System and methodology for filling prescriptions

Abstract

An overall pharmacy system and methodology begins with bulk medications and supplements introduced into the work flow, individually packaged and assembled into med pass orders per patient and delivered to the long-term care (LTC) facility or other institution for patient consumption. The process according to one embodiment of this invention begins by converting bulk medications and supplements to packaged unit doses and ultimately individually packaged med pass bags for each patient on a 24-hour schedule. The various safeguards and measures built into this system increase patient safety eliminate waste and increase labor efficiency by reducing and/or minimizing the disposal of unused medications and supplements. The design of the overall system and its individual components allows for physical control of each unit dose package from start to finish without any unit dose package free fall in the system. This process is automated and does not rely upon manual sorting. The med pass bags are consolidated into the final shipping container and do not require manual sorting and packing.

Claims

1. A system for processing prescription orders for patients of multiple medications, comprising: a pre-packaging apparatus that receives a bulk supply of a variety of different medications, enters information pertaining to the bulk supply of medications into an inventory database, and pre-packages each different medication in the bulk supply of medications into new individual containers, each new individual container storing only an individual dose of only one of the different medications, and updates the inventory database with information regarding the new individual containers; an inventory dispensing apparatus that receives a patient's prescription order for a plurality of identified medications, selects a number of the new individual containers required to fulfill the prescription order, and dispenses, through a discharge assembly, and while maintaining positive physical control throughout the dispensing and based on the selection, the number of the new individual containers including the plurality of identified medications to a packaging apparatus; and the packaging apparatus that performs a packaging process by assembling the dispensed new individual containers into a package, and outputs the package corresponding to the patient's order, wherein each new individual container is a blister package having a base portion defining a cavity for receiving the individual dose of the medication and a generally planar closure, and wherein the discharge assembly comprises channels which constrain movement of the new individual containers.

2. A method for processing prescription orders for patients of multiple medications, the method comprising: receiving, using a pre-packaging apparatus, a bulk supply of a variety of different medications; removing, using the pre-packaging apparatus, each different medication; entering information pertaining to the bulk supply of medications into an inventory database; pre-packaging, using the pre-packaging apparatus, each of the different medications in the bulk supply of medications into new individual containers, each new individual container storing only an individual dose of only one of the different medications; updating the inventory database with information regarding the new individual containers; receiving a patient's prescription order for a plurality of identified medications; selecting, at an inventory dispensing apparatus, a number of the new individual containers required to fulfill the prescription order; dispensing, using the inventory dispensing apparatus, while maintaining positive physical control throughout the dispensing, and based on the selection, the number of the new individual containers including the plurality of identified medications to a packaging apparatus; assembling, using the packaging apparatus, the dispensed new individual containers into a package; and outputting, from the packaging apparatus, the package corresponding to the patient's order, wherein each new individual container is a blister package having a base portion defining a cavity for receiving the individual dose of the medication and a generally planar closure, and wherein the inventory dispensing apparatus comprises channels which constrain movement of the new individual containers.

3. The method of claim 2, further comprising: assembling identical medications after the pre-packaging and prior to the dispensing.

4. The method of claim 2, further comprising: labeling each of the new individual containers with relevant medication information.

5. The method of claim 2, wherein the outputting step further comprises: shipping the package corresponding to the patient's order to a location remotely located relative to the inventory dispensing apparatus.

6. The method of claim 2, further comprising: verifying the patient's prescription after receiving the patient's prescription.

7. The method of claim 2 wherein the assembling further comprises: bagging, using the packaging apparatus, the dispensed new individual containers associated with a single order for each patient into a bag.

8. The method of claim 7 further comprising: accumulating, using the packaging apparatus, a plurality of the bags for a given patient, each bag being associated with a different order.

9. The method of claim 2 wherein the outputting further comprises: shipping a package corresponding to a first patient's order to a first location remotely located relative to the inventory dispensing apparatus; and shipping a package corresponding to a second patient's order to a second location remotely located relative to the inventory dispensing apparatus and the first location.

10. The method of claim 2 wherein the medications in the bulk supply of a variety of medications are not contained in the new individual containers prior to the pre-packaging.

11. The system of claim 1, wherein the inventory dispensing apparatus includes a storage arrangement that stores the new individual containers; a discharge assembly that moves selected ones of the new individual containers from the storage arrangement; and a conveyor that receives the selected ones of the new individual containers from the discharge assembly and conveys the selected ones of the new individual containers to the packaging apparatus.

12. A system for processing prescription orders for patients of multiple medications, comprising: a pre-packaging apparatus that receives a bulk supply of a variety of different medications, each different medication being received in a different container, enters information pertaining to the bulk supply of medications into an inventory database, removes each different medication from the respective different container, and pre-packages each of the removed medications in the bulk supply of medications into new individual containers, each new individual container storing only an individual dose of only one of the different medications removed from the respective one of the different containers, updates the inventory database with information regarding the new individual containers, and stores the pre-packaged new individual containers in tubes in a storage apparatus, each new individual container stored in each tube including the same medication as the other individual containers in the respective tube; an inventory dispensing apparatus that includes a storage arrangement that stores the new individual containers in the tubes; a discharge assembly that moves selected ones of the new individual containers related to a patient's prescription order from the storage arrangement; and a conveyor that receives the selected ones of the new individual containers from the discharge assembly and conveys the selected ones of the new individual containers to the packaging apparatus, and a packaging apparatus that performs a packaging process by assembling the dispensed new individual containers into a package, and outputs the package corresponding to the patient's order, wherein both the discharge assembly and the conveyor comprise channels which constrain movement of the new individual containers to allow movement only along a longitudinal direction of the channels, and wherein the discharge assembly and conveyor maintain positive physical control of the new individual containers.

13. The system according to claim 12, wherein each individual dose of one medication stored in each new individual container has a single expiration date.

14. The system according to claim 12, wherein the pre-packaging apparatus pre-packages each of the removed medications in the bulk supply of medications into new individual containers before receiving the patient's prescription order for the plurality of identified medications.

15. The system according to claim 12, wherein each individual container is a blister package having a base portion defining a cavity for receiving the individual dose of the medication and a generally planar closure.

16. The system according to claim 15, wherein the channels have a cross-section corresponding to a cross-section of the blister package.

17. The system according to claim 12, wherein the packaging apparatus stakes together a plurality of packages corresponding to a plurality of patient orders.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:

(2) FIG. 1 is a schematic representation of one embodiment of a methodology and associated system components for automated fulfillment of patient prescriptions for a long term care facility according to this invention.

(3) FIG. 2 is a perspective view of an exemplary system for storing and dispensing medications and supplements in accordance with the present disclosure.

(4) FIG. 3 is a perspective view of an exemplary package for containing a single dose of a medication/supplement in accordance with the present disclosure.

(5) FIG. 4 is a perspective view of an exemplary carrier of a conveyor in accordance with the present disclosure.

(6) FIG. 5 is an end elevation view of the carrier of FIG. 4.

(7) FIG. 6 is a perspective view of a first dispensing module and an adjacent portion of a conveyor of the dispensing system of FIG. 2.

(8) FIG. 7 is a perspective view of one embodiment of a second dispensing module of the dispensing system of FIG. 2 according to one embodiment of the present disclosure.

DETAILED DESCRIPTION OF THE INVENTION

(9) The detailed description exemplifies specific embodiments of the invention which are described in sufficient detail so as to allow a person of ordinary skill in the art to practice the invention without undue experimentation. It will be appreciated that the apparatus and associated method may vary as to configuration and as to details of the parts and steps without departing from the basic concepts as disclosed herein. While the invention is susceptible to various modifications and alternative forms, a specific embodiment thereof is shown by way of example in the FIGURE and will herein be described in detail. It should be understood, however, that there is no intent to limit the invention to the particular form disclosed, but on the contrary, the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the claims.

(10) Referring to FIG. 1, this invention is generally directed to a process or method and associated system and sub-systems 10 to provide a turnkey solution for dispensing solid medications and nutritional supplements 12 to be taken orally in health care settings, including but not limited to long term care (LTC) and assisted living settings 14. The process begins by converting bulk medications and supplements 12 to individual packaged unit doses 18 and ultimately individually packaged med pass bags 20 containing the prescribed medications and supplements 12 for each patient on a 24-hour schedule. Generally, this invention is directed to a process 10 for filling prescriptions which begins with receiving an order 22 by the system 10. Additionally, inventory management is also automated via a master packaging fill event server 24. The various safeguards and measures built into the system of this invention include unit dose scanning at various steps as well as personal inspections, as needed, to increase patient safety, eliminate waste and increase labor efficiency by reducing and/or minimizing the disposal of unused medications and supplements.

(11) The system and associated method 10 of this invention is used to dispense unit dose oral solid medications and supplements 12 within a LTC facility 14 based on a twenty-four (24) hour fill cycle. The system 10 is capable of handling vials as an added feature should the system require and so demand. The medications and supplements 12 are delivered by the pharmacy within the LTC to the LTC facility patients. The system 10 is designed to fulfill cycle-fill orders, new prescription orders, PRN orders, ER box restock orders and leave of absence orders in both manual and STAT delivery modes.

(12) One objective of this system and methodology 10 is to avoid the need for disposal of unused medications and supplements 12 thereby attacking the waste and inefficiency issues at their source. The strategy and approach utilized by this invention utilizes a unit dose dispenser 28, but the invention is much more comprehensive than just the medication and nutritional supplement automated dispenser 28 that may be utilized. The comprehensive strategy employed by this solution to the efficient and economical distribution of medications and supplements 12 begins with logging into an inventory database 30 the bulk medications and supplements 12 before each of the medications and supplements 12 are initially placed in bulk inventory storage 46 or directly packaged in a unit dose packager 38 and then assembled in a unit dose tube 32 in conjunction with pharmacist review 34. A fill event server 24 is updated at each step in the process and positive control of each unit dose package 18 is maintained throughout the entire process 10. In other words, gravity feed and the random nature of medications freefalling through the system 10 is avoided in the approach according to this invention. After the unit dose storage tubes 32 are prepared and entered into the dispenser inventory database 36, they are loaded into the automated dispenser 28 for the assembling via automated filling and bagging of individual med pass patient bags 20.

(13) The bulk medications and supplements 12 are individually packaged in unit dose packages 18 by a unit dose packager 38. The unit dose packager 38 in one embodiment of this invention includes a pill shuttle and magazine loader system (not shown) which seals individual medications/supplements 12 into blister packages, separates the blister packages into discrete lanes and loads the individual blister packages 18 into tubes 32. The unit dose packages 18 may be stored in inventory 48 prior to being placed in tubes 32 as demand indicates. Multiple tubes 32 may be filled simultaneously and once the tubes 32 are filled, they are verified by a pharmacist and upon proper verification, transferred to the unit dose dispenser 28 for dispensing to fill the individual prescription orders.

(14) In one embodiment, the unit dose packager 38 utilized with this invention is manufactured by Pentapack N.A. Corp. (www.pentapackna.com) as Model BP515. The Pentapack packager packages medications and supplements 12 in the blister packages 18 and may be utilized in combination with a pill shuttle (not shown) to aid an operator in the loading of bulk medications and supplements 12 into the unit dose packager 38.

(15) The tubes 32 filled with unit dose packages 18 are loaded into the dispenser 28. The dispenser 28 provides an automated solution to the efficient and timely preparation of med pass bags 20 handled in LTC and assisted living settings 14 by filling individual med pass orders for each patient and assembling them in a bag 20 of unit dose medications and supplements 12 and staking individual bags together as needed. The unit dose dispenser 28 may be located remotely from the LTC facility 14 and will serve multiple facilities 14. The staked bags 20 are then packed into a tote 40 and delivered to the LTC 14 for distribution. At each step in the process, the unit dose packages 18 are tracked via one or more bar code scanners 26 and the status of each unit dose package 18 is cataloged and regularly updated in the pharmacy information management system (PIMS) database 42.

(16) The design of the overall system 10 and its individual components according to this invention allows for physical control of each unit dose 18 from start to finish without any unit dose free fall in the system. This process is automated via appropriate computer operations 50 and does not rely upon manual sorting. The med pass bags 20 are consolidated into the final shipping tote 40 and do not require manual sorting and packing. The fill event server 24 interfaces with the unit dose dispenser 28 to provide appropriate pick commands 52 according to the orders 22. It will be appreciated that although it is preferable to separately retain each of the unit doses within individual packages 18 which are assembled with one another in a given bag 20 such as date sequential for a single patient, med pass or by patient number (for multiple patients within an institutional setting); the medications and supplements 12 may be alternatively packaged in any convenient form which allows a set of medications or supplements 12 which was selected via the order 22 to be taken at a given time or med pass to be easily retrieved for use without departing from the invention.

(17) Each individual bag 20 may be configured with an indicia 44 containing information about whom the individualized prescription has been created for, and the time that the dose is to be taken. For example each bag 20 may contain the name of who is to take the order, for example Jane Doe and their address, should the packet get misplaced, 1990 Paxit Drive, Columbus, Ohio 43230. Each Dose packet preferably contains the date and time the dose is to be taken, for example a series may appear as: 8:00 AM on Tuesday, Jun. 1, 2009, 2:00 PM on Tuesday, Jun. 1, 2009, 8:00 PM on Tuesday, Jun. 1, 2009, 8:00 AM on Wednesday, Jun. 2, 2009, . . . 8:00 PM on Tuesday, Jun. 29, 2009. The bag 20 may include additional information such as Take with food and any other precautions. Inserted instructions or content list may also be included within each bag 20. In addition, the bag 20 may contain information listing information about the medications or supplements 12 contained therein. The string of individualized bags 20 are placed in the tote 40 with any other portions of the order 22, and shipped to the LTC 14.

(18) A user may submit an order 22 into the PIMS database 42 which order may originate from a consumer, patient, doctor, administrator or pharmacist via an internet enabled computer or appliance, accessing through the Internet, a web site hosted by a web server. Within the web site the individual can establish a dosing schedule by selecting the times during each day and the medications and/or supplements 12 to be taken at those times. The fill event server 24, which is associated with the system 10, receives the processed orders 22 from the PIMS 42. It will be appreciated that alternative forms of data communication, such as electronic data interchange, XML, and so forth may be utilized to allow the user to submit the order(s) to be processed by the system 10. Furthermore, the communication system may be integrated within, or operate in conjunction with an institutional computer system, such as a hospital, nursing-home, LTC and similar systems that may act as a user on behalf of a patient. It should also be appreciated that institutions often prefer their own interface wherein alternative communication protocols are established for communicating the dose information to the temporal dosing system without departing from this invention. Prescription orders 22 that are phoned in or sent in by facsimile can be entered into the PIMS 42 through a control terminal (not shown) by a local operator. Moreover, control terminal will also be used for performing maintenance on prescription processing system 10 and for interacting with and updating software programs on the system 10.

(19) In one embodiment, the unit dose dispenser 28 which may be utilized with this invention is described in related patent application Ser. Nos. 12/559,630 and 12/559,601, each filed Sep. 15, 2009 and each incorporated by reference herein in its entirety.

(20) A conveyor (not shown) of the dispenser receives individual unit dose packages 18 from a series of dispensing modules and at a down-stream end of the conveyor, the unit dose packages 18 are deposited into a bag 20. The bag 20 is collected with other bags and the groups of bags are joined via heat and staked together. The staked bags 20 are then loaded into a tote 40 and once the tote 40 is filled, it is automatically labeled, verified through a scanner 26 and delivered to the LTC 14 for consumption by the patients. The inventory of the dispenser 28 is updated 36 as reflected in the fill event server 24.

(21) FIG. 2 depicts an exemplary automated dispensing system 110 in accordance with the principles of the present disclosure. In the embodiment shown, the dispensing system 110 is configured to store and dispense individually packaged and labeled doses of medications/supplements, and to assemble the dispensed medications/supplements into individual medication orders, such as time-pass medication orders to be delivered to a long-term care facility, for example. It will be appreciated, however, that a dispensing system in accordance with the present disclosure may alternatively be configured to dispense other items. The dispensing system 110 is divided into distinct modules that are dedicated to dispensing the medications/supplements based on the demand, or order frequency, of those items. In the embodiment shown, a first module 112 is configured to dispense medications/supplements having a relatively high demand or order frequency, and a second module 114 of the dispensing system 110 is configured to store and dispense medications/supplements having a relatively lower demand or order frequency.

(22) With continued reference to FIG. 2, the dispensing system 110 further includes an endless conveyor 130 comprising a plurality of carriers 132 that move past the first, high-demand module 112 and the second, low-demand module 114 to collect ordered medications/supplements and carry them to a designated location for further processing. In the embodiment shown, a first end 134 of the conveyor 130 is positioned adjacent the high-demand module 112. The carriers 32 are moved along the conveyor 130 past the high-demand module 112 and the low-demand module 114 toward a second end 136 where the medications/supplements are packaged for delivery to a long term care facility. In the embodiment shown in FIG. 2, the conveyor 130 comprises a pair of oppositely disposed, longitudinally extending rails 138a, 138b supporting the plurality of carriers 132. The conveyor 130 may further comprise cross-members 140 extending between the rails 138a, 138b and support leas 142 configured to support the longitudinally extending rails 138a. 138b a distance above a floor surface.

(23) In one embodiment, the medications/supplements are provided in packages 116 sized to receive an individual dose of a particular medication/supplement, commonly referred to as a blister pack. With reference to FIG. 3, an exemplary package 116 comprises abase portion 118 defining a cavity for receiving the individual dose of the medication/supplement 120, and a generally planar closure 122 disposed over an open end of the base portion 118. The packages 116 may be provided with information 124 related to the medication/supplement 120 contained in the packages 116, such as the name of the medication/supplement 120, the manufacturer, the date manufactured, the lot number, and/or other information. In the embodiment shown, information 124 is provided on the closure 122 and includes machine-readable information, such as a bar-code, that may be used to facilitate the automated storing, tracking, dispensing, and packaging of orders.

(24) FIGS. 4 and 5 depict an exemplary carrier 132 comprising an elongate, generally rectangular body 150 having a longitudinal channel 152 formed into one side and extending between the ends of the body 150. The channel 152 is shaped complementarily to the shape of the packages 116 and includes a deep central portion 154 and shallower side portions 156a, 156h disposed on opposite sides of the central portion 154, whereby a package 116 can be received in the channel 152 with the base 118 positioned in the central portion 154 and the sides of the closure 122 supported on the side portions 156a. 156b. The side portions 156a, 156b are enclosed at their upper ends, such as by top plates 158 or other structure so that packages 116 received in the channel 152 are constrained for movement only along a longitudinal direction of the channel 152.

(25) As shown in FIGS. 2 and 6, the first or high-demand module 112 of the dispensing system 110 is located upstream from the second or low-demand module 114 along the conveyor path 131 of the conveyor 130 and travel of the carriers 132. The high-demand module 112 in one embodiment includes two units or banks 113 of storage tubes 115, each positioned on opposite sides of the conveyor 130, although only one unit 113 is shown in FIGS. 2 and 5 for clarity. Each unit 113 of the high-demand module 112 includes a number of vertically oriented storage tubes 115 such that the unit dose packages 116 in each tube 115 are stacked vertically one upon another. The unit dose packages 116 are loaded in storage tubes 115 in a generally vertical stack and similarly oriented with the base portion 118 depending downwardly from the upper planar closure portion 122 of the package 116.

(26) The low-demand module 114 is downstream from the high-demand module 112 (FIG. 2) and may include two banks or units 166 of medication/supplement storage tubes 174, one unit 166 positioned on each lateral side of the conveyor 130 although the units 166 on only one side of the conveyor 130 are shown in FIG. 2 for clarity. As is the case with the high-demand module 112, the units 166 may feed unit dose packages 116 to the opposite ends of the carriers 132, although this is not accomplished simultaneously from the opposite ends of the carriers to inhibit the unit dose packages 116 from being pushed to the opposing unit 166.

(27) Referring now to FIG. 7, the low-demand module 114 includes a storage module 160 for storing the individually packaged and labeled medications/supplements, a pick device 162 for retrieving selected medications/supplements from the storage module 160, and a transfer station 164 for delivering the selected medications/supplements to the carriers 132 of the conveyor 130 to fill orders. The storage module 160 has one or more storage units 166 positioned alongside the conveyor 130, as may be desired, to accommodate storage of the medications/supplements needed to fill the medical orders.

(28) When the carriers 132 on the conveyor 130 that are assigned to a particular order are aligned with slots on a transfer station 164 adjacent the conveyor 130 in the low-demand module 114 that contain the packages 116 for that particular order, the medications/supplements 120 are pushed into the assigned carrier 132. The assigned carrier 132 may already have unit dose packages 116 therein from the upstream high-demand module 112.

(29) The conveyor 130 thereafter carries the carriers 132 to the packaging station 126 for final packaging and assembly of the patient orders. During movement of the packages 116, the carriers 132, transfer nests, and transfer stations are each configured to maintain positive control of the medications/supplements 120 such that no medication/supplement 120 is allowed to free fall during the dispensing process.

(30) From the above disclosure of the general principles of the present invention and the preceding detailed description of at least one preferred embodiment, those skilled in the art will readily comprehend the various modifications to which this invention is susceptible. Therefore, we desire to be limited only by the scope of the following claims and equivalents thereof.