the collection tray 1676. The collection tray 1676 can then be
caused to move upwards or downwards to the labeling device 1656. The pushing
device 1686 of the collection tray 1676 can then be caused to push the
medication
from the collection tray 1676 into the labeling device 1656. In the labeling
device
1656, the drug can be identified by a barcode reader which can read the
medication's
barcode. The labeling device 1656 can also apply a label to the medication.
The
labeling device 1656 can then transfer the medication to the pickup location
1674.
In a preferred embodiment, the labeling device 1656 can transfer the
medication to
the pickup location 1674 by a conveyance mechanism, such as an S-rail or a
conveyor, hi a preferred embodiment, the pickup location 1674 can have a cover
which can be automated. When the medications arrive at the pickup location
1674,
as requested by the user, the cover can open. Once the user removes the
requested
medications, the cover can automatically close and secure itself to the pickup
location 1674.
Without limiting the generality of the claimed invention, those skilled in the
art can appreciate that the components of the dispensing system - physical and
program code - can be physically split and operated from different locations,
connected together by a computer network. Further, components of the system
can be divided and owned and operated by multiple entities, connected by a
computer network if applicable.
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It will be apparent to those of ordinary skill in the art that methods
involved
in the remote dispensing of pharmaceuticals or other medical products can be
embodied in a computer program product that includes a computer usable medium.
For example, such a computer usable medium can include a readable memory
device, such as a hard drive device, a CD-ROM, a DVD-ROM, or a computer
diskette, having computer readable program code segments stored thereon. The
computer readable medium can also include a communications or transmission
medium, such as a bus or a communications link, either optical, wired, or
wireless,
having program code segments carried thereon as digital or analog data
signals.
Figure 38 illustrates a view 2000 of a display screen of a user interface
showing a main screen used to dispense a prescription medical product in
accordance with a preferred embodiment of the present invention. The system is
fully integrated with a pharmacy software system and if located at a medical
facility,
for example, a hospital can be integrated with the facilities software
platforms and
systems. The system enables the dispensing of starter prescription doses and
initial
fills at the point of care medical facility or at a remote dispensing site and
captures
mail order refills in a preferred embodiment. The preferred embodiment
provides
communication user interfaces to both local area networks (LANS) and wide area
networks. A pharmacy workstation can be equipped with modems such as a 56 kps
modem, for example, for telecommunication connections and 10/100 MB Ethernet
Network Interface cards. The communication user interfaces support remote
dispensing of medical products, real time, third party claims adjudication,
remote
diagnostics and maintenance. The first interface screen accessed by a user is
the
main screen 2000 which provides a user interface such as, for example, a touch
screen that may offer gray scale images or a color touch screen having
ergonomic,
easy to use interfaces such as buttons. These interfaces include a resources
button
2002, a dispense button 2004, a new Rx button 2006, a log off button 2008 and
an
exit button 2009.
Figure 39 illustrates a view 2010 of a display screen of a user interface
illustrating use of a dispense function interface such as a button in
accordance with a
preferred embodiment of the present invention. A user activates the dispense
button
2004 by touching the dispense button 2004. Where there is a medical product
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waiting to be dispensed the dispense interface button 2004 flashes with the
number
of medical products waiting in the queue. Clicking on the dispense button,
2004
allows access to the dispense screen.
Figure 40 illustrates a view 2020 of a display screen of a user interface
illustrating a dispense queue in accordance with a preferred embodiment of the
present invention. The dispense queue screen has a list 2022 of medical
products
available for dispensing. The product to be dispensed is selected by clicking
on the
product or touching the screen to highlight it. A subsequent interface, the
select
button, 2024, for example, can be touched to select the product.
Figure 41 illustrates a view 2040 of a display screen of a user interface
showing a review 2040 of patient script information in accordance with a
preferred
embodiment of the present invention. The dispense screen provides all of the
patient
specific information 2042 for review. After reviewing the patient information
for
accuracy, the user can click on or touch the dispense button 2044.
Figure 42 illustrates a view 2050 of a display screen of a user interface
showing the prompt for scanning a barcode on a medical product in accordance
with
a preferred embodiment of the present invention. The remote control dispensing
system unit releases the medication to be dispensed to the user. The user is
prompted to scan the barcode on the medication to identify the dispensed
product as
part of a verification method. This verification ensures that the product
dispensed
from the RCD system matches the prescription for the patient.
Figure 43 illustrates a view 2060 of a display screen of a user interface
showing the barcode check information in accordance with a preferred
embodiment
of the present invention. As discussed herehabefore, each medication or
medical
product dispensed has a barcode identifier label. Using a scanner, the barcode
identifier is scanned and the barcode data appears in the field labeled
"Results of
Barcode Check" 2052. The proper completion of the printed label scan check
returns the user to the main screen described with respect to Figure 38.
Figure 44 illustrates a view 2070 of a display screen of a user interface
showing the access of the resources function by interacting with the resources
button
2072 in accordance with a preferred embodiment of the present invention. All
non-
dispensing functionality is provided by the resource interface and executable
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instructions provided with respect to the resources interface. Interaction
with the
resources button 2072, for example, by touch or clicking on it using a
computer
mouse provides access to view the resources screen which is analogous to
access to
inventory management.
Figure 45 illustrates a view 2080 of a display screen of a user interface
showing the details of the "Resources" function in accordance with a preferred
embodiment of the present invention. The resources screen 2080 has a user
interface
button 2082 to add/edit inventory.
Figure 46 illustrates a view 2090 of a display screen of a user interface
showing the method of selecting the medical product, for example, a drug that
needs
to be accessed and edited in accordance with a preferred embodiment of the
present
invention. For ease of accessing the drug a first letter of the drug to be
edited can be
selected from the interface buttons 2092 a-z indicative of the alphabet.
Figures 47A and 47B illustrate a preferred embodiment of a remote control
dispensing system, the resources of which are being managed by the user
interface
described with respect to Figure 45 and Figure 46 in accordance with the
present
invention. The RCD 2010 can have a total of 60 columns 2102, for example. When
the medical products are loaded, the bottles, for example, are loaded
horizontally
with the cap first to ensure that they are dispensed properly during the
dispensing
process. The columns can be numbered and the name of the medical products can
be attached to columns to assist with a loading or reloading process. Figure
47B
illustrates a schematic 2120 that can be attached to the inside of the
dispenser door.
The RCD, in a preferred embodiment, has helixes placed in multiple slots, such
as
slots. A helix clips on to a plastic cam, which in turn clips on to the rotor
of a
25 small electronic motor attached to the back of the dispense drawer. The
terminus or
small end of the helix sits roughly in the 12 o'clock position when at rest.
Helixes
come in multiple sizes, with larger sizes holding larger medical products when
loading the RCD, the medical products are placed between the coils of the
helix
starting with the space in front In a preferred embodiment the item is made to
lean
30 forward to
ensure that the item falls correctly during the dispense process. =
In a preferred embodiment, some items must be put into clear plastic
containers so they discharge properly. The dividers between the slots are
anchored
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to the drawer by a nut at the top and back of the dispense drawer. There is
one nut
per drawer. Should an item not fit into a standard sized slot, the dividers
between
the slots can be adjusted. This can be accomplished by first unclipping the
neighboring motor from the slot next to the one needing adjustment. Removing
the
motor provides better access to the nut to be loosened. After the nut has been
removed, the divider can be moved. After the desired width is selected, the
flanges
are clipped on the bottom of the divider into the slots on the bottom of the
dispense
drawer, and the nut is tightened. Note that the motor removed from the drawer
cannot be used for dispensing.
In the preferred embodiment if a drug does not fit into a modified slot in the
RCD, it can be stored in the storage drawer (bottom drawer) and entered into
the
inventory. The dispense door still opens, but the drug has to be manually
retrieved
from the storage drawer.
Figure 48 illustrates a view 2140 of a display screen of a user interface
showing the access of the reporting function by the use of the reports button
2142 in
accordance with a preferred embodiment of the present invention. To navigate
to the
reports menu the user thus touches or clicks on the resources button in the
main
screen as shown in Figure 38 which provides access to all non-dispensing
functionality and then clicks or touches the interface button "Reports" 2142.
Figure 49 illustrates a view 2160 of a display screen of a user interface
showing the selections of reports available in accordance with a preferred
embodiment of the present invention. A type of report is selected by double
clicking
or touching it. In a preferred embodiment, the system provides four types of
reports.
The first report being inventory by brand name report 2162. This report
provides
information by brand name on the current number of drug packages in the RCD
unit
as well as the location of the drugs in the RCD unit (column/helix). The
second
report is inventory by generic name report 2164. This report provides
information
by generic name on the current number of drug packages in the RCD unit as well
as
the location of the drugs in the RCD unit (column/helix). The next report is
called
the PIC level report 2166. This report provides documentation of drugs that
are at or
below the set PIC level. The last report, but not limited to, is the
transaction report
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2168. This report provides documentation on all transactions completed by the
drug
dispensing software.
Figure 50 illustrates a view 2180 of a display screen of a user interface
showing the access to an "Assign User" functionality by the use of a
particular
button in accordance with a preferred embodiment of the present invention. The
assign users button 2182 is accessed after touching or clicking the resources
button
on the main screen. Each user has a user name, user ID and password. User
access
to the executable instructions is limited to four levels: password control,
dispense
authority, inventory control and schedule for dispensing. The individual with
password control determines user access.
Figure 51 illustrates a view 2200 of a display screen of a user interface
showing the method used to add a new user to the system in accordance with a
preferred embodiment of the present invention. The responsibility to add a new
user
and enter the pertinent information rests with the password administrator. At
the
display screen 2200 the user creates their own User BD by typing in a unique
configuration of numbers and letters in the User ID field 2204 and then the
password
in field 2206. In the field corresponding to the user name 2202 the actual
name of
the user is entered. In a subsequent step the user's permission level is
checked and
by activating the save button interface the information is saved.
Figure 52 illustrates a view 2220 of a display screen of a user interface
showing the method to edit user privileges in accordance with a preferred
embodiment of the present invention. To edit user privileges 2222 the name of
the
user to be edited is activated by touching the screen or clicking to highlight
the
name. Then the privileges are either checks or unchecked by the checks in
boxes
next to the appropriate privileges. The password administrator has the
responsibility
to assign privileges.
Figure 53 illustrates a view 2240 of a display screen of a user interface
showing the use a method to create a new medical product prescription (Rx)
using
the "New Rx" interface button in accordance with a preferred embodiment of the
present invention. The user begins from the display screen 2240 by selecting
the
"New Rx" interface button 2242 either by touching the interface or clicking on
New
Rx button 2242.
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Figure 54 illustrates a view 2260 of a display screen of a user interface
showing the method used to select the patient in the "New Rx" option in
accordance
with a preferred embodiment of the present invention. The patient is selected
by
accessing the interface 2262 that provides an alphabet panel by, for example,
touching or clicking on the first letter of a patient's last name.
Figure 55 illustrates a sequential view 2280 of a display screen of a user
interface showing the next step in the method to select the patient in
accordance with
a preferred embodiment of the present invention. The patient's name is hig
ilighted
2282 by clicking or touching the patient's name that is listed under the
particular
alphabet. The name is selected by interfacing by touch or via the mouse click
with
the select button 2284.
Figure 56 illustrates a view 2300 of a display screen of a user interface
showing a method to select a prescriber in accordance with a preferred
embodiment
of the present invention. Similar to the method to select the patient, a first
letter of
the last name of the prescriber is selected from an alphabet panel 2302.
Figure 57 illustrates a view 2320 of a display screen of a user interface
showing a subsequent step in the method used to select the prescriber in
accordance
with a preferred embodiment of the present invention. The prescriber is
selected by
clicking or touching on the prescriber's name 2322 and then selecting the
prescriber
by clicking or touching the screen.
Figure 58 and Figure 59 illustrate views 2340, 2360 of a display screen of a
user interface showing steps in a method to select a drug in accordance with a
preferred embodiment of the present invention. The first letter of the drug
name is
selected from the interface button 2342 that is alphabetized. As discussed
herein the
interface buttons are accessed by touch or a click of a mouse, The drug name
is then
selected by highlighting the drug 2362 and then touching or clicking on the
select
button 2364.
Figure 60 illustrates a view 2380 of a display screen of a user interface
showing the information fields than can be edited pertaining to a drug in
accordance
with a preferred embodiment of the present invention. Dosage information can
be
entered in field 2382, followed by filling the fields for day's supply 2384,
refill
2386, DAW 2388, authorization 2390 and payment 2392.
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Figure 61 illustrates a view 2400 of a display screen of a user interface
showing the required fields that need to be entered in accordance with a
preferred
embodiment of the present invention. The data boxes required such as script
expiration, level of service and such need to be filled and then the fmish
interface
button 2402 has to be accessed via touch or a click. The dispense button on
the main
screen flashes a message indicating a dispense along with the number of
prescriptions available.
Figure 62 illustrates a view 2420 of a display screen of a user interface
showing a reload inventory function interface, in particular a button, in
accordance
with a preferred embodiment of the present invention. The reload functionality
is
also accessed by accessing the resources button on the main screen as
reloading is a
non-dispensing function. Then the reload inventory button 2422 is touched or
clicked.
Figure 63 illustrates a view 2440 of a display screen of a user interface
showing the prompts to scan a barcode of a medical product to be reloaded into
inventory in accordance with a preferred embodiment of the present invention.
The
barcode on the medical product is required to be scanned prior to be reloaded
into
inventory.
Figure 64 illustrates a view 2460 of a display screen of a user interface
showing the selection of the drug and the related information in accordance
with a
preferred embodiment of the present invention. The drug to be reloaded is
selected
by accessing the drug name 2462 via touching the interface or clicking on it.
The
number of packages to be placed in inventory is added to the Number to Add box
2464. The RCD ID 2466 and the col/helix ID box 2468 provide the physical
location to restock the product.
Figure 65 illustrates a view 2480 of a display screen of a user interface
showing the use of the save interface (button) after restocking a particular
medical
product in accordance with a preferred embodiment of the present invention.
After
restocking the product, for example, the drug save button 2482 is accessed by
touching the interface button. The screen clears and this process is repeated
until the
process of restocking is complete. By touching or clicking on the main button
2484
the user returns to the main screen.
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Figure 66 illustrates a view 2500 of a display screen of a user interface
showing the use of the add/edit patient interface button in accordance with a
preferred embodiment of the present invention. The system to dispense
pharmaceuticals also provides for adding or editing the list of patients. This
functionality is accessed via the resources button in the main screen
described with
respect to Figure 38. Once the resources screen 2500 appears, the add/edit
patient
button 2502 can be touched or clicked to begin the process of revising the
patient
list.
Figure 67 illustrates a view 2520 of a display screen of a user interface
showing the subsequent step in the method to add a patient in accordance with
a
preferred embodiment of the present invention. The ADD button 2522 is used by
touching or clicking on as the next step.
Figure 68 illustrates a view 2540 of a display screen of a user interface
showing a plurality of fields that need to be filled to effectively add a
patient in
accordance with a preferred embodiment of the present invention. Data in all
the
applicable fields or data boxes need to be entered, for example, last name
2542. The
pages are changed by clicking or touching the tabs such as Allergy 2544,
Disease
2546 etc. Upon completion of the process to enter all pertinent patient
information
the Save button 2548 is interfaced to save the patient information. The
save/back
button 2550 is interfaced to save patient information and clear the form for
the next
patient. The main button 2552 is used to access the main screen.
Figure 69 illustrates a view 2560 of a display screen of a user interface
showing the use of the add/edit prescriber interface button in accordance with
a
preferred embodiment of the present invention. The resources screen 2560 is
again
accessed via the resources button on the main screen. The add/edit prescriber
button
2562 is interfaced with via touch or clicking on.
Figure 70 illustrates a view 2580 of a display screen of a user interface
showing a subsequent step in the method to add a prescriber in accordance with
a
preferred embodiment of the present invention. To add a prescriber the add
button
2582 is touched or clicked. The prescriber's last name is accessed from the
alphabetized interface buttons grouped in the interface 2584.
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Figure 71 illustrates a view 2600 of a display screen of a user interface
showing the fields that are required to be filled to add the prescriber in
accordance
with a preferred embodiment of the present invention. The data box fields such
as,
for example, name 2602, DEA 2604, related to the particular prescriber need to
be
entered. The save button 2606 is used to save prescriber information. The
back/don't save button 2608 returns the user to the previous screen without
saving
information. The save/back button 2610 saves the information and returns the
user
to the previous screen.
Figure 72 illustrates a view 2620 of a display screen of a user interface
showing the start of an adjudication method in accordance with a preferred
embodiment of the present invention. The adjudication method starts after the
instructions from the new Rx method described hereinbefore in Figures 53-61.
After
creating a new Rx (prescription) and entering in a patient specific dosing
instructions
and filling out the required data fields the adjudication button 2622 is used
by
touching or clicking.
Figure 73 illustrates a view 2640 of a display screen of a user interface
showing a dispense queue in the adjudication method in accordance with a
preferred
embodiment of the present invention. At the main screen when a claim is
returned,
text flashing in the largest button tells a user whether the claim has been
paid
(dispensed) or rejected (pending). A number after the caption such as, for
example,
DISPENSE1, indicates how many products are in each queue. The dispense queue
screen 2640 is a queue-viewing page. Scripts can be dispensed; deleted or
reversed
from this screen by using the respective buttons 2642, 2644, 2646.
Figure 74 illustrates a view 2660 of a display screen of a user interface
showing drug utilization review (DUR) alerts in an adjudication method in
accordance with a preferred embodiment of the present invention. lithe claim
has
been paid, but with DUR alerts a screen similar to display screen 2660 is
displayed
to the user after selecting "Dispense". The pharmacist is then called into the
process. After viewing the alerts the pharmacist can choose the appropriate
options
and if so inclined enters a password and selects the override function by
touching the
override button 2662.
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Figure 75 illustrates a view 2680 of a display screen of a user interface
showing script information in the DUR alert described with respect to Figure
74 in
accordance with a preferred embodiment of the present invention. This is a
viewing
screen.
Figure 76 illustrates a view 2700 of a display screen of a user interface
showing the patient transaction history in an adjudication method in
accordance with
a preferred embodiment of the present invention. This screen is another
viewing
screen.
Figure 77 illustrates a view 2720 of a display screen of a user interface
showing the patient script information to be reviewed after an override or a
returned
claim during the adjudication process in accordance with a preferred
embodiment of
the present invention. After an override or if the claim is returned without
an alert or
rejection, a screen similar to the view 2720 is displayed for the user.
Figure 78 illustrates a view 2740 of a display screen of a user interface
showing the final process that includes the scanning of barcodes as part of
the
adjudication process in accordance with a preferred embodiment of the present
invention. This is a safety check step in the adjudication and dispense
process.
Figure 79 illustrates a view 2760 of a display screen of a user interface
showing a reason for rejection as part of the adjudication process in
accordance with
a preferred embodiment of the present invention. If the adjudication claim has
generated a reject then in the main screen a pending message is generated in a
button. After selecting the pending queue in the queue-viewing screen and
selecting
a script from the list box, a screen such as view 2760 is displayed to the
user. This
screen can display multiple reject reasons such as up to 20 reasons one of
which is
shown in the field 2762. Extra tabs and text boxes are dynamically constructed
and
displayed on need. The reasons are color-coded. Yellow indicates an onsite
issue,
green a TSI issue which can be resolved on-site, blue an administrative
concern and
pink requiring the intervention of the pharmacist.
Figure 80 illustrates a view 2780 of a display screen of a user interface
showing a subsequent step indicating unresolved issues as part of the
adjudication
process in accordance with a preferred embodiment of the present invention. If
the
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user tries to resubmit the claim without first addressing all outstanding
rejection
issues, they are prohibited from proceeding and the display screen 2780
appears.
Figure 81 illustrates a view 2800 of a display screen of a user interface
showing a rejection correction form as part of the adjudication process in
accordance
with a preferred embodiment of the present invention. When the reject message
is
selected a rejection correction form 2802 is displayed. The current value is
displayed in the text field. The user has the option of revising the form 2802
and
trying to resubmit the claim. If the claim is repeatedly rejected the user
needs to
contact the administrator depending on the nature of the reason for rejection.
Figure 82 illustrates a view 2820 of a display screen of a user interface
showing a claim pending adjudication after being resubmitted as part of the
adjudication method in accordance with a preferred embodiment of the present
invention. After selecting the interface button "OK" 2804 in the previous
screen
2800, the reason for rejection is removed from the screen. If there were
twenty
reject reasons the same process is repeated until they are all examined. The
claim is
then ready to be reexamined and resubmitted by interfacing and touching button
2822.
Figure 83 illustrates a view 2840 of a display screen of a user interface
showing a DUR alert removal form as part of the adjudication method in
accordance
with a preferred embodiment of the present invention. Typically on-site staff,
and
administrators can handle a majority of errors, however, any drug related
reject
causes a screen such as screen 2840 to be displayed. Intervention and outcome
fields
can only be entered once on a resubmitted claim. Therefore, if more than one
DUR
reject reason exists, all is overridden if one of them is. It should be noted
that a
screen similar to display screen 2840 is displayed if a paid claim has DUR
alerts.
Figure 84 illustrates a view 2860 of a display screen of a user interface
showing a returned claim as a result of the adjudication process in accordance
with a
preferred embodiment of the present invention. If the returned claim has more
than
three errors a screen similar to screen 2860 is displayed to the user.
Figure 85 illustrates a view 2880 of a display screen of a user interface
showing an access users screen for dispensing, tracking and returning of
particular
classes of drugs such as, for example, narcotics in accordance with a
preferred
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embodiment of the present invention. On the assign users screen an access
level
field 2882 is additionally displayed to further control the dispensing of
classes of
drugs. The number 0-99 can be entered in the field 2882.
Figure 86 illustrates a view 2900 of a display screen of a user interface
showing an access level field for adding and editing medical products into a
system
for dispensing medical products in accordance with a preferred embodiment of
the
present invention. The access level field 2902 is added to add and edit drug
or
medical product screens to better control certain classes of drugs such as
narcotics.
In the example, since this drug is set to "2", any user with an access level
of 2 or
higher can dispense the medical product. Other users get an access denied
message.
In the blind count field 2904 when "Yes" is selected, upon dispensing the
medical
product, the user is asked to count the amount currently on hand in inventory.
If the
number differs from that within the database they are asked again to make
certain if
the count differs. A warning is immediately printed and the fact that there is
a
discrepancy is recorded and can be reviewed in a discrepancy report.
Figure 87 illustrates a view 2920 of a display screen of a user interface
showing the denial of access to dispense a medical product in accordance with
a
preferred embodiment of the present invention. The screen 2920 is displayed if
the
user does not have the proper access level and attempts an access.
Figure 88 illustrates a view 2940 of a display screen of a user interface
showing an inventory count required field for an access level in accordance
with a
- preferred embodiment of the present invention. If the user has a proper
access level,
but the drug or medical product is set to force a blind count the screen 2940
is
displayed. A number such as 31 is entered by the user, which differs than the
amount listed in the inventory.
Figure 89 illustrates a subsequent view 2960 of a display screen of a user
interface showing a response to an incorrect entry made into an inventory
count for
an access level field in accordance with a preferred embodiment of the present
invention. Because in the previous screen 2940 a number 31 was inputted and is
different from the inventory count, the user is prompted again to verify the
entry. If
the amount entered is still wrong in field 2962, a warning is sent to the
printer with
pertinent information.
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Figure 90 illustrates a view 2980 of a display screen of a user interface
showing a discrepancy report generated in response to a denial of access in
accordance with a preferred embodiment of the present invention. It delineates
information pertaining to the drug, the user, date/time information, quantity
counted
and quantity on hand in the inventory.
Figure 91 illustrates a view 3000 of a display screen of a user interface
showing a return/wasted interface button 3002 in accordance with a preferred
embodiment of the present invention. This button 3002 appears in the resource
screen and is important for tracking certain classes of drugs such as, for
example,
regulated medication such as narcotics.
Figure 92 illustrates a view 3020 of a display screen of a user interface
showing return/wasted information generated in accordance with a preferred
embodiment of the present invention. A transaction 3022 can be selected on the
return/waste display screen and then selected using the interface button 3024.
Figure 93 illustrates a view 3040 of a display screen of a user interface
showing the details of the selected transactions for an access level user in
accordance
with a preferred embodiment of the present invention. The selected
transactions are
displayed on the left half 3042 of the screen. The current quantity dispensed
appears
in the field 3044. The user enters the amount returned or wasted, and then the
actual
amount dispensed. A witness can then enter their user ID in field 3046 and
password in field 3048 to save the changes. This form allows for the complete
return of a drug. The entire amount to return is entered in field 3050, "0"
into
amount wasted field 3052 and "0" into actual quantity dispensed. A record of
the
transaction is made, albeit for a quantity of zero.
Figures 94A-94D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing displays for
dispense
summaries in accordance with a preferred embodiment of the present invention.
As
described herein with respect to Figures 16A-27D a method for dispensing and
managing samples of medical products are described. The following figures
describe an alternate preferred embodiment for dispensing and managing samples
of
medical products. This alternate preferred embodiment documents the sample
process and addresses all the JCAHO standards. The drug sampling sequence of
CA 02833710 2013-11-19
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executable instructions can be used by a system enclosed in a special cabinet
or a
stand alone processor. In a preferred embodiment the executable instructions
are
provided for a touch screen monitor. In another preferred embodiment, the
monitor
also responds to mouse and keyboard commands. Further, in a preferred
embodiment, in order to input text into a text box, it has to be in focus. A
text box
receives focus automatically, or by the user pressing or clicking on the
appropriate
box interface. Upon coming into focus, the interface box or field may change
color,
for example, the text box is yellow when it has focus. Message boxes are used
to
prevent improper or inadequate entries. The sequence described with respect to
Figures 16A-16D remain the first steps that are performed in the method for
dispensing medical product samples. Figure 94A provides a dispense summary
display screen. All entries need to be verified for accuracy. The interface
3062
allows the selection of additional medications for a patient. The interface
3064
allows the user to select back to the main screen. The finish interface 3066
selection
allows the printing of labels and monographs for a patient. If the write a
script field
3068 is selected, some of the other buttons are disabled multiple samples and
scripts
can be created for the same patient by selecting add another medication
interface
3062.
Figure 94B describes further details of the dispense summary once write a
script interface 3068 is selected. Three new buttons appear while four buttons
disappear. The quality field 3082 has to be filled. The selections that can
then be
made include cancel, create script and fax to pharmacy or create script. In a
preferred embodiment the processor does not fax a script to the pharmacy.
Instead it
transfers the data over the sites' intranet to a base computer. The base
computer acts
as a server and stores the data into a directory. Another set of executable
instructions polls the directory, when a file is found it is either printed or
faxed. The
fields number of refills and may call for delivery are optional fields.
Figure 94C illustrates another preferred embodiment of a subsequent
dispense summary screen analogous to the description in Figure 94B. In Figure
94D, the screen display 3120 is displayed when a fax to the pharmacy fails.
After a
pre-determined time period, for example, approximately sixty second, the image
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3120 disappears and the main screen appears. Selecting the OK button 3122
removes the image 3120 immediately and displays the main screen.
Figures 95A-95G illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the methods of
entering
medical products to an inventory in accordance with a preferred embodiment of
the
present invention. The method of entering or adding to inventory begins with
selecting the maintenance interface button 3142 in the main screen, followed
by
selecting the databases interface button 3162 on the touch screen 3160
displayed.
When a medical product is first loaded into the system database, the add
method is used, however if additional quantities of the product are added at a
later
date, the load method is used. The inventory interface button 3182 is touched
for
selection and an item can be removed from the inventory by the interfacing
with the
delete button 3184 or added to inventory by interfacing with the add interface
button
3182.
Figure 95D is a screen 3200 that requires the entry into the name and
company fields 3202, 3204. By selecting the drug or medical product name in
Figure 95E using the interface button 3222 a view into the inventory database
editor
is provided. As depicted in Figure 95F, the interface 3242 can be used to
select a
letter to search for the medical product. This interface allows for data to be
entered
quickly and easily and enforces naming conventions for consistency. Using
interface
button 3244 a number of packages is entered. The product can be added to the
database using the add interface button 3246. In the subsequent screens
further
information such as lot, expiration data, and quantity added. The save button
3262
is used to save data.
Figures 96A-96D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the methods for re-
entering or editing medical products to an inventory in accordance with a
preferred
embodiment of the present invention. The method includes using the maintenance
interface button 3282 to enter the screen 3300 from where the load/edit
interface
button 3302 can be accessed. The user is then prompted to add a name and
company
information. In this case the user may be an agent of a medical pharmaceutical
company or another distributor. The first initial of the drug can be accessed
and then
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selected from the alphabetized list. The use of on screen 3320 next interface
button
3344 on screen 3340 brings up the inventory database editor screen described
in
Figure 95E. It should be noted that the inventory database editor utilizes a
number
of utility programs such as a drug name utility that allows the user to search
through
a drug sample database, a "Mfg" button that allows a search through a database
containing names of drug manufacturers, and a get new gcn interface utility
that
retrieves a number which determines the proper patient monograph for a sample.
All these utilities, reduce and preferably eliminate the need for excess
typing and
maintain naming conventions.
Whether a drug name is manually created, or selected with the drug name
utility, the following applies: the PIC number (minimum quantity required)
must be
entered. Another utility examines this field and sends an email if shortage
exist; the
lot and expiration data must be entered next. Samples are always stored and
entered
in the same order, closest expiration data first; enter the lot, depress the
'tab' or
'enter' key to give the date (YYYY) focus. Type the numeric value for the
following eight characters (YYYYMMDD), after the required number of elements
in
each field is realized, focus automatically shifts to the next open field on
its right.
Further, samples with different lot and expiration numbers are entered
separately.
Each quantity field is specific to their own specific lot and expiration. When
sample
data is saved the sum of the individual quantities are placed into the
`OnHand' text
field. When the quantity of samples dispensed exceeds the quantity of a
specific lot,
the balance is subtracted from the next lot. The lot and expiration fields
also
automatically shifts to the left. The first sig, 'TAKE AS DIRECTED' is posted
automatically whenever the 'CLEAR ALL FIELDS' button is selected. The
remaining fields can be filled in and saved. There is an additional field
called
'COMMENT'. This field can be used to capture all other data of interest. For
example: If a sample reaches its expiration date and is removed, the number,
date,
and reason for removal can be entered in this field.
Figures 97A-97D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the steps of the
method
associated with the databases functions to include a prescriber name in
accordance
with a preferred embodiment of the present invention. The method begins with
CA 02833710 2013-11-19
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selecting the maintenance interface button 3362 which allows access to the
screen
3380 from which the database interface is selected using button 3382. Once the
prescriber is selected in screen 3400 and added, the screen 3420 prompts the
user to
enter the prescriber's name and license number and other pertinent
information.
Figures 98A-98C illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the methods for
viewing
a transaction or loading databases in accordance with a preferred embodiment
of the
present invention. Similar to the previous description herein the maintenance
interface button 3442 is used to enter the databases on screen 3460. The
database to
be viewed can be selected from display screen 3480. In a preferred embodiment
the
transaction and load databases are for viewing purposes only.
Figures 99A-99D illustrate display screens in a user interface that is used in
a
system for dispensing samples of medical products showing the method to view
multiple reports in accordance with a preferred embodiment of the present
invention.
The executable instructions for viewing reports can be accessed using the
maintenance button 3502 which access screen 3520 allowing the user the
interface
with the reports button 3522. A multiple listing of reports are provided to
the user in
screen 3540. The type of report needed can be selected 3542 by touching the
screen
and then printed using a print interface 3544. The options for viewing the
report are
provided in field 3562 along with a print interface 3566.
Figures 100A-100C illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing-the method to
determine the software version of the medical products in accordance with a
preferred embodiment of the present invention. Upon selecting the maintenance
interface button 3582 and subsequently accessing executable instructions with
respect to databases via the display screen 3580, the current version of the
executable instruction in use.
Figures 101A-101B illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing the method to
access a desktop computing processor in accordance with a preferred embodiment
of
the present invention. The maintenance interface button in display screen 3600
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allows the access to a screen 3610 for entry of a password which enables
executable
instructions to exit to a desktop computing interface.
Figure 102 illustrates a warning 3620 screen in a user interface that is used
in
a system for dispensing samples of medical products in accordance with a
preferred
embodiment of the present invention. Once the process for dispensing the
samples
of medical products is completed by selecting the close button the screen 3620
is
displayed.
Figure 103 illustrates an initial screen 3640 in a system for dispensing
samples of medical products in accordance with a preferred embodiment of the
present invention. As indicated in the figure, the close interface button 3642
is the
only difference between the interface at a cabinet or in a stand alone
version.
Figure 104 illustrates a maintenance screen 3660 in a system for dispensing
samples of medical products in accordance with a preferred embodiment of the
present invention. A fingerprint interface button 3662 and a delay closing
interface
button 3664 and a delay closing interface button 3664 are present in the
system
integral with the dispensing cabinet.
Figures 105A-105C illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing a method used
for
delaying the closing of a cabinet in accordance with a preferred embodiment of
the
present invention. Upon selecting the maintenance interface section 3682 in
the
main screen 3680 and accessing the delay closing interface 3702 from the
maintenance screens the delay closing executable instructions are processed.
The
user can set the delay time and visually confirm the delay time in the field
3722.
Figures 106A-106D illustrate display screens in a user interface that is used
in a system for dispensing samples of medical products showing a method used
for
registering fingerprints in accordance with a preferred embodiment of the
present
invention. The method for registering fingerprints includes accessing the
fingerprint
interface button 3762 from the maintenance screen 3760. the user is prompted
by
the messages on screen 3780 to add their name, and place their finger in the
interface
field 3802 for accepting and registering their fingerprint. The registered
fingerprint
provides a controlled access to the user at a subsequent time.
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The systems and methods to dispense medical products in the preferred
embodiments have an information display device for retrieving and caching
information from a communication network during periodically established
communication sessions. The display device includes a graphical display
device, a
communication transceiver connectable to a communication network that receives
display data. The network can include the Internet or other local and wide
area
networks. The device also includes a microprocessor and a memory device that
stores display data, at least one display template, and program information.
The
display templates include variable field identifiers. Further the program
information
comprises a display generator providing a modified template by replacing the
variable field identifiers with corresponding display data, and displaying the
modified template on the graphical display device. The microprocessor and the
memory device record at least one dispensing operation value for a subset of
data
that are subsequently sent to the communication network. The display device
formats textual data and graphical data for display on the touch screen. The
microprocessor may include an operating system, as well as application and
communication software to implement the functions with respect to dispensing
medical products. The operating system for the system of the present invention
includes a processing system with at least one high speed processing unit and
a
memory system. In accordance with the practice of persons skilled in the art
of
computer programming, the present invention has been described herein with
reference to acts and symbolic representations of operations or instructions
that are
performed by the processing system. Such acts, operations and instructions are
also
referred to sometimes as being computer executed or processing unit executed.
It will be appreciated that the acts and symbolically represent operations or
instructions include the manipulation of electrical signals by the processing
unit. An
electrical system with data bits causes a resulting transformation or
reduction of the
electrical signal representation, and the maintenance of data bits at memory
location
in the memory system to thereby reconfigure or otherwise alter the processing
unit's
operation, as well as other processing of signals. The memory locations where
data
bits are maintained are physical locations that have particular electrical,
magnetic,
optical, or organic properties corresponding to the data bits.
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The data bits may also be maintained on a computer readable medium
including magnetic disks, optical disks, organic disks, and any other volatile
or non-
volatile mass storage system readable by the processing unit. The computer
readable
medium includes cooperating or interconnected computer readable media, which
exist exclusively on the processing system or is distributed among multiple
interconnected processing systems that may be local or remote to the
processing
system.
It should be understood that the programs, processes, methods and systems
described herein are not related or limited to any particular type of computer
or
network system (hardware or software), unless indicated otherwise. Various
types of
general purpose or specialized computer systems may be used with or perform
operations in accordance with the teaching described herein.
Figures 107A-107G illustrate display screens in a user interface that is used
in a system for dispensing medical products showing a method for an express
sequence for logging into the system and for dispensing the medical products
in
accordance with a preferred embodiment of the present invention.
As described hereinbefore, the system for dispensing medical products
includes a pharmacy workstation or node including, for example, a Pentium
based
computer running the Windows operating system. The workstation hardware
includes a keyboard, mouse, high definition color monitor, touch screen
monitor,
laser printer, bar code scanner and communication interfaces. A single
pharmacy
workstation can control an unlimited number of RCD cabinets that can be daisy
chained together in order to meet high volume requirements. All prescription
processing and adjudication can be managed by the workstation. This
workstation
can be connected to any network, for example, to a LAN or a WAN or the
Internet in
order to provide remote dispensing capability. The remote dispensing
capability can
be coupled with a video teleconferencing module. The graphical user interfaces
can
use touch screen functionality.
The system provides communication interfaces to any network such as, for
example, LANs and WANs. The pharmacy workstations can be in accordance with
a preferred embodiment of the present invention equipped with, but not limited
to,
56 kps modems for telecommunications connections and 10/100MB Ethernet
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Network Interface cards. These communications interfaces support remote
dispensing, real-time third party claims adjudications, remote drug
utilization
reviews, remote diagnostics and maintenance functionality. A laser bar code
scanner
is connected to the processor, including but not limited to, a personal
computer, a
personal digital assistant, and a pager, to provide drug verification for
inventory and
dispensing processes.
The log-in is a secure process either through an identification process such
as, for example, a fingerprint identification process, a write-in or through
the use of
an assigned user screen as described herein below. Alternate embodiments
include
identifying the user, be it a physician, or pharmacist or other authorized
personnel by
using a barcode identifier on a badge of the user to retrieve the user
identifier which
requires a card reader or a radio frequency log-in process using a personnel
digital
assistant.
Figure 107A illustrates a display screen 3850 in a user interface that is the
first step within the express interface 3852. The user, upon selecting the
express
interface button, for example, is prompted to log-in.
Figure 107B illustrates the display screen 3870 in the user interface that
prompts the user to enter the user name in a specified field 3872, enter user
identification in a graphical area or field 3874, a password in field 3876 and
access
level in field 3878. In an alternate log-in method the add fingerprint button
interface
3882 can be utilized.
Figure 107C illustrates the display screen 3890 in the user interface that is
the next step if the add fmgerprint interface button 3882 had been previously
selected. The user is instructed to place in field 3892 a finger on the sensor
a
plurality of times, such as, for example four times.
Figure 107D illustrates a display screen 4000 in the user interface that
indicates needing another sample of the fingerprint to verify the user's
privilege to
log-in using the fingerprint identification process.
Figure 107E illustrates a display screen 4020 in the user interface that
indicates that the user was rejected during the express log-in method. The
password
of the user is required for the log-in process.
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Figure 107F illustrates a display screen 4040 in the user interface that is
used
in a system for dispensing medical products. The user is prompted to select a
script
(prescription or Rx) for a medical product from the dispense queue upon a
successful
log-in process.
Figure 107G illustrates a display screen 4060 in the user interface that is
used
in the system for dispensing medical products. The user interface prompts the
user
to select a first letter of a patient's last name which expedites finding the
patient
information in the system. This is an easier method to search for patients in
accordance with a preferred embodiment of the present invention.
Alternatively, the
user can type in the patient's name in field 4066 to access the patient's
script. A
preferred embodiment provides for an expedited dispense with a drug
utilization
review and adjudication/verification process.
Figures 108A-108E illustrate display screens in a user interface that is used
in a system for dispensing medical products showing a method for verifying the
bar
code of a medical product in accordance with a preferred embodiment of the
present
invention.
Figure 108A illustrates a display screen 4080 which is the first screen with
the express dispense method that prompts the user to select the express button
4082.
If the user has not signed or logged in previously, they are prompted to do so
at this
time. Once they are logged into the system they move on to the next screen in
accordance with the present invention.
Figure 108B illustrates a display screen 5000 showing the next step after a
successful log-in and selecting the express button. The user is prompted to
scan the
pharmacy prescription label or script. This is a label printed locally by the
pharmacy
computer system. In an alternate embodiment, the user may type in a unique
transaction identifier such as, for example, including a barcode number in
field 5004.
Figure 108C illustrates a display screen 5020 in the user interface used in a
system to dispense medical products. Once the barcode has been scanned into
the
system the medication requested is dispensed from the dispensing unit. If the
medication requested is not stocked at this location the user receives a
message
stating that the item is not in stock as seen in field 5022.
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Figure 108D illustrates a display screen 5040 in the user interface used in
the
system that expedites the dispensing of medical products. Once the medication
is
dispensed from the unit the user is required to scan the barcode on the bottle
into the
system in a manner analogous to the scan performed of the prescription label
previously. Tithe barcode being used is a customized barcode it may include,
for
example, but not limited to, fourteen digits having the lot number and
expiration
date. Once the lot number barcode is scanned into the system, the lot number
and
expiration is automatically logged into a sequence of instructions. The
dispensing
process is completed at this time and the user is returned back to the main
menu.
This dispensing process, albeit expedited, still provides for a drug
utilization review
(DUR) and adjudication. This minimizes and preferably precludes a multiple
dispense scenario of a prescription medical product. In a preferred embodiment
the
barcode may include a unique transaction identifier including, but not limited
to, a
patient identifier, a script date, NDC number, quantity and IEN. This
transaction
identifier can be generated by parsing the fields in a script to generate the
unique
transaction identifier.
Figure 108E illustrates a display screen 5060 in the system to dispense
medical products. Tithe user has used a barcode consisting of a locally
devised
numbering system they are prompted to type in the lot number and expiration
date at
this time. They can enter the information in fields 5062, 5064. Once they have
entered this information the dispensing process is completed and the user is
returned
back to the main menu.
The expedited dispense method includes a double bar code check as
described with respect to Figures 108A-108E. The transaction identifier
includes,
but is not limited to, the Rx number or some other unique identifier such as
the NDC
number (National Drug Code) and quantity. It should be noted, since numerous
patients get the same drug, the NDC number is re-used and in effect if it is
passed
under the bar code reader, it initiates another Rx. Thus, the NDC number alone
is
not a sufficient unique identifier to prevent a multiple drop of drugs for the
same Rx.
Figures 109A ¨ 109Q illustrate display screens in a user interface that is
used
in a system for dispensing medical products showing a method for creating and
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accessing reports, in particular customi7ed reports, in accordance with a
preferred
embodiment of the present invention.
Figure 109A illustrates a display screen 5080 in the user interface which
provides a menu to select a report. The "ADD" button 5082 allows the user to
create
a new report, which appears in the list box for future use precluding
repetitive
creation of that particular report. The 'DELETE" button 5084 deletes the
report and
removes it from the list box. The system provides a few standard reports that
the
end user can use or delete at their discretion. These reports include, but are
not
limited to, discrepancy report, inventory by brand name report, lot and
expiration
report, patient names and PIC level reports.
Figure 109B illustrates the display screen 6000 in the user interface that a
user is presented with as the initial menu after selecting the ADD interface
button
5082. The user can select different button interfaces such as create reports
6002,
open reports 6004, edit reporting category 6006, create new reporting category
6008,
edit reports 6010 or exit 6012.
Figure 109C illustrates the display screen 6020 in the user interface if the
create reports interface button is chosen. In this screen the fields that are
going to be
included in the report are picked or entered. Any data that is collected and
stored in
a database may be selected to generate the report. This screen has the format
fields
inteiface button 6022 that enables the formatting of fields selected.
Figure 109D illustrates the display screen 6040 in the user interface that is
displayed upon selecting the format fields interface button. After the fields
are
selected, the user can set the length of each field 6042, and also the order
6044 in
which it appears in the report. If a field containing a date range is not
chosen,
selecting the "PREVIEW REPORT" interface button 6046 displays the report. If a
field 6048 containing a date range is chosen, a screen allowing the user to
select the
appropriate date field is displayed.
Figure 109E illustrates the display screen 6060 in the user interface once the
preview report button interface is selected. If date range interface 6048 on
Figure
109D is chosen, this screen allows the user to select which field to use as a
filter.
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Figure 109F illustrates the display screen 6080 in the user interface once the
interface button 6062 view report is selected in the previous display screen
6060.
This is the final product of the report that the user needs.
Figure 109G illustrates the display screen 7000 in the user interface once the
interface button 6004 open reports is selected in the screen 6000. This
display
screen 7000 provides a list of the reports that have been created and are
ready to be
executed at any time. The user can scroll down the list of reports and select
any
pertinent report to view and subsequently print a selected report.
Figure 109H illustrates a display screen 7020 in the user interface once the
interface button 6008 entitled create new reporting category is selected in
the display
screen 6000. This screen allows the user to rename fields from a pre-existing
database that might be used in a report such as, for example, by selecting in
field
7022 from the different databases that can be accessed. The display screen
also
allows the user to select which fields they want to allow a second user to see
or use.
This portion allows the user to select which database and which table (in
field 7026)
within that database this category (in field 7028) is going to reference.
Figure 1091 illustrates a display screen 7040 in the user interface that is
viewed once the display report interface button is selected. After a report is
chosen,
a report can be viewed as shown.
Figure 109J illustrates a display screen 7060 in the user interface that is
accessed after setting the database and recording the category the user is
going to
reference. The user is able to rename and choose which fields are going to be
displayed for creating reports. The user can select the category names and the
corresponding name to be displayed by scrolling through the options.
Figure 109K illustrates the display screen 7080 in the user interface once the
interface button 6006 edit reporting category is selected. The user is able to
edit a
reporting category, in order to be able to add fields to choose for the
report. This
screen displays the reporting category so that the user can choose the
particular
report for editing.
Figure 109L illustrates a display screen 8000 in the user interface that
allows
the user to set the fields that may be displayed in the reporting module. The
user
selects which fields to activate by selecting the field names.
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Figure 109M illustrates the display screen 8020 in the user interface once the
interface button 6010 edit reports is selected. This screen allows users to
edit
existing reports. The user selects the report in the field 8022 and then edits
it by
using the button 8024.
Figure 109N illustrates the display screen 8040 in the user interface that
allows the user to add or remove fields from an existing report. Figure 1090
illustrates the display screen 8060 in the user interface that allows the user
to
configure the fields in the report. Figure 109P illustrates the display screen
8080 in
the user interface that allows the user to preview the report just created.
Figure
109Q illustrates the display screen 9000 in the user interface that allows the
user to
view the report. The user can also print the report by selecting the interface
button
9004.
A preferred embodiment of the present invention includes wireless
encryption and a secure log-in process for the wireless access.
Figures 110A-1-D are schematic diagrams illustrating preferred
embodiments that can include web-based dispensing ability. Each remote
dispenser
has a computer, for example, a personal computer, which is in communication
with a
server such as, for example, but without limitation, Microsoft Internet
Information
Server (ES). The TES allows a user to configure a web site, control and manage
the
site remotely through the Internet. Alternatively, a personal information
device can
be used, for example, a PDA or a Palm Pilot, to dispense the pharmaceuticals.
A
server is a shared processing computer on a network, such as a local area
network
that can be as simple as a regular personal computer or the fastest and
largest
processor even serving a gatekeeper control function. The platform or a
software
operating system and/or open hardware can be, but is not limited to WindowseNT
4.0, Windows 2000, or Windows XP. However, preferred embodiments of the
dispensing system of the present invention are platform independent. The layer
of a
sequence of instructions can rest atop any operating system on any hardware
system.
For example, the sequence of instructions of a system in accordance with a
preferred
embodiment of the present invention can rest atop a customer network and using
a
simple telnet connection can generate reports using the custom report module
described hereinbefore. Predetermined time delays can be programmed into the
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system in accordance with a preferred embodiment of the present invention to
provide adjudication remotely, and printing of prescription labels. In another
embodiment, the DUR can be by-passed to allow for an immediate print of a
script.
Further, applets or mini-sequence of instructions can be used by any
computer in the network that is equipped with a Java-capable browser.
Preferred
embodiments of the dispensing system also include a servlet which is an applet
operable within a web browser environment. A user, accessing their network,
accesses the web server to enable a remote dispense operation. A preferred
embodiment of the present invention includes a web-based reporting process.
In the preferred embodiment as illustrated in Figures 110A-1 and 110A-2, a
prescription or Rx is faxed to a pharmacy. A pharmacy software 9012 is used to
create the Rx. In an embodiment, an adjudication server 9052 or a third party
server
9056 can be used to translate a claim from the dispensing software at a
dispense
location 9066 to many different forms. The Rx is then sent to an application
server
9020, followed by the Rx being sent to a remote site having a dispense PC
9066.
The Rx is dispensed using a PC 9032 or a handheld device 9038 such as a
personal
information device, for example, a PDA such as a Palm Pilot. In an embodiment,
the Rx information is sent back to the application/web server 9020 and/or the
pharmacy software. Video conferencing capability can be integrated into this
preferred embodiment.
In another preferred embodiment also illustrated in Figures 110A-1 and
110A-2 the pharmacy function can be handled by a service. The service enters
the
Rx into a dispensing software. The service adjudication server 9052 or a third
party
server 9056 can be used to translate a claim from the dispensing software to
many
different forms. The Rx is then sent to the application server 9020. Then the
Rx is
sent to a remote site such as to the dispense interface processor 9032. The Rx
is
dispensed using a PC 9032 or a handheld device 9038. In an alternate
embodiment,
Rx information is sent back to the application /web server 9020. A video
conferencing ability can also be integrated with this embodiment.
Still referring to Figures 110A-1 and 110A-2, an Rx can be created on a
dispense PC 9066. Further, an adjudication server 9052, 9056 can be used. The
Rx
can be dispensed using a PC 9032 or a handheld device 9038.
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As also illustrated in Figure 110A, an Rx can be created on a dispense PC
9066. The Rx is then sent to the application server 9020. The adjudication
server
9052 or a third party server 9056 translates a claim from the dispensing
software to
many different forms. The Rx is sent to the application server 9020 and from
thereon the Rx is sent to a remote site having a dispense PC 9032. The Rx is
dispensed using a PC or a handheld device 9038. Optionally, the Rx information
is
sent back to the application/web server 9020. Video conferencing ability can
also be
integrated in this embodiment. Preferred embodiments include the application
server 9020 running a web server for generating reports at a remote location.
Further, a dispense PC 9032 can be in communication with a web server for
remote
reporting function. Modem options are available for all components for LAN
backup.
As illustrated in accordance with a preferred embodiment of the present
invention in Figure 110B, a pharmacy enters or generates a script on the
pharmacy
computer 9104. The pharmacy is in communication via a network with a
dispensing
RCD co-located at the same site as the pharmacy. The pharmacy server 9110
prints
a label on a network printer. The printout is used to scan in the dispense
information. A computer 9124 or a handheld computer 9118 receives a dispense
signal and is used to dispense a pharmaceutical. The dispense function can be
browser controlled 9122 as described hereinbefore.
Figure 110C illustrates an embodiment of a system used at a pharmacy or
other site in accordance with a preferred embodiment of the present invention.
The
physician enters the Rx into the pharmacy system computer 9202 and requests a
local DUR review. The script is sent to a server 9204 performing a DUR.
review.
The script having been subjected to a DUR is received back from the server
9204 in
approximately one second. In an alternate embodiment, the Rx is printed
directly to
printer 9208 bypassing DUR review. The Rx sits in a printer queue for
approximately three minutes post the DUR review. The Rx label is printed on
the
printer 9208 and the Rx label is scanned and the drug is dispensed using the
PC 9210
from the RCD dispenser 9212. Alternately, a more detailed DUR is conducted,
which can take up to three minutes for a script to reach the dispenser.
Another
embodiment which is faster, which includes no DUR occurring and the physician
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bearing any liability by having to enter a justification explaining why they
are
bypassing the DUR. Both alternatives are susceptible to multiple dispenses
from
one printout.
Figure 110D illustrates a preferred embodiment of a system to dispense
pharmaceuticals in accordance with a preferred embodiment of the present
invention. The physician enters an Rx into a pharmacy system computer 9302 and
requests a local DUR. The script is sent to a server 9304 in approximately one
second to conduct the DUR. The script is received back from the server 9304 in
approximately one second. The Rx is then printed to a bit bucket or stored in
a hold
pattern. A link code is polling the pharmacy software approximately every
fifteen
seconds for new scripts. An express or expedited dispense link code prints
available
Rx label on the printer 9308 with a unique transaction identifier, for
example, a
barcode. For a regular dispense function, the link code enters the Rx into a
queue
for dispensing. The Rx label is then scanned and the drug is dispensed in less
than
one minute, and preferably in less than 20 seconds. This link method enables a
detailed DUR to be performed prior to sending the script to the dispensing
machine
9312 and does not take three minutes to complete. The link interface can poll
the
pharmacy system every few seconds for new scripts. Scripts can be sent to the
printer for an express dispense sequence in emergency room environments, or be
put
into the remote dispensing software dispense queue for a standard dispense. If
the
pharmacy system is not available, remote dispensing software can provide
special
access to physicians so that they can enter and dispense scripts safely from
the
system in accordance with a preferred embodiment of the present invention.
Post
dispensing the pharmaceutical, a signal can be sent to the centralized
pharmacy
server or any patient database server.
A preferred embodiment includes an automated pharmaceutical dispensing
system for a facility. The automated pharmaceutical dispensing system has a
modular design, including a master dispensing unit, which is capable of
controlling a
plurality of dispensing systems that can be daisy chained together or be in an
alternate configuration, each unit measuring no more than 80 inches in height
and
operating on 110V AC power. Each unit has no less than 48 pharmaceutical
dispensers, which measures and adjusts to the size of the packaged
pharmaceuticals
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or pills loaded in them. The RCD units count and dispense pharmaceuticals from
the dispensers automatically without having to physically remove each
dispenser
from a storage rack and load it into a counting slot. The master dispensing
unit must
contain a PC/server, which interfaces with the standard health care system
software
and controls the output of the additional dispensing units. The additional
dispensing
units are able to operate at locations remote from the main pharmacy, so that
they
can be installed at locations like evening and weekend clinics. The dispensing
units
are able to hold directions in a buffer memory until appropriate personnel are
available to complete the filling procedure.
In particular, the system in accordance with a preferred embodiment
accommodates a facility such as, for example, a pharmacy that is not
operational 24
hours per day. The system provides a barcode scanner with each unit, barcode
scanning software, which interface with appropriate host software printed
labels, an
UPS, a printer, cabling and other hardware as needed to install and connect
the
system to the host system, server software and pharmacy specific software
needed to
operate and interface with the host system, individual dispensers with a
minimum
capacity of at least 800 cc, an internal buffer, which holds the counted
product until
released by authorized personnel. Further, the system in accordance with the
present
invention includes telephonic, help-line responses within one-hour of call, 7
days per
week.
A perspective view of an alternative remote control dispenser (RCD) cabinet
9500 is shown in Figure 111. The remote control dispenser cabinet 9500 is an
environmentally controlled cabinet for housing packages or bottles holding
drugs or
medicine that can be adversely impacted by or degrade in a room temperature
environment. For example, medicines for chemotherapy need to be stored at
temperatures of approximately 40-50 F. While humidity can also be controlled
as
explained below, typically humidity is not as much of a concern as temperature
since
the drugs are typically stored in a moisture-proof container.
Referring to Figure 111, the RCD 9500 has a housing 9502 that receives a
drug containing unit 9504 and holds an environmental control unit 9506. The
drug
containing unit 9504 has a chamber 9508 that is predominantly surrounded by a
plurality of insulated walls 9510. In the embodiment shown, the drug
containing
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unit 9504 is a slideable unit that slides into the housing 9502. The chamber
9508
receives a plurality of dispensers 9514. Each dispenser 9514 has a mechanism
and/or structure for moving and dispensing the packages and bottles.
In the embodiment shown, each dispenser 9514 is associated with its own
dispensing location 9516. The RCD 9500 can have a single dispensing opening,
such as in the embodiment shown in Figure 1A.
Still referring to Figure 111, the environment of the chamber 9508 is
controlled. In the embodiment shown, a chiller plate 9522 overlies the chamber
9508. The chiller plate 9522 is part of the environmental control unit 9506 as
described herein below.
The environmental control unit 9506 has a heat exchanger 9524 at the top of
the RCD unit 9500. The heat exchanger 9524 has a plurality of small fans 9526
that
draw ambient air in and blows the air across a plurality of condenser coils
9528. The
air dissipates heat from the condenser coils 9528.
The environmental control unit 9506 of the remote control dispenser cabinet
9500 has a compressor 9530 located within the housing 9502. The compressor
9530
increases the pressure within the refrigerant and directs the refrigerant
towards the
condenser coils 9528. The environmental control unit 9506, in addition, has an
evaporator 9532 located in the housing 9502 of the remote control dispenser
cabinet
9500. The refrigerant passes from the condenser coils 9528 to the evaporator
9532
through a metering device 9534 or capillator resulting in a pressure drop and
the
refrigerant expanding to a gaseous state. Because of this change in pressure
within
the evaporator 9532, the evaporator absorbs heat. In the embodiment shown, the
environmental control unit 9506 has a second heat exchanger 9536, as best seen
in
Figure 112. The evaporator 9532 within the second heat exchanger 9536 extracts
heat from the coolant within tubes 9538, as best seen in Figure 112, carrying
chilled
water that is pumped by a pumping unit 9540 from this second heat exchanger
9536
to the chiller plate 9522 to cool the chamber 9508 of the drug containing unit
9504.
It is recognized that in the alternative, a fan system can be used wherein
when the slideable unit 9512 of the drug containing unit 9504 is in the closed
position, cooling air is blown over the dispensers 9514.
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Still referring to Figure 111, a portion of the housing 9502 is broken away to
show an ambient air drug container dispenser having a plurality of adjustable
racks
110 each having a plurality of columns 112, such as shown in Figure 1B. In
addition
to the racks 110, the remote control dispenser cabinet 9500 has a plurality of
drawers
120 of helix dispensers 122.
The helix dispensers 122, when activated, rotate in a single direction. As the
helix 122 rotates, any pharmaceutical packages disposed on the helix are
pushed
forward toward the front of the cabinet 124. The pharmaceutical packages
include,
for example, IV solutions, suspensions, syringes, inhalers, topical items and
pills.
One full rotation of the helix 122 will cause the outermost package to be
released,
causing the package to fall into the bin 126. After the package drops into the
bin
126, an operator slides open the bin 126 and removes the package. While the
bin is
open, a door blocks the opening between the bin 126 and the dispensing area to
prevent pilferage. The helix-dispensing unit described above is particularly
suitable
for packages of various non-standard sizes, for example, boxes, bags, and
kits.
Larger-sized helixes 122 may be used for smaller packages. The helixes 122 are
each individually driven by a stepper motor located in the rear of each tray.
In one embodiment, the cabinet has three columns 112 and four rows of
drawers 120. While the remote control dispenser cabinet 9500 is shown with the
columns 112 and the drawers 120 of helix dispensers 122, it is recognized that
a
cabinet with an environmental control unit 9506 for control of a chamber 9508,
can
be built not including columns or drawers exposed to ambient conditions.
Referring to Figure 112, a side sectional view of the remote control dispenser
cabinet 9500 is shown. The dispensers 9514 are positioned within the chamber
9508
surrounded by insulated walls 9510. The dispenser 9514 as shown has a helix as
explained below with respect to Figure 114A. The dispensing location 9516 is
positioned relative to the dispenser 9514 so that a person may not gain access
to
drugs located within the dispenser 9514. There is a redundant lock and key
mechanism in compliance with requirements for narcotic drugs. Overlying the
dispenser 9514 is the chiller plate 9522. The chiller plate 9522 is connected
to the
second heat exchanger 9536 through a pair of flexible tubing 9542 to allow the
chilled water to run between the components.
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The pump unit 9540 for the chilled water system is located under the second
heat exchanger 9536. The compressor 9530 is shown within the housing 9502
above
the second heat exchanger 9536. The first heat exchanger 9524 with the fans
9526 is
shown on top.
The RCD 9500 has a barcode reader, such as a hand-held unit similar to that
discussed above with respect to Figure 1A, located near the dispensing opening
9516
to read a code on the dispensed package and transmit the barcode information
to the
computer, which informs the user whether the code on the dispensed package 74
matches that which was requested by the user. As discussed above, an
alternative
embodiment has a semiconductor chip that can be embedded in the dispensed
package which, when passed through an RF field, charges a capacitor as
explained
above with reference to Figure 1A. The semiconductor chip can also be used to
uniquely identify a dispensed item.
As discussed above with respect to Figure 112, the cabinet 9500 has both an
environmental controlled chamber 9508 and a portion exposed to ambient air.
Four
rows of drawers 120 are shown in front of the compressor 9530 for the
environmental control unit 9506. The drug containers from the ambient air
portion
are accessed from a bin 126 as discussed above with respect to Figure 111 and
with
respect to embodiment shown in Figure 1C.
Upon validating the barcode or the unique electronic signature of the
dispensed package, the computer generates a label containing prescription
information at a label printer to be placed on the package, and generates a
document
at a document printer containing additional instructions for the patient or
practitioner. Several remote control dispenser cabinets including the
environment
controlled RCD cabinet 9500 can be integrated into a single installation
operated by
a single computer 46. The cabinets 20 and 9500 can each be individually
connected
to the host computer 46, or may be daisy-chained, with only one cabinet in the
chain
connected to the host 46.
Figure 113A is a perspective view of a dispenser unit 9514. The dispenser
9514 of this embodiment has a ramp 9548 on which the bottles of drugs 74 are
located. At the front of the ramp 9548, a roller dispenser 9550 is located.
The roller
dispenser 9550 has a pair of end walls 9552 and a curved side wall 9544 in the
shape
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of a section of a canister. The roller 9550 is adapted to rotate about a pair
of
bushings 9556.
Referring to Figure 113B, the roller dispenser 9550 blocks access to the
bottles of drugs 74 from the dispensing location 9516. In the embodiment
shown,
the dispensing location 9516 has an insulated door 9560 to assist in keeping
the
chamber 9508 at the proper environmental condition. The roller dispenser 9550
receives one of the bottles of drugs 74 and drops the bottle 74 to the
dispenser
location 9516.
A motor assembly 9562 is connected to the roller dispenser 9550 by a cable
9564 and rotates the unit causing a bottle cradled within a hollow portion of
the
roller to be dispensed. The remaining bottles remain above the dispenser.
Further
details regarding the roller dispenser are disclosed in the PCT application
number
PCUUS96/16758 filed on October 18, 1996, and having an International
Publication
No.: W097/14393, the entire teachings of which are incorporated herein by
reference.
Referring to Figure 114A a perspective view of an alternative dispenser
95 Ma is shown. The dispenser 9514a has a helix 9570 and is controlled by a
motor
9572, as seen in Figure 114B, at the back of the dispenser 9514a to rotate the
helix
9570 and move the bottles forward wherein the bottles and/or packages 74 drop
one
at a time from the dispenser and pass to the dispensing location 9516. Figure
114B
shows an alternative embodiment of the dispenser 9514b of Figure 114A wherein
a
bar 9574 is used to adjust the location of the drug bottle 74 relative to the
helix
9570. The horizontal bar 9574 extends within the helix 9570 to allow bottles
74 of
different size to be used within the same helix 9570. The bar is mounted from
the
front. In an alternative helix dispenser embodiment, the pitch of the helix is
varied
to adjust for various size packages or bottles.
An automated drug dispensing system 9580 in accordance with a preferred
embodiment of the present invention is shown in Figure 115. Similar to the
embodiment shown in Figure 1A, the system 9580 includes a remote control
dispenser (RCD) cabinet 9582, a host computer 9584, and a document printer 56.
In
contrast to the embodiment of Figure IA, the system 9580 has a label printer
(label
writer unit) 9586 integral with the RCD cabinet 9582.
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The cabinet 9582 includes a rack 24 comprising a plurality of bins. Packages
32 such as drug bottles, containing pharmaceuticals of various types, are
distributed
among the columns 34, each column 34 containing a separate type of
pharmaceutical, or multiple columns 34 containing the same pharmaceutical. The
embodiment shown has four racks 24 enclosed in the cabinet chamber. Two racks
are in the main cabinet 20 and two are on the doors 22. The doors are secured
by
locks 28.
The RCD cabinet 9582 has a controller 9590 that receives a request via an
interface from a computer 9584. The controller 9590 interprets the command
sent
from the computer 9584 and enables a dispensing actuator 68 in the appropriate
column 34. The lowest package 32 in the appropriate column 34 is released from
the column 34 and ejected onto a ramp. The released package 32 (74) slides
down
the ramp 30 into an opening 9592.
The opening 9592 has a bar code reader 9594 that reads a code 98 on the
dispensed package 74 and transmits the barcode information along an interface
9596
to the computer 9584, which informs the user whether the code 98 on the
dispensed
package 74 matches that which was requested by the user. The barcode 98 can be
disposed on the side, top, and/or bottom of the package 74. In an alternative
embodiment, a semiconductor chip can be embedded in the dispensed package
which, when passed through an RF field, charges a capacitor. When the
capacitor
reaches an appropriate level, a weak RF signal is emitted. The signal can
include,
for example, approximately a 12 digit number. The semiconductor chip can also
be
used to uniquely identify a dispensed item.
Upon validating the barcode 98 or the unique electronic signature of the
dispensed package 74, the computer sends a signal to the label writer unit
9586
within the RCD cabinet 9582 to generate a label 9598 containing prescription
information on the package, and the computer generates a document 60 at a
document printer 56 containing additional instructions for the patient or
practitioner.
The label writer unit 9586 in a preferred embodiment has a laser unit 9602
containing a laser source, a laser controller 9604, as seen in Figure 116A, a
label
locator 9606 and a package handler 9608 all located within the RCD cabinet
9582,
as seen in Figure 115. still referring to Figure 116A, the laser controller
9604 of the
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label writer unit 9586 receives a signal from the computer 9584 seen in Figure
115
through the controller 9590. The laser controller 9604 controls the label
locator
9606 that projects abeam to locate an orientation marker 9610 on the bottle
74. In
the embodiment shown, the package handler 9608 has a bottle handler 9612 that
can
grasp and orient the bottle 74, if necessary to position the label including
the
orientation marker 9610 on the bottle 74 relative to the laser unit 9602. The
laser
controller 9604 controls the laser unit 9602 that sends a beam out of a head
housing
9614 of the laser unit 9602. The beam is modulated allowing complete alpha
numeric engraving on a label. The head housing 9614 can rotate relative to a
main
unit 9616 of the laser unit 9602.
Figure 116B shows a perspective view of a package 74 with an integral label
9618 with information imprinted by a laser. The label contains the unique
transaction identifier and includes the barcode information. The label locator
9606
is located above the package 74 and is in proximity to the laser head housing
9614 of
the laser unit 9602. The label 9618 has an image burnt onto by the laser.
Figure 117 is a sectional view of the opening 9592 of the remote control
dispenser (RCD) cabinet 9582 that receives the packages 74 that slide down the
ramp 30 of Figure 115. The RCD cabinet 9582 has the bar code reader 9594
underlying the opening 9592. The package handler 9608 has a pusher plate 9620
for
moving a package 74 in position relative to the bar code reader 9594, wherein
the
bar code is read to ensure that the correct package is being distributed as
discussed.
Overlying the opening 9592 is the laser unit 9602 for printing the label on
the
package 74. The location of a label locator is determined by the style of
package 74.
It is recognized that a package can have multiple label locators. The package
handler 9608 has a bottle handler 9612 for rotating bottle-style packages if
necessary.
The pusher plate 9620 pushes the package from overlying the bar code reader
9594 to a dispensing opening after the package is labeled. A printer 56 prints
instructions 60 at a location separate from the label and outside of the RCD
cabinet
9582, as seen in Figure 115.
It is recognized that the integral label printer can be used with other
systems
discussed in this application. For example, the prescription can be dispensed
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directly to the patient using a card reader mounted directly on or near the
cabinet.
The card reader is adapted to receive a card from a patient. The card is
programmed
with patient information that is stored in an electronic memory on the card by
a
licensed practitioner. The patient inserts the card in the card reader and
receives
his/her medication automatically from the cabinet. The medication bottle 74
may be
filled with a single dose of medication for a particular patient, or can
include weekly
or monthly doses.
A preferred embodiment of the present invention includes a web enabled
drug sampling system integrated with systems illustrated with respect to
Figures
110A-1-110D.
In view of the wide variety of embodiments to which the principles of the
present invention can be applied, it should be understood that the illustrated
embodiments are exemplary only, and should not be taken as limiting the scope
of
the present invention. For example, the steps of the flow diagrams may be
taken in
sequences other than those described, and more or fewer elements may be used
in
the block diagrams. While various elements of the preferred embodiments have
been described as being implemented in software, in other embodiments in
hardware
or firmware implementations may alternatively be used, and vice-versa.
It will be apparent to those of ordinary skill in the art that methods
involved
in the dispensing of medical products may be embodied in a computer program
product that includes a computer usable medium. For example, such a computer
usable medium can include a readable memory device, such as, a hard drive
device,
a CD-ROM, a DVD-ROM, or a computer diskette, having computer readable
program code segments stored thereon. The computer readable medium can also
include a communications or transmission medium, such as, a bus or a
communications link, either optical, wired, or wireless having program code
segments carried thereon as digital or analog data signals.
The claims should not be read as limited to the described order or elements
unless stated to that effect.
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While this invention has been particularly shown and described with
references to preferred embodiments thereof, it will be understood by those
skilled in
the art that various changes in form and details may be made therein without
departing from the scope of the invention.
