Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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SYSTEM AND APPARATUS FOR ITEM MANAGEMENT
INCLUDING ITEM DETECTION
FIELD
The field relates generally to item management and, more particularly, to item
management providing for improved efficiency in item distribution.
BACKGROUND
Personnel involved in handling of items are routinely required to manage and
organize the items for delivery to an appropriate user or process. An item as
used
herein, means or refers to a separate article, object, or product. Care is
required to
ensure that the correct item is delivered to the user or process. Examples of
such
item-management tasks involve handling of medicament or nutriceutical items
ultimately intended for use by a patient, consumer, or other user. A
medicament
means or refers to a medication product while a nutriceutical can represent a
dietary
supplement which provides health or medical benefits. (e.g., a vitamin, a
mineral, or a
supplement.)
Items such as medicaments and nutriceuticals are provided in various physical
forms, such as solid or substantially solid forms, granular forms, gel forms,
and liquid
forms. Solid or substantially solid medicament and nutriceutical items may be
shaped
into small solid tablets in the physical form of capsules, spheres, ovals,
disks, multi-
angles, squares, triangles, and ellipses. Gel, granular, or liquid-form items
may be
packaged in the form of small capsules and gel caps (for oral consumption), or
ampules containing a liquid. Medicament and nutriceutical items may also be
provided which differ in strength of the active chemical constituent. For
example, a
single medicament or nutriceutical item may be provided with a concentration
of 1, 5,
or 10 milligrams of the active chemical constituent.
One way in which the foregoing types of items are managed for delivery to the
ultimate user is through automated dispensing machines. Automated dispensing
machines are frequently utilized by pharmacies, hospitals, long-term care
facilities,
and others in the health-care field for purposes of automatically dispensing
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medicaments required to fulfill patient prescription orders and to dispense
medicaments administered to patients in hospitals and long-term care
facilities, such
as nursing homes. Automated dispensing machines can also be used in retail
distribution, such as to dispense nutriceutical or food items. Such automated
dispensing machines are computer controlled to dispense an appropriate
quantity of
medicaments and, typically, to package the medicaments. And, automated
dispensing
machines can typically be programmed to dispense and package all medicaments
required to fulfill all prescription orders and dispense requests for a given
eight-hour
work shift. The automated dispensing machine will proceed to automatically
execute
the instructions until all requested medicaments have been output.
Automated dispensing machines typically store and dispense a plurality of
different medicament types. Medicaments which are frequently prescribed or
utilized,
referred to as "fast-moving" medicaments, are stored within the automated
dispensing
machines in large quantities as loose, bulk form items within cassettes,
cells,
canisters, magazines, racks, or other storage apparatus. A single medicament
type is
stored in each storage apparatus.
Medicaments which are less frequently prescribed or utilized are referred to
as
"slow-moving" medicaments. Medicament types which are infrequently required
may be stored in the automated dispensing machine in what is referred to as an
"exception storage apparatus," a type of storage apparatus which derives its
name
merely from being an alternative to the medicament storage apparatus used for
the
faster moving medicaments. Slow-moving medicaments could include medicament
types with unusual chemical constituents or with unusual active-constituent
concentrations. An exception storage apparatus stores small quantities of the
less-
frequently used medicaments which could not be efficiently stored in large
bulk
quantities. Unlike the cassettes, cells, canisters, magazines, racks, or other
storage
apparatus for the faster moving medicaments, more than one medicament type can
be
stored in a single exception storage apparatus.
An exception storage apparatus can be provided, for example, as a drawer, or
as a tray-like device, which pulls out from the automated dispensing machine
and
which includes a plurality of medicament-holding cells, or compartments, for
holding
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one medicament item or a small quantity of medicaments. In certain automated
dispensing machine types, the cells of the exception storage apparatus are
movable
along a track. The cells can be indexed forward along the track toward an
opening so
that the cell contents fall serially (i.e., one-after-the-other) through a
cell bottom
opening for packaging by the machine. Any number of cells can be provided in
the
exception storage apparatus. For example, an exception storage apparatus could
include 64 total cells grouped in four rows of 16 cells all movable along the
track.
More than one exception storage apparatus may be provided.
The exception storage apparatus offers the operator an opportunity to increase
the range of dispensing options because more than one type of medicament can
be
stored in such storage apparatus. For example, the medicaments can be arranged
in
the exception storage apparatus to dispense medicaments for a particular
patient
according to the order in which the medicaments are to be taken by the patient
(e.g.,
breakfast, lunch, and dinner) or can be loaded to meet the medicament
requirements
of more than one patient.
Upon activation, the automated dispensing machine automatically meters out
from the appropriate storage apparatus the desired quantity of medicament(s)
called
for by the prescription order or dispense request. The medicament item or
items are
directed from the storage apparatus to the packaging apparatus by means of
gravity
through a chute or other guide apparatus, or by mechanical means such as an
auger.
The packaging device may then load the dispensed medicaments into one or more
packages. The type of package utilized is based on the capability of the
particular type
of automated dispensing machine. By way of example only, automated dispensing
machines may load the medicaments into containers such as vials, bottles,
blister
packages, or pouch packages. The medicament or medicaments, once packaged in
the
container type utilized by the automated dispensing machine, may then be
delivered to
the patient or other designated user.
Loading or replenishment of the cassettes, cells, canisters, or other storage
apparatus for the fast moving medicaments is relatively easy. All that is
required is
placement of a loaded storage apparatus into the machine (e.g., in place of a
depleted
storage apparatus) or the pouring of a quantity of the bulk-form medicaments
into a
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depleted storage apparatus.
However, loading or replenishment of the cells or compartments of the
exception storage apparatus is more problematic because a human being must
manually load or replenish the cells or compartments. In a pharmacy, hospital,
or
long-term care facility, the human is a pharmacy technician or a registered
pharmacist.
The technician or pharmacist must manually load the medicament items directly
into
the exception storage apparatus cells. Alternatively, the medicament items can
be
placed into the cells of a "loading device." A loading device is a device with
cells or
compartments that correspond to the cells of the exception storage apparatus.
The
loading device can be loaded at a workstation and carried to the automated
dispensing
machine so that the medicament contents of the loading device can be
transferred into
the appropriate cells of the exception storage device. By way of example only,
a busy
pharmacy might use dozens of different loading devices to load the exception
storage
apparatus during a given work shift.
The exception storage apparatus loading process is tedious and time
consuming, irrespective of whether the medicament items are placed directly
into the
exception storage apparatus cells or are placed into the cells of a loading
device for
transfer to the exception storage apparatus. As can be appreciated, the
loading process
must be undertaken in a deliberate and considered manner to ensure that the
correct
medicament is placed in the correct cell or compartment. Placement of the
correct
medicament in the correct cell or compartment can be difficult because the
cells or
compartments of a typical exception storage apparatus or loading device are
relatively
small and are in close proximity to each other. The chance of an inadvertent
error
may be increased because certain medicaments have similar shapes, sizes, and
appearances.
Typically, printed paper instructions are generated which direct the
technician
or pharmacist to place the required medicament into a designated cell or
compartment.
At a minimum, valuable time is required to follow the instructions. The
instructions
may require complex ordering of different medicament types among the cells
raising
the possibility, no mater how slight, that the wrong medicament could be
placed in a
cell or compartment. And, because the technician or pharmacist must take her
eyes
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off the exception storage apparatus or loading device to read the
instructions, and
because the cells typically look alike, there is also a slight possibility
that the wrong
medicament item could be placed in the cell. And, since more than one loading
device could be used by a pharmacy, there is a possibility, no matter how
remote, that
an incorrect loading device could be used to load the exception storage
apparatus.
If a pharmacist is required to inspect a loading device or exception storage
apparatus before use to verify that the medicaments were loaded correctly,
then the
pharmacist must essentially repeat the loading process to confirm that the
correct
medicament was received in the correct cell.
A skilled pharmacist's time is extremely valuable. Time spent loading an
exception storage apparatus is time that could be spent counseling patients.
And, an
automated dispensing machine must typically be deactivated or taken "off line"
in
order to load the exception storage apparatus. Any time spent loading an
exception
storage apparatus can represent lost productive time in which the automated
dispensing machine cannot be used to fulfill prescription orders or dispense
requests,
thereby decreasing efficiency and increasing costs to the operator.
Problems similar to those described for operators of automated medicament
dispensing machines can exist for operators of other types of automated
dispensing
machines in which both fast and slow moving items must be dispensed from a
single
machine. For instance, the same issues would face the operator of an automated
dispensing machine used to dispense nutriceutical products or other retail
food
products.
Problems identical to those described above exist with respect to loading of
medicaments and other items into other types of containers with plural cells
or
compartments, particularly if different types of medicaments or items are to
be loaded
into the same container. Blister packages represent such a container into
which plural
medicaments or items may be loaded. A blister package is a type of pre-formed
container used for holding medicaments, nutriceuticals, or other small goods
and
items.
The primary component of a blister package is a plurality of cells made from a
thin web of formable material. Any number and arrangement of the cells can be
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provided. Each cell has an upper opening through which one or more item is
placed
in the cell. A closure of paperboard, or a seal of aluminum foil or plastic
may be
placed over all of the cells to close the blister package container. The
closed blister
package container is then ready for delivery to the patient.
Certain blister packages are referred to as push-through-packs. In a push-
through-pack, the material in which the cells are formed is collapsible by
pushing with
a human finger. The seal is breakable so that the item within the cell can be
pushed
through the seal and out of the blister package container for use.
Blister packages may be used as compliance containers by printing the days of
the week above each cell. Such an arrangement ensures that the medicaments may
be
taken one-after-another at the correct date and time.
A disadvantage of blister packages is that they cannot be easily used as
compliance containers if more than one type of medicament is required to be in
the
container. This is because the blister package is typically loaded with the
same type
of medicament by means of a form-fill-seal machine.
To load the blister package with different types of medicaments in an order in
which the medicaments are to be taken would require hand-loading by a human.
Such
a process would require use of instructions to determine which cell a
medicament is to
be placed into. Repeated manual tasks of hand-loading would be required to
load
different types of medicaments in a single blister package. From a human
factors
standpoint, such a process would be tedious and subject to potential error.
Errors
could occur, for example, because of the number of repetitive actions
required, the
look-alike nature of medicament-type items, and the look-alike nature of the
cells.
Any error in loading one or more cells of the blister package, for example
with the
wrong medicament, or the wrong medicament for the date and time of
administration,
could harm the patient and must be avoided.
An additional problem with any repetitive hand-loading of any container,
including the aforementioned "loading devices" and blister packages, is the
lack of
any positive feedback confirming that the medicament or other item has been
loaded
into the correct cell. The aforementioned container-loading systems lack any
type of
feedback to instantaneously confirm and verify that the correct medicament or
other
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item has been placed into the correct cell. Providing such feedback could help
assure
that the correct medicament is provided for the patient, thus overcoming some
of the
human-factors limitations of any hand-loading operation.
There is a need for an item-management system, apparatus and methods which
would improve the item management and distribution process, which would
facilitate
more accurate item management and distribution, and which would reduce the
time
needed to manage items, thereby freeing personnel for other important tasks
and
improving the quality of care which can be offered.
SUMMARY
Item-management systems, apparatus and methods are described. The
systems, apparatus, and methods facilitate management and organization of
items,
such as medicaments. The systems, apparatus, and methods may be used, for
example, to ensure that the correct item is provided to a user or other
process.
The systems, apparatus, and methods are described in the preferred context of
management of medicament-type items but can have application with respect to
management of other items, such as nutriceuticals.
In embodiments, a medicament-management system with a sensor guide is
provided. The system enables a pharmacy user to rapidly and accurately load
medicament container cells with medicaments or other items. The loading is
preferably performed by hand-loading. The sensor guide provides an opportunity
for
medicament detection and for feedback to alert the user if an error has been
made in
the loading.
In an embodiment, a medicament management system comprises a
portable medicament container, a docking station to which the container is
temporarily docked for hand-loading, a sensor guide, visible information
sources
which communicate visible information to a user, and at least one controller.
In embodiments, the containers are portable medicament containers. Each
container preferably has walls which define plural cells. Each cell defines a
cell upper
opening through which a medicament is hand-loaded into the cell. In
embodiments,
the container or containers may be blister packages. In other embodiments, the
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containers may be used to transfer medicaments to an automated dispensing
machine.
Preferably, the sensor guide overlies the container when the container is
docked. The sensor guide may include plural openings and each of the openings
is in
alignment with one of the cells of the docked container. The openings act as
guides to
assist the user in loading the medicament or other item in the correct cell. A
sensor
may be associated with each opening. The sensor detects passage of a
medicament
through the opening toward the container cell. A signal is generated
responsive to the
detection.
In embodiments, each sensor of the sensor guide preferably includes a sender
which emits a signal and a receiver across the sensor opening from the sender
which
receives the signal. In the embodiments, the medicament is detected when the
signal
is interrupted by the medicament passing through the opening.
The at least one controller is preferably able to access information
indicating
the cell in which each medicament is expected from a database or other
information
source. Preferably, the at least one controller generates a signal if the
medicament is
not detected as expected. Such signal may include an error description
allowing a
user to correct the error. The error description may be a description of an
overcount, a
description of an undercount or a description that the medicament was placed
into the
incorrect cell. The error descriptions are preferably displayed to a user on a
video
display when appropriate. Other error messages could include use of the
visible
information sources.
The at least one controller may control the visible information for the cell
in
which the medicament is to be expected. By way of example only, the at least
one
controller may activate the visible information source for the correct cell to
provide
information to the user directing the user to load the medicament in the
indicated cell.
In addition, the at least one controller may generate a signal responsive to
the
medicament being detected as expected. A record can be updated or created
indicating that the cell was loaded properly and as expected.
In embodiments, visible information sources may include a visible information
source associated with each guide opening. The visible information sources may
indicate by "yes" state information, the cell into which the medicament is to
be hand
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loaded.
In embodiments, the visible information sources may include a plurality
docking station light sources and aligned light pipes extending from the light
sources
to a top of the docking station. Each docking station light pipe is most
preferably
associated with each cell of a docked container. The docking station light
pipes are
preferably in alignment with sensor guide light pipes corresponding to each
sensor
guide opening and cell of the docked container when the sensor guide overlies
the
docking station and docked holder. The aligned docking station and sensor
guide
light pipes are capable of providing visible information along a top of the
sensor
guide to thereby provide instructions to a user regarding which opening and
cell to
load a medicament or other item into.
In certain embodiments, a container may be temporarily docked at the docking
station while being hand-loaded. A second of the containers is temporarily
docked
after the first container is removed from the docking station. The docking
station may
include circuitry enabling control of visible information proximate the cells
indicating
"yes" and "no" states of the cells.
If the container is a blister package, it is preferred that the docking
station
include structure into which the blister package nests when docked. In
embodiments,
the docking station may include cell-receiving pockets which receive the
blister
package cell walls to enable the nesting. Nesting may provide improved support
for a
container of a blister-package type. A sensor guide may or may not be utilized
with
such embodiments. The visible information sources communicate the visible
information to the user. The "yes" state information indicates the cell into
which the
medicament is to be loaded. In embodiments, the visible information may be
viewable directly on the docked container proximate the cells.
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BRIEF DESCRIPTION OF THE DRAWINGS
Exemplary item-management systems, apparatus, and methods may be
understood by reference to the following description taken in conjunction with
the
accompanying drawings, in which like reference numerals identify like elements
throughout the different views. For convenience and brevity, like reference
numbers
are used for like parts amongst the embodiments. The drawings are not
necessarily to
scale, emphasis instead being placed upon illustrating the principles of the
invention.
In the accompanying drawings:
FIGURE 1 is a perspective view of a representative holder docked at a docking
station;
FIGURE 2 is a schematic side sectional view of the representative holder and
docking station taken along section 2-2 of Figure 1;
FIGURE 3 is a schematic top sectional view of a representative holder docked
at a docking station taken along section 3-3 of Figure 1 with certain holder
portions
cut away to facilitate understanding;
FIGURE 4 is a top side view of the representative holder of Figure 1;
FIGURE 5 is a left side elevation view of the representative holder of
Figure 1;
FIGURE 6 is a schematic top sectional view of a representative wireless-type
holder docked at a docking station taken along a section, such as section 3-3
of Figure
1 with certain holder portions cut away to facilitate understanding;
FIGURE 7 is a perspective view of a further exemplary embodiment showing
a docking station with a guide, and a holder docked at a docking station;
FIGURE 8 is a schematic side sectional view of the further exemplary docking
station and guide taken along section 8-8 of Figure 7;
FIGURE 9 is a schematic top sectional view of the further exemplary docking
station and guide taken along section 9-9 of Figure 7;
FIGURE 10 is a top side view of the holder shown in Figures 7-9 shown apart
from the docking station;
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FIGURES 11A-11C are enlarged fragmentary views of region 11 of Figures 3,
6, and 9 provided to illustrate an alternative indicator embodiment comprising
a multi-
colored lamp which may be used with the holders or guide of Figures 3, 6, and
9;
FIGURE 11D is an enlarged fragmentary view of region 11 of Figures 3, 6,
and 9 provided to illustrate a further alternative indicator embodiment
comprising a
tri-lamp indicator which may be used with the holders or guide of Figures 3,
6, and 9;
FIGURE 12A is a schematic illustration of an exemplary system including a
docking station and computer external to the docking station;
FIGURE 12B is a schematic illustration of a further exemplary system
including a docking station and computer internal to the docking station;
FIGURE 13 is a perspective view of a storage cabinet including four
representative holders temporarily stored therein;
FIGURE 14 is an exemplary log-on screen display;
FIGURE 15 is an exemplary screen display for loading of a holder;
FIGURE 16 is an exemplary screen display for verification of the items loaded
in the holder;
FIGURE 17 is an exemplary screen display for verification of the items loaded
in the holder including a reference image of a medicament;
FIGURE 18 is a perspective view of an exemplary automated medicament
dispensing machine with which the representative holders of Figures 1-10 may
be
utilized;
FIGURE 19 is a perspective view of the exemplary automated medicament
dispensing machine of Figure 18, but with one exemplary exception storage
apparatus
in an outwardly-extended position ready to receive medicaments;
FIGURE 19A is an enlarged fragmentary view of a portion of the exemplary
exception storage apparatus of Figure 19;
FIGURE 20 is a perspective view of the exemplary automated medicament
dispensing machine of Figures 18 and 19 but with the representative holder of
Figures
1-10 positioned on the exemplary exception storage apparatus;
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FIGURES 21A- 21C are schematic side sectional views of the representative
holder of Figures 1-5 and exception storage apparatus of Figures 19-20 taken
along
section 21-21 of Figure 20. Figures 21A-21C show an exemplary sequence for
loading the contents of the holder into the exception tray;
FIGURE 22 is an exemplary series of medicament-containing pouch packages
of the type produced by the automated dispensing machine of Figures 18-20;
FIGURE 23 is a perspective view of a further embodiment of a medicament
management system including a docking station, holder, and sensor guide;
FIGURE 24 is a perspective view of the medicament management system of
Figure 23, but with the sensor guide in a storage position;
FIGURE 25 is a partially exploded view of the medicament management
system of Figure 23 including a docking station, holder, and sensor guide;
FIGURE 26 is a top view of the medicament management system of Figure 23
including a docking station, holder, and sensor guide;
FIGURE 27 is a left side elevation view of the medicament management
system of Figure 23 including a docking station, holder, and sensor guide;
FIGURE 28 is a section view of the medicament management system of
Figure 23 taken along section 28-28 of Figure 26;
FIGURE 28A is an enlarged section view of the medicament management
system of Figure 23 taken along section 28A-28A of Figure 28;
FIGURE 29 is a perspective view of an exemplary holder;
FIGURE 30 is a top plan view the exemplary holder of Figure 29;
FIGURE 31 is a bottom plan view the exemplary holder of Figure 29;
FIGURE 32 is a perspective view of an exemplary sensor guide of Figure 23;
FIGURE 33 is a bottom plan view the exemplary sensor guide of Figure 23;
FIGURE 34 is a partially exploded view of the sensor guide of Figure 23;
FIGURE 35 is an enlarged perspective view of a portion of Figure including a
sensor module;
FIGURE 36 is an exploded view of an exemplary sensor module of the sensor
guide of Figure 23;
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FIGURE 37 is a perspective view of a further embodiment of a medicament
management system including a docking station, holder, and sensor guide;
FIGURE 38 is a perspective view of the medicament management system of
Figure 37, but with the sensor guide in a storage position;
FIGURE 39 is a partially exploded view of the medicament management
system of Figure 37 including a docking station, holder, and sensor guide;
FIGURE 40 is a top view of the medicament management system of Figure 37
including a docking station, holder, and sensor guide;
FIGURE 41 is a left side elevation view of the medicament management
system of Figure37 including a docking station, holder, and sensor guide;
FIGURE 42 is a section view of the medicament management system of
Figure 37 taken along section 42-42 of Figure 37;
FIGURE 42A is an enlarged section view of the medicament management
system of Figure 37 taken along section 42A-42A of Figure 42;
FIGURE 43 is a section view taken along section 43-43 of Figure 37
illustrating exemplary interlock switches;
FIGURES 43A and 43B are enlarged section views of an exemplary interlock
switches of Figure 43 taken along sections 43A-43A and 43B-4B of Figure 43;
FIGURES 44A-44B are perspective and top plan views of the docking station
of Figure 37;
FIGURE 45 is a perspective view of the exemplary holder of Figure 37;
FIGURE 46 is a side elevation view of the exemplary holder of Figure 45;
FIGURE 47 is a top plan view the exemplary holder of Figure 45;
FIGURE 48 is a perspective view of the exemplary sensor guide of Figure 37;
FIGURES 49A-49B are top and bottom plan views of the exemplary sensor
guide of Figure 37;
FIGURE 50 is a partially exploded view of the sensor guide of Figure 37;
FIGURE 51 is an enlarged perspective view of a portion of Figure 50
including a sensor module;
FIGURE 52 is an exploded view of an exemplary sensor module of the sensor
guide of Figure 23;
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FIGURE 53 is a schematic block diagram of exemplary systems for item
management;
FIGURE 54 is an exemplary screen display for loading a holder for the system
of Figure 23;
FIGURE 55 is an exemplary screen display for selection of an available
holder;
FIGURE 56 is an exemplary screen display for selection of a medicament
container;
FIGURE 57 is an exemplary screen display for holder filling;
FIGURE 58 is an exemplary screen display for completion of holder filling;
FIGURE 59 is an exemplary screen display for prescription order completion;
FIGURES 60-63 are exemplary screen displays for an overcount error;
FIGURE 64 is an exemplary screen display for an undercount error;
FIGURES 65-66 are exemplary screen displays for a medicament placement
error;
FIGURES 67-72 are exemplary screen displays for a verification process;
FIGURE 73 is an exemplary screen display for loading a holder for the system
of Figure 37;
FIGURE 74 is an exemplary screen display for selection of an available
holder;
FIGURE 75 is an exemplary screen display for selection of a medicament
container;
FIGURE 76 is an exemplary screen display for holder filling;
FIGURE 77 is an exemplary screen display for completion of holder filling;
FIGURE 78 is an exemplary screen display for prescription order completion;
FIGURES 79- 82 are exemplary screen displays for an overcount error;
FIGURE 83 is an exemplary screen display for an undercount error;
FIGURES 84- 85 are exemplary screen displays for a medicament placement
error; and
FIGURES 86-91 are exemplary screen displays for a verification process.
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While the systems, apparatus, and methods are susceptible to various
modifications and alternative forms, specific embodiments thereof have been
shown
by way of example in the drawings and are herein described in detail. It
should be
understood, however, that the description herein of specific embodiments and
methods is not intended to limit the invention to the particular forms
disclosed, but on
the contrary, the intention is to cover all modifications, equivalents, and
alternatives
falling within the scope of the invention as defined by the appended claims.
DETAILED DESCRIPTION
Referring first to Figures 1-9 and 12A, there are shown embodiments of an
exemplary system 10 for management of items. The embodiments are described in
the context of a preferred item-management system for management of medicament
11 items. System 10, preferably includes holder 13, docking station 15 to
which
holder 10 may be temporarily docked, and controller 17 which may include one
or
more controls capable of operating system 10. The term "at least one
controller,"
therefore, means or refers to embodiments in which controller 17 includes one
or
more controller components. Controller 17 may include components internal
and/or
external to docking station 15. In a further exemplary system 10' (Figure
12B),
controller 17 is illustrated as being entirely within docking station 15.
System 10 may
be configured and arranged based on the needs of the pharmacy, hospital, long-
term
care facility or other operator. While it is envisioned that embodiments of
system 10
or 10' will be utilized in the health-care industry, it should be understood
that such
systems and others may have application in fields outside of the health-care
industry
for dispensing of items other than medicaments 11.
Referring then to Figures 1-5, there is shown an exemplary holder 13 for
managing and organizing medicaments. A further exemplary holder 13' is
illustrated
in Figure 6. The word "holder" means or refers to apparatus which holds one or
more
items. Holder 13' is a wireless-type holder but is otherwise identical to
holder 13.
For simplicity and brevity, like reference numbers of holder 13 and docking
station 15
are used to identify like parts of holder 13' and docking station 15' and the
description
of holder 13 and docking station 15 are incorporated by reference with respect
to
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holder 13' and docking station 15'.
Exemplary holder 13, 13' has a tray-like appearance in that holder 13, 13' is
a
flat, shallow container used for carrying, holding, and organizing items which
are
preferably medicaments 11. However, other holder configurations may be
utilized
depending on the needs of the user.
For simplicity and brevity, like reference numbers of holder 13 and docking
station 15 are used to identify like parts of holder 13' and docking station
15' and the
description of holder 13 and docking station 15 are incorporated by reference
with
respect to holder 13' and docking station 15'.
Exemplary holder 13, 13' includes a body 19, a top and a bottom 21, 23, a
front and a rear side 25, 27, and a left and a right side 29, 31. Holder 13,
13' further
includes cells, of which cell 33 is representative. Each cell 33 is defined by
a wall 35,
of which wall 35 is representative. For purposes of simplicity and brevity,
each cell
33 of holder 13, 13' is indicated by reference number 33 and each wall is
indicated by
reference number 35.
Each wall 35 defines a cell 33 upper opening, or inlet 37, and a cell lower
opening, or outlet 39. As shown in the examples, the cell inlets 37 extend
through,
and are included in and along, the body top 21 while the cell outlets 39
extend
through, and are included in and along, the body bottom 23. In the
embodiments,
medicaments 11 are loaded into each cell 33 through inlet 37 and are
discharged from
cell 33 through outlet 39 as described in detail below.
In the embodiments, each cell 33 is identical and, as noted, reference number
33 indicates each identical cell 33. However, it is possible that cells 33 of
holder 13,
13' may have a structure which is not identical and which may differ depending
on the
needs of the user.
Referring to Figures 1-6 each exemplary holder 13, 13' shown includes sixty
four total cells 33 organized into four rows of sixteen cells. In the
examples, the
organization of cells 33 is identical to the organization of cells 41 of
exception storage
apparatus 43 shown pulled out from automated dispensing machine 45 in Figures
18-
21C. Exemplary holder 13, 13' is configured and arranged such that each cell
33
outlet 39 is in registry with (i.e., aligned with) a corresponding cell 41 of
exception
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storage apparatus 43 permitting direct movement of medicaments 11 from holder
13,
13' into exception storage apparatus 43 as shown in the example of Figures 21A-
21C.
Holder top 21 is preferably provided with human-readable indicia 47
identifying each cell 33. In the examples, indicia 47 is an integer from 1 to
64
proximate each cell 33. Other types of indicia 47 may be used, such as alpha-
numeric
indicia.
Holder 13, 13' further includes at least one indicator 49 for each cell 33, of
which indicator 49 is representative. For purposes of simplicity and brevity,
each
indicator of holder 13, 13' is indicated by reference number 49. An indicator
49 is
located on holder 13, 13' top side 21 next to each cell 33. Each indicator 49
could be
located inside body 19 if body is translucent. One indicator 49 is provided
for each
cell 33 for a total of sixty four indicators 49 in these examples. Each
indicator 49 may
be a visible indicator in the form of a selectively-operable lamp (i.e., an
artificial light
source). Energizing of each lamp-type indicator 49 indicates the cell 33 into
which
the medicament 11 or other item is to be loaded. Preferably, each indicator 49
is a
light-emitting diode (LED), although it is envisioned that other types of lamp-
type
indicators 49 may be used.
Controller 17 is operable to selectively operate each indicator 49 when holder
13 is docked at docking station 15. Selective operation of an indicator 49
proximate
to a cell 33 prompts the technician or pharmacist to place each medicament 11
into the
cell 33 associated with the activated indicator 49 or indicators 49.
Collectively, the
indicators 49 comprise a type of pick-to-light system. Thus, if a medicament
11 is to
be loaded in the cells 33 designated by human-readable indicia 47 as cells 1,
3, 6, 9,
12, 15, 18, 21, 24, and 27, each of the indicators 49 next to such cells 33
may be
activated communicating to the technician or pharmacist the specific cells 33
which
should contain that medicament 11. Use of a pick-to-light system of indicators
49
advantageously communicates information to the technician or pharmacist
without
resort to a set of written instructions. A pick-to-light system is far
superior to written
instructions because the person responsible for loading or verification of
holder 13,
13' need not take his or her eyes off of holder 13, 13' to read the
instructions thereby
increasing accuracy and reducing the time required to load or verify the
medicaments
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11 that should be in the holder 13, 13'.
As illustrated in yet a further embodiment illustrated in Figures 11A, 11B,
and
11C, indicator 49 could comprise a single multi-colored indicator 49 for each
cell 33.
For example a multi-colored LED lamp could be used as indicator 49. As is
known,
changing the voltage to a multi-colored LED or selectively activating one of
plural
LED anodes causes the LED to emit a different color as represented in Figures
11A-
11C. Each different color can be used to communicate a different type of
information
to the technician loading the holder 13, 13'. For example, a red color signal
from
indicator 49 (Figure 11A) could indicate that one medicament 11 is to be
loaded into
that cell 33. A green-color signal from indicator 49 (Figure 11B) could
indicate that
more than one medicament 11 is to be loaded in that cell 33. A yellow-color
signal
from indicator 49 (Figure 11C) could indicate that a half-size medicament is
to be
loaded in that cell 33.
A further indicator 49 embodiment is illustrated in Figure 11D. In the
example of Figure 11D, a plural-lamp indicator 49 could be provided for each
cell 33
for purposes of communicating information to the technician or pharmacist. In
Figure
11D, a plural-lamp indicator 49 consisting of three lamps is provided adjacent
each
cell 33. Any number of lamps could be used. Each lamp of indicator 49 could,
for
example, consist of an LED lamp of a different color, such as red 49a, green
49b, or
yellow 49c. Each color could indicate a different type of information as
described in
connection with the multi-colored LED example of Figures 11A-11C. Energizing
of
only the red-color indicator 49a could indicate that one medicament 11 is to
be loaded
into that cell 33. Energizing of only the green-color indicator 49b could
indicate that
more than one medicament 11 is to be loaded in that cell 33. Energizing of
only the
yellow-color indicator 49c could indicate that a half-size medicament is to be
loaded
in that cell 33. Alternatively, the lamps may all be of the same color and the
number
of activated indicator lamps 49 proximate each cell 33 could indicate the
quantity of
medicaments to be placed in each cell 33. Alternatively, the indicator 49
could have a
blink pattern indicating the medicament 11 to be loaded into the cell 33. A
constant
blink could indicate that one medicament 11 is to be loaded into the cell, two
blinks
could indicate that more than one medicament 11 is to be loaded in that cell
33, and
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three blinks could indicate that a half-size medicament is to be loaded in
that cell 33.
Operation of the indicators 49 as described can also be used for verification
of
medicaments received in each cell 33.
Holder 13, 13' further includes a pair of legs 51, 53 depending from holder
13,
13' bottom side 23. Legs 51, 53 may be provided to support holder 13 on a
surface
(such as counter top 85). Referring to Figures 1 and 5, bottom side 23 may
extend
outwardly from holder sides 29, 31 for a purpose described below.
Referring to Figures 1-6 and 21A-21C, exemplary holder 13, 13' further
includes a planar shuttle member 55 positioned in planar track 57 in holder
proximate
each cell 33 outlet 39. Shuttle member 55 includes openings 59 and a pull 61
which
permits the technician or pharmacist to grasp shuttle member 55 with his or
her hand
and to pull or push shuttle member 55.
In the example, shuttle member 55 is movable between a first position in
which shuttle member 55 covers and closes each cell 33 outlet 39 as shown in
Figure
21A and a further position in which the shuttle member 55 openings 59 are in
alignment with each cell 33 outlet 39, thereby opening each cell outlet 39
permitting
medicaments 11 to drop from each cell 33 into a corresponding cell of
exception
storage apparatus 43 as shown in Figure 21C. The first position of shuttle
member 55
is referred to herein as a "cell-closed position" and the further position of
shuttle
member 55 is referred to herein as a "cell-opened position." In between these
positions, the cells 33 are partially open permitting medicaments to start to
fall from
cells 33 as shown in Figure 21B.
In the embodiments, shuttle member 55 serves as a gate, opening and closing
each cell 33 as shuttle member 55 moves between the cell-closed (Figure 21A)
and
cell-opened positions (Figure 21C). Shuttle member 55 thereby blocks each cell
outlet 39 in the cell-closed position permitting a medicament 11 to be loaded
into each
cell 33 for organizing and storage and further opens each cell outlet 39
permitting
each medicament 11 to be discharged from holder 13, 13' for loading into
exception
storage apparatus 43 as described below.
Referring to Figure 3, holder 13 and docking station 15 may include structure
configured to enable or facilitate docking of holder 13 with docking station
15. In the
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embodiment, holder 13 is provided with a female alignment pin receiver 63 and
docking station 15 is provided with a male alignment pin 65 which is inserted
into and
seated in receiver 63 when holder 13 is docked with docking station 15. The
mechanical interconnection of receiver 63 and pin 65 properly locates holder
13 at
docking station 15. A contact-switch-type proximity detector 66 may be
provided to
indicate to controller 17 that holder 13 is properly docked at docking station
15.
Holder 13' and docking station 15' may be provided with receiver 63, pin 65,
and
detector 66.
Figures 1-5 and Figure 6 are provided to show exemplary types of connections
between a holder and a docking station. Referring first to Figures 1-5, an
exemplary
electro-mechanical connection between holder 13 and docking station 15 is
shown. In
the example, holder 13 body 19 is provided with a pair of electrical contacts
67, 69
permitting control over operation of indicators 49 through docking station 15
and
controller 17. Two contacts 67, 69 are not required as any number of contacts
will
suffice. When holder 13 is properly docked with docking station 15, contacts
67, 69
are brought into operable connection with corresponding contacts 71, 73 on
docking
station. Contacts 71, 73 are connected by suitable electrical conductors 75,
77 to
programmable logic controller 79 of controller 17. Contacts 67, 69 are
operably
connected to indicators 49 through appropriate conductors (not shown)
permitting
selective energizing and operation of indicators 49 to indicate the cell 33
into which
each medicament 11 is to be loaded. Examples of representative contacts 67,
69, 71,
73 for a holder 13 with sixty four indicators 49 are AmplimiteTM 37 position,
size 4
HD-20 male and female contacts available from Tyco Electronics of Harrisburg,
Pennsylvania.
Referring now to Figure 6, the holder 13' embodiment shown therein includes
structure enabling wireless connection between holder 13', docking station
15,' and
controller 17. Holder 13' includes a control circuit board 68, with a wireless
transmitter/receiver 70 powered by a battery 72 associated with holder 13'.
Board 68
is operably connected to indicators 49 through appropriate conductors (not
shown)
permitting selective energizing and operation of indicators 49 to indicate the
cell 33
into which each medicament 11 is to be loaded or to permit verification of
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medicaments 11 received in cells 33. Transmitter/receiver 70 sends and
receives
signals with docking station 15' transmitter/receiver 74 permitting selective
operation
of indicators 49 through docking station 15' and controller 17.
In the examples of Figures 1-5 and Figure 6, exemplary holder 13, 13' and
docking station 15, 15' are provided with apparatus 81, 83 for uniquely
identifying
holder 13, 13' to docking station 15, 15' and system 10 or 10' as shown
schematically
in Figure 3. Positive identification of holder 13, 13' enables the user to
precisely
control loading of appropriate medicaments 11 into holder 13 and 13' permits
the user
to maintain more accurate records of medicaments 11 which have been dispensed.
In
such embodiments, holder 13, 13' may include an identification element 81 and
docking station 15, 15' may include an identification element detector 83 as
shown in
Figure 3. The identifier element 81 may, for example, consist of a radio
frequency
identification tag (RFID) and the detector 83 may be an RFID tag reader (i.e.,
an
interrogator) on docking station 15. The exemplary RFID tag 81 may be re-
writable
or read-only, as desired. Exemplary RFID reader 83 provided on docking station
15,
15' detects information embedded on the RFID tag 81. Information embedded in
RFID tag 81 identifying holder 13, 13' may be used by system 10, 10' to
control the
medicament-dispensing process.
An identification element detector 84 may be provided on automated
dispensing machine 45 (Figures 19, 20). In the example utilizing RFID tags,
detector
84 may comprise an RFID reader. If the correct holder 13, 13' identification
element
81 is detected by detector 84, the technician or pharmacist is prompted to
transfer
medicaments 11 from holder 13, 13' to exception storage apparatus 43.
Conversely, if
an incorrect holder identification element 81 is detected by detector 84, the
technician
or pharmacist is prompted to not load the exception storage apparatus 43.
Holder 13, 13' may be made of any suitable material or combination of
materials. Preferably, body 19 is made of plastic material construction for
reasons of
ease of manufacture, low weight, ease of cleaning, and cost. Indicators 49 are
preferably LED-type lamps but may comprise other types of visible indicators.
Referring next to Figures 1-3, and 6 there are shown embodiments of docking
stations 15, 15' capable of use with a respective exemplary holder 13, 13'.
Each
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docking station 15, 15' may be placed on a counter top 85, such as the counter
top 85
at a workstation in a pharmacy, long-term care facility, hospital, or other
facility. A
mounting bracket 87 may be provided to mechanically secure docking station 15,
15'
to counter top 85.
Each exemplary docking station 15, 15' preferably includes housing 89
including top and bottom walls 91, 93, left and right side walls 95, 97 and
front and
rear walls 99, 101. Indicator 102 is provided on front wall 99. Indicator 102
is
preferably an LED lamp which is activated if a holder 13 is properly docked at
docking station 15, 15' and is recognized as an authorized holder 13 by system
10, 10'
by means of identifier element 81.
In the embodiments of Figures 1-3 and 6, housing 89 encloses a programmable
logic controller (PLC) 79 and a power supply 103. In such embodiments, PLC 79
is a
component of controller 17. Power-supply port 105 is provided for connection
to a
suitable 120 Volt electrical power source by means of an electrical cord (not
shown)
to supply electrical power to PLC 79. PLC 79 includes instructions permitting
selective closing and opening of relays within PLC 79 corresponding to the
indicator(s) 49 of holder 13, 13' which are to be selectively operated to
indicate the
cell 33 into which each medicament 11 is to be placed. Power supply 103
preferably
provides 5 Volt DC power to selected ones of LED-type indicators 49 once the
appropriate relays of PLC 79 are selectively closed, thereby providing
selective
energizing and operation of indicators 49. In embodiments utilizing a multi-
color
LED-type indicator 49 (Figures 11A-11C) PLC 79 may also regulate the voltage
to
each indicator 49 or selectively energize the anodes to change the color
emitted by the
multi-colored LED. In wireless holder embodiments 13', control circuit board
68
(e.g., a controller on board 68) activates indicator 49 responsive to signals
generated
by PLC 79 to transmitter/receiver 74. An exemplary PLC 79 suitable for use as
a
component of controller 17 is a Model 06 Koyo Electronics PLC available from
Automation Direct, Inc. of Cumming, Georgia.
Referring to the embodiment of Figure 12A, system 10 may include a server
107 operably connected to PLC 79 via data port 109 and communication link 111.
In
the embodiment, controller 17 includes both PLC 79 and server 107 operatively
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connected thereto. Server 107 may include memory 113 with a program of
instructions 115 residing in memory 113. Server 107 is representative of any
data
management system operated by a pharmacy, hospital, long-term care facility,
or other
operator for purposes of managing information related to dispensing of
medicaments
11. Communication link 111 may be any link capable of transmitting data and
other
information. Link 111 may, for example, comprise a dedicated land line,
wireless
link, ethernet, interne, intranet, local area network (LAN), or other suitable
connection enabling data transmission between PLC 79 and server 107. Server
107 is
preferably an off-the-shelf computer representative of any suitable data-
management
controller. It is envisioned that holder 13 can be connected directly to
server 107
without a docking station 15, for example through a suitable communication
link.
In a further illustrative embodiment represented by Figure 12B, system 10'
includes an on-board computer 117 within docking station 15, 15' housing 89
and
computer 117 serves as controller 17. Computer 117 includes a program of
instructions 119 residing in memory 121 which are operable to selectively
energize
and operate the indicators 49 to indicate the cell 33 into which one or more
medicament(s) is/are to be placed. In this embodiment, computer 117 is linked
to
automated dispensing machine 45 via communication link 123 and server 124.
Communication link 123 may be of the type as described previously in
connection
with link 111 and server may be a pharmacy information system server provided
to
manage pharmacy workflow generally. Overall activation of indicators 49 is
provided
by computer 117 in this example. System 10' is otherwise identical to system
10 and
the description of system 10 is incorporated by reference with respect to
system 10'.
Each docking station 15, 15' further preferably includes a video display 125,
keyboard 127, and mouse 129 permitting a technician or pharmacist to input and
receive information from server 107 or computer 117 of controller 17. A
biometric
identification device 130 may be provided to permit the technician or
pharmacist to be
identified to the system 10 or 10', particularly when logging on to the
system. The
biometric device 130 may be a fingerprint reader, retina scanner, or other
suitable
device. A bar code scanner 131 is preferably operably connected to controller
17.
Video display 125 is preferably a touch screen display permitting a technician
to input
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information to controller 17 by simply touching her finger on a desired
portion of the
display 125. Bar code scanner 131 may be any off-the-shelf scanner capable of
reading a bar code 133 on a container 135 provided to hold medicaments 11.
Keyboard 127 may be an off-the-shelf QWERTY-type keyboard 127 permitting a
technician to input information to controller 17 and system 10, 10'.
Figures 7, 8, 9, and 10 illustrate a further holder 13" and docking station
15"
embodiment suitable for use with an item-management system, such as system 10
or
10'. For simplicity and brevity, like reference numbers of holders 13, 13' and
docking
stations 15, 15' are used to identify like parts of holder 13" and docking
station 15"
and the description of holders 13, 13' and docking stations 15, 15' are
incorporated
by reference with respect to holder 13" and docking station 15". The
embodiment of
Figures 7-10 differs from the embodiments of Figures 1-6 because the indicator
or
indicators 49 which are selectively-operable to indicate the holder cell 33
into which
an item is to be loaded are located on a guide 136 associated with docking
station 15".
Use of guide 136 with indicators 49 located thereon enables use of the item-
management system with a holder 13" which does not include indicators 49
thereon,
typical of holders presently in use.
Referring further to Figures 7-10, holder 13" includes body 19, top and bottom
sides 21, 23, sides 25-31, cells 33 (including inlet and outlet openings 37,
39), legs 51,
53, shuttle member 55. An identification element 81 of the type previously
described
is preferably provided on body 19. An alignment pin receiver 63 may be
provided to
receive pin 65 of docking station 15" to position holder 13" at docking
station 15".
Exemplary docking station 15" includes detector 83, housing 89 with walls 91-
101,
lamp 102, power supply 103, and ports 105, 109, and is provided with a video
display
125, keyboard 127, mouse 129, biometric identification device 130, and bar
code
scanner 131 for the purposes described in connection with docking stations 15,
15'.
Docking station 15" includes a guide 136 attached to housing front wall 99.
Guide 136 is preferably a planar member located in a plane above a holder 13"
docked at docking station 15" beneath guide 136. Guide 136 is provided with
openings, each of which is identified by reference number 138 for brevity. In
the
example, guide 136 is provided with 64 total openings 138 grouped in four rows
of
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openings 138. This opening 138 pattern is identical to the pattern of cells 33
in holder
13". This opening 138 pattern is such that the openings 138 in guide 136 are
in
registry and alignment with the corresponding cells 33 of holder 13" when
holder 13"
is docked at docking station 15". This arrangement allows a technician to
rapidly and
accurately load each cell 33 of holder 13" by inserting a medicament through
the
appropriate opening 138 in guide and into the corresponding cell 33 during
holder 13"
loading.
Indicators 49 on guide 136 are proximate each opening 138 to indicate to the
technician, upon activation, which opening 138 a medicament 11 or other item
is to be
inserted. Indicators 49 may, for example, be a single lamp (preferably an LED)
as
illustrated in Figures 1, 3-4, 6-7, and 9, a multi-colored LED as illustrated
in Figures
11A-11C, or plural indicators 49 as illustrated in Figure 11D, or another
indicator
type. Human-readable indicia 140 is preferably provided on guide 136 so that
each
opening 138 on guide 136 has the same indicia 140 as indicia 47, 211 on holder
13"
and exception storage apparatus 43. Indicia 140 further assists the technician
to
ensure that the correct medicament 11 is loaded into the correct guide 136
opening
138. Guide 136 indicators 49 are connected to PLC 79 through appropriate
conductors (not shown) permitting selective energizing and operation of
indicators 49
to indicate the opening 138 through which each medicament 11 is to be loaded.
Guide
136 may be made of any suitable material such as metal, plastic, laminate or a
combination of materials.
Docking station 15" is otherwise identical to docking station 15 previously
described and illustrated and the description of docking station 15 is
incorporated by
reference. Controller 17, as previously described, controls operation of
docking
station 15" and indicators 49 on guide 136 and holder 13", docking station
15", and
controller 17 may be used as part of an item-management system, such as system
10
or 10' (Figures 12A, 12B).
Figures 14-17 are exemplary screen displays of a type which could be
displayed to a technician or pharmacist on display 125 for purposes of
implementing
system 10 or 10' using holder 13, 13', or 13" and docking station 15, 15', or
15".
The screen displays of Figures 14-17 are intended to represent non-limiting
examples
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as the type and number of screen displays can be modified and the information
provided in the screen displays may be customized to meet the needs of the
particular
pharmacy, hospital, long-term care facility or other operator. For convenience
and
brevity, the screen displays of Figures 14-17 are described in connection with
system
10 including holder 13 and docking station 15, it being understood that the
screen
displays and methods of implementing system 10 are applicable for use with
system
10' or with holder 13', 13" and docking station 15', 15".
Referring to the screen displays of Figures 14-17, a technician or registered
pharmacist initiates use of system 10 by logging on to the system 10,
preferably at
docking station 15. Preferably, loading of holder 13 is performed by a
technician
while verification of the loaded holder 13 is performed by a registered
pharmacist.
Referring to Figure 14, the technician is initially presented with a log-on
screen 137 displayed on video display 125. The technician logs on to the
system 10
by keying his or her password into the password field 139 using keyboard 127
and
selecting the ENTER icon 141. Alternatively, the technician could utilize
biometric
device 130 to identify herself to the system 10. The technician's password
information is transmitted to server 107 (or server 124 in system 10'),
whereupon it is
determined that the technician is an authorized user.
If a holder 13 is not already docked at docking station 15 as shown in Figures
1-3 (or is not in wireless communication with docking station 15' as in Figure
6),
a further screen (not shown) may be displayed on video display 125 prompting
the
technician to dock a holder 13 at docking station 15. In the example of
Figures 1-3,
holder 13 is shown docked at docking station 15 by insertion of pin 65 in
receiver 63,
thereby positioning holder 13 to form an electrical connection between holder
contacts
67, 69 and docking station contacts 71, 73. Identification element detector 83
identifies the unique identifier element embedded in holder 13. Detector 83
preferably detects an RF1D-type identification element 81 to identify holder
13 to
system. If the docked holder 13 is recognized by system 10 (or if wireless-
type holder
13' is recognized by system 10), indicator lamp 102 is activated to inform the
technician that the system 10 is in a ready state. Proximity detector 66 may
also
indicate to controller 17 that holder 13 is properly docked at docking station
15.
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Referring next to Figure 15, if the technician is authorized and if holder 13
is
docked and recognized, then a holder-loading screen 143 is displayed on video
display
125. Holder-loading screen 143 provides information for loading each
medicament
11 into the correct cell 33.
Information which may be presented on holder-loading screen 143 can include
an identification field 145 identifying the operator name (e.g., Nowtime
Pharmacy),
technician name, and date and time-of-day on which holder 13 is being loaded.
Additional information which may be displayed in connection with screen 143 is
the
holder identifier 147 and transaction code 149 which indicates the transaction
corresponding to loading of the holder 13 for record-keeping purposes.
Preferably,
the transaction number and all other information relating to loading and
verification of
holder 13 is stored in a database on server 107 or 124. Holder identifier 147
may be
any symbol or group of symbols capable of distinguishing one holder 13 from
another
holder 13. In the example, holder identifier 137 is identical to the
identifier
embedded in RFID tag-type identification element 81. In the example, the
holder
identifier 147 is the number 2. A unique identifier 147 can be important if
more than
one identical holder 13 is used by the pharmacy, hospital, long-term care
provider or
other operator.
Referring further to Figure 15, holder-loading screen 143 includes information
151 required for loading of cells 33 of holder 13. Preferably, information 151
is
displayed in the form of a graphical user interface (GUI), thereby
facilitating ease of
use by the technician. In the example, information 151 includes a select field
152, a
cell location field 153, a medication type field 155, a dosage strength field
157, an
NDC number 159 field, a shelf location 161 field, and a status 163 field. In
the
example, information 151 is displayed for each medicament 11 to be loaded into
holder 13. In the example of Figure 15, three medicament 11 types, namely,
Cardura
tablets, Azithrmycin tablets, and Coumadin tablets are to be loaded into
holder 13.
The cell location field 153 identifies the cell 33 into which medicament 11 is
to be loaded by referencing the human-readable indicia 47 associated with the
designated cell 33. In the example, Cardura tablets are to be loaded into
cells of
holder 13 associated with the human-readable indicia 47 represented by numbers
"1,
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3, 6, 9, 12, 15, 18, 21, 24, 27" while the other medicaments are to be loaded
into the
other cells 33 of holder 13 identified in the cell location field 153. The
ordering of the
medicaments 11 is determined by the order in which the medicaments 11 are
required
in order to load each container or containers (e.g., a vial, bottle, blister
package, or
pouch package) for each prescription order or dispense request. For example,
server
107 may order the medicaments 11 presented on screen 143 based on the sequence
in
which prescription orders or dispense requests are to be filled for more than
one
patient or may order the medicaments 11 presented on screen 143 based on a
drug
regimen for a single patient, for example, ordering the medicaments by the
time of day
the medicaments 11 are to be taken by the patient (e.g., breakfast, lunch, and
dinner).
The slow mover medicaments 11 indicated on screen 143 may be arranged and
ordered for serial dispensing (i.e., one-after-the-other) or may be arranged
and ordered
to alternate with medicaments dispensed from other storage apparatus (e.g.,
cassettes,
cells, canisters, etc.) within automated dispensing machine 45.
The medication type field 155 and dosage strength field 157 information refers
to the type and strength of the medicament 11, while the NDC number field 159
information refers to the 10-digit National Drug Code (NDC) number for the
specific
medicament 11 called for by the prescription order or dispense request.
The shelf location field 161 information refers to the shelf location of the
pharmacy, hospital, long-term care facility, or the like at which the
medicament
container, for example representative container 135 (Figure 1), holding a
medicament
11 is located. This information is provided to assist the technician in
retrieving the
container 135 from storage. In the example, fictitious alpha-numeric shelf
locations
are displayed.
As illustrated in Figures 1 and 7, it is envisioned that the technician will
scan
the bar code 133 on the container 135 with bar code scanner 131. Program of
instructions 115 running on server 107 can then verify that the correct
container 135
has been selected from storage based on information contained in bar code 133.
The
technician can also verify that the correct medicament container 135 has been
selected
by comparing the medication type 155, strength 157, and human-readable NDC
information 159 on the screen 143 with human-readable information on the label
for
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container 135.
The status information field 163 indicates the status of the holder-loading
process. Selection of each medicament 11 for loading can be made simply by
touching the technician's finger on the row 165 of touch-screen video display
125
associated with one medicament 11 or by selecting the row 165 with another
input
device, such as keyboard 127 and mouse 129. In the example of Figure 15, the
technician is in the process of loading Cardura tablets into cells 33. This is
indicated
by the row 165 associated with Cardura tablets having been selected as
indicated by
the X character in the select field 152 and the IN-PROCESS text in status
information
field 163. The row 165 associated with the Azithrmycin tablets indicates
FILLED in
the status information field 163 indicating that loading of the Azithrmycin
tablets has
been previously completed. The row 165 associated with the Coumadin tablets
has
not yet been selected as indicated by the UNFILLED indication in field 153.
PLC 79 (or computer 117 in system 10') selectively activates the indicator 49
for each cell 33 into which the medicament 11 is to be loaded once the
appropriate
row 165 associated with the medicament is selected. This pick-to-light feature
enables the technician to load medicaments 11 without any necessity for
reliance on
written loading instructions. Thus, in the example of Figure 15, the indicator
49,
preferably an LED lamp, associated with each of cells 33 indicated by the
human-
readable indicia 47 "1, 3, 6, 9, 12, 15, 18, 21, 24, 27" is energized to tell
the
technician to load a Cardura tablet into each of these cells 33. Each
indicator 49
associated with each other cell 33 of holder 13 is not activated. Activation
of only
each indicator 49 associated with the cell to be loaded is referred to herein
as selective
indicator 49 activation or operation.
Once all cells 33 associated with a row 165 are filled, the technician then
selects the next row 165 of medicaments to be filled and proceeds to load
holder 13 as
directed by indicators 49. Selection can again be accomplished by touching the
technician's finger on the row 165 of touch-screen video display 125
associated with
the next medicament 11 to be loaded in holder 13 or by selecting the row 165
with the
keyboard 127 or mouse 129. The indicator or indicators 49 previously activated
are
deactivated and the appropriate indicators 49 for the next medicament 11 to be
loaded
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are activated. This process is repeated until all medicaments 11 have been
loaded in
holder 13 as called for by screen 143.
Once all cells 33 of holder 13 are loaded as required by holder-loading screen
143, the technician clicks on, or otherwise selects, the HOLDER FILLED icon
167.
Selection of icon 167 sends a signal to server 107 (or server 124 in system
10'
indicating that loading of holder 13 has been completed. Each loaded holder 13
can
subsequently be verified by a registered pharmacist prior to loading of
medicaments
11 from loaded holder 13 into automated dispensing machine 45.
Referring now to Figure 13, a storage cabinet 169 may optionally be provided
to store one or more holder 13, 13a, 13b, and 13c thereby facilitating loading
and
verification of multiple holders. In the example, each holder represented by
reference
numbers 13a, 13b and 13c has structure identical to holder 13. Loaded holders
13,
13a, 13b, and 13c may be stored in cabinet 169 after loading and before
verification or
may be stored in cabinet 169 after verification by a registered pharmacist and
before
loading of the verified medicaments 11 into exception storage apparatus 43 of
automated dispensing machine 45.
If provided, storage cabinet 169 includes top and bottom walls 171, 173,
sidewalls 175, 177, and a front opening 179 through which holders (e.g.,
holder 13)
are placed into cabinet 169. Stacked opposed slot pairs 181,183 may be
provided to
receive the bottom 23 of each holder 13 permitting holders 13, 13a, 13b, and
13c to be
stored in cabinet 169.
As already noted, each loaded holder 13 can be verified by a registered
pharmacist to ensure that each cell 33 has been loaded with the correct
medicament
11. Figure 16 shows an exemplary holder-verification screen 185 which
corresponds
to the holder-loading screen 143 for that holder 13. Holder-verification
screen 185
includes information 187 required for verification of the medicaments 11
loaded into
cells 33 of holder 13. This information is essentially identical to that
displayed in
connection with holder-loading screen 143. For convenience and simplicity,
reference
numbers of information displayed on holder-loading screen 143 are used again
to
identify corresponding fields of information on holder-verification screen
185.
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As with the holder-loading screen 143, an identification field 145 can be
provided to identify the operator name (e.g., Nowtime pharmacy), name of the
pharmacist responsible for medicament 11 verification, and the date and time-
of-day
on which holder 13 is verified. The holder identifier 147 and transaction code
149 are
also preferably displayed for the same purpose as described in connection with
the
holder-loading screen 143.
Preferably, information 187 is again displayed in the form of a graphical user
interface (GUI), thereby facilitating ease of use by the verifying pharmacist.
In the
example, the displayed information 187 again includes a select field 152, a
cell
location field 153, a medication type field 155, a dosage strength field 157,
an NDC
number field 159, a shelf location field 161, and a status information field
163
including the information described in connection with holder-loading screen
143. In
the example, information 187 is again displayed for each medicament 11 to be
loaded
into holder 13. In the example of Figure 16, the Cardura tablets, Azithrmycin
tablets,
and Coumadin tablets previously loaded into cells 33 of holder 13 are
presented for
verification by the pharmacist.
In order to verify that each cell 33 holds the correct medicament 11, the
pharmacist simply selects the row 165 to be verified. Selection is
accomplished by
touching the touch screen display 125 on row 165 or by selecting row 165 with
the
keyboard 127 or mouse 129. The status information field 163 again indicates
the
status of the holder-verification process.
Referring further to Figure 16, the screen display 185 shows an example of
displayed information for verification that the Cardura tablets have been
correctly
loaded into the cells 33 indicated by the human-readable indicia 47 "1, 3, 6,
9, 12, 15,
18, 21, 24, 27" located on holder 13. Selection of the Cardura tablets for
verification
is indicated in the example by the row 165 associated with Cardura tablets
having
been selected as indicated by the X character in the select field 152 and the
IN-
PROCESS text in status information field 163. The row 165 associated with the
Azithrmycin tablets indicates VERIFIED in the status information field 163
indicating
that verification of the Azithrmycin tablets has been completed. The row 165
associated with the Coumadin tablets has not yet been selected for
verification as
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indicated by the UN-VERIFIED indication in field 163. A selected row 165 can
also
be highlighted to facilitate identification of the row 165 then being
verified.
Referring next to Figure 17, a further verification screen display 186 may be
provided to assist the pharmacist with the verification process. As each row
165 is
selected, a medicament-specific verification screen 186 may be displayed. In
the
example, screen 186 displays the row 165 being verified including the cell
location
field 153, medication type field 155, dosage strength field 157, NDC number
field
159, shelf location field 161, and status information field 163. Screen 186
also
displays a reference image of the physical appearance of the medicament 188
together
with a word description 190 of the physical appearance of the medicament 11.
In this
example of the Cardura medicaments 11, the word description 190 is white
oblong
tablet. A screen display similar to display 186 of Figure 17, including a
reference
image 188 and word description 190, may be displayed to the technician during
the
holder-loading process associated with screen 143 to assist the technician in
placing
the correct medicament(s) 11 into each cell 33.
Upon selection of a row 165, PLC 79 of controller 17 again selectively
activates each indicator 49, preferably an LED lamp, for each cell 33 to be
verified by
the pharmacist. As with the loading process, this pick-to-light capability
enables the
pharmacist to rapidly confirm that the correct medicament 11 has been loaded
into the
correct cell 33 without the necessity for reliance on written verification
instructions.
The pharmacist can quickly compare the physical appearance of each medicament
11
in each indicated cell 33 without the necessity of reliance solely on written
instructions. This process is facilitated by presentation of screen 186 and
the
reference image and description information 188, 190 as the pharmacist can
quickly
compare the appearance of the medicament 11 on screen 186 with the appearance
of
the medicament(s) 11 in each cell 33 associated with an activated indicator
49.
Thus, in the verification example of Figures 16-17, each indicator 49
associated with each of cells indicated by the human-readable indicia 47 "1,
3, 6, 9,
12, 15, 18, 21, 24, 27" into which Cardura tablets was to be loaded, is
activated by
PLC 79 of controller 17 (or computer 117 in system 10') during the
verification
process. Each other indicator 49 is inactive.
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If screen 186 is provided, selection of the DONE icon 192 returns the
pharmacist to screen 185 for selection of the next medicament 11 to be
verified.
Once all cells 33 associated with a row 165 are verified, the technician then
selects the
next row 165 of medicaments to be verified and proceeds to verify the
medicament(s)
in each cell 33 as directed by indicators 49. The indicator or indicators 49
previously
activated are deactivated and the appropriate indicators 49 for the next
medicament 11
are activated. This process is repeated until all medicaments 11 have been
verified as
called for by screen 185.
Once all rows 165 and medicaments 11 are verified, the pharmacist selects the
HOLDER VERIFIED icon 189. Selection of icon 189 sends a signal to server 107
of
system 10 (or server 124 of system 10') indicating to system 10 that holder 13
has
been fully verified and that the medicament 11 contents are in the correct
cells 33
ready for use with automated dispensing machine 45. A record may be made of
the
verified medicament 11 contents of holder 13 cells 33 which may be stored in a
database residing on server 107 (or server 124). Such a record is useful in
further
confirming that the correct medicaments 11 were loaded in holder 13. Each
verified
holder 13 can then be stored in cabinet 169 awaiting use, or the holder 13 and
its
medicament 11 contents can be taken directly to automated dispensing machine
45 for
immediate loading of medicaments 11 into exception storage apparatus 43.
Referring now to Figures 18-20, there is shown an exemplary automated
dispensing machine 45 and exception storage apparatus 43 which may be quickly
and
accurately loaded with medicaments 11 using holder 13 or 13' or 13".
Dispensing
machine 45 includes a cabinet 191 with top and bottom walls 193, 195 and left
and
right sidewalls 197, 199. A touch-screen video display 201 is mounted to
sidewall
199. Display 201 includes controls permitting a technician or pharmacist to
control
operation of automated dispensing machine 45 and to receive information about
the
status of the medicament filling process.
Exemplary automated dispensing machine 45 includes twenty pull-out drawers
of which drawers 203 are exemplary. In the example, drawers 203 are organized
into
five rows of four drawers 203. Each drawer 203 supports a plurality of
removable
cassette-type storage apparatus (not shown), each of which stores a large
quantity of
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bulk-form medicaments 11. The cassettes can be replenished as medicaments 11
stored therein are depleted.
Exemplary automated dispensing machine 45 further includes a pair of doors
205, 207 which cover exception storage apparatus 43 as shown in Figure 18 and
which can be opened as shown in Figures 19-20. As previously described,
exception
storage apparatus 43 may be provided to store and to dispense "slow mover"
medicaments 11 loaded therein. In the example, automated dispensing machine 45
includes a single exception storage apparatus 43. However, any number of
exception
storage apparatus 43 may be provided based on the needs of the operator.
In the example, exception storage apparatus 43 is a drawer or tray-like device
which can be pulled out from cabinet 191 as shown in Figures 19-20. When in
the
state of Figures 19-20, automated dispensing machine 45 is temporarily shut
down
and is out of service and unavailable to fill prescription orders and dispense
requests
while exception storage apparatus 43 is pulled out from cabinet 191.
Therefore, it is
important to load exception storage apparatus 43 as promptly as possible to
return
automated dispensing machine 45 to service.
The exception storage apparatus 43 shown in Figures 19-20 can be described
as having a somewhat flat and narrow configuration with a plurality of cells
41
provided therein. Each cell 41 of exception storage apparatus 43 is capable of
storing
one medicament 11, or a small quantity of medicaments 11 as illustrated in
Figures
21A-22. In the example, cells 41 include 64 total cells grouped in four rows
of 16
cells.
Cells 41 are indexed for movement along a track (not shown) in exception
storage apparatus 43. Cells 41 are indexed forward along the track toward an
opening
(not shown) in the bottom of apparatus 43 so that the contents of each cell 41
fall
through a cell bottom opening (not shown) and to a packaging device within
automated dispensing machine 45 through chutes, hoppers or other guide
structure, or
by a mechanical device such as an auger. Medicaments 11 may be discharged from
cells 41 by any other suitable means including a movable gate (not shown) over
a cell
bottom outlet (not shown), or by a solenoid, air-powered actuator, air-jet, or
mechanical arm which ejects the medicament through an upper cell inlet 209 of
the
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type shown in Figure 19A. The medicaments 11 fall via chutes, guides to a
packaging
device or are directed to packaging device by mechanical means (e.g. an
auger).
In the example, automated dispensing machine 45 includes a pouch-package-
type packaging apparatus (not shown) within a lower portion of cabinet 191.
Alternatively, packaging apparatus capable of packaging medicaments 11 into
other
container types (e.g., bottles, vial, blister packages) may be utilized. A
pouch-
package-type packaging device includes a form-fill-seal packaging device. A
"form-
fill-seal" packaging device forms a package (i.e., a pouch) in a web of
packaging
material, fills the package with the medicament(s), and seals the package
forming a
plurality of discrete packages, or pouches.
In the example, one or more medicament 11 discharged from the cassette-type
storage apparatus (not shown) or exception storage apparatus 43 is loaded into
separate pouches 202 formed (e.g., by heat-sealing or sonic welding) in a web
of
packaging material 204 as illustrated in Figure 22. Information can be printed
on each
pouch 202 by a printer (not shown) associated with automated dispensing
machine 45
and such information can include the patient's name 206, medicament name and
quantity 208, prescription number 210, date 212, instructions for taking the
medicament 214 (such as time of day the medicament is to be taken) and machine-
readable indicia 216 (such as a bar code) representative of the aforesaid
information.
Pouch packages are ideal for use in administering medication regimens because
the
exact medicaments to be taken at a given time can be packaged together in a
single
pouch, and the pouches can be organized and labeled in the exact order in
which each
medicament is to be taken, for example, morning, noon and evening. An
exemplary
automated dispensing machine 45 is a model ATP 320, 371, or 384 dispensing
machine available from Chudy Group, LLC of Powers Lake, Wisconsin.
Transfer of medicaments 11 from holder cells 33 to exception storage
apparatus 43 will now be described in connection with Figures 21A-21C. In the
example, cells 33 of holder 13 are positioned and arranged so that they have a
pattern
which is identical to that of cells 41 in exception storage apparatus 43.
Holder 13,
therefore, can be placed directly on top of exception storage apparatus 43 as
shown in
Figure 20 and Figures 21A-21C with each cell 33 and 41 completely aligned and
in
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registry. In the example, holder 13 and exception storage apparatus 43 each
have 64
total cells 33, 41 grouped in four rows of 16 cells. Human-readable indicia
211 is
preferably provided on exception storage apparatus 43 (Figure 19A) so that
each cell
33 on holder 13 has the same indicia 47 as indicia 211 on exception storage
apparatus
43. The cell 33 pattern and indicia 47 of holder 13 is most preferably
identical to the
cell 41 pattern and indicia 211 of exception storage apparatus 43.
Referring again to Figures 20 and 21A-21C, the verified holder 13 is taken to
exception storage apparatus 43 of automated dispensing machine 45 by a
technician or
pharmacist. Holder 13 is set on top of exception storage apparatus 43. Legs
51, 53
position holder 13 over exception storage apparatus 13 as shown, for example,
in
Figures 21A-21C to ensure that holder 13 is in the correct orientation on
exception
storage apparatus 43 with correct alignment of cells 33, 41. Once aligned,
holder 13
is initially in the position shown in Figure 21A.
At this point in the process, identification element 81 is detected by
detector
84 of automated dispensing machine 45. If the correct holder 13 is positioned
over
exception storage apparatus 43, the technician/pharmacist is given a prompt
signal by
video display 201. If an incorrect holder 13 is positioned over exception
storage
apparatus 43, then display 201 prompts the technician/pharmacist to not
transfer the
medicaments 11 and may present an error message and/or alarm. In addition,
system
10 or 10' may deactivate automated dispensing machine 45 preventing automated
dispensing machine 45 operation until the correct holder 13 is in place or the
technician/pharmacist overrides the system 10, 10'.
Prior to medicament 11 transfer and as shown in Figure 21A, shuttle member
55 is in its "closed" position with cell 33 outlets 39 covered by shuttle
member 55.
Medicaments 11 cannot exit cells 33 in this closed position.
Next, and as shown in Figure 21B, the technician grasps pull 61 and moves
shuttle member 55 in the direction of arrow 217. Movement of shuttle member 55
in
the direction of arrow 217 partially opens cell outlets 39 as openings 59 in
shuttle
member 55 are aligned with cell outlets 39. As a result, medicaments 11 begin
to fall
by means of gravity into the aligned cells 41 of exception storage apparatus
43.
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Finally, and as shown in Figure 21C, the technician moves shuttle member 55
fully in the direction of arrow 217 by means of pull 61 to fully align
openings 59 in
shuttle member 55 with cell outlets 39. Cells 33 are fully open in this
position
causing medicaments 11 in cells 33 to fall into the corresponding cells 41 of
exception
storage apparatus 43. Exception storage apparatus is now correctly loaded and
is
ready for dispensing and packaging of the slow mover medicaments 11 stored in
cells
41. This loading process shown in Figures 21A-21C is very rapid (less than one
minute) and enables automated dispensing machine 45 to be quickly returned to
service.
Systems 10, 10' accurately and rapidly enable loading of medicaments 11 in
the exact order in which the medicaments 11 are to be loaded into exception
storage
apparatus 43. The medicaments 11 are rapidly verified by the system 10, 10'
and
docking station 15 in a way which is not possible based solely in reliance on
written
instructions. This is because selective operation of the indicators 49 permits
pharmacy personnel to load and verify the contents of holder 13 without having
to
take his or her eyes off of the holder 13 to read instructions. Each exemplary
system
10, 10' therefore, speeds the holder-loading process while at the same time
providing
a high confidence level that each cell 33 and 41 has been loaded with the
correct
medicament 11. Accurate loading of medicaments 11, in turn, provides a better
level
of care for all patients which, of course, is always the primary objective of
any
pharmacy, hospital, long-term care facility or other care-giver.
And, time required for selecting, verifying, and loading medicaments 11 into
the automated dispensing machine is significantly decreased. This frees
pharmacists
to better serve their patients and enables the automated dispensing machine 45
to be
immediately returned to service. The result once again is improved patient
care and
reduced cost of operation to the pharmacy, hospital, long-term care provider
or other
operator.
Further Exemplary Embodiments
Referring now to Figures 23-53, there are illustrated further exemplary item-
management systems 1010, 1010'. As with systems 10, 10', systems 1010, 1010'
are
described in the context of a preferred item-management system for management
of
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medicament 1011 items.
A sensor guide 1301, 1301' may be used with systems 1010, 1010' to provide
heightened accuracy in loading holder 1013, 1013'. Sensor guide 1301, 1301'
provides for medicament detection and for positive feedback confirming that
the
medicament 1011 or other item placed into holder 1013, 1013' was correctly
placed
into holder 1013, 1013' providing an opportunity to reduce human-factors-
related
errors as described herein.
System 1010 illustrated in Figures 23-36 facilitates accurate and rapid
loading
of a holder 1013 in the form of a container used in loading an automatic
dispensing
machine 49. System 1010' illustrated in Figures 37-52 facilitates accurate and
rapid
loading of a holder 1013' in the form of a container known as a blister
package.
The terms "holder" and "container" are used interchangeably throughout this
document. A "holder" or "container" means or refers to an apparatus which
holds
one or more items, such as medicaments 1011. Blister packages are a type of
holder
and container and are identified herein by reference number 1013'.
In the examples, each holder 1013, 1013' is used in conjunction with a
respective docking station 1015, 1015' to which holder 1013 or holder 1013'
may be
temporarily docked. A controller 1017 may include one or more control capable
of
operating systems 1010, 1010'. As with the above-described embodiments, the
term
"at least one controller," therefore, means or refers to embodiments in which
controller 1017 includes one or more controller components. Controller 1017
may
include components internal and/or external to docking station 1015, 1015'.
For simplicity and brevity, like reference numbers of system 1010 are used to
identify like or similar parts of system 1010'.
In the example of system 1010, medicaments 1011 are loaded in holder 1013
in the exact order in which medicaments 1011 are to be loaded into exception
storage
apparatus 43 of automated dispensing machine 45, examples of which are
described
above. This may be the order in which the medicaments 1011 are to be taken by
the
patient. Once transferred to exception storage apparatus 43, automated
dispensing
machine 45 will package the medicaments 1011 into one or more pouch package
202
as described in connection with systems 10, 10' and as illustrated, for
example, in
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Figure 22. Each pouch package 202 is subsequently delivered to a patient for
whom
the medicament 1011 is intended. If pouch packages 202 are arranged in the
order in
which the medicaments 1011 are to be taken, the patient merely opens one pouch
202
after the other and takes the medicament 1011 therein in accordance with the
prescription order provided by the patient's physician.
In the example of system 1010', the medicaments 1011 may also be loaded in
an order required by a prescription order, for example in the order in which
the
medicaments 1011 are to be taken by a patient in accordance with the
physician's
instructions. Automated dispensing machine 45 is not needed for system 1010'
because, after closure, holder 1013' becomes the container given to the
patient. In
embodiments, the patient can merely push against a cell 1033 which then causes
the
medicament 1011 to be pushed out of the holder 1013' through a closure 1042
(e.g., a
foil safety seal) as described herein.
As with the previous embodiments, systems 1010, 1010' utilize visible
information to assist pharmacy personnel (e.g., a technician, pharmacist or
other user)
in the loading and any verification of the contents of holder 1013, 1013'
without
having to take his or her eyes off of holder 1013, 1013' to read written
instructions
which may be written on a piece of paper. For each of systems 1010, 1010', the
user
simultaneously sees the medicament 1011, the cell 1033, sensor guide opening
1317
and visible information at the moment the medicament 1011 is hand loaded into
the
cell 1033 which improves the accuracy of the prescription fulfillment and
minimizes
the risk of error.
Systems 1010, 1010' make the tedious, labor-intensive, and time-consuming
process of loading holders 1013, 1013' easier and faster, particularly if
different types
of medicaments 1011 must be loaded into separate cells 1033 of the same holder
1013, 1013'. Each exemplary system 1010, 1010' therefore, provides an
opportunity
for better patient care because there is an improved confidence level that the
correct
medicament 1011 is being provided to the patient in accordance with the
physician's
instructions and because time saved administering medicaments can be allocated
to
other aspects of patient care provided by the pharmacy, hospital, long-term
care
facility or other care-giver.
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Systems 1010, 1010' may be configured and arranged based on the needs of
the pharmacy, hospital, long-term care facility or other operator. While it is
envisioned that embodiments of systems 1010, 1010' will be utilized in the
health-
care industry for loading of medicaments 1011, it should be understood that
such
systems and others may have application in fields outside of the health-care
industry
for management and dispensing of items other than medicaments 1011. For
example,
small parts could be loaded into a holder 1013 or a holder 1013' of a blister-
package-
type 1013.
Referring next to Figures 28-31 and Figures 23-25, and 27, exemplary holder
1013 of system 1010 will now be described. Exemplary holder 1013 may be used
for
loading an automatic dispensing machine 49 in the same manner as described
previously in connection with systems 10, 10' and holders 13, 13', 13".
Holder 1013 illustrated in Figures 28-31 includes a body 1019, a top and a
bottom 1021, 1023, a front and a rear side 1025, 1027, and a left and a right
side 1029,
1031. Holder 1013 includes cells 1033, each of which is defined by a wall
1035. In
the example of holder 1013, cells 1033 and walls 1035 define an oval shaped
cell
1033. The oval shape could match an oval shape of cells 41 of exception
storage
apparatus 43. For brevity, only certain of the cells 1033 are indicated by
reference
numbers 1033 and 1035, it being understood that each cell 1033 has the same
structure in the example.
Holder 1013 has a tray-like appearance in that it is a flat, shallow container
used for carrying, holding, and organizing items which are preferably
medicaments
1011. As illustrated in Figures 28-31, holder 1013 is a portable container
which can
be easily carried by a user from docking station 1015 to automatic dispensing
machine
49 for transfer of medicaments 1011 from holder 1013 to exception storage
apparatus
43. However, other configurations of holder 1013 may be utilized depending on
the
needs of the user.
In the examples, each cell wall 1035 of holder 1013 defines a cell 1033 upper
opening, or inlet 1037, and a cell lower opening, or outlet 1039. As shown in
the
examples, the cell inlets 1037 extend through, and are included in and along,
the body
top 1021 while the cell outlets 1039 extend through, and are included in and
along, the
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body bottom 1023. Medicaments 1011 are loaded into each cell 1033 through
inlet
1037 and are discharged from cell 1033 through outlet 1039.
In the examples, each cell 1033 is identical in structure. However, it is
possible that cells 1033 of holder 1013 may have a structure which is not
identical and
which may differ depending on the needs of the user.
Referring again to Figures 28-31, the illustrated exemplary holder 1013 is
provided with sixty four total cells 1033 organized into four rows of 16 cells
1033. In
the examples, the organization of cells 1033 is identical to the organization
of cells 41
of exception storage apparatus 43 of automated dispensing machine 45 described
above in connection with Figures 18-21C. Exemplary holder 1013 is configured
and
arranged such that each cell 1033 outlet 1039 is in registry with (i.e.,
aligned with) a
corresponding cell 41 of exception storage apparatus 43 permitting direct
movement
of medicaments 11 from holder 1013 into exception storage apparatus 43 in the
same
manner as cells 33 are aligned with cells 41 as shown in the example of
Figures 21A-
21C. Cells 1033 can be of any number and need not be arranged in rows and
columns
as illustrated. For example, cells 1033 could be arranged in any number of
rows,
columns, or other patterns to correspond to cells 41 of an exception storage
apparatus
43 other than as illustrated or for use in transferring medicaments 1011 or
items to a
device other than exception storage apparatus 43.
Holder top 1021 is preferably provided with human-readable indicia 1047
identifying each cell 1033. In the examples, indicia 1047 is an integer from 1
to 64
proximate each cell 1033. Other types of indicia 1047 may be used, such as
alpha-
numeric indicia.
Holder 1013 further includes at least one indicator 1049" for each cell 1033,
of
which indicator 1049" is representative. For purposes of simplicity and
brevity, each
indicator 1049" of holder 1013, 1013' is indicated by reference number 1049",
it
being understood that each indicator 1049" has the same structure in this
example.
Each indicator 1049" is located through holder 1013 body 1019 from bottom 1023
to
top 1021. In the example, indicators 1049" are organized into four rows of 16
indicators 1049"corresponding to the pattern of cells 1033 of holder 1013 and
positioned so as to be below each cell 1033 and approximately centered on each
cell
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CA 02846365 2014-03-14
1033. One indicator 1049" is provided for each cell 1033 for a total of sixty
four
indicators 1049" in the example, although other indicator types and
arrangements may
be provided as described herein.
Each indicator 1049" may be a visible information source in the form of a
selectively-operable light pipe. A light pipe means or refers to a light-
transmissive
device used for transporting or distributing natural or artificial light. The
indicators
1049" may be of molded plastic, fiber optics, or other light-communicating
materials.
Each indicator 1049" (and indicators 1049', 1049" ' described herein) includes
a first
end 1054, or inlet, a body 1056, and a second end 1058, or outlet. Light
(i.e., visible
information) from a light source such as an LED indicator 1049 which enters
the inlet
1054, is communicated through body 1056 to outlet 1058. When docked at docking
station 1015, indicator 1049" is aligned with docking station indicators 1049,
1049' to
receive and communicate light. Indicators 1049, 1049', 1049"communicate light
so
that the light is visible to a user on holder 1013 top 1021.
Holder 1013 further includes a pair of front legs 1051 and a pair of rear legs
1053 depending from holder 1013 bottom side 1023. Leg pairs 1051, 1053 may be
provided to support holder 1013 on a surface (such as workstation counter top
1085).
Referring to the bottom plan view of Figure 31, exemplary holder 1013 further
includes a planar shuttle member 1055 positioned in planar track 1057 in
holder 1013
proximate each cell 1033 outlet 1039. Shuttle member 1055 includes openings
1059
and a pull 1061 which permits the technician or pharmacist to grasp shuttle
member
1055 with his or her hand and to pull or push shuttle member 1055.
In the example, shuttle member 1055 is movable between a first position
shown in Figures 28, 28A, and 31 in which shuttle member 1055 covers and
closes
each cell 1033 outlet 1039 in the same manner as illustrated in Figure 21A for
holder
13 and a further position in which the shuttle member 1055 openings 1059 are
in
alignment with each cell 1033 outlet 1039, thereby opening each cell outlet
1039
permitting medicaments 1011 to drop from each cell 1033 into a corresponding
cell of
exception storage apparatus 43 in the same manner as illustrated in Figure 21C
for
holder 13. The first position of shuttle member 1055 is referred to herein as
a "cell-
closed position" and the further position of shuttle member 1055 is referred
to herein
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CA 02846365 2014-03-14
as a "cell-opened position." In between these positions, the cells 1033 are
partially
open permitting medicaments 1011 to start to fall from cells 1033. This
intermediate
position would be the same as for holder 13 illustrated in Figure 21B.
In the embodiments, shuttle member 1055 serves as a sliding gate or closure,
opening and closing each cell 1033 as shuttle member 1055 moves and slides
between the cell-closed (e.g., Figure 2IA) and cell-opened positions (e.g.,
Figure
21C). Shuttle member 1055 thereby blocks each cell outlet 1039 in the cell-
closed
position permitting a medicament 1011 to be loaded into each cell 1033 for
organizing
and storage and further opens each cell outlet 1039 permitting each medicament
1011
to be discharged from holder 1013 for loading into exception storage apparatus
43 in
the same manner as described in connection with holder 13 and Figures 21A-21C
above.
Body 1019 also preferably includes a bar code 1132 (Figure 24) with a code
uniquely identifying holder 1013.
Holder 1013 may be made of any suitable material or combination of
materials. Preferably, body 1019 is made of plastic material construction for
reasons
of ease of manufacture, low weight and portability, ease of cleaning, and
cost.
Indicators 1049" are preferably light pipe-type indicators but may comprise
other
types of indicators.
Referring now to Figures 45-47 and Figures 37-39 and 52, exemplary holder
1013' of system 1010' will next be described. As illustrated, holder 1013' is
a
portable blister-package-type container for managing and organizing
medicaments
1011. In the example, a loaded holder 1013' can be delivered to a patient as
an
integrated container including medicaments 1011 as required to fulfill the
patient's
prescription order. For simplicity and brevity, like reference numbers of
holder 1013
are used to identify like parts of holder 1013'.
Exemplary holder 1013' includes a body 1019, a top and a bottom 1021, 1023,
a front and a rear side 1025, 1027, and a left and a right side 1029, 1031.
Holder
1013' further includes cells, of which cell 1033 is representative. Holder
1013 cells
1033 are referred to by some in industry as "wells" and the terms cells and
wells are
used interchangeably herein. Each cell 1033 is defined by a wall 1035, of
which wall
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1035 is representative. In the example of holder 1013', cells 1033 and walls
1035
have an elongate "D" shape (in cross-section), which is a shape employed in
certain
blister-package-type containers. Other cell 1033 and wall 1035 shapes may be
utilized. For purposes of simplicity and brevity, each cell 1033 of blister
package
1013 is indicated by reference number 1033 and each wall is indicated by
reference
number 1035, it being once again understood that each cell 1033 has the same
structure in the example. Exemplary holder 1013' has a tray-like appearance in
that it
is a flat, shallow container used for carrying, holding, and organizing items
which are
preferably medicaments 1011.
Each wall 1035 defines a cell 1033 upper opening, or inlet 1037 and a cell
bottom 1040. As shown in the examples, the cell inlets 1037 extend through,
and are
included in and along, the body top 1021. In the embodiments, medicaments 1011
are
loaded into each cell 1033 through inlet 1037.
In the embodiments, each cell 1033 is identical. However, it is possible that
cells 1033 of holder 1013' may have a structure which is not identical and
which may
differ depending on the needs of the user. For example, certain cells 1033 of
holder
1013' could have a depth or a cross-sectional shape which differs from the
depth and
cross-sectional shape of other cells of holder 1013'.
Referring further to Figures 45-47 and 37-39 each illustrated exemplary
blister
package 1013' includes thirty two total cells 1033 organized into eight rows
of four
cells 1033. The illustrated organization of cells 1033 is merely exemplary.
Cells
1033 can be of any number and need not be arranged in rows and columns as
illustrated. For example, cells 1033 could be arranged in any number of rows
and
columns, in a circular pattern, or in any other suitable arrangement.
A closure 1042 may be affixed to body 1019 to cover cell inlets 1037 and
provide an integrated and sealed blister-package-type holder 1013'. Closure
1042
may be of a thin foil, paperboard, or other suitable material capable of
closing holder
1013'. Closure 1042 may be joined to body 1019 by any suitable means including
adhesive(s), sonic bonding (i.e., plastic welding), and heat sealing. Holder
1013'
protects medicaments 1011 and other items therein from contact with the
outside
environment and provides a convenient container with which to deliver the
contents
2014-03-13
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CA 02846365 2014-03-14
of the holder 1013' to the patient or other end user.
Before or after loading of holder 1013', an adhesive-backed label 1044 may be
affixed to holder 1013'. Label 1044 may include all information needed for use
of
holder 1013' as a self-contained, sealed, patient-specific container which may
include
a course of medicaments 1011 as prescribed by a physician. Alternatively,
holder
1013' may include a non-patient-specific label (not shown) generally
identifying the
medicament 1011 contents so that the holder 1013' can be subsequently
delivered to
any patient requiring the medicaments 1011.
Label 1044 may include any suitable information including patient name 1046
(e.g., "John Doe"), physician name 1048 ("Dr. Jane Smith"), medicament name,
strength, and NDC number 1050 (e.g., "Naproxen Anaprox 375mg", 11-digit NDC
"00093014801"), instructions 1052 and a unique barcode 1054. In addition or as
a
substitute for label 1044, the aforementioned information may be printed
directly on
closure 1042, preferably before joining closure 1042 to body 1019.
Body 1019 may, for example, be made of material capable of having the cells
1033 formed therein by processes such as thermoforming or cold forming. In
embodiments, a preferred material for body 1019 is polyvinyl chloride (PVC)
sheet.
The PVC sheet may be between about 0.008 and about 0.012 inches in thickness,
as
an example. PVC sheet is inexpensive and can be thermo-formed to form cells
1033.
The material selected for body 1019 may be selected so that cells 1033 are
collapsible by pushing with a human finger. Closure 1042 is preferably
breakable so
that a medicament 1011 within cell 1033 can be pushed through closure 1042 and
out
of holder 1013' for use. In other embodiments, body 1019 may be of a
relatively
thicker plastic sheet material which does not collapse, thus forming a rigid
tray. In
such an embodiment, closure 1042 may be of a "peel-off' type to permit access
to
medicaments 1011 or other items within cells 1033.
Body 1019 may be light-transmissive, and preferably transparent, thereby
permitting the contents of each cell 1033 to be seen through bottom 1023
without
opening holder 1013'. Body 1019 could also be translucent or opaque as
required, for
example for ultra-violet light protection of medicaments 1011 therein.
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-45-
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Closure 1042 affixed to holder 1013' may include human-readable indicia (not
shown) identifying each cell 1033 and/or providing information to assist the
patient
comply with the physician's instructions. Closure 1042 is a suitable surface
for
indicia because it can have a relatively large surface area suitable for
printing. For
example, indicia on closure 1042 could include a day of the week and/or time
at
which a particular medicament 1011 is to be removed from blister-package-type
holder 1013' and taken by the patient. Other types of indicia and information
may be
provided used.
Referring next to Figures 23-28A, 36 and Figures 37-44B, 50 and 52, there are
shown embodiments of docking stations 1015, 1015' capable of use with a
respective
exemplary holder 1013, 1013'. Each docking station 1015, 1015' may be placed
on a
counter top 1085, such as the counter top 1085 at a workstation in a pharmacy,
long-
term care facility, hospital, or other facility.
Each exemplary docking station 1015, 1015' preferably includes housing 1089
including top and bottom walls 1091, 1093, left and right side walls 1095,
1097 and
front and rear walls 1099, 1101. As illustrated in Figures 23-28A, docking
station
1015 may include a pair of rear legs 1102, 1104 attached to rear wall 1101
which
raises the rear wall 1101 so that docking station 1015 is angled down toward
front
wall 1099.
As illustrated in Figures 37-39 and 41, exemplary docking station 1015' is
supported with a cradle 1106. Cradle 1106 may be made of a single piece of
metal
sheet or other material and may have a rear leg 1108 which may be elongated to
angle
docking station 1015' toward front wall 1099, a deck 1110 on which docking
station
1015' rests, and a front retainer 1112 against which front wall 1099 rests to
retains
docking station 1015' on cradle 1106. Angling docking stations 1015, 1015'
toward
front wall 1099 may help a technician, pharmacist, or other user better see
medicaments 1011 or other items at the moment the medicament 1011 enters the
holder 1013, 1013' and in an optional subsequent verification process.
As illustrated in Figures 24-27, and 37-38 and 41, exemplary docking stations
1015, 1015' may further include structure permitting sensor guide 1301, 1301'
to be
removed from a holder 1013, 1013' and temporarily stored on docking station
1015,
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1015'. Docking station 1015 may include a seat 1114 formed by uprights 1116
and
rear legs 1102, 1104. Seat 1114 is provided to temporarily hold sensor guide
1301
upright away from holder 1013. In the example of docking station 1015', sensor
guide 1301' may simply be placed on end resting against rear wall 1101 of
docking
station 1015'. These arrangements permit holder 1013, 1301' to be docked and
undocked from docking station 1015, 1015', permit optional verification of a
loaded
holder 1013, and permit use of systems 1010, 1010' without sensor guide 1301,
1301'
as described herein.
In the embodiment of system 1010 illustrated in Figures 23-28A, docking
station 1015 housing 1089 is generally rectangular in shape, although any
shape may
be utilized. Housing 1089 has a generally planar top wall 1091 and may include
resilient pads (not shown) on which holder 1013 rests when docked at docking
station
1015.
Referring to Figures 23-27, holder 1013 and docking station 1015 may include
locating structure which cooperates to enable or facilitate repeatable docking
of holder
1013 with docking station 1015 in a single and identical position. As
illustrated in
Figures 23-27, such locating structure may comprise a pair of female alignment
pin
receivers 1063 on opposite sides 1029, 1031 of holder 1013 and a pair of male
alignment pins 1065 on docking station 1015. Male alignment pins 1065 are
received
in a respective receiver 1063 when holder 1013 is docked with docking station
1015.
The mechanical interconnection of receivers 1063 and corresponding pins 1065
locates holder 1013 at docking station 1015 in a single and identical position
and
constrains holder 1013 from lateral movement. The exemplary locating structure
permits plural different holders 1013 to be repeatedly docked in a single and
identical
position with a single docking station 1015.
Locating structure for holder 1013 may further include an alignment guide
1223 (Figure 26) along docking station 1015 housing 1089 rear wall 1101.
Alignment
guide 1223 is received in recess 1225 provided in holder 1013. Alignment guide
1223
cooperates with alignment pin receivers 1063 and male alignment pins 1065 to
limit
lateral movement of holder 1013.
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-47-
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In the embodiment of Figures 37-39, 41-44B, docking station 1015' housing
1089 is generally rectangular in shape although, as with docking station 1015,
any
shape may be utilized. In this illustrated embodiment, housing 1089 top wall
1091 is
preferably planar and includes a plurality of pockets 1229. For convenience
and
brevity, select pockets are indicated by reference number 1229, it being
understood
that the other pockets have the same structure. Pockets 1229 are provided to
receive
cells 1033 of holder 1013' nested therein for purposes of locating holder
1013' at a
known position on docking station 1015'.
In the examples, pockets 1229 have an arrangement or pattern which matches
the pattern of holder 1013' cells 1033. Each pocket 1229 is defined by a wall
1231, of
which wall 1231 is representative. Each wall 1231 defines a pocket upper
opening
1233. In the example of docking station 1015', pockets 1229 have an elongate
"D"
shape (in cross-section) which matches and is complementary to the elongate
"D"
shape of holder 1013' cells or wells 1033. In the embodiments, the cells 1033
of
holder 1013' are inserted into pockets 1229. Walls 1035 defining cells 1033
may be
sized to fit snugly within a respective pocket 1229. The complementary
elongate "D"
shapes of the cells 1033 and pockets 1229 may serve as a type of key which
helps to
position holder 1013' in a single orientation in docking station 1015'.
Preferably,
holder 1013' body 1019 and bottom 1023 rest on top wall 1091 of housing 1089
during the process of loading medicaments 1011 into each cell 1033 through
cell inlet
1037.
The aforementioned arrangement limits lateral movement of holder 1013' in
any lateral direction. Since holder body 1019 and bottom 1023 preferably rest
on top
wall 1091, holder 1013' is effectively held in place in position to receive
the
medicaments 1011 or other items therein which is of particular importance when
seeking to load holder 1013'accurately. This also locates holder 1013' at a
known
position which is important so that the location of each cell 1033 is known to
system
1010' as previously described in connection with system 1010.
In the examples, docking station 1015' is configured to simultaneously dock
from one to four separate and distinct holders 1013'. Docking station 1015'
illustrated in Figures 37-39 and 44A-44B includes four groups of thirty two
total
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-48-
CA 02846365 2014-03-14
pockets 1229 for a total of 128 pockets 1229. Each of the four groups is
organized
into four columns of eight pockets (8 rows x 4 columns) 1229a, 1229b, 1229c,
1229d
to accommodate a holder 1013' having 32 cells 1033 in a pattern which matches
that
of a group of pockets 1229a-1229d. As illustrated in Figures 38-39 and 42A, a
holder
1013' is shown nested in one of the groups of pockets 1229a.
Docking station 1015' top wall 1091 is preferably provided with human-
readable indicia 1103 identifying each cell pocket 1229. In the examples,
indicia
1103 is proximate each pocket 1229 and is an integer from 1 to 32 for each
group of
pockets 1229. Other types of indicia may be used, such as alpha-numeric
indicia.
It can be important that docking station 1015' provide adequate support for
holder 1013' during loading or subsequent verification. Providing support can
be
important because the material used for holder 1013' body 1019 is frequently
quite
thin and pliant. In the example, docking station 1015' top wall 1091 and
pockets
1299, particularly if cells 1033 are snugged against pockets 1229, provide
multiple
points of support across holder 1013' body 1019 and cells 1033. The support
provided by docking station 1015' top wall 1091 and pockets 1229 ensures that
such a
holder 1013' will not collapse during loading, potentially resulting in loss
of costly
medicaments 1011.
As illustrated in Figures 42-43, yet another benefit of pockets 1229 is that
they
permit holder 1013' cells 1033 to fit within docking station 1015' with holder
1013'
top 1021 flush and essentially co-planar with docking station 1015' top wall
1091.
Since holder 1013' is closely against docking station 1015', sensor guide
1301' may
be placed closely against holder 1013' to "sandwich" holder 1013' between
docking
station 1015' and sensor guide 1301' so that the structure of sensor guide
1301'
continuously guides medicaments 1011 all the way into the appropriate cell
1033 as
described herein. Thus, pockets 1229 serve to locate, potentially support, and
permit
full seating of holder 1013' with docking station 1015' in the example.
As previously described, it is possible that holder 1013' cells 1033 for the
blister-package-type container can have a structure other than the rows and
columns
illustrated or in which there are differences in structure amongst the cells.
Previously-
described examples include cells 1033 with different depths or with different
cross-
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-49-
CA 02846365 2014-03-14
sectional shapes. To accommodate these different cell 1033 arrangements and
types,
holder 1013' pockets 1229 can be sized, shaped, and configured to match the
pattern
of cells 1033.
In the example, holder 1013'is illustrated with pockets 1229 integrated into
housing 1089 so that holder 1013' is a single unit. In other embodiments,
docking
station 1015' could have a generally planar top wall 1091 and indicators 1049
and/or
1049', but sized, shaped, and configured to receive a removable adapter (not
shown)
including the pockets 1229 in a pattern which could be identical to the
pattern of 128
pockets 1229 illustrated in Figures 38-40 and 44A-44B. The adapter could
include an
indicator identical to indicator 1049' next to each pocket 1229 and in
alignment with
an indicator 1049 or 1049' when the adapter is mounted on the docking station.
Plural different adapters could be utilized interchangeably with the same
docking
station 1015', each with a pocket 1229 pattern to accommodate a different
holder
1013'. It is possible, therefore, that a single docking station 1015' could
accommodate multiple different types of holders 1013' by means of an adapter.
Referring to the schematic block diagram of Figure 53, exemplary holder
1013, 1013' and docking station 1015, 1015' may be provided with apparatus for
uniquely identifying holder 1013, 1013' to docking station 1015, 1015' and
system.
Positive identification of holder 1013, 1013' enables the user to precisely
control
loading of appropriate medicaments 1011 into holder 1013 and 1013' permits the
user
to maintain more accurate records of medicaments 1011 which have been loaded
and
dispensed.
In such embodiments, holder 1013, 1013' may include an identification
element 1081 and docking station 1015, 1015' may include an identification
element
detector 1083 as shown in Figure 53. The identifier element 1081 may, for
example,
consist of a radio frequency identification tag (RFID) and the detector 1083
may be an
RFID tag reader (i.e., an interrogator) on docking station 1015, 1015'. The
exemplary
RFID tag 1081 may be re-writable or read-only, as desired. Exemplary RFID
reader
1083 provided on docking station 1015, 1015' detects information embedded on
the
RFID tag 1081. Information embedded in RFID tag 1081 identifying holder 1013,
1013' may be used by system 1010, 1010' to control the medicament-dispensing
2014-03-13
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CA 02846365 2014-03-14
process. The unique identifier of the RFID tag 1081 could be matched to a file
for the
patient or holder 1013, 1013' in database 1371 to associate such holder with
the
patient's prescription order. By way of further example, holder 1013, 1013'
may
include other types of identifier elements, such as a bar code 1132, (Figures
24, 47)
and detector is a barcode scanner 1131 to identify holder 1013, 1013'
For embodiments utilizing holder 1013', an identification element detector
1083 may be provided apart from docking station 1015, 1015' at any appropriate
physical location at which identification of holder 1013' is desired. For
example, an
identification element detector 1083 could be provided at the patient's
bedside to
identify holder 1013' and confirm that holder 1013' is for the intended
patient.
Detection of the identification element 1081 corresponding to the holder 1013'
intended for the patient, could be used to prompt the care giver to deliver
holder 1013'
to the patient. Conversely, if an incorrect holder identification element 1081
is
detected by detector 1083, the care giver would not provide the holder 1013'
to the
patient.
For embodiments utilizing a holder 1013, an identification element detector 84
may be provided on automated dispensing machine 45 (Figures 19, 20) as
previously
described. In the example utilizing RFID tags, detector 84 may comprise an
RFID
reader. If the correct holder 1013 identification element 1081 is detected by
detector
84, the technician, pharmacist, or other user is prompted to transfer
medicaments 1011
from holder 1013 to exception storage apparatus 43. Conversely, if an
incorrect
holder identification element 1081 is detected by detector 84, the technician,
pharmacist, or other user is prompted to not transfer medicaments 1011 from
holder
1013 to exception storage apparatus 43.
Referring to Figures 28-28A and 36 and Figures 38-44B and 50-52, exemplary
docking stations 1015, 1015' include a plurality of indicators 1049, 1049'
within
housing 1089. Indicators 1049 may be lamp-type indicators which emit or
communicate light energy as indicated in Figures 28-28A and 42-42A. Exemplary
indicators 1049 separately represent individual light sources and,
collectively,
represent a light source. Indicators 1049 are preferably directed toward
docking
station top wall 1091 and are provided in a pattern which matches the pattern
of the
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-51-
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cells 1033 of holders 1013, 1013' such that at least one indicator 1049 is
provided for
(i.e., associated with) each cell 1033. Preferably, each indicator 1049 is a
light-
emitting diode (LED), although it is envisioned that other types of indicators
1049
may be used. Indicators 1049 may all be mounted on a single circuit board 1237
within housing 1089. Circuit board 1237 represents circuitry operatively
connected to
controller 1017 enabling controller 1017 to selectively control indicators
1049, 1049'
as discussed herein.
Referring to Figures 28-28A and 36 and Figures 42-42A and 44A-44B,
exemplary docking stations 1015, 1015' further include a plurality of
indicators 1049'
within housing 1089 between indicators 1049 and top wall 1091 of housing 1089.
In the examples, each indicator 1049' may be a visible indicator in the form
of a
selectively-operable light pipe of the type described in connection with
indicators
1049"of holder 1013 and the description of such indicators 1049" is
incorporated
herein by reference. Indicators 1049' include first and second ends 1054,
1058, and
body 1056. Each indicator 1049' is aligned with an indicator 1049 and receives
light
from indicator 1049 in first end 1054. Indicator 1049' body 1056 communicates
the
light through housing 1089 so that light is visible to a user from indicator
1049'
second end 1058 at top wall 1091 of docking station 1015, 1015'. In the
example of
system 1010, light from indicators 1049' is communicated to aligned holder
1013
indicators 1049" when the holder 1013 is docked. In the example of system
1010',
light from indicators 1049' is viewable by a user next to, or proximate, a
pocket 1229.
In the docking station embodiment 1015, indicators 1049, 1049' are most
preferably provided in a pattern which matches the pattern of holder 1013
cells 1033
and indicators 1049" of holder 1013 such that at least one indicator 1049,
1049' is
provided for (i.e. associated with) each cell 1033. In the example, indicators
1049,
1049' are organized into four rows of 16 indicators 1049, 1049' corresponding
to the
pattern of cells 1033 of holder 1013 and positioned so as to be below each
cell 1033
and approximately centered on each cell 1033 when a holder 1013 is docked at
docking station 1015.
When docked, holder 1013 is seated or docked on docking station 1015 such
that indicators 1049"of holder 1013 are in alignment with indicators 1049,
1049' of
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-52-
CA 02846365 2014-03-14
docking station 1015 and light energy from indicators 1049, 1049' is
communicated
through a corresponding aligned holder 1013 indicator 1049 to the top wall
1021 of
holder 1013.
In the docking station embodiment 1015', holder 1013' is preferably a
container of a blister-package-type and does not include indicators 1049". In
this
embodiment, indicators 1049, 1049' are most preferably provided in a pattern
on
docking station 1015' which matches the pattern of holder 1013' cells 1033
such that
at least one indicator 1049, 1049' is provided for (i.e., associated with)
each cell 1033
when a holder 1013' is docked in one of the group of pockets 1229a-1229d. In
this
example, indicators 1049, 1049' are organized into four groups of 32 total
pockets
1229 for a total of 128 indicators 1049, 1049'. Each of the four groups of
indicators
1049, 1049' is organized into four rows of eight indicators 1049, 1049', one
group
corresponding to each group of pockets 1229a, 1229b, 1229c, 1229d. In this
example,
indicators 1049, 1049' are positioned so as to be above each pocket 1229 and
approximately centered on each pocket 1229 with the effect being that
indicators
1049, 1049' are positioned slightly above and centered on cells 1033 of a
docked
holder 1013.
The foregoing examples illustrate that the location of indicators 1049, 1049'
is
not critical. Indicators 1049, 1049' may be provided in various locations to
communicate visible information to assist the technician, pharmacist, or other
user to
load a medicament 1011 in the correct cell 1033. In other embodiments, it is
envisioned that indicators (e.g., indicators 1049) could be located entirely
off of
docking station 1015, 1015' with the visible information from indicators 1049,
projected onto holder 1013, 1013', by for example, lasers, mirrors,
projectors, or fiber
optics.
Exemplary indicators 1049, 1049', are selectively-operable in that, they
selectively communicate light energy, which is a type of visible information.
When
an indicator 1049 is activated, the aligned indicator 1049' communicates light
information to top 1021 of holder 1013'. Conversely, when an indicator 1049 is
not
activated, the aligned indicator 1049' does not communicate light information
to top
1021 of holder 1013. The preferred light energy provided by indicators 1049,
1049'
2014-03-13
-53-
CA 02846365 2014-03-14
may be viewable to a user on the holder 1013, 1013' proximate each cell 1033
to
indicate the cell 1033 into which a medicament 1011 or other item is to be
placed.
Preferably, the light energy provided by indicators 1049, 1049' is viewable to
a user on holder 1013' of a blister-package-type because holder 1013' body
1019 may
be made of a transparent plastic material. The light energy is viewable
through the
light-transmissive transparent plastic material of body 1019 along top 1021 of
holder
1013'. In other embodiments, an opening (not shown) in body 1019 could be
provided proximate each cell 1033. Each opening would be in alignment with one
of
the indicators 1049' when holder 1013' cells 1033 are nested within pockets
1229 of
docking station 1015'.
Referring next to Figures 23-28A and 32-36 and Figures 37-43 and 48-52, a
sensor guide 1301, 1301' may optionally be provided to detect the physical
presence
of medicaments 1011 or other items loaded into cells 1033 of holder 1013,
1013'. In
the example, sensor guide 1301, 1301' serves as a guide to aid in correct
loading of a
holder 1013, 1013'. Sensor guide 1301, 1301' provides positive feedback to
controller 1017 indicative that a medicament 1011 or other item has been
loaded into
the correct cell 1033 of holder 1013, 1013'. Sensor guide 1301, 1301' can
provide
feedback for a medicament 1011 overcount and undercount. And, sensor guide
1301,
1301' can provide positive feedback indicative that a medicament 1011 or other
item
has been loaded into an incorrect cell 1033 of holder 1013, 1013'.
Responsive to detection of an erroneous loading of a medicament 1011 by
sensor guide 1301, 1301', controller 1017 can generate a signal. The signal
may
include an error description presented to a user on video display 1125 as
described in
connection with Figures 60-66 and 79-85. The error description may include a
description of an overcount, an undercount, and an incorrect cell and can
include
instructions describing the error and how to correct the error.
The information provided by sensor guide 1301, 1301' to controller 1017 can
be used for numerous purposes, including to create a record that the holder
1013,
1013' was loaded properly and to make loading more efficient.
In the embodiments illustrated by Figures 23-28A and 32-36 and Figures 37-
43 and 48-52, sensor guide 1301, 1301' may overlie holder 1013, 1013'.
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Medicaments 1011 or other items are detected as they pass through sensor guide
1301,
1301' during loading into a cell 1033 to alert the user in the event of an
error so that
corrective action can be taken. In the embodiments, exemplary sensor guides
1301,
1301' have essentially the same structure and operation, except that each
sensor guide
1301, 1301' is sized, shaped, and configured to function with the respective
holder
1013, 1013' and docking station 1015, 1015'.
Exemplary sensor guide 1301, 1301' may include a body 1303, a top and a
bottom 1305, 1307, a front and a rear side 1309, 1311, and a left and a right
side 1313,
1315. Exemplary sensor guide 1301, 1301' has a planar, generally rectangular
shape
which corresponds to docking station 1015, 1015'. Bottom 1307 is preferably
generally planar to permit sensor guide 1301, 1301' to abut holder 1013 or
1013' top
1021. Sensor guide 1301, 1301' includes openings 1317, each defined by a wall
1319. For convenience, only certain of openings and walls 1317, 1319 are
indicated
by reference numbers, it being understood that the other openings and walls
are the
same in the embodiments.
In the example of sensor guide 1301, openings 1317 and walls 1319 have an
oval shape which matches and aligns with the oval shape of holder 1013 cells
1033
and cell inlets 1037. In the example of sensor guide 1301', openings 1317 and
walls
1319 have an elongate "D" shape which matches and aligns with the elongate "D"
shape of holder 1013' cells 1033 and cell inlets 1037 and pockets 1229 of
docking
station 1015'. Other shapes of openings 1317 and walls 1319 may be utilized.
The
aligned cell 1033 walls 1035 and sensor guide opening 1317 walls 1319 form a
continuous guide surface from openings 1317 into cell 1033, particularly if
holder top
1021 and sensor guide bottom 1307 abut, which constrains medicaments 1011 to
enter
and stay in the cell 1033 into which they are placed by the user (e.g., a
technician or
pharmacist).
Sensor guide 1301 may further include four legs 1316, one leg 1316 at each
corner of sensor guide 1301. Legs 1316 may be seated in a recess 1318 in
holder
1013 top wall 1021 to locate sensor guide 1301 in a single repeatable position
on
holder 1013 and docking station 1015.
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As is well illustrated in Figures 28-28A and 42-42A, each sensor guide 1301,
1301' opening 1317 is aligned with a corresponding cell 1033 of a holder 1013
or
1013'. In the embodiments of Figures 23-28A and 32-36, sensor guide 1301 is
sized
for use with a holder 1013 which includes sixty four cells 1033 as previously
described. In this example, sensor guide 1301 is provided with 64 openings
1317
organized into a pattern of four rows of 16 openings (4 rows x 16 columns)
1317 to
match the pattern of the sixty four cells 1033 of holder 1013.
In the embodiment of Figures 37-52, sensor guide 1301' is sized for use with
from one to four holders 1013'. In this example, sensor guide 1301' is
provided with
128 openings 1317 organized into a pattern of four groups of 32 openings (8
total
rows x 16 total columns) 1317a, 1317b, 1317c, 1317d to match the pattern of
the 128
pockets 1229a-1229d of docking station 1015'.
Sensor guide top 1305 is preferably provided with human-readable indicia
1323 identifying each cell 1033. In the examples, indicia 1323 is an integer
from 1 to
32 for each group of 32 openings 1317 proximate each cell 1033. Other types of
indicia may be used, such as alpha-numeric indicia.
As illustrated in Figures 28-28A, exemplary sensor guide bottom 1307 may
rest directly against holder 1013 top 1305 with legs 1316 seated in recess
1318 in
holder 1013 top wall 1021. As illustrated in Figure 37-43, sensor guide 1301'
bottom
1307 may rest directly against holder 1013' top 1021. Top 1021 is preferably a
flat
planar surface in a blister package embodiment. Each sensor guide opening 1317
is in
alignment with one of the holder 1013' cells 1033. In other embodiments,
sensor
guide 1301, 1301' may be spaced from holder 1013 or 1013'. Sensor guide 1301
of
system 1010 may include a recess 1225 which receives pull 1061 of holder 1013
when
sensor guide 1301 rests on holder 1013.
Referring to Figures 38-39, 43-43B and 49B, exemplary sensor guide 1301'
includes four interlock switches 1320, one for each of the four groups of
pockets
1229a-1229d and openings 1317a-1317d to indicate to controller 1017 that a
holder
1013' is docked, or not docked, at one of such positions of docking station
1015'.
Two of the four interlock switches 1320 are illustrated in Figures 43-43B, it
being
understood that each other interlock switch 1320 has the same structure and
operation.
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Interlock switches 1320 include a spring-loaded (e.g., biased) plunger 1322
which
extends toward pocket 1324 in top 1021 of docking station 1015'.
Figures 43A and 43B illustrate sensor guide 1301' seated on docking station
1015'. In Figure 43A a holder 1013' is docked at pockets group 1229a and no
holder
1013' is docked at pockets group 1229b. In Figure 43A, body 1019 of docked
holder
1013' covers pocket 1324 in docking station 1015'. Also in Figure 43A, plunger
1324
contacts body 1019 and closes interlock switch 1320. Closure of interlock
switch
1320 generates a signal to controller 1017 indicating that a holder 1013' is
docked in
the associated one of the group of pockets group, in this example pockets
group
1229a. Controller 1017 permits operation of indicators 1049, 1049', 1049" '
for
pockets 1229 and openings 1317 for pockets group 1229a and openings group
1317a.
As illustrated in Figure 43B, no holder 1013' is docked at pockets position
1229b and pocket 34 of docking station 1015' is uncovered by a holder 1013'.
In this
state, plunger 1322 is biased to extend into pocket 1324 and, consequently,
interlock
switch 1320 remains open. When interlock switch 1320 is open, controller 1017
disables activation of indicators 1049, 1049', 1049" for the associated group
of
pockets and openings, which is pockets group 1229b and openings group 1317b in
this example. Consequently, a user cannot be prompted by indicators 1049,
1049',
1049" ' to load a medicament 1011 where no holder 1013' is docked.
Sensor guides 1301, 1301' may include structure to ensure that they are
located in a single, repeatable position on holder 1013, 1013'. Sensor guide
1301
preferably includes legs 1316 and interference between legs 1316 and recess
1318
locates sensor guide 1301, in a single position.
Referring now to Figures 28-28A and 34-36 and Figures 42-42A and 50-52, a
sensor module 1325 may be provided within sensor guide 1301, 1301' for each
sensor
guide opening 1317 to detect the physical presence of a medicament 1011 or
other
item which falls through sensor module 1325. For convenience and brevity,
select
modules are indicated by reference number 1325, it being understood that the
other
modules have the same structure and operation in the examples.
As illustrated in Figure 34, sensor guide 1301 may include 64 sensor modules
1325, one for each opening 1317. Like openings 1317, sensor modules 1325 are
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arranged in four rows of 16 sensor modules 1325 and each sensor module 1325 is
aligned with an opening 1317.
As illustrated in Figure 50, sensor guide 1301' may include 128 sensor
modules 1325, one for each opening 1317. In this example, sensor modules 1325
are
organized into a pattern of four groups of 32 total sensor modules (8 total
rows x 16
total columns) 1325a, 1325b, 1325c, 1325d. Each of the four groups of sensor
modules 1325 is organized into eight rows of four sensor modules 1325, one
group
corresponding to each group of pockets 1229a, 1229b, I229c, 1229d and openings
1317a-1317d. In this example, each sensor module 1325 is aligned with an
opening
1317 of sensor guide 1301'.
Referring to Figures 28-28A, 34-37, 42-42A, and 50-52, an exemplary sensor
module 1325 may include a first housing portion 1327 and a second housing
portion
1329. When assembled, housing portions 1327, 1329 include an opening 1331
through which a medicament 1011 or other item passes.
A pair of infrared (IR) senders 1333 are positioned at one end of sensor
module 1325 directed into opening 1331 and an infrared (IR) receiver 1335 is
spaced
from senders 1333 across opening 1331 at an opposite end of sensor module
1325.
A lens support 1337 supports first and second lenses 1339, 1341. First lens
covers IR sender 1333 and second lens covers receiver 1335 protecting sender
1333
and receiver 1335 from damage by contact with medicament 1011 or other
objects.
Lenses 1339, 1341 may be made of polycarbonate or other suitable IR-energy-
transmissive materials. First lens 1339 preferably permits passage of IR
energy from
sender 1333 while blocking ambient light external to sensor guide 1301, 1301'
thereby intensifying the IR energy from sender 1333. Second lens 1341 is
preferably a
narrow slit which permits a narrow band of IR energy to contact receiver 1335.
The
collective effect of lenses 1339, 1341 is to minimize false detection events
that could
be caused by shadows or movement of a user's hand near a sensor module 1325.
Each sensor module 1325, and IR sender and receiver 1333, 1335 may be
operatively connected to circuitry in the form of a printed circuit board
1343. Circuit
board 1343 may be connected to docking station 1015, 1015' via a flexible
cable
1345. Docking station 1015, 1015' is operatively connected to controller 1017
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permitting sensor module 1325 to send a signal to controller 1017 indicative
that a
medicament 1011 has been detected.
As illustrated in Figures 28-28A and 42-42A, during operation, IR sender
1333 emits, generates, or outputs a signal in the form of IR energy. The IR
energy is
across opening 1331 and through second lens 1341. The IR energy signal is
received
through second lens 1341 by IR receiver 1335. When a medicament 1011 or other
item passes through opening 1331 between IR sender 1333 and IR receiver 1335,
IR
energy received by IR receiver 1335 is momentarily blocked.. The decrease in
IR
energy causes sensor module 1325 to output a signal in the form of a voltage
output
change which is interpreted by controller 1017 as detection of a medicament
1011 or
other item passing through sensor module 1323. Plural medicaments 1011 can be
passed through sensor module 1325 and a separate count will be registered by
controller 1017 for each medicament 1011.
Sensor module 1325 may be mounted within (i.e., inside) sensor guide 1301,
1301' in any suitable orientation. In the example of sensor guide 1301, each
sensor
module 1325 is oriented generally parallel to left and right sides 1313, 1315
of sensor
guide 1301 whereas in the example of sensor guide 1301' sensor module 1325 is
oriented generally parallel to front and rear sides 1309, 1311 of sensor guide
1301.
It is contemplated that sensor guides 1301, 1301' may be implemented in
embodiments other than the illustrated sensor guides 1301, 1301'. For example,
sensor guide 1301, 1301' may be an integral element of docking station 1015,
1015'
or holder 1013. In such embodiments, a sensor module 1325 may be provided for
each cell 1033. An appropriate data-communication connection, 1343, 1345 may
be
provided between each sensor module 1325 and controller 1017.
As illustrated in Figures 28-28A and 42-42A, sensor guide opening walls 1319
may extend below sensor guide bottom 1307 and be sized to nest within a
corresponding cell 1033 of holder 1013, 1013'. In such an embodiment, each
sensor
guide wall 1319 extends into the corresponding cell 1033 of holder 1013, 1013'
and
nests into wall 1035 of cell 1033 providing a continuous guiding surface from
opening
1317 through and into cell 1033 thus assuring that a medicament 1011 or other
item
can only enter the cell 1033 of holder 1013, 1013' aligned with each opening
1317 of
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sensor guide 1301, 1301'. Such an embodiment would be particularly useful when
spacing between sensor guide 1301, 1301' and holder 1013, 1013' is desired.
The
continuous guide surface formed by walls 1035, 1319 would prevent unwanted
bouncing of a medicament 1011 from one cell 1033 to another cell 1033 which
could
occur when a medicament 1011 or other item is loaded into a cell 1033. Such an
embodiment would also help to position sensor guide 1301, 1301' in the single,
repeatable position on holder 1013, 1013'.
Sensor guide 1301, 1301' further includes at least one indicator 1049" ' for
each cell 1033, of which indicator 1049" is representative. ( The symbol "
refers to
triple prime.) For purposes of simplicity and brevity, each indicator 1049" '
of sensor
guide 1301, 1301' is indicated by reference number 1049", it being understood
that
each indicator 1049" has the same structure and operation in the example.
Indicators 1049" / are preferably provided in a pattern which matches the
pattern of cells 1033 and indicators 1049', 1049" of docking station 1015,
1015' and
holder 1013 indicators 1049"such that at least one indicator 1049" ' is
provided for
(i.e., associated with) each opening 1317 and cell 1033. In the examples, each
indicator 1049" ' is located through sensor guide 1301, 1301' body 1303 from
the top
1305 of sensor guide 1301, 1301' to the bottom 1307 of the sensor guide 1301,
1301'.
In the example of sensor guide 1301, indicators 1049" ' are organized into
four
rows of 16 indicators 1049" ' corresponding to the pattern of cells 1033 of
holder 1013
and openings 1317 of sensor guide 1301 and positioned so as to be below each
opening 1317 and approximately centered on each opening 1317. As illustrated
in
Figures 28-28A, each exemplary indicator 1049, 1049', 1049", 1049" for each
respective cell 1033 is in axial alignment when holder 1013 is docked at
docking
station 1015 and sensor guide 1301 is docked or mounted on top of holder 1013.
Exemplary sensor guide 1301' includes indicators 1049" ' organized into four
groups of 32 total indicators 1049" / for a total of 128 indicators 1049" ' in
the same
manner as indicators 1049, 1049' of docking station 1015. Each of the four
groups of
indicators 1049" ' is organized into eight rows of four indicators 1049" ',
one group
corresponding to each group of pockets 1229a-129d and openings 1317a-1317d. As
with indicators 1049, 1049' of docking station 1501', indicators 1049" are
positioned
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so as to be above each opening 1317 and approximately centered on each opening
1317. As illustrated in Figures 42-42A and 50-52, each indicator 1049, 1049',
1049"
for each respective cell 1033 is in axial alignment when holder 1013' is
docked at
docking station 1015' and sensor guide 1301' is docked or mounted on top of
holder
1013'.
In the examples, each indicator 1049" ' may be a visible indicator in the form
of a selectively-operable light pipe of the type described in connection with
indicators
1049' and 1049"of docking station 1015, 1015' and holder 1013 and the
description
of such indicators 1049', 1049" is incorporated herein by reference. When
sensor
guide 1301, 1301' is seated on a docked holder 1013, 1013', indicator 1049" '
is
aligned with indicators 1049, 1049', 1049" (all a visible information source)
and
receives light, a type of visible information, from such indicators. In the
examples,
light (i.e., visible information) enters the inlet 1054 of indicator 1049" and
is
communicated through indicator body 1056 to outlet 1058 . Since each set of
indicators 1049 1049', 1049" (for holder 1013), 1049" ' is aligned when in
condition
for operation, indicators 1049, 1049', 1049", and 1049" ' communicate the
light
through sensor guide 1301, 1301' so that light is visible to user along top
wall 1305 of
sensor guide 1301, 1301' next to, or proximate, an opening 1317 of sensor
guide
1301, 1301'.
The preferred light energy provided by indicators 1049, 1049', 1049", and
1049" ' may be viewable to a user on the holder 1013, 1013' top 1305 proximate
each
cell 1033 to indicate the cell 1033 into which a medicament 1011 or other item
is to
be placed. The presence or absence of light energy can be seen by the user at
the
moment the medicament 1011 or other item enters opening 1317 so that the user
has a
confidence level that the medicament 1011 was placed into the correct opening
1317.
Such confidence level is heightened further by detection of the medicament
1011 or
other item by sensor guide 1301, 1301'.
Sensor guides 1301, 1301' may be made of any suitable material or
combination of materials. Preferably, body 1303 is made of plastic material
construction for reasons of ease of manufacture, low weight, ease of cleaning,
and
cost. Indicators 1049" ' are preferably light pipe-type indicators but may
comprise
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other types of indicators. For example, indicators may be LEDs, liquid crystal
displays (LCD) or other visible indicators.
As previously mentioned, systems 1010, 1010' may be used without a sensor
guide 1301, 1301'. Sensor guide 1301, 1301'may be seated in its cradle 1106 or
against docking station 1015' and deactivated or systems 1010, 1010' may be
provided without a sensor guide 1301, 1301'. For example, system 1010' for
loading
holders 1013' of a blister-package-type container can be used without a sensor
guide
1301' by simply placing a medicament 1011 directly into a cell 1033 indicated
by
indicators 1049, 1049'.
Controller 1017 is operable to selectively operate indicators 1049, 1049',
1049", and 1049" associated with each cell 1033 when holder 1013, 1013' is
docked
at docking station 1015, 1015' and sensor guide 1301, 1301' is seated on
holder 1013,
1013'. Each set of indicators 1049, 1049', 1049", and 1049" corresponding to
each
opening 1317, cell 1033, and/or pocket 1229 represents a visible information
source.
Selective operation of indicators 1049, 1049', 1049", and 1049" proximate to a
cell
1033 or sensor guide opening 1317 prompts the technician, pharmacist, or other
user
to place each medicament 1011 into the cell 1033 or opening 1317 associated
with the
activated indicators 1049, 1049', 1049", and 1049".
As with systems 10, 10', indicators 1049, 1049', 1049", and 1049" comprise
a type of pick-to-light/place-to-light system. Thus, if a medicament 1011 is
to be
loaded in the cells 1033 designated by human-readable indicia 1047 as cells 1,
3, 6, 9,
12, 15, 18, 21, 24, and 27, each of the indicators 1049, 1049', 1049", and
1049" next
to such cells 1033 may be activated communicating to the technician,
pharmacist, or
other user the specific cells 1033 which should contain that medicament 1011.
In
other embodiments, indicators 1049, 1049', 1049", and 1049" may be deactivated
to
provide the visible information. In such an embodiment, indicators 1049,
1049',
1049", and 1049" may initially be activated. Deactivation of just the
indicators
1049, 1049', 1049", and 1049" associated with the cell 1033 into which the
medicament 1011 or other item is to be placed provides the visible
information. The
state of indicators 1049, 1049', 1049", and 1049" indicating that a medicament
1011
should be placed into a cell may be thought of as a "yes" state while the
state of
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indicators 1049, 1049', 1049" ' indicating that a medicament should not be
placed into
a cell 1033 may be thought of as a "no" state for the implicit and apparent
reason that
the user is being prompted to either place, or not place, a medicament 1011
into an
indicated cell 1033.
Use of a pick-to-light/place-to-light system of indicators 1049, 1049', 1049",
and 1049" ' advantageously communicates information to the user (e.g., a
technician
or pharmacist) without resort to a set of written instructions. A pick-to-
light/place-to-
light system is far superior to written instructions because the user need not
take his or
her eyes off of holder 1013, 1013' to read the instructions, thereby
increasing accuracy
and reducing the time required to load or verify the medicaments 1011 that
should be
in the holder 1013, 1013'.
In further embodiments, systems 1010, 1010' may have multi-colored
indicators as described in connection with Figures 11A, 11B, and 11C, but
implemented by means of indicators 1049, 1049', 1049", and 1049". For example,
indicator 1049 could comprise a single multi-colored indicator 1049 for each
cell
1033, pocket 1229, and opening 1317. In an embodiment, a multi-colored LED
lamp
could be used as indicator 1049 and the voltage could be changed by controller
1017
so that indicator 1049 would emit a different color as described previously.
Indicators
1049', 1049", and 1049" ' would operate to communicate the color to a position
on
sensor guide 1301, 1301' next to the associated opening 1317 and cell 1033.
The
color differences could be used to communicate information of the type
described
above in connection with Figures 11 A, 11B, 11C and the entire description of
Figures
11A-11C is incorporated herein by reference.
In yet other embodiments of systems 1010, 1010', multiple sets of indicators
may be provided for each cell 1033 and sensor guide opening 1317 (e.g., three
sets of
indicators 1049, 1049', 1049", and 1049" for each cell 1033). Such an
embodiment
may operate under the control of controller 1017 in the same manner and for
the same
purposes as described previously in connection with Figure 11D and the
description of
Figure 11D is incorporated herein by reference.
Also as described previously, controller 1017 can control indicators 1049,
1049', 1049", and 1049" ' to have a blink pattern indicating the medicament
1011 to
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be loaded into the associated cell 1033 through sensor guide opening 1317. A
constant blink could indicate that one medicament 1011 is to be loaded into
the cell,
two blinks could indicate that more than one medicament 1011 is to be loaded
in that
cell 1033, and three blinks could indicate that a half-size medicament is to
be loaded
in that cell 1033. Controller 1017 can also control operation of indicators
1049,
1049', and 1049" for each cell 1033 for verification of medicaments 1011
received in
each cell 1033.
Systems 1010, 1010' may include a controller 1017 as described in connection
with controller 17, but with controller 1017 controlling indicators 1049,
1049', 1049",
and 1049" associated with each cell 1033 and opening 1317. For example,
systems
1010, 1010' could operate with a controller 1017 including a programmable
logic
controller (PLC) 79 and server 107 connected thereto for purposes of
controlling
indicators 1049, 1049', 1049", and 1049" ' as described in connection with
Figures
12A and 12B and the description of such controller 17 embodiments is
incorporated
herein by reference with respect to controller 1017.
Referring to the schematic block diagram of Figure 53, controller 1017 for use
with systems 1010, 1010' is most preferably a client computer 1349 (i.e., a
processing
device) operably connected to data port 1109 of docking station 1015, 1015'
and
communication link 1111. Client computer 1349 may include memory 1113 with a
program of instructions 1115 residing in memory 1113. Client computer 1349 may
be
connected via a communication link 1119 to a pharmacy information system (PIS)
1351 residing on server 1353. The PIS 1351 passes each prescription order to
system
1010, 1010' and client computer 1349 after the prescription order is first
approved by
the PIS 1351. Client computer 1349 then provides overall control of system
1010,
1010'.
Controller 1017 may further be in data-transmission relationship with sensor
guide 1301, 1301'. Detection of a medicament 1011 by each sensor module 1325
is
used by controller 1017 to confirm that a medicament 1011 has been placed into
the
correct cell 1033 and to count the quantity of medicaments 1011 placed into
each cell
1033 as described below.
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Each system 1010, 1010' further preferably includes a video display 1125,
keyboard 1127, and mouse 1129 permitting a technician, pharmacist, or other
user to
input and receive information from client computer 1349 of controller 1017 or
PIS
1351. A biometric identification device 1130 may be provided to permit the
technician, pharmacist, or other user to be identified to the system 1010 or
1010',
particularly when logging on to the system. The biometric device 1130 may be a
fingerprint reader, retina scanner, or other suitable device. A bar code
scanner 1131 is
preferably operably connected to controller 1017. Video display 1125 is
preferably a
touch screen display permitting a technician, pharmacist, or other user to
input
information to controller 1017 by simply touching her finger on a desired
portion of
the display 1125. Bar code scanner 1131 may be any off-the-shelf scanner
capable of
reading a bar code 1133 on a container 1135 provided to hold medicaments 1011.
Keyboard 1127 may be an off-the-shelf QWERTY-type keyboard 1127 permitting a
user to input information to controller 1017 and system 1010, 1010'.
Exemplary Operation and Use
Systems 1010, 1010' may be used with or without sensor guide 1301, 1301',
although use with sensor guide 1301, 1301' provides heightened accuracy and is
preferred.
In embodiments, not including a sensor guide 1301, 1301' or in which the
sensor guide 1301, 1301' is not activated/utilized and is in the storage
position of
Figures 24 and 38, systems 1010, 1010' may be used as described above in
connection
with Figures 14-17, with the information presented on the video display 1125
adjusted
to conform to the number and arrangement of cells 1033 of holder 1013, 1013'.
The
description of operation of systems 10, 10' and Figures 14-17 is incorporated
by
reference with respect to embodiments of systems 1010, 1010'.
More specifically, in exemplary system 1010 holder 1013 is provided with
sixty four cells 1033 arranged in four rows of 16 cells 1033 identical with
holder 13
and the sixty four cells 33 of holder 13. In the examples, the structure of
each holder
13, 1013 and the pattern of the cells 33, 1033 is as required to conform to
cells 41 of
exception storage apparatus 43 of automated dispensing machine 45 as
previously
described. Accordingly, holder 1013 may be loaded and verified in the same
manner
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as described for holder 13 in connection with Figures 14-17 with controller
1017
operating indicators 1049, 1049', 1049", and 1049"to provide the visible
information
directing the user to either load a medicament 1011 into a cell 1033 or to
verify that
the medicament 1011 loaded in each cell 1033 is correct. The result would be a
holder 1013 that has been loaded and verified as correct for transfer of the
medicaments 1011 to automated dispensing machine 45 in the same manner as
described in connection with systems 10, 10'.
And, container loading and verification of a holder 1013' of a blister-package-
type may be loaded and verified in the same manner as described for holder 13
in
connection with Figures 14-17 with holder 1013' docked at docking station
1015' and
controller 1017 operating indicators 1049, 1049', and 1049" 'to provide the
yes or no
state visible information directing the user by means of the yes state visible
information to either load a medicament 1011 into a cell 1033 or to verify
that the
medicament 1011 loaded in each cell 1033 is correct. Once loaded and verified,
holder 1013' may be closed with closure 1042 in a conventional manner for
blister-
package-type containers as described herein.
Use of sensor guide 1301, 1301' is illustrated in Figures 54-72 which
represent
exemplary screen displays of a type which could be displayed to a technician,
pharmacist, or other user on video display 1125 for implementation of system
1010,
while Figures 73-91 represent exemplary screen displays displayed on video
display
1125 for implementation of system 1010'. The screen displays of Figures 54-91
are
intended to represent non-limiting examples as the type and number of screen
displays
can be modified and the information provided in the screen displays may be
customized to meet the needs of the particular pharmacy, hospital, long-term
care
facility or other operator.
Referring then to systems 1010, 1010', a user (e.g., a technician or
pharmacist)
may initiate use of system 1010, 1010' in the same manner as for system 10 by
logging on to the system 1010, 1010'. Preferably, loading of holder 1013,
1013' is
performed by a technician while verification of the loaded holder 1013, 1013'
is
performed by a registered pharmacist. (For simplicity and brevity, the person
operating system 1010, 1010' is referred to as a "user.") The user may log on
via a
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log-on screen 137 (Figure 14) by means of keyboard 1127 entry of a password,
or by
means of a biometric device 1130 as described in connection with Figure 14
with the
result being that the user is recognized as being authorized.
Referring now to Figures 54 and 73, if a holder 1013, 1013' is not already
docked at docking station 1015, 1015' as shown in Figures 23 and 37, then a
New
order screen 1355, 1355' (Figures 54, 73) may be displayed on video display
1125.
The new order screen 1355, 1355' prompts the user to initiate loading of a
holder
1013, 1013' for purposes of loading automatic dispensing machine 49 or for
preparation of a self-contained container 1013', potentially in fulfilment of
a
prescription order.
Information which may be presented on new order screen 1355, 1355' can
include an identification field 1357 identifying the operator name 1359 (e.g.,
Red
Cross Pharmacy). Optionally, the user name, date and time-of-day on which
holder
1013 is being loaded 1360 could be provided. Additional information which may
be
displayed in connection with New order screen 1355, 1355' is an Order field
1361,
which displays all pending prescription orders awaiting attention. In the
examples of
Figures 54 and 73, a single prescription order 1363 is awaiting fulfillment.
Each
prescription order has previously been processed by PIS 1351 and released for
fulfillment to controller 1017.
Order field 1361 may include a patient identifier and transaction code 1365
(e.g., "ID: 218" "Single Patient _02_06_2013_3_18") which indicates the
transaction
corresponding to loading of the holder 1013, 1013' for record-keeping
purposes. In
other embodiments, the name of the person for whom the prescription is
intended may
also be presented. New order screen 1355, 1355' may also show holders 1013,
1013'
available for fulfilment of the order, including the holder identifier 1369
(e.g., "Tray
Number 3") for each holder 1013, 1013'. In the exemplary screen display
examples
of Figures 54-91, "tray" is used synonymously and interchangeably with
"holder" and
"container." Holders 1013, 1013' indicated by 1370 are available to be loaded
with
medicaments 1011 to fulfill the prescription orders.
Preferably, the transaction code and all other information relating to loading
and verification of holder 1013, 1013' is stored in a database 1371 on client
computer
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1349. Holder identifier 1369 may be any symbol or group of symbols capable of
uniquely distinguishing one holder 1013, 1013' from another holder 1013,
1013'.
In the examples, holder identifier 1369 may be identical to an identifier
embedded in
RFID tag-type identification element 1081 if such an element 1081 is provided.
In the
examples, the holder identifier 1369 is the number "3". A unique identifier
1369 can
be important if more than one identical holder 1013 is used by the pharmacy,
hospital,
long-term care provider or other operator. For holder 1013', unique identifier
1369 is
illustrated as number "3" as illustrated in Figure 73.
The user then touches video display 1125 next to an order in Order field 1361
to select the prescription order. In the examples of New order screens 1355,
1355'
illustrated in Figures 54 and 73, there is a single order pending in each
illustrated
Order field 1361. In Figures 54 and 73, the "-" symbol 1372 indicates that the
selected prescription order is being processed. Alternatively, another input
device,
such as a mouse 1129 may be used to select the prescription order. The user
further
selects an available holder 1013, 1013' for the prescription order. By
touching display
next to holder identifier 1369. The row next to holder identifier 1369 may
become
highlighted as illustrated in Figures 54 and 73. The user then touches the
Fill icon
1373 to start the loading process.
Referring next to Figures 55 and 74, the next step in the exemplary process is
to physically get the holder 1013, 1013' for fulfillment of the order. Once
the Fill
icon 1373 is touched, an instruction field 1375 may appear on display 1125.
The
words "Please scan the bar code for the tray" 1377 may appear to prompt the
user to
scan bar code 1132 on holder 1013, 1013' with bar code reader 1131. Controller
1017
validates bar code 1132 and associates the holder 1013, 1013' with the
prescription
order in database 1371. The user may touch the "Ok" icon 1379 following the
scan to
signal to controller 1017 that the bar code 1132 has been read or controller
1017 may
automatically move to the next step. If the holder 1013, 1013' is not valid,
then an
error message (not shown) may be displayed on display 1125 and the user must
obtain
the correct holder 1013, 1013' or otherwise correct the error before
proceeding
further.
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Referring next to Figures 56 and 76, the next step in the exemplary process is
to select a container 1135 (Figure 53) of medicaments 1011 to be loaded into
holder
1013, 1013'. Instructions for the prescription order residing in database 1371
include
the exact type and quantity of medicament 1011 to be loaded into holder 1013,
1013'
and the cell 1033 into which each medicament 1011 is to be loaded.
Instruction field 1381 may appear on display 1125 to prompt the user to select
the container 1135 holding one of the types of medicaments 1011 to be loaded
into
holder 1013, 1013' in accordance with the order. The order may require just a
single
type of medicament 1011 or plural different types of medicaments 1011.
Instruction
field 1381 may display information identifying the type 1383 of medicament
1011 to
be loaded into holder 1013, 1013' (e.g., "Fluoxetine HCL") and the National
Drug
Code (NDC) 1385 associated with that type of medicament 1011 (e.g., the 11
digit
NDC "55111014701"). The words "Please scan the medication bottle" 1387 may
appear to prompt the user to scan the bar code 1133 on container 1135.
In addition, a Medicament-identification field 1388 may appear with further
information identifying the required medicament 1011 including the medicament
type
and strength 1389 (e.g., "Fluoxetine HCL Prozac 10 mg"), FDA and customer NDC
numbers 1391 (e.g., 11-digit NDC "55111014701" and 9-digit customer NDC
"551110147"), medicament 1011 quantity required 1393 (e.g., "1"), physical
appearance 1395 of the medicament 1011 (e.g., "blue/obl/Fluoxetine 10mg
R147"),
manufacturer name 1397 (e.g., "DR. REDDY'S LAB"), expiration date and lot
number 1399 ("Assigned EXP: 2/7/2014" "Lot: C204817").
Also in the examples, a holder-view field 1401 may appear in the background
for the reasons described below. Holder-view field 1401 may be a plan view
graphic
representation of a respective sensor guide 1301, 1301'.
The user then utilizes bar code scanner 1131 to scan bar code 1133 affixed to
container 1135. The code corresponding to bar code 1133 is transmitted to
controller
1017 which validates the code. The code may be validated, for example, by
comparing the code embedded in bar code 1133 with an expected code in database
1371 on client computer 1349 of controller 1017 for the prescription order. If
the
container 1135 is not valid, then an error message (not shown) is displayed on
display
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1125 and the user must obtain the correct container 1135 or otherwise correct
the error
before proceeding further. The "+" symbol 1402 indicates that the container
1135 has
not yet been validated as correct for the prescription order.
Referring next to Figures 57 and 76, if medicament container 1135 is a valid
container with the medicament 1011 required to fulfill the prescription order,
then
Filling screen 1403, 1403' may be displayed to assist the user with loading of
the
required type of medicament 1011 (e.g., Fluoxetine HCL in the examples) into
holder
1013, 1013'. Holder view field 1401 is fully viewable on Filling screen 1403,
1403'.
Holder view field 1401includes a number next to each cell (e.g., 1-64 or 1-32)
which
correspond to indicia 1323 next to opening 1317 on sensor guide 1301, 1301'.
In the
examples of Filling screen 1403, Holder view field 1401 is a plan view of
sensor
guide 1301 and the 64 openings 1317 and aligned cells 1033 of holder 1013. In
the
example of Filling screen 1403', Holder view field 1401 is a generalized plan
view of
sensor guide 1301' and the arrangement of the 128 openings 1317 of sensor
guide
1301' and the aligned cells 1033 of each separate holder 1013'. (i.e., ovals
are
provided corresponding to the elongate "D" shaped cells 1033 of holder 1013')
In
Figure 77, the terms "Card 1", "Card 2", "Card 3", "Card 4" refer to the
position of
each separate holder 1301' which may be docked at docking station 1015'.
In the examples, the Fluoxetine HCL medicament 1011 corresponding to the
validated container 1135 is displayed in medicament-identification field 1388.
Information on any other medicaments 1011 to be loaded into holder 1013, 1013'
may
be turned off to avoid any possible confusion.
Filling screen 1403, 1403' provides instructions to the user regarding which
sensor guide 1301, 1301' opening 1317 and cell 1033 each Fluoxetine HCL
medicament 1011 is to be placed into in these examples. The instructions may
include highlighting of each cell 1405 corresponding to the opening 1317 and
cell
1033 into which the Fluoxetine HCL medicament 1011 is to be hand-loaded by the
user. The contrast between the highlighted oval 1405 indicative of the "yes"
state and
un-highlighted cells 1407 indicative of the "no" state (for convenience only
certain of
the un-highlighted cells are indicated by 1407) enables the user to easily
identify the
opening 1317 and cell 1033 into which the Fluoxetine HCL medicament 1011 of
the
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examples is to be placed.
The instructions of Filling screen 1403, 1403' may further include the
quantity
1406 of medicament(s) 1011 to be placed into opening 1317 and cell 1033. This
may
be accomplished as illustrated in Figures 57 and 76 by displaying a number
(e.g., "1")
within the highlighted cell 1405 corresponding to the required opening 1317
and cell
1033 consistent with the quantity "1"indicated by reference number 1393. In
the
example of Filling screen 1403, a quantity of one 10 mg Fluoxetine HCL is to
be
placed into opening 1317 and cell 1033 identified by the number "5." In the
example
of Filling screen 1403', a quantity of one 10 mg Fluoxetine HCL is to be
placed into
the holder 1013' in the Card 1 position of docking station 1015' and the
holder 1013'
opening 1317 and cell 1033 identified by the number "1." For both Filling
screens
1403, 1403' of Figures 57 and 76, dash "-" symbol 1409 indicates that the
prescription
order is being processed and that the medicament container 1135 was validated
as
correct. (In the screen displays, a dash "-" symbol indicates that processing
is taking
place whereas a "+" symbol indicates that processing is not taking presently
occurring.) The "X" symbol 1411 in or next to medicament-identification field
1388
indicate that the medicament 1011 has not yet been placed into opening 1317
and cell
1033.
Simultaneous with display of Filling screen 1403, 1403', controller 1017
causes docking station 1015, 1015' to provide the visible information to the
user next
to each opening 1317 and cell 1033 into which the medicament 1011 is to be
placed.
In the example of system 1010, this may be accomplished by activating
indicators
1049, 1049', 1049", and 1049" ' next to opening 1317 number "5" of sensor
guide
1301 and aligned cell 1033 number "5" of holder 1013. Indicators 1049, 1049',
1049", and 1049" ' for more than one opening 1317 and cell 1033 may be
simultaneously activated if a medicament 1011 of the same type is to be placed
into
more than one cell 1033 of the same holder 1013. In a further embodiment, the
indicators 1049, 1049', 1049", and 1049" for all openings 1317 and cells 1033
could
be activated to provide the "no" state information while the indicators 1049,
1049',
1049", and 1049" for the cell 1033 into which the medicament 1011 is to be
placed
could be deactivated, with the deactivated indicators providing the "yes"
state
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information.
Referring to Figure 76, in the example of system 1010', controller 1017
activates indicators 1049, 1049', and 1049" next to opening 1317 number "1" of
sensor guide 1301' and aligned cell 1033 number "1" of holder 1013' for a
holder
1013' in the pockets 1229a corresponding to Card 1. If the same type of
medicament
1011 is to be placed into plural openings 1317 and cells 1033, then indicators
1049,
1049', 1049" for such openings 1317 and cells 1033 may be simultaneously
activated
as described above.
Accordingly, the user is provided with visible information both on Filling
screen 1403, 1403' of display 1125 (Figures 57, 76) and from visible
information
sources on sensor guide 1301, 1301' indicating the opening 1317 and cell 1033
into
which the medicament 1011 is to be placed. Filling screen 1403, 1403' and
indicators
1049, 1049', 1049", and 1049" ' make it possible for the user to correctly
load the
medicament 1011 without any reliance on paper instructions. The user can keep
her
eyes on the medicament 1011, opening 1317, cell 1033, and the visible
information
provided by indicators 1049, 1049', 1049", and 1049" at the moment the
medicament 1011 enters opening 1317 and cell 1033 providing a high confidence
level that the medicament 1011 has been placed into the correct cell 1033.
Next, and as illustrated in Figures 28-28A and 42-42A, the user utilizes the
visible information to actually hand-load medicament(s) 1011 into the opening
1317
and cell 1033. In the examples, the user removes one 10 mg Fluoxetine HCL
medicament 1011 from container 1135. The user grips the medicament 1011 with
her
hand and fingers and positions the medicament 1011 just over the sensor guide
opening 1317 and cell 1033 number "5" of the holder 1013 docked at the docking
station 1015 in the example of system 1010 or into sensor guide opening 1317
and
cell 1033 number "1" in the example of system 1010'. The user gently drops the
medicament 1011 into the opening 1317 and cell 1033. Preferably, the
medicament
1011 should be released as close as possible to sensor guide opening 1317.
Gentle
dropping avoids "bouncing" which can occur when a hard medicament 1011 strikes
a
hard surface, such as shuttle 1055 closing cell 1033. Bouncing could cause
medicament 1011 to fall on the floor or land in an incorrect cell 1033.
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Figures 28-28A and 42-42A illustrate entry of a medicament 1011 into a cell
1033. As illustrated, medicament 1011 first falls through opening 1317 of
sensor
guide 1301, 1301'. Medicament 1011 momentarily breaks the IR beam generated by
senders 1333 across opening 1331 onto receiver 1335 causing a voltage drop
which is
detected by controller 1017 as previously described. A single breaking of the
IR beam
would indicate that one medicament 1011 had been placed into an opening 1317
and
controller 1017 would increment one count. A count is incremented or
registered for
each medicament 1011 placed into opening 1317 and cell 1033. In this way, a
total
count of medicaments 1011 placed into each cell 1033 is created and stored in
the
database 1371 residing on client computer 1349.
If the detected count matches the expected count for that cell 1033, then a
record is created in database 1371 that the correct quantity of medicament
1011 was
placed into the cell 1033. If no other cells 1033 are required to be loaded
with this
type of medicament 1011, then controller 1017 may automatically change the
appearance of medicament-identification field 1388 to replace the "X" symbol
1411
with a "Nr" symbol 1415 to indicate that the medicament 1011 has been placed
into the
cell 1033. Plus "+" symbol 1413 indicates that the medicament 1011 required by
Medicament ID field 1388 has been correctly loaded in the expected cell 1033.
Controller 1017 may immediately move to the next type of medicament 1011
to be loaded into holder 1013. Alternatively, the user may manually touch the
Update
icon 1417 which causes controller 1017 to move to the next type of medicament
1011
to be loaded into holder 1013. In the examples, this may be accomplished by
deactivating indicators 1049, 1049', 1049", and 1049" for, in the examples,
opening
1317 and cell 1033 number "5" and by un-highlighting oval 1405 on Filling
screen
1403, 1403'. Then, indicators 1049, 1049', 1049", and 1049" ' for the next
opening
1317 and cell 1033 into which the next type of medicament 1011 is to be loaded
may
be activated and the corresponding cell(s) on Filling screen 1403, 1403' may
be
highlighted as previously described. This same process of indicator 1049,
1049',
1049", and 1049" ' deactivating and activating and displaying an updated
Filling
screen 1403, 1403' can occur automatically without touching Update icon 1417
if
controller 1017 is programmed to operate automatically.
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The foregoing process is repeated until all cells 1033 of holder 1013, 1013'
have been loaded.
Figures 58 and 77 illustrate that the medicaments 1011 (i.e., Fluoxetine 1389
and Furosemide 1389) displayed in the two separate Medicament ID fields 1388
have
been loaded with processing completed as indicated by the "+" 1413 and the
operation
completed "1" symbols 1415. The user may scroll up or down through the
medicament-identification fields 1388 using up/down scroll icons 1416 to
confirm
that a plus "+" symbol 1413 and "Ir" symbol 1415 are present to indicate that
the each
type of medicament 1011 has been placed into each opening 1317 and cell 1033
as
required by the prescription order.
Referring further to Figures 58 and 77, Once all cells 1033 have been loaded,
controller 1017 may cause "Tray Filled" icon 1419 to become highlighted and
the user
may touch Tray Filled icon 1419 to indicate to controller 1017 that the
loading
process has been completed. Touching of Tray filled icon 1419 sends a signal
to
controller 1017 indicating that loading of holder 1013, 1013' has been
completed.
Referring next to Figures 59 and 78, Filled screen 1420, 1420' is next
displayed indicating the status is "filled" completing the loading process.
The status
of holder "3" is indicated as having been filled as indicated by the word
"Filled" 1422.
Each holder 1013, 1013' may optionally be immediately verified by a
pharmacist or may be undocked and stored for subsequent pharmacist
verification
prior to transferring medicaments 1011 from loaded holder 13 into automated
dispensing machine 45 or affixing closure 1042 to holder 1013'. The status of
the
prescription order of Order field 1361 in Figures 59 and 60 is indicated as
"Incomplete" 1424 because verification has not yet occurred.
Sensor guide 1301, 1301' further provides positive feedback to controller 1017
in the event that medicament 1011 is placed into the wrong opening 1317 and
cell
1033 or if a greater or lesser quantity of medicaments 1011 than required has
been
placed into a cell 1033. The feedback is useful to help a user correct any
errors that
could occur when loading holder 1013, 1013'.
Referring to Figures 60 and 79, if a greater than expected quantity of
medicaments 1011 are detected by sensor guide 1301, 1301', then system 1010,
1010'
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enters an overcount mode. The signal provided by sensor module 1325 increments
or
registers counts by controller 1017 for the opening 1317 and cell 1033. In an
overcount mode, controller 1017 may cause Overcount warning screen 1421, 1421'
to
be immediately displayed with the cell 1405 corresponding to the opening 1317
and
cell 1033 including the excess quantity of medicaments 1011 surrounded by a
blinking box 1423. An Error field 1425 including a text message 1427
describing the
overcount error can be displayed.
In the examples of Figures 60 and 79, the text message 1427 informs the user
that the quantity of medicaments 1011 in the cell 1033 designated by number
"5"
exceeds the expected count by one medicament 1011. In addition, controller
1017
may blink the indicators 1049, 1049', 1049", and 1049" ' for the opening 1317
and
cell 1033 including the overcount to indicate to the user the opening 1317 and
cell
1033 requiring attention.
Referring further to Figures 60 and 79, in response to the Overcount warning
screen 1421, 1421', the user can elect to correct the error immediately or can
elect to
correct the error upon completion of loading all medicaments 1011 into holder
1013,
1013'. In the examples, the user can touch the Correct Now icon 1429 or the
Correct
Later icon 1437.
Figures 61 and 80 may next be displayed responsive to touching the Correct
Now icon 1429. Controller 1017 may cause video display to display Correction
field
1431 with instructions 1433 for correcting the error. In the examples,
Corrections
field 1431 prompts the user to place the sensor guide 1301, 1301' in the
storage
position of Figures 24 and 38 and to inspect cell 1033 number "5" for the one
medicament 1011 overcount. Once the error is corrected, the "Resume" icon 1435
may be touched indicating to controller 1017 that the error has been corrected
and to
proceed with loading the next cell 1033. Controller 1017 may update database
1371
to indicate that the error has been corrected. The user can then proceed to
load the
next cell 1033. Or, if a different type of medicament 1011 is to be loaded,
controller
1017 can then cause display of the next Filling screen 1403, 1403' so that the
user can
load the next type of medicament 1011 into holder 1013, 1013'.
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Referring again to Figures 60 and 79, as an alternative to immediate
correction
of the overcount error, the user can elect to touch Correct later icon 1437 to
correct the
error upon completion of loading all medicaments 1011 into holder 1013, 1013'.
Figures 62 and 82 illustrate instructions which may be displayed if the
Correct later
icon 1437 is selected. Once all cells 1033 have been loaded, Correction field
1439
(Figures 62, 82) may appear with instructions for correcting the previous
error to the
cell 1033 identified by number "5". In the examples, Correction field 1439
prompts
the place sensor guide 1301, 1301'in the storage position (Figures 24, 38) and
to
inspect the cell 1033 identified by number "5" for a single medicament 1011
overcount. Once the overcount error is corrected, the user touches the Resume
icon
1441.
Referring now to Figures 63 and 82, if more than one error occurred, then
controller 1017 may display Warning field 1443 notifying the user that another
cell
1033 requires error correction. In the examples, instructions 1445 in Warning
field
1443 prompt the user to correct an overcount in the cell 1033 designated by
number
"6". The user may touch Ok icon 1447 whereupon Correction field 1439 (Figures
62,
81) is displayed prompting correction of the overcount error as preciously
described.
If the user does not correct the errors, then controller 1017 deactivates
system 1010,
1010' requiring the user to take further action to correct the error or start
over.
Referring to Figures 64 and 83, if fewer than the expected quantity of
medicaments 1011 are detected by sensor guide 1301, 1301' and controller 1017,
then
system 1010, 1010' enters an undercount mode. In an embodiment, an undercount
can occur if the required quantity of medicaments 1011 is not detected as
having been
placed into the opening 1317 and cell 1033 and the user touches the Update
icon 1417
(Figures 57, 76) to move to loading the next type of medicament 1011. In
another
embodiment in which controller 1017 automatically moves to the next medicament
type (i.e., without touching Update icon 1417), an undercount could occur if
the
required quantity of medicaments 1011 is not detected as having been placed
into the
opening 1317 and cell 1033 within a predetermined time. A timer decremented by
controller 1017 can be used to determine whether the predetermined time has
elapsed
before detection of the required quantity of medicaments 1011.
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Referring further to Figures 64 and 83, in the event of an undercount,
controller 1017 may cause Undercount warning screen 1449, 1449' to be
displayed
and can cause the cell 1405 corresponding to the opening 1317 and cell 1033
including the undercount to be surrounded by a blinking box 1423 in the same
manner
as described for the overcount error mode. An Error field 1455 including a
text
message 1457 describing the undercount error and prompting addition of the
required
quantity of medicaments 1011 can be displayed. In the examples, the text
message
1457 prompts the user to add one medicament 1011 to the opening 1317 and cell
1033
designated by number "5". In addition, controller 1017 may blink the
indicators 1049,
1049', 1049", and 1049" ' for the opening 1317 and cell 1033 including the
undercount to indicate to the user the opening 1317 and cell 1033 requiring
attention.
In response, the user adds the required quantity of medicament(s) 1011 to the
opening 1317 and cell 1033 causing detection of the added medicament(s) 1011
by
sensor module 1325 and controller 1017 incrementing or registering the
required
counts and updating of the database 1371 for that cell 1033 to reflect loading
of the
correct quantity of medicaments 1011. The user then touches the Resume icon
1451
indicating to controller 1017 that the error has been corrected and to proceed
with
loading the next cell 1033. Controller 1017 may update database 1371 to
indicate that
the error has been corrected.
While not illustrated in the figures, systems 1010, 1010' may be configured to
permit correction of the undercount error upon completion of loading all
medicaments
1011 into holder 1013, 1013' in the same manner as previously described in
connection with correction of the overcount error, but with the screen
displays and
information modified to indicate an undercount error. If the user does not
correct the
undercount error, then controller 1017 deactivates system 1010, 1010'
requiring the
user to take further action to correct the error or start over.
Referring now to Figures 65-66 and 84-85, an incorrect cell error mode is
entered if the medicament 1011 is accidentally placed in an incorrect opening
1317.
During routine loading, the opening 1317 and cell 1033 into which a medicament
1011 is to be placed is indicated by Filling screens 1403, 1403' and by
indicators
1049, 1049', 1049", and 1049" ' for the opening 1317 and cell 1033 as
previously
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described.
If a medicament 1011 is detected by sensor guide 1301, 1301' and controller
1017 as having been placed into an opening 1317 and cell 1033 other than as
indicated, then controller 1017 may cause Incorrect Cell warning screen 1453,
1453'
to be displayed. Controller 1017 can further cause both the cell 1405
corresponding to
the correct opening 1317 and cell 1033 and the incorrect cell 1454
corresponding to
the opening 1317 and cell 1033 into which the medicament 1011 was incorrectly
placed to be surrounded by a blinking box 1423 in the same manner as described
for
the overcount and undercount error modes. An Error field 1458 including a text
message 1460 describing the undercount error and prompting addition of the
required
quantity of medicaments 1011 can be displayed.
Since an incorrect cell error should be corrected immediately, the correct
later
option for the overcount and undercount modes is not available for the
incorrect cell
error correction mode. The resume icon 1459 is touched to correct the error.
Figures 66 or 85 may next be displayed responsive to touching the resume icon
1459
including Correction field 1461 with instructions 1463 for correcting the
error. In
these examples, Correction field 1461 prompts the user to place the sensor
guide
1301, 1301' in the storage position of Figures 24 and 38 and to inspect cell
1033
numbers 5 and 8. In the examples, the instructions 1463 inform the user that a
medicament 1011 intended for cell number "5" was incorrectly placed in cell
number 8.
In response, the user places the sensor guide 1301, 1301' in the storage
position (Figures 24, 38) and reaches into the cell 1033 with her fingers to
remove the
incorrect medicament 1011 from cell number 8. The user can then touch the
Resume
icon 1465 indicating to controller 1017 that the error has been corrected and
to
proceed with loading the next cell 1033. Controller 1017 may update database
1371
to indicate that the error has been corrected. The user can then proceed to
load the
next cell 1033. Or, if a different type of medicament is to be loaded,
controller 1017
can then cause display of the next Filling screen 1403, 1403' so that the user
can load
the next type of medicament 1011 into holder 1013, 1013'.
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Referring now to Figure 13, a storage cabinet 169 may optionally be provided
to store one or more holder 1013, 1013' in the same manner as described in
connection with system 10 thereby facilitating loading and verification of
multiple
holders.
As with systems 10, 10', each loaded holder 1013, 1013' of systems 1010,
1010' can be verified by a user who is a registered pharmacist to ensure that
each cell
1033 has been loaded with the correct medicament 1011. The verification
process
preferably occurs without any need for use of sensor guide 1301, 1301' and
sensor
guide 1301, 1301' is preferably in the storage position illustrated in Figures
23 and 38
during verification. It will be apparent that verification for systems 1010,
1010' may
be essentially the same as for systems 10, 10'.
Referring now to Figures 67 and 86, verification begins by entry into a
verification mode and display of Verification start screen 1471, 1471'. Holder
1013,
1013' may be docked at docking station 1015, 1015' following loading.
Alternatively, holder 1013, 1013' may be retrieved, for example, from storage
cabinet
169, and then docked at docking station 1015, 1015' for verification.
The information which may be presented on Verification start screen 1471,
1471' may be essentially identical to that displayed in connection with New
order
screens 1355, 1355' and Filling screens 1403, 1403'. For convenience and
simplicity,
reference numbers for information displayed on New order screens 1355, 1355'
and
Filling screens 1403, 1403'are used again to identify corresponding fields of
information on Verification start screens 1471, 1471'. Verification start
screens 1471,
1471' may include an identification field 1357 identifying the operator name
1359
(e.g., Red Cross Pharmacy). Optionally, the user name, date and time-of-day on
which holder 1013 is being loaded 1360 could be provided. Additional
information
which may be displayed in connection with Verification start screen 1471,
1471' is an
Order field 1361 which displays all pending holders 1301, 1301' awaiting
verification.
In the examples of Figures 67 and 86, a single order 1363 is awaiting
verification. Order field 1361 may include a transaction code 1365 (e.g., "ID:
6237")
which indicates the transaction corresponding to loading of the holder 1013,
1013' for
record-keeping purposes and may indicate the quantity 1367 of holders 1013,
1013'
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used to fulfill the prescription order. Verification start screen 1471, 1471'
may also
show the holder identifier 1369 (e.g., "Tray Number 1") for each holder 1013,
1013'.
The status of the prescription order of Order field 1361 in Figures 67 and 86
is
indicated as "Incomplete" 1424 because verification has not yet occurred.
The Verification start screen 1471, 1471' prompts the user to initiate
verification of a holder 1013, 1013'. The user then selects the holder 1301,
1301' for
verification by touching video display 1125 next to the order in Order field
1361 or by
another input device, such as a mouse 1129. The user then touches the Check
icon
1473 to start the verification process.
Referring next to Figures 68 and 87, Verification screen 1475, 1475' may be
displayed for the selected holder 1013, 1013'. In the examples, Verification
screen
1475, 1475' preferably includes holder-view field 1401 with a plan view of
respective
holders 1013, 1013'.
In addition, Medicament-identification field 1388 may appear for each
medicament 1011 expected to be in holder 1013, 1013' to assist the user with
the
verification. Medicament-identification field 1388 may include information
identifying one type of the loaded medicaments 1011 including the medicament
type
and strength 1389 (e.g., "Naproxen Anaprox 375mg"), FDA and customer NDC
numbers 1391 (e.g., 11-digit NDC "00093014801"), medicament 1011 quantity 1393
expected to be loaded in the holder (e.g., "24"), physical appearance 1395 of
the
medicament 1011 (e.g., "Pch Obl Tb 148"), manufacturer name 1397 (e.g.,
"TEVA"),
expiration date and lot number 1399 (e.g., "Assigned EXP: 12/15/2013" "Lot:
J67934461").
A second Medicament-identification field 1388 may include information
identifying a second type of the loaded medicaments 1011 expected to be in
holder
1013, 1013' including the medicament type and strength 1389 (e.g., "Oxycodone
HCL
5mg), FDA and customer NDC numbers 1391 (e.g., 11-digit NDC "00406055201"),
medicament 1011 quantity 1393 expected to be loaded in the holder (e.g.,
"26"),
physical appearance 1395 of the medicament 1011 (e.g., "Wht Rnd Tb 0552"),
manufacturer name 1397 (e.g., "Malinckrodt"), expiration date and lot number
1399
("Assigned EXP: 12/1/2018" "Lot: ZJ7890321"). Plus "+" symbol 1402 indicates
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that verification of the medicament 1011 of Medicament ID field 1388 has not
yet
begun.
Preferably, the transaction code and all other information relating to loading
and verification of holder 1013, 1013' is stored in a database 1371 on client
computer
1349.
In order to verify that each cell 1033 holds the correct medicament 1011, the
user simply selects the Medicament-identification field 1388 to be verified by
touching the screen display 1125 next to the field 1388 or by using another
input
device such as a mouse 1129 or keyboard 1127.
Referring next to Figures 69 and 88, Verification screen 1475, 1475' may be
displayed responsive to selection of one of the Medicament-identification
fields 1388.
Figures 69 and 88 show examples of displayed information for verification of a
total
of 16 Naproxen tablets previously loaded into the openings 1317 and cells 1033
indicated by the human-readable indicia 1323 for the cells numbered "1, 4, 5,
7, 9, 10,
13, 16, 19, 21, 22, 24, 27" of holder 1013 and the single Naproxen loaded in
cell
numbered "1" of holder 1013'. Selection of the Naproxen tablets for
verification is
also indicated in the examples by highlighting the cells 1467 expected to
include the
Naproxen and highlighting the Medicament-identification field 1388 for
Naproxen.
Dash "-" symbol 1409 indicates the Medicament-identification field 1388 is
being
processed for verification. A reference image 1469 may be displayed to the
user to
assist with the verification process. The Medicament-identification field 1388
associated with the Oxycodone HCL medicaments 1011 can be turned off during
verification of the Naproxen.
Also upon selection of the exemplary Medicament-identification field 1388 for
the Naproxen, controller 1017 again selectively activates each indicator for
the cell(s)
1033 to be verified by the pharmacist. In the example of system 1010,
indicators
1049, 1049', 1049" of docking station 1015 and holder 1013 are activated and
in the
example of system 1010' indicators 1049, 1049' of docking station 1015' are
activated. In the examples, each other indicator 1049, 1049',1049"is inactive.
As with the loading process illustrated in Figures 28-28A, 42-42A, 57 and 76,
this pick-to-light/place-to-light capability enables the user to rapidly
confirm that the
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correct medicament 1011 has been loaded into the correct cell 1033 without the
necessity for reliance on written verification instructions. The user can
quickly look
with her eyes into each cell 1033 and can see the medicament 1011 in the cell
1033.
The user can compare the physical appearance of each medicament 1011 in each
indicated cell 1033 without the necessity of reliance solely on written
instructions.
This process is facilitated by presentation of the reference image 1469 as the
user can
quickly compare the appearance of the medicament 1011 on Verification screen
1475,
1475' with the appearance of the medicament(s) 1011 in each highlighted cell
1033
associated with the activated indicators 1049, 1049', 1049".
Selection of the Update icon 1477 completes verification for Medicament -
identification field 1388 and the exemplary Naproxen. Once all cells 1033
associated
with a Medicament-identification field 1388 are verified, the user then
selects the next
Medicament-identification field 1388 to be verified. This process is repeated
until all
medicaments 1011 have been verified as called for by Verification screen 1475,
1475'.
Referring next to Figures 70 and 89, once all Medicament-identification fields
1388 and medicaments 1011 are verified, controller 1017 displays a Barcode
scan
Field 1480 with instructions prompting the user to scan a bar code 1132 on the
holder
1013, 1013' with bar code scanner 1131. Scanning of the bar code 1132 and
touching
the Ok icon 1481 sends a signal to controller 1017 indicating to system 1010,
1010'
that holder 1013 has been fully verified and that the medicament 1011 contents
are in
the correct cells 1033 ready for use with automated dispensing machine 45 or
that
holder 1013' has been fully verified and that the medicament 1011 contents are
in the
correct cells 1033 and that holder 1013' is ready to be sealed by closure
1042. Plus
"+" symbol 1480 indicates that the medicaments 1011 of Medicament-
identification
field 1388 are no longer being processed and the / symbol 1482 indicates that
the
medicaments of Medicament-identification field 1388 have been verified and the
records of database 1371 are updated accordingly.
Referring next to Figures 71 and 90, controller 1017 displays a Digital
signature field 1483 with instructions prompting the user to digitally sign
the holder
creating a record in database 1371 of the user responsible for the
verification. The
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user can enter a digital signature by keying in her user name in the user name
field
1485 and keying in her password in the password field 1487. Alternatively, a
biometric prompt 1489 prompts the user to place her thumb on biometric scanner
1130. The biometric scan serves as the digital signature.
Referring to Figures 72 and 91, Verification complete screen 1491, 1491' may
be displayed. Information identifying the prescription order may appear
identical to
that from Verification start screen 1471, 1471' (Figures 67, 86). The status
of the
prescription order in Order field 1361 may be indicated as Complete 1492
indicating
that it has been verified as correct and the status of the holder 1013, 1013'
may be
indicated as Complete 1494 confirming that the medicaments 1011 in holders
1013,
1013' have been verified as correct.
A record may be made of the verified medicament 1011 contents of holder
1013, 1013' cells 1033 which may be stored in database 1371 residing on
controller
1017. Such a record is useful in further confirming that the correct
medicaments 1011
were loaded in holder 1013, 1013'. Each verified holder 1013 can then be
stored in
cabinet 169 awaiting use, or the holder 1013 and its medicament 1011 contents
can be
taken directly to automated dispensing machine 45 for immediate loading of
medicaments 1011 into exception storage apparatus 43. Holder 1013' is
preferably
immediately sealed with closure 1042 and is labeled 1044 with patient-specific
information or other identifying information if holder 1013' is not intended
for a
specific patient.
Holder 1013 of system 1010 may be utilized to transfer the organized
medicaments 1011 in holder cells 1033 to an exception storage apparatus 43 of
exemplary automated dispensing machine 45 of the same type as described above
in
connection with Figures 18, 19, 20, 21A, 21B, and 21C. For convenience and
brevity,
the structure and operation of exemplary automated dispensing machine 45 is
incorporated herein by reference and will not be fully described here in
connection
with holder 1013. An exemplary automated dispensing machine 45 which may be
used with holder 1013 is a model ATP 320, 371, or 384 dispensing machine
available
from Chudy Group, LLC of Powers Lake, Wisconsin.
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Holder 1013 is a lightweight portable device which may be conveniently
loaded at a workstation separate from automated dispensing machine 45. This
permits
holder 1013 to be loaded at a time and sequence in the work day that is
convenient to
the pharmacy. After loading and optional verification, holder 1013 may be
easily
carried by a user from the workstation or a storage cabinet 169 to exception
storage
apparatus 43 so that the medicaments 1011 can be accurately, quickly and
easily,
transferred to exception storage apparatus 43 and automated dispensing machine
45.
If automated dispensing machine 45 must be shut down (i.e., deactivated to
permit the
transfer of medicaments 1011 to exception storage apparatus 43, then the rapid
transfer of medicaments 1011 made possible by use of holder 1013 minimizes
that
downtime in the same manner as described above for holder 13. The transferred
medicaments 1011 may then be packaged by automated dispensing machine 45 into
separate pouches 202 formed (e.g., by heat-sealing or sonic welding) in a web
of
packaging material 204 in the same manner as illustrated in Figure 22.
Referring then to Figures 18-21C, exception storage apparatus 43 is a drawer
or tray-like device which can be pulled out from cabinet 191 of automated
dispensing
machine 45. When exception storage apparatus 43 is pulled out, automated
dispensing machine 45 is temporarily shut down and is out of service and
unavailable
to fill prescription orders and dispense requests. Exception storage apparatus
43
illustrated in Figures 19-20 can be described as having a somewhat flat and
narrow
configuration with a plurality of cells 41 provided therein. Each cell 41 of
exception
storage apparatus 43 is capable of storing one medicament 1011, or a small
quantity of
medicaments 1011, as illustrated in Figures 21A-22. In the example, cells 41
include
64 total cells grouped in four rows of 16 cells, the same pattern as cells
1033 of holder
1013.
As described above, medicaments 1011 transferred to cells 41 of exception
storage apparatus 43 cells 41 are indexed for movement along a track (not
shown) in
exception storage apparatus 43. Cells 41 are indexed forward along the track
toward
an opening (not shown) in the bottom of apparatus 43 so that the contents of
each cell
41 fall through a cell bottom opening (not shown) and to a packaging device
within
automated dispensing machine 45 through chutes, hoppers or other guide
structure, or
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by a mechanical device such as an auger. Medicaments 1011 may be discharged
from
cells 41 by any other suitable means including a movable gate (not shown) over
a cell
bottom outlet (not shown), or by a solenoid, air-powered actuator, air-jet, or
mechanical arm which ejects the medicament through an upper cell inlet 209 of
the
type shown in Figure 19A. The medicaments 1011 fall via chutes, guides to a
packaging device or are directed to packaging device by mechanical means (e.g.
an
auger).
Also as described above, exemplary automated dispensing machine 45
includes a pouch-package-type packaging apparatus (not shown) within a lower
portion of cabinet 191. Alternatively, packaging apparatus capable of
packaging
medicaments 1011 into other container types (e.g., bottles, vial, blister
packages) may
be utilized. A pouch-package-type packaging device includes a form-fill-seal
packaging device. Packaging apparatus is preferably a "form-fill-seal"
packaging
device which forms a package (i.e., a pouch) in a web of packaging material
204, fills
the package 202 with the medicament(s), and seals the package 202 forming a
plurality of discrete packages 202, or pouches.
In the example, one or more medicament 1011 discharged from the cassette-
type storage apparatus (not shown) of automated dispensing machine 45
described
previously or exception storage apparatus 43 is loaded into separate pouches
202
formed (e.g., by heat-sealing or sonic welding) in a web of packaging material
204 as
illustrated in Figure 22. Information can be printed on each pouch 202 by a
printer
(not shown) associated with automated dispensing machine 45 and such
information
can include the patient's name 206, medicament name and quantity 208,
prescription
number 210, date 212, instructions for taking the medicament 214 (such as time
of
day the medicament is to be taken) and machine-readable indicia 216 (such as a
bar
code) representative of the aforesaid information. As above, pouch packages
202 are
ideal for use in administering medication regimens because the exact
medicaments
1011 to be taken at a given time can be packaged together in a single pouch
package
202, and the pouches can be organized and labeled in the exact order in which
each
medicament 1011 is to be taken, for example, morning, noon and evening.
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Transfer of medicaments 1011 from holder cells 1033 to exception storage
apparatus 43 is accomplished in the same manner as described in connection
with
Figures 21A-21C. Holder 1013 may be placed directly on top of exception
storage
apparatus 43 in the same manner as shown in Figure 20 and Figures 21A-21C with
each cell 1033 and 41 completely aligned and in registry. As previously
described,
holder 1013 and exception storage apparatus 43 each have 64 total cells 1033,
41
grouped in four rows of 16 cells. Human-readable indicia 211 is preferably
provided
on exception storage apparatus 43 (Figure 19A) so that each cell 1033 on
holder 1013
has the same indicia 1047 as indicia 211 on exception storage apparatus 43.
The cell
1033 pattern and indicia 1047 of holder 13 is most preferably identical to the
cell 41
pattern and indicia 211 of exception storage apparatus 43.
Referring again to Figures 20 and 21A-21C, the holder 1013 which is
preferably verified as correct is taken to exception storage apparatus 43 of
automated
dispensing machine 45 by a user or pharmacist. Holder 1013 is set on top of
exception storage apparatus 43 in the same manner as illustrated in Figure 20.
Legs
1051, 1053 position holder 1013 over exception storage apparatus 43 as shown,
for
example, in the same manner as holder 13 in Figures 21A-21C to ensure that
holder
1013 is in the correct orientation on exception storage apparatus 43 with
correct
alignment of cells 1033, 41. Once aligned, holder 1013 is initially in the
position
shown in Figure 21A in the same manner as holder 13.
If holder 1013 includes an identification element 1081 and automated
dispensing machine 45 includes an identification element detector 84, then the
detector 84 may identify holder 1013. If the correct holder 1013 is positioned
over
exception storage apparatus 43, the user is given a prompt signal by video
display 201
to proceed with transfer of the medicaments 1011. If an incorrect holder 1013
is
positioned over exception storage apparatus 43, then display 201 prompts the
user to
not transfer the medicaments 1011 and may present an error message and/or
alarm. In
addition, system 1010 may deactivate automated dispensing machine 45
preventing
further operation until the correct holder 1013 is in place or the user
overrides the
system 1010.
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Prior to medicament 1011 transfer and as shown in Figure 21A, shuttle
member 1055 is in the same position as shuttle member 55 in a "closed"
position
with cell 1033 outlets 1039 covered by shuttle member 1055 in the same manner
as
cells 33 are closed in Figure 21A. Medicaments 1011 cannot exit cells 1033 in
this
closed position.
Next, the user grasps pull 1061 and moves shuttle member 1055 in the same
manner as pull 61 is moved in the direction of arrow 217 in Figure 21B.
Translating
movement of shuttle member 1055 partially opens cell outlets 1039 as openings
1059
in shuttle member 1055 are aligned with cell outlets 1039. As a result,
medicaments
1011 begin to fall by means of gravity into the aligned cells 41 of exception
storage
apparatus 43 in the same manner as medicaments 11 fall from cells 33 in Figure
21B.
Finally, the user moves shuttle member 1055 fully to the "open" position in
the same manner as shuttle member 55 is moved in the direction of arrow 217 in
Figure 21C. Cells 1033 are fully open in this position causing medicaments
1011 in
cells 1033 to fall into the corresponding cells 41 of exception storage
apparatus 43 in
the same manner as medicaments 11 fall into exception storage apparatus 43
illustrated in Figure 21C. Exception storage apparatus 41 is now correctly
loaded and
is ready for dispensing and packaging of the slow mover medicaments 1011
stored in
cells 41. This loading process, which is the same as shown in Figures 21A-21C
in the
example, is very rapid (less than one minute) and enables automated dispensing
machine 45 to be quickly returned to service.
Holder 1013' of system 1010' is the container in which medicaments 1011 are
ultimately delivered to the patient. Before or after loading of holder 1013',
a label
1044 may be applied to holder 1013 as previously described (Figure 44). Once
loaded
and verified, holder 1013' may be closed with closure 1042 in a conventional
manner
for blister-package-type containers.
Systems 1010, 1010' accurately and rapidly enable loading of medicaments
1011 in the exact order in which the medicaments 1011 are to be loaded into
exception storage apparatus 43 or packaged in a container (e.g., a blister-
package-type
holder 1013') for use by a specific patient or for another purpose. Sensor
guide 1301,
1301' provides the option for positive feedback indicative that the
medicaments 1011
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were loaded correctly or that an error has occurred. The use of indicators
1049,
1049',1049", and 1049" ' permits a user (e.g., a technician or pharmacist) to
load and
optionally verify the contents of holder 1013, 1013' without having to take
his or her
eyes off of the holder 1013, 1013' to read instructions thereby reducing the
amount of
time needed to load and optionally verify each holder 1013, 1013'.
Providing the correct medicament 1011 to the patient provides for a better
level of patient care. Time saved in the fulfillment of prescription orders
can be
utilized for other purposes, such as counseling patients. Thus, systems 1010,
1010'
provide the opportunity for improvements in patient care.
* * *
While the principles of this invention have been described in connection with
specific embodiments, it should be understood clearly that these descriptions
are made
only by way of example and are not intended to limit the scope of the
invention.
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