WO2001067345A1

WO2001067345A1 - Automated electronic encrypted prescription filling and record keeping and retrieval system

Info

Publication number: WO2001067345A1
Application number: PCT/US2001/006601
Authority: WO
Inventors: James I. Mccartney
Original assignee: Mccartney James I
Priority date: 2000-03-03
Filing date: 2001-03-01
Publication date: 2001-09-13
Also published as: AU2001250788A1

Abstract

A prescription and dispensing system (10) provides a physician (21) with a means of preparing and routing a prescription electronically to a central facility (40) contracted by the physician (21) to fill and deliver his patient's prescriptions, or to a pharmacy (46) where the medication may be picked up by the patient (50). The physician (21), using a hand-held PDA device (20), chooses from a drop-down menu of drugs and dosages specifically tailored to that physician's medical and pharmaceutical needs. After entering his identification number, the physician (21) can access a patient's medical records via a database at a host computer (30). The patient's medical information is then transmitted back to the PDA (20) where the physician can examine up-to-date patient information. The physician (21) then writes a prescription by choosing the drug and dosage from the menu which is transmitted via wire or RF communication to his office computer.

Description

AUTOMATED ELECTRONIC ENCRYPTED PRESCRIPTION FILLING AND RECORD

KEEPING AND RETRIEVAL SYSTEM

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention relates to an automated prescription filling system, and particularly to an automated electronic system to allow physicians to automatically enter and update patient information via a hand-held PDA device, and where through an internet connection, a remote prescription fulfillment facility can fill the prescription and forward it to a patient, or, alternatively, to a local pharmacy for dispensing the medication to the patient, thereby eliminating delays and mis-reading of physician's handwriting m normal handwritten prescriptions.

2. Description of Related Art

Physicians typically dispense prescriptions via handwritten notes, scribbled quickly, often resulting m illegible, indecipherable prescriptions. Needless to say mistakes even of the minor type may have devastating effects if a wrong prescription or wrong dosage is dispensed.

In addition to misreading a physician's handwritten prescription, there are delays associated with the common prescription dispensing system. Normally, a doctor prescribes one or more drugs after a patient visit. The handwritten prescription is then carried by the patient to a local pharmacy. The patient normally has to wait or to return when the prescription is ready. The patient's record must be separately updated to include the patient's latest visit and latest prescription.

Recent attempts have been made m the industry to provide the physician with a device to allow the physician to electronically enter the prescription thereby eliminating any problems associated with the deciphering of the physician's handwriting. Further, attempts have been made to provide the physician with a database of the patients' medical history, recent office visits, recent drug prescriptions, and history of medical reactions or allergies to specific types of medication.

However, although the problems associated with illegible handwritten prescriptions has been somewhat addressed m the industry, there still remains a need for the dispensing of accurate prescriptions m a timely manner without the patient having to wait an undesirable amount of time until a pharmacy receives the prescription, searches and obtains the drug, and dispenses the prescription, all while simultaneously updating a patient's medical record.

The steps that have been taken m the industry to address these problems are not convenient for the physician and are not integrated to provide a streamlined and automated electronic encrypted prescription filling and retrieval system.

The present invention overcomes the shortcomings found m the prior art by providing a unique electronic prescription filling system which allows the physician to utilize a hand-held Personal Digital Assistant (PDA) , allowing him to choose from a variety of specific drugs particular to that physician's specialty and broad enough to meet the patient's needs, to enter the prescription which automatically updates the patient's medical history, to transfer the prescription to a remote, prescription- filling service, which immediately and automatically dispenses the medication directly to the patient, or, m the alternative, notifies a local pharmacy informing it that a prescription has been entered and needs to be filled. If the prescribing physician has contracted with the fulfillment facility, the net prescription, meaning the total dosage less whatever drug amount supplied by the physician, will be fulfilled and shipped or mailed directly to the patient.

BRIEF SUMMARY OF THE INVENTION The present invention provides an automated electronic prescription filling system allowing physicians to prescribe medication m an easy, accurate, and safe manner, and providing the patient with medication quickly and without delay.

In the preferred embodiment, a physician is provided with a Personal Digital Assistant or PDA. The physician is prompted to enter his or her individual identification code. Once the physician is authorized, he will be asked to enter the patient ' s name and/or I.D. code, usually the patient's social security number. The access information is then sent to a host computer, preferably the physician's office computer, via either a wired or wireless connection. The office computer has all of the patient's relevant information stored m its memory. The physician then chooses which portions of the patient's record he wishes to see. This information is then sent back to the physician's PDA where it is displayed.

Once the patient has been identified and his or her current medical information has been displayed, the physician is now ready to examine the patient. After the examination, if the physician wishes to prepare a prescription, he may select a particular drug from a "pull down" menu of various drugs. The list of drugs exist m a database within the memory of the physician's PDA or, preferably the physician's office computer, where there is greater memory capacity. The various drugs have been pre-entered according to whatever drugs the physician may foresee dispensing as part of their practice. For example, a cardiologist may have access to a list of drugs relating to heart-related ailments, as well as other non-heart related medication which he may foresee dispensing to his patients. Once a drug has been selected, the physician refers to the "dosage" area of the PDA display. Here, he selects the proper dosage corresponding to the drug he has previously selected. From the "duration" display, the physician selects the number of days the patient is to take the prescribed drug. The PDA allow the physician to prescribe more than one drug to a particular patient, at the same time.

Once the physician has entered all of the required information, he "submits" the information, and the data is transmitted back to the physician's office computer and to the physical location where the prescription is to be filled. This location may be the remote facility that redirects the data to a dispensing pharmacy or it may be the fulfillment facility that is contracted with the physician to fill and ship the prescription directly to the patient.

In an alternate embodiment of the present invention, a patient's medical data can be accessed by the scanning or swiping of a bar-coded identification card carried by the patient or maintained m the physician's office. Upon a patient's visit, the card containing the patient's name, address, and identification number (i.e. social security number) can be scanned allowing the patient's medical records to be accessed for instant updating.

In yet another embodiment, a "smart card" containing the patient's medical records can be read and the information thereon accessed. A "smart card" is a small electronic device about the size of a typical credit card that contains electronic memory. The smart card may include an embedded integrated circuit. The card is inserted into a smart card reader which reads the information on the card and allows it to be accessed and updated.

Typically, a smart card contains considerably more information than a typical bar-coded card. A typical smart card would hold from 2 to 8 kB of information. In addition to standard patient information such as name, address, emergency contact, insurer and social security number, the card could hold such specific information as special medical alerts, allergies, current prescriptions and dosages, and an up-to-date patient history.

Once the patient and physician's identification numbers are entered, the information is transferred to the physician's office computer. The patient's records are then accessed and the encrypted data is transferred to and displayed on the PDA held m the physician's hand. By scrolling down through each field, the physician will then be able to see information such as the patient's name, address, emergency contact, and insurer; a case synopsis for that particular patient; medical alerts, the patient's allergies, current drugs being taken and their dosages; and the date, diagnosis and disposition of prior visits including the medications and dosages prescribed, if any.

For the patient's current visit, the physician can select the proper diagnosis code from the resident database of CPT and/or Medicare codes. The physician can enter specific characteristics of his diagnosis. Alternately, he can use a voice record option to create a digitized recorded voice diagnosis for later transcription. In all cases, the digitized data is encrypted for secure transmission. After the patient's visit and diagnosis, the physician will prepare the patient's prescription in the same manner as described m the preferred embodiment , above .

The physician has the option of generating either an office-filled prescription or a hard copy prescription. If an office-filled prescription is selected, the prescription data is transmitted to a remote contracted facility which passes the prescription directly to the patient, or m the alternative, to a participating pharmacy for fulfillment. If a hard copy is requested, a printer connected to the physician's office computer prints a completed prescription for the patient to take to their local pharmacy. The remote location which passes along the prescriptions to the pharmacies may also analyze the prescriptions for each patient, physician and diagnostic code. The remote location would then be able to compare individual prescription patterns to overall benchmarks based upon the participating population.

The present invention can be utilized outside of the medical prescription- filling industry. The same system can be used m other applications. For example, m the automotive industry, it is useful to access a car owner's information via a remote, hand-held PDA, update the car owner's car information after work has been done on the car, and transmit the information to a remote facility where such updates can be monitored and analyzed. The information can then be forwarded from the remote facility directly to the car owner for his or her records.

The present invention can be used m virtually any other business environment, such as inventory or quality control management, and financial services.

Accordingly, it is an object of the present invention to automatically access a patient's medical information prior to examining a patient, without having the physician refer directly to his office computer or to hard copy medical files.

It is another object of the present invention to provide a hand-held PDA which allows the physician to access and analyze patients' records from his office but while away from his desktop computer.

It is still another object of the present invention to provide a system which automatically updates a patient's medical records after the creation of each prescription.

It is another object of the present invention, to provide a means where prescriptions are entered electronically thereby eliminating the danger of misreading prescriptions and dispensing incorrect medications or dosages due to a physician's illegible handwriting.

It is still yet another object of the present invention to provide a system where a separate, remote facility, receives the electronic prescription, analyzes and verifies the prescription data, and transmits the prescription directly to a local, participating pharmacy thereby reducing or eliminating patient waiting time.

It is another object of the invention to transmit prescription data from a hand-held PDA to the physician's office computer via wireless communication means. It is another object of the present invention to transmit data from the physician's office computer to a remote prescription-fulfillment facility via the Internet.

It is still another object of the present invention to encrypt all transmitted prescription information. In yet another application of the present invention, a physician may dispense a portion of the prescribed drugs according to the amount of that particular drug the physician maintains m his office inventory while utilizing the present invention to supply and dispense the balance of the prescription to the patient.

It is another object of the present invention to provide an electronic prescription filling and transmission system which fully complies with local pharmaceutical and prescription dispensing laws.

It is yet another object of the present invention to reduce the cost of pharmaceuticals to the end user through the reduction of fulfillment and distribution costs.

In accordance with these and other objects which will become apparent hereinafter, the instant invention will now be described with particular reference to the accompanying drawings .

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS Figure 1 shows a block diagram of the preferred embodiment of the prescription dispensing system of the present invention.

Figure 2 shows a block diagram of an alternate embodiment of the prescription dispensing system of the present invention.

Figure 3 shows a typical screen layout of the hand-held PDA used m the present invention.

Figure 4 shows another screen layout of the hand-held PDA used m the present invention.

Figure 5 shows yet another screen layout of the hand-held PDA used m the present invention.

DETAILED DESCRIPTION OF THE INVENTION

Turning now to the drawings, FIG. 1 illustrates the basic components of the preferred embodiment of the present invention 10 including a Personal Digital Assistant (PDA) 20 to be held m the hand of a user such as a physician 21, the physician's office computer 30 connected to PDA 20 preferably located within the physician's office, and a remote prescription-fulfillment facility 40 connected via the Internet to the physician's office computer 30, wherein facility 40 dispenses the prescription to a patient 50.

PDA 20 is a handheld device that can include telephone, fax, computing and networking features. The typical PDA used here is a pen-based PDA, operated by a stylus, but could also be operated by a conventional keyboard. PDA 20 may include both handwriting and voice recognition features.

Data is programmed into the PDA's memory storage unit customized to that physician's anticipated pharmaceutical and medical needs. In this way, only those medications particular to that physician's anticipated medical needs are programmed into the PDA's memory, thereby resulting in greater efficiency m data entry.

Physician 21 is presented with a user interface on PDA 20 to enter patient and prescription data. A typical PDA display may be m the form of drop down lists, check boxes and keypads.

Standard HTML, C++, Java and VISUAL BASIC^* languages are used to fashion the user interface .

FIG. 3 shows a typical PDA display screen 31. This may be the initial screen seen by the physician. After connecting to computer 30, physician 21 must first identify himself as the one authorized to use PDA 20, by entering his or her identification number using the corresponding ID# Keypad 32 and PIN Keypad 33.

The physician then enters the number of a patient m order to access that patient's medical information. The patient's identification number is entered utilizing ID# Keypad 32 and PIN

Keypad 33- The patient's medical information resides within the memory storage device located m office computer 30.

FIG. 4 depicts PDA screen 45 after the patient identification number has been forwarded to computer 30 and the patient's records have been accessed. Here, the patient's name, "John Doe, Jr.", appears m the Patient Information Box 41. Patient Diagnosis Box 42 informs the physician that he is now connected to computer 30, informs him when he last requested information and provides the patient's diagnosis history.

FIG. 5 shows PDA screen 55 which provides the physician with the dates of the patient's recent visits 51. The physician can select any of these dates and a screen will display the details relating to that particular visit. One or more scroll - down menus which allow the physician to choose from a variety of medications 52, dosages 53 and prescription durations 54. Physician 21 can simply select the proper medication, dosage, and the length of time to take the medication from the scroll down menus, and this information is forwarded to computer 30 and, m turn, to facility 40 which ultimately dispenses the prescription to patient 50.

In an alternate embodiment, the prescription information can be entered directly from office computer 30. Referring once again to FIG. 1, PDA 20 accesses information stored m computer 30 via either a wire connection 22 or via a wireless RF connection 23. Prescription-fulfillment facility 40 is contracted with the physician to dispense prescriptions. Facility 40 monitors the communication and transfer of information between PDA 20 and computer 30 and dispenses the electronic prescription for delivery to patient 50. This streamlined process eliminates patient waiting time at pharmacies, provides up-to-date information to the physician, and eliminates the dangers associated with the mis-readmg of illegible prescriptions.

FIG. 2 shows an alternate embodiment of the present invention where facility 40 forwards the prescription information to a contracted prescription-dispensing facility such as a pharmacy 46 which dispenses the prescription to patient 50.

Once supported by the PDA HTML standard, a Java, C++, or VISUAL BASIC application is created to provide a tree structure for the drug database that resides m PDA 20 or on office computer 30. Portions of the data entry interface is coded in C++ or VISUAL BASIC for Windows CE . Inputted information can be stored locally m PDA 20 using a PDA version of a database system, and on office computer 30 using database systems such as ORACLE^", SQL SERVER^*, or ACCESS^" . The application includes the ability to store signatures input live by the physician right on the PDA display.

Because memory m PDA 20 is limited, transactions between PDA 20 and office computer 30 which have been successfully transmitted are forwarded to the recycle bin where they can be discarded. The available memory of PDA 20 is constantly monitored, and at a certain threshold, the user is prompted to delete transmitted items from the local system. As an added feature, the user has the option of keeping a transmission log which can be periodically uploaded to office computer 30. Transactions are stored locally m the prescription database m PDA 20, and earmarked for transmission to office computer 30. These transactions are transmitted to computer 30 where they are processed by a dedicated server application. The server application is written using an Internet Information Server (IIS) compliant Application Program Interface (API) using C++ and/or VISUAL BASIC^' to allow for flexibility. Core routines handle communications between the server and the PDA while maintaining synchronization management. Routines responsible for data encryption are also written m C++ and/or VISUAL BASIC".

The server application is responsible for storage of data on office desktop computer 30 and for transmitting the data to remote prescription- forwarding facility 40. Upon successful completion of a data transfer, a record will indicate that the data was successfully transmitted. Source markup language files can be encrypted to protect the proprietary data. A list of successful transactions can be displayed. A feature is provided to permanently prohibit transmission of unwanted or erroneous communications. Reports can be created listing all of the transactions and compiling aggregate statistics of the data.

The present invention includes a daemon application that captures completed transactions and stores them m a master database. The application is also written in IIS compliant API using C++ and/or VISUAL BASIC . A daemon is a process that runs in the background of another application and performs specified operations at predefined times or in response to certain events. The successful transactions captured by the daemon application are sorted by patient and physician and stored in a database similar to that used in the PDA-desktop computer interface. The appropriate prescription-fulfillment facilities are notified via email and are sent the posted transactions. The host, i.e. the physician, or the physician's office, receives an acknowledgement that such a notification has occurred.

Load balancing software will take into account the load experienced by a server receiving a request. A decision will subsequently be made as to whether to pass the transactions on to a machine less taxed. The database accessed by the daemon application will be based on the latest MICROSOFT^" SQL Enterprise Server product to provide the greatest proficiency at high server loads and will be modified and upgraded as necessary to take advantage of the newest and best available technology.

The transmission of patient and pharmaceutical information raises the issues of confidentiality and legal compliance. Consequently, the present invention provides for the security of transmissions via encryption techniques. However, wire transfers of information between the PDA and the server pose inherent encryption obstacles given the processor limitations on the handheld PDA. Wireless, RF transmissions can also be easily intercepted.

To address these issues within a modern cryptographic context, the present invention utilizes a public key encryption to transmit a universal secret key and thereafter to use both private and public key encryption methods, without having to resort to unmanageable key lengths. The dual methods of cryptographic protection provide enhanced security to all data transmissions. Further, the theft of one unit does not compromise the other units. RSA encryption technology may be licensed and utilized, while being supplemented by a private key encryption methodology.

The instant invention has been shown and described herein m what is considered to be the most practical and preferred embodiment. It is recognized, however, that departures may be made therefrom within the scope of the invention and that obvious modifications will occur to a person skilled m the art.

Claims

CLAIMSWhat Is Claimed Is:

1. An automated electronic prescription dispensing and filling system, said system comprising: a first computer with memory storage means capable of storing information regarding prescription drugs, dosage of said drugs, and duration of consumption of said drugs; a second computer with memory storage means, said second computer connected to said first computer via communication means; means for accessing a patient's medical records, said records stored m said second computer ' s said memory storage means ; display means available on said first computer; selection means available on said first computer allowing a user to select one of said prescription drugs, amount of said dosage, said duration of consumption, and said medical records appearing on said display means; updating means available on said first computer to allow said user to update and revise said information and said medical records ; and a remote facility including means for receiving and monitoring said communications between said first and said second computers wherein said remote facility dispenses said prescription to a patient.

2. The automated electronic prescription dispensing and filling system of claim 1 wherein said selection means is available on said second computer thereby allowing said user to select and update said information and said medical records from said second computer.

3. The automated electronic prescription dispensing and filling system of claim 1 wherein said accessing means comprises a bar-coded identification card containing basic patient identification information and a bar-code card reader.

4. The automated electronic prescription dispensing and filling system of claim 1 wherein said accessing means is a smart card containing detailed patient medical records and a smart card reader.

5. The automated electronic prescription dispensing and filling system of claim 1 wherein said information is customized to a particular physician's anticipated pharmaceutical and medical needs.

6. The automated electronic prescription dispensing and filling system of claim 1 wherein said first computer is a portable PDA capable of being held m said user's hand.

7. The automated electronic prescription dispensing and filling system of claim 1 wherein said communications means is by wireless RF transmission.

8. The automated electronic prescription dispensing and filling system of claim 1 wherein said means for receiving and monitoring said communications between said first computer and said second computer is via the Internet .

9. The automated electronic prescription dispensing and filling system of claim 1 wherein said selection means is a scroll -down menu.

10. The automated electronic prescription dispensing and filling system of claim 1 further comprising encryption means to provide enhanced security to said transmission of said information.

11. The automated electronic prescription dispensing and filling system of claim 10 wherein said encryption means comprises both private and public key encryption methods.

12. An automated electronic prescription dispensing and filling system, said system comprising: a first computer with memory storage means capable of storing information regarding prescription drugs, dosage of said drugs, and duration of consumption of said drugs; a second computer with memory storage means, said second computer connected to said first computer via communication means ; means for accessing a patient's medical records, said records stored m said second computer's said memory storage means ; display means available on said first computer; selection means available on said first computer allowing a user to select one of said prescription drugs, amount of said dosage, and said duration of consumption appearing on said display means; a remote facility including means for receiving and monitoring said communications between said first and said second computers and means to transmit said prescription; and a prescription-dispensing facility which receives said prescription from said remote facility for dispensing said prescription to a patient.

13. The automated electronic prescription dispensing and filling system of claim 12 wherein said prescription-dispensing facility is a pharmacy.

14. The automated electronic prescription dispensing and filling system of claim 12 wherein said accessing means comprises a bar-coded identification card containing basic patient identification information and a bar-code card reader.

15. The automated electronic prescription dispensing and filling system of claim 12 wherein said accessing means is a smart card containing detailed patient medical records and a smart card reader.

16. A method for electronically prescribing, dispensing and filling a prescription, said method comprising the steps of: allowing a physician to access a patient's medical records; providing a first computer with memory storage means capable of storing information regarding prescription drugs, dosage of said drugs, and duration of consumption of said drugs; providing a second computer with memory storage means, said second computer connected to said first computer via communication means; displaying said information on said first computer and said second computer; selecting, by selection means available on said first computer or said second computer, one of said prescription drugs, amount of said dosage, and said duration of consumption appearing on said display means; preparing an electronic prescription; updating said patient's said medical records ; transmitting said information, electronically, to said second computer; and providing a remote facility which includes means for receiving and monitoring said communications between said first and said second computers and further including means for dispensing said prescription to a patient or to a prescription- fulfillment facility such as a pharmacy.

17. An automated electronic information monitoring system, said system comprising: means for accessing an entity's records, said records containing information pertinent to said entity; a first computer with memory storage means capable of storing said information, said first micro-computer is portable and capable of being carried by a first user; a second computer with memory storage means, said second computer connected to said first computer via communication means ; display means available on sa d first computer and said second computer for displaying said information; selection means available on said first computer and said second computer allowing said first user to select one of said records ; means for encrypting said communications; and a remote facility including means for receiving and monitoring said communications between said first and said second computers wherein said remote facility transmits said communications and said information to a second user.