US20200035344A1 - Medication preparation queue - Google Patents

Abstract

A system an method provides monitoring of an electronic data feed including data indicating medication orders, and provides, for display at an output device, an electronic virtual queue in which orders for medications to be prepared are listed and updated in real time based on changes from the electronic data feed. Information indicative of an order for medication for a patient from the electronic data feed is received based on monitoring the electronic data feed, and the system and method determines a position in a virtual queue configured to display multiple medication orders to be filled based a position associated with another medication having a same type or a same component as the medication, and provides, for display at the output device, the virtual queue and an indicator of the order for the medication at the position in the virtual queue among respective indicators of the multiple medication orders.

Description

CROSS REFERENCE TO RELATED APPLICATIONS
• This application is a continuation application of U.S. application Ser. No. 13/901,501, entitled “MEDICATION PREPARATION QUEUE,” filed on May 23, 2013, the entirety of which is incorporated herein by reference.
BACKGROUNDField
• The present disclosure generally relates to medication distribution, and, in particular, relates to systems and methods for managing preparation and delivery of a medication in a healthcare facility.
Description of the Related Art
• Certain pharmaceutical drugs are compounded to fit the needs of a patient. Compounding pharmacists combine or process appropriate ingredients using various tools to create a compounded pharmaceutical drug. For instance, compounding of sterile intravenous (IV) compounds can be done in anticipation of medication orders based on standard doses, or compounding can be done specific to a patient's need based on a physician order. Compounding may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a non-essential ingredient that the patient is allergic to, or to obtain the exact dose(s) needed of particular active pharmaceutical ingredient(s). It may also be done for more optional reasons, such as adding flavors to a medication or otherwise altering taste or texture. Compounding is most routine in the case of intravenous (IV)/parenteral medication.
• In cases of patients admitted to a healthcare facility, one or more medications for a patient or infusions to be administered to the patient are prescribed by the patient's physician. A pharmacy, generally located within the patient's hospital or healthcare facility, prepares the medication according to the physician's prescription, for example, in a cleanroom (e.g., an environment having a controlled level of contamination that is specified by a number of particles per cubic meter at a specified particle size). In cases where the medication is an infusion solution, an appropriately trained and credentialed pharmacist places the infusion solution in a bag, bottle, syringe, or other container and labels the container. The infusion solution is then commonly staged in a pickup location, such as a bin-sorting area. A sorting person is then responsible for placing each prepared medication into bins or delivery carts that correspond to the locations where the medications will be delivered, such as an Intensive Care Unit (ICU). A delivery person retrieves the medications from the bins that correspond to areas of the healthcare facility to which that delivery person delivers. The delivery person then delivers the medications to the appropriate locations of the healthcare facility.
• The medication is then delivered to the patient's location, and if the medication is an infusion solution, a clinician such as a nurse or other clinician hangs the infusion solution from a rack. The nurse connects a tube between the infusion solution and an infusion pumping system and inserts a cannula at the end of the tube into the vessel of the patient for delivery of the infusion solution to the patient.
SUMMARY
• According to certain embodiments of the present disclosure, a system for managing preparation of a medication for a patient, the system includes a memory that includes instructions, and one or more processors. The one or more processors is configured to execute the instructions to receive information indicative of an order for medication for a patient from an electronic data feed, and determine whether the order for medication for the patient can be filled with a returned (“retrieved” or “retrievable”) medication. The one or more processors is also configured to provide a notification to fill the order with the returned medication when the determination indicates the order can be filled with a returned medication, and provide a notification to fill the order by preparing the medication when the determination indicates a returned medication is not available to fill the order.
• According to certain embodiments of the present disclosure, a method for managing preparation of a medication for a patient is provided. The method includes receiving information indicative of an order for medication for a patient from an electronic data feed, and determining whether the order for medication for the patient can be filled with a returned medication. The method also includes providing a notification to fill the order with the returned medication when the determination indicates the order can be filled with a returned medication, and providing a notification to fill the order by preparing the medication when the determination indicates a returned medication is not available to fill the order.
• According to certain embodiments of the present disclosure, a machine-readable storage medium that includes machine-readable instructions for causing a processor to execute a method for managing preparation of a medication for a patient is provided. The method includes receiving information indicative of an order for medication for a patient from an electronic data feed, and determining whether the order for medication for the patient can be filled with a returned medication. The method also includes providing a notification to fill the order with the returned medication when the determination indicates the order can be filled with a returned medication, and providing a notification to fill the order by preparing the medication when the determination indicates a returned medication is not available to fill the order.
• According to certain embodiments of the present disclosure, a system for managing preparation of a medication for a patient is provided. The system includes a memory that includes instructions, and one or more processors. The one or more processors is configured to execute the instructions to receive information indicative of an order for medication for a patient from an electronic data feed, and determine a position in a virtual queue configured to display multiple medication orders to be filled based on at least one of an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. The one or more processors is also configured to execute the instructions to provide an indicator of the order for medication for display at the position in the virtual queue.
• According to certain embodiments of the present disclosure, a method for managing preparation of a medication for a patient is provided. The method includes receiving information indicative of an order for medication for a patient from an electronic data feed, and determining a position in a virtual queue configured to display multiple medication orders to be filled based on at least one of an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. The method also includes providing an indicator of the order for medication for display at the position in the virtual queue.
• According to certain embodiments of the present disclosure, a machine-readable storage medium that includes machine-readable instructions for causing a processor to execute a method for managing preparation of a medication for a patient is provided. The method includes receiving information indicative of an order for medication for a patient from an electronic data feed, and determining a position in a virtual queue configured to display multiple medication orders to be filled based on at least one of an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. The method also includes providing an indicator of the order for medication for display at the position in the virtual queue.
• According to certain embodiments of the present disclosure, a system for managing preparation of a medication for a patient is provided. The system includes a memory that includes instructions, and one or more processors. The one or more processors is configured to execute the instructions to receive information indicative of an order for medication for a patient from an electronic data feed, and determine whether the order can be filled with an available prepared medication or a returned medication. When the determination whether the order can be filled with an available prepared medication or a returned medication indicates a prepared medication or returned medication is available to fill the order, the one or more processors is configured to provide a notification to fill the order with the available prepared medication or returned medication, the notification including a pickup location at which the returned medication can be retrieved. When the determination indicates an available prepared medication or returned medication is not available to fill the order, the one or more processors is configured to provide a notification to fill the order by preparing the medication. The one or more processors is also configured to determine a position in a virtual queue configured to display multiple medication orders to be filled based on at least one of an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication, and provide an indicator of the order for the medication for display at the position in the virtual queue, wherein the indicator of the order for the medication is provided for display at a position in the virtual queue associated with another medication having a same type or a same component as the medication. The one or more processors is yet configured to receive an image or barcode identifying a component used to formulate the medication, provide the image or barcode to a person responsible for verifying the medication is filled using the component, and receive an input indicating the person has verified the medication has been filled using the component. The one or more processors is also configured to provide an indication that the order for the medication is ready for delivery to the patient.
• According to certain embodiments of the present disclosure, a method for managing preparation of a medication for a patient is provided. The method includes receiving information indicative of an order for medication for a patient from an electronic data feed, and determining whether the order can be filled with an available prepared medication or a returned medication. The method also includes providing a notification to fill the order with the available prepared medication or returned medication, the notification including a pickup location at which the returned medication can be retrieved when the determination whether the order can be filled with an available prepared medication or a returned medication indicates a prepared medication or returned medication is available to fill the order, and providing a notification to fill the order by preparing the medication when the determination indicates an available prepared medication or returned medication is not available to fill the order. The method further includes determining a position in a virtual queue configured to display multiple medication orders to be filled based on at least one of an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. The method yet further includes providing an indicator of the order for the medication for display at the position in the virtual queue, wherein the indicator of the order for the medication is provided for display at a position in the virtual queue associated with another medication having a same type or a same component as the medication, and receiving an image or barcode identifying a component used to formulate the medication. The method also includes providing the image or barcode to a person responsible for verifying the medication is filled using the component, receiving an input indicating the person has verified the medication has been filled using the component, and providing an indication that the order for the medication is ready for delivery to the patient.
• According to certain embodiments of the present disclosure, a machine-readable storage medium that includes machine-readable instructions for causing a processor to execute a method for managing preparation of a medication for a patient is provided. The method includes receiving information indicative of an order for medication for a patient from an electronic data feed, and determining whether the order can be filled with an available prepared medication or a returned medication. The method also includes providing a notification to fill the order with the available prepared medication or returned medication, the notification including a pickup location at which the returned medication can be retrieved when the determination whether the order can be filled with an available prepared medication or a returned medication indicates a prepared medication or returned medication is available to fill the order, and providing a notification to fill the order by preparing the medication when the determination indicates an available prepared medication or returned medication is not available to fill the order. The method further includes determining a position in a virtual queue configured to display multiple medication orders to be filled based on at least one of an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. The method yet further includes providing an indicator of the order for the medication for display at the position in the virtual queue, wherein the indicator of the order for the medication is provided for display at a position in the virtual queue associated with another medication having a same type or a same component as the medication, and receiving an image or barcode identifying a component used to formulate the medication. The method also includes providing the image or barcode to a person responsible for verifying the medication is filled using the component, receiving an input indicating the person has verified the medication has been filled using the component, and providing an indication that the order for the medication is ready for delivery to the patient.
• It is understood that other configurations of the subject technology will become readily apparent to those skilled in the art from the following detailed description, wherein various configurations of the subject technology are shown and described by way of illustration. As will be realized, the subject technology is capable of other and different configurations and its several details are capable of modification in various other respects, all without departing from the scope of the subject technology. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not as restrictive.
BRIEF DESCRIPTION OF THE DRAWINGS
• The accompanying drawings, which are included to provide further understanding and are incorporated in and constitute a part of this specification, illustrate disclosed embodiments and together with the description serve to explain the principles of the disclosed embodiments. In the drawings:
• FIG. 1 illustrates an example architecture for managing preparation of a medication.
• FIG. 2 is a block diagram illustrating an example client and server from the architecture ofFIG. 1 according to certain aspects of the disclosure.
• FIG. 3 illustrates an example process for managing preparation of a medication using the server ofFIG. 2.
• FIGS. 4A-4D are example illustrations associated with the example process ofFIG. 3.
• FIG. 5 is a block diagram illustrating an example computer system with which the client and server ofFIG. 2 can be implemented.
DETAILED DESCRIPTION
• In the following detailed description, numerous specific details are set forth to provide a full understanding of the present disclosure. It will be apparent, however, to one ordinarily skilled in the art that the embodiments of the present disclosure may be practiced without some of these specific details. In other instances, well-known structures and techniques have not been shown in detail so as not to obscure the disclosure.
• The disclosed system provides a virtual (e.g., electronic) queue in which orders for medications to be prepared (e.g., by a pharmacist) are listed and updated, in real-time, according to various factors, such as when an order is changed or discontinued. The orders are taken from an electronic data feed such as a Health Level 7 (HL7) feed. Data from the feed is processed in order to identify various aspects of each order to add to the virtual queue. The system then determines whether the order for the medication can be filled with an already prepared medication item or a returned or retrievable unused medication item, or whether the order should be filled by preparing a medication item. Appropriate instructions for filling the order are provided for display in the queue based on how the order can be filled. In certain instances, a notification or preferred retrieval route may be provided to a delivery person to retrieve a medication item if the retrievable medication item can be used to fill the order.
• The electronic data feed is monitored to update, in real-time, an order for a medication in the queue if, for example, a patient is discharged and the order for the patient is no longer needed. The queue will continually update based on changes from the electronic data feed. Thus, if an order is changed or discontinued, the entry for the order will be immediately updated in the queue. This will result in preventing a compound medication from being made that is no longer needed at that point in time, thereby preventing waste. This will also result in preventing a dispensing of a product out for delivery or finalized and ready for delivery that may no longer be needed by a patient. This will further result in decreasing inefficient use of labor, and keeping a prepared medication on hand to potentially be used for a new order coming in.
• Each order for a medication is placed at a position in the virtual queue based on various factors including, for example, an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. Two or more medication orders that require the same or similar medication components may be grouped together in the queue, for example, to avoid unnecessary wasting of the component. The disclosed system is also configured to capture images or barcode readings of each component used to prepare the medication for the order, and the images or barcode readings may be provided to a local or remote pharmacist or other authorized inspector for verification that the medication for the order has been prepared with the appropriate components. Upon verification, the virtual queue is updated to reflect that the order has been filled and that the prepared medication for the order may be retrieved for delivery to a patient.
• Turning now to the drawings,FIG. 1 illustrates anexample architecture100 for managing preparation of a medication according to certain aspects of the present disclosure. For ease and clarity of illustration only, without any intent to limit the scope of the present disclosure any way, it is assumed that the prepared medication provided as an example forFIG. 1 is an anesthetic IV solution.
• Thearchitecture100 includes apharmacy1 having amedication storage area10, a fill and/or preparation (fill/prep)area20, and a delivery pickup area30 (e.g., bin-sorting area). Themedication storage area10 includes a plurality of medications and supplies including, for example, an anesthetic drug (e.g., bupivacaine or chloroprocaine) and an appropriate fluid for the anesthetic drug. The anesthetic drug and the fluid are taken from themedication storage area10 to the prep/fill area20 where they are mixed together to produce the anesthetic IV solution. A patient/medication ID device72, such as a barcode label or a radio frequency identification (RFID) tag, is provided on (e.g., affixed to) a package70 (e.g., IV bag) containing the IV solution at the prep/fill area20. The patient/medication ID device72 includes patient/medication ID information indicative of the medication and the patient to whom the medication is prescribed. Thepackage70 is then taken by a technician at thepharmacy1 to thedelivery pickup area30. The technician determines an appropriate bin ordelivery cart90 into which to place thepackage70, and then loads thepackage70 onto theappropriate delivery cart90 for delivery to a scheduled delivery/drop location60 (e.g., a patient room) by adelivery person2.
• In the illustrated embodiment, the prep/fill area20 has abarcode reader24 provided therein that the technician at thepharmacy1 can use to read the patient/medication ID device72 (a barcode label in the illustrated example) before thepackage70 is taken to thedelivery pickup area30. The prep/fill area20 may also have animage recording device25, such as a camera, for recording preparation of thepackage70. Thedelivery pickup area30 has abarcode reader34 connected to aclient110 provided therein that the technician at thepharmacy1 can use to read the patient/medication ID device72 once thepackage70 is taken to thedelivery pickup area30. Thedelivery cart90 may also be provided with a location barcode label reader. Thedelivery person2 can use thebarcode reader34 to scan thepackage70 to indicate thedelivery person2 will begin delivery of thepackage70.
• Thepharmacy1 includes a server130 (e.g., pharmacy server) that includes aprocessor40. Theserver130 is coupled to anoutput device134, such as a display, and aninput device136, such as a keyboard. Theserver130 can be any device having an appropriate processor, memory, and communications capability for running a preparation tracking application and receiving, processing, and sending information associated with amedication database45 and prepared medications. Theprocessor40 is coupled to themedication database45 that is configured to store a variety of information. Themedication database45 can include information such as, but not limited to: the patient's name or ID, the medication name or ID, the scheduleddelivery location60, the scheduled delivery time, an expiration date or time for a prepared medication, an estimated administration time for the prepared medication, an urgency of delivery of the prepared medication, a current location of the prepared medication, an order status of the prepared medication, a return status of the prepared medication, one or more read locations where the medication/patient ID information and/or the location ID information was read by thebarcode scanner84, a time when the information was read, and the name or ID of thedelivery person2. Themedication database45 is configured to electronically provide and receive the information according to various interoperability standards, such as the HL7 standard, which can include data received from various medical devices such as an infusion pump. The electronic data feed providing the HL7 standardized data is different than a printer feed in which data is not provided for exchange, integration, sharing, and retrieval of electronic health information as with the HL7 standardized data. For example, the electronic data feed can include data formatted for the HL7 standard that indicates a current or past status of an infusion pump, respiratory device, dispensing machine, or other medical device.
• Theprocessor40 of theserver130 at thepharmacy1 is configured to electronically receive information from themedication database45 according to an interoperable standard such as the HL7 standard and process the information to identify one or many orders to be prepared in the prep/fill area20 of thepharmacy1. Theprocessor40 then determines whether each order can be filled using an available medication that has already been prepared (e.g., in the medication storage area10), a retrieved or retrievable medication that will no longer be needed by another patient, or whether the order must be filled by preparing a new medication. As such, theprocessor40 is configured to make the determinations in “real-time,” namely, substantially immediately in response to corresponding data from themedication database45.
• A medication may be retrieved by thedelivery person2 and returned to thepharmacy1. The retrieved medication may be scanned upon its return to thepharmacy1 and listed in an inventory of available retrieved medications. In certain aspects, the retrieved medication may be scanned when initially retrieved (e.g., but not yet returned to the pharmacy1) by thedelivery person2 and also be listed in the inventory of available solutions. If the retrieved medication has passed its expiration date, or is not within a threshold time duration of its expiration date, e.g., exceeding the amount of time required to deliver to and administer the retrieved medication at another location, then the retrieved medication is discarded. However, if the retrieved medication is not within the threshold time duration of its expiration date, the retrieved medication is re-entered into inventory for possible re-use.
• Theprocessor40 of theserver130 at thepharmacy1 provides appropriate notifications to anoutput device134 based on the determination whether each order can be filled using an available medication that has already been prepared, a retrieved or retrievable medication that will no longer be needed by another patient, or whether the order must be filled by preparing a new medication, including, for example, how the order should be filled, and a location of a retrievable medication that can be used to fill the order. For example, a notification can be displayed on theoutput device134 indicating that a retrieved medication for bupivacaine IV solution and be used to fill a new order for bupivacaine IV solution. In determining whether retrieved or retrievable medication can be used to fill the order, theprocessor40 is configured to calculate the expiration date of the retrieved or retrievable medication. The expiration date of the retrieved or retrievable medication is used to determine whether the retrieved or retrievable medication can be used to fill the order.
• Theprocessor40 is configured to determine an expiration date for a returnedpackage70 based on, for example, the stability and sterility of the returnedpackage70. Information indicative of the stability and sterility of the returnedpackage70 may be obtained from themedication database45. For example, the stability of the returnedpackage70, which indicates a length of time a drug in the returnedpackage70 retains its properties without loss of potency (i.e., “shelf life”) can initially be entered by a pharmacist or other health care provider when the returnedpackage70 is first prepared. The sterility of the returned package, which indicates the conditions in which thepackage70 was prepared (e.g., an environment particle count), can be determined based on a known location in which thepackage70 was prepared as stored in themedication database45. For instance, if the package returnedpackage70 is prepared in a sterile zone, it may be given a longer expiration time frame than if the returnedpackage70 were not prepared in a sterile zone. Theprocessor40, based on a stability date entered by a pharmacist and a sterility indicator calculated based on the known location in which thepackage70 was prepared, can then generate an expiration date for the returnedpackage70.
• In certain aspects where a retrieved or retrievable medication can be used to fill the order, an identification of the retrievable medication and of theretrieval location50 can be provided to aclient110 in or associated with thedelivery pickup area30 for display on anoutput device114 at or near thedelivery pickup area30 instructing thedelivery person2 to retrieve the retrievable medication from theretrieval location50. A route for retrieving the retrievable medication from the retrieval location50 (e.g., a patient room) may also be provided to theclient110 based on, for example, current deliveries being made by thedelivery person2. Theclient110 can be, for example, a computer system associated with thedelivery pickup area30 such as a desktop computer or mobile computer. Theclient110 can also be, for example, a tablet computer, mobile device (e.g., a smartphone or PDA), or any other device having appropriate processor, memory, and communications capabilities. Aclient110 that is a mobile device may, for example, be associated with thedelivery person2.
• Upon determining how the order from themedication database45 can be filled, theprocessor40 of theserver130 in thepharmacy1 provides an entry for the order for display on theoutput device134 of theserver130 and in a virtual queue of orders to be filled by thepharmacy1. The entry for the order is listed at an appropriate position in the queue among any other order(s) in the queue. The position of each order for a medication in the queue as determined by theprocessor40 may be based on, for example, an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to the delivery/drop location60, an estimated time at which the medication will be needed for administration to a patient at the delivery/drop location60, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. Two or more medication orders that require the same or similar medication components may be grouped together in the queue, for example, to avoid unnecessary wasting of the component used to prepare the medication.
• Records of the preparation of the medication for the order using one or more components is recorded and stored in themedication database45 for later verification by a pharmacist or other inspector responsible for authorizing the prepared medication as being ready for delivery to a patient. The records can include, for example, images or video recorded by theimage recording device25 or barcodes for the component(s) read by thebarcode reader24. The records may then be provided to the pharmacist for verification. Upon verification, thepackage70 prepared for the order is identified as prepared in the queue and ready for delivery to the delivery/drop location60 by thedelivery person2. At any time, if themedication database45 indicates that the order has changed, such as due to a status change of the patient for whom the order is written, the queue is automatically updated to modify or remove the listing for the order in the queue based on the change to the order indicated by themedication database45.
• Thedelivery location60 and/or theretrieval location50 can include, for example, patient rooms having an infusion device for providing an IV infusion from a package to a patient. In the illustrated example, theretrieval location50 and thedelivery location60 are provided withlocation barcode label52 andlocation barcode label62, respectively. Each of the location barcode labels52,62 includes unique location ID information indicative of therespective location50,60 where the corresponding barcode label is provided. As described above, the package70 (e.g., IV bag) containing the medication (e.g., IV solution) is provided with a patient/medication identification (ID)device72. In the illustrated example, the patient/medication ID device72 is a barcode label that includes patient/medication information indicative of the patient (e.g., “Jane Smith”) and the medication (e.g., “bupivacaine IV solution”). The patient/medication information may also contain other drug or patient related information such as the patient's medical conditions (e.g., allergies), name of the drug (e.g., bupivacaine), the drug dosage, the drug concentration, the drug administration schedules, and the drug administration rate.
• Also depicted in thearchitecture100 ofFIG. 1 is areader device84 that is hand carried by thedelivery person2 and/or attached to thedelivery cart90 and is configured to read the patient/medication information from the patient/medication ID device72 provided on thepackage70. In the illustrated example, thereader device84 is a barcode scanner. In those embodiments in which thebarcode scanner84 is hand carried by thedelivery person2, thescanner84 is also configured to read the location ID information from the location barcode labels52,62,92.
• In the embodiments described above, thelocation ID devices52,62,92 and/or the patient/medication ID device72 are passive ID devices, meaning that certain action (e.g., scanning) has to be taken by the participant (e.g., a pharmacy technician or the delivery person2) to retrieve information therefrom. In other embodiments, the ID devices can be active ID devices, meaning that the information retrieval from the ID devices occur automatically without an action taken by the participant. In some embodiments, the active ID devices can actively transmit signals containing the relevant information to thereader device84 through a wireless link. The wireless link can use a variety of technologies including Bluetooth, ZigBee, wireless USB, and proprietary systems. In other embodiments, the active ID devices do not themselves transmit signals, but respond to query signals generated by a reader device (e.g., by altering impedance of an RF circuit therein) as the reader device passes by the ID devices in close proximity.
• In the illustrated example, each time thebarcode scanner84 scans an ID device (e.g., patient/medication ID device or location ID device), the information read thereby is provided to themedication database45 via wireless transmission to awireless bridge50 that receives the information. Thebridge50 is in data communication with theprocessor40 via ahospital network150. Thenetwork150 can include, for example, any one or more of a personal area network (PAN), a local area network (LAN), a campus area network (CAN), a metropolitan area network (MAN), a wide area network (WAN), a broadband network (BBN), the Internet, and the like. Further, thenetwork150 can include, but is not limited to, any one or more of the following network topologies, including a bus network, a star network, a ring network, a mesh network, a star-bus network, tree or hierarchical network, and the like.
• Theprocessor40 is configured to receive medication/patient ID information and/or location ID information read by thebarcode scanner84, generate location, use, and re-use information therefrom. Theprocessor40 is configured to store the information in themedication database45.
• Thearchitecture100 further comprises trackingdevices120,152 that allow a care provider4 (e.g., a nurse assigned the task of administering the patient-specific medication to the patient) to monitor the progress of the delivery of the medication. Each of thetracking devices120,152 is configured to receive a tracking request by thecare provider4, access themedication database45, either directly or via theprocessor40, retrieve the delivery progress information stored in thedatabase45, and indicate a delivery progress of the medication to thecare provider4 based on the delivery progress information. In the illustrated example, thetracking device120 is an automated dispensing machine having a processor (not shown), adisplay121, and akeyboard123; and thetracking device152 is a mobile communication device (e.g., a cell phone, personal digital assistant (PDA), or pager) having a processor (not shown), a display151, and a keyboard153. The delivery progress information can inform thecare provider4 of a last-known read location and time of the last reading. Based on such information, thecare provider4 can decide, e.g., whether to wait for the delivery at thedelivery location60, go to the delivery location later at an expected delivery time, or go to the last-known location to retrieve the medication from thecart90.
• FIG. 2 is a block diagram200 illustrating anexample server130 andclient110 in thearchitecture100 ofFIG. 1 according to certain aspects of the disclosure. Theclient110 and theserver130 are connected over thenetwork150 viarespective communications modules218 and238. Thecommunications modules218 and238 are configured to interface with thenetwork150 to send and receive information, such as data, requests, responses, and commands to other devices on thenetwork150. Thecommunications modules218 and238 can be, for example, modems or Ethernet cards.
• Theserver130 includes aprocessor40, acommunications module238, and amemory232 that includes themedication database45 and apreparation tracking application234. Theprocessor40 of theserver130 is configured to execute instructions, such as instructions physically coded into theprocessor40, instructions received from software in memory240, or a combination of both. For example, theprocessor40 of theserver130 executes instructions from thepreparation tracking application234 to receive information indicative of an order for medication for a patient from an electronic data feed (e.g., medication database45) and determine whether the order can be filled with an available prepared medication or a returned medication.
• A determination whether an available prepared or returned medication can be used to fill the order can be based on, for example, a comparison between at least two of an expiration time of the available prepared or returned medication, an estimated amount of time for delivering the available prepared or returned medication to the delivery/drop location60, an estimated time at which the available prepared or returned medication will be administered to a patient at the deliver/drop location60, and a delivery deadline for the available prepared or returned medication.
• For example, if a returned medication is estimated to expire in ten minutes, and it is estimated to take thirty minutes to deliver the returned medication to the delivery/drop location60, then the determination may indicate that the returned medication cannot be used for completing the order of the other medication. As another example, if the order must be delivered to the delivery/drop location60 within two hours, and the estimated time to deliver an available prepared medication to the delivery/drop location60 is one hour, then the determination may indicate that the available prepared medication should be used for completing the order. As yet another example, if a returned medication is estimated to expire in one hour, it is estimated to take thirty minutes to deliver the returned medication to the delivery/drop location60, and the order must be delivered to the delivery/drop location60 within forty-five minutes, then the determination may indicate that the returned medication can be used for completing the order of the other medication.
• When theprocessor40 determines the order can be filled with an available prepared medication or a returned medication, theprocessor40 is configured to provide a notification to fill the order with the available prepared medication or returned medication. The notification can include, for example, an instruction to assist with preparation of the order using the prepared or returned medication. For instance, the notification can indicate that a returned medication should be combined with another returned medication to fill the order, and further indicate a pickup location (e.g., retrieval location50) at which the medication can be retrieved if it is not yet retrieved. As an example, if two returned medications are each for Cefazolin (2 gm/NS 50 ml), and a new order for Cefazolin (4 gm/NS 100 ml) is received by theprocessor40, then theprocessor40 can send a notification (e.g., to the output device134) indicating that the two returned medications of Cefazolin (2 gm/NS 50 ml) should be combined to fill the new order for Cefazolin (4 gm/NS 100 ml).
• Similarly, theprocessor40 may be configured to provide a notification indicating to proceed with completing the order when the determination indicates that a prepared or returned medication is not available for completing the order. For example, if the order for the medication must be delivered to the delivery/drop location60 within thirty minutes, and the estimated time to deliver a returned medication to the delivery/drop location60 is one hour, then a notification on theoutput device134 can indicate that the returned medication cannot be used for completing the order of the other medication. In certain aspects, the same notification or another notification can be provided by theprocessor40 indicating the returned medication is expired, or the returned medication will expire within a threshold time period. The threshold time period may be based on an expiration time of the returned medication and an estimated amount of time for delivering the returned medication to the delivery/drop location60.
• Theprocessor40 is further configured to place the order in a virtual queue of orders to be filled. The order for medication from themedication database45 is placed in a position in the virtual queue determined based on various factors. The factors affecting the position of an order for medication in the virtual queue include, for example, an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location (e.g., delivery/drop location50), an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication.
• The order may be listed by theprocessor40 at a position among other orders in the virtual queue where the order is provided with other orders of the same type (e.g., the same type of medication) or having a shared component. For instance, a new order for medication that requires a particular medication component for formulation can be grouped with other orders in the virtual queue that require the same particular medication component for formulation.
• Such component based aggregation of medication orders may allow a healthcare facility, such as a hospital, to substantially minimize the amount of medication that is wasted when component medications are picked, or retrieved, by a healthcare professional, for the purposes of preparing ordered medications. For example, theprocessor40 may provide, to a healthcare professional and for display on theoutput device134, an indication of a container, or a set of containers, which provides a sufficient amount of the component medication to prepare the orders while minimizing any excess amount of the component medication, e.g. any amount of the component medication that is left unused after the ordered medications are prepared. Theprocessor40 thus minimizes the amount of component medications that is wasted when ordered medications are prepared. For example, theprocessor40 may aggregate medication orders based on common component medications such that a healthcare professional can sequentially prepare ordered medications that have a common component medication. In this manner, the likelihood of any component medication being wasted, or expiring, is substantially minimized.
• Accordingly, theprocessor40 is configured to aggregate received orders into batches, or groups, e.g. based on the component medications that are indicated by each order for display in the queue. For example, theprocessor40 may batch the orders such that orders that have a common (e.g., the same) component medication are picked together. After batching the orders, e.g. based on the component medications, theprocessor40 may select the first batch of orders and determine the containers from inventory (e.g., in the medication storage area10) that should be picked to prepare the first batch of orders in a manner that minimizes wasted component medications. The containers may include vials, bags, bottles, packages, or generally any container that can store a component medication.
• Theprocessor40 of theserver130 is further configured to execute instructions from thepreparation tracking application234 to determine a first batch of orders and provide an indication of the component medications needed to prepare the first batch, the amount of the component medications that needs to be retrieved for the first batch, and the containers from inventory that should be retrieved for the first batch. For example, theprocessor40 may provide a user interface for display on theoutput device134 to assist a healthcare professional with picking the component medications for the first batch. The healthcare professional may retrieve the containers from the inventory of themedication storage area10 for preparing the first batch. For example, the healthcare professional may identify each container that is retrieved from inventory, e.g. by scanning the containers with abar code scanner24. Theprocessor40 may transmit indications of the scanned containers tomedication database45 and themedication database45 may store an indication that the containers are being removed from the inventory of themedication storage area10 and being delivered to a temporary inventory of the preparation/fill area20. The containers may then be delivered to the preparation/fill area20 for preparation of the first batch of orders.
• Theprocessor40 of theserver130 is further configured to execute instructions from thepreparation tracking application234 to receive an image or barcode identifying a component used to formulate the medication, and provide the image or barcode to a person, such as the pharmacist, responsible for verifying the medication is filled using the component. For example, during preparation of thepackage70, a technician may place each component medication used to formulate thepackage70 into a capture area of the prep/fill area20 where theimage recording device25 orbarcode reader24 can capture a record (e.g., image or barcode reading) of each component medication being used. Theprocessor40 is configured to receive an input indicating the person has verified the medication has been filled using the component, and provide an indication that the order for the medication is ready for delivery to the patient. For example, the image or barcode reading of each component medication used to formulate thepackage70 can be provided to a pharmacist in thepharmacy1 or remote from thepharmacy1 for review (e.g., as displayed on output device134) and verification (e.g., using aninput device136 of the server130) that the appropriate component medications were used to prepare thepackage70. Upon verification by the pharmacist, theprocessor40 indicates that the order is complete and that thepackage70 for the order is ready for delivery.
• FIG. 3 illustrates anexample process300 for managing preparation of a medication using theexample server130 ofFIG. 2. WhileFIG. 3 is described with reference toFIG. 2, it should be noted that the process steps ofFIG. 3 may be performed by other systems. Theprocess300 begins by proceeding from beginningstep301 when thepreparation tracking application234 is initiated to step302 when information indicative of an order for medication for a patient is received from an electronic data feed. Next, indecision step303, a determination is made whether the order can be filled with an available prepared medication. If the determination ofstep303 indicates that the order can be filled with an available prepared medication, theprocess300 proceeds to step305 in which a notification is provided to fill the order with the available prepared medication. If the determination ofstep303 indicates that a prepared medication is not available that can be used to fill the order, theprocess300 proceeds todecision step304 in which a determination is made whether the order can be filled with a returned medication.
• If indecision step304 it is determined that the order can be filled with a returned medication, theprocess300 proceeds to step306 in which a notification to fill the order with the returned medication is provided. The notification may include a pickup location (e.g., retrieval location50) at which the returned medication can be retrieved. If indecision step304 it is determined a returned medication cannot be used to fill the order, theprocess300 proceeds to step307 in which a notification to fill the order by preparing the medication is provided.
• Next, aftersteps305,306, or307, theprocess300 proceeds to step308 in which a position in a virtual queue configured to display multiple medication orders to be filled is determined based on at least one of many factors. The factors include an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. Instep309, an indicator of the order for the medication is provided for display (e.g., on the output device134) at the determined position in the virtual queue. The indicator of the order for the medication can be provided for display at a position in the virtual queue associated with another medication having a same type or a same component as the medication (e.g., as a grouping of medications of the same type or having the same component).
• Next, instep310, an image or barcode is received identifying a component used to formulate the medication, and instep311 the image or barcode is provided to a person, such as a pharmacist, responsible for verifying the medication is filled using the component. After receiving an input (e.g., usinginput device136 of the server130) instep312 indicating the person has verified the medication has been filled using the component, theprocess300 proceeds to step313 in which an indication that the order for the medication is ready for delivery to the patient is provided. The indication can be provided for display with the virtual queue displayed on theoutput device134, or can be provided for display on theoutput device114 of theclient110. Theprocess300 then ends instep314.
• FIG. 3 set forth anexample process300 for managing preparation of a medication using theexample client110 andserver130 ofFIG. 2. An example will now be described using theexample process300 ofFIG. 3, aserver130 that is a desktop computer, aclient110 that is a tablet associated with adelivery person2, and a new order to be filled for Cefazolin (2 gm/NS 50 ml).
• Theprocess300 begins by proceeding from beginningstep301 when thepreparation tracking application234 is initiated to step302 when a new order for Cefazolin (2 gm/NS 50 ml) for a patient inroom 5E-12 (i.e., the delivery/drop location60) is received from a hospital's HL7 feed. Next, indecision step303, a determination is made whether the order for Cefazolin (2 gm/NS 50 ml) can be filled with any available prepared medication. The determination ofstep303 indicates that a prepared medication is not available that can be used to fill the order for Cefazolin (2 gm/NS 50 ml), and theprocess300 proceeds todecision step304 in which a determination is made whether the order for Cefazolin (2 gm/NS 50 ml) can be filled with a returned medication. Indecision step304 it is determined that the order for Cefazolin (2 gm/NS 50 ml) can be filled with a returned medication, so theprocess300 proceeds to step306 in which a notification to fill the order with the returned medication is provided for display.
• Next, afterstep306, theprocess300 proceeds to step308 in which a position in a virtual queue configured to display multiple medication orders to be filled is determined based on at least one of many factors. The factors include an estimated amount of time to prepare the medication, an estimated amount of time to deliver the medication to a delivery location, an estimated time at which the medication will be needed for administration to a patient at the delivery location, a delivery deadline for the medication, a degree of urgency for delivery of the medication, a type of the medication, or a component of the medication. Instep309, an indicator of the order for the medication is provided for display (e.g., on the output device134) at the determined position in the virtual queue as provided in theexample illustration400 ofFIG. 4A. Specifically,FIG. 4A provides anexample illustration400 of a graphical user interface for displaying thevirtual queue403 andnotifications420 and422 on theoutput device134 of the pharmacy'sdesktop computer130. The graphical user interface includes an identification of thecurrent time402, 6:45 AM, and avirtual queue403 of50unchecked orders406 to be filled that may be sorted by, for example, priority, due time, location, type, medication component, or alphabetically, and may be searched using asearch interface404. Fiveorders408,410,412,414, and416 are listed and additional orders may be viewed by scrolling the interface below the five listedorders408,410,412,414, and416.
• For each order, a due time, patient location, medication information, level of priority, and return status may be indicated. For example, the first order listed identifies thenew order408 for Cefazolin (2 gm/NS 50 ml) received instep302 that is to be delivered topatient room 5E-12 by 8:00 AM. The indicator of thenew order408 for Cefazolin (2 gm/NS 50 ml) is provided at a first position in thevirtual queue403 because of the delivery deadline of 8:00 AM for the medication and the degree of urgency indicated as stat for delivery of the medication. The indicator of thenew order408 for Cefazolin (2 gm/NS 50 ml) is provided in the first position next to theother order410 for Cefazolin (2 gm/NS 50 ml), which is in the second position. The twoorders408 and410 are grouped together because they are medications that share medication components. If one of the twoorders408 or410 is selected, asecond user interface430 may be displayed as provided in the example illustration ofFIG. 4B.
• Theexample user interface430 includes aninformation display area431, and abatch display area432. Theinformation display area431 may display information regarding a selected order for a medication and/or a selected component medication. Thebatch display area432 may display batches of orders for medications that have been grouped together, e.g., based on a common component medication. In operation, theuser interface430 may be displayed on theoutput device134 in thepharmacy2 and particularly in themedication storage area10, e.g. to facilitate a healthcare professional with picking component medications in a manner that minimizes any wasted amounts of the component medications.
• Returning to theexample illustration400 ofFIG. 4A, the user interface also includes a messages area418 that identifies420 the new order for Cefazolin (2 gm/NS 50 ml) received instep302, but also includes thenotification422 ofstep306 to be read by the pharmacist filling the new order for Cefazolin (2 gm/NS 50 ml). Thenotification422 indicates to the pharmacist that an order for Cefazolin (2 gm/NS 50 ml) that has been returned from patient room 3NW-5 at 5:32 AM may be used to fill thenew order408 for Cefazolin (2 gm/NS 50 ml).
• In certain aspects where an already prepared but discontinued order is retrievable to fill the new order for Cefazolin (2 gm/NS 50 ml) received instep302 but not yet retrieved, the pharmacy'sdesktop computer130 may provide another notification to thetablet110 of adelivery person2 who is responsible for delivering and retrieving medications, such as infusion solutions, within a healthcare facility so that thedelivery person2 can retrieve the medication to fill the new order for Cefazolin (2 gm/NS 50 ml). Thedelivery person2 may thus be provided with a list of discontinued medications and their location in healthcare facility on theirtablet110. The list of discontinued medications provided to thetablet110 of thedelivery person2 can be ordered, for example, to identify an efficient route (e.g., based on distance, an urgency of retrieving a medication, etc.) for retrieving discontinued medications. In certain aspects, if the delivery person is delivering medications to a particular area of the healthcare facility, then the list of discontinued medications can be ordered based on the areas to which thedelivery person2 is delivering. Thedelivery person2 may then retrieve the discontinued medications and return them to a workroom in the pharmacy.
• FIG. 4C provides anexample illustration440 of thetablet110 displaying an efficient route for retrieving discontinued medications. Specifically, thetablet110 displays avisualization442 of a route by which to retrieve four unused medications and deliver two new medications. The visualization indicates acurrent location446 of thetablet device110 and the route, from thecurrent location446, to retrieve four unused medications and deliver two new medications. From thecurrent location446, the route proceeds448 to afirst location450 in which one medication is picked up and one medication is dropped off Next, the route proceeds452 to asecond location454 in which a medication is picked up. Thereafter, the route proceeds456 to athird location458 in which a medication is dropped off Afterwards, the route proceeds460 to afourth location462 in which two medications are picked up. The route then returns464 to thepharmacy1 so that the four retrieved unused medications can be returned.
• Returning to theprocess300 ofFIG. 3, instep310, an image or barcode is received identifying a component used to formulate thenew order408 of Cefazolin (2 gm/NS 50 ml). Instep311 the image or barcode is provided to the pharmacist to verify thenew order408 for Cefazolin (2 gm/NS 50 ml) is filled using the correct medication component as provided in theexample illustration470 ofFIG. 4D. The example illustration includes a graphical user interface that identifies details of the order being filled472. Thedetails472 include the medication components used to prepare the medication. The graphical user interface also includes an identification of the patient for whom the medication is being prepared, as well as the person (e.g., pharmacy technician) preparing themedication482. The graphical user interface further includes animage472, taken by the person preparing the medication, of each component medication used to formulate the medication to fill the order, as well as amagnification472 following a cursor of theinput device136 to assist the pharmacist in verifying each medication component.Graphical tools478 are provided to assist the pharmacist in viewing theimage474, including zoom, contrast, photo annotation, and label reprinting. The pharmacist verifies each medication component as correct for formulating the order using adisposition toolbar480 provided in the graphical user interface.
• After receiving an input (e.g., usinginput device136 of the server130) instep312 indicating the pharmacist has verified the medication has been filled using the medication component, theprocess300 proceeds to step313 in which an indication that the order for the medication is ready for delivery to the patient is provided. The indication can be provided for display with the virtual queue displayed on theoutput device134, or can be provided for display on theoutput device114 of theclient110. Theprocess300 then ends instep314.
• FIG. 5 is a block diagram illustrating anexample computer system500 with which theclient110 andserver130 ofFIG. 2 can be implemented. In certain aspects, thecomputer system500 may be implemented using hardware or a combination of software and hardware, either in a dedicated server, or integrated into another entity, or distributed across multiple entities.
• Computer system500 (e.g.,client110 and server130) includes abus508 or other communication mechanism for communicating information, and a processor502 (e.g.,processor212 ofclient110 andprocessor40 of server130) coupled withbus508 for processing information. By way of example, thecomputer system500 may be implemented with one ormore processors502.Processor502 may be a general-purpose microprocessor, a microcontroller, a Digital Signal Processor (DSP), an Application Specific Integrated Circuit (ASIC), a Field Programmable Gate Array (FPGA), a Programmable Logic Device (PLD), a controller, a state machine, gated logic, discrete hardware components, or any other suitable entity that can perform calculations or other manipulations of information.
• Computer system500 can include, in addition to hardware, code that creates an execution environment for the computer program in question, e.g., code that constitutes processor firmware, a protocol stack, a database management system, an operating system, or a combination of one or more of them stored in an included memory504 (e.g.,memory220 ofclient110 andmemory232 of server130), such as a Random Access Memory (RAM), a flash memory, a Read Only Memory (ROM), a Programmable Read-Only Memory (PROM), an Erasable PROM (EPROM), registers, a hard disk, a removable disk, a CD-ROM, a DVD, or any other suitable storage device, coupled tobus508 for storing information and instructions to be executed byprocessor502. Theprocessor502 and thememory504 can be supplemented by, or incorporated in, special purpose logic circuitry.
• The instructions may be stored in thememory504 and implemented in one or more computer program products, i.e., one or more modules of computer program instructions encoded on a computer readable medium for execution by, or to control the operation of, thecomputer system500, and according to any method well known to those of skill in the art, including, but not limited to, computer languages such as data-oriented languages (e.g., SQL, dBase), system languages (e.g., C, Objective-C, C++, Assembly), architectural languages (e.g., Java, .NET), and application languages (e.g., PHP, Ruby, Perl, Python). Instructions may also be implemented in computer languages such as array languages, aspect-oriented languages, assembly languages, authoring languages, command line interface languages, compiled languages, concurrent languages, curly-bracket languages, dataflow languages, data-structured languages, declarative languages, esoteric languages, extension languages, fourth-generation languages, functional languages, interactive mode languages, interpreted languages, iterative languages, list-based languages, little languages, logic-based languages, machine languages, macro languages, metaprogramming languages, multiparadigm languages, numerical analysis, non-English-based languages, object-oriented class-based languages, object-oriented prototype-based languages, off-side rule languages, procedural languages, reflective languages, rule-based languages, scripting languages, stack-based languages, synchronous languages, syntax handling languages, visual languages, wirth languages, embeddable languages, and xml-based languages.Memory504 may also be used for storing temporary variable or other intermediate information during execution of instructions to be executed byprocessor502.
• A computer program as discussed herein does not necessarily correspond to a file in a file system. A program can be stored in a portion of a file that holds other programs or data (e.g., one or more scripts stored in a markup language document), in a single file dedicated to the program in question, or in multiple coordinated files (e.g., files that store one or more modules, subprograms, or portions of code). A computer program can be deployed to be executed on one computer or on multiple computers that are located at one site or distributed across multiple sites and interconnected by a communication network. The processes and logic flows described in this specification can be performed by one or more programmable processors executing one or more computer programs to perform functions by operating on input data and generating output.
• Computer system500 further includes adata storage device506 such as a magnetic disk or optical disk, coupled tobus508 for storing information and instructions.Computer system500 may be coupled via input/output module510 to various devices (e.g.,barcode reader34 and24). The input/output module510 can be any input/output module. Example input/output modules510 include data ports such as USB ports. The input/output module510 is configured to connect to acommunications module512. Example communications modules512 (e.g.,communications module218 and238) include networking interface cards, such as Ethernet cards and modems. In certain aspects, the input/output module510 is configured to connect to a plurality of devices, such as an input device514 (e.g.,input device116 ofclient110 andinput device136 of server130) and/or an output device516 (e.g.,output device114 and134).Example input devices514 include a keyboard and a pointing device, e.g., a mouse or a trackball, by which a user can provide input to thecomputer system500. Other kinds ofinput devices514 can be used to provide for interaction with a user as well, such as a tactile input device, visual input device, audio input device, or brain-computer interface device. For example, feedback provided to the user can be any form of sensory feedback, e.g., visual feedback, auditory feedback, or tactile feedback; and input from the user can be received in any form, including acoustic, speech, tactile, or brain wave input.Example output devices516 include display devices, such as a LED (light emitting diode), CRT (cathode ray tube), or LCD (liquid crystal display) screen, for displaying information to the user.
• According to one aspect of the present disclosure, theclient110 andserver130 can be implemented using acomputer system500 in response toprocessor502 executing one or more sequences of one or more instructions contained inmemory504. Such instructions may be read intomemory504 from another machine-readable medium, such asdata storage device506. Execution of the sequences of instructions contained inmain memory504 causesprocessor502 to perform the process steps described herein. One or more processors in a multi-processing arrangement may also be employed to execute the sequences of instructions contained inmemory504. In alternative aspects, hard-wired circuitry may be used in place of or in combination with software instructions to implement various aspects of the present disclosure. Thus, aspects of the present disclosure are not limited to any specific combination of hardware circuitry and software.
• Various aspects of the subject matter described in this specification can be implemented in a computing system that includes a back end component, e.g., as a data server, or that includes a middleware component, e.g., an application server, or that includes a front end component, e.g., a client computer having a graphical user interface or a Web browser through which a user can interact with an implementation of the subject matter described in this specification, or any combination of one or more such back end, middleware, or front end components. The components of the system can be interconnected by any form or medium of digital data communication, e.g., a communication network. The communication network (e.g., network150) can include, for example, any one or more of a personal area network (PAN), a local area network (LAN), a campus area network (CAN), a metropolitan area network (MAN), a wide area network (WAN), a broadband network (BBN), the Internet, and the like. Further, the communication network can include, but is not limited to, for example, any one or more of the following network topologies, including a bus network, a star network, a ring network, a mesh network, a star-bus network, tree or hierarchical network, or the like. The communications modules can be, for example, modems or Ethernet cards.
• Computing system500 can include clients and servers. A client and server are generally remote from each other and typically interact through a communication network. The relationship of client and server arises by virtue of computer programs running on the respective computers and having a client-server relationship to each other.Computer system500 can be, for example, and without limitation, a desktop computer, laptop computer, or tablet computer.Computer system500 can also be embedded in another device, for example, and without limitation, a mobile telephone, a personal digital assistant (PDA), a mobile audio player, a Global Positioning System (GPS) receiver, a video game console, and/or a television set top box.
• The term “machine-readable storage medium” or “computer readable medium” as used herein refers to any medium or media that participates in providing instructions or data toprocessor502 for execution. Such a medium may take many forms, including, but not limited to, non-volatile media, volatile media, and transmission media. Non-volatile media include, for example, optical disks, magnetic disks, or flash memory, such asdata storage device506. Volatile media include dynamic memory, such asmemory504. Transmission media include coaxial cables, copper wire, and fiber optics, including the wires that comprisebus508. Common forms of machine-readable media include, for example, floppy disk, a flexible disk, hard disk, magnetic tape, any other magnetic medium, a CD-ROM, DVD, any other optical medium, punch cards, paper tape, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM, a FLASH EPROM, any other memory chip or cartridge, or any other medium from which a computer can read. The machine-readable storage medium can be a machine-readable storage device, a machine-readable storage substrate, a memory device, a composition of matter effecting a machine-readable propagated signal, or a combination of one or more of them.
• As used herein, the phrase “at least one of” preceding a series of items, with the terms “and” or “or” to separate any of the items, modifies the list as a whole, rather than each member of the list (i.e., each item). The phrase “at least one of” does not require selection of at least one item; rather, the phrase allows a meaning that includes at least one of any one of the items, and/or at least one of any combination of the items, and/or at least one of each of the items. By way of example, the phrases “at least one of A, B, and C” or “at least one of A, B, or C” each refer to only A, only B, or only C; any combination of A, B, and C; and/or at least one of each of A, B, and C.
• Furthermore, to the extent that the term “include,” “have,” or the like is used in the description or the claims, such term is intended to be inclusive in a manner similar to the term “comprise” as “comprise” is interpreted when employed as a transitional word in a claim.
• A reference to an element in the singular is not intended to mean “one and only one” unless specifically stated, but rather “one or more.” The term “some” refers to one or more. Underlined and/or italicized headings and subheadings are used for convenience only, do not limit the subject technology, and are not referred to in connection with the interpretation of the description of the subject technology. All structural and functional equivalents to the elements of the various configurations described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and intended to be encompassed by the subject technology. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the above description.
• While this specification contains many specifics, these should not be construed as limitations on the scope of what may be claimed, but rather as descriptions of particular implementations of the subject matter. Certain features that are described in this specification in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a subcombination or variation of a subcombination.
• Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In certain circumstances, multitasking and parallel processing may be advantageous. Moreover, the separation of various system components in the aspects described above should not be understood as requiring such separation in all aspects, and it should be understood that the described program components and systems can generally be integrated together in a single software product or packaged into multiple software products.
• The subject matter of this specification has been described in terms of particular aspects, but other aspects can be implemented and are within the scope of the following claims. For example, the actions recited in the claims can be performed in a different order and still achieve desirable results. As one example, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In certain implementations, multitasking and parallel processing may be advantageous. Other variations are within the scope of the following claims.
• These and other implementations are within the scope of the following claims.

Claims (20)

What is claimed is:

1. A system for managing preparation of a medication for a patient, the system comprising:

one or more processors; and

a memory comprising instructions that, when executed by the one or more processors, cause one or more processors to:

monitor an electronic data feed, the electronic data feed including data indicating medication orders;

provide, for display at an output device, an electronic virtual queue in which orders for medications to be prepared are listed and updated in real time based on changes from the electronic data feed;

receive, based on monitoring the electronic data feed, information indicative of an order for medication for a patient from the electronic data feed;

determine a position in a virtual queue configured to display multiple medication orders to be filled based a position associated with another medication having a same type or a same component as the medication; and

provide, for display at the output device, the virtual queue and an indicator of the order for the medication at the position in the virtual queue among respective indicators of the multiple medication orders.

2. The system ofclaim 1, wherein the instructions, when executed, further cause the one or more processors to:

aggregate a plurality of orders into batches based on respective component medications that are indicated by each of the plurality of orders;

select, based on at least a first component medication of the respective component medications, a first batch of orders;

determine medication containers that should be retrieved from a storage location to prepare the first batch of orders;

provide an indication of the medication containers for display on the output device.

3. The system ofclaim 1, wherein the instructions, when executed, further cause the one or more processors to:

receive, from a recording device, respective captured images of each component used to prepare the medication associated with the order;

provide the respective captured images for display; and

receive, after the respective captured images are provided for display, a verification that the medication was prepared with each component.

4. The system ofclaim 3, wherein the instructions, when executed, further cause the one or more processors to:

update, upon receiving the verification, the virtual queue to identify the medication as having been prepared and ready at a retrieval location for delivery to a delivery location

5. The system ofclaim 3, wherein the instructions, when executed, further cause the one or more processors to:

receive a first automated notification provided by a first reader device at a retrieval location associated with a preparation of the medication, and a second automated notification provided by a second reader device on a delivery cart, based on respective scannings of an active identification device affixed to the medication by the first and second reader devices, the scannings occurring wirelessly without a scanning action taken by a participant;

store delivery progress information based on the first and second automated notifications, the delivery progress information including a last-known read location associated with the medication and a time of a last location reading at the last-known read location;

receive, from a tracking device, a tracking request for the delivery progress information; and

provide, responsive to the tracking request, the delivery progress information to the tracking device to inform a user of the last-known read location and time of the last location reading.

6. The system ofclaim 1, wherein the instructions, when executed, further cause the one or more processors to:

identify an unused medication designated to be returned from a location associated with a patient before the unused medication is administered to the patient by a medical device designated to administer the unused medication to the patient;

determine whether the order for the medication can be filled with the returned unused medication; and

provide for display a notification to fill the order with the returned unused medication.

7. The system ofclaim 6, wherein determining whether the order for the medication can be filled with the returned unused medication is based on a comparison between at least two of an expiration time of the returned unused medication an estimated amount of time for delivering the returned unused medication to a preparation location, a time that the returned unused medication is to be administered to a patient, and a delivery deadline for the returned unused medication.

8. The system ofclaim 6, wherein the instructions, when executed, further cause the one or more processors to:

determine that the order for the medication can be filled with the returned unused medication and another returned medication,

wherein the notification indicates that the returned unused medication should be combined with another returned medication to fill the order

9. The system ofclaim 6, wherein the instructions, when executed, further cause the one or more processors to:

provide, for display at a computing device remote from the system, a notification configured to cause a display of a graphical visualization of a path by which a delivery person can retrieve the returned unused medication while delivering at least one other medication, overlaid on a graphically displayed map.

10. The system ofclaim 1, wherein the one or more processors is further configured to:

identify a delivery location for the order of medication;

determine whether an order for another medication is ready for delivery to or near the delivery location; and

provide a notification to a device associated with a delivery person responsible for delivering the order for the medication to delay delivery of the other medication until the order of medication has been filled.

11. A non-transitory machine-readable storage medium comprising machine-readable instructions for causing a computing device to perform operations comprising:

monitoring an electronic data feed, the electronic data feed including data indicating medication orders;

providing for display, an electronic virtual queue in which orders for medications to be prepared are listed and updated in real time based on changes from the electronic data feed;

receiving, based on monitoring the electronic data feed, information indicative of an order for medication for a patient from the electronic data feed;

determining a position in a virtual queue configured to display multiple medication orders to be filled based a position associated with another medication having a same type or a same component as the medication; and

providing an indicator of the order for the medication for display at the position in the virtual queue among respective indicators of the multiple medication orders.

12. The non-transitory machine-readable storage medium ofclaim 11, the operations further comprising:

aggregating a plurality of orders into batches based on respective component medications that are indicated by each of the plurality of orders;

selecting, based on at least a first component medication of the respective component medications, a first batch of orders;

determining medication containers that should be retrieved from a storage location to prepare the first batch of orders;

providing an indication of the medication containers for display on the output device.

13. The non-transitory machine-readable storage medium ofclaim 11, the operations further comprising:

receiving, from a recording device, respective captured images of each component used to prepare the medication associated with the order;

providing the respective captured images for display; and

receiving, after the respective captured images are provided for display, a verification that the medication was prepared with each component.

14. The non-transitory machine-readable storage medium ofclaim 13, the operations further comprising:

updating, upon receiving the verification, the virtual queue to identify the medication as having been prepared and ready at a retrieval location for delivery to a delivery location

15. The non-transitory machine-readable storage medium ofclaim 13, the operations further comprising:

receiving a first automated notification provided by a first reader device at a retrieval location associated with a preparation of the medication, and a second automated notification provided by a second reader device on a delivery cart, based on respective scannings of an active identification device affixed to the medication by the first and second reader devices, the scannings occurring wirelessly without a scanning action taken by a participant;

storing delivery progress information based on the first and second automated notifications, the delivery progress information including a last-known read location associated with the medication and a time of a last location reading at the last-known read location;

receiving, from a tracking device, a tracking request for the delivery progress information; and

providing, responsive to the tracking request, the delivery progress information to the tracking device to inform a user of the last-known read location and time of the last location reading.

16. The non-transitory machine-readable storage medium ofclaim 11, the operations further comprising:

identifying an unused medication designated to be returned from a location associated with a patient before the unused medication is administered to the patient by a medical device designated to administer the unused medication to the patient;

determining whether the order for the medication can be filled with the returned unused medication; and

providing for display a notification to fill the order with the returned unused medication.

17. The system ofclaim 16, wherein determining whether the order for the medication can be filled with the returned unused medication is based on a comparison between at least two of an expiration time of the returned unused medication an estimated amount of time for delivering the returned unused medication to a preparation location, a time that the returned unused medication is to be administered to a patient, and a delivery deadline for the returned unused medication.

18. The non-transitory machine-readable storage medium ofclaim 16, the operations further comprising:

determine that the order for the medication can be filled with the returned unused medication and another returned medication,

wherein the notification indicates that the returned unused medication should be combined with another returned medication to fill the order

19. The non-transitory machine-readable storage medium ofclaim 16, the operations further comprising:

provide, for display at a computing device remote from the system, a notification configured to cause a display of a graphical visualization of a path by which a delivery person can retrieve the returned unused medication while delivering at least one other medication, overlaid on a graphically displayed map.

20. A method for managing preparation of a medication for a patient, the method comprising:

monitoring, by one or more computing devices, an electronic data feed, the electronic data feed including data indicating medication orders;

providing for display, by at least one of the computing devices, an electronic virtual queue in which orders for medications to be prepared are listed and updated in real time based on changes from the electronic data feed;

receiving, by at least one of the computing devices, based on monitoring the electronic data feed, information indicative of an order for medication for a patient from the electronic data feed;

determining, by at least one of the computing devices, a position in a virtual queue configured to display multiple medication orders to be filled based a position associated with another medication having a same type or a same component as the medication; and

providing, by at least one of the computing devices, an indicator of the order for the medication for display at the position in the virtual queue among respective indicators of the multiple medication orders.

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