US20230009417A1

US20230009417A1 - Drug library dynamic version management

Info

Publication number: US20230009417A1
Application number: US17/929,654
Authority: US
Inventors: Ben Xavier; Dennis Krabbe; Timothy Kil; Jody Polk; Aaron Fields-Cypress; Julius Tobias
Original assignee: ICU Medical Inc
Current assignee: ICU Medical Inc
Priority date: 2018-07-26
Filing date: 2022-09-02
Publication date: 2023-01-12
Also published as: CA3107315A1; EP3827337A1; US20220384059A1; TW202018729A; WO2020023231A1; TWI821335B; EP3827337A4; US20200035355A1; CO2021000838A2; US11309070B2; CA3107315C; AU2019309766A1; ZA202100262B

Abstract

A drug library management system generates versions of drug library data that can be used by infusion pumps, and version of drug library data that can be used by systems or components in a clinical environment other than infusion pumps. One version of the drug library data may be customized for a particular infusion pump, while another version may be a generalized version that can be used by middleware systems that process messages received from various infusion pumps that are using a different version of the drug library data. The generalized version may be archived separately from a drug library database used by the drug library management system to generate the various versions.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent application Ser. No. 16/908,539, filed on Jun. 22, 2020 and titled “Drug Library Dynamic Version Management,” which is a continuation of U.S. patent application Ser. No. 16/512,266, filed on Jul. 15, 2019 and titled “Drug Library Dynamic Version Management,” which is a continuation of International Patent Application No. PCT/US2019/041715, filed on Jul. 12, 2019 and titled “Drug Library Management System,” which claims priority to U.S. Provisional Patent Application No. 62/703,772, filed on Jul. 26, 2018 and titled “Drug Library Management System.” Any and all applications for which a foreign or domestic priority claim is identified in the Application Data Sheet, or any correction thereto, are hereby incorporated by reference under 37 C.F.R. § 1.57.

TECHNICAL FIELD

This disclosure relates to the field of clinical management, and particularly to systems and methods for efficient management of drug libraries in a networked clinical environment.

BACKGROUND

Modern medical care often involves the use of medical infusion pumps to deliver fluids and/or fluid medicine to patients. Infusion pumps permit the controlled delivery of fluids to a patient and provide flexible yet controlled delivery schedules. Drug libraries within the infusion pumps provide some limits pertaining to the delivery of fluids. Infusion pumps can communicate with a server configured to manage drug library updates and operational software updates of the individual infusion pumps.

SUMMARY

Various techniques for managing drug libraries across a clinical environment and a cloud environment are described herein. These techniques may include creating and maintaining medication and administration data in a drug library database, using the data to create and maintain drug libraries, and distributing the drug libraries to various systems and components. For example, customized drug library data may be provided to infusion pumps for use in administration of medication, while generalized drug library data is proved to middleware, archives, etc. for use in system management, reporting, backup, etc. These and other embodiments are described in greater detail below with reference to FIGS. 1-10 . Although many of the examples are described in the context of a hospital environment including particular infusion pumps, data formats, and the like, the techniques described herein can be applied to other types of infusion pumps, data formats, etc.
Some aspects of the present disclosure relate to a drug library management system that facilitates centralized management of the drug libraries that are used by various infusion pumps, including in clinical environments that have different types and/or versions of infusion pumps. Medications, administration rules, critical care area rules, and the like are maintained using the drug library management system, also referred to herein as the “drug library manager.” The drug library manager generates and distributes drug library data in pump-specific formats or other customized formats as needed. Therefore, different types and versions of infusion pumps, even those that use drug library data in different formats or that use different drug library data altogether, may be used in a clinical environment and managed using a single drug library management system.
Additional aspects of the present disclosure relate to generating versions of drug library data that can be used by systems or components in the clinical environment other than infusion pumps. For example, drug library data may be used by middleware systems, reporting systems, archival systems, and the like. When a drug library is to be finalized, the drug library management system may generate a version of drug library data that is standardized or otherwise generalized, in addition to a version that is customized for the specific infusion pump(s) that use the drug library data. The generalized version of the drug library data can be used by middleware systems that process messages received from various infusion pumps, reporting systems that report data generated by or otherwise associated with various infusion pumps, etc. In addition, or alternatively, the generalized version can be archived so that historical versions of the drug library data may be available when needed (e.g., for historical reporting, for troubleshooting problems with infusion pumps when a prior version of the drug library was used, etc.). Advantageously, the generalized version may be archived separately from the drug library database used by the drug library manager, and therefore the drug library database does not need to store historical drug library data.

BRIEF DESCRIPTION OF DRAWINGS

Throughout the drawings, reference numbers may be re-used to indicate correspondence between referenced elements. The drawings are provided to illustrate example embodiments described herein and are not intended to limit the scope of the disclosure.

FIG. 1 is a block diagram of an example clinical environment and an example cloud environment according to some embodiments.

FIG. 2 is a block diagram illustrating components of a clinical environment according to some embodiments.

FIG. 3 is a schematic diagram illustrating components of an infusion pump and a connectivity adapter of a clinical environment according to some embodiments.

FIG. 4 is a block diagram illustrating components of a cloud environment according to some embodiments.

FIG. 5 is a block diagram of various data flows and interactions between a drug library manager, an end user device, an infusion pump, and various other system components during the creation and distribution of drug libraries according to some embodiments.

FIG. 6 is a block diagram of illustrative components of a drug library according to some embodiments.

FIG. 7 is a flow diagram of an illustrative process for managing the creation, maintenance, and distribution of drug libraries according to some embodiments.

FIG. 8 is a user interface diagram of an illustrative interface for creating and maintaining medication and administration data according to some embodiments.

FIG. 9 is a user interface diagram of an illustrative interface for creating and maintaining organizational information according to some embodiments.

FIG. 10 is a block diagram of various data flows and interactions between drug library manager, an infusion pump, and various other system components during the use of drug libraries according to some embodiments.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

The present disclosure is directed to management and use of drug libraries in a networked clinical environment. The clinical environment may include various types and/or versions of infusion pumps. An infusion pump operates using a drug library that describes the medications available for administration, rules for administration of the medications, clinical care areas in which the pump may operate, and the like. Different types or versions of infusion pumps may be configured to use different formats of drug library data. In addition, it may be necessary or desirable to maintain a history of changes to the drug library data.
Some aspects of the present disclosure relate to a drug library management system that facilitates centralized management of the drug libraries that are used by various infusion pumps, including in clinical environments that have different types and/or versions of infusion pumps. Medications, administration rules, critical care area rules, and the like are maintained using the drug library management system, also referred to herein as the “drug library manager.” The drug library manager generates and distributes drug library data in pump-specific formats or other customized formats as needed. Therefore, different types and versions of infusion pumps, even those that use drug library data in different formats or that use different drug library data altogether, may be used in a clinical environment and managed using a single drug library management system.
Additional aspects of the present disclosure relate to generating versions of drug library data that can be used by systems or components in the clinical environment other than infusion pumps. For example, drug library data may be used by middleware systems, reporting systems, archival systems, and the like. When a drug library is to be finalized, the drug library management system may generate a version of drug library data that is standardized or otherwise generalized, in addition to a version that is customized for the specific infusion pump(s) that use the drug library data. The generalized version of the drug library data can be used by middleware systems that process messages received from various infusion pumps, reporting systems that report data generated by or otherwise associated with various infusion pumps, etc. In addition, or alternatively, the generalized version can be archived so that historical versions of the drug library data may be available when needed (e.g., for historical reporting, for troubleshooting problems with infusion pumps when a prior version of the drug library was used, etc.). Advantageously, the generalized version may be archived separately from the drug library database used by the drug library manager, and therefore the drug library database does not need to store historical drug library data.
Although aspects of some embodiments described in the disclosure will focus, for the purpose of illustration, on particular examples of infusion pumps, mediation administration rules, formats of drug library data, and the like, the examples are illustrative only and are not intended to be limiting. In some embodiments, the systems and methods described herein may be applied to additional or alternative infusion pumps, mediation administration rules, drug library data formats, etc. Various aspects of the disclosure will now be described with regard to certain examples and embodiments, which are intended to illustrate but not limit the disclosure.

Overview of Example Network Environment

FIG. 1 illustrates network environment 100 in which clinical environment 102 communicates with cloud environment 106 via network 104. The clinical environment 102 may include one or more healthcare facilities (e.g., hospitals). The components of the clinical environment 102 are described in greater detail below with reference to FIG. 2 . The network 104 may be any wired network, wireless network, or combination thereof. In addition, the network 104 may be a personal area network, local area network, wide area network, over-the-air broadcast network (e.g., for radio or television), cable network, satellite network, cellular telephone network, or combination thereof. For example, the network 104 may be a publicly accessible network of linked networks such as the Internet. In some embodiments, the clinical environment 102 and the cloud environment 106 may each be implemented on one or more wired and/or wireless private networks, and the network 104 may be a public network (e.g., the Internet) via which the clinical environment 102 and the cloud environment 106 communicate with each other. The cloud environment 106 may be a cloud-based platform configured to communicate with multiple clinical environments. The cloud environment 106 may include a collection of services, which are delivered via the network 104 as web services. The components of the cloud environment 106 are described in greater detail below with reference to FIG. 4 .

Components of Clinical Environment

FIG. 2 illustrates the clinical environment 102, which includes one or more clinical IT systems 202, one or more infusion pumps 204, and one or more connectivity adapters 206. Further, the clinical environment 102 may be configured to provide cloud user interfaces 208 (e.g., generated and provided by the cloud environment 106). The clinical IT system 202 may include a hospital information system (HIS) designed to manage the facilities' operation, such as medical, administrative, financial, and legal issues and the corresponding processing of services. The HIS can include one or more electronic medical record (EMR) or electronic health record (EHR) systems, as well. The infusion pump 204 is a medical device configured to deliver medication to a patient. The connectivity adapter 206 is a network component configured to communicate with other components of the clinical environment 102 and also communicate with the cloud environment 106 on behalf of the other components of the clinical environment 102. In one embodiment, all messages communicated between the clinical environment 102 and the cloud environment 106 pass through the connectivity adapter 206. In some cases, the connectivity adapter 206 is a network appliance with limited storage space (e.g., memory and/or persistent storage). The cloud user interfaces 208 may be provided to a user in the clinical environment 102 via a browser application, desktop application, mobile application, and the like. The user may access status reports and other data stored in the cloud environment 106 via the cloud user interfaces 208.
The components 202-208 illustrated in FIG. 2 may communicate with one or more of the other components in the clinical environment 102. For example, each of the clinical IT system 202 and the infusion pump 204 may communicate with the connectivity adapter 206 via physical local area network (LAN) and/or virtual LAN (VLAN). Although not shown in FIG. 2 , the clinical environment 102 may include other medical devices and non-medical devices that facilitate the operation of the clinical environment 102.

Overview of Messaging in the Clinical Environment

FIG. 3 illustrates the messages and data received, stored, and transmitted by the connectivity adapter 206 in the clinical environment 102. As shown in FIG. 3 , the infusion pump 204 may include motor controller unit (MCU) 320 and communications engine (CE) 322, and memory 324 storing drug library data 326 and operational software 328. The drug library data 324 includes boundaries for drug delivery for various medications that can be delivered to patients by infusion pumps. The operational software 328 can include the operating system of the infusion pump 204, as well as other software for performing various functions. Each type of infusion pump and even different versions of the same type of infusion pump may operate with a different operating system. In some embodiments, the MCU 320 uses a less powerful processor (e.g., 12 MHz) and the CE 322 uses a more powerful processor (e.g., 400 MHz).
The MCU 320 may generate and send pump messages to the CE 322 for storage and transmission to the connectivity adapter 206. The pump messages may include clinical information. The CE 322 may send such pump messages to the connectivity adapter 206. Pump messages sent to the connectivity adapter 206 via the CE 322 and generated by the MCU 320 may be transformed by the transformation worker 330 into a standardized dataset message (e.g., message format used by the connectivity adapter 206 to communicate with the cloud environment 106, sometimes referred herein as simply a message). For example, the transformation worker 330 may use drug library data 342, described below, to transform a pump message into a standardized dataset message.
The CE 322 may also receive messages from the connectivity adapter 206 indicating that updates, such as updates to the drug library or updates to the operational software are available and may send messages to the connectivity adapter 206 requesting the updates (e.g., update data). The CE 322 may also receive the update data from the connectivity adapter 206 for storage in the memory 324. The update data may be drug library update data or may be operational software update data. The update data may be provided over a different communication channel than the communication channel(s) used to send or receive messages.
As also shown in FIG. 3 , the connectivity adapter 206 may include transformation worker 330, device status manager 332, cache 334, an inbound queue 336, an outbound queue 338, and a data store 340. The transformation worker 330 may transform the messages sent to the connectivity adapter 206 from the infusion pump 204 into the standardized dataset message. The transformation worker 330 may also transform messages sent from the connectivity adapter 206 to the infusion pump 204 into a message format usable by the infusion pump 204.
The inbound queue 336 receives and stores messages from the cloud environment 106 for processing by the connectivity adapter 206. For example, the inbound queue 332 may receive a drug library update message from the cloud environment 106. The drug library update message may be notification that a drug library update is available for a least a portion of the infusion pumps 204 associated with the connectivity adapter 206. In an embodiment, the connectivity adapter 206 may comprise more than one inbound queue such that, for example, there is at least an inbound queue 336 for messages received from the cloud environment 106 over the network 104 and at least another inbound queue for messages received from one or more infusion pumps 204 over the local network. The messages stored in the inbound queue 336 may be associated with one or more sequence identifiers (IDs). The messages received from the cloud environment 106 may be sent over a message channel associated with the network 104.
The outbound queue 338 receives and stores messages to be sent from the connectivity adapter 206. For example, the outbound queue 338 may receive a drug library update message to be sent to one more infusion pumps over the local network. The drug library update message may be a notification to one or more infusion pumps 204 that a drug library update is available. In an embodiment, the connectivity adapter 206 may comprise more than one outbound queue such that, for example, there is at least an outbound queue 338 for messages to be sent to the cloud environment 106 over the network 104 and at least another outbound queue for messages to be sent to one or more infusion pumps 204 over the local network. The messages stored in the outbound queue 338 may be associated with one or more sequence identifiers (IDs). The messages sent from the connectivity adapter 206 to the infusion pumps 204 may be sent over a message channel associated with the local network.
The device status manager 332 receives the drug library and operational software updates from the cloud environment 106 and caches blocks of the update data in the cache 302. The device status manager 332 processes the received messages from the inbound queue 336 and sends messages to the outbound queue 338 for transmission to the cloud environment 106 or to the infusion pumps 204. The data received from the cloud environment 106 may be sent over a data channel associated with the network 104 and separate from the message channel of the network 104. Because the data channel in the cloud environment is separate from the message channel in the cloud environment, the data transfer does not interfere with the clinical messaging from the connectivity adapter to the cloud environment. The data sent from the cache 302 to the infusion pumps 204 may be sent over a data channel associated with the local network and separate from the message channel associated with the local network. Because the data channel in the local network is separate from the message channel in the local network, the data transfer does not interfere with the clinical messaging from infusion pumps to the connectivity adapter. Thus, congestion on both the message channel of the cloud environment and the message channel of the local network is reduced.
The device status manager 332 also processes transformed messages provided by the transformation worker 330 and merges the data included in the transformed messages into the cache 334 to update the current state of the infusion pump 204 stored in the cache 334.
The data store 340 may store, among other things, drug library data 342. The drug library data 342 may be a generalized version of pump-specific drug library data that is stored on a pump 204. The drug library data 342 may be used to process messages received from a pump 204. For example, the pump 204 may send a message to the connectivity adapter 206 regarding a drug infusion process that has been initiated on the pump 204. The message may include a subset of information about the medication being infused or the infusion process, and the connectivity adapter 206 may derive information from the message. For example, the message may include an identifier of the medication that is being infused, but the message may not include the name of the medication. The connectivity adapter 206 can access the drug library data 342 and obtain the name of the medication that corresponds to the identifier received from the pump. As another example, the message may include an identifier for a clinical care area, but the message may not include the name of the clinical care area. The connectivity adapter 206 can access the drug library data 342 and obtain the name of the medication that corresponds to the identifier of the clinical care area. As a further example, the message may include a channel identifier for a particular channel of the infusion pump, a line identifier for a particular line of the infusion pump, an auto-program reference ID for a particular order number, other identifier information, some combination thereof, etc. The connectivity adapter 206 may determine a corresponding name, description, or other human-readable form from the message data using the drug library data 342. The use of the drug library data 342 to process messaged received from an infusion pump 204 is described in greater detail below.

Components of Cloud Environment

FIG. 4 illustrates the cloud environment 106, which includes drug library manager (DLM) 402, report manager 404, device manager 406, data flow manager (DFM) 408, cloud manager (CM) 410, data analyzer (DA) 412, a drug library database (DLDB) 414, and a drug library archive 416.
The DLM 402 may provide a set of features and functions involved in the creation and management of drug libraries for use with infusion pumps, as described in greater detail below. The drug libraries may provide user-defined settings for pump configuration and drug infusion error reduction. For example, the drug libraries may be used as part of a dose error reduction system (DERS).[0033] The report manager 404 may provide various reporting capabilities for clinically relevant infusion data which users can choose to use for further analysis, such as tracking and trending of clinical practices.
The device manager 406 may oversee and manage the maintenance of infusion pumps, providing users the capability to view and manage asset and operational data. For example, the device manager 406 may schedule drug library and software updates for infusion pumps.
The DFM 408 may facilitate storing, caching, and routing of data between compatible infusion pumps, compatible external systems, and the like. For example, the DFM 408 may store infusion and operational data received from infusion pumps, store and cache infusion pump drug libraries and software images, convert and route network messaging between the cloud environment 106 and the clinical environment 102, convert and route medication order information from a hospital information system to an infusion pump (e.g., auto-programming or smart-pump programming), and/or convert and route alert information and infusion events from infusion pumps to hospital information systems (e.g., alarm/alert forwarding, and auto-documentation, or infusion documentation).
The CM 410 may serve as a general-purpose computing platform for the other modules illustrated in FIG. 4 . Functionally, the CM 410 may be similar to Microsoft Windows or Linux operating systems as it provides the following services: networking, computation, user administration and security, storage, and monitoring.
The DA 412 may provide data analytics tools for generating user interfaces and reports based on the data generated and/or received by the other modules illustrated in FIG. 4 .
The DLDB 414 may store data regarding medications, medication administration rules, clinical care areas, and other data maintained and used by the drug library manager 402 to generate drug library data for infusion pumps and other systems or components.
The drug library archive 416 may store generalized drug library data that has been generated by the drug library manager 402. The drug library archive 416 may store a copy of every generalized drug library data set generated by the drug library management, or some subset thereof, for use in record keeping, reporting, etc. Use of archived generalized drug library data is described in greater detail below.
Although not illustrated in FIG. 4 , the cloud environment 106 may provide other resources such as processors, memory, disk space, network, etc. The modules 402-412 may be hardware components configured to perform one or more of the techniques described herein. Alternatively, the modules 402-412 may be implemented using software instructions stored in physical storage and executed by one or more processors. Although illustrated as separate components, the modules 402-412 may be implemented as one or more hardware components (e.g., a single component, individual components, or any number of components), one or more software components (e.g., a single component, individual components, or any number of components), or any combination thereof.
In some embodiments, the cloud environment 106 can be implemented using a commercial cloud services provider (e.g., Amazon Web Services®, Microsoft Azure®, Google Cloud®, and the like). In other embodiments, the cloud environment 106 can be implemented using network infrastructure managed by the provider and/or developer of the modules 402-412 shown in FIG. 4 . In some embodiments, the features and services provided by one of more of the modules 402-412 may be implemented on one or more hardware computing devices as web services consumable via one or more communication networks. In further embodiments, one of more of the modules 402-412 are provided by one or more virtual machines implemented in a hosted computing environment. The hosted computing environment may include one or more rapidly provisioned and released computing resources, such as computing devices, networking devices, and/or storage devices

Overview of Drug Library Management System

With reference to an illustrative embodiment, FIG. 5 shows a network environment in which aspects of drug library management may be implemented. As shown, a DLM 402 may include a DLM editor 500 component. The DLM editor 500 may include executable instructions that generate a user interface 512 for display on an end-user computing device 510. For example, the DLM may include, or be associated with, a web server that generates web pages, sends the web pages to the end-user computing device 510, and processes user inputs and interactions with the web pages.
The DLM editor 500 may be used to manage data stored in the DLDB 414, and to generate drug library data for use by various devices and systems, such as infusion pumps 204A, 204B, and the connectivity adapter 206. The data to be stored in the DLDB 414 may include data regarding medications 506, administration rules 508 regarding use of the medications 506, clinical care areas (CCAs) 504 in which medications are used, and other data related to the management of drug libraries.
In some embodiments, the DLDB 414 may include data related to the management of all drug libraries associated with the cloud environment 106. In other embodiments, the DLDB 414 may include data related to a subset of drug libraries associated with the cloud environment 106 (e.g., drug libraries for a particular clinical environment 102 or group of clinical environments, drug libraries for a particular customer or other entity, etc.). For example, there may be multiple DLDBs that are physically or logically separate from each other.
Medications 506 are data entities that represent medications that can be administered via an infusion pump. In some embodiments, a medication 506 data entity may include data regarding a name of a medication, an identifier of the medication (e.g., a unique identifier used by an HIS), an indication of whether the medication is a high-risk medication, and/or other information.
Administration rules 508 are data entities that represent the parameters by which a medication may be administered. For example, an administration rule 508 for a particular medication may include data representing various medication administration parameters such as a dosing unit, a clinical use, and/or other information. In some embodiments, an administration rule 508 for a particular medication 506 may include medication administration parameter data regarding an absolute or “hard” minimum and/or maximum limit to the administration of the medication (e.g., minimum or maximum amount that may be administered overall or in a period of time, minimum or maximum rate at which the medication may be administered, etc.). Such hard limits typically cannot be overridden. In some embodiments, the administration rule 508 may also or alternatively include data regarding a recommended or “soft” minimum and/or maximum limit to administration of the medication. Such soft limits may be overridden (e.g., by users with the proper level of authority, after generation of an alert such as an audible and/or visual notification, etc.). There may be any number of administration rules 508 for a single medication 506. For example, different administration rules 508 may be separately maintained for different clinical uses of the same medication 506, different infusion pumps 204 through which the medication is to be administered, and/or different CCAs 504 in which the medication is to be administered. In some embodiments, a medication 506 may be associated with zero or more administration rules 508. In some embodiments, an administration rule may only be associated with a single medication 506.
CCAs 504 are data entities that represent organizational units of health care enterprises. For example, CCAs may represent hospitals, individual hospital facilities, departments, or lines of care. In some embodiments, a CCA corresponds to a unit of similar clinical uses, patient types, other characteristics, some combination thereof, etc. CCAs 504 may be associated with various medications 506 and administrative rules 508.
FIG. 6 shows an example of a medication 506A associated with multiple administration rules 508A and 508B. The administration rules 508A and 508B are associated with different CCAs 504A and 504B respectively. CCA 504A may correspond to a pediatric unit of a hospital, and CCA 504B may correspond to an ICU of the hospital. The pediatric CCA 504A and ICU 504B may each have various data elements, any or all of which may correspond to medication administration settings. For example, as shown, pediatric CCA 504A may include a data element specifying a maximum dose rate of 200 mL/hr. ICU CCA 504B may include a data element specifying a maximum dose rate of 999 mL/hr. Pediatric CCA 504A may be associated with an administration rule 508A for medication 506A, and that administration rule 508A is more restrictive (e.g., smaller maximum doses) than the administration rule 506B—for the same medication 506A—that is associated with ICU CCA 504B, which is for an adult population. In some embodiments, settings for the pediatric CCA 504A may prevent or override a less restrictive administration rule 508A when the medication 506A is used within the pediatric CCA 504A. However, if the administration rule 508A for the medication 506A is more restrictive than a setting of the pediatric CCA 504A, the setting of the CCA 504A will not override the administration rule 508A.
Returning to FIG. 5 , a user may use the DLM editor 500 to organize medications, administration rules, and CCAs into drug libraries that are distributed to infusion pumps and other system components. In some embodiments, the organizational mechanism may be referred to as a worksheet 502. A worksheet 502 is a dataset that includes references to the individual medications and administration rules to be made available to infusion pumps. In addition, the worksheet 502 can be directed to a particular infusion pump 204 or group of infusion pumps 204 that share the same customized drug library data format. Rather than providing data to the infusion pump 204 regarding every medication 506 and administration rule 508 available in the DLDB 414, a worksheet 502 may be used to specify a subset of medications 506 and administration rules 508. For example, a CCA 504 may be added to a worksheet 502, and all of the medications 506 and administration rules 508 associated with the CCA 504 and the target infusion pump 204 are automatically added. In some embodiments, individual medications may optionally be added to a worksheet separately from any CCA that may be added.
The worksheet 502 dataset may be stored in the DLDB 414. The worksheet 502 dataset may include data representing various properties of the worksheet, such as a name, infusion pump type and/or version targeted by the worksheet, creator of the worksheet, creation and/or edit date, approval status, version, and the like. In addition, the worksheet 502 dataset may include a collection of pointers or other references to the data entities representing the various CCAs, medications, and administration rules that are associated with the worksheet 502. Creation of worksheets 502 and other associated operations are discussed in greater detail below.
The DLM editor 500 or some other component of the DLM 402 can generate drug library data using a worksheet 502. For example, once a worksheet 502 has been created or edited, the worksheet 502 may be in a “pending” status, awaiting approval. After the appropriate approval has been granted, the DLM 402 can generate customized drug library data 520 that represents the CCAs, medications, administration rules, and other data in the format that is required for operation of the target pump 204. In addition, the DLM 402 can generate generalized drug library data 522 for use by a middleware component such as the connectivity adapter 206, for reporting and archival purposes, etc.
As shown in FIG. 5 , the DLM 402 can send the customized drug library data 520 and generalized drug library data 522 to a connectivity adapter 206 that is in communication with multiple infusion pumps 204A, 204B. The connectivity adapter 206 can store the generalized drug library data 522 in the data store 340. The generalized drug library data 522 may be incorporated into the drug library data 342 as the generalized drug library data that corresponds to the customized drug library data 520 that has also been or soon will be received.
The CA 206 can provide the customized drug library data 520 to the appropriate infusion pump 204A, or instruct the appropriate infusion pump 204A to obtain the customized drug library data 520. The infusion pump 204A can store the customized drug library data 520 in memory 324 for use in future operation. For example, the infusion pump 204A may replace customized drug library data 326 currently in memory with the newly-received customized drug library data 520.
Other infusion pumps, such as those that do not operate using the same format of customized drug library data, are not provided with or instructed to obtain the customized drug library data 520. For example, infusion pump 204B may be a different type of infusion pump than infusion pump 204A, or may be a different version of infusion pump 204A that is not compatible with the customized drug library data 520. In this example, infusion pump 204B is not provided with the customized drug library data 520. As another example, infusion pump 204B may be located in a location that is associated with a different CCA than infusion pump 204A. The customized drug library data 520 may be targeted at the CCA with which infusion pump 204A is associated, but not the CCA with which infusion pump 204B is associated. In this example, infusion pump 204B is not provided with the customized drug library data 520. Details and examples of the drug library update process are described in greater detail in a co-pending international patent application no. PCT/______, attorney docket number ICUH.223WO, titled “UPDATING INFUSION PUMP DRUG LIBRARIES AND OPERATIONAL SOFTWARE IN A NETWORKED ENVIRONMENT” and filed ______, which is incorporated by reference herein.
The worksheet structure allows for comparison among different versions of drug library data selected for a particular subset of CCAs and infusion pumps. For example, a worksheet that is being edited can be compared to a current version of the worksheet and/or one or more historical versions of the worksheet. The various versions of the worksheet—and therefore the various versions of the corresponding drug library data—may be stored as generalized drug library data (e.g., JavaScript Object Notation or JSON files) and may be compared to each other (e.g., using text-based comparison methods) to determine any differences between the files. Differences between the files may be presented to a user so that the user can see what is different between the versions of the drug library data. These storage and comparison methods are generally more efficient than storing multiple versions of each individual record of drug library data in the DLDB along with corresponding effective dates, indicators of active/inactive status, and the like.
The worksheet structure also allows users to build specific drug libraries for specific purposes from a shared dataset. For example, a first worksheet designed for a cancer center utilizes a first subset of the overall DLDB, while a second worksheet designed for a pediatric center utilizes a second subset of the overall DLDB that is different than the first subset. The individual records for the CCAs, medications, and administration rules may be maintained in the DLDB without being changed for the different worksheets. The worksheet datasets for the different worksheets may be modified in the DLDB, and may reference data for the CCAs, medications, and administration rules.
The worksheet structure facilitates maintaining and viewing lifecycle of a particular set of drug library data. For example, a particular set of drug library data, corresponding to a particular worksheet, may progress through various stages, including: editable, in review, active, and archived. Data regarding each of the states may be included in the worksheet dataset. Accordingly, the worksheet structure provides revision control for each set of drug library data independently from other sets of drug library data (as managed using other worksheets).
The worksheet structure also facilitates identification and implementation of global changes that are to be cascaded to all worksheets. For example, when two worksheets contain a particular CCA and that CCA is updated (e.g., a new administration rule is added, a limit is changed, etc.), then both worksheets may automatically incorporate the changes made to CCA by virtue of the worksheets referencing the CCA data that has been changed rather than including a copy of CCA as it previously existed. As another example, when a worksheet's dataset has been updated, the system can notify health care professionals that new drug library data may need to be finalized to incorporate the changes for use on infusion pumps.

Example Drug Library Management Process

FIG. 7 is a flow diagram of an illustrative process 700 that may be executed by a DLM Editor 500 or some other component of the DLM 402 to manage the creation and maintenance of data in the DLDB 414, and the creation and maintenance of drug libraries for use by infusion pumps 204, connectivity adaptors 206, reporting systems, archival systems, and the like. Advantageously, the process 700 facilitates the maintenance of DLDB data in a streamlined manner, such that data regarding, medications, administration rules, CCAs, and the like needs to be created or edited only once, and the changes will be reflected across all associated drug libraries. Moreover, the process 700 provides the creation of generalized drug library data that may be archived in addition to being used by other systems or components. Thus, a repository of archived generalized drug library data files can provide snapshots of the state of drug libraries at various points in time, without requiring the maintenance of out-of-date data in the DLDB. Portions of the process 700 will be described with reference to the diagram of illustrative data flows and interactions shown in FIG. 5 , and the diagrams of illustrative user interfaces shown in FIGS. 8 and 9 .
The process 700 shown in FIG. 7 begins at block 702. The process 700 may begin in response to an event, such as when the DLM editor 500 begins execution. When the process 700 is initiated, a set of executable program instructions stored on one or more non-transitory computer-readable media (e.g., hard drive, flash memory, removable media, etc.) may be loaded into memory (e.g., random access memory or “RAM”) of a computing device of the cloud environment 106. The executable instructions may then be executed by a hardware-based computer processor (e.g., a central processing unit or “CPU”) of the computing device. In some embodiments, the process 700 or portions thereof may be implemented on multiple processors, serially or in parallel.
At block 704, the DLM editor 500 or some other component of the DLM 402 can manage medications in the DLDB 414. Management of medications may include creating, viewing, updating, and/or deleting medication 506 data entities.
In some embodiments, a user may use an end-user computing device 510 to access the DLM editor 500, as shown in FIG. 5 . The end-user computing device 510 may present an interface for management of medications in the DLDB 414. For example, the DLM editor 500 may provide interface 800, shown in FIG. 8 , to manage a particular medication 506. Interface 800 includes an infusion pump selection area 802, a medication information entry area 804, a dosing limitations entry area 806, and a clinical care area selection control 808.
The user may use the infusion pump selection area 802 to select the infusion pump(s) and/or pump version(s) which may be used to administer the medication. The user may use the medication information entry area 804 to manage properties of the medication. For example, identification-related properties such as a generic drug name 840 and display name 841 may be entered. A clinical use 842 may also be entered. Medication amount 843, volume amount 844, medication unit 845, and concentration type may also be entered.
In some embodiments, a single medication may be associated with different display names. For example, an infusion pump may only support a limited number of characters for display of medication names. Because the length of some medication names may exceed the character limit, a shortened name, such as a brand name, abbreviation, or the like may be used. Additionally, or alternatively, emphasis may be applied to portions of medication names for display to help avoid errors in the administration of the medications. Illustratively, the display name may be entered using “tall man” lettering in which part of a medication's name is displayed in upper case letters to help distinguish it from other medication names that may look and/or sound similar (e.g., “prednisone” and “prednisolone” may be displayed as “predniSONE” and “predniSOLONE”).
A subset of the information in the various entry areas may corresponds to an administration rule for the medication, indicated by administration rule data entry group 810. In some embodiments, additional and/or alternative information in the various entry areas may be part of a particular administration rule. For example, an administration rule may be assigned to a single infusion pump and/or pump type, and therefore the infusion pump selection area 802 may be included in the administration rule data entry group 810. As another example, an administration rule may not include a specific display name for the medication, and therefore administration rule data entry group 810 may not include display name 841, or display name 841 may be optional.
In some embodiments, a single medication may also or alternatively be associated with different clinical uses, amounts, volumes, units, and/or concentration types. Additional medication entries—corresponding to different database records, different presentations of the interface 800, etc.—may be used to capture these different combinations of properties. However, each of the medication entries can be linked to the top-level medication (e.g., as identified by a generic medication name and a unique identifier). In this way, the medication and all of its different available combinations of properties can be treated as a single unit when desired, or as separate medication entities when desired.
Returning to FIG. 7 , at block 706 the DLM editor 500 or some other component of the DLM 402 can manage administration rules in the DLDB 414. Management of administration rules may include viewing and/or updating deleting medication 506 data entities.
In some embodiments, a user may use interface 800, shown in FIG. 8 , to manage administration rules for a particular medication 506. In addition to identification and other properties of a medication 506 as described above, the interface 800 includes a dosing limitations entry area 806. The dosing limitations entry area 806 may be used to specify various administration limits, permissions, and the like. The data provided in these fields is then incorporated into the drug library for the selected infusion pump, and serves to constrain the manner in which the medication is permitted to be administered by the infusion pump. For example, after specifying a dosing unit 860, a user may enter a lower hard limit 861, lower soft limit 862, upper soft limit 863, and/or upper hard limit 864, all in terms of the selected dosing unit. An infusion pump that is administering the medication subject to this administration rule will not be permitted to administer an amount outside the hard lower and upper limits. The infusion pump may be permitted to administer an amount outside the soft lower and upper limits, but before doing so the infusion pump may be required to perform various procedures, such as initiating alerts, prompting for authorization, or the like.
Additional administration techniques 865, such as bolus administration, piggyback delivery, piggyback interruption, and the like may be permitted or blocked. Some administration techniques may be associated with their own properties, and permission of such techniques may cause display of additional data entry areas or interfaces. For example, if bolus administration is permitted in the additional administration techniques 865 section, then additional fields for dosing unit, upper and lower hard/soft limits, and the like may be shown.
In some embodiments, multiple administration rules 508 may be associated with a single medication 506. For example, different administration rules may be used for different infusion pumps. As another example, different administration rules may be associated with different clinical uses or concentrations of the medication. In these cases, additional medication entries may be added for the medications, and the different administration rules may be created accordingly. However, each of the separate medication entries and corresponding administration rules may be associated with a single top-level medication 506 data entity.
Returning to FIG. 7 , at block 708 the DLM editor 500 or some other component of the DLM 402 can manage CCAs in the DLDB 414. Management of CCAs may include creating, viewing, updating, and/or deleting CCA 504 data entities. In some embodiments, a user may use a remote computing device 510 that presents an interface for management of CCAs in the DLDB 414. For example, the DLM editor 500 may provide interface 900, shown in FIG. 9 , to manage a particular CCA 504.
Interface 900 includes an infusion pump selection area 902, a CCA information entry area 904, a pump settings entry area 906, and a medication selection control 908. A user may use the infusion pump selection area 902 to select the infusion pump(s) and/or pump version(s) which may be used to administer medication in the CCA. The user may use the CCA information entry area 904 to manage properties of the CCA. For example, identification-related properties such as a CCA name 940, service line 941, and CCA description 942 may be entered. The user may use the pump settings entry area 906 to manage CCA-specific settings for the selected pump(s), such as pump limits and other operational settings of the pump(s) in the CCA. For example, the user may provide a maximum dose rate 960, permit or prohibit additional administration functions 961 such as delayed start or standby, and set occlusion alarm settings 962. In some embodiments, the user may enter CCA-specific patient limits used to constrain which patients are permitted to be treated using the infusion pump on the CCA. For example, patient limits may include minimum body surface area (BSA) 963, maximum BSA 964, minimum height 965, maximum height 966, minimum weight 967, maximum weight 968, and the like.
Although FIG. 7 illustrates blocks 704 and 706 occurring in a sequential manner on one execution path, and block 608 occurring in a parallel execution path, this example is illustrative only. In some embodiments, the operations that correspond to blocks 704, 706, and 708 may be performed sequentially, asynchronously, in parallel, or individual blocks may be repeated as needed.
At block 710, the DLM editor 500 or some other component of the DLM 402 can manage the medications available to the CCAs in the DLDB 414. For example, interface 800 for a particular medication 506 includes a clinical care area selection control 808. A user can activate this control 808 to access an interface that facilitates selection of CCAs in which the medication 506 is permitted to be administered. As another example, interface 900 for a particular CCA 504 includes a medication selection control 908. A user can activate this control 908 to access an interface that facilitates selection of medications that are permitted to be administered in the CCA 504.
At block 712, the DLM editor 500 or some other component of the DLM 402 can generate a worksheet 502 for management of a drug library. The worksheet 502 provides the mechanism by which a drug library is generated for use by an infusion pump. Separate drug libraries may be generated and maintained for different infusion pumps and/or infusion pumps in different facilities, CCAs, and the like. In some embodiments, a user may use a remote computing device 510 that presents an interface for management of worksheets in the DLDB 414. The user may enter worksheet-specific information, such as a name for the worksheet, an infusion pump type and/or version targeted by the worksheet, and the like. Data representing the worksheet-specific information may be stored in the DLDB 414.
At block 714, the DLM editor 500 or some other component of the DLM 402 can add one or more CCAs 504 to the worksheet 502. Addition of CCAs 504 also has the effect of adding the various medications 506 and administration rules 508, associated with the CCAs 504, to the worksheet 502. In this example, the CCAs provide the organizational means by which groups of medications may be added to a particular worksheet and therefore to a particular drug library.
In some embodiments, the DLM editor 500 or some other component of the DLM 402 can add one or more medications 506 to the worksheet 502. Addition of medications 506 to the worksheet 502 may also have the effect of adding various administration rules 508, associated with the medications 506, to the worksheet 502. In some embodiments, medications may be added in addition to CCAs, or medications may be added individually without the addition of CCAs to the worksheet. [0077] At block 716, the DLM editor 500 or some other component of the DLM 402 can finalize the worksheet 502. The worksheet 502 may be finalized on-demand (e.g., immediately upon request by a user of the DLM editor 500), or it may be subject to an authorization workflow. For example, the use may request finalization of a worksheet after various changes have been made. Other users may then access the worksheet, view the changes if desired, and approve or reject the worksheet. Once the changes to the worksheet are approved, the worksheet may be finalized.
At block 718, the DLM editor 500 or some other component of the DLM 402 can generate customized drug library data using the worksheet 502. As described above, the worksheet may specify a particular pump type or version to which the worksheet applies. The DLM 402 can use drug library specification data for the particular infusion pump type or version to generate customized drug library data of the pump.
Drug library specification data may include rules for generating customized drug library data required by the infusion pump, such as the data structure and format in which the drug library data is expected to be delivered, functions or other transformations to be applied to data from DLDB 414 to produce data that is able to be used by the infusion pump, etc. For example, a first type of infusion pump may expect data fields a, b, c, d, and e to be present, in that sequence, for each medication record. A second type of infusion pump may also expect fields a, b, and c, to be present, together with data that corresponds to field d with a mathematical transformation applied, and also a different field f instead of field e. In addition, the second type of infusion pump may expect the fields to be in a different sequence than the first type of infusion pump. The drug library specification data for the two different types of infusion pumps can provide data regarding these expected data fields, formats, transformations, sequences, and the like.
The DLM 402 can determine which infusion pump type and/or version is specified in the worksheet 502 data set. The DLM 402 can then generate customized drug library data 520 for the infusion pump using the worksheet 502 data in the DLDB 414 and the drug library specification data for the infusion pump.
At block 720, the DLM editor 500 or some other component of the DLM 402 can generate generalized drug library data using the worksheet 502. As described above, the generalized drug library data is data used by middleware components (e.g., connectivity adapters 206), reporting systems, archival systems, and the like. Each of these different devices and components may be configured to operate using the same generalized drug library data. Illustratively, the generalized drug library data may be created in a standardized data format, such as JavaScript Object Notation (JSON), eXtensible Markup Language (XML), or the like. In some embodiments, generalized drug library specification data may be used to generate the generalized drug library data. Generalized drug library specification data may include rules for generating the generalized drug library data, such as the data structure and format in which the generalized drug library data is to be delivered, the functions or other transformations to be applied to data from the DLDB 414 to produce the generalized drug library data, etc. The DLM 402 can generate the generalized drug library data using the worksheet 502 data in the DLDB 414 and the generalized drug library specification data.
Although FIG. 7 illustrates blocks 718 and 720 occurring in a sequential manner on one execution path, this example is illustrative only. In some embodiments, the operations that correspond to blocks 718 and 720 may be performed in a different sequence, asynchronously, or in parallel.
At block 722, the DLM editor 500 or some other component of the DLM 402 can distribute the drug library data generated above. For example, as shown in FIG. 5 , the DLM 402 can provide the generalized drug library data 520 and customized drug library data 522 to a connectivity adapter 206. In some embodiments, the DLM may also or alternatively store the generalized drug library data in a drug library archive 416. Storage of generalized drug library data 520 in the drug library archive 416 can provide certain benefits, such as the ability to access the drug library, as it existed when generated, at some future time even after other intervening versions of the drug library have been generated. In addition, by maintaining prior versions of drug libraries in the separate archive 416, the size and complexity of the DLDB 414 may be controlled because it is not necessary to store records for every prior version of data in the DLDB 414.
At block 724, the process 700 may terminate. In some embodiments, the process 700 may return to prior blocks. For example, a user may return to block 712 to generate additional worksheets for other CCAs, infusion pumps, etc.
Example Drug Library Use
FIG. 10 is a diagram of data flows and interactions between components of the networked clinical environment 102 and cloud environment 106 during use of drug library data. As shown, an infusion pump 204 may send a message at [A] to a connectivity adapter 206. For example, the message may indicate the start of a medication infusion process for a particular medication. The customized drug library data used by the infusion pump 204 may use an identifier of “13BSF68X” for the medication. Therefore, the message may include the identifier “13BSF68X” instead of the name of the medication, in order to reduce the size of the message. The message may include other information about the infusion, such as a timestamp for the start of the infusion, a dosage amount, etc. Alternatively or in addition, to reduce the overall size of the message, the message may include identifiers for other data regarding the infusion, or other information from which human-readable forms can be derived. For example, the message may include a patient identifier, an infusion type identifier, a CCA identifier, a channel identifier, a line identifier, an auto-program reference identifier, other identifiers, some combination thereof, etc.
The connectivity adapter 206 may receive the message from the infusion pump, and process the message at [B]. For example, the connectivity adapter 206 may process the message into a standardized dataset message using generalized drug library data in the data store 340. The generalized drug library data may include the name of the drug that corresponds to the identifier “13BSF68X,” the name of the CCA that corresponds to a CCA identifier, etc.
The connectivity adapter 206 may therefore include the drug name, CCA name, etc. in the standardized dataset message without receiving the drug name, CCA name, and the like from the infusion pump 204. The connectivity adapter 206 may send the standardized dataset message to the cloud environment 106 at [C].
The infusion pump 204 may send a second message to the connectivity adapter 206 at [D]. The second message may relate to a past event at the infusion pump 204, such as an infusion occurring days earlier when a different version of customized drug library data was being used by the infusion pump 204. For example, when the cloud environment 106 received the standardized dataset message at [C], it may have determined that a prior message had not been received (e.g., by inspecting a sequential message identifier in the message). The cloud environment 106 may then have initiated a process to obtain the missing message, and as a result the infusion pump 204 re-sent (or sent for the first time) the message to the connectivity adapter 206 at [D].
The connectivity adapter 206 can begin processing the second message at [E]. However, the infusion that is the subject of the message occurred when the infusion pump 204 was using an older version of the customized drug library data. Therefore, the message may include information (e.g., an identifier) that the connectivity adapter 206 is unable to resolve by referencing the generalized drug library data currently present in the data store 340, because generalized drug library data currently present in the data store 340 corresponds to the current customized drug library data used by the infusion pump 204. In this instance, the connectivity adapter 206 may retrieve, from the cloud environment 106 at [F], an archived version of the generalized drug library data that corresponds to the customized drug library data used by the infusion pump 204 when the second message was originally generated.
The connectivity adapter 206 may proceed with processing the second message at [G] into a standardized dataset message using the archived version of generalized drug library data. For example, the connectivity adapter 206 may determine the drug name using the identifier and the archived version of the generalized drug library data and proceed with processing the second message at [G] into a standardized dataset message that includes the drug name. The connectivity adapter 206 may then send a second standardized dataset message to the cloud environment 106 at [H].
Embodiments of the present disclosure can be defined by the following non-limiting clauses:
Clause 1: A system configured to manage a drug library within a clinical environment, the system comprising:

- a plurality of infusion pumps configured to deliver medication to one or more patients, each respective infusion pump of the plurality of infusion pumps comprising a memory configured to store drug library data;
- a drug library manager comprising one or more computer processors and memory, the drug library manager configured to:
  - receive, from a user device, first input data representing one or more medications;
  - receive, from the user device, second input data representing one or more administration rules, wherein the second input data comprises:
    - data representing a medication of the one or more medications;
    - data representing an infusion pump type of a plurality of infusion pump types; and
    - data representing one or more medication administration parameters;
  - receive, from the user device, third input data representing one or more clinical care areas, wherein the third input data comprises:
    - data representing one or more clinical care area settings; and
    - data representing an association of a clinical care area with zero or more administration rules
  - receive, from the user device, fourth input data representing selection of a first clinical care area of the one or more clinical care areas; store, in a drug library database, worksheet data representing a drug library, wherein the worksheet data comprises:
    - a first reference to infusion pump data in the drug library database, the infusion pump data representing the first infusion pump type; and
    - a second reference to clinical care area data in the drug library database, the clinical care area data representing the first clinical care area;
  - generate customized drug library data using the worksheet data, wherein the customized drug library data is formatted according to a pump-specific format associated with the first infusion pump type, wherein the customized drug library data represents a subset of medications in the drug library database and a subset of administration rules in the drug library database, and wherein individual administration rules of the subset of administration rules are associated with individual medications of the subset of medications;
  - generate generalized drug library data using the worksheet data, wherein the generalized drug library data represents the subset of medications and the subset of administration rules;
  - provide, to a first infusion pump of the plurality of infusion pumps, the customized drug library data, wherein the first infusion pump is associated with the first infusion pump type, and wherein a second infusion pump of the plurality of infusion pumps is not provided with the customized drug library data, the second infusion pump associated with a second infusion pump type; and
  - provide, to a connectivity adapter in communication with the first infusion pump and the second infusion pump, the generalized drug library data.

Clause 2: The system of Clause 1, wherein the first infusion pump is configured to replace, in memory of the first infusion pump, a prior version of customized drug library data with the customized drug library data.
Clause 3: The system of Clause 1, wherein the first infusion pump is configured to:

- display infusion data comprising a medication name; and
- transmit an infusion message to the connectivity adapter, wherein the infusion message comprises a medication identifier and does not comprise the medication name.

Clause 4: The system of Clause 3, wherein the connectivity adapter is configured to at least:

- receive, from the first infusion pump, the infusion message; and
- determine the medication name using the medication identifier and the generalized drug library data.

Clause 5: The system of Clause 4, wherein the connectivity adapter is further configured to at least:

- receive, from the second infusion pump, a second infusion message comprising a second mediation identifier; and
- determine a second medication name using the second medication identifier and second generalized drug library data associated with the second infusion pump.

Clause 6: The system of Clause 1, wherein:

- an administration rule of the subset of administration rules is associated with a medication of the subset of medications;
- the administration rule is associated with a first upper dosing limit;
- the first clinical care area is associated with a second upper dosing limit that is lower than the first upper dosing limit; and
- the second upper dosing limit overrides the first upper dosing limit during administration of the medication by the first infusion pump.

Clause 7: The system of Clause 1, wherein:

- an administration rule of the subset of administration rules is associated with a medication of the subset of medications;
- the administration rule is associated with a first upper dosing limit;
- the first clinical care area is associated with a second upper dosing limit that is higher than the first upper dosing limit; and
- the first upper dosing limit is implemented during administration of the medication by the first infusion pump.

Clause 8: The system of Clause 1, wherein the drug library manager is further configured to at least:

- receive, from the user device, input associated with a medication and representing selection of at least one of: a lower hard dosing limit, a lower soft dosing limit, an upper soft dosing limit, or an upper hard dosing limit; and
- store, in the drug library database, administration rule data representing the selection, wherein the administration rule data references medication data representing the medication.

Clause 9: The system of Clause 1, wherein the connectivity adapter is configured to at least:

- receive, from the first infusion pump, an infusion message associated with a prior version of customized drug library data;
- obtain a prior version of generalized drug library data that corresponds to the prior version of customized drug library data; and
- process the infusion message using the prior version of generalized drug library data.

Clause 10: The system of Clause 1, wherein the drug library manager is further configured to at least:

- store status data in connection with the worksheet data, wherein the status data indicates a status of the worksheet data; and
- receive, from the user device, input indicating a change in status of the worksheet data, wherein the customized drug library data and generalized drug library data are generated in response to receiving the input indicating the change in status of the worksheet data.

Clause 11: The system of Clause 1, further comprising a drug library archive, wherein the drug library manager is further configured to provide the generalized drug library data to the drug library archive, and wherein the drug library archive is configured to store a plurality of versions of generalized drug library data for each of a plurality of different drug libraries.
Clause 12: The system of Clause 11, wherein the drug library manager is further configured to:

- compare the generalized drug library data to one of: second generalized drug library data or second worksheet data; and
- generate user interface data for displaying a difference based on comparing the generalized drug library data.

Clause 13: A computer-implemented method comprising:

- under control of one or more computing devices configured with specific computer-executable instructions,
  - storing, in a drug library database, worksheet data representing a drug library, wherein the worksheet data comprises:
    - a first reference to infusion pump data in the drug library database, the infusion pump data representing a first infusion pump type of a plurality of infusion pump types; and
    - a second reference to clinical care area data in the drug library database, the clinical care area data representing a first clinical care area of a plurality of clinical care areas;
  - generating customized drug library data using the worksheet data, wherein the customized drug library data is formatted according to a pump-specific format associated with the first infusion pump type, wherein the customized drug library data represents a subset of medications in the drug library database and a subset of administration rules in the drug library database, and wherein individual administration rules of the subset of administration rules are associated with individual medications of the subset of medications;
  - generating generalized drug library data using the worksheet data, wherein the generalized drug library data represents the subset of medications and the subset of administration rules;
  - providing the customized drug library data to an infusion pump associated with the first infusion pump type; and
  - providing the generalized drug library data to a computing system in communication with the infusion pump.

Clause 14: The computer-implemented method of Clause 13, further comprising:

- accessing archived generalized drug library data corresponding to a prior version of the worksheet data;
- comparing the generalized drug library data to the archived generalized drug library data; and
- presenting a user interface displaying a difference between the generalized drug library data and the archived generalized drug library data.

Clause 15: The computer-implemented method of Clause 13, further comprising:

- receiving input associated with a medication and representing selection of at least one of: a lower hard dosing limit, a lower soft dosing limit, an upper soft dosing limit, or an upper hard dosing limit; and
- storing, in the drug library database, administration rule data representing the selection, wherein the administration rule references medication data representing the medication.

Clause 16: The computer-implemented method of Clause 13, further comprising:

- storing status data in connection with the worksheet data, wherein the status data indicates a status of the worksheet data; and
- receiving input indicating a change in status of the worksheet data, wherein the customized drug library data and generalized drug library data are generated in response to receiving the input indicating the change in status of the worksheet data.

Clause 17: The computer-implemented method of Clause 13, further comprising providing the generalized drug library data to a drug library archive configured to store a plurality of versions generalized drug library data for each of a plurality of different drug libraries.
Clause 18: The computer-implemented method of Clause 13, wherein generating the generalized drug library data comprises formatting the generalized drug library data using JavaScript Object Notation.
Clause 19: A system comprising:

- a computer-readable memory storing executable instructions; and
- one or more processors in communication with the computer-readable memory, wherein the one or more processors are programmed by the executable instructions to at least:
  - store, in a drug library database, worksheet data representing a drug library, wherein the worksheet data comprises:
    - a first reference to infusion pump data in the drug library database, the infusion pump data representing a first infusion pump type of a plurality of infusion pump types; and
    - a second reference to clinical care area data in the drug library database, the clinical care area data representing a first clinical care area of a plurality of clinical care areas;
  - generate customized drug library data using the worksheet data, wherein the customized drug library data is formatted according to a pump-specific format associated with the first infusion pump type, wherein the customized drug library data represents a subset of medications in the drug library database and a subset of administration rules in the drug library database, and wherein individual administration rules of the subset of administration rules are associated with individual medications of the subset of medications;
  - generate generalized drug library data using the worksheet data, wherein the generalized drug library data represents the subset of medications and the subset of administration rules;
  - provide the customized drug library data to an infusion pump associated with the first infusion pump type; and
  - provide the generalized drug library data to a connectivity adapter in communication with the infusion pump.

Clause 20: The system of Clause 19, further comprising the connectivity adapter, wherein the connectivity adapter is configured to at least:

- receive, from the infusion pump, a first infusion message comprising a medication identifier that corresponds to a medication infused by the infusion pump;
- determine a medication name using the medication identifier and the generalized drug library data;
- receive, from the infusion pump, a second infusion message associated with a prior version of customized drug library data;
- obtain a prior version of generalized drug library data that corresponds to the prior version of customized drug library data; and process the second infusion message using the prior version of generalized drug library data.

Clause 21: A system comprising:

- computer-readable storage; and
- one or more computer processors configured to at least:
  - receive customized drug library data formatted according to a pump-specific format associated with a first infusion pump type, wherein the customized drug library data represents a plurality of medications and a plurality of administration rules, and wherein individual administration rules of the plurality of administration rules are associated with individual medications of the plurality of medications;
  - receive generalized drug library data, wherein the generalized drug library data represents the plurality of medications and the plurality of administration rules;
  - send the customized drug library data to an infusion pump associated with the first infusion pump type;
  - store the generalized drug library data in the computer-readable storage, wherein a prior version of the generalized drug library data is stored in the computer-readable storage;
  - receive, from the infusion pump, a first infusion message comprising a first medication identifier that corresponds to a first medication infused by the infusion pump;
  - determine a first medication name using the first medication identifier and the generalized drug library data;
  - receive, from the infusion pump, a second infusion message associated with a prior version of customized drug library data, the second infusion message comprising a second medication identifier that corresponds to a second medication infused by the infusion pump; and
  - determine a second medication name using the second medication identifier and the prior version of generalized drug library data.

Clause 22: The system of Clause 21, further comprising the infusion pump, wherein the infusion pump is configured to replace, in memory of the infusion pump, a prior version of customized drug library data with the customized drug library data.
Clause 23: The system of Clause 22, wherein the infusion pump is configured to:

- display infusion data comprising the first medication name; and
- transmit the first infusion message to a connectivity adapter comprising the one or more processors, wherein the first infusion message comprises the first medication identifier and does not comprise the first medication name.

Clause 24: The system of Clause 22, wherein the infusion pump is configured to:

- display infusion data comprising a clinical care area name; and
- transmit the first infusion message to a connectivity adapter comprising the one or more processors, wherein the first infusion message comprises a clinical care area identifier and does not comprise the clinical care area name.

Clause 25: The system of Clause 21, wherein the one or more processors are further configured to at least:

- receive, from a second infusion pump, a third infusion message comprising a third mediation identifier, wherein the second infusion pump is associated with a second infusion pump type; and
- determine a third medication name using the third medication identifier and second generalized drug library data.

Clause 26: The system of Clause 21, wherein:

- an administration rule of the plurality of administration rules is associated with the first medication and a clinical care area of a plurality of clinical care areas;
- the administration rule comprises a first upper dosing limit;
- the clinical care area is associated with a second upper dosing limit that is lower than the first upper dosing limit; and
- the second upper dosing limit overrides the first upper dosing limit during administration of the first medication by the infusion pump.

Clause 27: The system of Clause 21, wherein:

- an administration rule of the plurality of administration rules is associated with the first medication and a clinical care area of a plurality of clinical care areas;
- the administration rule comprises a first upper dosing limit;
- the clinical care area is associated with a second upper dosing limit that is higher than the first upper dosing limit; and
- the first upper dosing limit is implemented during administration of the first medication by the infusion pump.

Clause 28: A computer-implemented method comprising:

- under control of one or more computing devices configured with specific computer-executable instructions,
  - receiving customized drug library data formatted according to a pump-specific format associated with a first infusion pump type, wherein the customized drug library data represents a plurality of medications and a plurality of administration rules, and wherein individual administration rules of the plurality of administration rules are associated with individual medications of the plurality of medications;
  - receiving generalized drug library data, wherein the generalized drug library data represents the plurality of medications and the plurality of administration rules;
  - sending the customized drug library data to an infusion pump associated with the first infusion pump type;
  - storing the generalized drug library data in a computer-readable storage, wherein a prior version of the generalized drug library data is stored in the computer-readable storage;
  - receiving, from the infusion pump, a first infusion message comprising a first medication identifier that corresponds to a first medication infused by the infusion pump;
  - processing the first infusion message using the first medication identifier and the generalized drug library data;
  - receiving, from the infusion pump, a second infusion message associated with a prior version of customized drug library data, the second infusion message comprising a second medication identifier that corresponds to a second medication infused by the infusion pump; and
  - processing the second infusion message using the second medication identifier and the prior version of generalized drug library data.

Clause 29: The computer-implemented method of Clause 28, wherein processing the first infusion message comprises determining a first medication name using the first medication identifier and the generalized drug library data.
Clause 30: The computer-implemented method of Clause 28, wherein processing the second infusion message comprises determining a second medication name using the second medication identifier and the generalized drug library data.
Clause 31: The computer-implemented method of Clause 28, wherein sending the customized drug library data to the infusion pump cases the infusion pump to replace, in memory of the infusion pump, a prior version of customized drug library data with the customized drug library data.
Clause 32: The computer-implemented method of Clause 31, further comprising:

- displaying, by the infusion pump, infusion data comprising the first medication name; and
- generating, by the infusion pump, the first infusion message, wherein the first infusion message comprises the first medication identifier and does not comprise the first medication name.

Clause 33: The computer-implemented method of Clause 28, further comprising:

- receiving, from a second infusion pump, a third infusion message comprising a third mediation identifier, wherein the second infusion pump is associated with a second infusion pump type; and
- processing the third medication identifier and second generalized drug library data.

Clause 34: The computer-implemented method of Clause 28, wherein:

Clause 35: The computer-implemented method of Clause 28, wherein:

Clause 36: A non-transitory computer storage medium that stores an executable component that directs a computing system to perform a process comprising:

- receiving customized drug library data formatted according to a pump-specific format associated with a first infusion pump type, wherein the customized drug library data represents a plurality of medications and a plurality of administration rules, and wherein individual administration rules of the plurality of administration rules are associated with individual medications of the plurality of medications;
- receiving generalized drug library data, wherein the generalized drug library data represents the plurality of medications and the plurality of administration rules;
- sending the customized drug library data to an infusion pump associated with the first infusion pump type;
- storing the generalized drug library data in a computer-readable storage, wherein a prior version of the generalized drug library data is stored in the computer-readable storage;
- receiving, from the infusion pump, a first infusion message comprising a first medication identifier that corresponds to a first medication infused by the infusion pump;
- processing the first infusion message using the first medication identifier and the generalized drug library data;
- receiving, from the infusion pump, a second infusion message associated with a prior version of customized drug library data, the second infusion message comprising a second medication identifier that corresponds to a second medication infused by the infusion pump; and
- processing the second infusion message using the second medication identifier and the prior version of generalized drug library data.

Clause 37: The non-transitory computer storage medium of Clause 36, wherein processing the first infusion message comprises determining a first medication name using the first medication identifier and the generalized drug library data, and wherein processing the second infusion message comprises determining a second medication name using the second medication identifier and the generalized drug library data.
Clause 38: The non-transitory computer storage medium of Clause 36, the process further comprising:

Clause 39: The non-transitory computer storage medium of Clause 36, wherein:

Clause 40: The non-transitory computer storage medium of Clause 36, wherein:

Other Considerations

It is to be understood that not necessarily all objects or advantages may be achieved in accordance with any particular embodiment described herein. Thus, for example, those skilled in the art will recognize that certain embodiments may be configured to operate in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other objects or advantages as may be taught or suggested herein.
Many other variations than those described herein will be apparent from this disclosure. For example, depending on the embodiment, certain acts, events, or functions of any of the algorithms described herein can be performed in a different sequence, can be added, merged, or left out altogether (e.g., not all described acts or events are necessary for the practice of the algorithms). Moreover, in certain embodiments, acts or events can be performed concurrently, e.g., through multi-threaded processing, interrupt processing, or multiple processors or processor cores or on other parallel architectures, rather than sequentially. In addition, different tasks or processes can be performed by different machines and/or computing systems that can function together.
The various illustrative logical blocks, modules, and algorithm elements described in connection with the embodiments disclosed herein can be implemented as electronic hardware, computer software, or combinations of both. To clearly illustrate this interchangeability of hardware and software, various illustrative components, blocks, modules, and elements have been described above generally in terms of their functionality. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the overall system. The described functionality can be implemented in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the disclosure.
The various illustrative logical blocks and modules described in connection with the embodiments disclosed herein can be implemented or performed by a machine, such as a general purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A general-purpose processor can be a microprocessor, but in the alternative, the processor can be a controller, microcontroller, or state machine, combinations of the same, or the like. A processor can include electrical circuitry configured to process computer-executable instructions. In another embodiment, a processor includes an FPGA or other programmable device that performs logic operations without processing computer-executable instructions. A processor can also be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. Although described herein primarily with respect to digital technology, a processor may also include primarily analog components. For example, some or all of the signal processing algorithms described herein may be implemented in analog circuitry or mixed analog and digital circuitry. A computing environment can include any type of computer system, including, but not limited to, a computer system based on a microprocessor, a mainframe computer, a digital signal processor, a portable computing device, a device controller, or a computational engine within an appliance, to name a few.
The elements of a method, process, or algorithm described in connection with the embodiments disclosed herein can be embodied directly in hardware, in a software module stored in one or more memory devices and executed by one or more processors, or in a combination of the two. A software module can reside in RAM memory, flash memory, ROM memory, EPROM memory, EEPROM memory, registers, hard disk, a removable disk, a CD ROM, or any other form of non-transitory computer-readable storage medium, media, or physical computer storage known in the art. An example storage medium can be coupled to the processor such that the processor can read information from, and write information to, the storage medium. In the alternative, the storage medium can be integral to the processor. The storage medium can be volatile or nonvolatile. The processor and the storage medium can reside in an ASIC. The ASIC can reside in a user terminal. In the alternative, the processor and the storage medium can reside as discrete components in a user terminal.
Conditional language used herein, such as, among others, “can,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements, and/or states. Thus, such conditional language is not generally intended to imply that features, elements and/or states are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or states are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Further, the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied.
Disjunctive language such as the phrase “at least one of X, Y, or Z,” unless specifically stated otherwise, is otherwise understood with the context as used in general to present that an item, term, etc., may be either X, Y, or Z, or any combination thereof (e.g., X, Y, and/or Z). Thus, such disjunctive language is not generally intended to, and should not, imply that certain embodiments require at least one of X, at least one of Y, or at least one of Z to each be present.
Unless otherwise explicitly stated, articles such as “a”, “an”, or “the” should generally be interpreted to include one or more described items. Accordingly, phrases such as “a device configured to” are intended to include one or more recited devices. Such one or more recited devices can also be collectively configured to carry out the stated recitations. For example, “a processor configured to carry out recitations A, B, and C” can include a first processor configured to carry out recitation A working in conjunction with a second processor configured to carry out recitations B and C.
While the above detailed description has shown, described, and pointed out novel features as applied to various embodiments, it will be understood that various omissions, substitutions, and changes in the form and details of the devices or algorithms illustrated can be made without departing from the spirit of the disclosure. As will be recognized, certain embodiments described herein can be implemented within a form that does not provide all of the features and benefits set forth herein, as some features can be used or practiced separately from others. All such modifications and variations are intended to be included herein within the scope of this disclosure. Further, additional embodiments created by combining any two or more features or techniques of one or more embodiments described herein are also intended to be included herein within the scope of this disclosure.

Claims

1-20. (canceled)

21. A computer-implemented method comprising:

under control of one or more computing devices configured with specific computer-executable instructions,

storing, in a drug library database, worksheet data representing a drug library, wherein the worksheet data comprises:

a first reference to infusion pump data in the drug library database representing a first infusion pump type of a plurality of infusion pump types; and

a second reference to clinical care area data in the drug library database representing a first clinical care area of a plurality of clinical care areas;

generating customized drug library data using the worksheet data, wherein the customized drug library data is formatted according to a pump-specific format associated with the first infusion pump type, wherein the customized drug library data represents a subset of medications in the drug library database and a subset of administration rules in the drug library database, and wherein individual administration rules are associated with individual medications;

generating generalized drug library data using the worksheet data, wherein the generalized drug library data represents the subset of medications and the subset of administration rules, and wherein the generalized drug library data is different from the customized drug library data;

providing the customized drug library data to an infusion pump associated with the first infusion pump type; and

providing the generalized drug library data to a computing system in communication with the infusion pump.

22. The computer-implemented method of claim 21, further comprising:

receiving an infusion message from the infusion pump, wherein the infusion pump is configured to display infusion data comprising a medication name, and transmit the infusion message comprising a medication identifier and not comprising the medication name; and

determining the medication name using the medication identifier and the generalized drug library data.

23. The computer-implemented method of claim 22, further comprising:

receiving, from a second infusion pump, a second infusion message comprising a second medication identifier; and

determining a second medication name using the second medication identifier and second generalized drug library data associated with the second infusion pump, wherein the second infusion pump is associated with a second infusion pump type of the plurality of infusion pump types.

24. The computer-implemented method of claim 21, further comprising:

receiving, from a user device, input associated with a medication and representing selection of at least one of: a lower hard dosing limit, a lower soft dosing limit, an upper soft dosing limit, or an upper hard dosing limit; and

storing, in the drug library database, administration rule data representing the selection, wherein the administration rule data references medication data representing the medication.

25. The computer-implemented method of claim 21, further comprising:

storing status data in connection with the worksheet data, wherein the status data indicates a status of the worksheet data; and

receiving, from a user device, input indicating a change in status of the worksheet data, wherein the customized drug library data and the generalized drug library data are generated in response to receiving the input indicating the change in status of the worksheet data.

26. The computer-implemented method of claim 21, further comprising providing the generalized drug library data to a drug library archive, wherein the drug library archive is configured to store a plurality of versions of generalized drug library data for each of a plurality of different drug libraries.

27. The computer-implemented method of claim 21, further comprising:

accessing archived generalized drug library data corresponding to a prior version of the worksheet data;

comparing the generalized drug library data to the archived generalized drug library data; and

presenting a user interface displaying a difference between the generalized drug library data and the archived generalized drug library data.

28. The computer-implemented method of claim 21, further comprising:

receiving input associated with a medication and representing selection of at least one of: a lower hard dosing limit, a lower soft dosing limit, an upper soft dosing limit, or an upper hard dosing limit; and

29. The computer-implemented method of claim 21, further comprising:

receiving input indicating a change in status of the worksheet data, wherein the customized drug library data and the generalized drug library data are generated in response to receiving the input indicating the change in status of the worksheet data.

30. The computer-implemented method of claim 21, wherein generating the generalized drug library data comprises formatting the generalized drug library data using JavaScript Object Notation.

31. A system comprising:

a computer-readable memory storing executable instructions; and

one or more processors in communication with the computer-readable memory and programmed by the executable instructions to:

store, in a drug library database, worksheet data representing a drug library, wherein the worksheet data comprises:

generate customized drug library data using the worksheet data, wherein the customized drug library data is formatted according to a pump-specific format associated with the first infusion pump type, wherein the customized drug library data represents a subset of medications in the drug library database and a subset of administration rules in the drug library database, and wherein individual administration rules are associated with individual medications;

generate generalized drug library data using the worksheet data, wherein the generalized drug library data represents the subset of medications and the subset of administration rules, and wherein the generalized drug library data is different from the customized drug library data;

provide the customized drug library data to an infusion pump associated with the first infusion pump type; and

provide the generalized drug library data to a computing system in communication with the infusion pump.

32. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to:

receive an infusion message from the infusion pump, wherein the infusion pump is configured to display infusion data comprising a medication name, and transmit the infusion message comprising a medication identifier and not comprising the medication name; and

determine the medication name using the medication identifier and the generalized drug library data.

33. The system of claim 32, wherein the one or more processors are further programmed by the executable instructions to:

receive, from a second infusion pump, a second infusion message comprising a second medication identifier; and

determine a second medication name using the second medication identifier and second generalized drug library data associated with the second infusion pump, wherein the second infusion pump is associated with a second infusion pump type of the plurality of infusion pump types.

34. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to:

receive, from a user device, input associated with a medication and representing selection of at least one of: a lower hard dosing limit, a lower soft dosing limit, an upper soft dosing limit, or an upper hard dosing limit; and

store, in the drug library database, administration rule data representing the selection, wherein the administration rule data references medication data representing the medication.

35. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to:

store status data in connection with the worksheet data, wherein the status data indicates a status of the worksheet data; and

receive, from a user device, input indicating a change in status of the worksheet data, wherein the customized drug library data and the generalized drug library data are generated in response to receiving the input indicating the change in status of the worksheet data.

36. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to provide the generalized drug library data to a drug library archive, wherein the drug library archive is configured to store a plurality of versions of generalized drug library data for each of a plurality of different drug libraries.

37. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to:

access archived generalized drug library data corresponding to a prior version of the worksheet data;

compare the generalized drug library data to the archived generalized drug library data; and

present a user interface displaying a difference between the generalized drug library data and the archived generalized drug library data.

38. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to:

receive input associated with a medication and representing selection of at least one of: a lower hard dosing limit, a lower soft dosing limit, an upper soft dosing limit, or an upper hard dosing limit; and

39. The system of claim 31, wherein the one or more processors are further programmed by the executable instructions to:

40. The system of claim 31, wherein the generalized drug library data comprises JavaScript Object Notation data.