WO2012145789A1 - Gestion de médicaments - Google Patents

Gestion de médicaments Download PDF

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Publication number
WO2012145789A1
WO2012145789A1 PCT/AU2012/000432 AU2012000432W WO2012145789A1 WO 2012145789 A1 WO2012145789 A1 WO 2012145789A1 AU 2012000432 W AU2012000432 W AU 2012000432W WO 2012145789 A1 WO2012145789 A1 WO 2012145789A1
Authority
WO
WIPO (PCT)
Prior art keywords
medication
subject
packing
identifier
data
Prior art date
Application number
PCT/AU2012/000432
Other languages
English (en)
Inventor
Patrick Edward BANKS
Chen Chung LIAUW
Murray Robinson
Mark CASTON
Original Assignee
Svida Pty Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AU2011901559A external-priority patent/AU2011901559A0/en
Application filed by Svida Pty Ltd filed Critical Svida Pty Ltd
Priority to AU2012248118A priority Critical patent/AU2012248118A1/en
Publication of WO2012145789A1 publication Critical patent/WO2012145789A1/fr

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Classifications

    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
    • G16H20/13—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered from dispensers
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
    • B65B—MACHINES, APPARATUS OR DEVICES FOR, OR METHODS OF, PACKAGING ARTICLES OR MATERIALS; UNPACKING
    • B65B5/00—Packaging individual articles in containers or receptacles, e.g. bags, sacks, boxes, cartons, cans, jars
    • B65B5/10—Filling containers or receptacles progressively or in stages by introducing successive articles, or layers of articles
    • B65B5/101—Filling containers or receptacles progressively or in stages by introducing successive articles, or layers of articles by gravity
    • B65B5/103—Filling containers or receptacles progressively or in stages by introducing successive articles, or layers of articles by gravity for packaging pills or tablets
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
    • B65B—MACHINES, APPARATUS OR DEVICES FOR, OR METHODS OF, PACKAGING ARTICLES OR MATERIALS; UNPACKING
    • B65B57/00—Automatic control, checking, warning, or safety devices
    • B65B57/18—Automatic control, checking, warning, or safety devices causing operation of audible or visible alarm signals
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
    • B65B—MACHINES, APPARATUS OR DEVICES FOR, OR METHODS OF, PACKAGING ARTICLES OR MATERIALS; UNPACKING
    • B65B65/00—Details peculiar to packaging machines and not otherwise provided for; Arrangements of such details
    • B65B65/08—Devices for counting or registering the number of articles handled, or the number of packages produced by the machine
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
    • B65B—MACHINES, APPARATUS OR DEVICES FOR, OR METHODS OF, PACKAGING ARTICLES OR MATERIALS; UNPACKING
    • B65B67/00—Apparatus or devices facilitating manual packaging operations; Sack holders
    • B65B67/02—Packaging of articles or materials in containers

Definitions

  • the present invention relates to a method and apparatus for managing medication for a subject including a method and apparatus for packing medication for a subject.
  • the present invention seeks to provide a method of packing medication for a subject, the medication being packed into packaging including a number of receptacles for receiving medication, the method including, in a packing station:
  • the method includes, in the packing station, providing the indication of a receptacle by selectively illuminating the receptacle.
  • the method includes:
  • the packing station includes a processor, and wherein the method includes, in the processor, selectively activating the radiation sources in accordance with the packing data.
  • the indication of a medication includes an image of the medication.
  • the method includes:
  • the method includes:
  • the method includes:
  • the method includes, in the packing station, determining when a medication has been packed in accordance with input commands from a user. [0013) Typically the method includes, in the packing station:
  • the packaging includes a visual indicator of when medication in each receptacle should be administered.
  • the method includes sealing the packaging.
  • the packaging includes a base defining the number of receptacles and a cover layer, the method including sealing the packaging by applying the cover layer.
  • the cover layer includes a visual indicator of when medication in each receptacle should be administered.
  • the packing station communicates with a base station via a communications network to thereby determine the packing data.
  • the method includes:
  • the method includes, using a display to display at least one of:
  • the method includes, in the packing station:
  • the present invention seeks to provide apparatus for packing medication for a subject, the medication being packed into packaging including a number of receptacles for receiving medication, the apparatus including a packing station that:
  • a) determines packing data indicative of medication to be packed for the subject; b) provides an indication of a medication to be packed;
  • c) provides an indication of a receptacle into which the medication should be packed, thereby allowing a user to pack the medication into the receptacle in the packaging.
  • the packing station provides the indication of a receptacle by selectively illuminating the receptacle.
  • the packing station includes an array of radiation sources, each radiation source corresponding to a respective receptacle.
  • the packing station includes a processor, and wherein the processor selectively activates the radiation sources in accordance with the packing data.
  • the packing station includes a housing having a recess for receiving the packaging, the recess acting as a guide to thereby align the receptacles with the radiation sources.
  • the apparatus includes a display for displaying the indication of a medication to be packed.
  • the indication includes an image of the medication to be packed.
  • the packing station includes a sensing device for sensing identifier data.
  • a) determines a medication identifier associated with a medication, the medication identifier being indicative of an identify of the medication;
  • the packing station includes an imaging device for imaging the packaging.
  • the packing station includes a processing system coupled to at least one array, each array including a plurality of radiation sources for selectively illuminating receptacles in packaging, and each array being used for packing medication in respective packaging.
  • the present invention seeks to provide a method of managing medication for a subject, the method including, in a processing system:
  • the method includes:
  • the method includes displaying an image of the subject to allow a user to visually confirm the identity of the subject.
  • the method includes allowing an action to be performed, the action including at least one of:
  • the method includes determining an action to be performed using at least one of: a) action data stored in a store, the action data being indicative of actions to be performed; and,
  • the method includes determining whether an action can be performed using at least one of:
  • the method includes displaying a representation including at least some of the subject details and medication details to allow visual inspection of the displayed subject and medication details.
  • the method includes displaying at least one of an image of the subject and an image of the medication to allow visual inspection of at least one of the subject and the medication.
  • the method includes:
  • the method includes recording at least one of:
  • a medication identifier indicative an identity of any medication.
  • the method includes determining a medication identifier associated with a medication, the medication identifier being indicative of an identify of the medication. [0044] Typically the method includes determining whether an action should be performed at least in part using the medication identifier.
  • the method includes confirming a medication is an assigned medication in accordance with the identity of the medication.
  • the method includes:
  • the method includes displaying an image of the assigned medication to allow a visual comparison to be performed by the user.
  • the method includes:
  • the approval request is indicative of at least one of:
  • the method includes:
  • the method includes: a) determining assigned medication at least in part using the medication data associated with a subject;
  • the medication is packed in packaging including a number of receptacles, and wherein the packing instructions are indicative of receptacles into which respective medication should be packed.
  • method includes, in the packing station, displaying an indication of a receptacle into which medication should be packed to a user thereby allowing the user to pack the medication in the receptacle.
  • the packaging includes a visual indicator of when medication in each receptacle should be administered.
  • the method includes ⁇ in a packing station, applying the visual indicator to the packaging.
  • the method includes determining an identifier by:
  • the method includes sensing identifier data using a sensing device.
  • the method includes retrieving an identifier from a store using the identifier data.
  • the method includes sensing subject identifier data based on at least one of: a) an identification tag; and,
  • the processing system includes a store, and wherein the method includes at least one of storing in and retrieving from the store, at least one of:
  • the store is at least one of a memory and a database.
  • the subject data is indicative of at least one of:
  • the medication data is indicative of at least one of:
  • the processing system includes an input device, and wherein the method includes receiving input commands from a user using the input device.
  • the processing system includes a processor, and wherein the processor executes instructions stored in a store to cause at least one action to be performed.
  • the processing system includes a display for displaying indications.
  • the method is performed at least in part using an end station, coupled to a base station, via a communications network.
  • the base station includes a processing system and a store.
  • the end station includes a processing system having a display.
  • the end station includes a sensing device for sensing identifier data.
  • the method includes, in the end station:
  • the method includes, in the end station:
  • the method includes, in the end station:
  • the method includes, in the end station:
  • the base station being responsive to the medication request to seek approval for the medication request from at least one user.
  • the method includes, in the base station:
  • the method includes, in the approver end station:
  • the method is performed using a base station coupled to a packing station via a communications network.
  • the method includes, in the base station:
  • the medication management method includes defining at least dose by: a) determining at least one assigned medication for a subject;
  • the method includes defining a dose administration plan.
  • the present invention seeks to provide apparatus for managing medication for a subject, the apparatus including a processing system that:
  • a) determines a subject identifier indicative of an identity of the subject
  • the apparatus includes an end station, coupled to a base station, via a communications network.
  • the base station includes a processing system and a store.
  • the end station includes a processing system having a display.
  • the end station includes a sensing device for sensing identifier data.
  • the apparatus typically includes a packing station coupled to the base station via a communications network.
  • Figure 1 is a flow chart of an example of a process for managing the medication of a subject
  • Figure 2 is a schematic diagram of an example of a distributed computer architecture
  • Figure 3 is a schematic diagram of an example of a processing system
  • Figure 4 is a schematic diagram of an example of an end station
  • Figures 5A to 5C are a flow chart of an example of a process for administering assigned medication to a subject
  • Figures 6A to 6C are a flow chart of an example of a process for assigning medication
  • Figure 7A is a diagram of a first example of a user interface for entering prescription details
  • Figure 7B is a diagram of a second example of a user interface for entering prescription details
  • Figure 7C is a diagram of an example of a user interface for use in defining a dose administration plan
  • Figure 8 is a flow chart of an example of a packing process
  • Figure 9 is a flow chart of an example of a method of packing medication.
  • Figures 10A and 10B are schematic plan and side views of an example of a packing station;
  • Figures IOC and 10D are images of a specific example of a packing station
  • Figure 1 1 is a flow chart of an example of a process for defining packing data
  • Figure 12A is diagram of a first example of a user interface for use in defining a package layout
  • Figure 12B is diagram of a second example of a user interface for use in defining a package layout
  • Figures 13A to 13C are a flow chart of a second example of a process for packing medication
  • Figure 14 is a flow chart of an example of a process for allowing a subject to review their medication.
  • a subject identifier is determined.
  • the subject identifier is indicative of the identity of the subject and can be of any suitable form depending on the implementation.
  • the subject identifier is a unique alpha-numeric code, or similar, which is associated with the subject, such as a healthcare number, a unique identifier assigned to the subject on admission to hospital, or the like.
  • this is not essential, and any identifier that allows the subject's identity to be uniquely determined, such as the subject's name or the like, could be used.
  • the subject identifier can be provided to the processing system by having a user enter the subject identifier via an appropriate user interface, or the like.
  • the subject identifier can be determined based on subject identifier data sensed by a sensing device, such as an imaging device, barcode reader, or the like.
  • the processing system uses the subject identifier data to determine the subject identifier, for example by decoding the subject identifier data using a decoding algorithm, or by retrieving the subject identifier from a store, such as a database, using the subject identifier data.
  • the subject identifier and subject identifier data may be the same. However, more typically, the subject identifier data is an encoded version of the subject identifier that is presented in a format capable of being sensed by the sensing device. Thus, for example, the subject identifier data can be in the form of barcodes, which may be sensed using a barcode scanner, radio frequency identification tags (RFID), which may be sensed using RJFID scanning technology, or the like.
  • RFID radio frequency identification tags
  • the subject identifier data may be biometric data representative of the identity of the subject.
  • biometric data may include finger prints, facial attributes, optical characteristics or any other physical attributes that may be used to identify a person. These attributes may be sensed using an image sensor or suitable biometric scanning device.
  • sensing identifier data can also be used for sensing identifier data.
  • a barcode scanner is used as the sensing device, this is for the purposes of illustrating a possible implementation of the sensing device, but it will be understood that any other sensing device may be used in a similar manner.
  • the subject identifier is used to access medication data, with this being used to determine assigned medication for the subject at step 120.
  • the medication data which is typically stored in a store, such as a database, includes details of assigned medication for each of a number of subjects. In particular, this can include information such as active, stopped, and pending medications, or the like, as well as details of the times and days that each medication dose needs to be given to the patient. This process therefore typically involves having the processing system access the medication data and then determine the medication data associated with the subject using the subject identifier and/or identity of the subject.
  • an indication of any medication assigned to the subject is provided to a user, for example by having the indication displayed on a display of the processing system.
  • the medication details can include an image, such as a photo of the relevant medication, thereby allowing this to be easily recognised by the user, so that when performing an action they can ensure this is performed using the correct medication, for example by performing a visual comparison with the displayed image.
  • the medication details can additionally or alternatively be printed as a medication chart, which is a recognised way of representing the active medications for a patient and corresponding scheduled administration times. Typically medication charts only show the medication details along with empty boxes for the nurse to fill out whenever the medication was given.
  • the system can print a medication chart that specifically shows what times the medications should be given.
  • the dose administration results it can print medication charts that show when the medication was or was not given. This information could also be used as an electronic medication chart displayed on a tablet/pad or bedside device.
  • the above described process can help avoid problems related to incorrectly providing medication to the wrong subject, which can in turn have a negative impact on the health of the subject.
  • This process is therefore of particular benefit in scenarios where medication is provided to a number of different subjects on a regular basis, such as in hospital wards, nursing homes, or the like. In such situations, it is easy for the individuals administering the medication to misidentify the medication that should be given to each individual.
  • this can help ensure that the medication is administered correctly, particularly when the subject identifier is determined based on identifier data received from a sensing device.
  • the above described process also allows other actions associated with the management of medication, such as assigning or altering prescription of medication, entering details of prescribed medications, assigning or altering assigned medications, packing of medication, or the like, to be performed easily using, or by updating, the stored medication data. It will be appreciated that in some examples, the actions can be performed by third parties. Thus, for example, prescribing of medication may need to be performed separately by a suitably qualified medical practitioner, such as a Doctor, pharmacist, or the like, with details of the prescribed medication being added to the system to allow this to be administered to a subject. A number of further benefits and applications will become apparent from the examples discussed in more detail below.
  • the process is performed at least in part using a processing system, such as a suitably programmed computer system. Whilst this can be performed on a stand alone machine, in one example, this is more typically performed by one or more processing systems operating as part of a distributed architecture. An example of a distributed architecture will now be described with reference to Figure 2.
  • a base station 201 is coupled via a communications network, such as the Internet 202, and/or a number of local area networks (LANs) 204, to a number of end stations 203, and optionally to packing stations 205, which will be described in more detail below.
  • a communications network such as the Internet 202, and/or a number of local area networks (LANs) 204
  • LANs local area networks
  • packing stations 205 which will be described in more detail below.
  • the configuration of the networks 202, 204 are for the purpose of example only, and in practice the base station 201 , end stations 203 and packing stations 205 can communicate via any appropriate mechanism, such as via wired or wireless connections, including, but not limited to mobile networks, private networks, such as an 802.1 1 networks, the Internet, LANs, WANs, or the like, as well as via direct or point-to- point connections, such as Bluetooth, or the like.
  • the base station 201 includes one or more processing systems 210 that can be used in the process of managing medication, as well as to allow for storing, accessing and updating of relevant data, which is typically stored in a database 21 1. Whilst the base station 201 is a shown as a single entity, it will be appreciated that the base station 201 can be distributed over a number of geographically separate locations, for example by using processing systems 210 and/or databases 21 1 that are provided as part of a cloud based environment.
  • the end stations 203 and packing stations 205 are typically used to allow remote interaction with the base station 201 , for example, to allow users to interact with data stored at the base station 201. Through the use of portable end stations 203 this allows the management process to be performed remotely to the base station 201 , allowing the medication management process to be performed in situ.
  • the management process is implemented at least in part using suitable medication management applications software. Whilst this can be executed by each end station 203, more typically this is hosted by one or more processing systems 210, with the end stations 203 being used to allow user interaction with the medication management software, via the communications networks 202, 204. Each end station 203 therefore typically executes applications software allowing communication with the medication management software, such as a browser application, or the like. However, this is not essential and any suitable arrangement may be used.
  • the processing system 210 includes at least one processor 300, a memory 301, an input/output device 302, such as a keyboard and/or display, and an external interface 303, interconnected via a bus 304 as shown.
  • the external interface 303 can be utilised for connecting the processing system 210 to peripheral devices, such as the communications networks 202, 204, the databases 21 1, other storage devices, or the like.
  • peripheral devices such as the communications networks 202, 204, the databases 21 1, other storage devices, or the like.
  • a single external interface 303 is shown, this is for the purpose of example only, and in practice, multiple interfaces using various methods (e.g. Ethernet, serial, USB, wireless, mobile networks, such as 3G, 4G, GSM networks, or the like) may be provided.
  • the processor 300 executes instructions in the form of applications software stored in the memory 301 to allow the medication management process to be performed, or to provide access to any data required by the end stations 203.
  • the processing system 300 may be formed from any suitable processing system, such as a suitably programmed computer system, PC, web server, network server, or the like.
  • the base station 201 is implemented as part of a cloud architecture, and it will be appreciated from this that the processing system 210 can be a single processing system or multiple processing systems 210 interconnected by a computer network.
  • the end stations 203 include at least one processor 400, a memory 401 , an input/output device 402, such as a keyboard and/or display, and an external interface 403, interconnected via a bus 404 as shown.
  • the external interface 403 can be utilised for connecting the end station 203 to peripheral devices, such as a sensing device, the communications networks 202, 204, databases 21 1 , other storage devices, or the like.
  • peripheral devices such as a sensing device, the communications networks 202, 204, databases 21 1 , other storage devices, or the like.
  • a single external interface 403 is shown, this is for the purpose of example only, and in practice multiple interfaces using various methods (e.g. Ethernet, serial, USB, wireless, mobile networks or the like) may be provided.
  • additional hardware components such as a sensing device, may be incorporated into the end stations 203, depending on the particular implementation.
  • the processor 400 executes instructions in the form of applications software stored in the memory 401 to allow communication with the base station 201, to thereby perform aspects of the medication management process. For example, this can be used to allow an operator to interact with medication management applications software hosted by the base station 201 and/or to view or modify data, as will be described in more detail below.
  • the end stations 203 may be formed from any suitably programmed processing system, such as a suitably programmed PC, Internet terminal, laptop, hand-held PC, tablet, slate PC, iPadTM, mobile phone, smart phone, PDA (Personal Data Assistant), or other communications device.
  • one processing system configuration particularly well suited to an environment such as a hospital, nursing home, or the like will involve the use of end stations 203 in the form of portable hand-held devices, such as tablets and/or smartphones, in wireless communication with a base station 201.
  • Such wireless communications can include cellular networks, such as a mobile network, private networks, such as an 802.1 1 network, or the like.
  • This configuration allows users to conveniently access management functionalities remotely at the end stations 203 whilst performing their duties, but with storage and heavy processing tasks such as database queries being performed centrally at the base station 201.
  • the hand-held devices can include a combination of tablets and/or smartphones.
  • tablets can be provided associated with trolleys that are used for transporting drugs for administration around a ward, whilst smartphones are used by each user of the system, for example when interacting with the patient.
  • smartphones are used by each user of the system, for example when interacting with the patient.
  • the base station 201 is a cloud based server including the processing system 210 and database 21 1
  • end stations 203 are hand-held wireless devices that can display information to, and receive input from, a user via a touch screen based GUI.
  • the end stations 203 execute local application software to perform user interface functionalities such as presenting options to a user for selection by the user, receiving data input by the user and providing indications to the user.
  • the end stations 203 communicate wirelessly with the base station 201 to provide or receive instructions, requests, or data to the base station 201.
  • end stations 203 each include a sensing device, such as a barcode scanner or image sensor, which allows identifier data to be conveniently determined.
  • the identifier data can be in the form of a barcode, or any other unique means of identification.
  • a hand-held wireless end station 203 with a sensing device allows for the user to conveniently access the management functionalities with a high degree of portability.
  • a user selects an option displayed on the GUI of a hand -held end station 203, such as an option to administer medication. The user is then prompted to enter or use the sensing device to sense respective identifiers or identifier data as required.
  • the end station 203 is equipped with a sensing device, the user can simply sense corresponding unique identifier data, such as barcodes, to allow the identifiers to be easily determined.
  • the end station 203 then communicates with the base station 201 as required to retrieve data from the base station 201 or to request that the base station 201 performs processing, or the like.
  • the end station 203 may transmit the subject identifier to the base station 201 and request that the base station 201 provides an indication of the assigned medication.
  • end stations 203 may be provided as computer terminals to allow the use of other user interfaces, such as a keyboard and mouse, and the display of increased volumes of information to the user on a screen having a larger size than the hand-held devices, via a web interface, or the like.
  • a computer terminal of this type may be used to retrieve detailed reports on the history of actions performed, for example to view audit reports, perform stock audits, or the like.
  • such a computer terminal allows direct queries of the database 21 1 by the user.
  • a combination of hand-held devices and computer terminals may be used to allow the respective benefits or each type of end station 203 to be realised.
  • any appropriately configured end stations 203 may be used to deliver similar functionality, and these may be provided as off shelf devices such as mobile phones, PDAs, laptops, tablet computers or the like, or as custom-designed devices.
  • the partitioning of functionality between the end stations 203 and base station 201 may vary, depending on the particular implementation.
  • the end stations 203 may be simplified to provide a user interface only, and in this case the base station 201 may handle the majority of processing tasks.
  • the end stations 203 may be equipped with substantial processing power, such that the base station 201 merely acts as a database server for providing required information to the end stations 203 for remote processing.
  • a single processing system incorporating functionality of the end station 203 or packing station 205, and the base station 201 , may be used.
  • the medication management process is not particularly limited by the hardware implementation, and the skilled person will understand that variations in the processing system configuration will be possible.
  • the user uses a hand-held end station 203 and interacts with application software executed by the end station 203 via a touch screen based GUI, or the like. Actions performed by the end station 203 are performed by the processor 400 in accordance with instructions stored as applications software in the memory 401 and/or input commands received from a user via the I/O device 402. It will also be assumed that the hand-held end stations 203 include a sensing device for sensing identifier data. In particular, a barcode scanner will be used throughout the detailed examples, although it will be appreciated that any sensing device, such as a camera built into the hand-held device, along with appropriate image processing software, near-field RFID, or the like, can be used. Similarly, it will be appreciated that the use of hand-held devices is for the purpose of example only.
  • the base station 201 is a server which communicates with the hand-held end stations 203 via a wireless LAN, mobile networks, or the like, and the computer terminal end station 203 via a wired or wireless LAN, mobile networks, or the like, depending on the particular network infrastructure available.
  • the processing system 210 of the base station 201 hosts a medication management application that performs a majority of the processing tasks, with the end stations 203 being used primarily to provide the user interface. Actions performed by the processing system 210 are performed by the processor 300 in accordance with instructions stored as applications software in the memory 301 and/or input commands received from a user via the I/O device 302, or commands received from the end stations 203.
  • the user accesses the management application using the end station 203.
  • the user may be required to undergo an authentication process, for example by having the user supply a username and/or password, thereby allowing the medication management application to verify the user is authorised.
  • This can be used to prevent unauthorised access to information, such as subject and/or medication details, as will be appreciated by persons skilled in the art.
  • This can also be used to identify the user for other purposes, for example for auditing purposes, as will be described in more detail below, or for customising operation of the system, for example by customising the interface that is presented to the user.
  • This can allow the options presented to the user to be configured for that user, and the actions they may perform. For example, this allows the system to predict what ward to select for dose administration based on where the user works.
  • any suitable technique for identifying the user could be used.
  • an end station 203 such as a phone
  • gesture recognition can be used in which a user can draw a symbol and the system can recognise that the sequence and accuracy of symbol strokes entered matches a previously registered symbol for the user. This is particularly attractive for Asian cultures where a Chinese character can be used at the login.
  • the user can just enter a PIN using an onscreen numeric keypad. In both instances the user and end station 203 would have initially been paired (i.e. by entering a username and PIN, or a username and symbol on that end station 203).
  • the management application causes the end station 203 to display a list of available management actions at step 500, for example determined from action data stored in a store such as the database 210.
  • the action data is indicative of different actions that can be performed, such as administering medication, assigning medication, assigning a medication dose, approving medication and packing medications, and typically specifies a sequence of steps to be performed in order to allow each action to be completed.
  • the user selects an administer assigned medication option, with an indication of the selected action being provided to the management application implemented by the processing system 210.
  • the above described step may not however be required.
  • the processing system 210 may determine an action that the user needs to perform, such as dose administration, and cause this action to be automatically selected.
  • dose administration is being performed on a ward
  • the processing system 210 can automatically determine the ward and round based on the user who logged in and the time of day.
  • the management application prompts the user to use the end station 203 to sense subject identifier data, which in one example is provided on a tag worn by the subject, such as a wristband.
  • the tag includes a visual or other detectable representation of the subject identifier, such as a barcode, RFID tag or the like, allowing the end station 203 to sense the subject identifier, with corresponding subject identifier data being transferred to the processing system 210 at step 515.
  • This list contains the subject photo, name, ward, room, and bed and can be sorted by subject name, or by their room and bed numbers, or by the order in which they were previously dosed in the past, or by a preconfigured route through the ward.
  • the user can then select a subject directly from this list without having to use a search or barcode scanner.
  • the user can manually search for a subject based on their name. Accordingly, whilst the barcode scanner is particularly advantageous as it ensures the subject is correctly identified, alternative mechanisms to determine the subject identifier can be used.
  • the processing system 210 uses the subject identifier data to determine the subject identifier, and then uses this to access subject data and medication data for the subject at step 520.
  • the subject and medication data are typically stored in a store, such as the database 210, and is generally created during an initial set-up process.
  • the subject data can include, but is not limited to subject details, such as the subject's name, age, photo, medical history, details of any allergies, notes relating to administration of medication, details of the subject's location (eg: hospital and ward) or the like.
  • the medication data typically includes, but is not limited to, details of any assigned medications for the subject, together with associated dosing information.
  • subject data and medication data are typically stored together with the subject identifier of the associated subject, allowing the data to be accessed using the subject identifier. Whilst separate subject and medication data are described, this is not essential, and it will be appreciated that the medication data may form part of the subject data.
  • subject and medication details are transferred to the end station 203 allowing these to be displayed to the user at step 530, as part of a user interface.
  • the subject data is displayed, including the subject's photo, allergies and administration notes.
  • the user can continue or choose not to administer anything.
  • the photo of the subject is displayed to the user to allow the user to perform a visual comparison of the subject with the photo, thereby ensuring that the subject and medication details selected correctly correspond to the actual subject.
  • the above allows the user to view the subject details, such as the subject's medical records and details of any allergies, or the like, allowing the user to make an assessment if there is any reason why the medication should not be administered. This can include, for example, reviewing historical information, such as the amount of medication administered over the past 24 hours, the last time the medication was administered, or the like.
  • administration notes may also be displayed which give the user information on how to administer the medications. For example, an indication that "subject has difficulty swallowing" implies that the user may need to crush the tablets and mix in a glass of water, or possibly use a feeding tube.
  • the user can use the end station 203 to optionally sense medication identifier data provided on the medication, in a manner similar to that described above with respect to the subject identifier data.
  • the medication identifier data can be encoded on the medication in the form of a printed barcode, RFID tag or similar.
  • the medication identifier is a packaging identifier associated with a particular package of medication, such as a blister pack or pill box, including a number of different medications for administering to the user, as will be described in more detail below.
  • this can be determined using other techniques, such as manual input of the identifier by the user, or by having the end station 203 display a list of medications to be administered, allowing the user to select the relevant medication from the list.
  • sensing the identifier is generally preferred to ensure accuracy, it will be appreciated that other techniques for determining the identifier can be used.
  • the end station 203 transfers the medication identifier data to the processing system 210 at step 540, allowing the processing system to determine a medication identifier indicative of the identity of the medication at step 545.
  • the identity of the medication can be a medication type, however alternatively the identity can be uniquely indicative of a respective medication batch, or the like.
  • the user may scan a packaging identifier, which is then indicative of the multiple medications provided in the package.
  • the identity of the medication is compared to the medication assigned to the subject, as determined from medication data. This comparison can be performed either in the processing system 210 or the end station 203.
  • the comparison is used to ensure the medication is the assigned medication, and in the event that medication is incorrect, an indication of this is typically provided to the user in the form of an alert displayed on the end station 203, at step 560. In the event that this occurs, this allows the process to return to step 535, with the user selecting an alternative medication and repeating steps 540 to 555 until the correct medication is selected.
  • the above described process can be performed a number of times to allow all the relevant medications to be determined, so that these can be administered to the subject collectively.
  • the medication can be provided in a pack, such as a blister pack, so that the user need only scan the packaging a single time to determine a packaging identifier, which in turn allows all the relevant medications in the pack to be identified.
  • the medication details uploaded to the end station 203 can include the medication identifiers of the medications to be administered. Accordingly, this allows the end station 203 to perform the comparison itself, thereby avoiding the need for further communication with the base station 201.
  • the user administers the medications at step 565.
  • the user may make use of administration notes displayed to the user on the end station 203, as well as an image of the medication being administered. Again, this allows the user to visually compare the selected medication to the medication shown in the photo, allowing the user to assess whether the correct medication is being administered. It will be appreciated from this, that displaying a photo of the subject and the medication they are to receive can significantly increase the safety of the administration process, in particular reducing administration errors and the required skill level of the administration staff.
  • the administration notes can include a graphical representation of the blister pack, showing the respective receptacles within the pack within which the medication to be administered is provided.
  • the user can typically select each receptacle on the graphical representation, allowing the contents of each receptacle to be shown. This allows the user to identify the medication provided therein, which can be used for example to provide an indication of whether medication is taken, as described below.
  • the user can optionally provide an indication that the medication has been administered, for example by selecting an administration complete indication presented on the user interface by the end station 203.
  • the user may be required to initial or sign an administration record using an electronic signature capture system on the end station 203, thereby proving the medication has been administered.
  • the user may be presented with other options. This can include, for example, indicating if the wrong medication has been chosen, or allowing other actions to be requested, for example to allow an independent healthcare professional, such as a Doctor, to be consulted or to allow alternative medication to be assigned. It will be appreciated from this, that the workflow can therefore link with the workflows described in other flow charts as required.
  • this can be used to allow the user to indicate if a medication was not taken for any reason, or to indicate an actual dosage value that has been administered, for example if this differs to an intended dose (i.e. the patient was supposed to take two but only wanted to take one).
  • the end station 203 displays to a user all medications that are supposed to be administered to the subject.
  • the user can use the touch screen to selectively highlight any one of the medications. The user therefore highlights all the medications they are giving the subject and selects "done" to complete the process, and update the base station 201 accordingly. If any medications were not highlighted they will be prompted for a reason why that medication was not administered (e.g. refused, vomiting, etc.).
  • the end station 203 provides confirmation to the processing system 210, allowing the processing system to record that the medication has been administered at step 580.
  • the process of recording completion of the action can be performed by updating data stored in the database, such as the medication data, subject data or the like.
  • the process of recording completion typically involves recording details such as the action performed, a date or time at which the action was performed, the subject identifier of the subject, a user identifier indicative of an identity of the user performing the action and a medication identifier indicative the medication administered. It will be appreciated that any other relevant information may also be recorded.
  • an alert can optionally be sent to predefined recipient, such as a pharmacist, or predefined group of recipients, such as a pharmacy department, to notify them that a medication was not taken.
  • predefined recipient such as a pharmacist, or predefined group of recipients, such as a pharmacy department
  • the system can send an alert even if the user had not recorded that the medication was not administered, i.e. if the patient was missed or that round was missed and a specific period of time had elapsed, the system would automatically generate a missed dose alert.
  • Recording that medication has been administered (or has not been administered for any reason) is useful for auditing purposes, for example to determine the cause of an adverse reaction to medication, or the like. In particular, this can be used to generate reports, for example to view the dosing history or missed doses for individual patients, wards, or institutions. Usage reports can also show the total amount of medications administered to patients in comparison to medication supplied. Furthermore, records of administered medication can also be used for billing purposes, for example to bill users for medication.
  • Imprest medications typically exist in an imprest cupboard on the ward and are available to treat specific common conditions (e.g. vomiting), often a nurse is allowed to give an imprest medication without any prior entry into the system for that patient.
  • the system will present them with a list of on hand imprest items which the user can choose (or scan) which one to give and specify how much to give.
  • Some imprest items may be restricted to different user permission levels.
  • the above described process can be used to ensure that medication is administered to a subject as intended, for example by a medical professional thereby avoiding the problems associated with incorrect administration of medication to a subject. Additionally, details of the completed administering process can be subsequently reviewed as required, allowing the cause of any problems associated with the administering of medication to be identified, and subsequently addressed, for example by modifying the medication assigned.
  • the user initially accesses the management application using the end station 203, causing the end station 203 to display a list of available management actions at step 600.
  • the user selects an assign medication option, before sensing the subject identifier data, to determine the subject identifier at step 610.
  • the user can use the end station 203 to optionally sense medication identifier data provided on the medication, in a manner similar to that described above.
  • the user may identify the medication in some other manner, such as by inputting an indication of the identity of the medication via a suitable user interface, selecting medication from a list of available medication, or the like, as will be appreciated by persons skilled in the art.
  • the user will also typically provide additional information such as who initiated the new medication, route of administration (if not implied, e.g. intramuscular, subcutaneous), and dosing instructions.
  • the dosing instructions are an indication of when a particular dose of medication should be taken.
  • the dosing instructions are entered via a user interface that prompts the user to indicate the timing and dose.
  • Additional attributes that can also be optionally set include starting date, stop date, additional instructions (e.g. take with food), whether this is a PRN medication, whether it should be included in a blister pack, and the initial quantity on hand so that quantities can be tracked for reordering. Additionally, the user can specify whether the medication needs approval or already has approval, such as via an existing paper prescription.
  • the particular interface shown is for the purpose of example only, and is not intended to be limiting.
  • the interface is indicated to be for prescription entry, it will be appreciated that this is also for the purpose of example only and is not intended to be limited to prescribed medications.
  • the user interface can be used to enter details of an already prescribed medication, or to generate a request for a medication to be prescribed, or otherwise assigned to a subject.
  • the interface is intended for use with a subject that is a patient, this is again not intended to be limiting, and the term patient will therefore be understood to include any subject.
  • the user interface 700 includes an actions menu 710 including action icons corresponding to different actions that can be performed. This allows the user to select between different actions, such as assigning a medication, administering medications, packing medication, or the like.
  • the user interface 700 also includes a patient details window 720 which displays patient details for a currently selected patient.
  • patient details window 720 displays patient details for a currently selected patient.
  • a name, photo, age, height, weight and date of birth are shown, although this is not essential, and any suitable patient details may be displayed.
  • the user can then select a drug to be administered to the patient, either by entering details in a new drug window 730, or performing a search, for example from a list of available drugs. Alternatively the user may scan a medication identifier, as described above.
  • Information regarding assignment of the drug to the patient will then be displayed in the prescription window 740.
  • This can include any one or more of the current date, an indication of the start date on which medication is to be administered and optionally, a stop date and quantity to be supplied.
  • the name of the prescriber or initiator is also shown.
  • the prescriber could be the doctor that has previously generated the prescription being entered, or could be the initiator making the current request. If there is a previous prescription, this will include a unique "Rx" or prescription number, which can be entered by the user. Otherwise, an Rx number can be automatically generated by the processing system 210.
  • PRN dosing can be performed by selecting a PRN indication 741. It will be appreciated from this that the term prescription window applies equally to medication that is assigned but not necessarily prescribed, such as over the counter, herbal, traditional, alternative, and complementary medications.
  • Dosing information can then be entered via a dosing window 750.
  • the user can enter the dose, or number of capsules, in a dose field 751 and any repeat information in a repeat field 752.
  • a delivery route will typically be indicated in a route field 753 with any additional directions being specified in a field 754.
  • the dosing window 750 includes a dosing table 755 setting out when doses should be taken. In entering a dosage into the dosage table, the user can simply select an appropriate entry using the touch screen and then use appropriate inputs to increase or decrease the medication to be taken at the specified time.
  • directions for taking the medication, based on the entered information can then be generated automatically as shown at 758.
  • the user can then indicate using an approval window 760 whether approval is requested at 761, whether a paper prescription has previously been generated at 762, in which case approval is not required, or whether this is a non prescription drug request at 763, for example if the medication is over-the-counter, herbal, complementary, traditional, or the like.
  • the dosing information may be based on a previously issued prescription.
  • the dosing information can be proposed by the user, in which case this will typically have to be checked by a suitably qualified individual to make sure the proposed dosing is appropriate.
  • the dosing information can be interpreted by the processing system 210, and used to automatically set up the dose timings to be used during a packing process, described in more detail below, and by the above described administration process.
  • the end station 203 transfers a medication request to the processing system 210.
  • the medication request typically includes an indication of the subject identifier, and either the medication identifier, or an indication of the medication to be assigned, as well as additional information, such as dosing information, supplied as described above.
  • the processing system 210 access the subject data and medication data associated with the subject, using the subject identifier, allowing subject and medication details to be determined. [0188] At step 630, it is determined if approval for the medication and/or dosing has previously been provided. If so, then the process proceeds to step 670 to update the medication data associated with the subject. Otherwise, at least one approver is determined by the processing system 210 at step 635.
  • the approver is an individual that is authorised to approve the assigning of medication and may therefore be a medically qualified individual, such as a doctor, pharmacist, or the like.
  • approvers such as contact details including phone numbers, emails, addresses, or the like
  • contact details including phone numbers, emails, addresses, or the like
  • criteria specifying the type of approvals they are authorised to provide For example, the approver selected may depend on the subject to whom the medication is to be assigned, the type of medication or the like, thereby ensuring the approver is able to approve the assigning of the particular medication to the respective subject.
  • an approval request is transferred to the approver, for example by forwarding the approval request to an end station 203 used by the approver. This may occur for example by having an email or other notification transferred to the approver's end station 203, allowing the approver to access the management application and view the approval request.
  • the approver will typically need to undergo authentication, for example by providing a usemame and password, predetermined input gesture, PIN, or the like, in a manner similar to that described above.
  • the approval request typically includes any information required to prescribe, or otherwise assign, the medication to the subject, such as subject details, details of any existing assigned medications, subject symptoms, and details of the medication for which the current request is made.
  • this information may be made available by having the approver access this via the management application. In any event, this information allows the approver to ensure that the medication being requested is both suitable for the individual, for example taking into account the subject's medical history including allergies, symptoms, or the like, as well as to ensure it will not adversely react with existing assigned medications.
  • the approver reviews the approval request and assesses whether the medication is to be assigned. As part of this, at step 650, the approver may determine that additional consultation is required, in which case the approver will consult with one or more other individuals at step 655. This may be required, for example to allow the approver to consult with a pharmacist, specialist, or the like, to thereby ensure that assigning the medication is appropriate.
  • the approver provides an approval indication via their end station 203, together with any required dosing information, such as the dose, frequency and timing with which the medication should be administered, if this has not already been provided, or if this requires alteration.
  • the approval indication is transferred to the processing system 210 at step 665, allowing the processing system 210 to update the medication data associated with the subject at step 670. This ensures that when medication is administered to the subject in future using the process of Figures 5A to 5C, this is performed in accordance with the updated medication data, thereby ensuring the newly assigned medication is administered.
  • details of the completion of the approval process can also be recorded, for example by recording details of the user making the medication request, details of the approver, and any other relevant information. This again allows an audit trail of the assigning of medication to be established, allowing this to be reviewed in the event that any adverse outcomes are experienced.
  • a medication notification may be optionally sent to a pharmacist, for example by having the processing system 210 generate a prescription request, which can be electronically transferred to the pharmacist via an end station 203. This can be used to ensure that the medication is available the next time medication is to be administered to the subject. Similarly this notification may let the pharmacist know that they should access the management application and configure the dose timings, for example through the creation of a dose administration plan at step 680. As part of this process, the pharmacist will be authenticated by the system, for example by having the pharmacist provide a username and password, predetermined input gesture, PIN, or the like.
  • FIG. 7C An example of a dose administration plan is shown in Figure 7C.
  • the dose administration plan is presented by a user interface 700 including an actions menu 710 as in the previous example.
  • the dose administration plan interface includes a patient details window 720, showing details of a subject, such as a currently selected patient.
  • a medication window 770 is provided including a list of medications current assigned to the user at 771 , allowing the user to select a particular medication from the list 771 , with information regarding the selected medication being shown at 772. The user then determines when the medication is to be administered to the subject, and provides an indication by selecting a cell 781 in a dosing table 785 shown in a dosing window 780.
  • the dosing table 785 can be automatically populated, based on population of the dosing table 755 described above with respect to Figure 7A. In this instance, population of additional drugs can be performed, as well as altering the administration timing and/or dose of drugs, if required.
  • the dose administration plan is defined by the pharmacist in this example. This allows the pharmacist to take into account interaction between different assigned medications, as will be appreciated by persons skilled in the art. However, this is not essential, and alternatively, the dose administration plan can be defined by any suitably qualified user.
  • notifications may also be sent to other users at step 695, for example if they also choose to receive alerts when a specific patient's medications are changed, regardless of whether they need to perform any actions.
  • the medication is to be provided in a packaging that includes information indicating when medication is to be taken.
  • a packaging that includes information indicating when medication is to be taken.
  • This can be for example in the form of a blister pack, pill box, or other similar arrangement, which includes separate receptacles for different medications, and which includes indications indicating when the medications in each receptacle are to be taken.
  • This allows medications to be provided to the subject in accordance with a particular timing sequence, thereby allowing a subject to more easily adhere to a medication regime.
  • packing data is prepared.
  • the packing data typically specifies how the medication should be packaged in the packaging, and in particular specifies a receptacle within the packaging into which each type of medication is to be packed.
  • the packing data may be defined in any suitable manner, but typically involves using one of the processing systems 210, end stations 203 or a packing station 205, and optionally a dose administration plan, to define where in the packaging particular medications should be packed, thereby ensuring the are administered at an appropriate time.
  • the packing data is used to pack the medication into packaging, using one of the packing stations 205.
  • the manner in which this is performed will depend on the preferred implementation. For example, this could be performed automatically using a suitable packing machine. More typically however this is performed as a manual process, with a user being guided to perform the packing, as will be described in more detail below.
  • the packaging may optionally be checked to ensure packing has been performed correctly.
  • the packing is checked by an individual other than the packer to thereby help ensure that packing is correct. This is particularly important in the event that the user performing the packing at step 805 is a relatively unskilled worker, in which case oversight by medically qualified personnel may be mandatory, or at very least desirable, to ensure packing is error free, and to allow errors to be corrected as required.
  • the packaging is sealed, before being provided to a user or subject, thereby allowing the medication to be administered as part of the above described process at step 820. It will be appreciated that packaging may be sealed before or after checking, depending on the preferred implementation.
  • the packs may be prepared off site (e.g. at a pharmacy), in which case, the packs may then need to delivered. This is particularly feasible given the distributed nature of the architecture used, which allows data, such as dosing information or packing data to be transferred to a packing location, as required. Shipping of packaged medication can involve putting the packs in boxes, confirming shipment of the boxes, confirming receipt of the boxes at the facility, confirming receipt of the packs, or the like.
  • the packing station 205 determines packing data. Whilst this may be performed in any suitable manner, this typically involves retrieving previously generated packing data from a store, such as the database 21 1.
  • the packing data can be retrieved in any suitable manner, but can include, for example, sensing a packaging or subject identifier provided on the packaging, select from a list of packs to be packed, search for the subject by name and select from a list of packs, or the like.
  • the packing station 205 provides an indication of a medication to be packed.
  • the indication is typically provided to a user via a display, or the like, allowing the user to visually identify the medication, although any suitable technique may be used.
  • the indication of the medication can include an image of the medication, allowing visual confirmation by a user that the medication selected for packing is correct.
  • an indication of the receptacle into which the medication is packed can then be provided to the user, allowing the user to provide the medication in the correct receptacle.
  • This can be performed in any suitable manner, such as by having the packing station 205 present the indication on a display.
  • the indication is typically in the form of a representation of the packaging with a particular receptacle highlighted to thereby indicate the receptacle into which the medication should be packaged.
  • the above described process can therefore display an image of the particular medication to be packed, together with an indication of where the medication should be provided in the packaging. This allows the user to perform a visual comparison of the medication with the medication image, and the packing location with the packing indication. This significantly reduces errors associated with the packing process, and reduces the required skill of the packer. By reducing the skill required for mundane tasks, skilled staff are freed for tasks requiring decision making, or the like, thereby making the overall process more efficient.
  • the packing station 205 generally includes functionality similar to that of one of the end stations 203, and this will not therefore be described in further detail.
  • the packing station 205 includes an array onto which packaging can be positioned.
  • the array can be selectively illuminated to allow individual receptacles within the packaging to be identified, thereby allowing a user to ensure different medications are correctly provided into the correct receptacles.
  • An example of such a packing station 205 will now be described with reference to Figures 1 OA to 10D.
  • the packing station 205 includes a housing 1000 incorporating a display 1010, as well as a processor 101 1 , memory 1012 and an interface 1013, interconnected via a bus (not shown).
  • the packing station 205 also includes an array 1020, provided in an array housing, including a number of radiation sources, such as LEDs (Light Emitting Diodes) 1021 , although other sources of visible radiation can alternatively be used.
  • the array 1020 defines a recess 1022, which in use can receive packaging 1030, such as the base of a blister pack or similar.
  • the packaging 1030 includes receptacles 1031 , which when the packaging is positioned is in the recess 1001 align with the LEDs 1021 , so each LED 1021 can illuminate a respective receptacle 1031.
  • the array 1020 may also include an arm 1023 having an imaging device, such as a camera 1024, mounted thereon.
  • the camera is designed to allow the array 1020, and in particular the packaging 1030, to be imaged during the packing process, thereby allowing the packing process to be tracked.
  • the camera 1024 can capture a low resolution video throughout the whole packing process, with the camera taking a high resolution image when the user indicates that an individual medication has been packed, or when all packing is complete.
  • the process can store an image associated with a completed action, in this case packing of the medication, allowing this to be subsequent reviewed, for example to ensure the correct medication was indeed packed.
  • the video and the photos can also be used for auditing, training or the like.
  • the LEDs 1021 can be modulated to allow changes in an individual receptacle to be detected using the camera 1024. This can be used in conjunction with video processing technology to allow a degree of automated checking to be performed, for example to detect if filled receptacles should be empty, or vice versa.
  • the modulation of the LEDs 1021 can also be used to detect whether the user is somehow blocking the view of the pack so that the high resolution photo is only taken when all of the packaging receptacles are visible.
  • arrays 1020 can be wirelessly connected to the packing station 205, for example using Bluetooth or the like. Accordingly, it will be appreciated that the arrays 1020 may also include a processor, memory, and interface (not shown for clarity), to allow communication with the processor 101 1, as well as to allow commands provided by the processor 101 1 to be interpreted, and actions to be performed, such as illuminating respective LEDs 1021. It will be appreciated that in this example, as the LED array is connected via Bluetooth, the packing station can be implemented in the form of a standard hardware device, such as a suitably programmed smartphone, tablet/pad, or laptop which can connect to a LED array, thereby significantly reducing implementation costs.
  • a standard hardware device such as a suitably programmed smartphone, tablet/pad, or laptop which can connect to a LED array, thereby significantly reducing implementation costs.
  • a single packing station 205 can be used to control multiple arrays 1020, allowing the user to pack multiple packs at the same time. This can be used to allow multiple packs to be packed for a single subject, at the same time, which can be useful when using unit dose packs (i.e. one pack for breakfast, one pack for lunch, one pack for dinner, etc.), and which can also significantly increase the efficiency of the packer, for example by allowing multiple identical packs to be packaged simultaneously.
  • unit dose packs i.e. one pack for breakfast, one pack for lunch, one pack for dinner, etc.
  • the external interface 1013 can be utilised for connecting the packing station 205 to peripheral devices, such as a sensing device for sensing identifiers, the communications networks 202, 204, databases 21 1 , other storage devices, or the like.
  • peripheral devices such as a sensing device for sensing identifiers, the communications networks 202, 204, databases 21 1 , other storage devices, or the like.
  • a single external interface 1013 is shown, this is for the purpose of example only, and in practice multiple interfaces using various methods (e.g. Ethernet, serial, USB, wireless, mobile networks or the like) may be provided.
  • additional hardware components such as a sensing device, or camera 1024 may be incorporated into the packing station 205, depending on the particular implementation.
  • the processor 101 1 executes instructions in the form of applications software stored in the memory 1012 to allow communication with the base station 201, to thereby allowing the packing process to be performed. For example, this can be used to allow an operator to access packing data, view indications of medication to be packed on the display 1010, interact with medication management applications software hosted by the base station 201, or the like.
  • the processor 101 1 is adapted to control the LEDs 1021 , allowing the LEDs 1021 to be selectively activated in accordance with the packing data, thereby allowing the receptacles 1031 to be illuminated when medication is to be provided therein.
  • the functionality of the packing station 205 is broadly similar to that of the end stations 203, albeit with the addition of the array 1020. Accordingly, it will be appreciated that a packing station 205 can be formed from an end station 203 including, or otherwise in communication with, an array 1020, provided as a peripheral device. Thus, for example, the packing station 205 could include a tablet computer coupled to the array 1020, with the tablet providing processing and display functionality. Accordingly, the term packing station 205 will be understood to include an end station 203 with a peripheral array as required. Furthermore, where actions are described as being performed by an end station 203, it will be appreciated that these could also be performed by a packing station 205. [0229] The packing process will now be described in further detail with reference to Figures 1 1 and 12A and 12B. In particular, an example of the process for manually defining packing data will now be described with reference to Figure 1 1.
  • a user uses an end station 203, or packing station 205, to select a define packing data option, with an indication of the selected option being provided to the management application implemented by the processing system 210.
  • the user is typically required to undergo an authentication procedure to make sure the user is authorised to prepare the packing information, for example by providing a username and password, predetermined input gesture, PIN, or the like, in a manner similar to that described above..
  • the management application prompts the user to use the end station 203 to select a respective subject. Whilst this could be performed by sensing a subject identifier, as the subject may not present at this stage in the process, the user may alternatively simply select a user for example by accessing a list of available subjects, or by manually entering an indication of the subject identifier.
  • the processing system 210 access the subject's medication data to determine medication details, including any dosage plans, which are transferred to the end station 203 at step 1 1 15, allowing the end station 203 to display the medication details at step 1 120.
  • any additional available information such as existing packing data for the subject, as well as the pack template data that defines the types and layouts of the packs, would also be supplied.
  • the user selects a package layout and assigns medication to the receptacles.
  • the package layout shows the visual indications that will be provided on the packaging to be used, and this will typically include information regarding the time and date or day on which medication should be administered.
  • the package layout is divided into specific days (Monday, Tuesday, Wednesday etc) and times (breakfast, lunch, dinner and bedtime), however, other arrangement can be used.
  • the layout selected will depend on the particular circumstances.
  • the layout may be dictated by the preference of the administrating body, such as a nursing home or the like, and is generally related to the level of training available and the associated cost.
  • Highly trained homes prefer unit dose where each column is reserved for one medication and a pack represents the time of day resulting in more packs per patient, whereas less trained homes use multidose where each column represents the time of day and a whole pack can satisfy a week of medications.
  • a monthly pack where a pack represents a time of day like the unitdose pack, but the columns represent week one, week two, week three, week four. It will be appreciated that the user may define their own layout, or use pre-stored layouts retrieved from a store, such as the database 21 1 , as required.
  • the user interface 1200 includes an actions menu 1210 allowing different actions of the software system to be selected, as previously described.
  • a patient details window 1220 allowing different actions of the software system to be selected, as previously described.
  • a pack window 1230 allowing different actions of the software system to be selected, as previously described.
  • a medication window 1240 allowing different actions of the software system to be selected, as previously described.
  • a packaging representation 1250 allowing different actions of the software system to be selected, as previously described.
  • patient details will be automatically populated in the patient details window 1220.
  • a next particular pack of medication to be provided to the patient will be selected using the pack window 1230.
  • the medication window 1240 will then include a list 1241 of the different medications that are to be included in the respective pack with details 1242 of each medication also being shown.
  • the user can select a particular medication with an image of this being displayed.
  • the user can then select a cell 1251 in the packaging representation 1250, which corresponds to one of the packaging receptacles 1031.
  • the user can assign medication to particular receptacles 1031 in any suitable, manner, such as by dragging and dropping medication into a particular receptacle, or by providing a numerical value associated with a particular medication.
  • medications for the user can be assigned respective numerical values ("1", "2" etc) representing the quantity to be packed and administered, with the user simply entering these in the appropriate receptacle.
  • the user touches the cells to increase or decrease the value.
  • the user can increase or decrease the specified quantity of drugs to be included in the respective receptacle using the input buttons 1252.
  • using the lock toggle button and clicking on one cell 1251 can modify in an entire column of cells 1251 at once rather than an individual cell 1251, as this is typically how most medications are dosed.
  • the user can also choose to do special dosing like once per week, once every two days, once every three days, etc.
  • the above described process thereby provides a visual representation of the packaging, allowing the user to visualise the appearance of the final packaging, and in particular, the layout of medications within the packaging. This is in contrast to typical systems in which data is often prepared using input fields and the true layout is not known until the pack is printed.
  • This visualisation process can assist the user in ensuring that medication is laid out in an appropriate and accurate manner, thereby assisting in ensuring resulting packages can be easily used.
  • Figure 12B An alternative form of representation is shown in Figure 12B, which is designed to accommodate unit-dose packs.
  • the above described process can be used not only to define new package layouts, but also to schedule changes to packs.
  • many systems work off a current pack layout and it is up to the user to change the layout ready for the current week. However, if a medication starts in the middle of the week then continues for two weeks, the first week's pack will be half full, the second week's pack will be full, and the third week's pack will be half full.
  • the user would have to remember to change the pack layout each week, however by scheduling the changes each of the layouts can be defined at the time the medication was initiated.
  • the end station 203 At step 1 130, the end station 203 generates the packing data representing the packing layout, and including an indication of the visual indications that are to be printed on the packing, together' with a unique package identifier that is assigned to the package.
  • the package identifier can be a particular instance of a medication identifier and/or can be associated with multiple medication identifers, allowing the above described administering process of Figures 5A to 5C to be performed on the basis of the packaging identifier, to thereby ensure that the correct medication package is delivered to the correct subject.
  • the packing data is then transferred to the processing system 210 at step 1 135, allowing this to be stored for subsequent retrieval during the packing process, with the package identifier also being typically stored as part of the subject and/or medication data, to thereby uniquely associate the package with the subject.
  • this can be used to allow foil covers to be printed for use in the packing process. Whilst this may be performed on a pack by pack basis as part of the packing process, more typically this is performed as part of a batch process, with multiple foil covers being prepared and then provided for use in the packing process.
  • the user accesses the management application using the packing station 205 and selects a medication packing option.
  • the user is typically required to undergo an authentication procedure to make sure the user is authorised to prepare the packing information, for example by providing a username and password, predetermined input gesture, PIN, or the like, in a manner similar to that described above..
  • the user uses the packing station 205 to sense the packing identifier provided on the foil cover of the package to be packed.
  • the user can alternatively enter this information manually, or select from a list provided by the processing system 210.
  • the packing identifier is used to identify the package to be packed, and as an alternative the user can select a subject whose medication is to be packed. In one example, this can be achieved by sensing subject identifier data, for example from a box containing the subject's medications.
  • the user can simply enter details of the subject, such as the subject's name or identifier, or select the subject from a list of subjects, using a suitable user interface.
  • the processing system 210 may be used to schedule packing of medication, in which case, the processing system can simply select the next package to be packed automatically.
  • the packing identifier is transferred to the processing system 210, which uses this information to determine the associated packing data at step 1310.
  • the packing data is transferred to the packing station 205 at step 1320.
  • the automated packing system can then begin packing the medication in the packaging in accordance with the packing data, thereby ensuring that the medication is packed correctly.
  • the packing is performed manually. This is particularly relevant in a number of scenarios, for example in nursing homes, or the like, where the use of automated packing systems is unfeasible.
  • the packing station 205 determines the medications to be packed at step 1325, before displaying an indication of the medications to the user at step 1330.
  • the indication may be displayed in any appropriate manner, but will typically involve displaying details of the medication, such as a medication name and optionally other identifying information, such as an image of the medication, on a user interface presented on a display. This can be achieved for example by displaying information in a manner similar to that described with respect to the medication window 1240 of Figure 12A. It will be appreciated that at this stage, additional information, such as subject details or the like may also be displayed.
  • the user selects a next medication.
  • the user will typically sense the medication identifier associated with the next medication, using the sensing device at step 1340. This may be performed to allow the medication to be selected.
  • the next medication can be selected using appropriate input commands, for example based on manual selection from a list, or by selecting a "Next Medication” option which can be triggered by a capacitive button on the LED array, or similar, which will automatically select the next non-packed medication in the list.
  • the user may then sense the medication identifier data provided on the medication.
  • sensing the medication identifier from the packaging allows to the packing station 205 to compare the medication identifier of the selected medication to the assigned medication indicated in the medication data, thereby allowing a check to be performed to ensure the correct medication has been selected by the user, at step 1350.
  • step 1355 If it is determined that the selected medication is incorrect, an indication of this is displayed to the user at step 1355, allowing the process to return to step 1335, so that the user can selected the correct medication. It will be noted images of the medications are typically displayed to the user as extra confirmation for the user that the correct medication has been selected.
  • the packing station 205 displays an indication of the one or more receptacles in which the medication should be packed at step 1360. This can be displayed on a screen, such as the display 1010, or alternatively, as described above, can involve selectively activating the LEDs 1021 in the array 1020 to thereby illuminate the corresponding receptacles 1031 in the packaging. The user need then simply insert the medication into the indicated receptacles at step 1365, thereby ensuring the medication is correctly packed. [0257] A single medication can have multiple doses (e.g. 1 in the morning and 2 at night).
  • the user confirms the respective medication has been packed in the respective receptacles.
  • the processing system 210 can subtract the packed quantity from the quantity on hand for that patient so that system can know when to reorder medications.
  • the packing station 205 determines if all medication has been packed step 1375. If not, the process returns to step 1335 allowing a next medication to be packed. Otherwise, once all packing is completed, the packing station 205 can image the filled packaging using the camera 1024, allowing the image to be stored for subsequent review. This can be used to subsequently identify if incorrect packaging has occurred, which is useful for audit purposes or the like.
  • the image can be stored together with other information regarding the packing process, such as the time and date of packing, or the like.
  • the camera 1024 can be used to record low resolution video footage of the packing process and/or images each time a medication is packed, which can also be stored for subsequent review if required.
  • the packaging can be provided for verification at step 1380.
  • the verification process typically involves visual inspection by another user, such as suitably qualified pharmacist, or the like.
  • the verification process can be performed by illuminating all of the receptacles with white light so as not to obscure the colour of the medications themselves, allowing the pharmacist to more easily visually identify the packed medication, and confirm whether it is correct.
  • the verification involves two distinct phases which are combined as a linear process.
  • the user loads the pack and is presented with an initial screen that shows the pack and patient details.
  • the first phase of verification is then equivalent to the packing process where each dose is displayed individually, the difference is that the user does not select the medication rather the system goes through each medication sequentially.
  • the second phase is then a process of verifying combinations meaning that each can have a different combination of medication doses.
  • One of the checks can also include counting the number of empty receptacles. In both of these phases the user has the option to pass, fail, or fix the medications in that step. If one or more steps are failed, then the whole pack is considered to have failed checking. For unit dose packs there is no need to do combination verification (except for empty cells) as each column is dedicated to only one drug and so the first phase will cover this.
  • Verification is performed by someone other than the packer to thereby provide independent verification, with the verifier being an authorised user that is appropriately skilled to sign off on the packs.
  • the packaging can be again imaged by the camera 1024, with an image again being stored for example for subsequent review. Following this, the packaging is then sealed, although alternatively the pack can either be sealed before verification is performed, depending on the preferred implementation.
  • Sealing is typically achieved by applying the printed foil cover including the relevant visual indications.
  • the system can assist with the assembly phase by ensuring that the right foil and header card are used through barcodes scanning, and showing the user what colour folder to use, if any, and where to place any special stickers that may be required (e.g. start here, keep refrigerated, etc.).
  • the assembly phase is also tracked by having the user provide confirmation of completion of an action using the end station 203 or packing station 205. This allows the processing system 210 to track assembly of the packs, and in particular, where a batch and or pack is up to in its lifecycle.
  • the system can tell the user how many of each type of component is needed for the whole batch (e.g. 20 blue folders, 5 pink folders, and 2 purple folders). It will be appreciated that in the event that the foil cover has not been previously prepared, this can be printed by an appropriate printing device, at this time.
  • the next stage is the delivery of the packed medications to locations, such as healthcare facilities, for subsequent administration to subjects.
  • the delivery process broadly includes four different tasks, which are typically performed at different physical locations, with the process being tracked by having users enter details via an end station 203.
  • the first task involves putting the packs in boxes ready for shipping, with this being tracked by sensing a barcode on the box and each pack, allowing the processing system 210 to record which packs went into which box.
  • the second task is then shipping the boxes, with each box being scanned as it leaves the packing facility, to thereby record it is in transit.
  • the third step involves scanning the boxes as they arrive at the healthcare facility to record they have been received.
  • the fourth step involves scanning each pack as it is removed from the boxes.
  • alerts and reporting can be generated by the processing system 210, allowing users to identify if any boxes or packs have gone missing. It will be appreciated however that the delivery process is for the purpose of example only, and alternative delivery techniques may be used.
  • the medication is then administered as described above with respect to Figures 5A to 5C. Following this, empty packs may then be returned to the packing facility. Some of the components such as the coloured folders are reused, so tracking the returns helps to monitor stock levels. Additionally, some packs may be returned unused or partially used in which case the medications can also be returned to stock for the patient, helping to keep track of accurate quantities for individual patients. In situations where the dose administration system is not used, the return of unused medications can be a crude indication of a patient's compliance and can trigger missed doses alerts.
  • Each of the processes outlined above, including packing, verifying, fixing, assembly, delivery, and returns, are considered individual activities. Each activity would typically be performed as part of a batch process, and usually by different users. It will therefore be appreciated that for each activity, the user will be required to go through an authentication process before selecting the activity to be performed. Following this, the processing system 210 displays details of the respective medication pack, via the end station 203 or packing station 205, allowing the user to complete the activity for that pack. The processing system then records completion of the activity and loads details of the next pack, allowing the process to be repeated for the next pack in the batch.
  • each user may have their own limited view of a batch which shows the activities that have been assigned to them or can be performed by them. Multiple batches will be running concurrently as each batch will typically represent one healthcare facility for one week but typically takes longer than one week to complete (i.e. from ordering of new prescriptions through to return of used packs).
  • the above described process allows unskilled users to perform packing based on clear instructions and visual guides provided by the packing station, thereby reducing the likelihood of packing errors.
  • the accuracy of packing achieved using this process is further enhanced by requiring that each medication can be scanned before being packed, thereby reducing the likelihood of incorrect medication identification by unskilled workers.
  • the above described process guides users to accurately pack one or more blister packs at a time by displaying the details and image of the drug on screen in conjunction with illuminating the target receptacles in the blister pack.
  • the process reduces the chances of human error associated with such repetitive tasks by using barcode recognition, visual clues, and a well defined procedure. Additionally, by allowing independent verification to be performed using a systematic process, this can confirm that the correct drugs were packed into the pack, thereby simplifying the packing activity whilst reducing the chance of errors.
  • the above described process can also be performed using an end station 203, without a peripheral array.
  • the process is substantially as described above, however instead of illuminating specific receptacles using the array 1020, the end station 203 will merely display a representation of the package with the relevant receptacle highlighted. It will be appreciated that this allows the process to be used even in the event that an array is not available, thereby ensuring the packing process can be continued even in the event of hardware failure. It will be appreciated that in contrast, if hardware failure occurs with a robotic packing system, then typically it would not be possible to pack the medication.
  • the above described management system can also be used to provide subjects with access to their subject and medication data, for example to satisfy legislative requirements, as will now be described with reference to Figure 14.
  • the subject accesses the management application using an end station 203.
  • the subject will typically be required to provide authentication information, such as a username and password, predetermined input gesture, ⁇ , or the like, in a manner similar to that described above, including an indication of their subject identifier, or the like at step 1405.
  • This information is transferred to the processing system 210, allowing the processing system 210 to authenticate the subject at step 1410. It will be appreciated that this is performed to prevent unauthorised access to the subject data, and that as a consequence authentication failure will prevent the subject accessing the system.
  • the user selects a view details option, with this triggering the processing system 210 to access the subject and medication data for the subject at step 1420.
  • the subject and medication details can be transferred to the end station 203, allowing an indication of these to be presented to the subject at step 1430.
  • the user can also arrange these to be forwarded to an alternative location, such as an email address or the like, allowing the medical records to be more easily reviewed.
  • the system can provide translations of medication details so that they can be understood in other regions (e.g. the generic Paracetamol is known as Acetaminophen in the USA). Translations to other languages (e.g. English to Chinese) could be done on any patient or medication data.
  • the subject can optionally arrange for alerts to be generated by their end station 203 at step 1435.
  • the alerts can be generated in accordance with the medication data to indicate to the subject that medication is due to be administered. This is particularly useful in situations in which subjects are in charge of taking their own medication from a prepared package and can act to remind the subject that medication is due to be taken.
  • the subject allows the subject to review their own details including details of any assigned medications, which can be useful for example if the subject , is responsible for managing their own medication. Additionally, this can be used to allow the subject to update some details, such as personal information, thereby allowing the subject to ensure these are up to date, as well as allowing reminders to be generated, for example using a smartphone or the like, thereby ensuring adherence to medication regimes.
  • the above described system allows medication of a subject to be managed and accurately summarised for the subject. This process is particularly important in situations where access to medically trained personnel is restricted. In particular, the above described process provides sufficient oversight to allow medication to be administered by users that may have only limited or no medical qualifications.
  • the process provides an approval mechanism allowing a limited number of medically qualified practitioners, such as doctors, or pharmacists, to assign, manage and review medication for a greater number of subjects than would otherwise be possible if a face-to-face consultation were required.
  • the process can also be used to allow unskilled workers to package medication for subsequent self administration by subjects, thereby further reducing workloads on skilled professionals.
  • the system can provide significant benefits in terms of workforce optimisation to cope with workforce shortages and other associated issues.
  • the term assigned medication indicates any form of medication to be taken by a subject. This can include OTC (over the counter) or complementary and herbal medications, as well as prescribed medications.

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  • Bioinformatics & Cheminformatics (AREA)
  • Medicinal Chemistry (AREA)
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  • Medical Informatics (AREA)
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Abstract

L'invention concerne un procédé de conditionnement pour médicament pour un sujet, le médicament étant conditionné dans un conditionnement comprenant un certain nombre de réceptacles à des fins de réception du médicament, le procédé comprenant, dans un poste de conditionnement, l'étape consistant à déterminer les données de conditionnement indiquant le médicament devant être conditionné pour le sujet, l'étape consistant à procurer une indication du médicament devant être conditionné et, l'étape consistant à procurer une indication d'un réceptacle dans lequel le médicament doit être conditionné, pour ainsi permettre à un utilisateur de conditionner le médicament dans le réceptacle à l'intérieur du conditionnement.
PCT/AU2012/000432 2011-04-28 2012-04-26 Gestion de médicaments WO2012145789A1 (fr)

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US20170098060A1 (en) * 2015-10-05 2017-04-06 Cerner Innovation, Inc. Medication list generator
DE102017130111A1 (de) * 2017-12-15 2019-06-19 Multivac Sepp Haggenmüller Se & Co. Kg Verpackungsmaschine mit Visualisierung über eine Cloud
US10558201B2 (en) 2016-09-09 2020-02-11 The Procter & Gamble Company System and method for producing products based upon demand
US10613523B2 (en) 2016-09-09 2020-04-07 The Procter & Gamble Company Methods for simultaneously producing different products on a single production line
US10640354B2 (en) 2016-09-09 2020-05-05 The Procter & Gamble Company System and method for simultaneously filling containers of different shapes and/or sizes
US10643875B2 (en) 2016-09-09 2020-05-05 The Procter & Gamble Company System and method for simultaneously filling containers with different fluent compositions
US10640249B2 (en) 2016-09-09 2020-05-05 The Procter & Gamble Company Track system for creating finished products
US10796789B2 (en) 2015-12-04 2020-10-06 At&T Mobility Ii Llc Method and apparatus for initiating a medicine control action
CN114300156A (zh) * 2021-12-31 2022-04-08 浙江太美医疗科技股份有限公司 临床试验的受试者药物发放方法、装置、设备和存储介质
EP4001138A1 (fr) * 2020-11-23 2022-05-25 A.L.X.-Metall, Verpackungstechnik, Dipl.-Ing. Alexander Josek GmbH Appareil de scellage manuel à fonctionnalité étendue
US11584628B2 (en) 2016-09-09 2023-02-21 The Procter & Gamble Company System and method for independently routing vehicles and delivering containers and closures to unit operation systems

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Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20170098060A1 (en) * 2015-10-05 2017-04-06 Cerner Innovation, Inc. Medication list generator
US10867699B2 (en) * 2015-10-05 2020-12-15 Cerner Innovation, Inc. Medication list generator
US10796789B2 (en) 2015-12-04 2020-10-06 At&T Mobility Ii Llc Method and apparatus for initiating a medicine control action
US10640249B2 (en) 2016-09-09 2020-05-05 The Procter & Gamble Company Track system for creating finished products
US10640354B2 (en) 2016-09-09 2020-05-05 The Procter & Gamble Company System and method for simultaneously filling containers of different shapes and/or sizes
US10643875B2 (en) 2016-09-09 2020-05-05 The Procter & Gamble Company System and method for simultaneously filling containers with different fluent compositions
US10613523B2 (en) 2016-09-09 2020-04-07 The Procter & Gamble Company Methods for simultaneously producing different products on a single production line
US10558201B2 (en) 2016-09-09 2020-02-11 The Procter & Gamble Company System and method for producing products based upon demand
US11048243B2 (en) 2016-09-09 2021-06-29 The Procter & Gamble Company Method for producing different products on a single production line
US11584628B2 (en) 2016-09-09 2023-02-21 The Procter & Gamble Company System and method for independently routing vehicles and delivering containers and closures to unit operation systems
US11698626B2 (en) 2016-09-09 2023-07-11 The Procter & Gamble Company System and method for producing products based upon demand
DE102017130111A1 (de) * 2017-12-15 2019-06-19 Multivac Sepp Haggenmüller Se & Co. Kg Verpackungsmaschine mit Visualisierung über eine Cloud
EP4001138A1 (fr) * 2020-11-23 2022-05-25 A.L.X.-Metall, Verpackungstechnik, Dipl.-Ing. Alexander Josek GmbH Appareil de scellage manuel à fonctionnalité étendue
CN114300156A (zh) * 2021-12-31 2022-04-08 浙江太美医疗科技股份有限公司 临床试验的受试者药物发放方法、装置、设备和存储介质

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