text:
System and method for recording medication delivery to a patient
A care management system in which the management of the administration of care for patients is automated. Hospital information systems are monitored and the information from those systems is used in verifying the administrations of care to patients. The care management system monitors ongoing administrations for progress and automatically updates records and provides alarms when necessary. The care management system is modular in nature but is fully integrated among its modules. Particular lists of data, such as the termination times of all ongoing infusions, provide hospital staff current information for increased accuracy and efficiency in planning. Features include the automatic provision of infusion parameters to pumps for accurate and efficient configuration of the pump, and providing an alarm when an unscheduled suspension of an infusion exceeds a predetermined length of time. A passive recognition system for identifying patients and care givers is provided.
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This application is a continuation of U.S. Ser. No. 10/622,983 filed Jul. 18, 2003 now U.S. Pat. No. 6,915,170, which is a continuation of application Ser. No. 09/114,581 filed Jul. 13, 1998, now U.S. Pat. No. 6,671,563, issued Dec. 30, 2003, which is a continuation-in-part of U.S. Ser. No. 08/440,625 filed May 15, 1995 now U.S. Pat. No. 5,781,442, issued Jul. 14, 1998.
The invention relates generally to systems for managing patient care in a health care facility, and more particularly, to systems for collecting data and controlling the delivery of patient care.
Medical institutions are faced with a competitive environment in which they must constantly maintain or improve profitability and yet simultaneously improve patient care. Several factors contribute to the ever increasing costs of health care, whether it is delivered to the patient in a hospital or out-patient clinic setting. Health care deliverers face increased complexity in the types of treatment and services available, but also must provide these complex treatments and services efficiently, placing a premium on the institution's ability to provide complex treatment while maintaining complete and detailed medical records for each patient.
It is also advantageous to have a care management system that combines all of the various services and units of a health care institution into an interrelated automated system to provide "just-in-time" delivery of therapeutic and other drugs to the patient. Such a system would prevent administering an inappropriate medication to a patient by checking the medication against a database of known allergic reactions and/or side-effects of the drug against the patent's medical history. The interrelated system should also provide doctors, nurses and other care-givers with updated patient information at the bedside, notify the institution's pharmacy when an additional drug is required, or when a scheduled treatment is running behind schedule, and automatically update the institution's accounting database each time a medication or other care is given.
Inaccurate recording of the administration of drugs and usage of supplies involved in a patient's treatment results in decreasing revenues to the institution by failing to fully capture billing opportunities of these actual costs. Inadequate management also results in a failure to provide an accurate report of all costs involved in treating a particular illness.
In many hospitals and clinical laboratories, a bracelet device having a patient's name printed thereon is permanently affixed to a patient upon admittance to the institution in order to identify the patient during his or her entire stay. Despite this safeguard, opportunities arise for patient identification error. For example, when a blood sample is taken from a patient, the blood sample must be identified by manually transcribing the patient's name and other information from the patient's identification bracelet. In transferring the patient's name, a nurse or technician may miscopy the name or may rely on memory or a different data source, rather than actually reading the patient's bracelet.
Moreover, manually transferring other information, such as the parameters for configuring an infusion pump to dispense medication may result in errors that reduce the accuracy and/or effectiveness of drug administration and patient care. This may result in an increased duration of treatment with an attendant increase in costs.
Hospitals and other institutions must continuously strive to provide quality patient care. Medical errors, such as where the wrong patient receives the wrong drug at the wrong time, in the wrong dosage or even where the wrong surgery is performed, are a significant problem for all health care facilities. Many prescription drugs and injections are identified merely by slips of paper on which the patient's name and identification number have been handwritten by a nurse or technician who is to administer the treatment. For a variety of reasons, such as the transfer of patients to different beds and errors in marking the slips of paper, the possibility arises that a patient may be given an incorrect treatment. This results in increased expense for the patient and hospital that could be prevented using an automated system to verify that the patient is receiving the correct care.
Various solutions to these problems have been proposed, such as systems that use bar codes to identify patients and medications, or systems allowing the bedside entry of patient data. While these systems have advanced the art significantly, even more comprehensive systems could prove to be of greater value.
What has been needed, and heretofore unavailable, is an integrated, modular system for tracking and controlling patient care and for integrating the patient care information with other institutional databases to achieve a reliable, efficient, cost-effective delivery of health care to patients. The invention fulfills these needs and others.
Briefly and in general terms, the present invention provides a new and improved patient management system capable of monitoring, controlling and tracking the administration of care in a health care institution.
Generally, the patient management system comprises a number of CPUs having a variety of input and output devices for receiving patient data and for generating or displaying reports. A system of software programs operates on the CPUs to record, process, and produce reports from a database whose data is representative of the care a patient receives in the institution. The CPUs are connected together, along with at least one dedicated file server, to form a network. Patient data is input by users of the personal computers, and is stored in a data storage device connected to the file server.
More specifically, in a more detailed aspect by way of example and not necessarily of limitation, the patient management system includes a pharmacy computer, a nursing station CPU including a video display and printer and bedside CPUs connected to various clinical devices such as infusion pumps for providing medication to a patient and a barcode reader for reading barcode labels either affixed to the patient's identification bracelet or a label on a medication container. In operation, the patient management system verifies that the right medication is being dispensed to the right patient in the right dosage via the right delivery route at the right time by maintaining a database of information relating to the patient, the patient's condition, and the course of treatment prescribed to treat the patient's illness.
The patient wears an identification device that includes a barcode that can be read by a barcode reader connected to the bedside CPU. Medication to be administered to the patient in the course of the patient's treatment is identified with a label that is printed by a barcode printer in the pharmacy or by the manufacturer's supplied barcodes on unit dose packaging. When the medication is administered to the patient by a care-giver, the care-giver uses the barcode reader connected to the bedside CPU to read the barcode on the patient's identification device and the barcode on the label identifying the medication to be dispensed. The patient management system compares the patient's identity with the medication and verifies that it is the correct medication for the patient. Additionally, the caregiver may also have an identification device that bears a barcode with the caregiver's name and other information. Using the barcode reader, the care giver's identity can thus be stored in the database and linked to the treatment given to the patient to ensure complete and accurate tracking of all treatment given to the patient.
In another aspect, an identification system is provided that is passive in nature. That is, the system operates to automatically detect and identify an individual, such as a patient and/or caregiver without any particular action being required on the part of the individual. In a further aspect, an RF transponder is mounted at a patient's room or treatment area and automatically detects an identification device, such as a wrist band, on the individual to identify the individual. The identification device may comprise an electrical circuit.
In a further aspect, the patient management system also includes the capability of recording the present location of each clinical device in the institution, and maintains a history of the device usage in a device usage and event database. This database may also include a history of a device's maintenance and calibration.
In another aspect, the patient management system includes the ability to track usage of consumable supplies within the various units of the health care institution. This assists in managing the inventory of consumable supplies to ensure that supplies are always available. A further advantage is that it enables the institution's administration to project supply usage and thus purchase supplies in quantities that ensure cost discounts without incurring excessive inventory carrying costs.
In yet another aspect, the patient management system employs RF (radio frequency) transmitters and receivers to connect the various hardware elements of the system together into a local area network. This aspect is advantageous in that it provides increased flexibility in positioning of the hardware elements of the network while eliminating the need for costly network wiring throughout the institution.
These and other advantages of the invention will become apparent from the following more detailed description when taken in conjunction with the accompanying drawings of illustrative embodiments.
Referring now to the drawings, and more particularly to
Referring now to both
The care management system 30 of
A local area network 50, comprising a thin net, or ethernet cabling is used to connect the central file server 45 to the hardware that comprises the care management system.
In the present embodiment, the file server 45 of the care management system is connected by a local area network (LAN) 50 to computers and other peripheral equipment located in the institution's pharmacy, at nursing stations located throughout the institution, and at the patient's bedside. In the embodiment shown, the module located in the pharmacy comprises a central processing unit 60 to which is attached a video display 64 and a keyboard 62 for entry and display of patient information and drug parameters. Also attached to the pharmacy CPU is a bar code reader 68 which is adapted to read barcode labels that may be attached to drug containers, equipment, or caregiver identification badges as will be more fully discussed below. Also connected to the pharmacy CPU 60 is a bar code printer 69 and a printer 66 used for generating reports containing information about patient history and/or patient treatment. The printer 66 may also be used to print barcode labels generated by the pharmacy CPU 60 after patient or drug data is input by a technician or pharmacist into the pharmacy computer 60 using the keyboard 62 or other means.
Another computer, herein referred to as the nursing CPU 70, is located at a nursing station. Nursing stations are typically located in various sections and/or floors of a hospital or clinic and typically provide a central location for record storage and monitoring for a number of patient beds. The nursing CPU 70 located at the nurse station typically includes a video display 74 for displaying patient or other information pertaining to the operation of the particular unit of the institution, and a keyboard 72, mouse, touch screen 73, or other means for entering patient data or specific commands instructing the nursing CPU 70 to generate reports relating to either the patient's medical history or the course and progress of treatment for an individual patient on the attached printer 76 or on the video display 74. As will be discussed more fully below, the nursing station CPU 70 may also generate other reports such as, for example, a printout of drugs scheduled to be administered to patients, productivity measurements such as, for example, the amount of time a nurse spends with a patient or other reports useful for assisting in the efficient operation of the particular unit or the hospital. For example, a report listing the actual times of administration versus the scheduled times for administration may be prepared to assist in evaluation of staffing requirements.
Each care unit associated with the nursing station typically comprises one of more patient beds located in private rooms, shared rooms, or open or semi-open wards that contain multiple beds. In accordance with an embodiment of the present invention, each private room, semi-private room, or ward area has at least one bedside CPU 80 for monitoring and treating one or more patients. Each bedside CPU 80 has a video display 84 and a keyboard 82, mouse, touch screen 83, or other device. The bedside CPU 80 can be used by a nurse, physician or technician to access a variety of institutional databases to display a variety of information about a particular patient. This information can include an on-line, real-time, graphical patient medication administration record (MAR) that is derived from the patient's medication profile maintained by the hospital's pharmacy information system 20. The bedside CPU 80 also allows remote access to a patient's records stored by the file server 45 to display medication history for the patient. This medication history includes a listing of all drug or other treatments including past, present and future deliveries to the patient. Additionally, access to administration records of the hospital's administration system 40 is available through the network 5.
Each bedside CPU 80 can be connected through an appropriate interface to a variety of peripheral equipment. For example, a barcode reader 90 capable of reading barcodes on a patient's wristband or medication container; an infusion pump 92 for delivering medication to the patient in a predetermined, controlled manner; or various sensors 94 that can automatically monitor a patient's vital signs and send signals representative of these vital signs to the computer through an appropriate interface for storage and later retrieval by a selected software application to provide a graphic display of the patient's vital signs during the course of treatment.
A plurality of bedside CPUs are shown in the drawing; however, more or fewer may exist depending on the particular system and hospital requirements.
Referring now to
The programs of the care management system 30 control alarms or alerts generated by one of the modular applications. Alarms are routed automatically to the appropriate video display. For example, an occlusion alarm generated by a pump 92 may remain local for a predetermined period. After that period the patient's bedside computer 80 may then broadcast the alarm by causing the alarm to be communicated over the LAN 50 to alert other hospital staff of a potential problem or to cause a particular person responsible for the care of a patient, such as, for example, a physician or nurse, to be paged.
Each of the modular applications will now be described in detail. The operation of each of these modular applications in a clinical setting will be discussed more fully below. The medical administration management module 110 integrates medical order information, infusion pump monitoring, and barcode technology to support the real-time verification and charting of medications being administered to a patient. The medical administration management module 110 creates and maintains an on-line, real-time, patient-specific medication administration record ("MAR") or integrated medication administration record ("IMAR") for each patient. This medication administration module 110 contains all of the information generated in the institution regarding the care provided to the patient. The medication administration management module 110 gathers information from the various nursing and bedside CPU's 70, 80 (
In another embodiment, the physician accesses the pharmacy management system 20 through a dedicated terminal or through the care management system 30 via the network 5 using either a nursing CPU 70 or a bedside CPU 80. Alternatively, the treatment order may be entered by a nurse or other qualified caregiver into either the pharmacy management system 20 or the care management system 30.
Referring now to
Barcode systems are extremely flexible and the amount of information that can be represented by the barcode, while limited, can be used in a variety of ways. For example, as depicted in
One of the key advantages of the medical administration management module 110 (
When the medication to be administered is of the type that is typically delivered to the patient using an infusion pump, the medical administration management module 110 automatically records the start time of the infusion, queries the pump periodically throughout the infusion and maintaining a continuous log of the infusion, and records the end time of the infusion and the volume infused in a patient's MAR. If the infusion pump connected to the bedside CPU has a programmable display, the name of the drug, as well as other important information concerning the progress of the infusion can be displayed on the infusion pump throughout the infusion to provide a visual display of the status for the infusion. One such pump is shown in
Because the medication administration management module 110 maintains an on-line, real-time, patient specific graphical medication administration record that includes both past, present and future scheduled medications, a nurse may select a scheduled dosage on the MAR and indicate that it will not be administered for specified reasons selected from a list of options that are dependant upon the health status of the patient at a particular time. This system also allows a nurse to select a scheduled dose on the MAR, and record notes and observations about the dose selected from a list of options. The medical administration management module 110 also provides on-line, real-time help screens that can be accessed by a nurse or other caregiver to display specific information about selected medication and dose to be dispensed.
The medication administration management module 110 provides a list of on-going infusions that can be displayed on the video display of the pharmacy CPU 60 such as is shown in
The medication administration module 110 records and maintains in a stored file a log of alerts that are generated when any discrepancy is identified, for example, during the verification process which will be discussed more fully below. The medication administration module 110 also allows the nurse to acknowledge and correct the discrepancy in real-time, or override the alert by entering the appropriate command. Even where the nurse is allowed to override the alert, the medication administration application module 110 prompts the nurse for a reason for each alert override and then automatically enters the reason into the MAR for the patient.
The medication administration management module 110 assists the nurse or other health care professional in efficiently delivering care to the patients by providing the ability to perform on-line queries of the patient's MARs and produce reports designed to assist the nurse in planning medication administration and in scheduling the workload of dispensing the medication to the many patients for which a nursing unit is typically responsible. For example, the video display may be color coded to indicate the status and schedule of each drug administration, such as the patient's IMAR shown in
The clinical monitoring and event history module 130 shown in
The clinical monitoring event history module 130 may also be programmed to immediately display alarm conditions on remote monitoring screens, such as the video display 74 attached to the nursing CPU 70, as the alarm occurs. For example, the status of each patient's infusion can be represented on a video display at the nursing station as shown by the OVERVIEW computer screen in
The clinical device tracking and reporting module 120 shown in
The clinical device tracking and reporting module 120 also maintains a record containing the usage history of each clinical device, including information about the patient it was used to treat, its location, the date, time, duration of use, any alarms that occurred and what medications were dispensed. This history may also contain the maintenance and calibration records for a clinical device. Such information can be queried on-line by technicians, nurses or other hospital administration personnel to generate reports to assist in locating the clinical device, report on the historical usage of the device, and to provide a log of preventative maintenance and equipment calibration. The efficient calibration of complex and sensitive clinical devices is particularly important in a heath care institution to maintain accuracy and quality of therapeutic treatment delivery. Maintaining a history of the usage of the device is also helpful to justify purchasing additional clinical devices when needed, or where the record indicates that a particular clinical device has become obsolete and needs to be replaced by a newer model of the device.
The care management system 30 also includes a consumable tracking module 140 that maintains a record of all consumable item usage for treatment of each patient. This record ensures that appropriate supplies are ordered and delivered to the nursing unit in a timely and cost-efficient manner to prevent outages of necessary supplies. Such information may also be used by the hospital inventory systems through an appropriate interface or other management system to ensure that the supply purchasing is done as cost-effectively as possible. The consumable tracking module 140 provides on-line queries and report generation summarizing consumable uses for a particular patient, a particular nursing unit, or a variety of other purposes.
The unit management tool module 150 assists nurses in sharing information related to patients and automates routine transactions within the nursing unit. The unit management tool module 150 allows a nurse to record the allergies, handicaps, and special care needs of the patient which, cooperating with the medication administration record module 110 and the clinical monitoring and event history module 130, displays that information prominently on all appropriate display screens, either at the pharmacy video display 64, the nursing video display 74 or at the bedside video display 84 (
The knowledge resource tools module 160 provides a framework for information sharing among the various units in the hospital and also supports an assortment of everyday tools to used by the nurses, physicians and technicians involved in the delivery of health care within the institution. This module allows or assists in integrating external information sources into the care system 30 to improve the effectiveness of the care management team in treating the patients in the institution.
For example, the knowledge resource tools module 160 provides a variety of on-line tools including, for example, a calculator, a dose rate calculator for calculating the appropriate dosage and infusion rate for a particular drug to be infused into a patient, a standard measurement conversion calculator for converting between units of measurement, a skin surface area calculator, and a timer and stopwatch. These resources may be displayed on the video displays 64, 74, 84 at appropriate points within the system, and are available from any CPU either in the pharmacy, at the nursing station or at the bedside. These application tools can be programmed to appear on the video display 64, 74, 84 either automatically, such as, for example, when an infusion pump is configured at the start of an infusion to assist in the calculation of a dose rate. These resources may also be available upon entry of the appropriate command by a nurse, physician or technician.
Referring once again to
The background monitoring system 195 may also be disposed in a stand-alone microcomputer or may be incorporated in an existing microcomputer. The subsystem performs background tasks such as monitoring the status of the interface gateway 27.
As depicted in
The care management system software can be written to operate on a variety of operating systems to suit the needs of a variety of institutions. In a present embodiment, the software is written to interface with the nurses and physicians using the Windows environment Windows is a trademark of Microsoft, Inc.) on IBM compatible micro-computers. The Windows environment is well-known by those skilled in the art and will not be described in detail herein. The care management system software, when implemented using the Windows system, is particularly useful in that the Windows operating system provides the ability to load several programs at once. Multitasking programs, allowing several application programs to run simultaneously yet providing immediate access to the various software modules of the care management system 30 may also be used.
One particular mode of operation of the care management system will now be described. As described above, a patient entering a hospital or other care-giving institution is provided with a wristband necklace, ankle band or other identifier that is affixed to the patient in a manner so that the patient can be identified even if the patient is unconscious or otherwise unresponsive. Such a wristband 170 is depicted in
After the patient is admitted and situated in a bed within the institution, the patient is typically evaluated by a physician and a course of treatment is prescribed. The physician prescribes the course of treatment by preparing an order, which may request a series of laboratory tests or administration of a particular medication to the patient. The physician typically prepares the order by filling in a form or writing the order on a slip of paper to be entered into the hospital's system for providing care.
If the order is for administration of a particular medication regimen, the order will be transmitted to the institution's pharmacy. The order will arrive in written form at the pharmacy, will be evaluated by the pharmacy and processed. The pharmacy then prepares the medication according to the requirements of the physician. The pharmacy packages the medication in a container, such as the container 185 shown in
Generally, the medication is then delivered to the appropriate caregiving unit for administering to the patient. A nurse or technician carries the drug container 185 to the appropriate patient. In accordance with one embodiment of the present invention, the nurse or technician first read the barcode 175 on the patient ID bracelet 170 using the barcode reader 90 connected to the bedside CPU 80. The nurse or technician would then read the barcode 182 on the label 180 affixed to the drug container by swiping the barcode wand 95 across the barcode 182 printed on the label 180 of the drug container 185. Additionally, a record of the identity of the caregiver dispensing the medication may be obtained by reading the barcode 205 printed on an identity badge 200 (
For certain drugs, the care-giver is prompted to enter data descriptive of a selected patient parameter or parameters, such a laboratory value or a current vital sign, before completing the verification process. For example, the care-giver may be prompted to measure and enter a value for a patient's blood pressure before administering certain selected drugs. The system may include ranges of acceptable values for the parameters. If the system detects an out-of-range value for the parameter, the system causes an alarm to be provided. In an alternative embodiment, the parameters could be monitored and entered into the system automatically, eliminating the need for manual entry by the care-giver.
The data obtained then is analyzed by the medication administration management module 110 which records the therapeutic regimen information in the patient's MAR, and verifies that the right medication is being given to the right patient in the right dose by the right route and at the right time. If the medication administration management module 110 detects a discrepancy between the barcoded information printed on the patient bracelet 170 and the barcoded information on the label 180 affixed to the medication container 185, an alert is sounded and the appropriate information is displayed on the video display 84 attached to the bedside CPU 80. The nurse or technician then either corrects the discrepancy by either re-reading the barcode 175 on the patient's bracelet 170 and the barcode 182 on the medication container 185 or, alternatively, by entering the appropriate information into the bedside CPU 80 using the keyboard 82 or touch screen 83, mouse, or other device. In the event that the nurse or technician determines that the discrepancy cannot be automatically corrected by re-reading the barcodes and that the discrepancy is minor and will not affect the accuracy or safety of the delivery of the medication, the nurse or technician may override the alert.
In an embodiment of the present invention, where the medication is to be delivered using an infusion pump, such as the infusion pumps 92 attached to the bedside CPU 80, the care management system automatically downloads information consisting of the appropriate configuration parameters for the infusion from the pharmacy CPU 60 through the local area network 50 into the bedside CPU 80 and then into the infusion pump 92 when the verification function of the medical administration management module 110 is complete. This is particularly advantageous in that one potential source of inaccuracy is eliminated by automatically configuring the pump, thus eliminating the need for the nurse or technician to manually enter the parameters necessary to configure the infusion pump 92. In one embodiment, the infusion pumps 92 comprise IVAC Corporation Model 570 volumetric pumps. In an embodiment where the pumps cannot be automatically configured by downloading parameters from the network, the care management system 30 only verifies that the right treatment is being administered to the right patient. The pump must then be manually configured by the physician, nurse or technician.
Once the infusion pump is configured, the technician then starts the infusion by pressing the appropriate control on the infusion pump 92. Starting pump that is capable of being monitored automatically by the care management system 30 causes a signal to be transmitted from the pump to the bedside CPU 80 which is then logged by the clinical monitoring and event history module 130 and entered by the medical administration management module 110 into the patient's MAR. In the case where the institution is using a pump that is not capable of being configured by downloading parameters from the network, the nurse or other caregiver logs the start of the infusion using the touch screen device, mouse or other device connected to the bedside CPU 80. In this case, the video displays of the care management system 30 that display information about the status of the infusion will not display real-time data. Rather, the care management system 30 will project what the status of the infusion should be given the infusion parameters, the time elapsed since the infusion began, and any other events that were manually logged by the caregiver that may have affected the progress of the infusion.
The care management system 30, utilizing the application modules described above, monitors the infusion process in a real-time manner, providing alerts on the appropriate video display screens located throughout the institution and allows intervention by nurses or other caregivers at remote locations if necessary. If the pharmacy management system 20 is directly linked to the care management system 30, the care management system 30 may also provide a scheduling report to the pharmacy in determining the status of ongoing infusions, as well as in scheduling the preparing of medications for future infusions.
In another embodiment, the present invention includes a "Code Mode" that allows a care-giver to bypass the system to immediately cause a list of drugs that have been preselected by the institution to be used in an emergency situation. The initiation of the "Code Mode" causes a time-stamp to be placed in the patient's MAR along with the identity of the drug selected from the displayed list of drugs to be used to treat the emergency. This feature ensures that the emergency, and the treatment used to address the emergency, are accurately recorded in the patient's MAR.
While one particular embodiment of the present invention has been described above, alternative configurations of the care management system network are possible. For example, one alternative embodiment of the care management system 30 is depicted in
A further embodiment of the care management system 30 local area network is depicted in
Yet another embodiment of the care management system 30 local area network 50 configuration is shown in
Another embodiment of the care management system 30 is shown in
One example of such a system incorporates an intelligent RF computer chip into the caregiver or patient badge or wristband 240 that provides a unique, or programmed response with a passive RF transponder 230 located within a patient room or treatment area, such as in the frame 231 of the entry or exit of the room or treatment area, or mounted on a wall or ceiling. Each badge or wrist band 240 interacts with signals of the transponder 230 in a unique way, the unique interaction representing an assigned code for the badge or wristband 240. Utilizing this technology would remove manual steps and some of the "human factor" from the process of identifying the patient and caregiver.
When an individual 245 wearing a badge or wristband 240 having such a circuit enters a room or area where a transmitter/receiver 230 is located, the electronic circuit in the badge or wristband 240 interacts with signals emitted by the transmitter without any positive action on the part of the caregiver or the patient. This interaction may be sensed by the receiver, which may be capable of determining the identity of the badge or wristband 240 from the interaction of the electronic circuit with the emitted signals. Alternatively, the receiver may simply sense the interaction and provide a signal representative of the sensed interaction to a computer or other processor which has been programmed or otherwise configured to determine the identity of the individual associated with that particular badge or wristband 240.
Although the preceding paragraphs describe a passive recognition system using electrical circuitry, other approaches may also be used. For example, it can be envisioned that the patient and/or caregiver may have magnetically-encoded devices that can be automatically read by an appropriate detector located in the patient room or treatment area.
Such a system is advantageous in that it can also be used to track the location of patients and caregivers in an institution. This information would be useful to monitor patient movements, especially in the case of patients with reduced mental capacity who may be prone to wandering about the institution. It would also be useful to know the location of the caregivers within an institution so that in the event of an emergency, the caregiver could be quickly located.
While several forms of the invention have been illustrated and described, it will also be apparent that various modifications can be made without departing from the spirit and scope of the invention. Accordingly, it is not intended that the application be limited, except by the appended claims.
1. A system for recording the delivery of medication to a patient by a clinical device, comprising:
- a first processor in operable communication with the clinical device;
- input means operatively connected to the first processor for input of information related to the delivery of medication to the first processor;
- a second processor having a memory in which is stored a record associated with the patient containing patient information and information related to the delivery of medication to the patient;
- a means for communicating information related to the delivery of medication to the patient between the first and second processors, the information including identification data, clinical device operating parameters and medication delivery information;
- wherein identification data input into the first processor is compared to the stored identification data by either the first or second processor and the second processor downloads clinical device operating parameters to the first processor to program and operate the clinical device in accordance with the downloaded operating parameters if the comparison of the identification data satisfies a predetermined condition; and
- wherein medication delivery information associated with the operation of the clinical device in accordance with the downloaded operating parameters is communicated to the second processor for storage in the record associated with the patient.
2. The system of claim 1, wherein the medication delivery information associated with the operation of the clinical device includes at least one delivery value selected from the group consisting of a patients name, scheduled start time, actual start time, scheduled end time, projected end time, amount of medication delivered and amount of medication remaining to be delivered.
3. The system of claim 1, wherein the medication delivery information associated with the operation of the clinical device includes discrepancy information related to conditions occurring during medication delivery falling outside of predetermined ranges of acceptable values for such conditions.
4. The system of claim 1, further comprising a vital sign monitor.
5. The system of claim 4, wherein the vital sign monitor monitors a vital sign parameter of the patient and communicates discrepancy information to the second processor for storage in the record associated with the patient if a value of the vital sign parameter is outside of a range of predetermined acceptable values for the vital sign parameter.
6. The system of claim 1, wherein the record associated with the patient also includes laboratory test information.
7. The system of claim 6, wherein laboratory test information associated with the patient is communicated to the second processor for storage in the record associated with the patient and the communicated data is compared to a range of acceptable laboratory information values associated with the medication being delivered to the patient and discrepancy information is stored in the record associated with the patient is a predetermined condition is not satisfied.
8. The system of claim 7, wherein the second processor causes an alert to be communicated to a care-giver if the predetermined condition is not satisfied.
9. The system of claim 8, wherein the second processor monitors a status of the alert and increases a priority of the alert if a response to the alert is not received by the second processor within a predetermined time.
10. A method for recording the delivery of medication to a patient by a clinical device, comprising:
- storing information related to the delivery of medication to a patient in a record associated with the patient in a memory;
- sensing information related to the delivery of medication to a patient from an identification device associated with a patient;
- comparing the sensed information with the stored information;
- communicating clinical operating parameters to the clinical device to program the clinical device if the comparison of the sensed information with the stored information satisfies a predetermined condition;
- operating the clinical device in accordance with clinical operating parameters;
- monitoring the operation of the clinical device;
- storing medication delivery information associated with operating the clinical device in the record associated with the patient.
11. The method of claim 10, wherein monitoring the operation of the clinical device includes monitoring values generated by a vital sign monitor.
12. The method of claim 11, wherein monitoring the values generated by the vital sign monitor includes comparing the monitored values to a predetermined range of acceptable vital sign values and indicating a discrepancy if an out of range vital sign value is detected.
13. The method of claim 10, wherein monitoring the operation of the clinical device includes monitoring values of laboratory tests, comparing the monitored values to a predetermined range of acceptable laboratory test values and indicating a discrepancy if an out of range laboratory test value is detected.
14. The method of claim 10, wherein monitoring the operation of the clinical device includes comparing a value of a parameters associated with the operation of the clinical device to a predetermined range of acceptable values for the parameter and indicating a discrepancy if an out of range value for the parameter is detected.
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Patent History
Type: Grant
Filed: Dec 28, 2004
Date of Patent: Aug 22, 2006
Patent Publication Number: 20050119788
Assignee: Cardinal Health 303, Inc. (San Diego, CA)
Inventors: Joseph J. Engleson (Carlsbad, CA), Craig Chamberlain (Ann Arbor, MI)
Primary Examiner: Anthony Knight
Assistant Examiner: Ronald D. Hartman, Jr.
Attorney: Fulwider Patton LLP
Application Number: 11/024,998
International Classification: G05B 19/18 (20060101); A61K 9/22 (20060101); A61B 5/00 (20060101); G05B 15/02 (20060101);


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Right-wing media eagerly spread absurd claim that Obama plans to "ban sport fishing"
Research ››› ››› JOCELYN FONG
Following the lead of an ESPNOutdoors.com opinion writer, who provided no evidence for his claim that a federal strategy "could prohibit U.S. citizens from fishing," right-wing blogs have advanced the outlandish charge that Obama "wants to ban sport fishing." These media outlets cited the Interagency Ocean Policy Task Force's interim report on coastal and marine planning, but the task force has proposed nothing of the sort.
Right wing seizes on unfounded speculation by ESPN writer
ESPN column: Federal strategy "could prohibit U.S. citizens from fishing the nation's oceans, coastal areas, Great Lakes, and even inland waters." On March 9, Robert Montgomery wrote for EPSNOutdoors.com: "The Obama administration will accept no more public input for a federal strategy that could prohibit U.S. citizens from fishing the nation's oceans, coastal areas, Great Lakes, and even inland waters. This announcement comes at the time when the situation supposedly still is 'fluid' and the Interagency Ocean Policy Task Force still hasn't issued its final report on zoning uses of these waters." Montgomery's post, which was also featured on The Daily Caller, has since been updated to state that the strategy "could prohibit U.S. citizens from fishing some of the nation's oceans coastal areas, Great Lakes, and even inland waters" [emphasis added]. Montgomery also stated in the column:
Led by NOAA's Jane Lubchenco, the task force has shown no overt dislike of recreational angling, but its indifference to the economic, social and biological value of the sport has been deafening.
Additionally, Lubchenco and others in the administration have close ties to environmental groups who would like nothing better than to ban recreational angling. And evidence suggests that these organizations have been the engine behind the task force since before Obama issued a memo creating it last June.
Hoft: "New Regulations Will Ban Sport Fishing." On March 9, Gateway Pundit blogger Jim Hoft posted a blog titled, "Obama's Latest Assault on Freedom-New regulations Will Ban Sport Fishing." Asserting that Obama "wants to ban sport fishing," Hoft quoted from the ESPN column and further stated, "Barack Obama has a message for America's 60,000,000 anglers- We don't need you." From Hoft's post:
Fox Nation: "Obama to Ban Sport Fishing?" On March 10, Fox Nation featured the following headline, linking to the ESPN column and Hoft's Gateway Pundit post:
SayAnythingBlog: "Obama Pushes Ahead With Fishing Ban." In a March 9 post titled, "Because He's Not Unpopular Enough: Obama Pushes Ahead With Fishing Ban," SayAnythingBlog quoted from the ESPN column and wrote, "A ban on fishing would bring a visceral reaction from the public, to be sure. But even so, that a bill like this could even get this much serious consideration is an indication of just how far left Obama has shifted the federal government."
RedState: "Obama: The Will Of The People Be Damned - I'LL Decide Who Can Go Fishing." In a March 9 RedState post titled, "Obama: The Will Of The People Be Damned - I'LL Decide Who Can Go Fishing," Dave Poff quoted the ESPN column's claim that the Obama administration's plan "could prohibit U.S. citizens from fishing the nation's oceans, coastal areas, Great Lakes, and even inland waters." Poff also stated, "*Now* he means to ration recreational fishing and boating, folks," adding that Obama has been "[p]lotting a Federal takeover of all our bodies of water (freshwater...saltwater...doesn't matter), in an effort to set up MORE bureaucracies and circumvent the rights of the States to determine fair use and access rules amongst themselves based on the local interests of everyone involved."
Malkin: "Obama's war on fishing?!?!?!" In a March 9, post titled, "Obama's war on fishing?!?!?!" Michelle Malkin posted the ESPN column's claim that "[t]he Obama administration will accept no more public input for a federal strategy that could prohibit U.S. citizens from fishing the nation's oceans, coastal areas, Great Lakes, and even inland waters." Malkin added, "Longtime readers know I love to fish and have been at war with the anti-fishing nuts at PETA for years."
ESPN column, right-wing bloggers provided no evidence to substantiate claim
ESPN column doesn't support claim that Obama plans to ban sport fishing. Montgomery speculated about "collusion" between "green groups," who "would like nothing better than to ban recreational angling," and the Obama administration, but did not provide any evidence to support his assertion that the federal strategy "could prohibit U.S. citizens from fishing the nation's oceans, coastal areas, Great Lakes, and even inland waters." In fact, later in his column, Montgomery wrote that "the task force has shown no overt dislike of recreational angling," adding, "but its indifference to the economic, social and biological value of the sport has been deafening."
Task force plan seeks to "better manage," not ban recreational fishing alongside other uses of ocean, coasts, lakes. In its September 10, 2009, interim report, the Interagency Ocean Policy task force recommended that the administration implement "coastal and marine spatial planning," which has been described as ocean "zoning." The interim report states that such a system "will allow for the reduction of cumulative impacts from human uses on marine ecosystems, provide greater certainty for the public and private sector in planning new investments, and reduce conflicts among uses and, between using and preserving the environment to sustain critical ecological, economic, and cultural services for this and future generations." A December 9, 2009, task force report discussing coastal and marine spatial planning in more detail states that "CMSP provides an effective process to better manage a range of social, economic, and cultural uses, including" commerce and transportation, commercial fishing, conservation, mining, oil and gas exploration and development and recreational fishing, among many others. Nowhere in the September 10 or December 9 reports does the task force propose a ban on recreational fishing.
Fishing columnist Jeffrey Weeks: "ESPN should be ashamed." Charlotte Fishing Examiner columnist Jeffrey Weeks wrote on March 9: "In what may be the worst example of outdoor sports reporting in the history of America, ESPN has claimed that President Barack Obama is on the verge of banning recreational fishing." Weeks added, "Am I going to agree with everything that this task force does? Probably not. Issues like access to fishery grounds and over-regulation of species without sound scientific data are legitimate concerns. However, in no way shape or form is the task force President Obama created about to ban recreational fishing. That is silly. ESPN should be ashamed."
Marine biologist Larry Crowder: "It's not an environmentalist manifesto." The Christian Science Monitor reported on March 9 that marine biologist Larry Crowder, of Duke University, stated of the task force, "It's not an environmentalist manifesto. It's multiple-use planning for the environment, and making sure various uses ... are sustainable." CSM further reported that "Obama has said he will not override protections put in place by Presidents Clinton and Bush that established recreational fishermen as a special class" and that "nonpartisan experts say the task force has already made strides in better recognizing various stakeholder groups, including recreational fishermen, and that it doesn't intend to undermine the ability of states to manage their natural resources, as many fishermen fear."
Hot Air's Allahpundit: "I'm going to go out on a limb and predict that he will not, in fact, ban fishing." In a March 9 post titled, "ESPN: Obama may ban recreational fishing or something," Hot Air blogger Allahpundit wrote, "I'm going to go out on a limb and predict that he will not, in fact, ban fishing, but the meta-narrative is so irresistible - elitist President Arugula coming to grab the bitter-clingers' rods and reels! - that it simply must be blogged. Odds of a Palin Facebook comment: High." Referring to the jobs dependent on recreational fishing, Allahpundit further stated, "Think The One's going to hand Republicans that talking point in this political climate? How excited do you suppose red-district Democrats will be to see the White House bring down the hammer on fly fishermen with an election eight months away?"
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Our man Mark Jacobson has a beautiful story on Sonny Rollins in the latest issue of Men's Journal. Rollins played with the great musical innovators of the mid-century–Parker, Monk, Dizzy, Miles.
When he was at the top of his game he took a two year sabbatical to practice and get better.
He's 82 now and the man has kept playing long after his idols and many of peers are gone.
"I think he was really lost there for a while," said the esteemed jazz critic Gary Giddins about the work Sonny did in the early to mid 1970s, an exceedingly strange time to be a jazz musician of the traditionalist bent. In what appeared to be an ill-considered attempt to keep up, Sonny made a few "fusion" records with Bob Cranshaw's electric bass, a number of jazz-rock guitarists, and the criminally forgotten kilt-wearing, bagpipe-playing Rufus Harley, but nothing took off.
By the late 1970s, however, things began to look up. "Sonny seemed to relax," Giddins said. "It was as if he realized that he was primarily a concert artist and didn't have to spend all that time in the recording studio. His live solos became these great meditative, playful, stream-of-consciousness things. It was like the whole history of the music was just pouring out of him on any given night. The audience understands the process, waits for him to find his groove, then the whole place explodes, because when he's on, there's nothing else like it in this world. The fact that he has continued to play as well as he has for so long is a real blessing. I never thought I'd say this, but Sonny's really great period might be 1978 to now."
Recently, health problems have prevented him from playing:
"I mostly stay in," Sonny said, sitting in his leather chair with his now familiar blood-orange skullcap on his head. He had a bunch of tests scheduled to check on his lungs, which he said had gotten "a little worse." He believed that the problem had been building for some time, perhaps back to 9/11. "I was living so close to the Towers, and when they fell down, we had to stay there," he said. "It was such an upsetting time, I really felt like playing. I took out my horn and took this deep breath, something I've done a million times. But I immediately felt sick, like I'd gulped down something bad. Some poison. It was just in the air."
Sonny looked wistfully at his sainted ax sitting on a brick shelf beside the fireplace. He hadn't played for months, the longest period since he returned from India in 1971.
But he wasn't feeling sorry for himself. Indeed, he appeared in good spirits, even jolly. It was difficult in the beginning, he said, not being able to practice. It was something he feared. "I really felt that would be the end of me, not being able to play. But I'm coming to terms with it. We're here for such a short time, you have to make the most of it. I've been lucky, getting to spend my life playing this horn. So how can I complain?"
Besides, Sonny said, it wasn't like the verdict was in for sure. There was every chance he'd play again. This was a good thing, Sonny said, because "I haven't really met my goals. I haven't made my full statement yet."
He asked if I remembered what he'd said back in Germantown, about those transcendent notes, the notes that hadn't yet been blown, the ones that were going to take him "past Sonny Rollins, way past."
Of course I did, I said.
"Well, keep your ears open," Sonny said. "They're coming."
Made me think of Linda Ronstadt who told AARP last month that she has Parkinson's.
"No one can sing with Parkinson's disease," said Ronstadt. "No matter how hard you try."
Last week, she spoke with Sam Tanehaus in the New York Times:
"Every time Emmy comes to town, I wish I could get up on stage with her," Ms. Ronstadt said. "I know I'd be allowed to, but I can't do it." Instead she will sit in the audience "and think the notes I'd be singing" in earlier times.
"I have no choice," she added, withheld passion at last surging to the surface, just as it does in the songs she made her own. "If there was something I could work on, I'd work on it till I could get it back. If there was a drug I could take to get it back, I would take the drug. I'd take napalm. But I'm never going to sing again."


text:
StrokeSmart(TM) Launches Redesigned Magazine and Interactive Website
Offerings Provide the Stroke Community with Free Interactive Resource Directory
CENTENNIAL, Colo., Feb. 4, 2013 /PRNewswire-USNewswire/ — StrokeSmart, the flagship publication from National Stroke Association dedicated to the millions of families impacted by stroke, launched today with a redesigned magazine and a new interactive website.
The new StrokeSmart magazine features a sleek redesign, improved readability, more engaging content and additional elements such as links to extra content online and brain-boosting games and puzzles. The new StrokeSmart website (http://www.strokesmart.org) features daily content from the world of stroke, social media interaction, news and research about stroke prevention and recovery and a critical peer-to-peer conversation for stroke survivors nationwide. Combined, the redesigned print publication and new website comprise a community of stroke survivors, caregivers and healthcare professionals unlike anything that has existed before.
The new website also features a comprehensive database called the StrokeSmart Resource Directory. According to the StrokeSmart managing editor Matthew Colella, the Resource Directory functions "like a yellow pages for stroke," and enables users to search national and local listings for stroke-related companies, products and services. Businesses can upload a free Resource Directory entry or purchase an upgraded listing for improved search results and greater visibility. The StrokeSmart Resource Directory is free for website users and designed to be a one-stop destination for all stroke-related industry.
National Stroke Association's chief executive officer Jim Baranski said readership feedback and a shift in the publishing industry led to repackaging StrokeSmart into a multichannel offering for the stroke community. "Media consumption is cross-platform now and our readers told us they want 24/7 access to the important stories and information that StrokeSmart provides," he said. "Put simply they want an ongoing conversation about stroke—and we listened."
Recent data from National Stroke Association and StrokeSmart shows:
"It was clear that we must organizationally commit to a long-term content strategy and continue offering all of it for free," Mr. Baranski said. "Unfortunately, the number of people impacted by stroke isn't going to decrease any time soon–we want our current and future readers to have this resource at their fingertips."
Working under the direction of National Stroke Association's marketing team, media strategists Association Media Partners (AMP) redesigned the print magazine while also creating the content rich companion website to reach into a wider audience. AMP also developed a cross platform monetization strategy leveraged to drive revenue, ensuring that all subscribers continue to receive StrokeSmart free of charge.
StrokeSmart's newly integrated media platform collectively aims to share the stories and news of a community and world impacted by stroke. One subscriber, Julie Dueease, describes StrokeSmart articles as a "very important part of healing." "That's just one perspective," said Taryn Fort, director of marketing and communications at National Stroke Association, "but a valuable peek into what this brand is at its core. We want StrokeSmart to be a part of all the stroke recoveries happening across the country."
The first 2013 issue of StrokeSmart arrives in mailboxes this week with a fresh look that maintains the stories of heroism and triumph that readers have come to expect.
Anyone interested in StrokeSmart can subscribe or renew for free online or by calling 1-800-STROKES.
About National Stroke Association
National Stroke Association is the only national organization in the U.S. that focuses 100 percent of its efforts on stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke. Founded in 1984, the organization works every day to meet its mission to reduce the incidence and impact of stroke. Visit www.stroke.org to learn more.
Press Contact: Taryn Fort
SOURCE National Stroke Association
National Stroke Association's mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.


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Lawyers working for former college athletes in cases against the NCAA have filed a lawsuit for at-least $5million against a company that sell photos of college players online.
The lawyers state that Professional Photo Store Fronts and Printroom.com, owned by a company called Brand Affinity Technologies (BAT), sell these pictures without permission of the athletes and in violation of an NCAA rule.
School have the right to use photographs in promotion games but the case depends on whether selling the image is allowed.
An NCAA rule 12.5.2 prevents the athletes from allowing their 'name or picture to advertise, recommend or promote directly the sale or use of a commercial product of any kind.' It also states that if an athlete discovers about a sale involving their name or picture that the athlete or the school must do what they can to stop it.
The suit, which is being brought by former UTEP defensive lineman Yahchaaroah Lightbourne, says former student athletes are owed more than $5million.
This case isn't the only one that involves former college athletes at the moment. A class action lawsuit brought by former athletes against Electronic Arts for using their images in its video games is currently in court in New Jersey.
Also, another class action lawsuit brought by former UCLA basketball star Ed O'Bannon is looking to have EA, marketing company Collegiate Licensing and the NCAA award the group money they believe is owed to them for misappropriating their rights.
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