AU2006200205A1 - Method and system of medication dispensing and administration - Google Patents

Description

I

P/00/009 Regulation 3.2

AUSTRALIA

Patents Act 1990 COMPLETE SPECIFICATION Invention title: Method and System of Medication Dispensing and Administration The invention is described in the following statement: 8175256 I.DOC Method and System of Medication Dispensing and Administration ct n Field of the Invention 00 The invention relates to a method and system for dispensing and administration of medication.

In particular it relates to the interface between a person responsible for provision of medications from a bulk supply, such as a pharmacist and a person dispensing those medications to a person in need of the medication. This includes for example, dispensing medication from a hospital pharmacy to patients while ensuring that important criteria such as Ithe medication, dosage, patient and timing match the medication order issued by a doctor or other health care professional.

Background of the Invention In this specification where a document, act or item of knowledge is referred to or discussed, this reference or discussion is not an admission that the document, act or item of knowledge or any combination thereof was at the priority date publicly available, known to the public, part of the common general knowledge, or known to be relevant to an attempt to solve any problem with which this specification is concerned.

While the current invention will be described with reference to dispensation of medication to hospital in-patients it should be understood that the invention is not so limited but can apply more broadly to dispensation from any pharmacy to any people in need of medication.

Furthermore the people to whom the medication is dispensed may be situated in a wide variety of locations, such as a hospital, rest-care home, hospice or their own home and may be patients or residents.

The term 'dispense' and 'administer' (and grammatical variations thereof) when used throughout the specification are generally synonymous.

Hospitals constantly handle relatively large amounts of prescription medication and nonprescription medication (often referred to as 'over the counter' or OTC medication). Typically medication orders for prescription and OTC medication are issued by a doctor, dentist or other healthcare professional responsible for a patient under admission in the hospital. The medication order is typically written or printed in hard copy and handed in to a pharmacy so the order can be filled out.

Large hospitals often have their own pharmacy and bulk medication store within the hospital grounds, while small hospitals are more likely to rely on medication orders being filled out by one or more independent pharmacies located near the hospital. The pharmacy gathers together 8175256 I.DOC IND -2- 0 O the medications specified in the order which are then provided to the person, such as a nurse, who is responsible for administering the ordered medication to a patient.

In long-term hospital care facilities medication supply may be divided between the hospital 00 pharmacy, and pharmacists preferred by attending doctors.

As the principal interface between the end-user of medication and the supply chain, nurses Shave to record every use and application of mediation. Even with the exercise of great (-i Sdiligence, problems can occur if the patient medication record is not complete or if medication (N allergies or bad reactions have not been captured.

SThe constant handling and dispensing of medication within a hospital or residential facility or in the home/community care situation where a 'carer' or nurse administers medication is essential but a time consuming and labour intensive process. Furthermore, at each step of this process errors can potentially occur, often with extreme consequences for the patient. The larger the volume and number of medications handled within a hospital, the large the probability of human error.

Accordingly there have been a variety of attempts made to automate the medication dispensing process. For example, US 4,967,928 describes a device and method for dispensing medicines within a hospital ward or the like. The device includes a trolley that includes a computer and various input devices such as a card reader, keyboard, and barcode reader. The trolley is linked to a cabinet divided into two sections, a locked sections for dangerous drugs such as narcotics and a second for less dangerous medication. The computer controls the dispensing of medication and maintains a tally of the medications used in order to minimise theft and other loss of medications. However this device and method does not record or control the dispensing of medication to a specific patient.

US 5,842,976 describes a system that includes a database of patient medication records, each record being associated with a picture of the relevant patient. This data is held on a central computer, accessible by wireless access from a mobile charting computer that accompanies a nurse. Through the information available on the mobile charting computer the nurse can make a visual identification of the patient before dispensing medication to them and recording same on the central database via input to the mobile charting computer.

Typically the systems of the prior art are necessarily not 'open' systems and operate only in the context of specific hardware and/or software systems. That is, these systems are produced to operate within the confines of a specific set of hardware and software supplied by the system supplier. These systems generally use a computer that controls the dispensing of medication IO-3and maintains a tally of the medications used in order to minimise theft and other loss of (-i Smedications. However this device and method does not record or control the dispensing of medication to a specific patient. Furthermore whilst some systems allow for or include a 0_ system that makes the information accessible by wireless access from a mobile charting computer that accompanies a nurse these systems are sold as a complete solution utilising Sproprietary architecture and hardware.

There is therefore a need to for a system that ensures that the medication order filled out by a Spharmacy for a specific patient is in fact the medication order that is supplied to that patient.

IND

Summary of the Invention The present invention provides a method for monitoring dispensing of patient-specific medication the method comprising the steps of: registering a patient medical record in a database, receiving a medication order for the patient from a healthcare professional, entering details of the medication order in the patient medical record on the database, creating an automatically readable identifier specific to the medication order, assembling the medication specified in the medication order and applying the automatically readable identifier to the assembled medication, transporting the assembled medication and a remote terminal associated with an automatic reader to a patient location, confirming the patient's identity, passing the automatically readable identifier across the automatic reader at the time of dispensing and confirming a match with the patient identity and medication order, and dispensing the assembled medication to the patient the dispensing being recorded against the patient medical record in the database.

The invention may also include the further step of: (hh) managing medication dosage according to a therapeutic guideline.

IND -4- 0 O Typically the database is located on a central server. The central server may be located at a hospital or it may be located at some other location and communicates with a network of computers located in multiple pharmacies.

00 Typically the remote terminal is a small hand held device that communicates by wireless technology with the central server directly or indirectly through the use of an intermediate database. Alternatively the hand held device can be periodically docked to a computer terminal in order that information updated and exchanged between the server and hand held device.

IND

0 The automatically readable identifier and automatic reader can be derived from any convenient 0 (N 10 system known in the art. For example they may comprise a barcode and barcode scanner.

Alternatively the automatically readable identifier may be a digital code that can be scanned.

The medication can include one or more prescription or OTC pharmaceuticals included in a medication order. Typically the medication order is issued by a healthcare professional such as a doctor or a dentist.

Medication orders are typically handwritten or printed and details can be scanned or manually entered against the patient record in the database. Alternatively, in a particularly preferred embodiment the healthcare professional can use a remote terminal to transmit details of the medication order directly into the database.

In a particularly preferred embodiment the method of the present invention interfaces with a pharmacy prescription dispensing system such as 'FRED' (Fast Reliable Easy Dispensing System). FRED is a proprietary MS-DOS application written in DOS FOXPRO that can be used in various configurations ranging from single screen systems at smaller pharmacies to multiple screen configurations at the larger pharmacies. FRED is also available as 'WiniFRED' which is the next generation MS Windows Based Dispensing Software based on FRED. FRED is preferred because of its features such as fast reliable dispensing, quick internal updating and its facility for ScanCheck barcode dispensing. FRED also supports the vast majority of dispensing label formats that exist in pharmacies throughout Australia and communicates with an extensive array of point of sale (POS) systems via standard POS feed.

FRED also interfaces directly with well-known debtors systems such as 'BILL' and medication packing systems such as 'QuickPak' which are well adapted to cater for pharmacies that deal with institutions such as nursing homes. For pharmacies that service nursing homes, private hospitals, special accommodation houses and the like, FRED records dispensing for all patients and reports back per institution.

IND -5

O

O Typically the method of the present invention is used in association with one of the medication packaging systems well known in the art. Examples of such systems are the QuickPak medication packaging system for packing sachets of mediation and Persopack blister 0_ packaging system from Persocare. One of the advantages of the present method is that it is independent of the pharmacy and packaging system used.

While the patient's identity could be confirmed by asking them, or by a visual check against a picture on the remote terminal screen downloaded from the database, identification could also be carried out automatically. For example, each patient could be provided with a unique Iautomatically readable identifier such as a barcode or dot code on a bracelet. The automatically readable identifier could be incorporated into the plastic bracelets already in use in hospitals which include a panel on which the patient's name is written. Automatically readable identifiers are useful in situations where, for example, a patient is not sufficiently conscious to answer questions or where facial recognitions is impractical due to surgery or heavy bandaging.

Typically scanning the automatically readable identifier will automatically update the patient's database record with the time, details of medication type and dose.

At the time of dispensing the medication the nurse may enter a progress note or other comments into the remote terminal for inclusion in the patient record on the database.

Typically the nurse will be required to log-on to the remote terminal so that their name is automatically recorded each time the automatically readable identifier is scanned and their name is thus linked to the dispensing event.

Preferably the system of the present invention can also issue warnings relating to medication.

These warnings could be issued at any stage such as, when the medication order is entered in the patient record on the database, or at the time of dispensing the medication. The warning capability may be augmented by including a drugs database in the system, such as MIMS. Details of medication orders, dosages and drug combinations could then be checked against patient profile and the recommendations in the drugs database so that inadvisable dispensing can be avoided.

For example, if the patient's record includes information regarding allergy to penicillin, the system will issue a visual or aural warning if a medication order for that patient includes penicillin or a medication including penicillin. Alternatively if a patient medication order indicates a dosage of 3000 mg of diazepam per 24 hours, well above the dosage recommended in MIMs the system will issue a warning. The warnings may be issued on the remote terminal, or at a fixed terminal.

NO -6- 0 Thus the method of the present invention ensures that an auditable, easily interpreted record is Smaintained for each patient's past and current medications. The reporting mechanism and audit c trail allow hospitals to manage the productivity of a drug delivery round carried out by a nurse for a 00 ward of patients. For example it can be used to measure how long the dispensing process took and who performed the dispensing.

In a particularly preferred embodiment the method of the present system includes a database of patient medical records consisting of information and medication profiles from an issuing Spharmacy. Each patient record includes current medication prescribed and an associated picture of INO the relevant patient. This information is typically registered on the database by the organisation caring for the patient. The database is held on a central computer in the organisation or a central website hosted by another party, wireless access to the database being provided from a mobile charting PDA that accompanies a nurse. Through the information available on the mobile charting PDA the nurse can identify the patient and confirm that the correct patient is matched to the medication to be dispensed, prior to dispensing medication. The PDA will ensure only the medication specified in the correct prescription will be accepted. The nurse may identify the patient either visually (using the photograph) or by scanning or reading a barcode or similar identifier on the patient's wrist or medication profile. Each medication dispensed to a patient is time stamped to a nurse and the database information can be accessed locally and remotely.

In a particularly preferred embodiment the method and system of the present invention is hardware and pharmacy software independent and can be used in a range of situations including situations in which a hospital pharmacy or range of pharmacies are used by the organisation providing the medication administration, such as a hospital aged care facility, community nursing organisation or similar institution.

Preferably, the method of the present invention additionally contributed to inventory management.

For example the method may include the additional steps of: maintaining a database inventory of medications available in a bulk medication store, and adjusting the inventory each time details of a medication order are entered.

Each time the amount of a particular stored medication falls beneath a predetermined level the system will issue a warning so that more stocks can be purchased.

IO-7- O In a further embodiment the present invention provides a system for monitoring dispensing of Spatient-specific medication the system comprising: a central server, 00 one or more remote terminals transportable to a patient location, one or more automatic readers associated with each remote terminal and transportable to a patient location, (-i IND wherein the server (N receives patient medical information for registration in a database record, (ii) receives details of a medication order for a patient for recordal in the patient database record, (iii) creates an automatically readable identifier specific to a medication order for application to medication assembled in accordance with the medication order, (iv) forwards patient record information to the one or more remote terminals, receives information from the automatic reader each time an automatically readable identifier is read, and (vi) receives information from the remote terminal for use in updating the patient record.

The system may additionally include: (aa) a local distributed server, wherein the local distributed server, performs identical functions to the central server for records pertaining to a facility, and (ii) forwards patient medication dispensing records to the central server.

The system may include the additional steps of the server: maintaining a database inventory of medications available in a bulk medication store, and S(e) adjusting the inventory each time details of a medication order are entered.

In a further embodiment the present invention provides a method for monitoring dispensing of 00 patient-specific medication the method comprising the steps of: communicating patient medical record registration information from one or 5 more remote terminals, for recordal in a database, communicating a medication order for the patient from a healthcare professional for entry in the patient medical record on the database,

IND

communicating instructions to a remote device to create an automatically (N readable identifier specific to the medication order, the automatically readable identifier being suitable for application to medications assembled in accordance with the medication order, communicating patient medical record information to a remote terminal associated with an automatic reader, communicating from the automatic reader, information derived from reading the automatically readable identifier, and communicating from the remote terminal associated with the automatic reader, information relating to the dispensing of the medication assembled in accordance with the medication order.

In a further embodiment the present invention provides a server when used for the communications described in the above steps.

Typically the present invention will be used for monitoring dispensing of patient-specific medication using a server and comprising the steps of: receiving and storing medical records for one or more patients, receiving details of medication orders for the one or more patients from one or more healthcare professionals, forwarding the details of the medication orders to the appropriate medical records, IN -9- O forwarding instructions to a remote device to create an automatically readable (-i Sidentifier for each medication order, the automatically readable identifier being applied to medications assembled in accordance with the medication orders, 00 forwarding one or more patient medical records to a remote terminal associated with an automatic reader, receiving information derived from the automatically readable identifier when (-i Sread using the automatic reader, and (-i I(g) receiving information from the remote terminal associated with the automatic reader in relation to the dispensing of medication in accordance with the medication order.

The invention may include the additional steps of the server: receiving details of an inventory of medications available in a bulk medication store, and adjusting the inventory each time details of a medication order are entered.

This system of the present example also provides immediate benefits such as: 0 reduction in the time taken for a medication round, compliance with relevant legislation, reduction in the risk of maladministration of medication, provision of a record of delivery times to assist in managing the time interval prescribed for dosage, S provision of a record of time taken for each dispensing round to assist in management of productivity, and S provides a record of time taken for each round assisting in managing productivity.

Examples The present invention will be further described with reference to the following examples and drawings in which: ISO S Figure 1 is a schematic diagram of one embodiment of the method and system of SExample 4, 00 Figure 2 is a schematic diagram of a further embodiment of the method and system of Examples 3(a) and and Figure 3 is a schematic diagram of a further embodiment of the method and system of the Examples 2(a) and 2(b).

SExample 1 SExample 1 illustrates a basic embodiment of the present invention. In this embodiment the person administering medication can manually produce print) Medication Profiles for patients at the site of administration utilising the architecture of the present invention.

In this embodiment the invention works as follows: 1 The pharmacist inputs the prescription information supplied by the dispensing doctor or dentist into the pharmacy system FRED) and packs the medication/s.

2 A software agent collects that data and holds it in a central server.

3 The nurse or administering agent at the hospital aged care facility enters the web site via the internet to access the database and is able to view and print the medication profile.

4 The nurse prints the resident medication profile and uses this as a 'signing sheet' when administering the prescribed medications to the patient.

5 The nurse then has the option of recording that information into database via the web browser.

6 If the nurse does enter that information into the database, nursing staff are able to access reports regarding the administration of medication online.

7 If the data is not input into database the nurse or manager has to refer to the printed and signed medication profiles stored on location.

S-11-

NO

Examples 2(a) and 2(b) The embodiments of Examples 2(a) and 2(b) have the same functionality but differ in that 00 Example 2(a) has the data hosted on a central server which is accessed by the user through the internet. Example 2(b) has the data being stored on the user's server and is accessed via a WAN/LAN. Furthermore Example 2(b) limits the number of users in an organisation to a (-i maximum of 10 concurrent users.

(-i O The embodiment of Example 2(b) is a simple system based on one-way data flow from the Spharmacy to the organisation. The system works as follows: (-i 1 The pharmacist inputs the prescription information supplied by the dispensing doctor or dentist into the pharmacy system FRED) and packs the medication/s.

2 The software agent collects that data and holds it in a central server.

3 The nurse or administering agent at the hospital aged care facility enters the web site via the internet to access the database and is able to view and print the medication profile.

or 4 The nurse or administering agent at the hospital aged care facility logs into the system and is able to view and print the medication profile.

The nurse synchronises the resident medication profiles onto the PDA device to the database for administering the prescribed medications to the patient.

6 The nurse administers the medications using the PDA to identify the patient and then scan or enter data onto the PDA against the medication profile. The nurse can enter a range of data including exceptions. If the additional module, MIMS, is used then the nurse can check that database for drug details and interactions.

7 At the completion of the round the nurse synchronises the data to the server and prints the medication signing sheet that contains the patient, drug and administration times.

This sheet is then placed in a secure file for future reference.

I

O -12- O If local law allows for electronic signature the medication signing sheet will not be Srequired to be printed as the 'electronic signature' captured on the PDA will replace 00 the need for a paper based record.

8 The nurse and managers have access to the medication profiles and electronic medication signing sheets and can query the database and print reports.

SExample 3(a) and 3(b) O The embodiments of the present invention described in Example 3(a) and 3(b) have the same Sfunctionality but differ in that Example 3(a) has the data hosted on a central server which is accessed by the user through the internet. The embodiment of Example 3(b) has the data being stored on the user's server and is accessed via a WAN/LAN.

Example 3(b) limits the number of users in an organisation to a maximum of 10 concurrent users. It is a sophisticated system based on two-way data flow from the prescribing doctor to the pharmacy to the organisation and back again. The system works as follows: 1 The prescribing doctor issues the prescription through the system of the present invention or through other software applications to the pharmacy. Where the doctor elects to use the system and software of the present invention as the prescribing software that data is held in a transaction server automatically. Where the doctor elects to use other software or a manual prescription system the system of the present invention gathers that data from the pharmacy and places it into the transaction server.

2 The pharmacist inputs the prescription information supplied by the dispensing doctor or dentist into the pharmacy system FRED) and packs the medication/s.

3 Example 3(b) allows the use of multiple pharmacies to supply an organisation through the a Gateway server.

4 A software agent collects that data and holds it in a central server and the transaction server.

ID-13- The nurse or administering agent at the hospital aged care facility enters the web site via the internet and is able to view and print the medication profile.

00 Or The nurse or administering agent at the hospital aged care facility logs into system of the present invention and is able to view and print the medication profile.

6 The nurse synchronises the resident medication profiles onto the PDA device to the IDdatabase for administering the prescribed medications to the patient.

7 The nurse administers the medications using the PDA to identify the patient and then scan or enter data onto the PDA against the medication profile. The nurse can enter a range of data including exceptions. If the additional module, MIMS, is used then the nurse can check that database for drug details and interactions.

8 At the completion of the round the nurse synchronises the data to the server and prints the medication signing sheet that contains the patient, drug and administration times.

This sheet is then placed in a secure file for future reference.

Again, if the system of the present invention is used in a jurisdiction that allows for electronic signature the medication signing sheet will not be required to be printed as the 'electronic signature' captured on the PDA will replace the need for a paper based record.

9 The nurse and managers have access to the medication profiles and electronic medication signing sheets and can query the database and print reports.

The pharmacist and doctor have access to the administration records and can review the medication information remotely via the internet.

Example 4 In a further embodiment of the invention needs of the hospital can be catered for when stores of medications are held onsite and are prescriptions are dispensed from 'bulk' stores of medications.(versus aged care facilities and community care where only resident specific and NO -14- 0 time specific medications are ordered each time). That is, hospitals may carry a range of drugs in bulk packaging that are taken from some form of 'store room' and administered to patients 00 where this process does not involve a 3 rd party pharmacy packaging the medications for administration.

In general, hospitals need to charge the patient for the medications administered whereas in (-i Sother organisations such as aged and community care organisations the patient may not be (-i O invoiced or may be invoiced by the pharmacy directly.

SThis embodiment of the present invention is a sophisticated system based on two-way data (-i flow from the prescribing doctor to the pharmacy/store to the nurse and back again. The system works as follows: 1 The prescribing doctor issues the prescription the system of the present invention or through the hospital software applications to the (in-house) pharmacy. Where the doctor elects to use the system of the present invention as the prescribing software that data is held in the server of the present invention automatically. Where the doctor elects to use other software or a manual prescription system a software agent gathers that data from the pharmacy/store and places it into the server.

2 The pharmacist inputs the prescription information supplied by the dispensing doctor or dentist into the pharmacy system FRED) and packs the medication order for the patient.

3 The software agent collects that data and holds it in a central server.

4 The nurse logs into the system of the invention and is able to view and print the medication profile.

The nurse synchronises the resident medication profiles onto the PDA device to the database for administering the prescribed medications to the patient.

6 The nurse administers the medications using the PDA to identify the patient and then scan or enter data onto the PDA against the medication profile. The nurse can enter a INO range of data including exceptions. If the additional module, MIMS, is used then the nurse can check that database for drug details and interactions.

00 7 At the completion of the round the nurse synchronises the data to the server and prints the medication signing sheet that contains the patient, drug and administration times.

This sheet is then placed in a secure file for future reference.

SWhen the system of the present invention is used in jurisdictions that allow for O electronic signature the medication signing sheet will not be required to be printed as Sthe 'electronic signature' captured on the PDA will replace the need for a paper based (-i record.

8 The nurse and managers have access to the medication profiles and electronic medication signing sheets and can query the database and print reports.

9 The medication transaction automatically notates that the medication level in the hospital store has decreased and with user-defined limits creates a message to replenish the stock level of that medication when it falls below the minimum level defined by the user.

The pharmacist and doctor have access to the administration records and can review the medication information remotely 11 From the database the medication information can be retrieved by the accounting section to invoice the medication costs to the patient and/or agent medical insurance fund/government agency) Example This embodiment of the present invention is designed for users that have multiple sites and/or large numbers of concurrent users and the data is hosted on the user's server with no restrictions on the number of concurrent users. Typically, this would be a large hospital or care group with multiple sites wards.

I

O -16- O The embodiment of Example 5 has the same functionality as Examples 2(b) and 3(b) but is Sbased on the organisation hosting the system of the invention in-house.

00 Example 6 Example 6 relates to an embodiment of the system and method of the present invention as applied to the dispensing of medication during a regular dispensing round in an aged care Shospital. The use of technology in aged care facilities in Australia is slowly gaining greater ISO acceptance but many people employed in aged care are not highly computer literate and many organizations have relatively low levels of IT skills.

In this example, the system of the present invention is used in conjunction with the widely used FRED pharmacy dispensing system and the QuickPak medication packaging system.

At the commencement of a drug round the care provider such as a dispensing nurse collects the packages of patient medication and logs into a remote terminal consisting of a hand held device such as the Intermec CN2. The CN2, is a windows device, incorporating a barcode scanner and having a small 'qwerty' keyboard.

The dispensing nurse uses a unique password and synchronizes the CN2 to the database on a server located at the hospital pharmacy. This uploads the medication orders for the drug round.

The nurse progressively approaches each patient and scans a unique identifier associated with the patient via a wrist bracelet or the like. This calls up the patient medical record onto the screen of the CN2. The nurse then scans the barcode on the medication package that is assumed to correspond to the medication order for that patient. The CN2 then returns confirmation that the correct medication package has been scanned or issues a warning that the barcode does not match the patient medication order. If the wrong medication package has been scanned the nurse may scan other barcodes until the correct patient medication package is located.

IND -17- O Having verified that correct patient medication package has been located the nurse then dispenses Sthe medication to the patient and enters any comments in a free text format, noting any issues 00 pertaining to the patient.

At the completion of the drug round the nurse synchronizes the CN2 to the server database through a wireless network or a synchronization cradle and logs out. The use of a cradle is an alternative to a wireless connection between the server and the remote terminal. The nurse Sthen prints a report from server for sign off. The report containing the start and completion Stimes of the dispensing round, nurse identification and the exact time each patient and drug barcode was scanned.

Prior to commencing a new drug round the CN2 can again be synchronized wirelessly or placed in the synchronisation cradle, prior to the nurse logging in. This captures any updates in the database between the end of one dispensing round and the start of the next.

Given the relatively low level of computer skills in the aged care industry, the process of the present invention is made as straightforward as possible through the use of barcode scanning and simple stylus taps on the CN2 in preference to manual entries. This helps to minimise errors.

Example 7 Example 7 further describes the embodiment of Example 6 in terms of the functions the system performs.

In overview the system contains 5 core operations management capabilities which are discussed in detail below. They are: 1. Staff Operations Management.

2. Roles Operations Management.

3. Patients Operations Management.

4. Doctors Operations Management 5. Reports Operations Management.

ID-18-

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1. Staff Management The details of a staff member, such as a dispensing nurse will be recorded into this system and 00 updated as required by a person having a high level of access The user can search, add, edit, delete and assign staff member records according to access level.

Business Rules SThe Staff Operations Management capability can be accessed under the following rules: \O Rule 1 Identify Staff Member SThe user must identify the staff member.

The user requests a staff member list using a filter. By default, all staff member records will display in a data grid by page.

If there is more than one staff member with the same name as the search criteria, the system returns a list of all staff that meet the search criteria and allows the user to choose which staff member for whom he wishes to see details.

Rule 2 Enter or Update Staff Member Details The user must enter all mandatory fields for a new staff member.

The system will present the user with a form of data fields as listed below. The user must enter relevant data into each of the mandatory fields for the staff member.

The user can edit the details of the staff member.

The user can delete any staff record except their own.

Rule 3 Assign staff member to a role The user can assign a staff member to one or more roles.

2. Roles Management The details of a role will be recorded into this system and updated as required. Role management is used to associate a group of patients to a staff member. For example, typical roles could be 'PCA for Unit 'D1 Nurse for North Ward' etcetera. A user will access this IC-19function. The user can search, add, edit, delete and assign roles records according to their access level.

00 Business Rules The Roles Operations Management capability can be accessed under the following rules: Rule 1 Identify Roles SThe user must identify the role.

(-i INC The user requests a roles list using filter. By default, all roles records will display in a data grid by page.

Rule 2 Enter or Update roles Details The user must enter all mandatory fields for a new role.

The system will present the user with a form of data fields. The user must enter relevant data into each of the mandatory fields for the role.

The user can edit the details of the role.

The user can delete the a role record if no patient or staff member is assigned to this role record.

Rule 3 Assign staff to role The user can assign a staff member to one or more roles.

Rule 4 Assign patient to role The user can assign a patient to the role but a patient may be assigned to only one role.

3. Patient Management The original patient medical information will be registered on the system and updated as required. A user will access this function. The user can search, edit and be assigned to roles according to their access level.

Business Rules The Patient Operations Management capability can be accessed under the following rules: IN Rule 1 Identify Roles The user must identify the patient.

00 The user requests a patient list using a filter. By default, all patients' records will display in a data grid by page.

The user must view patient medication profile.

SThe user must view patient medication history by date range or by staff.

IDRule 2 Update patient Details The user enters all mandatory fields for a new role.

The system will present the user with a form of data fields. The user must enter relevant data into each of the mandatory fields for the role.

The user who has high access level can edit the details of the role.

The user who has high access level can delete the role record if no patient or staff member is assigned to this role.

Rule 3 Assign patient to role The user can assign a patient to only one role.

4. Doctor Management Doctor information once downloaded into the system cannot be updated. A user will access this function and can search and view the details.

Business Rules The Business Operations Management capability can be accessed under the following rule: Rule 1 Identify Doctors The user must identify the doctor.

The user requests a doctor list using filter. By default, all doctors' records will display in a datagrid by page.

The user must view the details of a doctor.

-21 Reports Management SA user will access this function. The user can view the details.

00 Business Rules Rule 1 The user can view the details of audit Rule 2 The user can delete the records of audit The word 'comprising' and forms of the word 'comprising' as used in this description does not I\N limit the invention claimed to exclude any variants or additions.

Modifications and improvements to the invention will be readily apparent to those skilled in the art. Such modifications and improvements are intended to be within the scope of this invention.

Claims (8)

1. 2. A method according to claim 1 which further comprises the step of: (hh) managing medication dosage according to a therapeutic guideline.
2. 3. A method according to claim 1 or 2 which further comprises the steps of: maintaining a database inventory of medications available in a bulk medication store, and adjusting the inventory each time details of a medication order are entered. INO -23- 0
3. 4. A system for monitoring dispensing of patient-specific medication the system comprising: 00 a central server, one or more remote terminals transportable to a patient location, one or more automatic readers associated with each remote terminal and (-i Stransportable to a patient location, IND wherein the server S(i) receives patient medical information for registration in a database record, (ii) receives details of a medication order for a patient for recordal in the patient database record, (iii) creates an automatically readable identifier specific to a medication order for application to medication assembled in accordance with the medication order, (iv) forwards patient record information to the one or more remote terminals, receives information from the automatic reader each time an automatically readable identifier is read, and (vi) receives information from the remote terminal for use in updating the patient record. A system according to claim 4 which further includes: (aa) a local distributed server, wherein the local distributed server, performs identical functions to the central server for records pertaining to a facility, and (ii) forwards patient medication dispensing records to the central server.
4. 6. A system according to claim 4 or claim 5 which further includes the steps of the server: maintaining a database inventory of medications available in a bulk medication store, and adjusting the inventory each time details of a medication order are entered. INO -24- 0
5. 7. A method for monitoring dispensing of patient-specific medication the method comprising the steps of: 00 communicating patient medical record registration information from one or more remote terminals, for recordal in a database, communicating a medication order for the patient from a healthcare Sprofessional for entry in the patient medical record on the database, I(c) communicating instructions to a remote device to create an automatically Sreadable identifier specific to the medication order, the automatically readable identifier being suitable for application to medications assembled in accordance with the medication order, communicating patient medical record information to a remote terminal associated with an automatic reader, communicating from the automatic reader, information derived from reading the automatically readable identifier, and communicating from the remote terminal associated with the automatic reader, information relating to the dispensing of the medication assembled in accordance with the medication order.
6. 8. A server when used for the following communication steps: communicating patient medical record registration information from one or more remote terminals, for recordal in a database, communicating a medication order for the patient from a healthcare professional for entry in the patient medical record on the database, communicating instructions to a remote device to create an automatically readable identifier specific to the medication order, the automatically readable IN O identifier being suitable for application to medications assembled in (-i Saccordance with the medication order, 00 communicating patient medical record information to a remote terminal associated with an automatic reader, communicating from the automatic reader, information derived from reading (-i Sthe automatically readable identifier, (-i IDand communicating from the remote terminal associated with the automatic reader, information relating to the dispensing of the medication assembled in accordance with the medication order.
7. 9. A method for monitoring dispensing of patient-specific medication using a server and comprising the steps of: receiving and storing medical records for one or more patients, receiving details of medication orders for the one or more patients from one or more healthcare professionals, forwarding the details of the medication orders to the appropriate medical records, forwarding instructions to a remote device to create an automatically readable identifier for each medication order, the automatically readable identifier being applied to medications assembled in accordance with the medication orders, forwarding one or more patient medical records to a remote terminal associated with an automatic reader, receiving information derived from the automatically readable identifier when read using the automatic reader, and IN -26- receiving information from the remote terminal associated with the automatic Sreader in relation to the dispensing of medication in accordance with the 00 medication order. The method for monitoring dispensing of patient-specific medication according to claim 9 which further includes the steps of the server: receiving details of an inventory of medications available in a bulk medication (NI IND store, and adjusting the inventory each time details of a medication order are entered.
8. 11. A method according to any one of the preceding claims and substantially as herein described with reference to the drawings. Exact Technologies Pty Ltd 18 January 2006