NZ619532B2 - Systems and methods for intelligent patient interface device - Google Patents
Systems and methods for intelligent patient interface device Download PDFInfo
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- NZ619532B2 NZ619532B2 NZ619532A NZ61953212A NZ619532B2 NZ 619532 B2 NZ619532 B2 NZ 619532B2 NZ 619532 A NZ619532 A NZ 619532A NZ 61953212 A NZ61953212 A NZ 61953212A NZ 619532 B2 NZ619532 B2 NZ 619532B2
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Classifications
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- G—PHYSICS
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- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
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- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H20/17—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered via infusion or injection
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
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- G16H70/00—ICT specially adapted for the handling or processing of medical references
Abstract
Disclosed is a system for use with one or more sources of patient-affiliated data corresponds with a group of patients (112). The system includes a plurality of patient interface devices (101a,b,...n) and a patient interface device gateway (104). The plurality of patient interface device (101a,b,...n)s each operable to administer medication to a patient, wherein each patient interface device (101) of the plurality of patient interface devices (101a,b,...n) stores a database (114) that comprises a plurality of patient records where each patient record of the plurality of patient records corresponds with a different, unique patient of the group of patients (112) and includes at least corresponding patient identification data and patient treatment data. Each patient interface device (101) of the plurality of patient interface devices (101a,b,...n) comprises logic adapted to utilize the database (114) stored at the patient interface device (101a,b,...n) to create a patient-specific guidance data set (109) for any patient of the group of patients (112). The patient-specific guidance data set (109) is adapted for use in interfacing the patient interface device (101a,b,...n) with the corresponding patient to administer medication to the patient. The patient interface device gateway (104) operative to interface the one or more sources of patient-affiliated data (105) with each patient interface device (101) of the plurality of patient interface device (101a,b,...n)s to automatically update each of said data bases (114) stored at each of said plurality of patient interface devices (101a,b,...n). The process of automatic updating of each of the data bases (114) is achieved by utilizing corresponding patient-affiliated data maintained by the one or more sources of patient-affiliated data (105). n)s each operable to administer medication to a patient, wherein each patient interface device (101) of the plurality of patient interface devices (101a,b,...n) stores a database (114) that comprises a plurality of patient records where each patient record of the plurality of patient records corresponds with a different, unique patient of the group of patients (112) and includes at least corresponding patient identification data and patient treatment data. Each patient interface device (101) of the plurality of patient interface devices (101a,b,...n) comprises logic adapted to utilize the database (114) stored at the patient interface device (101a,b,...n) to create a patient-specific guidance data set (109) for any patient of the group of patients (112). The patient-specific guidance data set (109) is adapted for use in interfacing the patient interface device (101a,b,...n) with the corresponding patient to administer medication to the patient. The patient interface device gateway (104) operative to interface the one or more sources of patient-affiliated data (105) with each patient interface device (101) of the plurality of patient interface device (101a,b,...n)s to automatically update each of said data bases (114) stored at each of said plurality of patient interface devices (101a,b,...n). The process of automatic updating of each of the data bases (114) is achieved by utilizing corresponding patient-affiliated data maintained by the one or more sources of patient-affiliated data (105).
Description
PCT/U52012/040179
SYSTEMS AND METHODS FOR INTELLIGENT PATIENT INTERFACE DEVICE
RELATED APPLICATIONS
This application claims priority to US. Provisional Patent Application No. 61/503,966 filed
CI July 1, 2011, entitled MS AND METHODS FOR INTELLIGENT PATIENT INTERFACE
DEVICE," which application is incorporated herein by reference in its ty.
FIELD OF THE INVENTION
The present invention relates to systems and methods for the provision of medical
services to a group of patients, and more particularly, to systems and methods for control of
intelligent patient interface devices adapted to interface with one or more patients of the group of
patients.
BACKGROUND OF THE INVENTION
-4 U! Patient interface devices used in the field of health care may be used to administer
medication and/or therapy and/or monitor an attribute ofa patient. In particular. infusion pumps
as used in the field of health care are electromechanical devices which control the flow rate of
liquid tions and foodstuffs. Infusion pumps may include a mechanical or capable of
displacing a syringe plunger to expel fluid from a e. Other types of infusion pumps may
use other mechanisms to effectuate the delivery of fluids.
In veterinary and human health care, infusion pumps are used in the delivery of
als, drugs, nutrition, or other ts to patients. lly, one or more substances are
combined to form a solution containing one or more medications and are then delivered by an
infusion pump to a patient. Such delivery may be into the bloodstream of the patient from a
medication source via tubing and an interconnected er or into the gut or directly into tissue.
Typically. infusion pumps are capable of controlling the flow rate of the medication to the
patient according to a predetermined programmable pattern. Such delivery may be continuous
or ittent. A particular pattern of delivery may be dependent on a combination of local
practices, the type of medication being delivered and utes of the patient.
The s of determining a proper protocol for medication delivery to a patient is often
complex and errors may reduce efficacy and may be potentially harmful to patients. As such,
automated logic devices have been developed to facilitate the determination and ation of
medication delivery protocols. Such logic devices have been implemented in infusion
pumps to
realize improved medication delivery. When implemented in this , the infusion devices
have been ed to as “smart pumps.” To date, however. systems have not been deployed
which recognize, generate and apply the full extent of data employable to further enhance
PCT/U82012/040179
automated facets of medication delivery. Specifically, these systems are either contextually
unaware of patient s when computing safety limits on medication ons, or limit their
contextual awareness to a query of patient databases {such as an electronic medical record,
also called an EMR, EHR, or eMAR) while initiating the infusion of medication therapy. In order
CI to maintain this limited contextual awareness, these systems must be uously connected to
the patient databases by wired or wireless means in order to function properly. As such they are
not tolerant of losses of connectivity due to network failure or poor wireless communication
coverage.
SUMMARY OF THE INVENTION
in view of the foregoing. an objective of the present invention is to provide apparatus and
methods for the provision of medical es to one or more patients of a
group of ts.
Another objective is to provide apparatus and s for the provision of medical
services using one or more of a plurality of communicatively interconnected patient interface
devices.
Another objective is to provide apparatus and methods for the management of patient
databases for a group of patients where the entirety of the patient databases are stored on each
t interface device of a plurality of communicatively interconnected t interface
devices.
One or more of the above-noted ives and additional advantages
may be realized by
an inventive system for use with one or more sources of patient-affiliated data corresponding
with a group of patients that includes a ity of patient interface devices. each for acing
with a t for the provision of medical care. Each patient interface device of the plurality of
patient interface s stores a database that comprises a plurality of t records where
each patient record of the plurality of patient records is related to a unique patientof the
group of
patients. In this regard. any patient interface device of the plurality of patient ace devices
may be used with any patient of the group of patients, thus reducing or eliminating the need to
have a specific patient interface device assigned to and/or follow a specific patient.
The system further includes a t interface device gateway operative to interface the
one or more sources of patient-affiliated data with each patient interface device of the plurality of
patient interface devices to automatically update the databases stored at each patient interface
device. Such automatic updating of the databases is achieved by utilizing corresponding patient-
affiliated data maintained by the one or more s of patient-affiliated data. in this regard, the
databases in each patient interface device may be maintained such that each patient interface
device comprises data that may be used by the patient interface device to create patient-specific
PCT/U82012/040179
guidance data sets which may be used by the patient interface device to control the patient
interface device while it is interfacing with a patient.
In various embodiments: at least a portion of the plurality of patient interface devices
may each be operable to administer medical treatment to a patient; at least a portion of the
ity of patient interface devices may each be operable to administer medication to a patient;
at least a portion of the ity of patient interface s may each be operable to administer
liquid tion to a patient; and at least a portion of the plurality of patient interface devices
each may comprise an infusion pump.
In one approach, all of the plurality of patient ace devices each
may se an
infusion pump. In another approach, at leasta portion of the plurality of t interface devices
may each be operable to monitor at least one attribute of a t.
In one approach, the group of ts may comprise ts admitted in a medical care
facility. such as for example, a clinic or hospital. In this regard, the group of patients may be
patients in a medical care facility who have been prescribed care using a patient interface
device, for example, who have been prescribed a medication for infusion pump administration.
The patient-affiliated data may e one or more data bases. Such databases may be
administered by the facility in which the system is located and may include one or more of the
following types of databases: an onic l Records (EMR) se, a pharmacy
database; a hospital medical record database; a medication administration record database; and
2O an admission, discharge and transfer database. Other appropriate databases may also be
included.
In an ment, the system may r include logic adapted to create a patient—
specific guidance data set for any patient of the group of patients. Such a patient-specific
guidance data set may be adapted for use in interfacing the patient interface device with the
corresponding patient. The logic may be capable of automatically updating a patient-specific
guidance data set in response to a change in the patient-affiliated data. In an approach, the
system may further include a therapy database and the logic may be capable of automatically
updating the patient-specific guidance data set in response to a change in the therapy se.
The logic may determine the updated patient-specific guidance data set based on therapy data
(including medication data) stored in the therapy database and the patient-affiliated data. Each
patient interface device of the plurality of patient interface devices may include such logic.
Further, each of the patient interface devices may include an input. Changes in the
patient-affiliated data may originate from the input of one of the plurality of patient ace
devices. In this regard, the input may be of any appropriate form, including for example, a
barcode reader, a card reader (e.g., capable of g a magnetic strip on a card), an RFID
reader. a keyboard, a key pad, a touch screen (e.g., with a menu-driven interface), a data port
PCT/U82012/040179
and/or a wireless adapter. Changes in the t-affiliated data may ate from a source
other than one of the plurality of patient interface devices, such as for example, a terminal
interconnected to the pharmacy database or any other database.
In a variation, each of the plurality of patient interface devices may be adapted to send
O1 data related to its performed actions to the one or more sources of patient-affiliated data via the
patient ace device gateway. In this regard, patient-affiliated data may reflect actions
performed by the plurality of patient ace devices. For e, where at least a portion of
the plurality of patient interface s are infusion pumps, each such infusion
pump may be
adapted to transfer pump-specific data sets to a pump surveillance database that may be part of
the system. The pump-specific data sets may e data related to
pump performance, such
as run time and/or voiume of medication pumped. The pump surveillance database may be
used to track infusion pump performance and ine maintenance and/or replacement
intervals.
By way of example, the patient interface device gateway may include a communication
link to the one or more sources of patient-affiliated data, a communication link to the therapy
database, and communication links to each patient interface device of the plurality of patient
interface devices. The patient interface device gateway may also include a communication link to
an external global therapy se. In an implementation, the patient interface device gateway
may be in the form of a server.
In another aspect, a method of updating a patient-specific guidance data set related to a
patient is disclosed. The patient-specific guidance data set is disposed within a first patient
interface device, and is adapted for use in interfacing the first patient interface device with a
corresponding patient. The method includes entering information related to a patient into the
first patient interface device, then automaticaliy transferring, over a patient interface device
gateway, the information from the first patient interface device to one or more s of patient-
affiliated data. The method further inctudes revising the one or more s of patient-affiliated
data with the information to create updated patient-affiliated data and automatically updating the
patient-specific guidance data set related to the patient to create an updated patient-specific
ce data set related to the t. The updating is performed by logic ed within the
first patient interface device and is based on data within a y database and the updated
t-affiliated data. The method further includes storing on the first patient interface device
the updated patient-specific guidance data set related to the patient and storing data related to
the updated patient-affiliated data on each patient interface device of a plurality of other patient
interface devices communicatively interconnected to the patient interface device gateway.
In an embodiment, the method may further e entering patient identification
information of the patient into the first patient ace , then accessing the updated
patient-specific guidance data set related to the patient in response to the entering patient
identification information step, and administering medical care to the patient according to the
updated patient-specific guidance data set related to the patient. in a variation, the
administering l care may comprise: administering medical treatment to a patient;
stering medication to a patient; and/or administering liquid medication to a patient. in a
variation, the administering medical treatment may e infusing liquid medication into the
patient where the t interface device is an infusion pump.
In an embodiment, each patient interface device of the plurality of other patient interface
devices may include logic adapted to te the updated patient—specific ce data set
reiated to the patient and the method may further include one of these other patient interface
devices generating. by the included logic, the updated patient-specific guidance data set reiated
to the patient. Such generating may be based on data within a therapy database and the
updated patient-affiliated data.
In still another aspect, a method of ng a plurality of patient interface device
databases is provided. Each patient interface device se of the plurality of patient interface
device databases comprises data related to a plurality of patients and is disposed within a
unique patient interface device of a plurality of patient interface devices. Each patient interface
device of the plurality of patient interface s is communicatively interconnected to a patient
interface device gateway. The method es revising patient-affiiiated data with information
related to a patient of the plurality of patients to create updated patient—affiliated data, then
updating a master database to create an d master database, and then ng each
patient interface device database.
In yet another aspect, a method of updating a plurality of t interface device
databases is provided. Each patient interface device database includes data related to a
plurality of patients. Each patient ace device database is disposed within a unique patient
interface device of a plurality of patient interface s. The method of the current aspect
includes revising a y database with information reiated to a medication to create a revised
therapy database, then updating a master se to create an updated masterdatabase. and,
based on the updated master database, updating each patient interface device database.
3O Another aspect provides for a patient interface device that comprises an input, a
computer readable memory adapted to store a se, logic d to select a record within
the database based on patient identification information received at the input, logic adapted to
generate a patient—specific guidance data set associated with a patient based on the record, and
logic adapted to control the patient interface device according to information stored in the
patient-specific guidance data set associated with the patient. The input is adapted to receive
patient fication information.
PCT/U520] 2/040179
in an approach, the patient interface device may include a data interface that is operable
to send and receive data d to changes in patient-affiliated data to a er network. The
patient interface device may include logic that is d to generate a t-specific guidance
data set from information obtained from a therapy database and the t-affiliated data via the
01 data interface. The data interface may be a wireless interface. The input may be operable to
receive information in the form of a bar code, an RFlD tag, a name, a serial number, an
identification number, a signal from an embedded identification device, and/or an identification
card.
In still another aspect, a plurality of patient interface devices are provided that include first
and second patient interface devices. The first patient interface device includes a first computer
readable memory, a database, and logic. The database is stored in the first computer readable
memory and es a first record associated with a first patient and a second record
ated with a second patient.
The logic is operable to create a first patient-specific guidance data set based on the first
record and ated with the first t. The first patient-specific guidance data set is
adapted for use in acing any of the plurality of patient interface s with the first patient.
The logic is also operable to create a second patient-specific guidance data set based on the
second record and associated with the second patient. The second patient-specific ce
data set is adapted for use in interfacing any of the plurality of interface devices with the second
patient. The plurality of patient interface devices further includes a second patient interface
device that includes a second computer readable memory, a copy of the database stored in the
second computer readable memory, and a copy of the logic.
Such a plurality of patient interface devices allows for any one of a number of patient
s to be used with a particular patient, since each patient interface device
may be capable
of employing its logic to the database stored on the patient interface device to create a patient-
specific guidance data set. For example, where the plurality of patient interface devices includes
a plurality of infusion pumps, any one of the plurality of infusion pumps may be employed to
infuse a medication into a patient. Such employment may be performed without the need forthe
ed infusion pump to have any additional data loaded into it prior to use infusing tion
into the patient. This is possible since the database es all the necessary data related to
the patient and the logic includes the necessary intelligence to determine an appropriate infusion
profile based on such data.
In another aspect, a system is provided for use with one or more sources of patient-
affiliated data ponding with a group of patients. The system includes logic and a patient
interface device gateway. The logic is adapted to create a ity of patient-specific guidance
data sets based on therapy data stored in a therapy database and patient data stored in the one
PCT/U52012/040179
or more sources of patient-affiliated data. Each patient-specific guidance data set is associated
with a unique t. The t interface device gateway is adapted to interface the logic with
the one or more sources of patient-affiliated data and the therapy database. The patient
interface device gateway is further adapted to send copies of data within the one or more
(.‘n s of patient-affiliated data and/or the therapy database to each patient interface device of
a plurality of patient interface s.
An additional aspect is provided that is a method of operating a patient interface device.
The method includes entering identification information for a first t into the patient interface
device and then automatically generating a first patient-specific guidance data set from a
database resident within the patient interface device. The first patient-specific guidance data set
is adapted for use in interfacing the patient interface device to the first patient. The method
further es interfacing the patient interface device with the first patient according to
parameters within the first patient-specific guidance data set. Such interfacing, for example, may
include monitoring an attribute of the patient and/or administering a medication to the patient.
in an embodiment of the present aspect, the method may further include entering
identification information for a second patient into the patient interface device. then automatically
generating a second patient-specific guidance data set from the database nt within the
patient interface device, and then interfacing the patient interface device with the second patient
according to parameters within the second patient-specific guidance data set. The method,
including interfacing with both the first and second patients, may be performed without any
communication between the patient interface device and an external database or external
device.
in another aspect, a method of managing data in a system that comprises
a ity of
patient interface devices is ed. The method includes ing data at a patient interface
device gateway and updating a master database based on the data received. The updating
includes a first set of changes to the master database. The method further inciudes
broadcasting the first set of changes to the piurality of patient interface devices and, for each
patient interface , updating a se resident in the patient ace device with the first
set of s.
in an embodiment, the method furtherincludes sending a firstsubset of the ed data
to a first database and sending a second subset ofthe received data to a second database. The
first and second databases are each unique databases that comprise patient-affiliated data. For
example, the first database may be a pharmacy database and the second database may be an
EMR se.
In r embodiment, the method may further include sending a first subset of the
received data to a first database and sending a second subset of the received data to a second
W0 2013/006234 PCT/U52012/040179
database, where the first subset of data is related to patient status, and the second subset of
data is related to patient interface device status. For example, where the patient interface device
is an on pump, the first subset of data may include information regarding the delivery of
medication to the patient, such as delivery time and date, tion type, dosage.
UT administration rate, and caregiver identification, while the second subset of data
may include
ation regarding the mance of the patient interface device, such as number of strokes
med and infusion pump serial number.
in still another aspect, a method of operating a patient interface device is provided that
includes identifying the presence ofa predetermined condition indicative of a lack of
currency of
data stored within the patient interface device. The identifying is med by the patient
interface device. In this regard, the patient ace device may be operable to identify a
number of unique predetermined conditions, any one of which could indicate a tack of
currency
of data stored within the patient interface device.
In an embodiment, the method may further include alerting a user to the lack of
ofdata stored within the patient interface device. The alerting may be performed by the patient
interface device and may. for exampie, be in the form ofa visuai or audible signal, Such ng
may be in se to the identification of the lack of cy of the data. in a variation, the
t interface device may prevent the user from using the patient interface device to interface
with a patient. In another variation, the patient interface device may delete at least a portion of
the data stored within the patient interface device.
In an embodiment. the identified predetermined condition may be the passage of a
predetermined amount of time from the receipt, by the patient interface device, of a
communication from a patient interface device gateway without the receipt of a subsequent
ication from the patient interface device gateway. Once such a predetermined amount
of time has passed without receiving a subsequent communication from the patient interface
device gateway, the patient interface device may react by alerting a user, preventing
a userfrom
using the patient interface device to interface with a patient, and/or deleting at least a portion of
the data stored within the patient interface device. in an example, the length of the
predetermined amount oftime may be assigned to the patient interface device based on the type
of the patient interface device. In r example, a common predetermined length of time
be assigned to each patient interface device ofa particular group, such as a medicai facility. In a
variation, the patient interface device may first react by preventing a userfrom using the patient
ace device to interface with a patient, and, if no receipt of a subsequent communication
from the patient interface device gateway occurs within a second predetermined amount of time,
the t interface device may then delete at least a n of the data stored within the patient
WO 06234 PCT/U52012/040179
interface device. The second predetermined amount of time may be determined in a manner
similar to that of the first predetermined amount of time.
In another embodiment. the identified predetermined condition may be based on the lack
of reception of a serialized communication from a patient interface device gateway. In this
regard, the method may e receiving, by the patient interface device prior to the identifying
step, a first communication from a t interface device gateway and a second
communication from the patient ace device gateway. Both the first communication and the
second communication may include serialized identifications. In such an embodiment, the
identifying step may include ining, by the patient interface device and based on the first
and second serialized identifications, the absence of one or more communications with
serialized identifications between the first and second serialized identifications. Once such a
predetermined condition (one or more missing communications) has been identified, the t
interface device may react by requesting the missing communications from the patient interface
device gateway, alerting a user as to the missing communications, preventing a userfrom using
the patient interface device to interface with a patient, and/or ng at least a portion of the
data stored within the patient interface device.
Numerous onal features and advantages of the present invention will become
apparent to those skilled in the art upon eration of the embodiment descriptions provided
hereinbelow.
BRIEF DESCRIPTION OF THE GS
Fig. 1A illustrates a system for interfacing with patients and managing data that includes
a plurality of patient interface s.
Fig. 18 illustrates a portion of the system of Fig. 1A with an interconnection between
patient interface devices.
Fig. 10 illustrates a n of the system of Fig. 1A with an avatar external to the patient
interface devices.
Fig. 2 is a flowchart of a method of updating a patient-specific guidance data set related
to a patient by inputting data into a patient ace device.
Fig. 3 is a flowchart of a method of updating a patient-specific guidance data set by
inputting data into patient-affiliated data.
Fig. 4 is a flowchart of a method of updating a patient-specific guidance data set by
ing data into a therapy database.
PCT/U52012/040179
DETAILED DESCRIPTION
Fig. 1A illustrates an intelligent system 100 for interfacing with a patient (e.g.,
administering medications such as l fluids using an infusion pump or inhalants to a
patient, administering therapyto a patient, or ring patient attributes) and managing data in
a given medical care facility or network of medical care facilities. The data managed includes,
for example, data related to types of medication, data related to the administration of
medications, data related to therapy red, patient related data (e.g., identification data,
patient attributes), and system performance data.
Generally the system 100 includes a piurality of patient ace devices 101 that
includes patient interface devices 101a, 101 b 101n, where n is any appropriate integer for a
particular facility. More than one patient interface device may be associated with a particular
patient. Each patient interface device of the plurality of patient interface devices 101
may be
capable of interfacing with a patient in an automated fashion in thateach may be programmed to
deliver medication or y, or monitor the patient and once initiated,
may perform at least a
portion of the function without further input. For example, in the case where the t interface
device 101a is an infusion pump, the infusion pump may be operable to deliver a liquid
medication to a patient by pumping the liquid medication through a er inserted into the
patient.
Each patient interface device of the plurality of t interface devices 101
may include
a memory 119 in which patient-specific guidance data sets 109 may be stored. Each patient
interface device may include input and output components to tate the transfer of ation
into and out of the patient interface devices 101. Each patient interface device may include at
least one network connection enabling connection to a patient interface device network 102 or
other patient interface devices 101 through, for exampie, a wired or wireless connection.
The patient interface device network 102 may tate a communicative interconnection
of the plurality of patient ace s 101 to a patient interface device gateway104. The
patient interface device gateway 104 may be in the form of a server. The patient ace
device gateway 104 may be communicatively onnected (eg, through a k 103) to
patient-affiliated data 105 that includes information related to specific individual patients. The
patient ace device gateway 104 may also be icatively interconnected to a therapy
database 106 that includes ation related to various therapies, including medications, such
as formularies containing details about formulation of tions and administration practices
for various types of medications. The patient interface device gateway 104 may also be
communicatively interconnected to a pump surveillance database 107, which may include
information related to the performance of a portion of the plurality of patient interface s
101 that inciude infusion pumps, The patient interface device gateway 104 may also be
W0 2013/006234 PCT/USZOIZ/040179
comm unicatively interconnected to any other riate database such as other databases that
a medical facility may maintain.
The system 100 may be comprised ofa single type of patient interface device 101. For
exampie, in an exemplary system, all of the patient interface devices 101 of the system 100 may
(II be infusion pumps. In such a , the patient interface device gateway 104 may be referred
to as an infusion pump gateway.
A master database 113 may be communicativaly interconnected to the patient interface
device gateway 104. The master database 113 may e data used to e the patient
interface devices 101. For example, the master database 113 may include information from the
patient—affiliated data 105 and/or the therapy database 106 that is pertinent to the operation of
the patient interface devices 101. As an example, where one or more of the t interface
devices 101 are infusion pumps, the master database 113 may include information about a
patient's condition and information about medications prescribed to the patient. The master
database 113 may also include data regarding nel g at the facility where it is being
used. Such data may be used to identify or verify the identity of personnel operating the patient
interface devices 101. The patient interface device gateway 104
may facilitate the nance
of the currency of the master se 113 as described below.
The system 100 may include one or more avatars 108. Each avatar 108
may be d
in the memory 119 of the patient interface devices. Each avatar 108
may comprise a database
114 and logic 115. The database 114 may e data from the master database 113, For
example, the database 114 may be a copy of the master database 113 and the database 114
may be periodically updated to maintain parity with the master database 113. In this , any
changes to the master database 113 may be communicated to the database 114 of each avatar
108.
The logic 115 of the avatar 108 may be capable of constructing t-specific guidance
data sets 109 from information disposed in the database 114. For example, where the
patient-specific guidance data sets 109 are to include information about the administration of
medication (e.g., where the patient interface device 101a is an infusion pump). the logic 115 of
the avatar 108 may be capable of constructing patient-specific guidance data sets 109 in the
3O form of infusion parameters from information disposed in the database 114 related to the patient
and the particular medication to be administered.
The system 100 may be operable to interface with ses external to the system 100.
such as a giobal therapy database 110 and a global master pump llance database 111,
each of which is discussed below.
Turning to the patient-affiiiated data 105, the patient-affiliated data 105 may contain data
for a patient group 112. Such patient-affiliated data 105 may include information about individual
.11-
PCT/U82012/040179
patients of the t group 112. The patient group 112 may, for example, be a group of
ts currently admitted to a particular hospital or facility, or it may be a subset of such a
group, such as patients currently admitted to a particular department of a hospital or patients
admitted to a particular hospital who have been prescribed infusion treatments. In another
example, the patient group 112 may be a group of patients currently admitted to a particular
network of als andlor other facilities that are under common management. The facilities
may, for example, be als, specialized ent centers, clinics, outpatient facilities,
physician’s offices, mobile treatment facilities, individual homes of patients, or any other
appropriate place or places where patients may receive infusions of medications. The patient
group 112 may also include future or past patients, such as patients scheduled to be admitted to
a ular ty or patients who had usly been admitted to a particular facility The
information about individual ts of the patient group 112 contained in the patient-affiliated
data 105 may include, but not be limited to, identification data (e.g., name, address, identification
numbers), medical history, medication history, and current health status.
The patient-affiliated data 105 may include multiple data sources located at multiple
locations. The patient-affiliated data 105 may include any appropriate database that
a hospital
may access to determine how to treat a patient, including patient information pertinent to
dosages of medications that may be administered to a patient. The patient-affiliated data 105
may include a facility’s (e.g., a hospital’s) medical record database or a n thereof,
For example, the patient-affiliated data 105 may include a pharmacy database that
contains data related to the medications currently ibed for and previously administered to
ular patient along with any information regarding drug allergies, interactions between drugs,
and appropriate , The pharmacy database may include
any other appropriate information.
For example, the patient—affiliated date 105 may include an Electronic Medical Records
(EMR) database maintained by a facility. In another example, the t-affiliated data 105
include a se that includes Medication Administration Records (MARs)which
may serve as
the legal record of the drugs administered to the patients at a facility. In another example, the
patient-affiliated data 105 may include a database that includes Admission, Discharge and
Transfer (ADT) information.
The patient-affiliated data 105 may be disposed in a single computer system or it
may be
distributed among a plurality of er systems. in this regard, each of the above-discussed
components of the patient—affiliated data 105 may each be disposed on one or more separate
computer systems. Thus. the cy database may be disposed on a server located in a
pharmacy of a hospital while an ADT database may be disposed in the admissions area of a
hospital. Alternatively, one or more of the databases of the patient-affiliated data 105 may be
ed external to the facility to which the data pertains.
PCT/U52012/040179
The t-affiliated data 105 may be communicatively interconnected to the patient
interface device gateway 104 such that information may be transferred: 1)from the patient-
affiliated data 105 to the patient interface device y 104 and to the master database 113
and the plurality of patient interface devices 101; and 2) from the ity of patient interface
(Fl devices 101 through the patient interface device gateway 104 to the master database 113 and to
the patient-affiliated data 105. In this regard, the t interface device gateway 104 may be
communicatively interconnected to each database within the patient-affiliated data 105. For
example, the patient interface device gateway 104 may be interconnected to the pharmacy
se via the k 103 which may be in the form of a Local Area Network (LAN), an
intranet, the internet and/or any other appropriate type of network. The connection between the
patient interface device gateway 104 and various components of the patient-affiliated data 105
may be wired or wireless.
As new patients are admitted to a facility, and as patients’ conditions change, it may be
necessary to update the patient-affiliated data 105. Such updates may be achieved in several
different ways. For e, the data within the patient-affiliated data 105 may be updated by
entering new information into one of the databases of the patient-affiliated data 105, such as by
an admissions clerk upon admitting a new patient or by a pharmacistentering a new prescription
into a pharmacy database.
In another example, a user may enter the update information into
any one of the plurality
of patient interface devices 101. In this regard, a patient ace device, such as patient
interface device 101a, may be used to assist in admitting a new patient (e.g., in an emergency
room) or in updating information regarding an existing patient. The information may then be
erred to the master database 113 and/or patient—affiliated data 105 via the patient interface
device gateway 104. Such a transfer may happen automatically, in that once the data is entered
into the patient interface device 101a, it may be transferred to the patient-affiliated data 105
without any other user input or command. In a ion, the user may be prompted by the
patient interface device 101a to confirm sending data to the patient interface device gateway 104
and/or t-affiliated data 105. In still another example, the patient interface device 101a
tically send information to the patient interface device gateway 104 at the occurrence of a
specific event, such as the beginning of delivering a medication to a t, the reaching of a
predetermined milestone during an infusion s (e.g., when half of the infusion has been
completed), and/or the completion of the delivery of medication to the patient by the infusion
pump 101a.
The patient ace device gateway 104 may update the master database 113 and/or
the patient-affiliated data 105. The patient interface devices 101 may also notify the patient
interface device gateway 104 if no events have happened over a predetermined period of time.
PCT/USZOIZ/040179
In this regard, such reporting may inform the master database 113 that such patient Interface
devices 101 are still connected to the network 102 and that such patient interface devices 101
have no new information to be submitted to the master database 113. Relatedly, a lack of such
reporting may indicate to the master database 113 that a patient interface device is missing or
inoperative. Patient interface devices 101 may also report their position (e.g., on within a
facility) to the master database 113. Such position determination may be achieved through any
appropriate means. For example, patient interface device on may be determined using
network attributes. In another example, patient ace device on may be determined by
reference to a known location of a patient ing care from the t interface device.
The information sent from the patient interface s 101 to the patient interface device
gateway 104 may contain several different types of information that are d to be sent to
several different . For example where the patient interface device is an infusion
pump,
ation sent from the patient interface devices 101 may include pump related data (e.g.,
number of strokes performed, pump serial number) to be sent to a pump surveillance database
107, medication usage data (e.g., a dose of medicine was used) to be sent to a pharmacy
database, and t information (e.g., the dose was administered to a patient) to be sent to a
MARS database. The patient interface device gateway 104 may possess the ability to receive
such information from the patient interface s 101 and parse the information and
pass the
parsed information onto the d destinations.
The therapy database 106 may contain one or more formularies, medication-specific
datasets or therapy-specific data sets. The medication-specific datasets may e
medication-specific identification data (e.g., lists of medications approved by a facility) and
medication-specific ation data (e.g., formulas for compounding medical fluids used to
deliver medications). The medication-specific data sets may include medication-specific infusion
data such as data related to how particular medications may be infused into a patient (e.g.,
concentrations, flow . The therapy database 106 may include and/or be part of a Clinical
Decision Support (008) system.
As new medications are approved by the facility or as new treatment protocols are
introduced for existing medications in the therapy database 106, it may be aryto update
the therapy database 106. Such updates may be achieved in several different ways. For
example, the data within the therapy database 106 may be updated by entering new information
into one of the datasets of the therapy database 106, such as by a pharmacist under the
direction of a Director of Pharmacy entering a new type of drug into a dataset including
medication-specific identification data.
In another e, a physician may enter updated information regarding a new
treatment protocol for a particular medication into any one of the plurality of patient interface
WO 06234 PCT/U82012/040179
devices 101. The information may then be transferred to the master database 113 and/or the
therapy data base 106 via the patient interface device gateway 104. Such a transfer may happen
automatically, in that once the data is entered into the patient interface device 101a, it may be
transferred to the master database 113 and/or the therapy database 106 without any other user
input or command.
According to another example of how the therapy database 106 may be updated, the
facility may subscribe to a global therapy database 110. The global therapy database 110 may
be onnected to the y database 106 via a network, such as via the Internet. The
globat therapy database 110 may be ined by a third party and as new therapies and/or
medications are added or new administration protocols are developed, the new global therapy
database 110 may be updated and the changes pushed to the therapy database 106 andfor the
master se 113, thus updating the therapy database 106 and/or the master database 113.
As noted above, the avatar 108 may be capable of constructing patient~specific guidance
data sets 109 from information disposed in the database 114. Such constructing may occur
__x (TI tically when identification information regarding a particular patient and/or a particular
dose of medication is inputted into the patient interface device 101a. In this regard, the patient-
specific guidance data set 109 for a ular patient will be created locally (e.g., within the
patient interface device 101a) on demand.
Accordingty, each patient ace device of the plurality of patient interface devices 101
may contain the information necessary to produce patient-specific guidance data sets 109 for
each patient in the patient group 112. For e, for each t, each patient interface
device of the plurality of patient interface devices 101 may include identification data, medication
data, and/or treatment data. The medication data may include a list of medications along with
rules for determining infusion parameters for a patient. The ent data may contain specific
instructions for use with specific patients (e.g., medications prescribed for each patient in the
patient group 1 12). In this regard, each patient interface device ofthe plurality of patient interface
devices 101 may possess the ability to te patient-specific guidance data sets 109 for any
patient. For e, each patient interface device of the plurality of patient interface devices
101 may possess the ability to generate infusion parameters for a patient. Such infusion
parameters may inciude infusion rate (e.g., mL/hr), infusion duration, dose duration, dose
interval, bolus size, or any other appropriate parameter. The infusion parameters may include
maximum andlor minimum values for each parameter.
Thus, each patient ace device of the plurality of patient ace devices 101 may
be capable of interfacing with any patient in the patient group 112. Thus, any patient interface
device of the plurality of patient interface devices 101 may be used to interface with (e.g., infuse
liquid medication where the patient interface device is an infusion pump) any patient in the
WO 06234 PCT/USZOI2/040179
patient group 112 by generating the particular patient-specific guidance data set to be used. In
this regard, managing patient interface device ory is fied as no searching is needed
for a particular patient interface device of the plurality of patient ace devices 101 that
contains unique ation for a ular patient to be treated.
In an alternative arrangement, the avatars 108 may construct patient-specific ce
data sets 109 for all appropriate patients who have data within the database 114 upon the arrival
of such data into the database 114. Moreover, when the se 114 is updated, new patient—
specific guidance data sets 109 may be calculated based on the updated data. In this regard,
updates to the patient—specific ce data sets 109 may be triggered by a change to the
1O master database 113. The patient ace device gateway 104 may assist in constructing the
master database 113 by accessing the patient-affiliated data 105 and the therapy database 106
via the network 103. For each t in the patient group 112, the patient interface device
gateway 104 may access the patient-affiiiated data 105 to obtain ation pertinent to the
treatment (e.g., medication administration) and/or monitoring for that patient, such as current
drug prescriptions, patient condition, patient health history, patient weight, patient age, patient
gender, known drug allergies, other drugs being administered, and/or any other appropriate data.
The patient ace device gateway 104 may access the therapy database 106 to obtain, for
example, medication formulation data and/or medication infusion data for the particular
medications prescribed to the patient. This process may be repeated for each patient of the
patient group 112 resulting in the construction of the master database 113.
The avatar 108 may also construct or update a patient-specific guidance data set 109 for
a particular patient in response to the entering of new data into a patient interface device ofthe
plurality of patient interface devices 101. Such construction or updating may be automatic. The
new data entered may be appropriate for storage within the patient-affiliated data 105 and/orthe
therapy database 106. As such, the new data may be forwarded, via the patient interface device
gateway 104 and network 103, to the patient-affiliated data 105 and/or the therapy database 106
and the patient-affiliated data 105 and/or the therapy database 106 may be updated accordingly.
The master database 113 may also be updated and in turn the databases 114 in each of the
other t ace devices 101 may be updated in response to the s to the master
database 113.
As noted, the patient interface device gateway 104 may facilitate the maintenance ofthe
master database 113. in this , updates or changes to the patient-affiliated data 105, the
therapy database 106, or any other source used to populate the master database 113 may,
through the patient interface device gateway 104, be incorporated into the master database 113.
Such changes may occur, for example, when a new patient is admitted, when a patient’s
information changes, when a new medication is added, or when a formulation for an existing
-16..
PCT/USZOIZ/040179
medication is changed. Such incorporation of changes may, for example, occur as a result of
the patient interface device gateway 104 periodicalty ing the various interconnected
databases to determine changes that may have occurred to the various interconnected
databases. An exemplary way of checking for such s would be to erthe entirety of
(It the various interconnected databases and compare the ation to the master database 113
to determine changes. An altemative process may be to query the various onnected
databases for changes that may have occurred since the last query and only incorporate the
recent changes into the master database 113. Stiil another ative is for the external
databases to be configured to notify the patient interface device gateway 104 when a change
occurs.
As previously noted, any changes to the master database 113 may be communicated to
the database 114 of each avatar 108. Such communication may take any appropriate form. In a
first example, the database 114 of each avatar 108 may be updated by copying an entirety of the
master se 113 to each se 114 of each avatar 108. In a second exampie, only
changed s (e.g., a complete patient record for a particular patient that has changed) may
be sent to each database 114 of the patient interface devices 101. In a third e. oniy
changed data (e.g., an update to a patient‘s condition. but not other patient information in the
patient’s record that is unchanged) may be sent to each database 114 of the t interface
devices 101.
The patient interface device gateway 104 may be in the form of a software program
resident on a computer system. The master database 113 may be resident on the same
computer system as the patient interface device gateway 104 or it may be resident on a separate
device. Where the master se 113 is resident on a separate device, as illustrated in Fig.
1A, that device may be interconnected directly to the patient interface device gateway 104 or it
may be communicatively interconnected to the patient interface device gateway 104 through the
network 103.
Each patient interface device ofthe plurality of patient interface devices 101 may contain
an independent avatar 108. In such an embodiment, any s to the t-affiliated data
105 and/or therapy database 106 may be communicated to the master database 113 via the
patient interface device gateway 104 and then communicated to each duat avatar 108 via
the t interface device gateway 104, which may in turn update each currently used
individual patient-specific guidance data set 109 that may change as a result of the update.
The logic 115 of the avatar 108 and therefore the set of rules it uses to create and update
the patient-specific guidance data sets 109 may be derived from one or more of a plurality of
different sources. For example. regulatony rules. industry rules, health care provider rules,
PCTfU52012/040179
individual facility rules, physician preferences and patient preferences may all be used to
determine the configuration of the logic 115.
When a source for the logic 115 is updated, the logic 115 may be correspondingly
updated. For example, such an update may be entered into the patient interface device gateway
Ui 104 and then be sent from the patient interface device gateway 104 to each patient interface
device of the plurality of patient interface devices 101 over the k 102. in this regard, each
avatar 108 of the system 100 may be maintained. A master copy of an avatar may be
maintained, for example, in the master se 113.
Each patient interface device of the plurality of patient interface devices 101 may be a
device capable of controlling the flow rate of medications being red to a patient, controlling
the delivery of therapy to a patient, and/or controlling the monitoring of one or more patient
attributes. Such control may be achieved using a rocessor and appropriate software
and/or hardware disposed within each patient interface device of the pluraiity of patient interface
devices 101. Each patient interface device of the plurality of patient interface devices 101
further include memory 119 where the patient-specific guidance data sets 109 may be .
Where the avatar 108 is disposed within each patient interface device, the memory may also
store the avatar 108.
Each patient interface device may include one or more components or inputs for the input
of data into the patient interface device. Such components may be in any appropriate form, such
as for e, buttons, keypads, keyboards, touch screens, barcode readers, radio frequency
identification (RFID) tag readers, biometric readers, card readers, data ports, network
interconnections, wireless network interfaces and/or any other appropriate form, The types of
data that may be received by the t interface device include, but are not iimited to, patient
fication data, caregiver identification data, patient-specific attributes, tion
identification data, medication-specific attributes, patient-specific guidance data sets and patient
status data. Each patient interface device may e ports operable to be interconnected to
devices or sensors that are operable to measure and/or monitor various patient attributes such
as. for example, heart rate, temperature, blood pressure, and oxygen saturation of blood.
Each patient interface device of the plurality of patient interface s 101 may inciude
a plurality of s. Where the patient interface device is an infusion pump, a first output may
be a mechanical output operable to pump medication h tubing to a patient. For example,
the patient interface device may include a movable ram operable to interface with and move a
plunger of a syringe to cause medication to be expelled from the e. The ram may be
controilable to deliver a medication to a patient at a ely controlled rate according to the
patient-specific guidance data set for the patient. In r implementation of the patient
ace device as an infusion pump, the mechanical output may be used to drive a peristaitic
PCT/U52012/040179
pump. The mechanical output of the patient interface device may be driven by a drive (e.g., a
motor) and the patient interface device may include logic (e.g., a motor controller) and one or
more sensors that are used to produce a controlled motion of the drive to e a controlled
flow rate of medication to a patient.
Other s that a patient interface device may generally comprise
may include a video
display which may. for example, icate information related to the patient, infusion status
and parameters. patient attributes, medication. patient interface device performance. medical
personnel, or any other appropriate t. The patient interface device may also include an
audio output capable of ng an alarm in response to predetermined occurrences (e.g.,
attempting to load an incorrect medication onto the patient ace device, unsatisfactory signal
from a sensor measuring an attribute of the patient). The patient interface device
may also have
the capability to send alerts of such occurrences to a variety of places via a network connection
(e.g., a wireless network connection). Such alerts may be sent to individuals (e.g., nurses and/or
physicians) or to locations (e.g., a nursing station). The audio output may also be capable of
playing audio operation instructions to assist in operating the patient interface device.
The network 102 connection may be of any riate form for exchanging data
between devices and may onnect the plurality of patient interface devices 101 to the patient
interface device gateway 104. The patient interface device gateway 104 may, in turn. be
interconnected via network 103 to the patient-affiliated data 105. the therapy database 106. the
pump surveillance database 107, other facility databases, and to databases external to the
system 100, such as the global therapy database 110 and the giobal master pump surveillance
database 111. The networks 102, 103 may be independent networks as illustrated in Fig. 1A. or
alternatively network 102 and network 103 may be the same network. For example, network 102
and network 103 may be a facility’s existing LAN. in such an example. the patient ace
device gateway 104 may communicate with the ity of t interface devices 101 through
the LAN as well as communicate with the databases (patient-affiliated data 105. therapy
database 106, pump surveillance database 107. databases external to the system 100) h
the LAN.
As noted. the patient ace device gateway 104 may be in the form ofor resident on
computer system. The interconnections between the patient interface device gateway 104 and
the patient-affiliated data 105, the therapy se 106, and to the pump surveillance database
107. may all be through a ty's existing network and/or h a dedicated network for the
system 100. It is also noted that the patient-affiliated data 105 may be disposed across
many
individual computer systems. For example, the pharmacy database may be disposed on a
er system within the pharmacy of the facility. while the database that ns the ADT
information may be located ere in the facility. However, both the pharmacy database and
PCT/U52012/040179
the ADT database may be interconnected to the facility's LAN and thus in communication with
the patient interface device gateway 104.
The pump surveillance database 107 may contain data related to the performance of
each patient interface device of the piurality of patient interface devices 101 that is in the form of
or includes an infusion pump. in this regard, as the patient interface devices 101 in the form of
infusion pumps are operated to r tions to patients, each such t interface
device may create logs of its activity. Such logs may contain data such as start and finish times
of performed infusions, number of strokes performed, total g time, type of tion
delivered, and any other appropriate data that may affect or indicate performance of the t
interface devices 100. The patient interface devices 101 may send such logs to the patient
interface device gateway 104, which may then send the logs to the pump surveillance database
107 via the network 103. in turn, the data within the pump surveillance database 107 may be
monitored and analyzed to assist in determining, for example, maintenance tasks to be
completed for particular patient interface devices and/or replacement of particular patient
__\ O1 interface devices. Additionally, data within the pump surveillance database 107 may be
automatically periodically delivered to the global master pump surveillance database 111. The
global master pump surveillance database 111 may aggregate patient interface device
performance data from a plurality of facilities to, for example, further refine nance and
replacement schedules and determine potential failure modes.
Other ses for storing performance data related to other types of patient interface
s 100 may aiso be interconnected to the patient interface device gateway 104 h the
network 103. For example, a blood pressure sensor monitor database and/or a compression
device monitor database may be interconnected to the patient interface device gateway 104
through the network 103. Such ses may function simiiarty to the pump surveillance
database 107 described above and may be used in a similar manner to manage the patient
interface devices 101. Moreover, global databases, similar to the global master pump
surveiiiance database 111 may exist for these other types of patient interface devices 109.
The data described herein as being transferred n the patient interface device
gateway 104 and the patient ace devices 101 may be encrypted. Moreover, data being
transferred between individual patient interface devices of the piuraiity of patient interface
devices 101 and/or between avatars 108 and/or between avatars 108 and patient interface
devices 101 may be encrypted. Such tion may help to maintain security of medical data
associated with patients as it is transmitted from point to point. Such encryption may assist in
preventing unauthorized ng of data and thus help to maintain t safety. Furthermore,
such tion may assist in ting unauthorized accessing of data and thus help to
maintain patient privacy.
PCT/U52012/040179
The data described herein as being stored in the databases 114 and/or the master
database 113 may be encrypted. As with data being transmitted, such encryption may help to
maintain security of medical data stored within the system 100, thus protecting safety and
The maximum predetermined amount of time between when data is entered into an
external database (e.g., patient-affiliated data 105) and when the entered data is distributed to
the master database 113 may be any appropriate amount of time. For example, such a
maximum predetermined time may be on the order of one second, one minute, one or more
hours, or any appropriate time therebetween. The m predetermined time may be
selectable by, for e, a system administrator and may be based on safety requirements,
bandwidth of the k 103, the amount of data to be transferred, and/or other riate
factors. In an arrangement, at intervals equal to the selected maximum predetermined time, the
patient interface device gateway 104 may query the various interconnected ses for
changes that have occurred since the last query.
In an alternative arrangement, the master database 113 may be at least partially
ined in real—time or near real-time. In such an embodiment, when changes are made to
an external se (e.g., patient-affiliated data 105). the external database may be configured
to notify the patient interface device gateway 104 of the changes. In this regard, the patient
interface device gateway 104 may subscribe to some or all of the externat databases and thus
be ed when changes to those databases occur. The system 100 may utilize a
ation te methods where some databases must be queried while other ses
notify the patient interface device gateway 104 when changes have occurred.
Similarly, the patient interface devices 101 may be configured such that changes to one
of the databases 114 within a patient interface device may be ately communicated to the
patient interface device gateway 104, which maythen immediately pass the update to the master
database 113. Alternatively, the patient interface devices 101 may be configured to send
s of their databases 114 at regular intervals. Each t interface device may also be
configured to send notices to the patient interface device gateway 104 if no changes to its
database 114 have occurred for a predetermined period of time.
The master database 113 may communicate regularly to the plurality of patient interface
devices 101. In this regard, at r time intervals, the master database 113 may broadcast a
journal to every t interface device of the plurality of patient interface devices 101. Such
journals may contain any updates that were made to the master database 113 since the last
journal was broadcast. in this regard, upon receipt and incorporation of a journal entry, the
patient interface devices 104 may have knowledge that their corresponding databases 114 were
up to date as of the time of such incorporation. The journals may be sequentially numbered
PCT/USZOIZIO40179
such that any patient interface device, upon receiving a journal broadcast, will be able to
determine from the serial number if any journal broadcasts were missed. For example, if a
patient interface device receives journal number 1004 and the lastjournal received by the patient
interface device wasjournal number 1002. the patient interface device may determine that it has
missed l number 1003. The patient interface device may then t journal number
1003 before applying the changes of journal number 1004.
If no data updates to the master database 113 occur over a predetermined period of
time, the master database 113 may inform the patient interface s 101 as such in a journal
that ns no updated data. Thus, the patient interface devices 104 may have knowledge that
their databases 114 were up to date as on the receipt of such an empty l entry.
In this regard, each database 114 of each patient interface device of the plurality of
patient ace devices 101 may be maintained such that the data n reflects all but the
most recent changes to other databases 114 of other t interface devices 101 and to
external databases. For example, where the t interface devices 101 notify the patient
-_\ 01 interface device gateway 104 of changes to its databases 114 every minute, and where the
master database interrogates external databases every minute, and where the master database
113 broadcasts a journal every minute, any data changes within the system 100 will be reflected
in the databases 114 of the patient interface devices 101 within at most about two minutes (e.g.,
one minute for a patient-affiliated data 105 change to be ed in the master database 113
plus one minute until a journal ast is sent out).
The above-described data maintenance arrangements may support additional system
features. For example, if a e occurs in network 102 and/or network 103, the individual
patient interface devices 101 may be e of tracking the amount of time that passes from
the last contact (e.g., the time of the last received journal) with the patient interface device
gateway 104. The patient interface devices 101 may be mmed to remain operational fora
predetermined amount of time from receiving a iast—in-time update. For exampie, in an
arrangement. the system 100 may be configured such that updates (e.g., journals) are sent to
the databases 114 every five minutes and the individual patient interface devices 101
may be
configured such that they may remain ionai for up to an hour after receiving a last-in—time
update. Thus. in such a case, if the network 102 becomes non-operational, the patient interface
devices 101 will remain operational for up to one hour. The length of one hour is exemplary.
The actual length used by a system 100 may be shorter or longer and may also be
programmable (e.g., by hospital administrators). Such operation may be used to prevent the use
of “stale" data by a patient interface device 101. “State” data, as used herein, indicates data that
has not been updated for a predetermined amount of time and as a consequence may be
rable for use in controlling the operation of a patient interface device 101.
W0 2013/006234 PCT/USZOIZ/040179
Once information within the avatar 108 is determined to be stale, the avatar 108 may
prevent usage of the stale data to operate the patient interface device 101. Such prevention
may be in any appropriate form. For example, the avatar 108 may look out users and only allow
access to the data (e.g., the database 114 and/or the patient-specific guidance data set 109) by
system administrators or other designated personnel. in this regard, data that is only resident in
the database 114 and nowhere eise (e.g., data d to an infusion that occurred after the last
in time communication with the patient interface device gateway 104) may be retrieved and
incorporated into the master database 113.
In another example, if the avatar 108 determines that the data has been stale for a
predetermined amount of time (e.g., l hours or days), it may wipe (e.g., delete such that
the deleted data is unrecoverable) the memory that ns the state data (e.g., the memory
that contains the database 114 and/or the patient-specific guidance data set 109). Such wiping
may optionally exclude any information within the database 114 that has not been communicated
to the patient interface device gateway 104. Such action would prevent use of the data to run
the patient interface device 101 and would also help data security by limiting or preventing
unauthorized access to the data. Since the patient interface devices 101 may be relatively small,
wireless units (e.g.. portable infusion pumps). they may be susceptible to theft or ntional
removal from the facility. Accordingly, the ability to wipe the memory that contains stale data
may be of particular value to data security.
When the networks 102 and/or 103 are restored after a period of unavailability, the
t interface devices 101 may send any data to the patient interface device y 104 that
had not been previously sent, such as, for example, data related to infusions that were
performed by the patient interface devices 101 while the ks 102 and/or 103 were
unavailable. The master database 113 may then be updated accordingly. Additionally, if the
network 103 was unavailable, any changes that occurred to the external databases (e.g., patie nt-
affiliated data 105, y database 106) may be communicated to the master se 113.
Once the master database 113 has been fully updated, each individual database 114 in the
patient interface devices 101 may be correspondingly updated.
in an implementation of the system 100. a single avatar may control more than one
patient interface device 101. Such an implementation is rated in Fig. 1B. In Fig. 1B, the
patient interface device 101a and patient interface device 101b are directly ted via link
117. Both devices 101a, 101b may be located proximate to a patient (e.g., bedside). Both
patient interface device 101a and patient ace device 101b may be interconnected to the
t. For example, patient interface device 101a may be in the form of a first infusion pump
and patient interface device 101b may be in the form of a second infusion pump, where each
PCT/USZOl2/040179
patient interface device 101a, 101b is used to deliver a different medical liquid to the same
patient.
Link 117 may be of any appropriate form, including for example, a wireless link (e.g.,
Wi-Fi and/or Bluetooth), a direct wired connection, or a fiber optic link. The link 117 may be
resilient in that it may be capable of remaining operational despite interference that may be
present in the facility. When linked, one of the avatars, for example avatar 108a, may become a
master avatar, while the other avatar, for example avatar 108b, may become a slave avatar or
become dormant white the master avatar 108a controls the slave patient interface device 101 b.
Which avatar becomes the master and which avatars or patient interface devices become the
staves may be determined automatically upon direct interconnection (e.g., by selecting the
master to be the unit with the highest serial number) or a user may select which avatar is the
master.
in such a -slave onship, the master avatar 108a may provide the slave patient
interface device 101b with the patient-specific guidance data set 10%. Thus, using patient-
specific guidance data sets 109a and 109b, master avatar 108a may control both patient
interface device 101a and patient interface device 101 b. Where both patient ace s
101a and 101b are stering tion, the use of the master avatar 108a to control both
patient ace s 101a, 101b may enhance the ability of the system to prevent the
administration ofdrugs or dosages by the individual patient interface devices 101a, 101 b that are
incompatibie with each other. The master avatar 108a may handle all communications with the
patient interface device gateway 104.
In another example, patient interface device 101a may be in the form of a patient monitor
and patient interface device 101 b may be in the form otan infusion pump. The avatar 108a
serve as a master avatar and control both the patient monitor patient interface device 101a and
the infusion pump patient interface device 101b. In such a configuration. the avatar 108a may
controi the infusion pump patient interface device 101b based on feedback from the t
r patient interface device 101a. For example, where the patient monitor patient interface
device 101a is a heart rate monitor, the delivery of medication via the infusion pump patient
interface device 101b may be altered (e.g., stopped) in se to a change in patient heart
rate detected through the heart rate monitor. Any such required alterations may be recorded in
the database 114 of patient interface device 101a and communicated to the patient interface
device gateway 104 and master database 113 (and then to all other patient ace device
databases 114).
in a variation of the system 100, at least a portion of the avatars may be devices separate
from the patient ace devices 101. In such a variation, the avatars may act as parent
devices controlling one or more chiid patient interface devices. Fig. 10 illustrates such a
W0 06234 PCT/U520] 2/040179
configuration where avatar 116 is a stand-alone device communicatively interconnected to
patient interface device 101a’ and 101b'. Communications to the patient interface device
gateway 104 would be managed by the avatar 1 16 which may be interconnected to the k
102. Using the logic 115, the avatar 116 may generate t-specific guidance data set 109a
and patient-specific guidance data set 10% based on data within the database 114, and then
transfer the patient-specific guidance data set 109a and patient-specific guidance data set 109b
to the t interface devices 101a‘ and 101b', respectively.
The communication between the patient interface s 101a’ and 101 b' may be one
way (5.9., the patient interface devices 101 a‘ and 101b‘ may accept a program for operation from
the avatar 116, but may not e any ional feedback) or two way (e.g., the 101a’ and
101b’ may e operational feedback). The links 118a and 118b between the avatar 116 and
the patient interface devices 101a’ and 101b’ may be of any appropriate form. including for
e, a ss link. a direct wired connection, or a fiber optic link. The link between the
avatar 116 and the patient interface devices 101a’ and 101 b’ may be a resilient, highly reliabie
-4 (TI link that does not require network 102 or network 103 to be operational. In this regard, the
avatar 116 and patient interface devices 101a'and 101b’ may remain operational independent of
whether network 102 or network 103 are operational. Thus, as iong as the database 114 does
not contain stale data, the patient interface devices 101a' and 101 b’ may remain operational and
interface with a patient.
The avatar 116 may take any appropriate form including a hand held device, such as a
smart phone or tablet computer that personnel may move from room to room. in another
example, the avatar 116 may be a stationary device such as a personal computer or workstation
located in a room.
Fig. 2 is a flowchart of a method of updating a patient-specific guidance data set related
to a patient, where the patient—specific guidance data set is adapted for use bya patient ace
device (9.9., for use in infusion pump administration of at ieast one medication to a
ponding patient). The method also includes updating ail ses resident within avatars
and updating the patient-affiliated data.
The first step 201 may be to enter information related to a patient into a first patient
interface device. The information related to the patient may include information that makes it
preferable to update the t-specific guidance data set for the patient, such as an update as
to the patient’s condition. The second step 202 may be to update the database of the avatar
associated with the patient interface device. A next step 203 may be to update the patient-
specific guidance data set based on the newly entered data. Step 203 may be performed by the
avatar associated with the patient interface device. A next step 204 may be to automatically
transfer at least a portion of the information from the first patient interface device to the patient
PCTfUSZOIZ/040179
interface device gateway. Step 204 may be performed in response to the first step 201 and over
a communication link, such as a network connection. A ing step 205 may then be to
update the master database. Additional steps 206, 207 may include transferring the information
from the master database via the patient interface device y to one or more sources of
patient-affiliated data to create revised t-affiliated data.
Another step 208, may be to automatically update other databases in other patient
interface devices such that each patient interface device may be capable of generating an
appropriate patient-specific guidance data set if required. Thus, each patient interface device
(the first patient interface device and each patient interface device of the plurality of other patient
interface devices) may have stored in its database the information necessary to generate any
appropriate patient-specific control data.
The method of Fig. 2 may further include accessing, after step 203, the updated
patient-specific guidance data set related to the patient, and interfacing with (e.g., ng
medication into) the patient ing to the patient-specific guidance data set related to the
-.L (31 patient.
As iliustrated, the method of Fig. 2 was red by step 201 when information related to
a t was entered into a first patient device. The method may also be triggered by the
patient interface device acing with the patient. For e, where the patient interface
device is an infusion pump, step 201 may be ed with the step of infusing medication into
the patient and the subsequent generation of information related to the infusion (e.g., amountof
infusion, duration of infusion, time of infusion). In this , the information nced in
subsequent steps would be the information related to the infusion.
In a variation of the method of Fig. 2, the identity of a patient may be unknown (e.g.,
where a patient arrives in an emergency room without the ability to be identified). in such a
case, only information that is available may be entered at step 201. Such information may
include gender. approximate height and weight, approximate age, and information regarding
patient condition. The der of the method may then be executed in a manner similarto as
discussed above.
in r variation of the method of Fig. 2, where the patient interface device is an
3O infusion pump, the ty ofa patient may be unknown and the patient ace device operator
may simply scan a medication and manually enter an infusion rate and then instruct the patient
interface device to carry out the infusion. in such a scenario, the patient interface device may be
operable to sound an alarm if the patient interface device operator enters in parameters that are
considered to be dangerous.
Fig. 3 is a flowchart of a method of updating a patient-specific guidance data set related
to a patient based on an update to the patient-affiliated data. The first step 301 may be to revise
PCT/U82012/040179
a patient-affiliated database with information related to the patient to create an updated
patient-affiliated database. The information related to the patient may include information, such
as a change in tion prescribed to the patient or the condition of the patient that makes it
preferable to update the patient-specific guidance data set for the patient. The second step 302
may be to automatically communicate the revision to the patient interface device gateway,
followed by the step 303 of updating the master database. As noted above, this may be
performed by the patient interface device gateway periodically downloading all or part of the
patient-affiliated data to the master database. or by the patient—affiliated data notifying the patient
interface device y when a change has occurred. After the master database has been
updated. the master database may be used in step 304 to update the databases resident in each
avatar. Such updating may occur on a periodic basis or the updating may be triggered by a
change to the master database. The updating of the databases may be performed by replacing
the entirety of each of the ses or it may be performed by transferring only selected (e.g.,
d) data to the databases.
-_\ ()1 A next step 305 may be to automaticaliy create an updated patient-specific guidance data
set at a t interface device that has been associated with a particular patient. In the next
step 306, the updated patient-specific guidance data set may be stored in the patient interface
device. For example, where a patient interface device had previously created a t-specific
guidance data set for use in interfacing with a patient, the receiving of an update to the patient
interface devices database may cause the patient ace device to create the updated patient-
specific guidance data set. in a more specific example where the patient interface device is an
infusion pump, the infusion pump may have previously run an infusion for a patient using a
particular set of parameters (e.g., flow rate, infusion duration). The change to the patientaffiliated
data (step 301) may result in it being ble to alter the infusion parameters for the
patient. In this regard, following the current method would resuit in an updated t-specific
guidance data set that includes updated infusion pump ters being stored at the infusion
pump.
The entire s illustrated in Fig. 3 may occur automatically (e.g., with no further
human interaction after step 301) in se to the on of the patient~affiliated data.
Fig. 4 is a fiowchart of a method of updating a patient-specific ce data set related
to a patient based on an update to the therapy se. The method of Fig. 4 is simiiar to the
method of Fig. 3, with a difference being that the updating in method of Fig. 3 is triggered by an
update to the patient-affiliated database, whereas the updating in method of Fig. 4 is triggered by
an update to the therapy se. Accordingly, the first step 401 of the method may be to
revise a therapy database with information related to a therapy and/or medication to create a
revised y database. The information related to the medication may include information,
W0 2013/006234 PCT/USZOI 2/040179
such as a new injection protocol, that makes it preferable to update the patient-specific guidance
data setfor the patient. The second step 402 may be to automatically communicate the revision
to the patient interface device gateway. followed by the step 403 of updating the master
database. After the master database has been updated, the master se may be used in
step 404 to update the databases resident in each .
A next step 405 may be to automatically create an updated patient-specific guidance data
set at a t interface device that has been associated with a particular patient. in the next
step 406, the updated patient-specific guidance data set may be stored in the patient interface
device.
Exemplary applications of the above systems and methods will now be presented.
A hospital may maintain a ity of different databases d to its patients. in this
regard, the hospital may have a pharmacy database maintained by an on—site pharmacy that
ns data related to medication prescribed for patients. The hospital may maintain a general
medical record database, a MAR se, an ADT database, and other databases that contain
-4 ()1 information related to ic patients. Together. these databases may form the patient—
affiliated data 105.
The al may also in data related to medications and their delivery. Such data
may be in the form of formularies that list medications approved for use in the hospital, along
with formulation data for mixing the medications and dosage information for administering the
medications. The data may also include infusion parameters and/or formulas for the
medications that may be administered through infusion. er this data may form the therapy
database 106. The hospitai may also subscribe to the global therapy database 110. The global
therapy database 110 may be maintained by a third party and s to the global therapy
database 110 may be communicated to the therapy database 106 at regular intervals and/or
when the global therapy database 110 updates medications and/or ies administered by
the hospital. The therapy database 106 may also include custom aries not present in the
global therapy database 110.
The hospital may also include the plurality of patient interface devices 101. The networks
102, 103 and the patient interface device gateway 104 may icatively interconnect the
t-affiliated data 105 and the therapy database 106 with the plurality of patient interface
devices 101.
When a first patient is admitted to the hospital. the hospital may update the patient-
affiliated data 105 with the first patient’s ation. This may include identification data, data
related to the first patient‘s ion, and prescribed medication data.
The pertinent information from the patient-affiliated data 105 reiated to the first patient
may be uploaded to each patient interface device of the plurality of patient interface devices 101
PCT/U52012/040179
such that the avatar 108 in each patient interface device of the plurality of patient interface
devices 101 may be capable of locally constructing the patient-specific guidance data set 109 for
the first patient.
Distributed data and avatars may have the advantage that if new patient-affiliated data or
new medication data is d into a particular patient ace device, a new patient-specific
guidance data set may be created locally (within an patient interface ) by the local .
Thus, the ability to locally develop an updated patient-specific ce data set may not be
dependent on an available network connectiOn.
After the first t has been admitted, the first patient may be placed in a room with a
first patient interface device 101a of the plurality of patient interface devices 101. Where the
t interface device is an infusion pump, a caregiver (e.g., nurse, ian) may then start
the s of stering medication to the first patient.
The caregiver may start by entering into the first patient interface device 101a
identification data for the caregiver followed by identification data for the patient. This may be
achieved in any appropriate manner including the scanning of bar codes associated with the
caregiver and patient using a bar code scanner communicatively interconnected to the first
t interface device 1018. Next, the caregiver may enter into the first patient interface device
1013 identification data for the tion to be administered. This may also be accomplished
by scanning a bar code on the container of the medication. If the medication is not one of the
medications approved for use with the first patient an audio and/or visual alarm may be
generated by the patient interface device 101a to alert the caregiver of this fact. If the
medication is approved for the first patient, the patient interface device 101a may generate a
patient-specific l data for the patient and load the riate infusion parameters from the
patient-specific guidance data set 109 for the first t. The infusion parameters may include
typical infusion parameters such as flow rate and total delivery time. Furthermore, since the
patient—specific guidance data set 109 was constructed localiy on the first patient interface
device 101a. there may be no need for the first patient interface device 101a to engage in
network communicatibns to determine if it is permissible to perform the infusion. Thus, during
network outages. the first patient interface device 101a may remain operational. Furthermore,
there may be little or no delays for network communications between the time the patient and
medication identification information is entered into the first patient interface device 101a and
when the first patient interface device 101a is ready to perform an infusion.
The caregiver may lead the medication onto the first patient interface device 1013,
interconnect the output of the patient interface device to the first patient (e.g., through tubing
interconnected to a catheter). The caregiver may then start the ry of the medication using
the first patient interface device 101 a. The first patient interface device 101a may communicate
PCT/U52012/04fll79
with the patient interface device y 104 to update the master database 113 and patient-
affiliated data 105 with information related to the start of the infusion process.
Once the first patient interface device 1013 completes the infusion process, the first
t interface device 101 a may communicate with the patient interface device gateway 104 to
update the master database 113 and patient-affiliated data 105 with information related to the
completion of the infusion process. Such information may e patient, medication, and
infusion process information. Thereafter, the avatar 108 may be employed to uct an
updated patient-specific guidance data set for the first patient. The updated patient-specific
guidance data set may reflect that the first patient received the infusion of tion. Also, the
updates to the master database 113 related to the performance of the infusion may be
communicated to every other patient interface device such that all patient interface s have
the updated data and would be available for subsequent interfacing with the first patient if
required to do so.
The first t interface device 101a may also communicate information regarding
_.\ (J1 pump performance to the patient interface device gateway 104. The patient interface device
gateway 104 may forward such information to the pump surveillance database 107 upon
completion of the infusion s. The first patient interface device 101a may send information
regarding non-patient-specific performance of the first patient interface device 101a. For
example, such ation may include start and stop times, total number of strokes, total run
time. and any other appropriate data collected by the first patient interface device 101a during
the infusion.
At a later point in time, a second caregiver, who may be unaware of the first infusion,
attempt to repeat the infusion process. However, upon accessing the updated patient-specific
guidance data set for the first patient, the first patient interface device 101a may alert the second
ver that the second infusion is not permitted since the first infusion has already been
administered or since it is too close in time to the first infusion to be performing a second
infusion. Moreover, since the updated information was uploaded to each patient interface
device, if the second caregiver had attempted to repeat the infusion process using a different
second t ace device, the second patient interface device would have issued the same
alert to the second caregiver.
After the first infusion is complete, the caregiver may at a later point in time t to
administer a second medication to the first patient using the first patient interface device 101a.
in the situation where the second medication is atible with the first medication, the first
patient interface device 101a may alert the caregiverthat the second infusion is not compatible
with the previously delivered medication. Moreover, since the updated information was ed
to each patient interface , if the caregiver, or a second caregiver, had attempted to
PCT/U52012/040179
perform the incompatible infusion using a ent second t interface device, the second
patient ace device would have issued the same alert.
While staying at the hospital, the first t's condition may change. For e, the
first patient may develop an additional condition that may e an additional infusion of
medication. Under such circumstances, the ver may update the patient-affiliated data 105
for the first patient. in a first scenario, the ver may enter information related to the
additional condition into the first patient interface device 101a. The information then may be
communicated to the patient—affiliated data 105 via the patient interface device gateway 104.
Thereafter, the avatar 108 may be employed to uct an updated patient-specific guidance
data set for the first patient. This updated patient-specific guidance data set
may reflect that the
first patient's condition has changed.
in a second scenario, the caregiver may enter information d to the additional
condition ly into the patient-affiliated data 105. For example, the caregiver may enter the
information into a terminal of the pharmacy database. Thereafter, the master database 113 may
be updated with the information and, in turn, each patient interface device of the ity of
patient interface devices 101 may receive the updated information. Then, the avatar 108 may
construct an updated patient-specific guidance data set forthe first patient that
may reflect that
the first t‘s ion has changed.
While the first patient is admitted to the al, the hospital may decide to change the
protocol for delivery of the first medication. In this , a caregiver or hospital administrator
may revise infusion data within the therapy database 106 d to the delivery of the first
medication. For example, the nominal delivery rate of the first medication may be reduced. This
revision may be entered into the system at a terminal of the therapy database 106 or at one of
the patient interface devices of the plurality of patient interface devices 101. in either case, the
master database 113 may be updated with the information and. in turn, each patient interface
device of the plurality of patient interface devices 101 may receive the updated information.
Thereafter an avatar 108 may be employed to construct an updated patient-specific guidance
data set for the first patient that reflects the new protocol.
While the first patient is admitted to the hospital, the third party administrator ofthe global
therapy database 110 may decide to change the protocol for delivery of the first medication.
This revision may be communicated to the therapy database 106 to revise infusion data within
the therapy database 106 related to the delivery of the first medication. Thereafter, the master
database 113 may be updated with the information and, in turn, each patient interface device of
the plurality of patient interface devices 1 01 may receive the updated information. Thereafter, an
avatar 108 may be employed to construct an d patient-specific guidance data set for the
first patient that reflects the new protocol. Moreover, updated patient—specific guidance data sets
W0 20 l 3/006234 PCT/USZOI 2/040179
may be generated at other patient interface devices for every other ed patient of the
hospital whose t-specific guidance data set includes the first medication.
As described, each patient interface device of the plurality of patient interface devices
101 may contain the data necessary to create a patient-specific guidance data set 109 for the
first patient. This may be advantageous for additional reasons. For example. if a particular
t interface device ofthe plurality of patient interface devices 101 experiences a failure. any
other patient interface device of the plurality of patient interface devices 101 could be tuted
forthe failed patient interface device since each one would contain the data necessary to create
an appropriate patient-specific guidance data set 109 for the first patient. Such a replacement
may be performed r or not network connections to the patient-affiliated data 105 and/or
therapy database 106 were available. In another example, if the first patient is moved to another
room of the ai, it may not be necessary to move the first patient interface device along with
the first patient. since a patient interface device in the other room would contain the data
necessary to generate a patient-specific guidance data set 109 for the first patient. in another
_.\ U1 example, the first t interface device may be moved from patient to patient without the need
download new data whenever the patient ace device is moved since the patient interface
device may include the data necessary to generate patient-specific guidance data sets 109 for
every patient who may receive an infusion. Such advantages may result in fewer total patient
interface devices required for a given ty as compared to a facility using patient interface
devices that may be dedicated entirely to a single patient during that patients stay at a facility.
In another example of the operation of the system 100, a physician may order a dose of
tion fora patient. and a pharmacy may prepare the dose. When the dosage is prepared,
a cist may enter information into a pharmacy database reflecting the ation of the
dose. The patient interface device gateway 104 may receive data from the pharmacy se
reflecting the preparation of the dose and the master database 113 may be updated accordingly.
Data related to the preparation of the dose may be included in the nextjournal broadcast of the
master database 113 and thereby be communicated to each patient interface device of the
ity of patient interface devices 101 well before the prepared dose has been transported to
the patient. Once the dose arrives at the patient, l personnel may enter patient and dose
identification information into a patient interface device and the avatar of the patient interface
device may calculate a patient-specific guidance data set 109 for the infusion of the dose into the
patient.
In a ion ofthe present scenario. if between the time the dosage is prepared and the
time the patient-specific guidance data set 109 is calculated a change in the patient’s condition is
detected, the avatar 108 may alter or t the dosage from being administered. For example,
if renal failure is detected and d into the facility’s records (and subsequently uploaded to
PCT/U82012/0401 79
the patient interface devices 101) afterthe dosage has been prepared, but before it has been
administered, the avatar 108 may prevent the dosage from being administered. Such prevention
may take the form of not performing any infusion ofthe drug and/or sounding an e alarm to
icate the danger. This may, for example. be enabled by the logic 115 of the avatar 108
which may not allow the particular medication to be administered where a t is listed as
having renal failure.
In additional examples of the operation of the system 100, the patient interface device
101a may be used to provide uous administration of a medical fluid. In such a situation,
the system 100 may provide several benefits in relation to ular Operational scenarios. In a
first scenario, during the course of administration of a first unit (e.g., a first IV bag) of medical
fluid, the flow rate of the medical fluid may be adjusted from the value prescribed. The patient
interface device 101a will record such changes in its memory HQ and communicate such
changes to the patient interface device y 104. When the first unit is empty, a second unit
may be placed in service. In such a ion, the patient interface device 1013 may retain
dge regarding the test used flow rate and begin administering the new unit using thatflow
rate instead of the prescribed flow rate. Moreover, if for some reason a second patient interface
device 101 b is used to administerthe second unit, it may know the last used flow rate and begin
administering the new unit using that flow rate.
In a second scenario, during the course of administration of a first unit of medical fluid
2O under an order for continuous administration of the medical fluid. a physician
may order the
discontinuance of the administration. Such an order may be entered into the patient interface
device 101a or may be entered into the patient-affiliated data 105 and be loaded into the patient
interface device 101a database 114 via the patient interface device gateway 104 and master
database 113 as described above. However, the pharmacy may have already prepared and
sent a second dose to the patient. In such a scenario, the second dose may arrive at the patient,
but the patient interface device 101a may prevent it from being administered based on the
physician‘s orders that are ted in the database 114 of the patient interface device 101a.
Moreover, if a second patient interface device 101b is ted to be used to administer the
second unit, the second t interface device 101b may know the physician’s latest orders
3O and also prevent administration of the second dose to the patient.
Since the administration of medical fluids to patients is an event that is communicated
back to the master database 113, such information may be available for inventory control
purposes. For example, where a dosage of medical fluid was prepared but not administered (as
in the es , the system 100 may reflect that the dosage was never used and alert
the pharmacy that the dosage must be returned to the pharmacy for reuse or destruction. Such
a feature may also assist in preventing the theft of dosages where in existing prior art facilities,
W0 2013/006234 PCT/U52012/040179
doses that were prepared but not administered may have been easily stolen since existing
systems may not have been able to verify that doses recorded by medical personnel as
administered were actually administered. In contrast, the systemv‘lOO may only list a dose as
being stered ifa patient interface device records the actual administration of the dosage.
Thus, if no patient interface device reports administration of the dose, the dose may be
considered to be not yet administered.
When a patient interface device is first placed into service, it may be provisioned.
ioning may entail recording the patient interface device’s serial number, interconnecting
the patient interface device to the network 102, and loading the patient interface device with the
avatar 108 and current versions of the database 114 and logic 115.
The foregoing ption of the present invention has been presented for purposes of
illustration and description. Furthermore, the ption is not intended to limit the invention to
the form disclosed herein. Consequently, variations and modifications surate with the
above teachings, and skill and knowledge of the relevant art, are within the scope of the present
invention. The embodiments described hereinabove are further intended to n known
modes of practicing the invention and to enable others skilled in the art to utilize the ion in
such or other embodiments and with various modifications required by the particular
application(s) or use(s) of the present invention. It is intended that the ed claims be
construed to include ative embodiments to the extent permitted by the prior art.
Claims (2)
1. A system for use with one or more sources of patient—affiliated data corresponding with a group of patients, the system including: a plurality of patient interface devices, each operable to administer medication to a patient, n each patient interface device of the plurality of patient interface devices stores a database that comprises a plurality of patient records where each patient record ofthe plurality of patient records corresponds with a different, unique patient of the group of patients and includes at least corresponding patient identification data and t treatment data, wherein each patient interface device of the plurality of patient ace s comprises logic adapted to utilize the database stored at the patient interface device to create a patient-specific guidance data set for any patient of the group of patients, and wherein the patient-specific guidance data set is adapted for use in interfacing the t interface device with the corresponding patient to administer tion to the patient; and a patient interface device y operative to interface the one or more sources of patient-affiliated data with each patient interface device of the plurality of patient interface s to automatically update each of said databases stored at each of said ity of patient interface devices, wherein such automatic updating of each of the databases is achieved by utilizing ponding patient—affiliated data maintained by the one or more sources of patient-affiliated data.
2. The system of Claim 1, wherein the group of patients are patients admitted to a medical care facility. 02/
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161503966P | 2011-07-01 | 2011-07-01 | |
US61/503,966 | 2011-07-01 | ||
PCT/US2012/040179 WO2013006234A1 (en) | 2011-07-01 | 2012-05-31 | Systems and methods for intelligent patient interface device |
Publications (2)
Publication Number | Publication Date |
---|---|
NZ619532A NZ619532A (en) | 2015-03-27 |
NZ619532B2 true NZ619532B2 (en) | 2015-06-30 |
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