Abstract:
A medication dispensing cart having a computer and monitor, a work surface with pull out keyboard, and plural drawers arranged as a vertical series of cassettes that can be added as needed. The battery powered device uses software and pass codes for controlling access to each drawer, and requires a second pass code for any drawer designated to contain narcotics. Records can be kept of who dispenses what medication and when for each cart in a system of carts. The cart in the system is in wireless communication with a system administrator. Emails alerting the system administrator of low battery power, of a cart switching to off, of an attempted break-in, and of inventory and usage data are sent automatically by email.

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
       [0001]    This application is a continuation of U.S. patent application Ser. No. 12/278,263, filed Mar. 11, 2009, which is a 371 of PCT/US2007/03765, filed Feb. 12, 2007, which claims the benefit of U.S. Provisional Application No. 60/772,416, filed Feb. 11, 2006. Each of the foregoing applications is incorporated herein by reference for all purposes. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    The present invention relates to dispensing medication to patients in hospitals and nursing homes. 
         [0003]    In the health care industry, an important component of patient care is medication. Medications, in the form of pills, capsules and liquids, are given to patients to relieve pain, to prevent or eliminate infections, and to treat illnesses and disease. Oftentimes the medications are given in doses that ate repeated at intervals during the day and may be part of a regimen that takes place over several days or even an extended period of time for chronic illness. Medications may have a powerful effect on the body. Some medications should not be taken with other medications or are carefully controlled because of their impact on the patient if too much is administered or because they are subject to abuse by others. 
         [0004]    In addition, if the wrong medication is given to a patient, or if the correct medication is given but in too large a dose or too frequently, harm may result. Accordingly, it is important to doctors, nurses and the staff and management of hospitals and nursing homes to make sure their patients take all prescribed medications and only the prescribed medication and to take them in accordance with their prescriptions. Usually, administrative controls and paper records, sometimes augmented by security measures, are used to achieve these objectives. 
         [0005]    However, there remains a need for better ways to dispense medications in a controlled manner. 
       BRIEF SUMMARY OF THE INVENTION 
       [0006]    The following presents a simplified summary of the invention in order to provide a basic understanding of some aspects of the invention. This summary is not an extensive overview of the invention. It is not intended to identify key or critical elements of the invention or to delineate the scope of the invention. Its sole purpose is to present some concepts of the invention in a simplified form as a prelude to the more detailed description that is presented later. 
         [0007]    According to its major aspects and briefly recited, the present invention is a cart designed for dispensing medication. The cart carries a computer for keeping track of who dispenses what type of medication, when it is dispensed, and that corroborates dispensing information automatically. 
         [0008]    The present cart includes a computer with wireless network access and a monitor, a power system having a battery pack to provide power to the computer and monitor, a cassette drawer system having one or more cassette drawers for holding medications, and a security system. Generally, the cassette drawer system, the power system and the security system are software controlled. Access to the cassette drawers is by pass code entry via the computer keyboard or a key override. Each cart user has a different code and only those having valid pass codes or keys can access the drawers. Particular medications, such as narcotics, require a second pass code or second key. 
         [0009]    The installation and use of the drawers is sensed by the computer so that it can record who accessed which cassette drawer and when. The use of the computer to track the dispensing of medications enables the cart administrator to compile this information and thereby confirm the medications were given by the cart users as prescribed. 
         [0010]    An important feature of the present invention is the use of email from the computer over a wireless network linking all other carts on a system. This feature allows the computer on each cart to keep an administrator informed of the status of each cart, such as the condition of the battery and the use of the cart. It also informs the administrator if there has been an attempt to open a drawer by force. 
         [0011]    Another important feature is the cassette drawer system. The drawer system allows additional drawers to be added or drawers to be removed. Drawers that have been added are automatically sensed by the computer and can then be opened only by those who have been given a code that permits access. Once a drawer has been added, it cannot be removed unless it is first opened. 
         [0012]    Still another important feature is the use of software to control access. The computer keyboard allows entry of pass codes by users and unlocks only the drawer they wish to access. No separate key pad or lock and key system is needed. 
         [0013]    Yet another feature is the use of software to control the raising and lowering of the computer monitor and work station. An electrical switch that is connected to the power system enables a user to adjust the height of the cart work station so that use of the cart can be made both in a standing and seated position. 
         [0014]    Still another feature of the present invention is the use of a power system that can be charged independently from the cart. The use of an encapsulated, self-contained power system and battery enables the user to charge the battery in smaller, more confined areas. Furthermore, a user can simply exchange a low charge power system for a fully charged power system without having to remove and replace the internal battery. 
         [0015]    These and other features and their advantages will be apparent to those skilled in the art of dispensing medications to patients from a careful reading of the Detailed Description of Preferred Embodiments accompanied by the following drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]      FIG. 1  is a perspective illustration of a medication dispensing cart, according to a preferred embodiment of the present invention; 
           [0017]      FIG. 2  illustrates a rear, perspective view of a medication dispensing cart according to a preferred embodiment of the present invention; 
           [0018]      FIG. 3  is a detailed, exploded, perspective view of the base of a medication dispensing cart, showing the battery in its cover being separated from the battery bracket on indicated in  FIG. 1  by reference number  10 , includes a computer/monitor  12 , preferably with both a computer and a monitor in one unit with the computer behind the monitor and in the same housing  14 . Cart  10  also has a work surface  16  with a slide out keyboard  18 . There is no security keypad; the keyboard&#39;s keypad serves for entry of codes to permit access. Work surface  16  is mounted on top of a mast  24  carried in turn by a rolling base  26 . Work surface  16  can optionally include holders for storing items, such as antibacterial lotions and drinks, which the user may need when making rounds with the cart  10 . 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0019]    Referring to  FIG. 2 , there is illustrated a rear view of the present cart  10  showing computer/monitor  12 , work surface  16 , mast  24 , and a power system  28 , which is carried by rolling base  26 . Work surface  16  can further include hidden USB port  80  for use if additional electronic devices, such as scanners, need to be employed. Computer/monitor  12  is attached to mast  24  or underneath the work surface through a mount  35  so that the entire top area of the work surface  16  is available to the user. Computer/monitor  12  is mounted using a tiltable bracket  34  so that the angle of viewing computer/monitor  12  can be adjusted to suit the particular user. A clear hard covering is applied over the monitor portion of computer/monitor  12  in order to make computer/monitor less susceptible to scratches and impact. Preferably the covering is about a ⅛.sup.th inch thick and made of acrylic polymeric plastic or other suitable plastic polymer. 
         [0020]    Mast  24  is vertically adjustable so that the user can work seated or standing and users of different heights can work comfortably. Preferably, mast  24  is electronically adjustable by pressing a button  29  rather than by turning a hand crank or other mechanical elevating mechanism. As shown in  FIG. 1 , the mast  24  is telescoped, with an outer mast member  25  dimensioned to receive an inner mast member  23 . This arrangement enables the raising and lowering of the computer/monitor  12  and work surface  16 . The raising and lowering of the mast  24  can be controlled by an electrical switch  29  that is connected to the power system  28  and mechanical means (not shown), such as a screw/nut drive system that utilizes a number of small balls (ball screw). In operation, a user would press the button  29  in one direction, such as forward, to activate the electrical switch  29  to lower the mast  24 , and in another direction, such as backward, to activate the electrical switch  29  to raise the mast  24 . The electrical switch  29  provides input to the power system  28 , which controls the raising and lowering of the mast  24  through an actuator connected to the mechanical means. Alternatively, the power system can also include a weight sensor connected to the actuator that can be used to override the raising and lowering of mast  24  based on the weight of the work surface  16  and computer/monitor  12 . For example, if the combined weight of the work surface  16  and computer/monitor  12  exceeds a preset, desired weight, the actuator will be tripped, and the mast  24  will no longer be moveable through the use of the button  29 . 
         [0021]    Power system  28  is illustrated in further detail in  FIGS. 3-4 . As shown, power system  28 , which is connected through mast  24  to computer/monitor  12 , includes a power system controller (not shown) and a battery  27  that is carried in a battery bracket  50  held in rolling base  26 . As discussed, the battery  27  can be charged in combination with the cart  10  or independently of the cart  10 , through a power cord  31 . Thus, work surface  16  further includes a power cord  31  plug rest  33  (shown in  FIG. 2 ) for conveniently storing the power cord  31  when the cart  10  is being moved or is not in the vicinity of a power source. Battery  27  can be fixed to battery bracket  50  with a variety of mechanical fasteners. In a preferred embodiment, battery  27  is fixed to battery bracket by two screws  52 . By removing screws  52 , battery  27  and its associated electronics can be removed from bracket  50  to expose the wiring connections. Once the wiring connections are disconnected, battery  27  can be lifted free using its handle  56 . Battery  24  is still in a cover  58  and may remain in cover  58  during recharging. 
         [0022]    In the event battery  27  needs to be replaced altogether, the screws  60  holding battery  27  in its cover  58  are removed, then the battery hold down screws  62  are removed and finally, battery  27  can be disconnected and replaced. It will be clear that having both a battery cover  58  that stays with battery  27  while battery  27  is either in service or being recharged, and which battery  27  and cover  58  can be quickly removed from cart  10 , makes it faster and easier to keep fully charged batteries on carts  10 . 
         [0023]    As discussed, battery  27  can be charged in combination with the cart  10  or independently of the cart  10 , through a power cord  31 . Thus, work surface  16  further includes a power cord  31  plug rest  33  for conveniently storing the power cord  31  when the cart  10  is being moved or is not in the vicinity of a power source. Additionally, power system  28  can be equipped with an LED indicator to show when the batter  27  is charging and/or fully charged. 
         [0024]    Battery  27  is designed to last through at least one shift of eight hours before requiring recharging, preferably about 10 hours. In addition, each battery is connected to the balance of cart  10  using a “Y” electrical connector  61  that permits a second, fully charged battery  27  to be connected (for “hot swapping”) to the unused part of the Y connector, and then the first battery  28  can be removed from the battery bracket and disconnected from the Y connector without loss of power, or data, to computer/monitor  12 , and the second battery can then be installed into the battery bracket. The connections that hold battery  28  in its bracket are designed for quick release so battery change out takes but a few minutes at most. 
         [0025]    Referring now to  FIG. 5 , cart  10  preferably includes a cassette drawer system  30 . As illustrated, at least one cassette drawer system  30  can be carried below work surface  16 . An exploded, detailed view of the cassette drawer system  30  is shown in  FIG. 6 . Cassette drawer system  30  is preferably modularized, and includes a cassette drawer manager  70 , which houses a cassette drawer controller and interface  72  for monitoring the status and activities of cassette drawers and receiving input for computer/monitor  12 . The cassette drawer system  30  is generally connected to work surface  16  and wired to computer/monitor  12 . More particularly, the top of cassette drawer manager  70  is bolted to work surface  16 . Accordingly, cassette drawer manager  70  includes bolt fasteners  74  along its top surface. Optionally, cassette drawer manager  70  includes a first key override lock  71  and a second key override lock  73 . In the event drawers need to be opened, and the cassette drawer system  30  or the computer/monitor  12  system is malfunctioning, a first key from authorized users will override the cassette drawer manager controller  72  to open the drawers containing certain medication. If narcotic medication needs to be accessed, a user must insert both a first key and a second key to open the narcotics-containing drawers. 
         [0026]    Beneath cassette drawer manager  70 , at least one cassette drawer  76  is latched. Depending on the dimensions of the cassette drawer manager  70  and the cassette drawers, up to four drawers  76  can be added. An added drawer  76  cannot be released without opening the drawer. As soon as a drawer  76  is added, it is sensed by controller of computer/monitor  12  and cannot be opened except by a user with an authorizing pass code. 
         [0027]    The latching mechanism between the cassette drawer manager  70  and a cassette drawer  76  will be the same as between a first cassette drawer and a second cassette drawer. This latching mechanism is shown in the expanded detailed drawings in  FIG. 6 . As between the cassette drawer manger  70  and a first cassette drawer, on the underside of cassette drawer manager  70  are a plurality of dovetail-shaped cutout portions  80  that are dimensioned to receive dovetail-shaped projections  84 . Similarly, on the underside of each cassette drawer  76  are a plurality of dovetail-shaped cutout portions  80  that are dimensioned to receive dovetail-shaped projections  84  on every lower cassette drawer  78 . In operation, dovetail projections  84  simply slide into dovetail cutouts  80 . 
         [0028]    Once cassette drawer  76  is seated fully into cassette drawer manager manager  70 , spring tabs  90  having pins  91 , which have been cut out from the bottom surface of cassette drawer manager  70 , are cammed upward as drawer  76  is slid into place, and snap downward into corresponding recesses  92  in the top surface of drawer  76 . Pins  91  on spring tabs  90  will hold drawer  76  in place until drawer  76  is opened by an authorized person who can then pull tabs  90  down to release drawer  76  from manager  70 . Preferably, once cassette drawer manager  70  and any and all additional cassettes are in place, the cassette drawer manager  70  and the cassette drawers are also electronically connected. 
         [0029]    As illustrated, cassette drawer manager  70  and cassette drawer  76  are generally U-shaped to facilitate engagement with the mast  24 . Each cassette drawer  76  typically has at least two compartments  94  that are independently lockable through electronic locks  100  and that have corresponding sensors  110 . Sensors  110  determine if a drawer is open or closed, including of course when a drawer is left open or not fully closed. A drawer that is opened without authorization causes an alarm to sound and initiates an email to the system administrator. All locks  100  are software controlled rather than by using keys. For example, a lock  100  could include a solenoid actuator connected to a lever and controlled by software. Keys can be lost or stolen or fall into the wrong hands. Furthermore, it is easier to change access pass codes using software than to re-key locks. Computer/monitor  12  can be programmed to lock every drawer unless unlocked by a person with the correct level of authorization who enters the correct pass code via keyboard  18 . Access to a compartment  94  containing narcotics requires two pass codes; otherwise one pass code unlocks a compartment  94 . Each user has his or her own pass code or codes so the user who accesses each drawer is known by the pass code used, as well as the time and date of the access by that user. 
         [0030]    Cart  10  is optionally provided with a plug in scanner for reading medication containers and automatically and accurately loading drawers and the computer database with the correct information about the medications being loaded into each drawer. In this way, the system administrator can have a real time inventory of medications in all carts in its system, knowing exactly what type and how much medication is in each drawer of each cart. 
         [0031]    Cassette drawer system  30  also has an optional utility cassette  78 , which can be used to store such items as rubber gloves, paper cups, tissues, and so forth. Because a utility cassette  78  need not be secured, cassette drawer manager  70  automatically deactivates sensors  110  and locks  100  of utility cassette drawers  78  that become part of the cassette drawer system  30 . 
         [0032]    A block diagram of the operating system for the cart  10  is shown in  FIG. 7 . As illustrated, computer/monitor  12  includes a computer controller and interface logic  200  that receives computer controller input and generates computer controller output. For example, computer controller  200  process user input, such as the identity of user, the biometric information of user, pass codes entered by user. Furthermore, computer controller provides output to cassette drawer system  30  relating to the designation of cassette drawers included in the cassette drawer system  30 . Significantly, computer/monitor  12  can, in real time, inventory medication as it is loaded and as it used, as well as which user is dispensing the medication. Additionally, computer/monitor  12  is equipped with a wireless network connection, preferably through SMTP (simple mail transfer protocol) so that the user of that cart  10  can communicate with a central administrator  400 . Computer/monitor  12  also communicates with administrator  400  without the active assistance of the user. Accordingly, the status and whereabouts of the cart  10  can be constantly and effectively monitored through wireless communication. 
         [0033]    As previously described, the cassette drawer system  30  also includes cassette drawer controller and interface logic  500 . This cassette drawer controller receives input from the computer controller about the cassette drawers and their designations. Cassette drawer controller, therefore, can lock and unlock drawers based on this input. Furthermore, the cassette drawer controller logs what the drawers do, including when they are opened and by whom. Accordingly, the cassette drawer system  30  has the ability to monitor itself. Similarly, the power system  28  also includes controller and interface logic  600 , which monitors the condition of battery  27 , and controls the raising and lowering of the mast  24 . For example, the condition of the battery  27  when low or when the unit is turning off due to low battery power, power system controller communicates these conditions to computer controller, which in turn reports by email to the administrator. Computer/monitor  12  will also automatically report by email an attempt to break into cart  10 , a log of the charging system, a log of the times and the identities of users who have accessed each cassette drawer. Other information can also be reported. 
         [0034]    To summarize an embodiment of the logic for the medication cart system,  FIG. 8  includes of flow chart. As shown, at  700 , a decision is made by medication cart  10  whether the battery  27  is suitable. If the battery  27  is not in a good condition and if communication is required at  701  as to the status of the battery  27 , an electronic communication is sent to central administrator at  702 . If maintenance is needed, the battery  27  will be charged or replaced at  703 . If the battery  27  is in good condition and communication is required at  704 , an electronic communication is sent to central administrator at  705 . 
         [0035]    At  706 , a decision is made as to whether medication must be dispensed or refilled. If narcotic medication must be dispensed or refilled at  707 , the narcotics drawer is unlocked with two pass codes at  709 . If communication as to the status of the narcotics drawer is required at  710 , an electronic communication is sent to central administrator at  711 . If non-narcotic medication must be dispensing or refilling at  712 , the medication drawer is unlocked with on pass code at  713 . If communication as to the status of the medication drawer is required at  714 , an electronic communication is sent to central administrator at  715 . If a utility drawer needs to be accessed at  716 , the utility drawer is unlocked with no need for a pass code at  717 . If communication as to the status of the utility drawer is required at  718 , an electronic communication is sent to central administrator at  719 . 
         [0036]    If user adds or subtracts a cassette drawer from the cassette drawer system  30  at  720  and communication is required as to the status of the cassette drawer system  30  at  721 , an electronic communication is sent to central administrator at  722 . If, on the other hand, an unauthorized access to the cassette drawer system  30  is attempted or accomplished at  730 , and communication is required as to the status of the cassette drawer system  30  at  731 , an electronic communication is sent to central administrator at  732 . 
         [0037]    It is intended that the scope of the present invention include all modifications that incorporate its principal design features, and that the scope and limitations of the present invention are to be determined by the scope of the appended claims and their equivalents. It also should be understood, therefore, that the inventive concepts herein described are interchangeable and/or they can be used together in still other permutations of the present invention, and that other modifications and substitutions will be apparent to those skilled in the art from the foregoing description of the preferred embodiments without departing from the spirit or scope of the present invention.