Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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Devices Systems and Methods for Automated
Medical Product or Service Delivery
All subject matter of the Priority Application(s) is incorporated herein by
reference
to the extent such subject matter is not inconsistent herewith.
SUMMARY
Described herein for various embodiments include systems, methods, and devices
for automated delivery of medical products or services. In certain
embodiments, the
systems and/or methods are at least partially controlled by a computer.
The foregoing summary is illustrative only and is not intended to be in any
way
limiting. In addition to the illustrative aspects, embodiments, and features
described
above, further aspects, embodiments, and features will become apparent by
reference to
the drawings and the following detailed description.
BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 illustrates a partial view of an embodiment disclosed herein.
FIG. 2 illustrates a partial view of an embodiment disclosed herein.
FIG. 3 illustrates a partial view of an embodiment disclosed herein.
FIG. 4 illustrates a partial view of an embodiment disclosed herein.
FIG. 5 illustrates a partial view of an embodiment disclosed herein.
FIG. 6 illustrates a partial view of an embodiment disclosed herein.
DETAILED DESCRIPTION
In the following detailed description, reference is made to the accompanying
drawings, which form a part hereof In the drawings, similar symbols typically
identify
similar components, unless context dictates otherwise. The illustrative
embodiments
described in the detailed description, drawings, and claims are not meant to
be limiting.
Other embodiments may be utilized, and other changes may be made, without
departing
from the spirit or scope of the subject matter presented here.
In an embodiment, at least one of the methods, devices, computer systems, or
computer program products disclosed herein is utilized for automated delivery
of medical
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services or products to a subject in a healthcare setting. In an embodiment,
at least one of
the methods, devices, computer systems, or computer program products disclosed
herein is
utilized for automated delivery of medical services or products to a subject
in a non-
healthcare setting. In an embodiment, at least one of the methods, devices,
computer
systems, or computer program products disclosed herein is utilized for
automated delivery
of medical services or products to a subject in a kiosk located, for example,
in an office;
school; pharmacy; retail store; drug store; airport; church, temple, synagogue
or other
place of worship; hospital; nursing home or other long-term care setting;
childcare facility;
adult care facility; government agency; or other location. In an embodiment,
at any of
these locations, the subject does not directly interact with a person, but
instead may
interact with a computerized device for assistance. In an embodiment, the
kiosk is part of
a network of kiosks. In an embodiment, each kiosk in the network of kiosks is
located at a
separate and distinct location. In an embodiment, multiple kiosks in the
network are
located in close proximity (e.g., multiple kiosks in an airport, school,
etc.). In an
embodiment, at least one kiosk in the network includes a GPS locator to
identify the
location of the subject seeking the medical product or service.
In an embodiment, the methods, devices, computer program products, or computer
systems disclosed herein assist in the assessment (e.g., diagnosis, temporary
stabilization,
determination of trauma, etc.) of a subject based on evaluated criteria (EC)
and using the
EC of the subject to assign a Health Status Indicator (HSI), which indicates
if medical
services or products may be delivered, and if so, which ones.
In an embodiment, the HSI of subjects is updated in real time with one or more
of
temporal, spatial, or subject-specific data. The data may be entered by a user
(e.g., the
subject him/herself or a healthcare provider), or by one or more sensors or
other detectable
indicators or tests.
In an embodiment, a request for a particular medical service or product is
made by
the subject or by a healthcare provider on behalf of the subject. For example,
a subject
may request pain relievers, antibiotics, bandages, anti-diuretics,
nutraceutical, stool
softeners, feminine hygiene products, cold compresses or heating pads, x-rays,
pregnancy
test, HIV test, cholesterol or blood glucose test, urinalysis, MRSA test, flu
test, bird flu
test, hearing test, eye exam, body mass index test, glucose strips, glucose
finger sticks, a
glucose monitor, heart monitor, etc.
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In an embodiment, visual inspection by an automated computing device, or
directly
by a healthcare worker (e.g., via Skype, video phone, or other similar
electronic
interaction) is provided by a screen at the kiosk. In this way, skin tone or
color, hair tone
or color, pallor, bruises, lacerations, rashes, etc. and overall condition can
be assessed if
needed in order to satisfy the threshold to receive the medical product or
service being
sought by or for the subject.
In an embodiment, audio inspection by an automated computing device, or
directly
by a healthcare worker (e.g., via telephone, voicemail, or other similar
electronic audio
interaction) is provided by a microphone or other input/output device operably
coupled to
the computing device that interacts with the kiosk and/or network of kiosks.
In this way,
coughing, heartbeat, voice, or overall condition can be assessed if needed in
order to
satisfy the threshold to receive the medical product or service being sought
by or for the
subject.
In an embodiment, the request for a particular medical service or product has
been
previously made by the subject at a healthcare facility, where the subject
obtained a coded
voucher that can be scanned or manually entered by the subject or for the
subject (e.g., if
the subject is not a human subject, or not an adult human subject, or not
capable of
engaging with the kiosk him/herself).
In an embodiment the subject pre-orders and/or pre-pays for the medical
service or
product prior to engaging with the automated kiosk or other remote system. In
an
embodiment, the voucher provides for a single dispensing of the medical
service (e.g.,
assessment or test, such as pregnancy test or HIV test, sexually transmitted
disease test,
malaria test, etc.) or product. In an embodiment, the voucher provides for a
series or
regular schedule of dispensing of the service or product (e.g., 3rd day of
each month). In
an embodiment, the voucher has an expiration date or a particular time window
during
which the medical service or product must be obtained or the voucher
terminates and is no
longer able to be used. In an embodiment, the voucher includes either a paper
voucher or
an electronic voucher (e.g., a voucher that can be displayed on a smartphone,
laptop,
notebook, or other electronic device or by electronic file such as with a
flash drive). In an
embodiment, the voucher must be presented at a specific kiosk location in
order for it to be
valid. In an embodiment, the voucher may be presented at any kiosk location.
In an
embodiment, the voucher includes information that can be scanned, for example,
by bar
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code, text recognition, Quick Response (QR) code, RFID, magnetic strip,
keyable code
sequence (numeric, alphabet, alpha-numeric, byte/binary, etc.), UPC bar code,
light
patterns, reflective patterns, etc. or other detectable identification. In an
embodiment, the
voucher contains encrypted electronic information specific to the subject,
such as
identifying information or information related to the prescription, payment,
schedule of
payment or dispensing of service or product.
In an embodiment, a subject must satisfy a verification threshold prior to
receiving
the requested medical product or service. In an embodiment, the verification
threshold is
pre-determined, and may be customized to the subject or the product or service
being
sought. For example, as described herein, for controlled substances, a
necessarily high
level of verification by the subject can be required, whereas for a bandage, a
low level of
verification by the subject can be required. In an embodiment, as described
herein the
verification threshold is satisfied by a pre-determined verification process,
including, for
example, identification (e.g., driver's license number, social security
number, etc.),
optionally a prescription (e.g., a voucher or pre-approval by a healthcare
worker) or
optionally insurance information or insurance approval, and optionally an
assessment of
the subject's electronic health record and/or queries regarding past use of
the medical
product or service, allergies, or other health conditions, etc. may be needed
to satisfy the
verification threshold. In an embodiment, the subject is seeking a medical
product or
service that has been pre-paid. In an embodiment, the verification threshold
is not
satisfied and instead the subject is denied the medical product or service
being sought. In
an embodiment, the subject may be referred to a healthcare facility or worker
for further
verification related to the medical product or service being sought. In an
embodiment, the
healthcare worker or facility is accessible by way of the kiosk itself In an
embodiment,
the healthcare worker or facility is not accessible by way of the kiosk and in
certain
instances a map or other location information is provided to the subject in
order to
continue the process elsewhere. In an embodiment, the kiosk accesses all
records for the
subject via the network and if the subject has exceeded the approved level or
number of
medical products or services being sought, the subject is denied and the
verification
threshold is not satisfied. In this case, the entire network may be flagged to
prevent the
subject from using another kiosk in the network to seek a product or service.
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In an embodiment, at the time the input information is provided to the system,
if a
pre-approval prescription is being sought, the prescription can be edited or
deleted, for
example if the subject is seeking a generic pharmaceutical rather than the
name-brand
pharmaceutical prescribed by the doctor, or if the subject is seeking an
equivalent
pharmaceutical drug that is approved by the subject's insurance. The subject
inputs
information into the input/output device that requests that the prescription
be edited. The
system includes circuitry configured for specific modifications of the
prescription without
further approval, as was previously entered by a healthcare worker, and grants
the
modification if it falls within the range specified for approval by the
healthcare worker. If
the requested modification falls outside the range specified for approval by
the healthcare
worker, then the request to modify the prescription is denied. The subject can
continue
with the original pre-approved prescription, or seek further engagement with
the kiosk
system in order to seek approval following the first round denial. If, upon
further input of
information into the system and optionally consultation with an automated
computerized
response system or human healthcare worker, the request to modify the
prescription is
satisfied, then the prescription is noted as modified and such information is
shared with the
kiosk system. The originally pre-approved prescription is then noted as
deleted or refused
by the subject.
In an embodiment, all input information and output information related to the
engagement of the subject with the kiosk is shared with the network to which
this
particular kiosk is a member, if a network exists. In an embodiment, all
information
regarding any particular subject is updated in real time such that the subject
cannot attempt
to redeem more than one voucher or pre-approved prescription, or cannot
attempt to seek
outright a medical product or service at more than one kiosk. Thus, the
updated
information regarding the subject prevents abuse of the system by prohibiting
the subject
from seeking the same thing twice within a specified time frame. As indicated
herein
elsewhere, the subject may seek a medical product or service on a schedule, as
approved
by a healthcare worker, which provides for automatic renewal of the
eligibility to receive
the medical product or service at a specific time, after a specified time
period, or at a
continuing time point. In an embodiment, the output includes dispensing of the
requested
medical product or service.
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In an embodiment, the subject or someone acting on behalf of the subject
(e.g., if
the subject is a minor, or non-human animal) is required to sign a signature
box as part of
the kiosk system input on the input/output device (for example, with a stylus
or finger).
Alternatively, a fingerprint may be provided instead of a signature for
receipt of the
product or service.
In an embodiment, the system alerts the subject if the subject is seeking a
medical
product or service that may cause adverse reactions with an item in the
subject's personal
medical history records (e.g., other medications, allergies, etc.). In an
embodiment, this
alert prevents the subject from receiving the medical product or service being
sought and
requires further interaction with the kiosk to modify the request, or
interaction with a
healthcare worker (e.g., either by telephone, videophone, email, chat, etc.)
at the kiosk, or
the subject is instructed to seek medical attention and the request is
outright denied.
In an embodiment, input information related to the subject seeking a medical
product or service is shared with one or more of a vendor, social media,
corporate sponsor,
advertising partner, corporate partner, or other third party. In an
embodiment, the subject
is notified that such sharing may be optional. In an embodiment, input
information related
to the subject is anonymized prior to sharing. In an embodiment, input
information related
to the subject seeking a medical product or service is shared with health
databases, such as
the CDC, state, local, or federal agencies. In an embodiment, the subject is
notified that in
order to proceed to seek the medical product or service being sought, it is
necessary to
share certain or all information related to that subject.
In an embodiment, a verification code not provided with the voucher but also
given
to the subject or subject's guardian (e.g., by text to a cell phone) is
required for added
security when obtaining the medical service or product at the kiosk by using a
voucher.
In an embodiment, the subject is able to check (e.g., by electronic access
through
the internet or another network) that a particular kiosk has the subject's
particular medical
service or product available.
In an embodiment, the methods, devices, computer systems, or computer program
products save healthcare facilities time, money, and reduce errors by
increasing efficiency
and collecting and presenting accurate information about each subject
receiving automated
medical services or products. Likewise, the methods, devices, computer
systems, or
computer program products provide benefits to subjects, including but not
limited to,
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customized attention, time savings, money savings, insurance compliance
(including
governmental compliance), reduction of errors, easier documentation (e.g.,
automatic
recording of dispensing of a drug), inventory control, controlled-substance
control (for
example by networking with the Drug Enforcement Agency), expiration management
of
any products that have an expiration date, and faster treatment. Thus, various
embodiments disclosed herein assist healthcare facilities, particularly
emergency
departments, reduce the overload of subjects who are able to receive adequate
medical
attention without having to go to the emergency room. Further, the high level
of data
collection from the subject at the kiosk or other remote location results in
fewer re-billing
events for payment of services due to inaccurate information received, or
mistakes made
on intake of the subject to a healthcare facility.
In an embodiment, the methods, devices, computer systems, or computer program
products also access any electronic health records that can include, among
other things, the
subject's past medical problems and/or treatments as well as possible
identifying
information. In an embodiment, the subject can request that his/her electronic
health
records be transferred to the kiosk, for example by uploading them to the
kiosk, by way of
scanning them in, by inserting via flash drive into the kiosk device, or
remotely by
electronic transfer by way of the intern& or other secure network access.
In an embodiment, where the medical service or product is an unusual one, the
subject may pre-order the product or service, or get pre-authorization (e.g.,
by way of
voucher as described herein for other embodiments) and the kiosk will then
stock the
product or service not usually stocked at the particular kiosk. In an
embodiment, the
stocking and order may be electronically or automatically controlled, or may
be manually
entered into the system. In an embodiment, the kiosk is part of a network
utilizes standard
inventory control principles adapted to the various embodiments disclosed
herein, for
example, by utilizing reordering points that detect a quantity or date that
indicates it is
time to re-order a particular product or service. For example, each product or
service (if
not located in a locked dropbox, as described herein) may be located in a
cartridge that
allows for the product or service to be easily delivered. In an embodiment,
the re-stocking
of various kiosks is done by way of a central location, a regional location,
or an individual
location. Thus, the worker or automatic re-stocking occurs in a manner similar
to re-
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stocking a vending machine, with additional levels of verification of identity
of each
product or service being stocked in the kiosk.
In an embodiment, the kiosk includes lockers (e.g., heavy metal locked boxes
or
safes) that are configured to be opened only by way of the voucher form the
subject has
obtained by the prescription writing healthcare provider and optionally by
added security
features such as providing subject identification (e.g., fingerprint, driver's
license number,
debit card, date of birth, social security number, subject-specific health
record number,
insurance card number, iris scan, passport number, credit card, Flexible
Saving Account
card, Health Saving Account card, Health Reimbursement Account card, etc.) or
optionally by a verification code obtained from the healthcare provider but
not necessarily
located on the voucher (e.g., a text or email or separate code obtained by the
subject). In
an embodiment, the coded locks include a termination time so that the voucher
must be
presented to open the locked box during a specific time period or the medical
service or
product can no longer be obtained by the subject. In an embodiment, the locked
boxes are
configured to be opened by a key, which is provided to the subject by the
healthcare
provider or in another manner. In an embodiment, the key or code utilized to
open the
locked drop box is patient specific or service/product specific. In an
embodiment, a
reading and/or imaging apparatus is utilized for reading/imaging a credit card
or debit
card, social security card, insurance card, voucher, etc. and the image or
other electronic
information is communicated through the network for use in evaluating the
identity,
payment, insurance coverage, etc. of the subject.
In an embodiment, each engagement with any aspect of the kiosk, including the
locked boxes, is recorded (e.g., by camera and/or electronic gate). For
example, the
locked drop boxes may record when the box is opened and filled, as well as
opened and
emptied. In an embodiment, a printed receipt of this activity is created
either
electronically or printed, to the worker filling the locked box, or to the
subject receiving
the product or service. In an embodiment, the locked boxes include codes that
change
after a designated time period, so that the subject must receive an updated
code in order
for the voucher to be valid.
In an embodiment, the system includes a real-time data collection and
integration
with the kiosk system for health information, payment information,
identification, etc..
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In an embodiment, payment for the medical service or product is handled
directly
by the kiosk, or the kiosk system. In an embodiment, payment is handled by the
supplier
of the product or service (e.g., by the pharmacy or pharmaceutical warehouse
that supplies
the kiosk). In an embodiment, the kiosk is configured to submit claims to a
subject's
insurance company. In an embodiment, the kiosk is configured to send bills to
the subject
prior to, during, or subsequent to the subject receiving the medical product
or service, such
as, for example, with a subject that is set up to receive regularly scheduled
pick ups, or if
the subject is able to pay electronically at another time (e.g., pre-
authorization for credit
card charge or other authorization, such as by an online electronic payment
system may be
required prior to allowing the subject to obtain the product or service prior
to payment). In
an embodiment, the bills are submitted to the subject electronically. In an
embodiment,
the bills are submitted to the subject by paper billing. In an embodiment, the
insurance
reconciliation and payment from the subject is all done electronically, prior
to the subject
receiving the medical service or product from the kiosk. In an embodiment, a
method for
obtaining payment from a subject or user (e.g. if the subject is a minor or
non-human), for
example by credit card, debit card, blue tooth payment, smart card, cash card,
cash bill or
check reader, electronic online payment, or other, as described herein.
In an embodiment, the kiosk is able to determine the coverage of the subject's
insurance, and direct the subject to medical services or products that are
covered under the
subject's plan and optionally away from those that are not. For example, the
kiosk may
provide a list of "Insurance authorized" products or services, and "Insurance
not
authorized" products or services, with the respective costs to the subject
also visible. In
this way, the subject may elect to have a product or service covered by the
insurance plan,
or not, and pay the corresponding costs associated with that decision.
In an embodiment, a weight may be necessary as part of the evaluation of the
subject, for example, in a situation where the subject is a pediatric or young
patient. The
dosage of a product or service may depend on the weight or age of the subject
in certain
instances, such that either the weight is accessed by way of health records,
prior input, or
subject input at present, or a scale (e.g., embedded within a chair or the
floor or a counter
top) is present at the kiosk and a current weight of the subject may be
obtained. In the
event of the subject being a baby or very young patient, the kiosk may query
whether a car
seat or other baby holding device is present on the scale, and instruct the
user to zero
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balance the scale with the baby carrier alone (without the subject) and then
place the
subject into the baby carrier, in order to obtain an accurate reading of the
subject's weight.
In an embodiment, the kiosk alerts the subject if a suggested product or
service (or
one requested by the subject) is not currently available at this particularly
location, and
optionally provide the map or directions for availability of the nearest kiosk
that does have
that particular product or service. In an embodiment, the kiosk recommends an
alternative
product or service that is located at this particular kiosk location.
In an embodiment, a subject has received a voucher or recommendation for a
particular product or service, but changes his/her mind. In the case of a
voucher, for
example, the subject may request that an alternative product or service be
provided instead
of the one(s) listed on the voucher (e.g., generic version of a trademarked
drug), and the
kiosk will determine whether or not this is possible, based, for example, on
the subject's
health history or queries, availability at this particular kiosk location,
and/or other
Evaluated Criteria. In an embodiment, the kiosk is able to grant the request
to modify the
voucher, and the original voucher is voided or held inactive by the kiosk
network. In an
embodiment, the kiosk is not able to grant the request to modify the voucher.
In an
embodiment, if the voucher is modified, a second level of identity
confirmation and/or
evaluation may occur. For example, the kiosk will confirm with the subject
that the
subject is not allergic to the product/service, or is not taking any
pharmaceuticals that may
have adverse reactions with the modified voucher request.
In an embodiment, the subject's request for a particular medical service or
product
is validated, for example, by checking with electronic health records or
pharmacy
databases, as well as with the Drug Enforcement Agency for information related
to the
subject, and whether the subject is authorized to receive the requested
medical service or
product. In an embodiment where the subject has a voucher from a healthcare
worker
prescribing the medical product or service, the prescription may be validated
based on
terms of the prescription and the subject's prior use of the kiosk (e.g., # of
pills per day,
time since last pill, # left on prescription, etc.) on a system-wide level.
In an embodiment, a roving worker transfers the medical product or service to
the
locked dropboxes at a scheduled time (e.g., once a day) or as needed. In an
embodiment,
one or more lock boxes keeps stock at least one particular product or service
obtainable by
a subject.
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In an embodiment, the subject includes a human. In an embodiment, the subject
includes a healthcare worker. In an embodiment, the computer systems, devices,
methods,
computer program products determine whether a healthcare worker is eligible to
directly
or remotely program the automated system to deliver the medical service or
product to the
subject, access a particular healthcare database, or perform a certain task
(e.g., diagnosis,
run tests, dispense pharmaceutical drugs or implements). In an embodiment, the
subject
includes a healthcare patient. In an embodiment, the subject is a fetus. In an
embodiment,
the subject is a non-human animal. In an embodiment, the subject is a mammal,
amphibian, fish, bird, or reptile. In an embodiment, the subject is a baby or
child. In an
embodiment subject is a geriatric. In an embodiment, the subject is a non-
adult. In an
embodiment, the subject is a cow, horse, dog, cat, or other domesticated
animal.
In an embodiment, the systems, devices, methods, and computer program products
described herein do not diagnose a subject. In an embodiment, the systems,
devices,
methods and computer program products described herein do not treat a subject,
but rather
instruct the subject to seek immediate medical attention such as, for example,
at the closest
emergency room, urgent care, or similar hospital facility. In an embodiment,
the systems,
devices, methods, and computer program products described herein instruct the
subject to
seek insurance approval prior to continuing with the process of automated
delivery of
medical services or products. In an embodiment, the systems, devices, methods,
and
computer program products described herein instruct the subject to submit
payment (e.g.,
electronically via credit card or bank account, etc.) prior to continuing with
the process of
automated delivery of medical services or products.
In an embodiment, the subject receives pharmaceutical drugs either previously
prescribed by a healthcare worker (e.g., doctor, nurse, mid-wife, nurse
practitioner, etc.) or
prescribed by way of the kiosk itself (e.g., by way of sensed information or
information
provided by the subject, information provided by a healthcare worker, or a
health record
(e.g., an electronic health record). In an embodiment, the subject must
provide
identification in order to receive the pharmaceutical drugs from the kiosk. In
an
embodiment, a single dose is provided to the subject by way of the kiosk. In
an
embodiment, a video camera records the subject receiving and optionally taking
the drug
or other medical product or service (e.g., imbibing, consuming, ingesting,
applying, etc. or
otherwise utilized the dispensed medical product or service). Thus, in an
embodiment, the
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kiosk includes at least one of audio or video recording (e.g., the kiosk
includes a
microphone, camera, keyboard, etc.) and may include instant messaging, audio
or video
transmission. In an embodiment, the camera includes a digital camera or
webcam. In an
embodiment, the kiosk accepts video or audio recording of the subject by way
of the
subject sending a recording of itself utilizing the medical product or service
by way of
mobile phone, electronic tablet, or digital camera to the kiosk.
Thus, in an embodiment the kiosk provides verification that the subject has
ingested or otherwise utilized the dispensed medical product or service.
In an embodiment, the prescription drug includes a measurable indicator, such
as a
radio frequency identification device, such that the kiosk itself is
configured to monitor the
drug in the subject's body (e.g., by way of transmission/reception of signals
with the drug
by way of a computer system). In an embodiment, the medical product or service
includes
packaging that has a radio frequency identification device or radio frequency
reflector that
is configured to transmit a signal once the package is opened or disturbed.
For example,
the box that houses a glucose testing kit contains an RFID, or the bubble
packaging for a
particular pharmaceutical drug each contains an RF reflector so that upon
utilization, the
signal is transmitted to the kiosk or to a third party.
In an embodiment, a subject seeks to obtain a sub-portion of a prior
prescription,
and the kiosk is configured to access the subject's health records and
determine that the
subject is allowed to obtain the requested sub-portion of the drug, and if so,
then the kiosk
dispenses the requested sub-portion. If the kiosk determines that the subject
is not
permitted to obtain the requested sub-portion, then the kiosk may optionally
be configured
to either deny the subject any of the drug, the kiosk may dispense only what
is permitted,
if any, to the subject, or the kiosk can request further information from the
subject to
evaluate whether or not to dispense at least one dose of the pharmaceutical
drug to the
subject. In an embodiment, the further information may include queries to the
subject,
queries to the subject's medical record(s), or queries by way of sensors
engaged with the
subject.
Thus, in an embodiment, a kiosk including at least one computing device
receives
at least one input from a subject relating to a subject's seeking a portion of
a prescribed
medical product or service and, utilizing circuitry of the computing device,
compares the
input from the subject with one or more verification datasets, and the
computing device
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generates a verification value based on the comparison. For example, the
verification
dataset may include information related to identification of the subject,
codes (insurance
codes, security codes, etc.) or prescription information. In an embodiment,
the verification
dataset further includes medical records or a medical record database of the
subject,
including physician information (or other healthcare worker information)
health care
profile, state of health, etc. Once the system has satisfied a verification
threshold,
dispensation of whole or part of the portion sought by the subject occurs. If
the
verification threshold is not met, the request by the subject is denied. In an
embodiment,
the subject is also referred to seek additional authorization, such as from a
health care
worker, pharmacy, or insurance company. In an embodiment, the subject is
instructed to
seek additional medical attention. The portion sought by the subject may
include at least
one daily aliquot, one weekly aliquot, one monthly aliquot, or any value
therebetween,
depending on the particular medical product or service being sought (e.g.,
liquid, pill form,
device form, etc.), and the portion sought by the subject may include any
amount less than
the full prescription amount usually dispensed (e.g., as a one time
prescription such as for
antibiotics, or as an on-going prescription such as for birth control pills).
In an embodiment, the computing device of the kiosk further accesses one or
more
healthcare providers for confirmation of the prescription or portion thereof
In an embodiment a system includes a medical record database in communication
with the kiosk, that communicates with the kiosk an output indicative of the
satisfaction or
denial of a medical record threshold upon inquiry or input from a subject for
a medical
product or service (e.g., a portion of a prescribed medical product or
service). Thus, in an
embodiment, the kiosk communicates to the subject's medical records, and the
medical
record database communicates with the kiosk. In an embodiment, the medical
record
database may include one or more of a subject's prescription information,
pharmacy
information, health care worker information, or health insurance information.
In an
embodiment, the computing device communicating with the kiosk includes
generating an
output indicative of the satisfaction or denial of a medical record threshold
(e.g., medical
record dataset differs from the verification dataset in that the verification
dataset may
include the medical record dataset as well as other identifying information).
In an
embodiment, the medical record threshold satisfaction or denial is determined
by at least
one of presence of an available prescription for which the subject is seeking
dispensation,
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approval of a new prescription for the subject for which the subject is
seeking
dispensation, means for contacting a health care worker for approval (e.g.,
transmitting a
signal from the medical database to a physician for approval) for example, for
a chronic
condition or on-going health issue related to the medical product or service
sought, or
approval by a health insurance company for a prescription for the subject. In
an
embodiment, the system communicates the output indicative of the satisfaction
or denial
of a medical record threshold with at least one of a health care worker,
pharmacy, or
health insurance company. In an embodiment, the computing device associated
with the
medical record database is configured to receive at least one input from the
kiosk
indicative of the dispensation of all or part of the prescription (or portion
thereof) sought
by the subject. In an embodiment, the dispensation includes a quantity or
amount of the
prescription dispensed. In an embodiment, the dispensation is recorded in the
subject's
medical records and/or transmitted to a third party (e.g., insurance company,
health care
worker, pharmacy, etc.).
In an embodiment the medical services or products include prescription
products or
services. In an embodiment, the medical services or products include non-
prescription
products or services. In an embodiment, the system has a specific user
identification (e.g.,
fingerprint, social security number, random subject identifier, retinal scan,
etc.) to identify
the subject. In an embodiment, a security breach identification service
operates to alert the
system when the kiosk or other remote facility has had an attempted disabling
or other
destruction or assault. In an embodiment, product identification (e.g., RFID
tag) alerts the
system if it has been obtained by way of breaking or disabling the kiosk. In
this regard, a
"check out" procedure may be implemented as part of the process of the subject
requesting
the medical product or service, and in order to control for inventory and
security. If the
"check out" procedure is breached in any way, the system shuts down and the
security
alert is triggered. In an embodiment, each engagement of the kiosk system is
registered or
recorded (e.g., by camera) and may be logged within the system. In an
embodiment,
automatic tracking of inventory includes automatically ordering more of a
particular
product when that product has run low (e.g., decreased past a certain
threshold that
triggers an automatic system alert to order more), and in an embodiment, any
drug or other
product recalls are automatically transferred within the system through the
network such
that no additional dispensing of the recalled product occurs, and optionally
the subjects
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having already received the recalled product are notified (e.g., by text to
their cell phone,
by email, by written mail notice, by telephone call, etc.).
In an embodiment, non-prescription medical services or products can be
purchased
by credit card/debit card/smart phone/wired money transaction/cash/electronic
money
transaction, or other means. For example, the kiosk may contain containers or
compartments for dispensing particular implements, such as eye glasses, canes,
walkers,
braces, and the like, that may be dispensed for example, by a tube or other
single-action
mechanism. In an embodiment, multiple requests by the subject are satisfied in
one single
transaction. In an embodiment, the subject is required to submit separate
requests for each
product or service requested.
In an embodiment, a voice recognition or facial recognition system is utilized
for
verification of the subject's identity, request, or receipt of the product or
service requested.
In an embodiment, the system includes a network, such as an intranet or the
Internet, or other local and wide area networks. As described herein, a host
system may
network to one or more remote kiosks or other remote locations or facilities
that may be in
different geographical areas, such as different parts of a city, different
cities, different
states, different countries, etc.
In an embodiment, the subject is provided with one or more options for
obtaining a
medical service or product. For example, if the subject reports having a
headache and
requests non-prescription pain reliever, the kiosk or other interactive remote
dispensing
system may ask if the subject has an allergy or prefers one pain reliever over
another, for
example, by listing aspirin, acetaminophen, or ibuprofen.
In an embodiment, a particular subject undergoes assessment with one or more
sensors. For example, in an embodiment, the subject is assessed with one or
more first
sensors that then activates one or more second sensors, depending on the
conditions
sensed and criticality of the subject based on the first sensing (and
optionally,
consideration of information included in a subject's health record(s)) a first
sensor initiates
a system (e.g., a subject passes by it or enters the facility), or self-
reporting of
characteristics (e.g., symptoms) by the subject. In an embodiment, the subject
undergoes
assessment based on a decision tree originating with the first sensor and/or
self-reporting
of characteristics (e.g., symptoms) by the subject. (See for example, Shi et
at., Science
Direct pp. 2016-2028, Vol. 42 (2007); U.S. Patent App. Pub. No. 2010/0049095,
the
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content of each is incorporated herein by reference.) For example,
nonphysiologic and
physiologic sensing can be performed by one or more sensors of the system
alone or in
conjunction with biological assays, which can be performed by the system
(blood glucose
finger prick test, breathalyzer, DNA swab, pluse-oximeter, etc.), or self-
reporting by the
subject of any characteristics (e.g., symptoms) and of the subject's perceived
severity or
criticality of such characteristics (e.g., symptoms) (e.g., battery of
questions or a figure of
a human or other model subject for reporting the location of pain or other
trouble) in order
to generate one or more Evaluated Criteria for the subject. In an embodiment,
the subject
is unaware of the assessment with one or more sensors. In an embodiment, the
subject is
unresponsive or unconscious. In an embodiment, the subject is given a choice
as to
whether to be assessed by the one or more sensors. In an embodiment, a privacy
curtain or
separate room space is designated for particular evaluations of the subject,
or if the subject
request it. In an embodiment, a curtain or other privacy screen closes
automatically when
the subject engages with the kiosk. In an embodiment, a subject may plug in a
set of
earphones or his/her own personal ear phones to hear any audible alerts or
messages from
the kiosk.
Next, depending on the results of the assessment (i.e., sensed conditions,
biological
assays, self-reported characteristics, and optionally the subject's health
record(s) (e.g.,
electronic health record)), and the corresponding Evaluated Criteria for the
subject, based
on comparison with a characterization value dataset. Once the EC for the
subject are
generated, the subject is assigned a Health Status Indicator (HSI) value based
on
comparison with a health status value dataset. The health status dataset may
include
indications, values or statistics of various bodily measurements or results of
assays or
sensed parameters, including but not limited to blood pressure, heart rate,
body
temperature, height, weight, body mass index, pupil size, blood glucose,
muscle mass,
viral load, viral infection, bacterial infection, bacterial load, pregnancy
status,
pharmaceutical or other drug presence or level, tumor presence or status,
blood type,
allergy status, nutrition status, and others. The health status dataset may
include general
population statistics, it may include statistics from a particular selected
population group
(e.g., based on gender, familial history, demographic, or geographic group),
it may include
the subject's own previously collected health records or information, or any
combination
thereof
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In an embodiment, sensed, assayed, or reported characteristics are compared
with
known values, including but not limited to a database of standardized values,
or a subject's
own health history values. Based on the HSI of the subject, a decision is made
utilizing
instructions implemented on a computing device (network, etc.) to initiate a
second set of
sensors, biological assays, or health queries (HQs). The second assessment can
be
predetermined or customized for a particular subject, depending on the needs
of the
healthcare facility or the needs of the subject.
For example, if it is detected or self-reported that a subject has an elevated
heart
rate and possible fever, the information from the subject's health record (or
information
from friends/relatives that are with the subject) can be considered in order
to determine
which immunizations the subject has or has not received. This may prompt an HQ
of
asking the subject if he/she has traveled anywhere recently, or been in close
proximity to
someone who has. This may also illicit further sensors to sense additional
characteristics
or the system to perform biological assays (e.g., finger prick for blood test
with PCR for
pathogens, etc.) and evaluate the overall condition of the subject based on
the sensed
conditions. If further sensors or biological assays indicate that the subject
has no other
symptoms, for example, this finding will determine a particular HIS and
instruct the
subject as to what steps to take next (e.g., seek further medical attention,
take a fever-
reducing medication sold over the counter or by prescription, seek rest,
etc.).
In an embodiment, at least one first sensor or other components of the system
is in
operable communication with at least one second sensor or other component. In
an
embodiment, the at least one first sensor or other component is in wireless
communication
with at least one second sensor or other component. Various modes of wireless
communication are described herein. In an embodiment, information obtained or
collected
regarding the subject is shared or transferred from one part of the system to
another. For
example, the results of an assay can be entered into the subject's medical
records, or the
subject's health records can direct the focus of a sensor for assessing the
subject's present
state of health. In this way, in an embodiment, the system represents an
integrated system
of multi-directional communication between one or more parties, including at
least one of
a subject, a healthcare worker, one or more databases, and one or more assays,
sensors, or
self-reporting queries. In an embodiment, assessing at least one symptom of
the subject as
an evaluated criteria includes in the input for receiving a medical product or
service. In an
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embodiment, assessing includes registering at least one self-reported
responses to one or
more health queries. In an embodiment, as described herein.
In an embodiment, at the time the subject first engages with the kiosk, he or
she
can refuse to have any data collected by way of assessment (e.g., sensors,
biological
assays, health record (including prescription records, stored electronic
monitoring data,
etc.), family health history (including questioning family members), or HQs).
In such a
situation, for example, the subject may still provide a fingerprint, driver's
license, social
security number, birth date, anonymous unique identifier, or other form of
identification
for check-in, and optional accessing of the subject's health records,
depending on the
request made by the subject (e.g., to obtain part or all of a prescription
drug). In an
embodiment, a date and/or time stamp is registered at the time the subject
engages with
the kiosk or begins the assessment process. In an embodiment, the system,
devices,
methods, etc. are fully scalable to accommodate multiple "feeder" healthcare
facilities or
healthcare workers utilizing the kiosk, or multiple different delivery devices
within one
kiosk system or kiosk location. For example, in an embodiment there are
multiple lock
boxes or cartridges for delivery a product or service.
In an embodiment, the systems, devices, methods, or computer program products
described herein include the ability to interact with additional information
from, for
example, another computer system of dataset (e.g., personal data storage,
personal
monitoring device or sensor network, patient tracking system (e.g., Amelior
EDTracker),
information system (e.g., Amelior ED), network sensors (e.g., mT TagTm or
other network
sensor), implanted sensors, or user input. See for example, U.S. Patent App.
Pub. Nos.
2007/0088713, and 2006/0212085, each of which is incorporated herein by
reference.
In an embodiment, the sensors include at least one of an electric potential
sensor,
high input impedance electrometer, electromagnetic sensor, radiofrequency
sensor,
microwave sensor, micropower impulse radar sensor, ultrasonic sensor, imager,
camera,
thermal sensor, laser, infrared sensor, or audio sensor. In an embodiment, the
sensor is
located in at least one of the walls, floor, input/output device, door,
doorway, pen, stylus,
or computer system hardware. In an embodiment, the imager includes at least
one of a
thermal imager, light imager, or ultrasonic imager.
In an embodiment, the sensor includes at least one of an ECG, EOG, EEG, MEG,
pulsometer, oximeter, pupillometer, fluid detector, biomechanical assessor,
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spectrophotometer retinal interrogator, respiration detector, spirometer, or
implanted
physiological sensor. In an embodiment, the fluid detector includes at least
one
microfluidic chip or device. In an embodiment, the respiration detector
includes at least
one of a remote imager or direct pressure sensor.
As described herein, the various components of the systems include one or more
transmitter, transceiver, or receiver in order to communicate among and
between
components, such as for example, within the kiosk network or in certain cases,
beyond the
network.
In an embodiment, the systems, devices, methods, or computer program products
described herein include access to the subject's health history (e.g.,
individual and/or
family health history). In an embodiment, the systems, devices, methods, or
computer
program products use artificial intelligence for at least one step of the
described
embodiment(s) (e.g., OSCAR-MDA, CodeBlue, etc.).
In an embodiment, the systems, devices, methods, or computer program products
described herein include interaction or tracking information with other
datasets, for
example, a public health database (e.g., CDC, NIH, state or local agency
database, etc.).
In an embodiment, the systems, devices, methods, or computer program products
described herein access and interact with infectious disease information, bio-
weapon or
chemical weapon information (e.g., Homeland Security), adverse effects of
drugs or
equipment (e.g., for manufacture recalls), or healthcare facility statistics
(e.g., infection
rates, hygiene, liability, etc.). In an embodiment, a decision may be made
based at least
partly on information received from such a database, that the subject must be
quarantined.
In an embodiment, information is transferred one or more directions, including
updating
databases with infectious disease or other public health issues (signs of
bio/chemical
weapons), adverse effects to drugs or equipment (e.g., for recalls), hospital
issues such as
infection rates, hygiene, or liability.
In an embodiment, the HSI of the subject or HQ satisfies a threshold
condition, and
optionally indicates that one or more Evaluated Criteria of the subject must
be monitored.
For example, the subject can be monitored continuously or intermittently
(e.g., at
predetermined times or customized times) based on the subject or subject's
condition. For
example, if a particular subject is requesting a narcotic prescription, but an
HQ or EC
indicates that the subject already has narcotic or narcotic metabolism by-
products in its
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body, the prescription may be denied, the subject may be assessed further
(e.g., determine
the precise level of narcotic or by-products in the blood), or directed to a
physician or
other healthcare worker.
In an embodiment, one or more sensors utilized in assessing the subject,
including
one or more remote non-conductive sensors, are located in one or more of
furniture, wall,
floor, door, doorway, reception counter, pen, computer monitor or other
hardware, or
computing device from which a subject is self-reporting one or more
characteristics (e.g.,
symptoms). In an embodiment, the one or more sensors are included in an exam
table,
chair armrest, gurney, or other furniture.
In an embodiment, the one or more sensors include at least one of ultrasound,
bioimpedance, or infrared thermometry. In an embodiment, the one or more
sensors
include audio sensors (e.g., cameras that are audio and/or video recorders),
or eye tracking
(e.g., imagers). See, for example, U.S. Patent App. Pub. Nos. 2010/0049095;
2006/0190419; 2008/0039698; or 2010/0174533, or U.S. Patent No. 6,475,161,
each of
which has been incorporated herein by reference.
In an embodiment, one or more subject specific characteristics are measured,
including but not limited to characteristics of the subject including at least
one of height,
weight, fingerprint, facial features, visible physical malformations, eye
characteristic,
appearance of skin, appearance of hair, appearance of nails, respiratory
sounds, body
temperature, blood gas level, heart rate, brain electrical activity,
respiration rate, facial
expression, blood chemistries, blood cell counts, platelet counts, antibody
titer, calcium
level, blood antigen type, tissue antigen type, evidence of a pathogen
exposure, lipids
levels, perception of pain level, body movement (tremors, spasms, or
paralysis, etc.), gait,
stiffness (e.g., muscle or joint stifthess), evidence of cognition state,
dehydration, self-
reported pain, self-reported malaise, self-reported injury, self-reported
event, rigor, fever,
self-reported light-headedness or dizziness, self-reported dry mouth, self-
reported nausea,
self-reported shortness of breath, self-reported thirst, weakness, self-
reported sleepiness,
hearing loss or problem, vision loss or problem, self-reported constipation or
diarrhea,
flatulence, self-reported urinary incontinence, self-reported loss of smell or
problem, self-
reported loss of voice or problem, self-reported loss of taste, self-reported
loss of ability to
walk, self-reported loss of ability to write, self-reported loss of ability of
limb or digit use,
or other characteristic. For example, the appearance of skin, hair, or nails
can be evaluated
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by standard criteria, including but not limited to hair loss or change in
condition, change in
any birthmarks, tattoos or skin blemishes (or arise of any new birthmarks,
moles, or other
skin marks), body odor, change in nail condition, damage due to exposure to
sun or
chemicals, etc. In an embodiment the evidence of cognition state includes at
least one
visual or auditory cue.
In an embodiment, one or more subject specific characteristics are assessed by
one
or more direct or indirect sensors (e.g., remote non-conductive sensors). In
an
embodiment, one or more subject specific characteristics are assessed by self-
reporting by
the subject. For example, in an embodiment, the subject interacts with at
least one
input/output computing device (e.g., kiosk, tablet, desktop, laptop, handheld
device, etc.)
and responds to health queries (HQs) relating to his or her characteristics
(e.g., symptoms)
or requests. For example, in an embodiment, the subject may be presented with
(in any
number of different possible languages or audio/visual representations such as
pictures of
a body denoting points of pain or illness) HQs relating to one or more
characteristics of:
abdominal pain, knee pain, blood in stool, low back pain, chest pain, nasal
congestion,
constipation, nausea or vomiting, cough, neck pain, diarrhea, numbness or
tingling in
hands or feet, difficulty swallowing, pelvic pain (female or male), dizziness,
eye
discomfort and/or redness, shortness of breath, foot or ankle pain, shoulder
pain, foot or
leg swelling, sore throat, headache, urinary problems, vision problems, heart
palpitations,
hip pain, wheezing, joint or muscle pain, skin rash or other rash, earache, or
other
symptoms.
In an embodiment, the HQs asked of the subject are customized and directed
based
on previous answers provided or other information known about the subject
(e.g., by way
of the self-reporting, or by way of electronic health record, sensed
information, etc.). For
example, the HQs may be different based on the person's gender, health
history, or
response to answering a first round of specific HQs. In an embodiment, the HQs
are
prioritized, for example, based on symptoms or request made (e.g., request for
narcotic
pain reliever) with the first HQ having a heavy weight assigned due to its
criticality or
seriousness of symptom(s), and depending on the response to that HQ, the HQs
that follow
are tailored to address the concerns presented in the prior response.
For example, if a subject with a history of heart disease engages with the
kiosk or
other remote facility, and a first remote non-conductive sensor senses and
signals that the
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subject has an irregular heartbeat, a second sensor quickly determines if the
subject is
responsive enough to answer HQs. If so, one of the first HQs for this subject
could be:
"How may I help you?" If the subject responds by requesting a full or partial
dose of his
nitroglycerine prescription, for example, the second HQ might be: "Do you have
chest
pain?" If the subject responds, "Yes," then another HQ could be, for example:
"Rank
your level of pain on a scale of 1 to 5, with 5 being greatest level of pain."
Again,
depending on the response, with each HQ receiving a particular numerical
Evaluated
Criteria value, the HQs will be adjusted specifically for the reporting
subject. For
example, if the subject reports a high level of pain "5," the system will
determine that the
subject has a high Evaluated Criteria value, and when compared with the Health
Status
Indicator dataset, generates a specific overall HSI value.
When one or more HSI values satisfy a threshold condition, the subject is
assessed
further, questioned further, or instructed to receive further medical
attention at a healthcare
facility. Depending on the responses by the subject, and optionally the
subject's health
records (e.g., accessed electronically) he/she may or may not receive his/her
requested
prescription. In an embodiment, the subject receives a placebo instead of the
requested
medical service or product.
In an embodiment, subject identification, request, payment authorization
and/or
insurance coverage is received by the kiosk device or system as a single data
entry point
by having the subject complete the step of entering information from his/her
insurance
card (e.g., scanning it, manually keying it in, orally reading it, etc.) or
may be received by
the kiosk device or system as multiple different data entry points by having
the subject
complete separate steps of entering information from a driver's license or
social security
card, a credit or debit card, and/or insurance card. If the subject has
previously used a
kiosk in the system, then entering this information is unnecessary, and in an
embodiment,
the subject is given a secure access (e.g., log in username and password) so
that the subject
may save time by not having to enter identifying information each time he/she
uses the
kiosk device or kiosk system. Thus, in an embodiment, the system includes a
storage
component, as described in the Figures, that stores one or more pieces of
health
information related to one or more of electronic health records, Evaluative
Criteria, HQs
(and/or answers thereto), subject-entered information, information entered by
a healthcare
worker, etc. Likewise, as part of the regularly scheduled medical product or
service
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delivery described elsewhere, in an embodiment the subject does not need
authorization to
receive the same medical product or service, but instead merely logs in the
system and
requests the regularly scheduled portion of the prescription already put in
place and
previously authorized. Thus, a prescription voucher or evaluation is not
always required
for particular embodiments described herein.
In an embodiment, the subject's request is granted and the medical service or
product is processed for dispensing directly at the kiosk or another location.
In an
embodiment, during processing, the kiosk has been pre-loaded with various
commonly
prescribed pharmaceutical drugs, implements, or tests. In an embodiment, the
system or
device includes labeling the product container or service slip, and optionally
includes
subject-specific information, as well as information of the contents therein.
In an
embodiment, the kiosk dispenses the medical product or service by scanning a
code on the
label or on the container. Various types of codes are described herein
elsewhere.
In an embodiment, the information input from the subject is assigned varying
degrees of confidence depending on the source of the information, in order to
reduce
conflicting information. For example, if a subject self-reports a high level
of pain, but
sensors detect no corresponding characteristics typical of a high level of
pain (e.g., rapid
heart rate, perspiration, agitation, facial expressions of discomfort, etc.),
the self-reported
HQ of a high level of pain may receive a lower numerical value than if the one
or more
sensors verify characteristics typical of a subject's being in a high level of
pain.
In an embodiment, exemplary HQs include but are not limited to, "What have you
tried for your condition today?" "Do you want to request a prescription drug?
If yes, have
you received a prescription for this drug before? If no, do you want to
request a non-
prescription drug?"; "Do you want to request any prescription services or
implements?"
"Do you smoke?"; "Do you have any allergies? If yes, are you allergic to any
pharmaceutical drugs?"; "Do you have any changes in skin or hair?"; "Do you
have
shaking or tremors?"; "Do you have numbness anywhere in your body?": "Have you
traveled lately?"; "Do you have difficulty swallowing?"; "Have you ever had a
fainting
spell or convulsion?"; "Do you have any lumps or bumps in your body?"; "Please
indicate
whether you are male or female."; "Are you pregnant?"; "Any change in
appetite?"; "Are
you sexually active?"; "Do you have any vomiting?"; "Do you drink alcohol?";
"List any
drugs ingested in the past 24 hours, including recreational or pharmaceutical
drugs.";
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"Have you had any medical biological assays or treatments (including
surgeries) lately?";
"Rate your pain on a scale of 1 to 5, with 5 being the highest amount of pain
you have ever
had."; "How is your energy level?"; "Are you socially withdrawn?"; "Have you
been
feeling anxious lately?"; etc. Further examples of potential questions are
available, for
example, in U.S. Pat. App. Pub. No. 2004/0138924, which is incorporated herein
by
reference.
If a subject engages the kiosk or other remote facility (e.g., by pushing a
"START"
button) but fails to answer at least one HQ., then one or more remote sensors
may assist in
determining if the subject is fully conscious, or able to proceed with the
process. For
example, a camera may determine if the subject is in pain, appears to be
having a seizure
or stroke, appears to be intoxicated, or is not fully conscious. At least a
portion of the
image is compared to various parameters and databases for signs of trauma,
evaluation of
appearance (skin, hair, nails, etc.), movement and cognition. At least a
portion of the
image is optionally compared with medical history by way of facial
recognition.
In an embodiment, the kiosk transmits a notification relating to the request
or
voucher set forth by the subject. For example, a red light/green light or
audio notice may
provide notice that the voucher is not valid, not functioning properly. In
another example,
the notice provides verification that the voucher is valid and is functioning
properly and
the request for the medical product or service is being processed.
In an embodiment, the subject utilizes a "smart" dispenser for his/her
individual
use, which is able to electronically communicate with the kiosk or other
remote facility.
For example, the "smart" dispenser is able to wirelessly (e.g., via Bluetooth,
flash drive,
etc.) upload and/or download information to the kiosk. In another example, the
"smart"
dispenser is able to communicate (e.g., electronically, by audio-visual mode,
or other
mode) with the kiosk for obtaining or requesting a medical product or service.
As shown in Figure 1, the system 100 includes at least one input/output device
117
either secured to a wall or movable (such as on a table or counter),
optionally including a
head sensor 118, and each can include data input such as for example one or
more of
keyboard input, mouse trackball or touchpad input, speech input, or
audio/video input. In
an embodiment, the input/output device includes a printer, fax, or scanner
(120 indicates a
printer/fax/scanner combination). In an embodiment, output includes a printed
voucher
for the subject to receive a requested product or service. As indicated, one
or more
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sensors 102, 118, are located in proximity to or in directly contact with the
subject 104.
The optional location indicator 119 (shown as an armband) for determination by
the kiosk
or kiosk network of the subject's location and optionally allows for
notification to the
subject if the subject is instructed to exit the kiosk and seek medical
attention elsewhere,
or obtain the requested medical product or service at another location. In an
embodiment,
the optional location indicator can map where the subject is located and where
the subject
should travel to obtain the requested medical service or product.
As indicated, in an embodiment, the input/output device (including a keyboard,
audio/video, or other device) includes a receiver 106 (optionally wireless,
shown on
camera), transceiver 108 (optionally wireless), transmitter 110 (optionally
wireless),
includes audio/video capabilities (e.g., camera 114), includes a power source
115, and
memory 116. In an embodiment, the input/output device 117 is operably coupled
to a
computer device 112.
In an embodiment, a code acceptor 160 is included in the system 100. For
example, the code acceptor 160 can include a voucher scanner, a fingerprint
swiper, an iris
scanner, a driver's license scanner, a bar code scanner, a QR scanner,
keyboard, or other
code acceptor.
In an embodiment, the system includes circuitry having one or more components
operably coupled (e.g., communicatively, electromagnetically, magnetically,
ultrasonically, optically, inductively, electrically, capacitively coupled, or
the like) to each
other. In an embodiment, circuitry includes one or more remotely located
components. In
an embodiment, remotely located components are operably coupled via wireless
communication. In an embodiment, remotely located components are operably
coupled
via one or more receivers 106, transceivers 108, or transmitters 110, or the
like.
In an embodiment, circuitry includes, among other things, one or more
computing
devices such as a processor (e.g., a microprocessor), a central processing
unit (CPU), a
digital signal processor (DSP), an application-specific integrated circuit
(ASIC), a field
programmable gate array (FPGA), or the like, or any combinations thereof, and
can
include discrete digital or analog circuit elements or electronics, or
combinations thereof
In an embodiment, circuitry includes one or more ASICs having a plurality of
predefined
logic components. In an embodiment, circuitry includes one or more FPGA having
a
plurality of programmable logic components.
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In an embodiment, circuitry includes one or more memory devices 116 that, for
example, store instructions or data. For example in an embodiment, the
automated data
collection system 100 includes one or more memory devices 116 that store
information
related to one or more characteristics of the subject that has been assessed,
electronic
health records, self-reported symptoms, insurance, or other health-related
information.
Non-limiting examples of one or more memory devices 116 include volatile
memory (e.g.,
Random Access Memory (RAM), Dynamic Random Access Memory (DRAM), or the
like), non-volatile memory (e.g., Read-Only Memory (ROM), Electrically
Erasable
Programmable Read-Only Memory (EEPROM), Compact Disc Read-Only Memory (CD-
ROM), or the like, persistent memory or the like, Erasable Programmable Read-
Only
Memory (EPROM), flash memory, or the like. The one or more memory devices 116
can
be coupled to, for example, one or more computing devices 112 by one or more
instructions, data, or power buses.
In an embodiment, circuitry includes one or more computer-readable media
drives,
interface sockets, Universal Serial Bus (USB) ports, memory card slots, or the
like, and
one or more input/output components such as, for example, a graphical user
interface, a
display, a keyboard, a keypad, a trackball, a joystick, a touch-screen, a
mouse, a switch, a
dial, or the like, and any other peripheral device. In an embodiment,
circuitry includes one
or more user input/output components that are operably coupled to at least one
computing
device to control (electrical, electromechanical, software-implemented,
firmware-
implemented, or other control, or combinations thereof) at least one parameter
associated
with, for example, the health information related to the subject's health
condition.
In an embodiment, the system is configured to operate in an application
service
provider format. In an embodiment, the system is configured to be implemented
using
open source tools. For example, in an embodiment, the system includes using
one or more
of Java, Java server pages (JSP), Java database connectivity (JDBC),
structured query
language (SQL), extensible markup language (XML), user interface language
(XUL)
and/or scalable vector graphics (SVG) technologies.
In an embodiment, image-based applications such as viewers and/or toolkits
(e.g.,
Insight Segmentation and Registration Toolkit (ITK)), are incorporated for
further intake
of information. In an embodiment, CAD implementations or image segmentation
may
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allow previous processing of images previously accepted on intake of
information from
the subject.
In an embodiment, circuitry includes a computer-readable media drive or memory
slot that is configured to accept non-transitory signal-bearing medium (e.g.,
computer-
readable memory media, computer-readable recording media, or the like). In an
embodiment, a program for causing a system to execute any of the disclosed
methods can
be stored on, for example, a computer-readable recording medium (CRMM), a non-
transitory signal-bearing medium, or the like. Non-limiting examples of signal-
bearing
media include a recordable type medium such as magnetic tape, floppy disk, a
hard disk
drive, Compact Disc (CD), a Digital Video Disk (DVD), Blu-Ray Disc, digital
tape,
computer memory, or the like, as well as transmission type medium such as a
digital
and/or analog communication medium (e.g., fiber optic cable, waveguide, wired
communications link, wireless communication link (e.g., receiver 106,
transceiver 108, or
transmitter 110, transmission logic, reception logic, etc.). Further non-
limiting examples
of signal-bearing media include, but are not limited to, DVD-ROM, DVD-RAM,
DVD+RW, DVD-RW, DVD-R, DVD+R, CD-ROM, Super Audio CD, CD-R, CD+R,
CD+RW, CD-RW, Video Compact Discs, Super Video Discs, flash memory, magnetic
tape, magneto-optic disk, MINIDISC, non-volatile memory card, EEPROM, optical
disk,
optical storage, RAM, ROM, system memory, web server, cloud, or the like.
In an embodiment, the ADC system 100 includes circuitry having one or more
modules optionally operable for communication with one or more input/output
components that are configured to relay user output/input. In an embodiment, a
module
includes one or more instances of electrical, electromechanical, software-
implemented,
firmware-implemented, or other control devices. Such devices include one or
more
instances of memory, computing devices, antennas, power or other supplies,
logic modules
or other signaling modules, gauges or other such active or passive detection
components,
piezoelectric transducers, shape memory elements, micro-electro-mechanical
systems
(MEMS) elements, or other actuators.
In an embodiment, the computing device further includes audio/visual
input/output
connected to the system and configured to interact with the subject. In an
embodiment,
the system further includes a printing device connected to the computing
device. In an
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embodiment, the system includes an input/output device including a graphical
interface
(e.g., display, touch screen, etc.).
In an embodiment, the one or more sensors include, for example, one or more
acoustic sensors, optical sensors, electromagnetic energy sensors, image
sensors,
photodiode arrays, charge-coupled devices (CCDs), complementary metal-oxide-
semiconductor (CMOS) devices, transducers, optical recognition sensors,
infrared sensors,
radio frequency component sensors, thermo sensors, three-dimensional sensors
(e.g. to
assess the subject's facial expressions exhibiting pain or discomfort,
flushing or redness,
or a subject's gait or other movements, etc.).
In an embodiment, one or more components of the system (e.g., chair
impregnated
with sensors for assessing one or more characteristics of the subject) operate
in a
networked environment using logic connections to one or more remote computing
devices
(e.g., a common network node, a network computer, a network node, a peer
device, a
personal computer, a router, a server, a tablet PC, a tablet, etc.) and
typically includes
many or all of the elements described above. In an embodiment, the logic
connections
include connections to a local area network (LAN), wide area network (WAN),
and/or
other networks. In an embodiment, the logic connections include connections to
one or
more enterprise-wide computer networks, intranets, and the internet. In an
embodiment,
the system 100, the one or more components of the system, or the like operate
in a cloud
computing environment including one or more cloud computing systems (e.g.,
private
cloud computing systems, public cloud computing systems, hybrid cloud
computing
systems, or the like).
In an embodiment, the subject 104 includes a fetus. In an embodiment, the
subject
includes a human being. In an embodiment, the human being includes a fetus. In
an
embodiment, the subject includes a living organism that is distinguished from
plants by
independent movement and responsive sense organs.
In an embodiment the one or more sensors 102 may sense heartbeat intervals and
ECG readings remotely by measuring small electrical potentials using a high
input
impedance electrometer. An example of such a sensor device is described in
U.S. Patent
Application Pub. No. 2006/0058694, supra; WO 2003/048789, supra; Harland,
Meas. Sci.
Technol., supra; Prance, 2007 Journal of Physics: Conference Series, supra,
each of which
is incorporated herein by reference. Such sensor devices are expected to
provide
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noninvasive and remote monitoring. In an embodiment, the one or more sensors
102 may
be worn by the subject in or on clothing or jewelry, such as in wrist bands,
and may be in
non-conductive contact with the body. For example, as described by U.S. Patent
Application Pub. No. 2006/0058694, supra; WO 2003/048789, supra; C.J. Harland
et al.,
14 Meas. Sci. Technol. 923-928 (2003), each of which is incorporated herein by
reference.
In an embodiment, the one or more sensors 102 may be included in or associated
with a
piece of furniture, such as a chair or desk, or electronics such as a personal
computer, or
with some other remote item within, e.g., within approximately one meter from
the
subject. In an embodiment, the one or more sensors 102 are able to measure
electric
potentials may be embedded in objects, such as a bed or chair, in direct but
non-
conductive contact with the subject. For example, as described by U.S. Patent
No.
7,245,956, supra, each of which is incorporated herein by reference. In an
embodiment,
the one or more sensors 102 may sense heartbeat intervals and
electrocardiographic
information by examining physiologic activity of the subject or its organs and
may be
operable to sense a characteristic of the subject 104 in response to an
electromagnetic
signal sent at or illuminating the subject and reflected from the subject. In
an
embodiment, the illuminating may include exposing, subjecting, or directing
energy at the
subject. Systems using illuminating or reflected electromagnetic signals,
including
radiofrequency (RF) or microwave signals, are described in U.S. Patent No.
7,272,431;
U.S. Patent Application Pub. No. 2004/0123667; or U.S. Patent Application Pub.
No.
2008/0045832; each of which is incorporated herein by reference. In an
embodiment, one
or more sensors 102, which may be or include a sensor array, may be deployed,
for
example, throughout a room, perhaps as part of a smart room network, so as to
monitor the
subject at rest or in motion.
In an embodiment, information gathered by the one or more sensors 102 may be
communicated to a computer. In an embodiment, information may be communicated
to a
computer of the system electronically. In an embodiment, information may be
communicated to a computer of the system wirelessly, for example using radio
waves or
ultrasound waves, or BluetoothTM technology. In an embodiment, a computer, may
be
used to process the information. The computer may be part of a network.
As illustrated in Figure 1, in one embodiment a system 100 for delivering
medical
products or services includes one or more sensors 102 configured to assess a
subject 104.
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As shown, the subject 104, can be assessed by various modes, including but not
limited to,
input/output device (e.g., user interface) 117, sensor (e.g., breathalyzer,
thermal scan,
respiration sensor, pupillometry, retinal scan, etc.) 118, audio/visual device
114 (e.g.,
camera), optionally including one or more of a receiver 106, transceiver 108,
transmitter
110, computer device 112, memory 116, or power source 115.
In an embodiment, the one or more sensors 102 includes a sensor array
configured
to sense a characteristic of the subject 102 without physically contacting the
subject. For
example, the sensor array may include at least two sensor heads. In an
embodiment, the at
least two sensor heads may include at least two sensor heads configured to
sense the same
characteristic of the subject. In an embodiment, the at least two sensor heads
may include
sensor heads configured to sense different characteristics of the subject. For
example, one
sensor head may be configured to sense temperature, another sensor head
configured to
sense heart rate, and a further sensor head configured to sense blood
pressure. In an
embodiment, the sensor includes a sensor responsive, without physically
contacting the
subject, to an impedance, capacitance, permittivity, reflectivity, absorption,
or electrical
activity of the subject. For example, a sensor including a capacitive
proximity sensor
element configured to sense a characteristic of a subject without physically
contacting the
subject is described in U.S. Patent Application Pub. No. 2008/0246495,
incorporated
herein by reference. For example, in an embodiment, a reflection or
reflectivity
characteristic may include an acoustic, light, or radio wave reflectivity. In
an
embodiment, the sensor includes a sensor responsive to the characteristic of a
subject
without physically contacting the subject. In an embodiment, the sensor
includes a sensor
configured to sense a characteristic of a subject, for example, at least one
anatomical or
physiological characteristic. The characteristics measured include steady
state
characteristics (e.g., height, weight, etc.), and variable characteristics
(e.g., heart rate,
blood oxygen level, etc.).
In an embodiment, the one or more sensors 102 includes a sensor configured to
sense an Evaluated Criteria of the subject 104 without physically contacting
the subject.
For example, the sensor may be configured for an association with a chair, a
pillow, or a
gurney. In an embodiment of this sensor, the sensor may include a sensor
configured for a
physical association with an article of clothing or garment wearable by a
subject and to
sense a characteristic of the subject without physically contacting the
subject. In an
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embodiment of this sensor, the sensor may include a sensor configured for a
physical
association with an object wearable by a subject and to sense a characteristic
of the subject
without physically contacting the subject. For example, the sensor may be
configured for
a physical association with eye glasses or jewelry. For example, a sensor
configured for a
physical association with an object wearable by a subject is described by U.S.
Patent
Application Pub. No. 2006/0058694, Electrodynamic sensors and applications
thereof, to
T. Clark et al.; WO 2003/048789, Electrodynamic sensors and applications
thereof, by T.
D. Clark et al.; or C. J. Harland et al., High resolution ambulatory
electrocardiographic
monitoring using wrist-mounted electric potential sensors, 14 Meas. Sci.
Technol. 923-
928 (2003), each of which is incorporated herein by reference.
In an embodiment, the one or more sensors 102 include a sensor device
configured
to sense an Evaluated Criteria of the subject 104 without physically touching
the subject.
In an embodiment, the sensor device includes a sensor device configured to
sense an
Evaluated Criteria of a subject without a resistive contact with the subject.
In an
embodiment, the sensor device includes a sensor device configured to sense an
Evaluated
Criteria of a subject without an electrically conductive contact with the
subject. In an
embodiment, the sensor device includes a sensor device configured to sense an
Evaluated
Criteria of a subject across a non-electrically conductive gap with the
subject.
In an embodiment, the sensor device includes an electrodynamic sensor device
configured to sense an electrical activity of the heart of a subject without
physically
contacting the subject. For example, the electrodynamic sensor may be
configured to
sense a heart rate, electrical activity of the heart, such as
electrocardiography (ECG), or
conductivity. An example of a high input impedance electrodynamic sensor
device
configured to sense an electrical activity of a heart of a subject without
physically
contacting the subject is described in U.S. Patent Application Pub. No.
2006/0058694;
WO 2003/048789, supra; Electrodynamic sensors and applications thereof, to T.
Clark et
al. In an embodiment, the sensor device includes an adaptive electric
potential sensor
device configured to sense a characteristic of a subject without physically
contacting the
subject. An example of an adaptive electric potential sensor device configured
to sense a
characteristic of a subject without physically contacting the subject is
described in R.L.
Prance et al., Adaptive Electric Potential Sensors for smart signal
acquisition and
processing, 76 Journal of Physics: Conference Series, 012025 (2007). In an
embodiment,
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the sensor device includes an electric potential probe sensor device
configured to sense a
characteristic of a subject without physically contacting the subject. An
example of an
electric potential probe sensor device configured to sense a body electrical
activity or
signals, such as for example arterial pulse or other body electrodynamics, of
a subject
without physically contacting the subject is described in C. J. Harland et
al., 13 Meas. Sci.
Tech. 163-169 (2002).
In an embodiment, the one or more sensors 102 include a sensor configured to
sense at least one of an electrical, acoustic, thermal, radiative, absorption,
reflection,
gaseous emission, or transmissibility Evaluated Criteria of the subject. In an
embodiment,
a thermal Evaluated Criteria may include an infrared measured thermal
characteristic. In
an embodiment, a thermal Evaluated Criteria may include microwave length (3-30
cm)
electromagnetic radiation naturally emitted by the subject. For example, a
sensor
configured to sense a thermal Evaluated Criteria of the subject includes a
microwave
radiometer operable to measure natural electromagnetic radiation from the
subject's
internal tissue in the microwave range. In an embodiment, the microwave
radiometer may
be combined with an infrared sensor as described in R. Avagyan et al., New
diagnostic
methods in acupuncture, ICMART '99 International Medical Acupuncture Symposium
7,
Riga, (May 21-23, 1999), each of which is incorporated herein by reference.
See also,
Pub. No. WO 2006/091123 (PCT/RU2006/000072), each of which is incorporated
herein
by reference. For example, a transmissibility characteristic may include a
light or radio
wave transmissibility characteristic of the subject that is utilized as an
Evaluated Criteria.
For example, in an embodiment, a radiative characteristic may include gammas
or other
types of radiation emitted by the body of the subject him/herself, for example
potassium
40. An embodiment of a gamma-ray sensor device configured to sense a
characteristic of
a subject without physically contacting the subject is expected to be provided
by the
RadtellTm passive gamma-ray sensor by Oak Ridge National Laboratory of Oak
Ridge,
TN.
In an embodiment, a sensor 102 is operably coupled to one or more sensor
control
units 134. In an embodiment, the one or more sensor control units 134 serve to
regulate
the activity of the one or more sensors 102. For example, in an embodiment,
one or more
sensor control units 134 regulate one or more times when the one or more
sensors 102
detect one or more signals from the subject that are related to one or more
Evaluated
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Criteria of the subject. In an embodiment, the one or more sensor control
units 134
regulate one or more time periods when one or more sensors 102 detect one or
more
signals from the subject that are related to one or more Evaluated Criteria of
the subject.
In an embodiment, a sensor 102 is configured to wirelessly communicate sensed
electrical signals originating from a subject. In an embodiment, a sensor 102
is
electrically or optically coupled to the control circuitry to communicate the
one or more
signals thereto. In an embodiment, a sensor 102 includes one or more sensor
housings
144. In an embodiment, one or more sensor housings 144 are operably coupled
with the
one or more sensors 102.
In an embodiment, numerous types of sensors 102 can be operably coupled to the
computing device 112. Examples of such sensors 102 include, but are not
limited to,
electrodes, surface plasmon resonance detectors, microelectromechanical
systems
detectors, microcantilever detectors, nitric oxide detectors, osmotic
detectors, relativity-
based detectors, chemical detectors, pressure detectors, electrochemical
detectors,
piezoelectric detectors, pH detectors, hydrogel detectors, enzymatic
detectors, ball
integrated circuit detectors, affinity viscosimetric detectors, blood pressure
detectors;
metal detectors, glucose detectors, and the like (e.g., U.S. Patent Nos.:
7,162,289;
6,280,604; 5,603,820; 5,582,170; 6,287,452; 7,291,503; 6,764,446; 7,168,294;
6,823,717;
7,205,701; 6,268,161; 4,703,756; 6,965,791; 6,546,268; 6,210,326; 6,514,689;
6,234,973;
6,442,413; Tu et al., Electroanalysis, 11:70-74 (1999), each of which is
incorporated
herein by reference). In an embodiment, one or more detectors 136 are
configured to
detect one or more of pH, chemicals, or nerve signals from the subject.
In an embodiment, one or more sensor housings 144 include circuitry that is
operably coupled to one or more sensors 102. In an embodiment, one or more
sensor
housings 144 include circuitry that is configured to facilitate elimination of
one or more
sacrificial layers. In an embodiment, one or more sensor housings 144 include
circuitry
that is configured to be operably coupled to one or more sensor control units
134. In an
embodiment, one or more sensor housings 144 include circuitry that is
configured to be
operably coupled to one or more sensor power sources 115. In an embodiment,
one or
more sensor housings 144 include circuitry that is configured to be operably
coupled to
one or more sensor receivers 106. In an embodiment, one or more sensor
housings 144
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include circuitry that is configured to be operably coupled to one or more
sensor
transmitters 110.
In an embodiment, a sensor 102 includes one or more sensor power sources 115
(including but not limited to batteries). In an embodiment, a sensor 102 is
operably
coupled to one or more sensor batteries 115. In an embodiment, a sensor
battery 115
includes a thin-film fuel cell such as a solid oxide type (SOFC), a solid
polymer type
(SPFC), a proton exchange membrane type (PEMFC), and/or substantially any
combination thereof. Methods to fabricate such thin-film fuel cells are known
and have
been described (e.g., U.S. Patent No.: 7,189,471, incorporated herein by
reference). In an
embodiment, one or more sensor batteries 115 include one or more storage films
that are
configured for energy storage and energy conversion. Methods to fabricate such
storage
films are known and have been described (e.g., U.S. Patent No.: 7,238,628,
incorporated
herein by reference). In an embodiment, a sensor battery 115 is a biobased
battery (e.g.,
U.S. Patent No.: 6,994,934, incorporated herein by reference). In an
embodiment, one or
more sensor batteries 115 are thin-film batteries. Methods to fabricate thin-
film batteries,
including thin film microbatteries, are known and have been described (e.g.,
U.S. Patent
Nos. 5,338,625, 7,194,801; 7,144,655; 6,818,356, incorporated herein by
reference). In an
embodiment, one or more sensor electromagnetic receivers (not shown) are used
to
electromagnetically couple power to energize one or more sensors 102 from an
external
power source 115. Methods to construct electromagnetic receivers have been
described
(e.g., U.S. Patent No.: 5,571,152), incorporated herein by reference. In an
embodiment,
the receiver and/or transmitter are not part of the sensor.
In an embodiment, the system 100 includes one or more sensor transmitters 110.
Numerous types of transmitters 110 can be used in association with system 100.
Examples of such transmitters 110 include, but are not limited to,
transmitters that transmit
one or more acoustic signals, optical signals, radio signals, wireless
signals, hardwired
signals, infrared signals, ultrasonic signals, and the like (e.g., U.S. Patent
Nos: RE39,785;
7,260,768; 7,260,764; 7,260,402; 7,257,327; 7,215,887; 7,218,900), each of
which is
incorporated herein by reference. In an embodiment, one or more sensor
transmitters 110
may transmit one or more signals that are encrypted. Numerous types of
transmitters are
known and have been described (e.g., U.S. Patent Nos. and Published U.S.
Patent
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Applications: 7,236,595; 7,260,155; 7,227,956; US2006/0280307), incorporated
herein by
reference.
In an embodiment, the system 100 includes one or more sensor receivers 106.
Numerous types of sensor receivers 106 may be used in association with system
100.
Examples of such sensor receivers 106 include, but are not limited to,
receivers that
receive one or more acoustic signals, optical signals, radio signals, wireless
signals,
hardwired signals, infrared signals, ultrasonic signals, and the like. Such
receivers 106 are
known and have been described (e.g., U.S. Patent Nos.: RE39,785; 7,218,900;
7,254,160;
7,245,894; 7,206,605), incorporated herein by reference.
In an embodiment, the system 100 includes a locked drop box 136 that is
optionally electronically connected to the computing device 112. In an
embodiment, one
or more compartments 145 hold various medical products or services that may be
sought
by a subject 104. In an embodiment, the system 100 includes a dispensing box
142
optionally where the medical product or service is dispensed. In an
embodiment, the
product or service is retrieved directly from the compartment 145 where it is
located. In
an embodiment, the compartment 145 is configured with at least one means for
alerting
the subject 104 that the medical product or service is located in that
compartment 145 and
is ready to be retrieved (e.g., by opening the compartment door). In an
embodiment, the
means for alerting the subject includes at least one audio, visual, or tactile
alert such as, for
example, a light, beeping, buzzing, vibration, or other similar alert. In an
embodiment, the
system 100 further includes a printer/scanner/fax 120. In an embodiment, the
system 100
includes a currency exchanger or acceptor 140. In an embodiment, a privacy
curtain/door
150 allows for privacy while the subject 104 uses the system 100. In an
embodiment, a
pillbox device 155 is configured to be engaged with the computing device 112,
by a port
for example, by way of a wired connection, flash drive (USB), Microdrive, or
wireless
connection. In an embodiment, the pillbox includes at least one compartment
(e.g.
closable compartment) operably coupled with circuitry configured for sending a
signal
when the compartment is engaged (e.g., opened, drug dispensed into the
compartment,
etc.).
Various statistical programs or computer algorithms for simulating systems may
be
implemented with various embodiments described herein. For example, ANOVA,
Monte
Carlo, etc., and other programs may be implemented.
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In an embodiment, a signal can be an external signal 188. Examples of such
signals include, but are not limited to, analog signals, digital signals,
acoustic signals,
optical signals, radio signals, wireless signals, hardwired signals, infrared
signals,
ultrasonic signals, and the like. In an embodiment, one or more signals may
not be
encrypted. In an embodiment, one or more signals may be encrypted. In an
embodiment,
one or more signals may be sent through use of a secure mode of transmission.
In an
embodiment, one or more signals may be coded for receipt by a specific
subject. In an
embodiment, such code may include anonymous code that is specific for a
subject.
Accordingly, information included within one or more signals may be protected
against
being accessed by others who are not the intended recipient.
As shown in Figure 1, in an embodiment describing methods, systems, and
computer program products described herein, one or more subjects engage with
the kiosk
for redemption of a voucher or request of one or more medical products or
services.
In an embodiment, at least one dataset described herein includes a dynamic
data
structure. In an embodiment, at least one dataset described herein includes a
static data
structure. In an embodiment, a subject is assessed based on queries of the
Evaluated
Criteria that form a data structure and that may be utilized to determine an
overall Health
Status Indicator value. In an embodiment, the query includes at least one of a
question of
the subject, observed or sensed Criteria, or input based on the subject's
health history or
health records. In an embodiment, the query includes a survey from an
input/output
device, for example. In an embodiment, the survey can be in any language, or
in pictorial
or other form. In an embodiment, the survey includes skip logic, or
conditional branching,
that allows for the survey to be customized for the subject based on the
subject's previous
responses. For example, if a subject's first query includes asking whether the
subject is
male or female, and the subject answers "female," then the survey skip logic
rules could
be such that it forces the subject to skip questions related to exclusively
male symptoms or
conditions.
In an embodiment, a particular Evaluated Criteria value is coupled to the
Health
Status Indicator value more tightly than another particular Evaluated Criteria
value. For
example, a heavier weight might be given to tightly coupled Evaluated Criteria
to
corresponding Health Status Indicator values (e.g., heart rate, respiration,
etc.). In an
embodiment, one or more Evaluated Criteria values are weighted heavier, thus
generating
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a higher value when included in the subject's response, and tipping the
analysis toward
granting the request by the subject, if an evaluation is needed for the
request. For
example, a heavier weight can be given to a characteristic that is sensed or
present in the
subject's health records, and a lesser weight to a self-reported
characteristic, particularly
when the data collected appears to be contradictory or inconsistent.
In an embodiment, no or minimal evaluation of the subject is required in order
to
grant the request of the medical product or service (e.g., band-aid request, 2
pills of
ibuprofen request, etc.), while moderate or high evaluation of the subject is
required in
order to grant other requests (e.g., pregnancy test request, statin request,
etc.), and certain requests will require that the subject seek additional
medical treatment
and will not be granted under any circumstances or will only be granted by way
of a
subject previously obtaining a voucher from a healthcare provider (e.g.,
narcotics request,
etc.).
As shown in Figure 1, the system 102 includes a computing device 112 with
optionally one or more of a receiver 106, transceiver 108, transmitter 110,
memory 116, or
power source 115. In an embodiment, as described, the dynamic dataset includes
a
compilation of data from each assessed subject in the queue. For example,
Subject is
assessed, generating ABC data (one or more Evaluated Criteria values based on
one or
more assessed characteristics of the subject), which provide the basis for
generation of a
Health Status Indicator value for Subject based on the Evaluated Criteria
value dataset, the
ABC data enters the Evaluated Criteria dataset for that subject. In an
embodiment, this
information is immediately uploaded so that any kiosk or remote access
delivery station in
the network is updated and the subject is disallowed from engaging a second
kiosk for the
same request that was just fulfilled or rejected.
FIG. 2 illustrates one embodiment that includes a system 255 including at
least one
computing device 200. The computing device can take various forms or be part
of an
object, such as a limited resource computing device, a wireless communication
device, a
mobile wireless communication device, an electronic pen, a handheld electronic
writing
device, a digital camera, a scanner, an ultrasound device, an x-ray machine, a
non-invasive
imaging device, a cell phone, a PDA, an electronic tablet device, a medical
apparatus
(implantable or otherwise), a printer, a car, and an airplane.
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The computing device 200 is operably connected to at least one input/output
device (see other Figures) for which the subject 204 can interact. For
example, in an
embodiment, the system 255 includes and input/output device 211, which
includes a non-
transitory signal bearing medium operable to interact with a user 218 (can be
self-reported
information, sensed information, or information obtained from health history
records or
family members, etc. given to a health care worker, a subject may self-report
or an
assistant may report on behalf of the subject) and receive input relating to
the subject's
seeking a medical product or service. In an embodiment, the input/output
device 211
includes a non-transitory signal bearing medium operable to compare the at
least one input
from the subject relating to the subject's attempt to attain a medical product
or service
with one or more verification datasets, as described herein, and generate a
verification
value based on the comparison, and optionally reinitiate receiving at least
one additional
input from the subject, and optionally repeating the comparing step and
generating a
verification value. In an embodiment, the non-transitory signal bearing medium
is
operable to reinitiate receiving at least one additional input from the
subject until a
verification threshold is satisfied or denied and communicate the output
indicative of the
verification value. In an embodiment, the output includes at least one of a
visual cue,
audio cue, or tactile cue. In an embodiment, the input/output device is
operable to convert
input into electronic signals that include digitized or weighted protocols.
In an embodiment, the verification datasets include one or more of an
inventory
dataset, an electronic medical record for the subject dataset, a verification
code dataset, or
health status indicator dataset. In an embodiment, the input includes at least
one input in
response to one or more queries. In an embodiment, the input includes at least
one
detected physiological parameter or characteristic, such as an electrical
measurement,
biochemical measurement, or thermal measurement, by way of one or more
sensors.
In an embodiment, the input includes input from a data storage device, such as
a
USB, CD, DVD, or similar storage device. Likewise, input may be provided
related to the
subject's seeking a medical product or service by way of a mobile phone,
computer tablet,
computer laptop, or other computing device.
In addition, if one or more sensors are employed, information is sensed 213.
The
system 255 further includes a comparator for the Verification value dataset
214, which is
operably coupled to electronic health records or family health history 215. In
an
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embodiment, the system 255 further includes at least one Generating Unit 217
for one or
more Verification value(s) for the subject. In an embodiment, the system 255
includes an
assigning Verification Value unit 225, and generates output 229 which may
include the
dispensing of the medical product or service being sought by the subject 204.
In an
embodiment, a signal can alert when the subject's verification value satisfies
the
verification threshold.
In an embodiment, the subject is further assessed for at least one symptom
(either
by way of being sensed by a sensor, self-reported, reported on behalf of the
subject,
retrieved from electronic health records, etc.) and comparing the evaluated
symptom
criteria with a health status dataset. This is particularly useful in cases
when the subject
does not have a pre-approved prescription. In an embodiment, the subject is
assigned a
health status indicator valued based on the comparison, and the system can
signal an alert
when the subject's health status indicator value satisfies a health status
threshold.
In an embodiment, generating a verification value includes coordinating a
medical
symptom code or value as a function of satisfying the threshold condition. As
described
herein elsewhere, a characteristic or symptom of a subject may be coded
thereby
generating a medical symptom code.
In an embodiment, comparing the input includes coordinating at least one piece
of
identification information with an identification dataset as a function of the
threshold
condition. Identification information is described herein, and includes, for
example, a
fingerprint, driver's license, or other information specific to the identity
of the subject
seeking a medical product or service. In an embodiment, at least one input is
stored.
In an embodiment, the system is further configured for transmitting one or
more
signals in response to communicating an output indicative of the verification
value, which
may include at least one of a tactile, audio, or visual representation. In an
embodiment,
the tactile representation includes at least one pattern of vibration (e.g., a
pulse pattern or
speed pattern). In an embodiment, the method and system further include
recording and
optionally storing the results of receiving at least one input from the
subject and/or the
verification value(s) of the subject. In an embodiment, the systems and
methods described
herein include recording a confirmation (e.g., audio, video, etc.)
confirmation that the
subject has taken or used the medical product or service. In an embodiment,
the recording
includes at least one of a time stamp, location stamp, subject name, medical
product or
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service name or code, or drug dosage. In an embodiment, recording includes
receiving an
RFID signal associated with the medical product or service (e.g., the RFID
signal indicates
the package open or the drug swallowed).
As set forth in Figures 1-2, a subject makes a request that requires at least
some
evaluation, and provides at least one response (e.g., by query or sensor) that
generates a
verification value dataset (can be static or dynamic). From the verification
dataset, the
subject's verification value is determined, optionally including analysis of
health
history/records. As shown, if one or more of a subject's verification values
exceeds a
[predetermined] threshold, the subject's request is granted. As described
herein, in an
embodiment, the verification input includes subject's identification (driver's
license,
fingerprint, etc.). In an embodiment, the verification input includes
identification as well
as symptoms or health conditions (e.g., by way of evaluated criteria or sensed
or reported
symptoms or conditions). As described herein, in an embodiment, the subject
presents a
voucher for redemption, and no evaluation is needed.
In an embodiment, the subject requests a medical product or service, and one
or
more of a subject's Evaluated Criteria may or may not exceed a [predetermined]
threshold,
yet the subject's request requires further evaluation based on the criteria
not exceeding the
threshold, or indicating that further evaluation is required in order to grant
the request.
Fig. 3 illustrates an input/output device 300 operably coupled with a
computing
device 320 that includes a processing unit 321, a system memory 322, and a
system bus
323 that couples various system components including the system memory 322 to
the
processing unit 321. The system bus 323 may be any of several types of bus
structures
including a memory bus or memory controller, a peripheral bus, and a local bus
using any
of a variety of bus architectures. The system bus 323 may be any of several
types of bus
structures including a memory bus or memory controller, a peripheral bus, and
a local bus
using any of a variety of bus architectures. By way of example, and not
limitation, such
architectures include Industry Standard Architecture (ISA) bus, Micro Channel
Architecture (MCA) bus, Enhanced ISA (EISA) bus, Video Electronics Standards
Association (VESA) local bus, and Peripheral Component Interconnect (PCI) bus,
also
known as Mezzanine bus.
The system memory includes read-only memory (ROM) 324 and random access
memory (RAM) 325. A basic input/output system (BIOS) 326, containing the basic
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routines that help to transfer information between sub-components within the
thin
computing device 320, such as during start-up, is stored in the ROM 324. A
number of
program modules may be stored in the ROM 324 or RAM 325, including an
operating
system 328, one or more application programs 329, other program modules 330
and
program data 331.
A user may enter commands and information into the computing device 320
through input devices, such as a number of switches and buttons, illustrated
as hardware
buttons 344, connected to the system via a suitable interface 345. Input
devices may
further include a touch-sensitive display with suitable input detection
circuitry, illustrated
as a display 332 and screen input detector 333. The output circuitry of the
touch-sensitive
display 332 is connected to the system bus 323 via a video driver 337. Other
input devices
may include a microphone 334 connected through a suitable audio interface 335,
and a
physical hardware keyboard (not shown). Output devices may include at least
one the
display 332, or a projector display 336.
In addition to the display 332, the computing device 320 may include other
peripheral output devices, such as at least one speaker 338. Other external
input or output
devices 339, such as a joystick, game pad, satellite dish, scanner or the like
may be
connected to the processing unit 321 through a USB port 340 and USB port
interface 341,
to the system bus 323. Alternatively, the other external input and output
devices 339 may
be connected by other interfaces, such as a parallel port, game port or other
port. The
computing device 320 may further include or be capable of connecting to a
flash card
memory (not shown) through an appropriate connection port (not shown). The
computing
device 320 may further include or be capable of connecting with a network
through a
network port 342 and network interface 343, and through wireless port 346 and
corresponding wireless interface 347 may be provided to facilitate
communication with
other peripheral devices, including other computers, printers, and so on (not
shown). It
will be appreciated that the various components and connections shown are
examples and
other components and means of establishing communication links may be used.
The computing device 320 may be designed to include a user interface. The user
interface may include a character, a key-based, or another user data input via
the touch
sensitive display 332. The user interface may include using a stylus (not
shown).
Moreover, the user interface is not limited to an actual touch-sensitive panel
arranged for
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directly receiving input, but may alternatively or in addition respond to
another input
device such as the microphone 334. For example, spoken words may be received
at the
microphone 334 and recognized. Alternatively, the computing device 320 may be
designed to include a user interface having a physical keyboard (not shown).
In certain instances, one or more components of the computing device 320 may
be
deemed not necessary and omitted. In other instances, one or more other
components may
be deemed necessary and added to the computing device.
In certain instances, the computing system typically includes a variety of
computer-readable media products. Computer-readable media may include any
media that
can be accessed by the computing device 320 and include both volatile and
nonvolatile
media, removable and non-removable media. By way of example, and not of
limitation,
computer-readable media may include computer storage media. By way of further
example, and not of limitation, computer-readable media may include a
communication
media.
Computer storage media includes volatile and nonvolatile, removable and non-
removable media implemented in any method or technology for storage of
information
such as computer-readable instructions, data structures, program modules, or
other data.
Computer storage media includes, but is not limited to, random-access memory
(RAM),
read-only memory (ROM), electrically erasable programmable read-only memory
(EEPROM), flash memory, or other memory technology, CD-ROM, digital versatile
disks
(DVD), or other optical disk storage, magnetic cassettes, magnetic tape,
magnetic disk
storage, or other magnetic storage devices, or any other medium which can be
used to
store the desired information and which can be accessed by the computing
device 720. In
a further embodiment, a computer storage media may include a group of computer
storage
media devices. In another embodiment, a computer storage media may include an
information store. In another embodiment, an information store may include a
quantum
memory, a photonic quantum memory, or atomic quantum memory. Combinations of
any
of the above may also be included within the scope of computer-readable media.
Communication media may typically embody computer-readable instructions, data
structures, program modules, or other data in a modulated data signal such as
a carrier
wave or other transport mechanism and include any information delivery media.
The term
"modulated data signal" means a signal that has one or more of its
characteristics set or
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changed in such a manner as to encode information in the signal. By way of
example, and
not limitation, communication media include wired media, such as a wired
network and a
direct-wired connection, and wireless media such as acoustic, RF, optical, and
infrared
media.
The computing device 320 may also include other removable/non-removable,
volatile/nonvolatile computer storage media products. For example, such media
includes a
non-removable non-volatile memory interface (hard disk interface) 345 reads
from and
writes for example to non-removable, non-volatile magnetic media, or a
removable non-
volatile memory interface 350 that, for example, is coupled to a magnetic disk
drive 351
that reads from and writes to a removable, non-volatile magnetic disk 352, or
is coupled to
an optical disk drive 355 that reads from and writes to a removable, non-
volatile optical
disk 356, such as a CD ROM. Other removable/nonremovable, volatile/non-
volatile
computer storage media that can be used in the example operating environment
include,
but are not limited to, magnetic tape cassettes, memory cards, flash memory
cards, DVDs,
digital video tape, solid state RAM, and solid state ROM. The hard disk drive
357 is
typically connected to the system bus 323 through a non-removable memory
interface,
such as the interface 345, and magnetic disk drive 351 and optical disk drive
355 are
typically connected to the system bus 323 by a removable non-volatile memory
interface,
such as interface 350.
The drives and their associated computer storage media discussed above provide
storage of computer-readable instructions, data structures, program modules,
and other
data for the computing device 320.
A user may enter commands and information into the computing device 320
through input devices such as a microphone, keyboard, or pointing device,
commonly
referred to as a mouse, trackball, or touch pad. Other input devices (not
shown) may
include at least one of a touch sensitive display, joystick, game pad,
satellite dish, and
scanner. These and other input devices are often connected to the processing
unit through
a user input interface that is coupled to the system bus, but may be connected
by other
interface and bus structures, such as a parallel port, game port, or a
universal serial bus
(USB).
The computing system may operate in a networked environment using logical
connections to one or more remote computers, such as a remote computer 380.
The
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remote computer 380 may be a personal computer, a server, a router, a network
PC, a peer
device, or other common network node, and typically includes many or all of
the elements
described above relative to the computing device 320, although only a memory
storage
device. The network logical connections include a local area network (LAN) and
a wide
area network (WAN), and may also include other networks such as a personal
area
network (PAN) (not shown). Such networking environments are commonplace in
offices,
enterprise-wide computer networks, intranets, and the Internet.
When used in a networking environment, the computing system is connected to
the
network 371 through a network interface, such as the network interface 370,
the modem
372, or the wireless interface 393. The network may include a LAN network
environment,
or a WAN network environment, such as the Internet. In a networked
environment,
program modules depicted relative to the computing device 320, or portions
thereof, may
be stored in a remote memory storage device. By way of example, and not
limitation,
remote application programs 385 as residing on computer medium 381. It will be
appreciated that the network connections shown are examples and other means of
establishing communication link between the computers may be used.
In certain instances, one or more elements of the computing device 320 may be
deemed not necessary and omitted. In other instances, one or more other
components may
be deemed necessary and added to the computing device 320.
The signal generator 390 includes a signal generator configured to generate a
signal indicative of the sensed Evaluated Criteria of the subject. In an
embodiment, the
signal may include a raw data signal, i.e., a capacitance measurement, a
change in position
of skin over artery in the neck, an acoustic pressure, or a brain electrical
activity of the
subject. In an embodiment, the signal generator may include a processor
circuit 392, a
treatment regimen circuit 394, a treatment decision circuit 396, or a
communications
circuit 398. In an embodiment, the communications circuit may be operable to
communicate using an electrical conductor or using a wireless transmission. In
an
embodiment, the signal generator may include an instance of the thin computing
device
320 and the processor circuit may be the processing unit 321.
In an embodiment, the system actively monitors (e.g., detects, tracks, etc.) a
subject located by using at least one of computerized axial tomography, fiber
optic
thermometry, infrared thermography, magnetic resonance imaging, magnetic
resonance
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spectroscopy, microwave thermography, microwave dielectric spectroscopy,
positron
emission tomography, ultrasound reflectometry, spectroscopic imaging, visual
imaging,
infrared imaging, single photon emission computed tomography, or the like.
In an embodiment, the system includes a subject tracking system (not shown in
figures). For example, in an embodiment, the system includes a subject
tracking system
for updating in real time a subject's virtual location in a virtual space
corresponding to the
physical location of the subject in a physical space, such as the doctor's
office, airport,
school, college campus, etc.. In an embodiment, the subject's location
relative to a locked
dropbox or product/service dispensary port is tracked by the tracking system.
In an
embodiment, a map is provided to the subject to direct the subject to seek
medical care
elsewhere. In an embodiment, the subject tracking system includes an optical
recognition
distributed sensor network that generates Health Status Indicator value based
in part on the
continuous monitoring of the overall physical condition of the subject,
including subject's
movements, gait, etc., optionally as part of approval of the request or
voucher redemption
from the subject for the medical product or service.
As shown in Fig. 4, the system 400 includes one or more kiosks (each shown as
411, 412, and 413) that are operably linked to a central server 405 that is
operably linked
to hard drive storage 410. Each kiosk (411, 412, 413) includes, as described
elsewhere
herein, optional components that can further communicate with the central
server 405,
including but not limited to a printer/scanner/fax, currency acceptors,
sensors for detecting
particular characteristics of the subject, as well as an interactive menu for
the subject to
provide input related to the subject's seeking a medical product or service.
In an
embodiment, the central server 405 includes circuitry configured for setting
up medical
products or services that are equivalents to each other, should the subject
request an
equivalent. In an embodiment, the central server 405 includes circuitry
configured for
generating output information related to the subject's seeking a medical
product or service.
In an embodiment, the central server 405 includes circuitry configured for
processing the
approval, verifying the pre-approval, or assessing the subject by way of
characteristic
evaluation criteria. In an embodiment, the central server 405 includes
circuitry configured
for processing financial transactions, including accepting currency or credit
card/debit
card/online financial transactions for the medical product or service, or
processing the
insurance claim. In an embodiment, the central server 405 includes circuitry
configured
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for determining inventory within each kiosk in the network, and for relaying
information
to a user or central re-stocking facility (not shown) in order to replenish
inventory that is
reaching pre-determined levels in any particular kiosk. In an embodiment, each
kiosk
signals the central server 405 when a particular medical product or service
has reached a
pre-determined level or after each dispensing of every medical product or
service in real-
time. In an embodiment, the central server 405 includes circuitry for
monitoring security
breaches at any of the kiosks in the network, and disables a kiosk that is
suspected of
being tampered with or whose security has been breached. In an embodiment, the
central
server 405 includes circuitry for communicating with each kiosk in determining
the
verification value of the subject and whether that value satisfies the
verification threshold
or not.
In an embodiment, each kiosk (411, 412, 413) includes circuitry for
communicating with one or more sensors, one or more input/output devices, the
central
server, etc. and may include a user interface for interacting with a subject
seeking a
medical product or service. In an embodiment, a server interface (not shown)
includes
circuitry for transmitting or receiving data wirelessly between a kiosk and
the central
server.
As described in Fig. 5, in an embodiment, the system 500 includes a kiosk 100
with one or more compartments (510, 520, 530, 540, 550, 560, 570, and 580)
optionally
with each compartment holding a different medical product or service than any
other
compartment. In an embodiment, an opening or slot 505 is included with each
compartment (510, 520, 530, 54, 550, 560, 570, 580) for dispensing of a
medical product
or service to a subject 104. In an embodiment, a central opening or slot 590
common to
more than one compartment (510, 520, 530, 540, 550, 560, 570, 580) for
dispensing of the
medical product or service to the subject 104. In an embodiment, the common
slot or
opening 590 may be configured to dispense a medical product or service from a
row,
column, or other multiple compartments (510, 520, 530, 540, 550, 560, 570,
580). In an
embodiment, the locked drop box 136 described previously also includes
circuitry for
transmitting or receiving data with the central server (dotted lines) and may
include
components such as security alarm sensors, camera 114, or electronic lock 575.
In an
embodiment, each kiosk 100, as described herein, includes multiple slots or
openings
(505, 590) where the medical product or service is dispensed upon satisfaction
of the
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verification threshold. In an embodiment, the input/output device of the kiosk
100 is in
electronic communication with one or more compartments (510, 520, 530, 540,
550, 560,
570, 580) and with the central server 405 (communication indicated by dotted
lines). As
indicated, the camera 114 and locked drop box 136 are also each in electronic
communication (dotted lines) with the server 405.
As described in Fig. 6, the system 600 includes a kiosk 100 for which a
subject 104
seeks a medical product or service by way of inserting a pillbox device 155
into the
input/output device 112 of the kiosk 100. In an embodiment, the pillbox device
155 is
configured to be inserted as a USB drive into the input/output device 112, and
information
is transferred between the pillbox device 155 and the server 405 (dotted
lines) and
optionally with one or more compartment 510 (dotted lines). In an embodiment,
the
pillbox device 155 can be inserted into the slot or opening 505 of a
particular compartment
510. In an embodiment, the pillbox device 155 can be inserted into the common
opening
or slot 590 common to more than one compartment 510. As indicated, the pillbox
device
155 includes one or more sectioned compartments (656, 657, 658, 659, 660) that
can allow
for dispensing of different pharmaceutical drugs (indicated by different
symbols on each
sectioned compartment). In an embodiment, the pillbox device includes a
transmitter or
receiver (indicated by the antenna 670) for communicating with one or more
computing
devices in the network such as at the kiosk 100 or with the server 405. In an
embodiment,
a GPS or other locator is included as part of the pillbox device.
All of the above U.S. patents, U.S. patent application publications, U.S.
patent
applications, foreign patents, foreign patent applications and non-patent
publications
referred to in this specification and/or listed in any Application Data Sheet,
are
incorporated herein by reference, to the extent not inconsistent herewith.
Those having skill in the art will recognize that the state of the art has
progressed
to the point where there is little distinction left between hardware,
software, and/or
firmware implementations of aspects of systems; the use of hardware, software,
and/or
firmware is generally (but not always, in that in certain contexts the choice
between
hardware and software can become significant) a design choice representing
cost vs.
efficiency tradeoffs. Those having skill in the art will appreciate that there
are various
vehicles by which processes and/or systems and/or other technologies described
herein can
be effected (e.g., hardware, software, and/or firmware), and that the
preferred vehicle will
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vary with the context in which the processes and/or systems and/or other
technologies are
deployed. For example, if an implementer determines that speed and accuracy
are
paramount, the implementer may opt for a mainly hardware and/or firmware
vehicle;
alternatively, if flexibility is paramount, the implementer may opt for a
mainly software
implementation; or, yet again alternatively, the implementer may opt for some
combination of hardware, software, and/or firmware. Hence, there are several
possible
vehicles by which the processes and/or devices and/or other technologies
described herein
may be effected, none of which is inherently superior to the other in that any
vehicle to be
utilized is a choice dependent upon the context in which the vehicle will be
deployed and
the specific concerns (e.g., speed, flexibility, or predictability) of the
implementer, any of
which may vary. Those skilled in the art will recognize that optical aspects
of
implementations will typically employ optically-oriented hardware, software,
and or
firmware.
In some implementations described herein, logic and similar implementations
may
include software or other control structures suitable to operation. Electronic
circuitry, for
example, may manifest one or more paths of electrical current constructed and
arranged to
implement various logic functions as described herein. In some
implementations, one or
more media are configured to bear a device-detectable implementation if such
media hold
or transmit a special-purpose device instruction set operable to perform as
described
herein. In some variants, for example, this may manifest as an update or other
modification of existing software or firmware, or of gate arrays or other
programmable
hardware, such as by performing a reception of or a transmission of one or
more
instructions in relation to one or more operations described herein.
Alternatively or
additionally, in some variants, an implementation may include special-purpose
hardware,
software, firmware components, and/or general-purpose components executing or
otherwise invoking special-purpose components. Specifications or other
implementations
may be transmitted by one or more instances of tangible transmission media as
described
herein, optionally by packet transmission or otherwise by passing through
distributed
media at various times.
Alternatively or additionally, implementations may include executing a special-
purpose instruction sequence or otherwise invoking circuitry for enabling,
triggering,
coordinating, requesting, or otherwise causing one or more occurrences of any
functional
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operations described above. In some variants, operational or other logical
descriptions
herein may be expressed directly as source code and compiled or otherwise
invoked as an
executable instruction sequence. In some contexts, for example, C++ or other
code
sequences can be compiled directly or otherwise implemented in high-level
descriptor
languages (e.g., a logic-synthesizable language, a hardware description
language, a
hardware design simulation, and/or other such similar mode(s) of expression).
Alternatively or additionally, some or all of the logical expression may be
manifested as a
Verilog-type hardware description or other circuitry model before physical
implementation in hardware, especially for basic operations or timing-critical
applications.
Those skilled in the art will recognize how to obtain, configure, and optimize
suitable
transmission or computational elements, material supplies, actuators, or other
common
structures in light of these teachings.
The foregoing detailed description has set forth various embodiments of the
devices and/or processes via the use of block diagrams, flowcharts, and/or
examples.
Insofar as such block diagrams, flowcharts, and/or examples contain one or
more
functions and/or operations, it will be understood by those within the art
that each function
and/or operation within such block diagrams, flowcharts, or examples can be
implemented, subjectively and/or collectively, by a wide range of hardware,
software,
firmware, or virtually any combination thereof. In an embodiment, several
portions of the
subject matter described herein may be implemented via Application Specific
Integrated
Circuits (ASICs), Field Programmable Gate Arrays (FPGAs), digital signal
processors
(DSPs), or other integrated formats. However, those skilled in the art will
recognize that
some aspects of the embodiments disclosed herein, in whole or in part, can be
equivalently
implemented in integrated circuits, as one or more computer programs running
on one or
more computers (e.g., as one or more programs running on one or more computer
systems), as one or more programs running on one or more processors (e.g., as
one or
more programs running on one or more microprocessors), as firmware, or as
virtually any
combination thereof, and that designing the circuitry and/or writing the code
for the
software and or firmware would be well within the skill of one of skill in the
art in light of
this disclosure. In addition, those skilled in the art will appreciate that
the mechanisms of
the subject matter described herein are capable of being distributed as a
program product
in a variety of forms, and that an illustrative embodiment of the subject
matter described
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herein applies regardless of the particular type of signal bearing medium used
to actually
carry out the distribution. Examples of a signal bearing medium include, but
are not
limited to, the following: a recordable type medium such as a floppy disk, a
hard disk
drive, a Compact Disc (CD), a Digital Video Disk (DVD), a digital tape, a
computer
memory, etc.; and a transmission type medium such as a digital and/or an
analog
communication medium (e.g., a fiber optic cable, a waveguide, a wired
communications
link, a wireless communication link (e.g., transmitter, receiver, transmission
logic,
reception logic, etc.), etc.).
In a general sense, those skilled in the art will recognize that the various
embodiments described herein can be implemented, subjectively and/or
collectively, by
various types of electro-mechanical systems having a wide range of electrical
components
such as hardware, software, firmware, and/or virtually any combination
thereof; and a
wide range of components that may impart mechanical force or motion such as
rigid
bodies, spring or torsional bodies, hydraulics, electro-magnetically actuated
devices,
and/or virtually any combination thereof. Consequently, as used herein
"electro-
mechanical system" includes, but is not limited to, electrical circuitry
operably coupled
with a transducer (e.g., an actuator, a motor, a piezoelectric crystal, a
Micro Electro
Mechanical System (MEMS), etc.), electrical circuitry having at least one
discrete
electrical circuit, electrical circuitry having at least one integrated
circuit, electrical
circuitry having at least one application specific integrated circuit,
electrical circuitry
forming a general purpose computing device configured by a computer program
(e.g., a
general purpose computer configured by a computer program which at least
partially
carries out processes and/or devices described herein, or a microprocessor
configured by a
computer program which at least partially carries out processes and/or devices
described
herein), electrical circuitry forming a memory device (e.g., forms of memory
(e.g., random
access, flash, read only, etc.)), electrical circuitry forming a
communications device (e.g.,
a modem, communications switch, optical-electrical equipment, etc.), and/or
any non-
electrical analog thereto, such as optical or other analogs. Those skilled in
the art will also
appreciate that examples of electro-mechanical systems include but are not
limited to a
variety of consumer electronics systems, medical devices, as well as other
systems such as
motorized transport systems, factory automation systems, security systems,
and/or
communication/computing systems. Those skilled in the art will recognize that
electro-
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mechanical as used herein is not necessarily limited to a system that has both
electrical and
mechanical actuation except as context may dictate otherwise.
In a general sense, those skilled in the art will recognize that the various
aspects
described herein which can be implemented, subjectively and/or collectively,
by a wide
range of hardware, software, firmware, and/or any combination thereof can be
viewed as
being composed of various types of "electrical circuitry." Consequently, as
used herein
"electrical circuitry" includes, but is not limited to, electrical circuitry
having at least one
discrete electrical circuit, electrical circuitry having at least one
integrated circuit,
electrical circuitry having at least one application specific integrated
circuit, electrical
circuitry forming a general purpose computing device configured by a computer
program
(e.g., a general purpose computer configured by a computer program which at
least
partially carries out processes and/or devices described herein, or a
microprocessor
configured by a computer program which at least partially carries out
processes and/or
devices described herein), electrical circuitry forming a memory device (e.g.,
forms of
memory (e.g., random access, flash, read only, etc.)), and/or electrical
circuitry forming a
communications device (e.g., a modem, communications switch, optical-
electrical
equipment, etc.). Those having skill in the art will recognize that the
subject matter
described herein may be implemented in an analog or digital fashion or some
combination
thereof
Those skilled in the art will recognize that at least a portion of the devices
and/or
processes described herein can be integrated into an image processing system.
Those
having skill in the art will recognize that a typical image processing system
generally
includes one or more of a system unit housing, a video display device, memory
such as
volatile or non-volatile memory, processors such as microprocessors or digital
signal
processors, computational entities such as operating systems, drivers,
applications
programs, one or more interaction devices (e.g., a touch pad, a touch screen,
an antenna,
etc.), control systems including feedback loops and control motors (e.g.,
feedback for
sensing lens position and/or velocity; control motors for moving/distorting
lenses to give
desired focuses). An image processing system may be implemented utilizing
suitable
commercially available components, such as those typically found in digital
still systems
and/or digital motion systems.
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Those skilled in the art will recognize that at least a portion of the devices
and/or
processes described herein can be integrated into a data processing system.
Those having
skill in the art will recognize that a data processing system generally
includes one or more
of a system unit housing, a video display device, memory such as volatile or
non-volatile
memory, processors such as microprocessors or digital signal processors,
computational
entities such as operating systems, drivers, graphical user interfaces, and
applications
programs, one or more interaction devices (e.g., a touch pad, a touch screen,
an antenna,
etc.), and/or control systems including feedback loops and control motors
(e.g., feedback
for sensing position and/or velocity; control motors for moving and/or
adjusting
components and/or quantities). A data processing system may be implemented
utilizing
suitable commercially available components, such as those typically found in
data
computing/communication and/or network computing/communication systems.
Those skilled in the art will recognize that at least a portion of the devices
and/or
processes described herein can be integrated into a mote system. Those having
skill in the
art will recognize that a typical mote system generally includes one or more
memories
such as volatile or non-volatile memories, processors such as microprocessors
or digital
signal processors, computational entities such as operating systems, user
interfaces,
drivers, sensors, actuators, applications programs, one or more interaction
devices (e.g., an
antenna USB ports, acoustic ports, etc..), control systems including feedback
loops and
control motors (e.g., feedback for sensing or estimating position and/or
velocity; control
motors for moving and/or adjusting components and/or quantities). A mote
system may
be implemented utilizing suitable components, such as those found in mote
computing/communication systems. Specific examples of such components entail
such as
Intel Corporation's and/or Crossbow Corporation's mote components and
supporting
hardware, software, and/or firmware.
Those skilled in the art will recognize that it is common within the art to
implement devices and/or processes and/or systems, and thereafter use
engineering and/or
other practices to integrate such implemented devices and/or processes and/or
systems into
more comprehensive devices and/or processes and/or systems. That is, at least
a portion
of the devices and/or processes and/or systems described herein can be
integrated into
other devices and/or processes and/or systems via a reasonable amount of
experimentation. Those having skill in the art will recognize that examples of
such other
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devices and/or processes and/or systems might include ¨ as appropriate to
context and
application -- all or part of devices and/or processes and/or systems of (a)
an air
conveyance (e.g., an airplane, rocket, helicopter, etc.) , (b) a ground
conveyance (e.g., a
car, truck, locomotive, tank, armored personnel carrier, etc.), (c) a building
(e.g., a home,
warehouse, office, etc.), (d) an appliance (e.g., a refrigerator, a washing
machine, a dryer,
etc.), (e) a communications system (e.g., a networked system, a telephone
system, a Voice
over IP system, etc.), (f) a business entity (e.g., an Internet Service
Provider (ISP) entity
such as Comcast Cable, Qwest, Southwestern Bell, etc.), or (g) a
wired/wireless services
entity (e.g., Sprint, Cingular, Nextel, etc.), etc.
In certain cases, use of a system or method may occur in a territory even if
components are located outside the territory. For example, in a distributed
computing
context, use of a distributed computing system may occur in a territory even
though parts
of the system may be located outside of the territory (e.g., relay, server,
processor, signal-
bearing medium, transmitting computer, receiving computer, etc. located
outside the
territory). A sale of a system or method may likewise occur in a territory
even if
components of the system or method are located and/or used outside the
territory.
Further, implementation of at least part of a system for performing a method
in one
territory does not preclude use of the system in another territory.
One skilled in the art will recognize that the herein described components
(e.g.,
operations), devices, objects, and the discussion accompanying them are used
as examples
for the sake of conceptual clarity and that various configuration
modifications are
contemplated. Consequently, as used herein, the specific exemplars set forth
and the
accompanying discussion are intended to be representative of their more
general classes.
In general, use of any specific exemplar is intended to be representative of
its class, and
the non-inclusion of specific components (e.g., operations), devices, and
objects should
not be taken limiting.
Those skilled in the art will appreciate that a user may be representative of
a
human user, a robotic user (e.g., computational entity), and/or substantially
any
combination thereof (e.g., a user may be assisted by one or more robotic
agents) unless
context dictates otherwise.
With respect to the use of substantially any plural and/or singular terms
herein,
those having skill in the art can translate from the plural to the singular
and/or from the
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singular to the plural as is appropriate to the context and/or application.
The various
singular/plural permutations are not expressly set forth herein for sake of
clarity.
The herein described subject matter sometimes illustrates different components
contained within, or connected with, different other components. It is to be
understood
that such depicted architectures are merely exemplary, and that in fact many
other
architectures may be implemented which achieve the same functionality. In a
conceptual
sense, any arrangement of components to achieve the same functionality is
effectively
"associated" such that the desired functionality is achieved. Hence, any two
components
herein combined to achieve a particular functionality can be seen as "operably
coupled to"
each other such that the desired functionality is achieved, irrespective of
architectures or
intermedial components. Likewise, any two components so associated can also be
viewed
as being "operably connected", or "operably coupled", to each other to achieve
the desired
functionality, and any two components capable of being so associated can also
be viewed
as being "operably couplable", to each other to achieve the desired
functionality. Specific
examples of operably couplable include but are not limited to physically
mateable and/or
physically interacting components, and/or wirelessly interactable, and/or
wirelessly
interacting components, and/or logically interacting, and/or logically
interactable
components.
In some instances, one or more components may be referred to herein as
"configured to," "configurable to," "operable/operative to,"
"adapted/adaptable," "able
to," "conformable/conformed to," etc. Those skilled in the art will recognize
that
"configured to" can generally encompass active-state components and/or
inactive-state
components and/or standby-state components, unless context requires otherwise.
While particular aspects of the present subject matter described herein have
been
shown and described, it will be apparent to those skilled in the art that,
based upon the
teachings herein, changes and modifications may be made without departing from
the
subject matter described herein and its broader aspects and, therefore, the
appended claims
are to encompass within their scope all such changes and modifications as are
within the
true spirit and scope of the subject matter described herein.
It will be understood by those within the art that, in general, terms used
herein, and
especially in the appended claims (e.g., bodies of the appended claims) are
generally
intended as "open" terms (e.g., the term "including" should be interpreted as
"including
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but not limited to," the term "having" should be interpreted as "having at
least," the term
"includes" should be interpreted as "includes but is not limited to," etc.).
It will be further
understood by those within the art that if a specific number of an introduced
claim
recitation is intended, such an intent will be explicitly recited in the
claim, and in the
absence of such recitation no such intent is present. For example, as an aid
to
understanding, the following appended claims may contain usage of the
introductory
phrases "at least one" and "one or more" to introduce claim recitations.
However, the use
of such phrases should not be construed to imply that the introduction of a
claim recitation
by the indefinite articles "a" or "an" limits any particular claim containing
such introduced
claim recitation to claims containing only one such recitation, even when the
same claim
includes the introductory phrases "one or more" or "at least one" and
indefinite articles
such as "a" or "an" (e.g., "a" and/or "an" should typically be interpreted to
mean "at least
one" or "one or more"); the same holds true for the use of definite articles
used to
introduce claim recitations. In addition, even if a specific number of an
introduced claim
recitation is explicitly recited, those skilled in the art will recognize that
such recitation
should typically be interpreted to mean at least the recited number (e.g., the
bare recitation
of "two recitations," without other modifiers, typically means at least two
recitations, or
two or more recitations). Furthermore, in those instances where a convention
analogous to
"at least one of A, B, and C, etc." is used, in general such a construction is
intended in the
sense one having skill in the art would understand the convention (e.g., "a
system having
at least one of A, B, and C" would include but not be limited to systems that
have A alone,
B alone, C alone, A and B together, A and C together, B and C together, and/or
A, B, and
C together, etc.). In those instances where a convention analogous to "at
least one of A, B,
or C, etc." is used, in general such a construction is intended in the sense
one having skill
in the art would understand the convention (e.g., "a system having at least
one of A, B, or
C" would include but not be limited to systems that have A alone, B alone, C
alone, A and
B together, A and C together, B and C together, and/or A, B, and C together,
etc.). It will
be further understood by those within the art that typically a disjunctive
word and/or
phrase presenting two or more alternative terms, whether in the description,
claims, or
drawings, should be understood to contemplate the possibilities of including
one of the
terms, either of the terms, or both terms. For example, the phrase "A or B"
will be
typically understood to include the possibilities of "A" or "B" or "A and B."
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With respect to the appended claims, those skilled in the art will appreciate
that
recited operations therein may generally be performed in any order. Also,
although
various operational flows are presented in a sequence(s), it should be
understood that the
various operations may be performed in other orders than those which are
illustrated, or
may be performed concurrently. Examples of such alternate orderings may
include
overlapping, interleaved, interrupted, reordered, incremental, preparatory,
supplemental,
simultaneous, reverse, or other variant orderings, unless context dictates
otherwise.
Furthermore, terms like "responsive to," "related to," or other past-tense
adjectives are
generally not intended to exclude such variants, unless context dictates
otherwise.
Various non-limiting embodiments are described herein as Prophetic Examples.
Prophetic Examples
Prophetic Example 1
An Automated Delivery System for Medical Products and Services
An automated system to provide medications, medical products and medical
services is comprised of kiosks with medication dispensers, physiological
sensors and a
computer-based network linking the kiosks, healthcare providers, patients, and
third party
payers (e.g., insurance companies).
Kiosks are manufactured with a computer interface including a touchscreen
monitor, a video camera, a keyboard and voice recognition capability. The
kiosk also
incorporates dispensers and storage for multiple medications and sensors to
detect the
quantity of medication delivered and to monitor the remaining inventory.
Custom
designed kiosks may be custom designed and adapted for example, from KIOSK
Information Systems, Louisville, CO 80027. They may incorporate multiple
component
technologies including: computers, liquid crystal displays, touch screens,
keyboards, card
readers, biometric identity scanners, bar code scanners, printers, video
cameras, and
wireless transceivers (e.g., broad band, WiFi, Bluetooth and RFID).
The kiosks may contain a computer interface with a biometric identity scanner
to
verify the patient's identity. For example the patient interacts with a touch
screen
computer (e.g., iPad2 from Apple, Inc., Cupertino, CA) and a fingerprint
sensor device
(e.g., Lumidigm Venus fingerprint sensor from Lumidigm Inc., Albuquerque, NM;
see
Lumidigm Venus Datasheet which is incorporated herein by reference). The
computer is
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programmed to interact verbally and by touch with the patient. The patient is
prompted to
touch the fingerprint sensor and the fingerprint data is compared to a
database of patient
medical records. Alternatively, the patient may present a credit card,
insurance card or
other identification to verify their identity. Payment for medication and/or
services may
be made at the kiosk card reader with a credit card or insurance plan debit
card (e.g., Flex
Plan). Payment may be included in the input received in conjunction with the
subject
seeking a medical product or service. The patient may also be queried verbally
by the
computer to verify their identity. For example, birthdate, social security
number, home
address, and authorization codes may be requested to gain access to the kiosk
and to
obtain medication or medical services. Alternatively the patient may be issued
a USB
flash drive by his healthcare provider which contains patient identification
information and
an authorization code for the kiosk as well as prescription information.
Following
authorization and access to the automated delivery system, the patient is
photographed at
the kiosk by the touch screen computer and the facial photograph is
transmitted to their
healthcare provider for identity verification.
A medication dispenser is integrated in the kiosk which is capable of
selecting a
small quantity of medication, packaging, labeling and dispensing it. For
example the
kiosk may dispense 30 tablets or 90 tablets of paroxetine, i.e., a 1 or 3
month's supply.
Machines to dispense medications are described (see e.g., U.S. Patent No.
8,033,424
issued to Rosenblum on Oct. 11, 2011 and U.S. Patent Application No.
2012/0303388 by
Vishnubhatla et al. published on Nov. 29,2012 which are incorporated herein by
reference.) For example a pharmacy packaging machine, iPack0 T60, which
packages
individual doses in blister packs is available from Pearson Medical
Technologies,
Alexandria, LA. Medical products such as syringes, transdermal patches,
lotions,
bandages and the like may also be dispensed from the kiosk using the
medication
dispenser (see e.g., U.S. Patent No. 8,033,424 Ibid.). The kiosks incorporate
medication
dispensers, medication storage lockers and medication inventory monitors. For
example,
when 30 tablets of paroxetine (30 mg tablets) are dispensed the status of
paroxetine stores
is updated on the kiosk computer, and if restocking is necessary an email or
text message
is sent alerting a pharmacy to replenish the storage locker of the specific
kiosk.
The kiosks are equipped with video cameras to record dispensation of
medication
to a patient. Video data of the patient receiving medication is captured by
the kiosk
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computer and transmitted to the healthcare provider (e.g., to a patient's
electronic health
record), to the insurer and to the patient. Moreover the video data may be
accompanied by
an email or text message with written details of the dispensation. For
example, the email
may detail: the patient's name and address, the prescription, the prescribing
physician, the
health insurance plan, the payment status, the cost of the medication and the
date, time and
kiosk location where it was dispensed. In an embodiment, the input received in
conjunction with the subject seeking a medical product or service includes at
least one of
an authorization code, insurance code, or identification code.
The automated delivery system also provides medical services at the kiosks
which
include measurement, analysis and reporting of physiologic and clinical
parameters to
provide remote medical services and to inform prescription delivery. For
example, the
kiosk may contain sensors to detect key physiological parameters such as:
heart rate, body
temperature, respiration rate and blood oxygen level and body weight. The
patient's
weight may be measured by an electronic scale under the chair at the kiosk
which
automatically transmits the weight to a central computer containing the
patient's medical
record. The patient's electrocardiogram may be measured by electric potential
sensors
which may be placed 1 meter apart on opposite sides of the chair.
Nonconductive electric
potential sensors to determine a patient's electrocardiogram are described
(see e.g.,
Harland et al., Meas. Sci. Technol. 13, 163-169, 2002 which is incorporated
herein by
reference). The patient's respiration rate and heart rate may be determined by
a remote
sensor that detects physiological activities by illuminating the patient with
radio frequency
(RF) electromagnetic signals and detecting the reflected electromagnetic
signal waves.
The sensor may be incorporated in the back of the chair. For example a remote
sensor to
detect respiration and heart rate is described (see e.g., U.S. Patent No.
7,272,431 issued to
McGrath on Sept. 18, 2007 which is incorporated herein by reference). The
patient's body
temperature is determined by thermal imaging with a radiometric camera (e.g.,
a 7320
ETIP camera available from Infrared Cameras, Inc., Beaumont, TX; see Spec.
Sheet IR
camera which is incorporated herein by reference). The infrared camera is
installed in the
kiosk and focused on the patient's forehead or eyes. Devices and methods to
determine
core body temperature noninvasively and remotely may be adapted from others
(see e.g.,
U.S. Patent No. 7,340,293 which is incorporated herein by reference).
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The patient's hematocrit and blood oxygen concentration is determined by a
photoplethysmograph device on the armrest of the chair. A system with a finger
clip emits
and detects different wavelengths of light through the tissue of the finger
(see e.g., Shaltis,
et al., Conf. Proc. IEEE Eng. Med. Biol. Soc. 4: 3567-3570, 2005 which is
incorporated
herein by reference). The extinction of selected wavelengths of light is
detected and may
be used to determine the hematocrit and the blood oxygen saturation value. For
example,
a system and method to measure hematocrit and blood oxygenation by
transilluminating
the patient's finger with light at wavelengths of: 660 nm, 805 nm and 1550 nm
is
described (see e.g.,U U.S. Patent No. 5,372,136 which is incorporated herein
by reference).
The biometric and physiological parameters determined remotely by the kiosk
automatic data collection system are transmitted wirelessly to a central
computer that
communicates with health information databases (e.g., Kaiser Permanente
electronic
health records may be accessed using EpicCare software from Epic Systems Corp,
Verona, WI; and Centers for Disease Control, Data and Statistics are available
online at:
http://www.cdc.gov/datastatistics). Wireless sensor networks for aggregating
and
transmitting physiological data to a central computer are described (see e.g.,
Gao et al.,
Proc. IEEE Conf. Technologies for Homeland Security, p. 187-192 , 2008 which
is
included herein by reference).
The automated medical services include computer programs and methods to
compare the patient's physiological parameters to parameters obtained from
healthy
individuals, to the patient's medical history and to the current prescription.
The system
includes a central computer with programs to correlate prescribed medications
with
current physiologic parameters. Computer programs to evaluate and compare
physiological datasets are described (see e.g., the paper titled: OSCAR-MDA An
Artificially Intelligent Advisor for Emergency Room Medicine by John L.
Pollock and
Devin Hosea 10/1997 and available online at
citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.49.4970&rep=repl&type=pdf.
and
Pollock, Cognitive Carpentry: A Blueprint for How to Build a Person, MIT
Press,
Cambridge, MA, 1995 which are incorporated herein by reference).
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Prophetic Example 2
Remote Delivery of Prescription Medication by an Automated Delivery System
An individual from the US is traveling in Europe for approximately 3 weeks on
a
business trip. After 1 week the subject loses his antidepressant medication
which he
requires to carry out his business and function in his daily activities. The
subject's
healthcare provider has established a network of kiosks in European cities
which deliver
medical products and services to authorized patients.
The patient obtains a supplementary amount of his antidepressant medication to
last for the remaining two weeks of the trip by contacting his healthcare
provider via the
intern& or by phone. The patient requests a supplemental prescription of
antidepressant,
e.g., 14 tablets of paroxetine, 30 mg each, and requests that prescription be
picked up at a
kiosk near his hotel in Paris. His doctor's office verifies his identity and
prescription
information on his medical record and authorizes dispensation of 14 tablets of
paroxetine
at the specified kiosk. If the patient has also lost his credit cards and
other identification
the doctor's office may provide him with an authorization code to allow access
to the
kiosk. Receipt of the medication by the patient is verified by photographs
taken at the
kiosk and transmitted to the healthcare provider.
Prophetic Example 3
Automated Drug Delivery System to Control Dispensation of a Controlled
Substance
A patient with chronic pain is prescribed, oxycodone, to control the pain and
the
patient receives their medication from an automated medication delivery
system. Prior to
prescribing oxycodone the physician may use the automated delivery system
network to
screen the patient. For example, the system may check the patient's name for
any criminal
record and it may search for any and all medical records of the patient which
discuss
controlled substances including prescription drugs, alcohol, or over the
counter drugs. The
system may also search medical records for other indicators of drug seeking
behavior, i.e.
frequent loss of prescriptions, frequent refill requests and seeing multiple
physicians.
Guidelines for prescribing opioids are available (see e.g., Substance Abuse
and Mental
Health Services Administration. SAMHSA Opioid Overdose Prevention Toolkit:
Information for Prescribers. HHS Publication No. (SMA) 13-4742. Rockville, MD
2013
available online at: store.samhsa.gov/shin/content//SMA13-4742/Toolkit
Prescribers.pdf
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which is incorporated herein by reference). Informed by the search conducted
by the
automated delivery system, the physician discusses an informed consent
agreement with
the patient. The automated delivery system can facilitate the discussion by
displaying a
list of topics and key information concerning oxycodone on a monitor in the
doctor's
office. For example, the displayed information from the informed consent
agreement may
include:
1) Risks and benefits of opioid therapy
2) Potential for physical dependence and cognitive impairment
3) Patient agrees to stop taking other pain medication unless recommended by
physician
4) Patient agrees to obtain prescribed medication from one physician and one
kiosk
5) Patient agrees to take medication according to prescribed dose and schedule
6) Patient is responsible for safeguarding supply of medication to prevent
family
members, friends or others from obtaining opioids
Following the discussion an informed consent agreement for prescription of
oxycodone (e.g., Oxycontin) may be printed from the automated medication
delivery
system and signed by the physician and the patient.
To help the physician execute a complete and legal prescription order
according to
Federal Law (see e.g., SAMHSA HHS Publication No. (SMA) 13-4742, Ibid.) the
medication delivery system displays a form on the monitor requesting the
required
information:
Patient's name and address
Physician's name, address and DEA registration number
Electronic signature of physician
Date of issue
Name and quantity of drug prescribed
Directions for use
Refill information
The completed prescription order is transmitted electronically to the pharmacy
along with a designated kiosk for dispensing the medication and an
authorization mode for
the patient to access the medication (e.g., a fingerprint for biometric
identification). For
example the physician prescribes a limited amount of Oxycontin, (e.g.,
sufficient drug for
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3-5 days) which are dispensed at a designated kiosk. To lower the risk for
patient abuse of
Oxycontin and/or reselling of Oxycontin the automated drug delivery system
verifies the
patient's identity and controls the number of refills issued to the patient
according to the
prescribed dose and schedule. For example the physician may prescribe:
Oxycontin 10
mg every 12 hours for 3 days, i.e., 6 tablets, with a refill prescription
available on day 4,
day 7, and day 10 following dispensation of the first prescription. To control
access to the
medication delivery system and to identify the patient the kiosk may have a
biometric
fingerprint sensor device (e.g., Lumidigm Venus fingerprint sensor from
Lumidigm Inc.,
Albuquerque, NM; see Lumidigm Venus Datasheet which is incorporated herein by
reference).
The kiosk may have a video camera which films receipt of the Oxycontin
prescription by the patient. Both events, fingerprint sensing and video
recording are
transmitted by the kiosk computer to the physician's office and stored in the
patient's
electronic medical record. Facial recognition software may be used to
automatically
compare the patient's photograph to the video recording obtained from the
kiosk. If the
facial images do not match or if the finger print identity and the facial
image identity do
not match an alert is sent to the physician's office and the patient's access
to the kiosk is
blocked until the identity discrepancies are resolved. Video data obtained by
the
medication delivery kiosk is transmitted to the physician's office and entered
in the
patient's medical record. For example, the system may ask the patient to
answer questions
about their chronic pain and their usage of Oxycontin prior to gaining access
to a refill.
Review of the video data containing the patient's responses may alert the
physician to
problems or to the need for additional medication. For example, the patient
may require
naloxone, an opioid antagonist, as a precaution for opioid overdose (see e.g.,
SAMHSA
HHS Publication No. (SMA) 13-4742, Ibid.). The automated delivery system kiosk
may
request the patient via text, email or phone to make an appointment with his
physician, and
the system may also alert the physician to contact the patient.
While various aspects and embodiments have been disclosed herein, other
aspects
and embodiments will be apparent to those skilled in the art. The various
aspects and
embodiments disclosed herein are for purposes of illustration and are not
intended to be
limiting, with the true scope and spirit being indicated by the following
claims.
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