FIELD OF INVENTION

This invention relates to automated pharmaceutical dispenser devices such as those that dispense a plurality of different drugs with varying doses used in hospitals, pharmacies and home health care facilities.

BACKGROUND

The dispensing of pharmaceuticals in hospitals, pharmacies, home healthcare, assisted living and similar facilities is a critical aspect of patient care. Pharmaceuticals are manufactured by numerous drug companies, most using different types of packaging, or packaging that is not uniform in size, drug quantity, labeling, or dosage. These packages can be syringes, ampules, vials, oral suspensions, tubes, jars, blister packs in single or multiple dose sheets, and many bottles of various sizes and shapes. The lack of standardization results in confusion for medical professionals regarding the delivery of proper dose and medication, and it is known to result in a large number of adverse drug reactions caused by errors in the stocking, storage and delivery of prescribed medication.

Historically, in a large multi-patient environment, like hospitals that can have hundreds of beds, prescriptions are written by doctors; the prescription is physically or electronically presented to a hospital pharmacy; the pharmacy picks and packs the medicine for physical transfer to a cart or tray for transfer to nurses for delivery to and consumption by patients in their rooms. Nurses are usually responsible for multiple patients located in different rooms or locations within the hospital. Each step in the delivery chain opens opportunities for mistakes in giving patients an improper dosage or improper medication. In reading poor hand writing or inverting numbers on a script, pharmacists may accidently provide the wrong dosage or drug for delivery to a patient. Errors may also occur during transport to the patient's room or during the administration of the drug by nurses. These errors result in many serious or fatal adverse drug reactions every year and cost our health care system many billions in excess costs annually.

Attempts to improve existing packaging, storage, script writing and delivery systems and methods have been made. Systems are known with automated computerized script writing, cross referenced against electronic digital patient medical record, automated storage and dispensing. U.S. Pat. No. 6,757,898 discloses an electronic tracking and patient cross checking system that is a significant improvement over manual systems. Doctors can now place scripts at a patient's bedside electronically through tablet computer and smart phones that are networked to interface directly with patient records and pharmacies. RFID and barcode systems are known that provide significant improvements in identifying and tracking drug type and dosage as the medication flows from script to patient. Further advances have been made with inventory management, tracking and control, reordering and stock adjustment systems. The security of inventory has also been improved by providing user authorization and authentication with delivery confirmation systems that allow for only dispensing drugs to authorized individuals and tracking the delivery of the dose until confirmation of delivery is provided.

Some attempts have been made to establish standardization in bar coding. 21 CFR 201.25 sets out guidelines for the pharmaceutical industry with respect to bar code formats and requirement for certain types of data. However, even with these advancements, there continue to be deficiency with these systems. Because there are no established standards for packaging, handling, tracking, dispensing and delivery of drugs in institutional environments, there remain significant inefficiencies, errors and limitations with existing designs. There is also a significant lack of standardization in the nature and structure of data that is captured and used in managing these functions. Automated dispensing machines have a number of limitations because they are generally designed to handle a variety of package designs or they require a significant amount of manual effort to stock or restock. Current state of the art automated dispensers, in order to handle a variety of medications, also require the manual preparation of individual unit doses of medication so that automated systems can accommodate the package for automated processing. Unit doses must be physically separated and placed in individual bin locations or canisters within the automated dispenser.

There are also limitations with respect to inventory monitoring and control of inventory in current pharmaceutical dispensers. In existing systems multiple individuals may have a key or access to secured areas or access point where medication is stored and inventoried. This leaves inventory vulnerable to unauthorized removal or theft.

Additionally, many of the known systems are very inefficient in both the unit dose package storage density and in the process of stocking and restocking of pharmaceuticals. In one known system, the McKesson Automation, Inc. system disclosed in U.S. Pat. No. 8,036,773 which is fully incorporated herein by reference, the system is designed to hold unit dose packages of various sizes. However, the McKesson system requires that each unit dose package be individualized or separated from multipack packages and that each separated unit dose package be place in individual carriers in a horizontal plane. The separation of the individual unit dose package is a manual process and requires a significant amount of physical labor to separate and load individual unit dose packages or to otherwise manipulate the unit dose packages to allow accommodation of different package sizes by the system. Alternatively, the user must purchase a standalone separating machine for the purpose of separating unit dose packages, which adds significant cost.

Because the system disclosed in U.S. Pat. No. 8,036,773 requires that each individual unit dose package be loaded into a carrier and then multiple carriers are stacked into a storage apparatus, there is a significant amount of unutilized space within the system and the unit dose package density is extremely low, requiring constant manual stocking as described above. Each time the system is stocked there is opportunity for error, and cost is added through manual processing. The loading or stocking procedure is just as lengthy and requires as much operator time as does the dispensing.

U.S. Pat. No. 8,090,472 issued to Schifman et al discloses an automated medication dispensing apparatus. This dispenser is similar to the dispenser disclosed in U.S. Pat. No. 8,036,773 in that it uses multiple pharmaceutical storage bins with multiple compartments for holding unit dose packages. The storage bins are stacked and each has an assigned location within a cabinet or enclosure. A robotic arm selects a pharmaceutical by selecting the proper bin location and moving the robotic arm to the bin location to extract the pharmaceutical stored at that location. The same limitations apply, in that there is low storage density, high manual processing and associated increase in error rates. The Schifman dispenser does improve security by including a camera for capturing still or video images of users accessing the apparatus.

Pharmaceutical dispensers have also improved by allowing digital communication with computer networks. Many healthcare facilities use integrated medical records management software to assist in patient care and to efficiently make available to clinicians patient information. Doctors can enter prescriptions into mobile computer devices such as tablets and smart phones. These wireless devices can be networked to centralized servers or cloud based databases that can interface with automated pharmaceutical dispensing systems. U.S. Pat. No. 8,090,471 discloses at a conceptual level such a system. These software applications have significantly improved the efficiency of the overall drug delivery process in healthcare facilities by reducing or eliminating mistake in script writing, patient identification. Software is also known for assisting in the management of inventory and access authorization in the automated pharmaceutical dispenser systems. However, these systems cannot improve efficiencies based on the lack of standardization or the limitations of the underlying automated dispenser design.

Personal Automated Dispensers

As the causes of mortality have shifted over the past one hundred years from acute infectious disease to chronic disease such as cardiovascular disease, cancer, diabetes and other age related diseases, pharmaceutical and biotech companies have developed a plethora of treatments that can be self-administered by patients without hospitalization and only minimal physician oversight. Patients with chronic ailments may often have multiple drugs that are taken at various times during the day. As lifespans increase and populations age, the challenge of managing medication schedules becomes more difficult and for some require assistance. Failure to maintain ones medication schedule can create serious medical problems for the patient. Additionally, some patients may have multiple prescriptions and can be confused about which drug relates to the appropriate schedule of administration, resulting in taking drug A on schedule intended for drug B. Additional problems exist with these patients simply failing to take their medication.

A number of personal automated medical dispensing devices are known. E-pill, LLC (www.epill.com/dispenser.html) manufactures a full line of personal dispensers having many of the features of larger systems but scaled to individual users. Many systems are microcontroller based and can have sophisticated user interfaces that allow users to set a number of system functions and features. A key feature of personal dispensers is a medication administration scheduling feature that provides notification to the user or healthcare providers of the time to take medication. Notification can be done via audible indicator, light flash, or wireless communication to a third person when medication is not removed from the dispenser at the appointed time. Although personal automated medical dispensers have improved, many of the same limitations existing with automated dispensers used in institutional venues carry over to personal automated medication dispensers, with some additional limitations. Much of the stocking procedure for personal automated dispensers is carried out manually, resulting in a system that is prone to error. Because of the smaller size of personal drug dispensers, restocking is required more often than larger automated systems, providing for even more opportunity for error. Additionally, many patients may be impaired either physically or cognitively and thus are incapable of properly stocking the dispenser and requiring assistance from a medical professional or family member for restocking. There are similar applications in the retail pharmacy, so called lights out order fulfillment and mail order facilities.

SUMMARY OF THE INVENTION

In view of the foregoing background, the present invention overcomes the limitations of the prior art by providing for a high efficiency automated pharmaceutical packaging method and dispensing systems for hospital, pharmacy, residential and home healthcare facilities.

In one aspect of the current invention, a method is disclosed that provides for ribbon segment packaging of pharmaceutical unit doses in a high-density manner for processing in high efficiency automated pharmaceutical dispensing systems. The invention consists of a means of packaging pharmaceuticals at the point of manufacture or post manufacturing prior to delivery to distribution. Pharmaceuticals are packaged in bands, tapes or ribbons of packaging material within a desirable width that can be wound about a reel or placed in a conduit for easy feeding of the ribbon into a dispenser. This packaging allows for the automated and uniform transport, tracking, storage and dispensing in a highly efficient manner. The packaging is two strips of layered ribbon material with pharmaceuticals packaged between the two bound layers. The bound ribbon with the captured unit dose is wound about a reel with a center core that may incorporate generally circular side supports of such size and configuration as to create an overall package with integrity onto which a continuous ribbon or length of prepackaged drugs can be wound.

The ribbon packaging consists of individually sealed segments with each segment having a cavity, and each cavity containing a single unit dose of a drug or pharmaceutical compound. The ribbon segment can also contain individual containers such as a vile, tube, or syringe or in itself being a container for a liquid or gel containing unit doses. Each ribbon segment is sequentially positioned on the ribbon so that there is only one dose per segment within the width of the ribbon package for each unit length, but multiple essentially identical segment lengths sequentially and uniformly spaced on the ribbon. Each side of individual ribbon sections may contain encoded data indicative of relevant information regarding the substance contain, dose, lot or manufacturer's date code, national drug code information, manufacturer's information, chain of custody, etc. The data can be essentially any type of data, and it can be encoded in a variety of know means, including single or multidimensional bar code. The data can be read as the ribbon segment passes over a reader to compare against the script to assure the proper medication is provided.

Each ribbon reel may be contained in a sealed conduit, cassette or cartridge for easy warehousing, transportation, storage and placement within the dispensing system, and to prevent contamination of the packaged pharmaceutical. Each can also be marked for identification using for example barcodes for type, batch and other data. The cartridge is formed from ridged support panels enclosing a ribbon reel. Standardized packaging may also be a container or box into which a fan-folded ribbon may be placed. In another alternative, each ribbon strip may be fed into a tube or similar conduit restraint system that allows for convenient insertion into the dispenser.

The ribbon segments may have holes punched on either or both linear edges to allow the ribbon to be pulled or drawn from the reel. The ribbon can be of essentially any width and length depending on the dispensing application and the pharmaceutical contained within the ribbon. Such means may also be used to move or advance the ribbon products through manufacturing and the several dispensing operations.

A presentation head may be incorporated into the conduit, cassette or cartridge for serially presenting or separating each reel ribbon segment. In response to the input from the controller based on a prescription, the presentation head will actively or passively be advanced to feed the ribbon into the automated dispensing device so that the each ribbon segment and its contents would be presented for dispensing in a way where after the dispensing a first ribbon segment, the next ribbon segment will be advanced to the dispensing position and available for a dispensing head. Such a presentation head may have a reader for reading the encoded data on each ribbon segment and that may be identified with human and machine readable elements such that a head can be directly and uniquely associated with a specific reel or cartridge so that the head's identity data defines the pharmaceutical that is dispensed.

In another aspect of the invention, an apparatus is provided that is in communication with at least one computer network and is capable of accepting prescriptions electronically from authorized devices in communication with said network. The apparatus comprises at least one pharmaceutical storage structure with plurality of storage locations that are capable of accepting a plurality of reel cartridges, cassettes or conduits each containing a different pharmaceutical or the same pharmaceutical with different unit doses. The apparatus also comprises a means for accessing and comparing patient medical data stored on the associated computer network against prescribed drugs to prevent improper administration of drugs and adverse drug reactions. The apparatus further comprises dispensing structure having a reader for reading encoded data on ribbon cartridges and segment and that is capable of locating storage locations and dispensing prescribed pharmaceuticals. The apparatus also comprises a printing means for printing encoded data on a container that can be read by a reader and representing patient information, drug and dose information.

Another aspect of the invention provides for high density storage and dispensing systems for pharmaceutics that requires fewer manual processes for stocking and restocking. The system has dense and uniform packaging, and no requirement for individual receptacles for each unit dose, eliminating complicated means of accessing individual storage areas that contain a very limited quantity of medications. The storage systems have a small physical foot print in comparison with known systems having the same capacity.

In one aspect of the invention methods are disclosed for providing unit dose pharmaceutical packaging for high efficiency transportation, tracking, storage, and distribution and dispensing to patients.

In another aspect of the current invention an apparatus is provided for a personal automated pharmaceutical dispenser for individual use that include security, ease of operation and a number of user friendly features.

