Abstract:
A packaging system and associated method for use with a pharmaceutical dispenser provides a turnkey solution for packaging pharmaceutical products such as solid medications and nutritional supplements to be taken orally in health care settings, including but not limited to long term care (LTC) and assisted living settings. An overall pharmacy system and methodology begins with bulk medications and supplements introduced into the work flow, individually packaged and assembled into medpass orders per patient and delivered to the LTC facility or other institution for patient consumption. The process begins by converting bulk medications and supplements to packaged unit doses and ultimately individually packaged medpass bags for each patient on a 24-hour schedule. The design of the overall system and its individual components allows for physical control of each unit dose package from start to finish without any unit dose package “free fall” in the system.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims priority under 35 U.S.C. §119(e) to U.S. Application No. 61/550,787, filed Oct. 24, 2011, the entire contents and disclosure of which are incorporated herein by reference. 
     BACKGROUND OF THE INVENTION 
     This invention is related to those disclosed in U.S. patent application Ser. No. 09/995,907, filed Nov. 28, 2001; U.S. patent application Ser. No. 11/962,210, filed Dec. 21, 2007; U.S. Provisional Patent Application Ser. No. 60/883,419, filed Jan. 4, 2007; International Application No. PCT/US07/87905, filed Dec. 18, 2007 and published as WO 2008/085673; U.S. Provisional Patent Application Ser. No. 61/120,209, filed Dec. 5, 2008; U.S. patent application Ser. No. 12/559,630, filed Sep. 15, 2009 and published as U.S. 2010/0176145; U.S. patent application Ser. No. 12/559,601, filed Sep. 15, 2009, and published as U.S. 2010/0172724; U.S. patent application Ser. No. 12/617,075, filed Nov. 12, 2009 and published as U.S. 2010/0174552; International Application No. PCT/US2009/066756, filed on Dec. 4, 2009 and published as WO 2010/065845; and each of these prior applications is hereby incorporated herein by reference in its entirety. 
    
    
     This invention relates generally to systems and associated methods for packaging pharmaceutical products for delivery to the patient and, more particularly, to automated dispensing and packaging systems and associated methods for delivering pharmaceutical products to individual patients in health care facilities. 
     Hospitals, long term care and other health care facilities distribute and administer pharmaceutical products to patients in individual doses numerous times per day. Pharmaceutical products such as prescription medications, nutritional supplements and the like are often stored in bulk by pharmacies and are repackaged into containers of multiple doses based on individual prescriptions for retail or outpatient distribution. For inpatient or in-facility distribution, pharmacies also often repackage bulk pharmaceuticals into “unit of use” or “unit dose” packages, for example, multiple blister packs that are connected together in a strip that contain multiple single doses of the pharmaceutical product. 
     The traditional method for distributing individual dosage units of pharmaceutical products to patients begins with the generation of a patient order by a physician for particular medications. The patient order is delivered to the pharmacy. There, the process of interpreting the patient order, pulling the specified medication or supplements from the drug storage areas, packaging the medication or supplements, and labeling the package is routinely done manually by pharmacy support personnel. After a final check by the facility pharmacist, the packaged individual dosage units are ready for distribution. In large facilities, the packages containing the patient&#39;s order are forwarded to individual nursing units where nursing staffers distribute and administer them to the patients. 
     There are several disadvantages associated with the traditional method of distributing individual dosage units of pharmaceutical products. To begin with, the process is labor and cost intensive. Many separate labor steps are required to fill a single patient order. In large facilities servicing hundreds of patients each day, the staffing requirements to rapidly process patient orders are substantial. In addition, with so many human inputs required in the existing process, there may also be a risk of human error. 
     As an attempt to address at least some of the issues with respect to staffing requirements and human error, a variety of automated medication dispensing systems have been developed. The current landscape for automated medication dispensing is dominated by a 30-day system utilizing either “bingo cards” or unit doses supplied in 30-day box. The known systems provide a 30-day or other multi-day supply for each patient pass-time for each prescription on a relatively long term basis. In the event the patient is discharged or the treatment is changed, the unused portion of the 30-day supply cannot be cost effectively reused even though the product may be labeled appropriately. The labor cost required to reintroduce the pharmaceutical products back into the distribution system and to maintain the integrity and traceability of manufacturer and expiration data exceeds the value of the pharmaceutical products, even if the substantial restocking fees are paid by the healthcare system. As a result, such unused pharmaceutical products are returned to the pharmacy for disposal. This disposal of unused pharmaceutical products is a significant waste of those resources as well as a detriment to the environment. 
     A variety of pharmaceutical dispensing systems have been used, some of which are described in the various patent applications noted above. While many such systems can select and accumulate the various medications and supplements for the patients in a LTC or similar facility, most known dispensing systems do not adequately package the dispensed medications and supplements for proper and efficient transfer to, storage at or distribution by the LTC facility healthcare workers. The ability to track, package and verify the dispensed medications and supplements in an efficient, reliable and predictable manner according to the specific needs, desires and preferences of the LTC facility is lacking in most such systems. 
     Hence, there is a continuing need to provide a system and overall methodology for packaging medication orders for individual patients in health care facilities. 
     SUMMARY OF THE INVENTION 
     This invention has many aspects and embodiments generally directed to a process or method and associated system and sub-systems to provide a turnkey solution for dispensing and packaging medications and nutritional supplements to be taken administered in health care settings, including but not limited to long term care (LTC) and assisted living settings. 
     The process according to one embodiment of this invention includes packaging unit doses and ultimately individually packaged medpass bags for each patient on a 24-hour schedule. Additionally, inventory management is automated and the various safeguards and measures built into this system increase patient safety eliminate waste and increase labor efficiency by reducing and/or minimizing the disposal of unused medications and supplements. 
     A dispenser for the automated filling and packaging of individual medpass patient orders is utilized. The dispenser provides an automated solution to the efficient and timely preparation of medpass orders handled in LTC and assisted living settings by filling individual medpass orders for each patient. These orders are assembled in a bag of unit dose medications and supplements and individual bags are combined together. The dispenser may be of any design according to this invention, although one such dispenser is disclosed in the patent applications noted above and incorporated herein. The medications and supplements are dispensed according to physicians&#39; orders and placed in packs which are then packed in a tote and delivered to the LTC for distribution. At each step in the process, the unit dose medications and supplements are tracked via a bar code scanner and the status of each unit dose medication is cataloged and regularly updated in the pharmacy information management system (PIMS) database. 
     The design of the overall system and its individual components allows for physical control of each unit dose package from start to finish without any unit dose package “free fall” in the system. This process is automated and does not rely upon manual sorting. The medpass bags are consolidated into the final shipping container and do not require manual sorting and packing thereby solving many of the problems associated with prior art solutions. 
     The various safeguards and measures built into the system of this invention include unit dose scanning at various steps as well as personal inspections, as needed, to increase patient safety, eliminate waste and increase labor efficiency by reducing and/or minimizing the disposal of unused pharmaceutical products. 
     One objective of this system and methodology is to avoid the need for disposal of prescriptions medications and nutritional supplements thereby attacking the waste and inefficiency issues at their source. This invention in one embodiment is a packaging system for prescriptions, medication and nutritional supplements. Positive control of each unit dose package is maintained throughout the entire process. In other words, gravity feed and the random nature of medications freefalling through the system is avoided according to one aspect of this invention. 
     The individual pharmaceutical products are packaged in a primary package referred to as unit dose packages and multiple such unit dose packages are dispensed for each medpass order. Individual medpass orders for each patient are assembled in a med pass bag as a secondary package of unit dose pharmaceutical products and individual med pass bags are stacked together. The staked bags are then packed in a travel pack as a tertiary package and delivered to the LTC for distribution. At each step in the process, the unit dose pharmaceutical products are tracked via a bar code scanner and the status of each unit dose is cataloged and regularly updated in the information management system database. 
     The various embodiments of this invention provide primary (i.e., unit dose packages), secondary (i.e., medpass bags) and tertiary packaging (i.e., travel packs containing one or more medpass bags) for unit doses of medications. One aspect of this invention is a dispensing collation table which in one embodiment is an automated assembly that re-orients a linear row of up to twelve unit dose packages into a shingled, four by three array. The resulting matrix is a flat, nested, compact structure that allows for robust vision verification and simplified loading into a secondary package or medpass bag. 
     Another aspect of this invention includes vision inspection systems which are utilized to inspect the unit dose array noted above prior to and after secondary packaging. Prior to packaging, a 2D barcode on each unit dose blister package contained in the array is inspected and verified against an order database. Post packaging, a second vision system is utilized to verify that the correct number of unit dose packages is present in the med pass bag to ensure none were lost in the packaging process. All images from both inspections are saved in electronic storage medium where they can easily be retrieved and viewed by operations personnel. Any unit dose packages or medpass bags not meeting inspection requirements are automatically removed from the system and scheduled for re-processing. The system is also able to detect unit dose package presence, even if the barcode cannot be read. 
     Another aspect of this invention is the secondary package, also known as the ‘med-pass’ bag which has various advantageous design features including:
         a) The front of the bag in one embodiment is an opaque material such as white LDPE, white HDPE or another such material so that on demand printing can be utilized to print specific order items such as patient name, room number, medpass time and medications contained within the bag.   b) The back of the bag in one embodiment is a clear, translucent, transparent or non-opaque material such as LDPE, HDPE or another material which enables both human and machine vision to view the specific labels of each unit dose medication contained within the bag.   c) Double sided tape in one embodiment is utilized between the two LDPE bag layers to facilitate reclosing of the bag if all medications are not administered at the same time.   d) Three tear perforation lines in one embodiment are punched, slit, or otherwise weakened across the bag to facilitate multiple methods of use:
           i. A first top perforation allows for tearing open of the bag above the double-sided tape line (item c above) so that the bag can be resealed.   ii. A second top perforation provides a convenient method of separating all patient information contained at the top of the bag from the listing of medications found on the rest of the bag. This feature satisfies HIPAA regulations. After HIPAA regulations have been satisfied, all other materials can be handled as normal waste without a shredding requirement.   iii. A bottom perforation allows the bag to be opened at the bottom so all medications can be removed if the reclosable feature is not to be used.   
           e) The invention in one embodiment utilizes technology to form pouches on line.   f) Resident, facility and medication information in one embodiment is printed in specific locations on the white LDPE to enable efficient storage in the cart, and to allow the nurse to quickly find the resident medications at a given administration time. Further, the printing on the bag can be ordered in alphabetical order to assist with verification against the Medication Administration record.   g) Printing on the medpass bag and unit dose blisters offers verifiable three-way medication checks.   h) Medpass bags can be printed with unique bag identification to verify the correct medications are loaded and the bag subsequently tracked through the dispensing process.       

     The addition of double sided tape to the interior of the medpass bag according to another aspect of this invention solves the problem of providing a reclosable bag to end users. In addition, the clear back of the medpass bag (in combination with the unit dose package orientation noted herein) provides a clear window for visual inspection of unit dose package content labels. Med pass bag forming on line permits use of a wider variety of materials at a significantly reduced cost and improved delivery time. 
     Another aspect of this invention is the tertiary package which is a sealed clear LDPE material travel pack that can hold from one to thirty secondary packages (medpass bags). The tertiary packages or travel packs are of variable length to accommodate any number of medpass bags needed for that medication cart. The clear material allows visual inspection of the contents without opening the sealed pack. Additionally, the pack is perforated in such a manner to allow both ease of opening and a re-closable feature utilizing a print and apply label that is affixed over the perforation area. The pack is disposable such that return to the pharmacy is not required. 
     The methodology to load the medpass bags into the tertiary package permits a significant packaging density thereby reducing both delivery costs and permitting increased storage quantities in the medication carts at the LTC facilities. 
     Prior art systems utilized a mechanism to drop loose unit dose packages into the secondary package or med pass bag. This method produced unpredictable results due to the random nature of how the unit dose packages are settled into the medpass bag as well as a bag thickness several inches thick. Further, due to the random orientation of unit dose packages, only 8 shallow unit dose packages (or 6 deep) could be loaded into a single medpass bag. The system of this invention orients all unit dose packages and allows loading in a controlled, predictable manner. This invention permits any mixture of shallow/deep unit dose packages up to 12 per medpass bag. 
     Prior art for unit dose vision inspection for such systems consisted of a complex array of three vision systems prior to packaging. A post packaging inspection was not possible due to a lack of predictable orientation of the unit dose packages. This invention utilizes one simplified vision system prior to packaging to inspect the 2D barcodes of each unit dose package. In addition, a post packaging camera utilizes a novel method of counting the number of unit dose packages in the sealed medpass bag as a quality inspection. 
     Prior art systems of this type consisted of a fixed volume, opaque corrugated box. This invention utilizes a clear travel pack that provides for simple inspection of the contents. It also greatly increases packing density since it can be sealed at variable lengths dependant on the number of secondary packages contained within. Prior art systems required return, cleaning and reuse of such packaging, but this invention ensures product is not accidentally discarded or returned. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein: 
         FIG. 1  is a perspective view of a pharmaceutical dispensing and packaging system according to one embodiment of this invention; 
         FIG. 2  shows an enlarged perspective view of a packaging system according to one embodiment of this invention for use with the pharmaceutical dispensing system; 
         FIG. 2A  is a top plan view of the packaging system of  FIG. 2 ; 
         FIG. 3  is a perspective view of a collation module of the packaging system according to one embodiment of this invention; 
         FIG. 4  is a top view partially broken away of the collation module of  FIG. 3 ; 
         FIG. 5  is a perspective view of one embodiment of a collation table utilized in the collation module; 
         FIG. 6  is a perspective view of a picker system as part of the collation module according to one embodiment of this invention; 
         FIGS. 7A-7E  are cross-sectional sequential views taken along line  7 A- 7 A of  FIG. 4  showing unit dose packages being transferred from a main conveyor of the dispensing system into the collation module according to one embodiment of this invention; 
         FIGS. 8A-8C  are cross-sectional sequential views taken line  8 A- 8 A of  FIG. 4  showing a first portion of the picker system transferring a number of unit dose packages from the collation table to a unit dose package nest; 
         FIGS. 9A-9C  are cross-sectional sequential views taken along line  9 A- 9 A of  FIG. 4  showing a second portion of the picker system transferring a number of unit dose packages from the collation table to the unit dose package nest; 
         FIG. 9D  is a print of a vision inspection picture of the unit dose packages seated in the nest during processing similar to the relevant portion of  FIG. 9C ; 
         FIGS. 10A-10C  are cross-sectional sequential views taken line  10 A- 10 A of  FIG. 4  showing a third portion of the picker system transferring a number of unit dose packages from the collation table to the unit dose package nest; 
         FIGS. 11A-11C  are cross-sectional sequential views taken along line  11 A- 11 A of  FIG. 4  showing a fourth portion of the picker system transferring a final set of unit dose packages from the collation table to the unit dose package nest; 
         FIG. 12  is a perspective view of a unit dose package insert module positioned to retrieve an array of unit dose packages in the unit dose package nest; 
         FIG. 12A  is a top plan view of the arrangement shown in  FIG. 12  with portions of the components removed for clarity; 
         FIG. 12B  is a cross-sectional view taken along line  12 B- 12 B of  FIG. 12A ; 
         FIGS. 13A and 14A  are sequential views similar to  FIG. 12A  showing fingers on a unit dose package insert assembly retrieving the array of unit dose packages from the unit dose package nest; 
         FIGS. 13B and 14B  are each cross-sectional views taken along lines  13 B- 13 B and  14 B- 14 B, respectively, of  FIGS. 13A and 14A ; 
         FIG. 14C  is a cross-sectional enlarged view of a portion of the unit dose package insert assembly capturing the array of unit dose packages; 
         FIGS. 15A-15D  are sequential partially cross-sectional views of a medpass bag formation module and unit dose package insert dial assembly according to one embodiment of this invention; 
         FIG. 16A  is a perspective view of one embodiment of a medpass bag according to this invention with an array of unit dose packages contained therein; 
         FIG. 16B  is a perspective view of multiple medpass bags heat staked together; 
         FIGS. 16C and 16D  are perspective views showing methods of opening the medpass bag according to various aspects of this invention; 
         FIG. 16E  is a print of a vision inspection picture of the unit dose packages contained in the medpass bag during processing; 
         FIG. 17  is a perspective of one embodiment of a bag accumulation module according to this invention; 
         FIGS. 18-21  are sequential top plan views of a portion of the bag accumulation module retrieving medpass bags for processing; 
         FIGS. 22-23 and 26-28B  are side elevational partially cross section sequential views of the module of  FIG. 17  processing individual medpass bags together and positioning them within a pre-formed travel pack; 
         FIGS. 24-25  are views similar to  FIG. 23  with selected medpass bags being processed through a rejection chute of the module of  FIG. 17 ; 
         FIG. 29  is a perspective view of a travel pack loader module which forms packs to receive medpass bags therein according to one embodiment of this invention; 
         FIGS. 30-32  are cross-sectional side elevational sequential views of the module of  FIG. 29  forming a pack according to one embodiment of this invention; 
         FIGS. 33-34  are sequential top elevational views of the module of  FIG. 30  showing a pack being cut from a supply of pack material; 
         FIG. 35  is a side elevational view showing the severed pack being pulled into an expanded configuration; 
         FIGS. 36A-36C  are sequential enlarged views of area  36 A of  FIG. 35  showing a free end of the pack being expanded according to one embodiment of this invention; 
         FIGS. 37 and 38  are sequential side elevational views similar to  FIG. 35  showing the pack being installed over a tubular shell in preparation for receipt of the medpass bags according to one embodiment of this invention; 
         FIGS. 39A and 39B  are sequential views of the enlarged section  39  shown in  FIG. 38 ; 
         FIGS. 40A and 40B  are sequential views of the enlarged section  40  shown in  FIG. 38 ; 
         FIG. 41  is a side elevational view similar to  FIG. 38  showing a subsequent pack being formed by the module according to one embodiment of this invention; 
         FIGS. 42A and 42B  are sequential views of the enlarged section  42  of  FIG. 41 ; 
         FIG. 43  is a perspective view of a travel pack loader module, label printer assembly and offload conveyors according to one embodiment of this invention; 
         FIG. 44  is a top plan view of the components shown in  FIG. 43 ; 
         FIGS. 45-47  are sequential views similar to  FIG. 44  showing a label being installed on a travel pack; 
         FIGS. 48-49  are side elevational sequential views of medpass bags being inserted into a pack in the shell in preparation for sealing and label application; 
         FIGS. 50-52  are side elevational partial cross-sectional views of the pack being sealed around the medpass bags according to one embodiment of this invention; 
         FIGS. 53-55  show an orthogonal cross-sectional view of the arrangement and sequential pack-sealing operation shown in  FIGS. 50-52 ; 
         FIGS. 56-58  are side elevational partial cross-sectional sequential views of the sealed and labeled travel pack being transferred to one of two offload conveyors according to one embodiment of this invention; 
         FIGS. 59 and 60  are top partial cross-sectional and sequential views of the travel pack being positioned on one of the offload conveyors; and 
         FIG. 61  is a perspective view of the travel pack with attached label containing a number of staked medpass bags with unit dose packages of medications and supplements ready for delivery to the LTC or other healthcare institution according to one embodiment of this invention. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     A dispensing system  10  according to one embodiment is shown in  FIG. 1  and is configured to store and dispense individually packaged and labeled doses of medications/supplements, and to assemble the dispensed medications/supplements into individual medication orders, such as time-pass medication orders to be delivered to a long-term care (LTC) facility, for example. The dispensing system  10  shown and described herein is one example of such a system that can be utilized in conjunction with a packaging system  12  as shown and described herein. The dispensing system  10  of one embodiment is divided into distinct modules that are dedicated to dispensing the medications/supplements based on the demand, or order frequency, of those items. In the exemplary embodiment shown, a first module  14  is configured to dispense medications/supplements having a relatively high-demand or order frequency, and a second module  16  of the dispensing system  10  is configured to store and dispense medications/supplements having a relatively lower demand or medium order frequency. 
     In the dispensing system  10  embodiment shown and described herein, the medications/supplements are provided in unit dose packages  18  sized to receive an individual dose of a particular medication/supplement, commonly referred to as a blister pack. With reference to  FIGS. 16A-D , an exemplary unit dose package  18  includes a base portion  20  defining a cavity for receiving the individual dose of the medication/supplement  22 , and a generally planar closure panel  24  disposed over an open end of the base portion  20 . The peripheral dimensions of the blister capsule base portion  20  of the unit dose packages are smaller than the perimeter dimensions of the upper, generally planar closure panel  24  of the packages  18 . The packages  18  may be provided with information  26  related to the medication/supplement  22  contained in the packages  18 , such as the name of the medication/supplement  22 , the manufacturer, the date manufactured, the lot number, and/or other information. In the embodiment shown, information  26  is provided on the closure panel  24  and includes machine-readable information, such as a bar-code or QR code, which may be used to facilitate the automated storing, inspecting, tracking, dispensing, and packaging of orders. 
     With continued reference to  FIG. 1 , the dispensing system  10  of one embodiment further includes an endless main conveyor  28  with a number of carriers that move past the first, high-demand module  14  and the second, low-demand module  16  to collect ordered medications/supplements and carry them to a designated downstream location for further processing and packaging. In the embodiment shown, a first, upstream end  32  of the main conveyor  28  is positioned adjacent the high-demand module  14 . The carriers  30  are moved along the main conveyor  28  past the high-demand module  14  and the low-demand module  16  toward a second, downstream end  34  where the medications/supplements are packaged in the packaging system  12  into boxes, cartons or totes for delivery to the LTC facility. Each carrier  30  defines a dedicated or designated space on the main conveyor  28  for a particular order. 
     The main conveyor  28  thereafter carries the carriers  30  to the packaging system  12  for final packaging and assembly of the patient orders. During processing of the packages  18 , the dispensing and packaging systems  10 ,  12  are each configured to maintain positive control of the medications/supplements  22  and packages  18  such that no medication/supplement  22  is allowed to “free fall” during the dispensing and packaging processes. 
     After the unit dose packages  18  of medications/supplements  22  for an order have been transferred from the modules  14 ,  16  to the assigned carrier or carriers  30  on the main conveyor  28 , the carriers  30  continue along the main conveyor  28  to the packaging system  12  for subsequent processing into appropriate containers for delivery to the one or more LTC facilities. A camera station with at least one sensor  38  may be positioned downstream of the low-demand module  16  and upstream of the packaging system  12  to verify the medications/supplements  22  in the carriers  30  via the bar code  26  on each unit dose package  18  in the carrier  30 . 
     The dispensing system  10  further includes a control  36  configured to receive orders for medications/supplements and to process the orders for delivery to a LTC facility. Orders may be electronically received by the control  36  from one or more LTC facilities, such as by transmission over a network, or by any other suitable method. Alternatively, orders can be input directly into the control  36  via an appropriate interface, such as a keyboard or other suitable devices. The control  36  identifies which medications/supplements  22  are required from the high-demand module  14  and the low-demand module  16  to fill each order. In one embodiment, the orders corresponding to each medication pass to be administered to a particular patient for that particular day are processed by the control  36  such that the unit dose packages  18  of medications/supplements  22  for each medication pass to be administered to the patient are assembled together, and the medpass bags are then grouped together in totes for delivery to the LTC facility. 
     The control  36  assigns one or more carriers  30  to receive the unit dose packages  18  of medications/supplements  22  for each order. The control  36  then controls the movement of the carriers  30  on the main conveyor  28  through the high-demand module  14  and the low-demand module  16  to receive the unit dose packages  18 . The control  36  may be coupled to an order entry database and via a web service the orders are passed to the dispensing system  10  one at a time. Alternatively, multiple orders may be passed at a time, for example, ten orders passed at a time. As such, the remaining, subsequent orders are buffered in the database. 
     In another embodiment, the dispensing system  10  may be configured to receive and process short turn-around time orders (“stat orders”) that are received separately from the periodically received orders from the LTC facilities. The control  36  integrates the stat orders into the orders being processed and may direct the assembled stat order to a separate location for subsequent handling. The control  36  may also be configured to receive signals from various sensors associated with the dispensing system  10  and packaging system  12  to facilitate managing operation of the systems  10 ,  12 . 
     One aspect of the dispensing and packaging systems  10 ,  12  of this invention is the structure and process for maintaining positive control (i.e., no free-fall or gravity induced movement of the unit dose packages  18 ) through the dispensing and packaging operations. This aspect minimizes mishandled, lost, errant or jammed packages  18  in the filling of patient orders. 
     Labor savings and safety of the systems have been previously identified herein. However, the fact that the control  36  may compare the unit dose package barcode  26  to the prescription order and the medpass bag barcode compared to the carrier ID (and therefore back to the prescription order) at the time of prescription fill is an advantage. This feature is the basis for eliminating the need for added nurse or other practitioner checks often required in manual and other automated dispensing systems (the first being at order entry and the second being at conversion from bulk to unit dose in the prepack operation). The methods of cross-checking the unit dose packages  18 , the med pass bag and travel pack back to the original order are a beneficial aspect of this invention. 
     The dispensing system  10  has been designed to be able to dispense unit dose packaged vials through the medium mover module  16 . The unit dose packages  18  for vials would be the same width as other medications or supplements, just longer and possibly deeper. 
     The dispensing system  10  is very modular. That is to say, if the application or utilization of the system were to go into a new area (acute care, for example) and fewer medications/supplements are required in the medium mover module  16  and more in the high mover module  14  were needed, the design modification of the dispensing system  10  is very easily accomplished. It is a very flexible system design. 
     The medium mover module  16  angled dispense tubes utilize cylindrical weights of a very specific weight and design to roll through the angled tubes ensuring a constant pressure against the back of the stack of unit dose packages  18 , thus keeping the first package to be picked parallel with the pick face. 
     Some embodiments of the dispensing system  10  included a feature that would allow the placement of miscellaneous single doses into the system, which would then be read and picked for distribution. This is a good feature for ‘ultra slow’ movers and could be designed to be even more compact with various embodiments of the dispensing system  10 . 
     Referring to  FIG. 2 , the packaging system  12  is shown in perspective view and is located at the downstream end  34  of the main conveyor  28 . The unit dose packages  18  for each of the medpass orders are delivered to the packaging system  12  on one or more carriers  30  on the main conveyor  28 . The unit dose packages  18  are linearly aligned and arranged on the carrier  30  and may have anywhere from one through twelve unit dose packages  18  on each carrier  30  according to one embodiment of this invention. 
     As a brief overview and further introduction of the packaging system  12 , the unit dose packages  18  are offloaded from the carriers  30  on the main conveyor  28  to a collation module  200  in which the unit dose packages  18  are initially processed on a collation table conveyor traversing relative to a collation table to be arranged in a 4×3 array on a unit dose package nest. 
     The array of unit dose packages are extracted from the collation module  200  while being maintained in the array and inserted into a med pass bag in a unit dose insert module  300 . The medpass bag is formed from upper and lower plies of material in a med pass bag formation module  400 . The array of unit dose packages are transferred from the collation module  200  into the med pass bag being formed by the med pass bag formation module  400  by a unit dose insert module  300 . The medpass bag formation module  400  forms the med pass bags around the sequentially delivered arrays of unit dose packages  18  and severs each medpass bag with the unit dose package array therein from upstream medpass bags. Each medpass bag is then delivered to a bag accumulation module  500  which collects all the medpass bags for a given patient, for example, and assembles them in a heat staked bundle. Up to four or more med pass bags may be heat staked together. The stacked medpass bags are then inserted into a travel pack loading module  600  which forms the travel packs and seals the accumulated medpass bags therein. A label printer and offload conveyor module  700  prints a label and applies it to the sealed travel pack which is then deposited onto an offload conveyor. The offload conveyor includes two parallel tracks, one for normal orders and one for stat or special urgent orders. The offload conveyor deposits the labeled travel packs into a tote or other receptacle for delivery to the long term care facility. 
     Referring to  FIGS. 2A-7E , portions of the collation module  200  will be described. The collation module  200  includes a collation conveyor  202  which traverses between an upstream end  204  adjacent to the downstream end of the main conveyor  28  and a downstream end  206  adjacent to the unit dose package insert module  300 . The collation conveyor  202  has a first or near lateral side  208  adjacent the unit dose insert module  300  and a second, or far lateral side  210  and includes a number of spaced channels  212  extending laterally between the sides  208 ,  210  of the conveyor  202 . Each channel  212  is mounted to a unit dose package nest  214  at the near side edge  208  of the collation conveyor  202  adjacent to the main conveyor  28 . The channels  212  and associated nests  214  traverse in an endless path from the upstream end  204  of the conveyor  202  toward the downstream end  206  of the conveyor  202  atop a collation table  216  ( FIG. 5 ). The channels  212  on the collation conveyor  202  are adapted to receive and hold the unit dose packages  18  arranged in a linear array just as in the carriers  30  on the main conveyor  28 . The linear arrangement of unit dose packages  18  are transferred from the individual carriers  30  on the main conveyor  28  by a shuttle assembly  218  that pushes the linear arrangement of unit dose packages  18  from each carrier  30  on the main conveyor  28  toward the channels  212  on the collation conveyor  202 . The shuttle assembly  218  is shown in  FIGS. 3 and 7A-7E . A transfer channel  220  is positioned between the downstream end of the main conveyor  28  and the upstream end  204  of the collation conveyor  202  and is in alignment with the travel path of the shuttle assembly  218  so as to provide a transitional path between the two conveyors. 
     Each nest  214  on the collation conveyor  202  includes four parallel slots  221 ,  222 ,  223 ,  224  referred to as the first, second, third and fourth slots from the upstream end of the nest  214  toward the downstream end of the nest  214 . According to one embodiment of this invention, the third slot  223  on each nest  214  is a bottomless slot and is aligned with the transfer channel  220  and the carrier  30  on the main conveyor  28  as well as the channel  212  on the collation conveyor  202 . As such, the shuttle assembly  218  pushes the unit dose packages  18  from each individual carrier  30  on the main conveyor  28  through the transfer channel  220  and the third slot  223  on the nest  214  so as to position the unit dose packages  18  on the associated channel  212  of the collation conveyor  202 . This operation will now be described in more detail with respect to  FIGS. 7A-7E . 
     As shown in  FIG. 7A , the unit dose packages  18  are positioned on the carrier  30  shown in cross-section in  FIGS. 7A-7E  and when the carrier  30  is aligned with the transfer channel  220 , a pusher  226  on the shuttle assembly  218  moves into position. As shown by arrow A in  FIG. 7A , the shuttle assembly  218  and the transfer channel  220  move vertically downward so that the transfer channel  220  is vertically and horizontally aligned with the carrier  30  on the main conveyor  28 . Likewise, the pusher  226  is mounted on the shuttle assembly  218  and a downwardly extending pusher bar  228  moves in the direction of arrow B along with the shuttle assembly  218  so as to be positioned on an outer edge of the unit dose packages  18  as shown in  FIG. 7B . Once the transfer channel  220  and the pusher  226  are aligned with the unit dose packages  18  and the carrier  30  on the main conveyor  28 , the pusher bar  228  translates laterally in the direction of arrow B as shown in  FIG. 7B  to thereby push the unit dose packages  18  off of the carrier  30  toward the transfer channel  220 . Continued movement of the pusher  226  continues to move the unit dose packages  18  off of the carrier  30  and onto and through the transfer channel  220  as shown in  FIG. 7C  by arrow C. Once the unit dose packages  18  are pushed entirely off of the carrier  30  of the main conveyor  28  and the transfer channel  220  to be positioned on the channel  212  on the collation conveyor  202 , the pusher  226  translates vertically upward in the direction of arrow D in  FIG. 7D  and returns longitudinally to the position as shown in  FIG. 7A  for a subsequent transfer operation on subsequent unit dose packages  18  residing on subsequent carriers  30  of the main conveyor  28 . 
     After the unit dose packages  18  pass through the transfer channel  220 , they are pushed through the third slot  223  on the nest  214  as shown in  FIGS. 7C and 7D  by the pusher bar  228  until they reside on the associated channel  212  of the collation conveyor  202 . As can be seen in  FIG. 7D , the unit dose packages  18  are arranged in a linear array of up to twelve packages  18  extending across the channel  212  on the collation conveyor  202 . The packages  18  are positioned adjacent to the near or first lateral side  208  of the collation conveyor  202  adjacent the associated nest  214 . The unit dose packages  18  are suspended and supported on the channel  212  by the upper generally planar panel  24  of the package  18  just as they were on the carriers  30  of the main conveyor  28 . 
     The collation table  216  is supported between the upper track of the collation conveyor  202  and the lower return track of the conveyor  202  as shown generally in  FIGS. 3 and 4 . Referring to  FIGS. 4 and 5 , the collation table  216  has an upper surface with a number of upwardly projecting ribs  230 . The series of ribs  230  form a series of grooves  232  between each adjacent pair of the ribs  230 . An upstream end of each rib  230  has a generally angled point  234  which forms a mouth  236  of the groove  232 . Each rib  230  includes a generally longitudinal section  238  adjacent the upstream end of the collation table  216  and an angled section  240  adjacent a downstream end of the table  216 . The angled section  240  is directed toward the near side  208  of the collation conveyor  202 . The ribs  230  form twelve grooves  232  corresponding to the maximum number of unit dose packages  18  housed on each carrier  30  of the main conveyor  28  and on each of the channels  212  of the collation conveyor  202  according to one embodiment of this invention. The upstream ends of the longitudinal sections  238  of the ribs  230  are staggered from the near lateral side  208  of the collation conveyor  202  adjacent the nest  214  to the opposite far side  210  of the conveyor  202  as shown particularly in  FIGS. 4 and 5 . Each groove  232  is open at the upstream mouth  236  of the groove  232  and at the downstream discharge end of the groove  232  adjacent the near lateral side  208  of the collation conveyor  202 . 
     Once again, consistent with the design concept of each system  10 ,  12 , a transfer of the unit dose packages  18  from the main conveyor  28  to the channels  212  on the collation conveyor  202  maintains positive control of each unit dose package  18  without allowing any of the unit dose packages  18  to free-fall throughout the transfer process. 
     It will be appreciated by those of ordinary skill in the art that while twelve unit dose packages  18  are shown in each carrier  30  and the associated channel  212  on the collation module  200 , any number less or more than twelve may be present on each carrier  30 , channel  212  or med pass order according to various embodiments of this invention. The following description is for twelve packages  18  on each carrier  30  and channel  212 , although fewer or more packages  18  may be present within the scope of this invention. The unit dose packages  18  are positioned adjacent the near lateral side  208  of the collation conveyor  202  and suspended in the channels  212  over the collation table  216  with the blister portion  20  of each unit dose package  18  projecting downwardly from the channel  212  as shown most clearly in  FIG. 8A . As the conveyor  202  and channels  212  move the unit dose packages  18  from the upstream end of the collation table  216  in a downstream direction, the blister portion  20  of each unit dose package  18  is fed into one of the grooves  232  on the collation table  216 . The unit dose packages  18 - 1 ,  18 - 2 ,  18 - 3  in the first, second and third positions on the channel  212  adjacent the lateral near side  208  of the collation table are sequentially fed into the first, second and third respective grooves  232 - 1 ,  232 - 2 ,  232 - 3  on the collation table  216  via the mouth  236  of the aligned groove and the angled arrangement shown in  FIG. 4 . For clarity, the first unit dose package is identified as  18 - 1 , the second as  18 - 2  and so on while the associated groove is identified as  232 - 1 , the second groove as  232 - 2  and so on. As the channel  212  progresses downstream on the collation conveyor  202 , the individual unit dose packages  18  are each fed into one of the grooves  232  on the collation table  216  formed by the adjacent ribs  230  and initially into the longitudinal section  238  of the groves  232 . As the channel  212  moves with the collation conveyor  202  in the downstream direction, each of the unit dose packages  18  present in the channel  212  is seated within one of the aligned grooves  232 . 
     The collation module  200  includes a picker system  242  suspended over the collation table  216  for transferring the unit dose packages  18  from the collation table  216  to the nest  214  associated with the respective channel  212 . The picker system  242  is shown particularly in  FIG. 6  and can also be seen in  FIG. 3 . The picker system  242  is mounted above the collation table  216  and collation conveyor on  202  an upper frame  244  as shown in  FIG. 3 . The picker system  242  includes three support frame members  246   a ,  246   b ,  246   c  which are mounted to the upper frame  244  above the collation table  216 . A longitudinally extending picker mount bar  248  is supported on the three support frame members as shown in  FIG. 6 . A series of four picker sub-assemblies  250   a ,  205   b ,  250   c ,  250   d  are mounted on the mount bar  248  and each picker sub-assembly has three pneumatically actuated pickers  252   a ,  252   b ,  252   c  directed downwardly toward the collation table  216 . The picker sub-assemblies are spaced on the mount bar  248 , are identical to each other and are identified as first, second, third and fourth sub-assemblies  250   a ,  250   b ,  250   c ,  250   d  herein. The first picker sub-assembly  250   a  is upstream from the remaining sub-assemblies and the second picker sub-assembly  250   b  is upstream from the third and fourth picker sub-assemblies. 
     The first picker sub-assembly  250   a  is positioned to retrieve the first three unit dose packages  18 - 1 ,  18 - 2 ,  18 - 3  adjacent the near lateral side  208  of the collation table  216  as shown in  FIGS. 8A-8C . Each of the pickers  252  extend downwardly to contact the upper panel of respective unit dose packages  18  aligned therewith as shown in  FIG. 8 . A suction tube  254  connected to each picker  252  creates a suction to pneumatically pull the unit dose package  18  upwardly to be held by the picker  252  as shown in  FIG. 8B . Once the first, second and third unit dose packages  18 - 1 ,  18 - 2 ,  18 - 3  are retrieved by the first picker sub-assembly  250   a , the first picker sub-assembly  250   a  retracts upwardly and extends laterally toward the nest  214  as shown in  FIG. 8A . The first picker sub-assembly  250   a  then moves downwardly with the unit dose packages  18 - 1 ,  18 - 2 ,  18 - 3  firmly held by the pickers  252  until the unit dose packages are positioned over the third slot  223  on the nest  214  as shown in  FIG. 8C . At that time, the unit dose packages  18  are pneumatically released from the pickers  252  and deposited into the third slot  223  on the nest  214  as shown in  FIG. 8C . After release of the unit dose packages  18 , the first picker sub-assembly  250   a  retracts once again for subsequent operations on a following channel  212  on the collation conveyor  202 . After the first three unit dose packages  18 - 1 ,  18 - 2 ,  18 - 3  are deposited by the first picker sub-assembly  250   a  into the third slot  223  on the nest  214 , the channel  212  advances downstream toward the position identified by line  9 A- 9 A in  FIG. 4 . The fourth, fifth and sixth unit dose packages  18 - 4 ,  18 - 5 ,  18 - 6  in the channel  212  are guided in the associated grooves  232 - 4 ,  232 - 5 ,  232 - 6  by the respective ribs in the angled section  240  of the collation table  216  so that they are positioned adjacent to the near lateral side  208  of the table as shown in  FIGS. 4 and 9A . The collation conveyor  202  then pauses while the second picker sub-assembly  250   b  moves into position to retrieve the fourth, fifth and sixth unit dose packages  18 - 4 ,  18 - 5 ,  18 - 6  for transfer from the channel  212  on the collation table  216  to the associated nest  214  as shown in  FIGS. 9A-9B . As shown in  FIG. 9C , the fourth, fifth and sixth unit dose packages  18 - 4 ,  18 - 5 ,  18 - 6  are deposited in the first slot  221  on the nest  214  and released by the second picker sub-assembly  250   b . A photograph of the unit dose packages  18  in the first and third slots  221 ,  223  on the nest  214  is shown in  FIG. 9D . 
     After the fourth, fifth and sixth unit dose packages  18 - 4 ,  18 - 5 ,  18 - 6  are deposited into the nest  214 , the channel  212  on the collation conveyor  202  indexes or advances downstream until it is aligned with line  10 A- 10 A of  FIG. 4 . Once again, as the channel  212  advances downstream, the remaining unit dose packages  18  in the channel  212  are guided by the angled section  240  of the associated ribs  230  on the collation table  216  so that they are shifted toward the near lateral side  208  of the collation table. The seventh, eighth and ninth unit dose packages  18 - 7 ,  18 - 8 ,  18 - 9  are then positioned adjacent the near lateral side  208  as shown in  FIG. 10A  so that the third picker sub-assembly  250   c  may extract them from the channel  212  on the collation table  216  and deposit them into the fourth slot  224  on the nest  214  as shown in  FIGS. 10A-10C . The unit dose packages  18 - 7 ,  18 - 8 ,  18 - 9  are positioned on the nest  214  so that the adjacent edges of the panel  24  of the unit dose packages overlap the panels  24  of the unit dose packages  18 - 1 ,  18 - 2 ,  18 - 3  in the third slot  223  on the nest  214  as shown in  FIG. 10C  thereby creating a shingled or overlapping arrangement between the unit dose packages  18  of the third and fourth slots  223 ,  224  in the nest  214 . 
     After the seventh, eighth and ninth unit dose packages  18 - 7 ,  18 - 8 ,  18 - 9  are deposited onto the nest  214 , the channel  212  and collation conveyor  202  advance downstream to be in alignment with line  11 A- 11 A in  FIG. 4 . The advancement of the channel  212  in this regard likewise shifts the tenth, eleventh and twelfth unit dose packages  18 - 10 ,  18 - 11 ,  18 - 12  in the channel  212  toward the near lateral side  208  of the collation table  216  due to the angled orientation of the associated ribs  230  and groove  232  on the collation table  216 . As such, the tenth, eleventh and twelfth unit dose packages  18 - 10 ,  18 - 11 ,  18 - 12  are positioned as shown in  FIG. 11A  for retrieval and transfer to the nest  214  by the fourth picker sub-assembly  250   d  as depicted in  FIGS. 11A-11C . The tenth, eleventh and twelfth unit dose packages  18 - 10 ,  18 - 11 ,  18 - 12  are deposited by the fourth picker sub-assembly  250   d  into the second slot  222  on the nest  214  and overlapping on top of the adjacent edges of the panels  24  of the unit dose packages  18  in the first and third slots  221 ,  223  of the nest  214  as shown in  FIG. 11C . 
     Having described the structure and operation of the accumulation module  200  and the transfer and handling of the unit dose packages  18  from the carrier  30  on the main conveyor  28  to the nest  214  on the collation conveyor  202 , one of ordinary skill in the art will appreciate that the description has included twelve unit dose packages  18  in each channel  212 ; however, any number less than twelve may be present in the channel  212  and, if so, then that number of unit dose packages  18  would be placed in the nest  214  with vacancies in the positions of the non-existent unit dose packages as shown in the nest arrangement of  FIG. 11C . Likewise, the description provided herein above follows a single channel  212  in the handling of the associated unit dose packages  18  through the various picker sub-assembly  250   a - d  operations. It will be appreciated by one of ordinary skill in the art that as the unit dose packages  18  of one channel  212  are being transferred by one of the picker sub-assemblies  250   a - d , the other picker sub-assemblies are likewise transferring the associated unit dose packages  18  from other channels  212  onto the nests  214  associated with those channels. In other words, as the first sub-assembly  250   a  is retrieving unit dose packages one, two and three  18 - 1 ,  18 - 2 ,  18 - 3  from a first channel, simultaneously the second picker sub-assembly  250   b  is likewise retrieving and transferring unit dose packages four, five and six  18 - 4 ,  18 - 5 ,  18 - 6  from a channel immediately downstream there from. Likewise, the third and fourth picker sub-assemblies  250   c ,  250   d  are retrieving and transferring the appropriate unit dose packages  18  from the associated preceding channels  212  on the collation table  216 . 
     The unit dose package module  300  is seen in  FIGS. 1, 2, 2A, 3, 4 and 12 . The unit dose package module  300  retrieves the array of unit dose packages  18  from the nest  214  on the collation module  200  and inserts it into a med pass bag  402 . As shown particularly in  FIG. 12 , the collation module  200  includes an offload assembly  256  which controls and offloads the array of unit dose packages  18  from the nest  214  for transfer to the unit dose module  300 . The offload assembly  256  includes a laterally extending mounting bar  258  positioned above the collation conveyor  202  proximate a downstream end of the collation module. The mounting bar  258  is supported by a framework  260  of members positioned above the collation conveyor  202  at the downstream end as shown in  FIG. 3 . The offload assembly  256  is mounted to the mounting bar  258  for translation in a lateral direction toward and away from the unit dose package insert module  300 . Mounted on three posts extending downwardly from the offload assembly  256  is an offload comb assembly  262  which includes a rearwardly extending flange  264  to which the offload comb assembly  262  is mounted to the posts on the offload assembly  256 . The offload assembly  256  includes four laterally extending and spaced comb members  266  oriented parallel to one another and extending toward the unit dose package insert module  300 . A series of four downwardly extending tabs  268 - 1 ,  268 - 2 ,  268 - 3 ,  268 - 4  are mounted perpendicular to the comb members  266  proximate a root portion of the comb members  266  as shown particularly in  FIGS. 12, 12B and 14A . Each of the comb members  266  is aligned with and superimposed above one of the slots  221 ,  222 ,  223 ,  224  of the collation module nest  214 . Likewise, each of the tabs  268 - 1 ,  268 - 2 ,  268 - 3 ,  268 - 4  is aligned with one of the slots of the nest  214  and, as can be seen from  FIG. 12 , the tab  268 - 3  aligned with the third slot  223  of the nest  214  is longer than the remaining tabs  268 - 1 ,  268 - 2 ,  268 - 4  because the third slot  223  of the nest  214  is deeper or bottomless compared to the remaining slots of the nest  214 . The extended length of this tab  268 - 3  is intended to insure that all of the unit dose packages  18 - 3  seated in the third slot  223  are offloaded from the nest  214 . 
     The offload assembly  256  operates to push the array of unit dose packages  18  off of the nest  214  and toward the unit dose insert module  300  as shown in  FIGS. 12A-14C . Referring to  FIGS. 12B and 13B  in particular, the comb members  266  are lowered and advanced toward the nest  214  in the direction of arrow E as shown in  FIG. 13B . Continued movement of the comb members  266  in this manner places the tabs  268 - 1 ,  268 - 2 ,  268 - 3 ,  26 - 4  against the array of unit dose packages  18  and the tabs  268  are positioned within the slots on the nest  214 . The comb members  266  are positioned atop the four rows of unit dose packages  18  in the array to thereby stabilize and secure them during the offload process from the collation module  200 . As such, upon appropriate command and at the appropriate time, the comb assembly  262  advances laterally from the collation module  200  and the tabs  268 - 1 ,  268 - 2 ,  268 - 3 ,  268 - 4  push the unit dose packages  18  in unison off of the nest  214  while the comb members  266  stabilize and secure them during the offload process. Simultaneously with this operation, one of two insert assemblies  302  on the unit dose package insert module  300  advances toward the nest  214 . 
     The unit dose package insert module  300  as shown particularly in  FIG. 12  includes a generally circular turntable  304  mounted for rotation about a central post  306  extending upwardly between a pair of similarly configured, but oppositely oriented insert assemblies  302 . Since these two assemblies  302  are identical with one another, only one of them will be described herein and it will be understood that the description is applicable to each of these assemblies  302 . Each insert assembly  302  includes a lower mounting block  308  mounted atop the turntable  304  and an upper mounting block  310  mounted on the lower mounting block  308 . Each of the mounting blocks  308 ,  310  includes a pedestal  312 ,  314  mounted on top of the respective mounting block. The pedestal  312  on the lower mounting block  308  is connected to a lower surface of the upper mounting block  310  and the pedestal  314  on the upper mounting block  310  is connected to a finger arrangement  316 . The finger arrangement  316  includes a lower and an upper finger assembly  318 ,  320 , each of which has a number of spaced fingers  322   a ,  322   b ,  324  projecting there from and toward the collation module  200  or the med pass bag formation module  400  depending upon the orientation of the insert assembly  302 . The upper finger assembly  320  is movable vertically relative to the lower finger assembly  318  to thereby clamp the array of unit dose packages  18  between the respective finger assemblies for secure offloading, manipulation and insertion into the med pass bag  402  as will be described. 
     The lower finger assembly  318  includes five spaced and generally parallel fingers  322   a ,  322   b  which are each designed to be inserted between rows of the blister or base portion  20  of the unit dose packages  18  in the array. This arrangement can be seen in  FIGS. 13 and 14A  in which the five lower fingers  322   a ,  322   b  are inserted beneath the upper closure panels  24  of the unit dose packages  18  in the array and the outer two fingers  322   a  on the lower finger assembly  318  are positioned on the outboard edges of the first and fourth rows of unit dose packages  18  and the inner three fingers  322   b  are positioned between the adjacent packages  18  in the array as will be appreciated from  FIG. 13A . 
     The upper finger assembly  320  has three spaced and generally parallel fingers  324  which are aligned with the three interior fingers  322   b  on the lower finger assembly  318  as shown in  FIG. 12A . The three fingers  324  on the upper finger assembly  320 , when positioned over the array of unit dose packages  18 , are superimposed onto the overlapping edges of the panels  24  on the packages  18  in the shingle arrangement of the array as can be seen in  FIG. 14A . The three fingers  324  of the upper finger assembly  320 , in combination with the fingers  322   a ,  322   b  on the lower finger assembly  318 , clamp the unit dose packages  18  there between for secure offloading from the nest  214  and manipulation for insertion into the med pass bag  402 . The three fingers  324  in the upper finger assembly  320  are interposed or interleaved between the comb members  266  on the offload assembly  256  as shown in  FIG. 14A . As such, during the transfer of the unit dose package array from the nest  214  to the unit dose package insert dial assembly  302 , the comb members  266  and the fingers  322   a ,  322   b ,  324  on the upper and lower finger assemblies serve to positively control and move the unit dose packages  18  in the array in an organized and fixed relationship. 
     The sequential operation of the engagement of the unit dose package array by the upper and lower finger members  322   a ,  322   b ,  324  and the comb members  266  is shown in  FIGS. 12A-14C . It is important to note that the upper finger assembly  320  is initially spaced from the lower finger assembly  318  to allow for insertion of the unit dose package array there between as shown generally in  FIG. 13B . Once the lower fingers  322   a ,  322   b  are inserted into the array seated on the nest  214 , the upper finger assembly  320  pivots downwardly as shown by arrow F in  FIG. 14B  to thereby clamp the unit dose package array between the upper and lower finger assemblies  318 ,  320 . Subsequently, the comb members  266  are withdrawn from the array and the upper and lower finger assemblies  318 ,  320  are retracted from the nest  214  as shown by arrow G in  FIG. 14C . At this point, the upper mounting block  310  is retracted relative to the lower mounting block  308  with the array of unit dose packages clamped between the upper and lower finger assemblies  318 ,  320 . Once the finger assemblies are retracted, the unit dose package insert module turntable  304  rotates approximately 180° so that the complementary insert assembly  302  is positioned for subsequent retrieval of a succeeding unit dose package array from the collation module  200 . Upon the 180° rotation, the unit dose package array which is sandwiched between the upper and lower finger assemblies  318 ,  320  is in position for insertion into the med pass bag  402  being formed by the bag formation module  400 . 
     Referring to  FIGS. 15A-15D , the bag formation module  400  and associated process for forming a med pass bag  402  is shown sequentially in these drawings. The bag formation module  400  is located adjacent to and downstream from the unit dose package module turntable  304  and is adapted to receive the array of unit dose packages held by the upper and lower finger assemblies  318 ,  320  after the turntable  304  has rotated 180° from the collation module  200  and toward the bag formation module  400 . In  FIGS. 15A-15D , the array of unit dose packages  18  held by the upper and lower finger assemblies  318 ,  320  is shown at the far right edge of the drawings. The med pass bag  402  is formed around the array of unit dose packages  18  and the med pass bag  402  includes an upper ply  404  mated with a lower ply  406  forming the back and front faces of the med pass bag  402 , respectively. 
     As previously described, the back face  404  of the med pass bag  402  is a clear plastic layer and is positioned as the upper ply of the med pass bag  402  as processed in the bag formation module  400  as shown in  FIGS. 15A-15D . The clear or transparent material of this ply  404  of the med pass bag  402  allows for imaging and tracking of the unit dose packages  18  in the med pass bag  402  at various locations throughout the system. A supply assembly  408  for the upper ply  404  of the med pass bag  402  is shown in the upper regions of  FIGS. 15A-15D  and includes a supply roll  410  of the upper ply material which is mounted for rotation on a shaft  412 . The supply roll  410  is driven by a motor and a sensor is provided to trigger the motor to unwind the supply roll  410  to supply an amount of the upper ply  404  based on input from the sensor. Likewise, a supply roll  414  mounted on an associated shaft  416  is provided for a supply of double-sided tape  418  which passes over an idler roller  420  before passing between a pair of mating rollers  422 ,  424  at which point the double-sided tape  418  is mated with the back face ply  404  material at the nip between the mating rollers  422 ,  424 . The combined back ply and double-sided tape material passes over a pair of oppositely rotating idler rollers  426 ,  428  after exiting the mating rollers at which point a take-up roller  430  receives a cover strip  432  pealed from the double-sided tape  418  thereby exposing an adhesive surface of the tape  418  on the upper ply  404  material before the med pass bag  402  is formed. The resulting ply  404  of med pass bag material with the adhered double-sided tape  418  passes over a final idler roller  434  before encountering a suction head  436  which pneumatically applies a suction force to the outer face of the upper ply  404  material to thereby regulate and control the feed and position of the ply into a bag forming assembly  438 . An air bar  482  is positioned between the final idler roller  434  and upper suction head  436 . The air bar feeds a stream of air to the upper ply  404  material to blow the material inwards in order to add tension and keep the material tight during array loading. 
     Likewise, a lower suction head  440  is positioned adjacent the bag forming assembly  438  and beneath the array of unit dose packages as shown in  FIGS. 15A-15D . The lower suction head  440  operates upon the lower ply  406  of material supplied from a supply roll  442  and which is fed over an idle roller  444  to a print head  446 . The supply roll  442  is also driven by a motor and a sensor is provided to trigger the motor to unwind the supply roll  442  to supply an amount of the lower ply  406  based on input from the sensor. As previously described, the material for the front ply  406  of material of the med pass bag  402  is generally opaque and capable of receiving pertinent printed information from the print head  446  as it passes over a print block  448  as shown in  FIGS. 15A-15D . After the front ply  406  material exits the print head  446 , it passes over an idler roller  450  before being exposed to the lower suction head  440  which regulates, positions and feeds the ply  406  into the med pass bag forming assembly  438 . 
     The converging plies  404 ,  406  of the med pass bag form an entry zone  452  for the upper and lower finger assemblies  318 ,  320  to horizontally insert the array of unit dose packages  18  held by the finger assemblies. Once the array is positioned in the entry zone  452 , the upper finger assembly  320  elevates upwardly in the direction of arrow H as shown in  FIG. 15A  and the array of unit dose packages  18  is deposited on the lower ply  406  positioned beneath the array while the finger assemblies  318 ,  320  are retracted back toward the turntable  304  on the unit dose insert module  300 . 
     The upper and lower suction heads  436 ,  440  draw the associated plies  404 ,  406  of the med pass bag  402  against the adjacent surface of the respective heads as shown by the arrows I and J in  FIG. 15B  while the upper and lower finger assemblies  318 ,  320  are retracted to thereby maintain proper positioning of the plies  404 ,  406  during the insertion and retraction operations. Alternatively, the upper and lower suction heads  436 ,  440  can be provided as upper and lower closure bars without applying suction to the associated plies  404 ,  406 . The upper and lower closure bars each include a flapper integrated therein to contain the array during indexing of the plies  404 ,  406 . The idler roller  428  is positioned on the end of a weighted dancer arm  488 , which pivots about the opposite end to move the idler roller  428  to take up slack in the upper ply  404 . Likewise, an idler roller is positioned on the end of another weighted dancer arm, which pivots about the opposite end to move the idler roller to take up slack in the lower ply  406 . When the upper and lower closure bars are open for array loading, the combination of the dancer arms and the air bar  482  keep tension on the plies  404 ,  406  to keep them clear of the array loading mechanism. 
     Positioned downstream from the entry zone  452  is a bag forming zone  454  which forms a seam  456  on three edges of the generally rectangular or square med pass bag  402 . The three seams  456  are formed on the downstream edge and the two lateral side edges of the bag  402  at the bag forming zone  454 . The bag forming zone  454  includes a lower platen  458  and upper die  460  which reciprocate relative to one another to thereby allow for entry of the plies  404 ,  406  and array of unit dose packages  18  when separated from one another as shown in  FIG. 15D  and sealed along the three sides of the plies  404 ,  406  and around the array when mated together as shown in  FIGS. 15A-15C . 
     The fourth edge of the med pass bag  402  is sealed by the downstream edge of the platen  458  and die  460  when the med pass bag  402  is at a perforation zone  462  downstream from the bag forming zone  454 . The die can include a rubber seal between the platen  458  and die  460  to provide some variation between the relative positioning of the platen  458  and die  460  during sealing. Alternatively, a spring washer or washers can be positioned between the platen  458  and die  460  to allow for the relative positioning of the platen  458  and die  460  during sealing. The perforation zone  462  includes one or more rotating perforation wheels  464  according to various embodiments of this invention to thereby form tear open perforation lines along the eventual bottom edge and the top edge adjacent the double-sided tape  418  in the med pass bag  402 . Only one perforation wheel  464  is shown in  FIGS. 15A-15D , but it will be appreciated that other wheels may be provided in the perforation zone  464 . 
     Instead of the perforation wheel  464 , the platen  458  and/or the die  460  can include teeth to tear open perforation lines along the eventual bottom edge and/or the top edge adjacent the double-sided tape  418  in the med pass bag  402 . A roller downstream of the platen  458  and die  460 , for example in the position of the perforation wheel  464 , serves as an idler roller driven by a stepper motor  484  via upper and lower spur gears  486  to pull material through the system. A sensor is provided to give feedback to the stepper motor  484  to determine an amount of drive required. 
     Immediately downstream from the perforation zone  464  is a cutting zone  466  with a cutter  468  which separates the adjacent medpass bags from one another. Downstream from the cutter  468  is located a picker assembly  502  which is lowered into the position of  FIG. 15B  to remove the med pass bag  402  formed around the array of unit dose packages  18  and transfer it to the downstream bag accumulation module  500 . The picker assembly  502  includes four pneumatically actuated suction heads  504  which selectively adhere to the upper ply  404  of the med pass bag  402  as shown in  FIG. 15C . 
     Referring to  FIGS. 16A-16E , one embodiment of the med pass bag  402  containing the array of unit dose packages  18  is shown.  FIG. 16A  is a perspective view of the back face  404  of the bag  402  with the clear ply surface of the bag making the unit dose packages  18  therein visible.  FIGS. 16C and 16D  are views of the opposite, front face  406  of the med pass bag  402  and show alternatives for opening the bag  402  to retrieve the unit dose packages  18  therein.  FIG. 16B  is a perspective view of a number of med pass bags  402  shown heat staked together as will be described later herein.  FIG. 16E  shows an actual image of the unit dose packages  18  taken in the med pass bag formation module. Vision inspection of the unit dose package array as it is being enclosed in the med pass bag  402  is included in various embodiments of this invention. 
     In one embodiment, the med pass bag  402  includes a bottom tear open perforation line  470  along a bottom edge of the bag  402  which allows for retrieval of the entire contents of the med pass bag  402  as shown by arrow K in  FIG. 16C . Alternatively, the med pass bag  402  may be opened along a first top perforation line  472  at the top edge of the bag  402  as shown by arrow L in  FIG. 16C . This exposes a re-closeable seam  474  at the top edge of the bag  402  which is selectively opened, closed, reopened and reclosed by the double-sided adhesive tape  418  sandwiched between the top and bottom plies  404 ,  406  of the med pass bag  402 . The ability to open and reclose the med pass bag  402  allows for retrieval of some, but not all, of the unit dose packages  18  at various times while still providing an operational and functional med pass bag  402  for the remainder of the contents therein. A second top perforation line  476  is provided adjacent the double-sided tape  418  and opposite from the first top perforation tear line  472 . The second top perforation tear line  476  adjacent the double-sided tape allows for complete removal of an upper portion  478  of the bag  402 . This offers a number of benefits and advantages, including the opportunity to open the bag  402  and retrieve the contents  18  therein. Likewise, once the contents  18  of the bag  402  are distributed to the patients at the LTC, the upper portion  478  of the bag  402  may be separated from the remainder of the bag  402  and disposed of in a discrete and confidential manner according to HIPAA regulations. The front face  406  of the bag  402  is printed with various information, including the specific medications, the patient&#39;s name, the administration time, room number, the facility, the provider and other data. Such information may be printed on the bag  402  as shown in  FIG. 16C  and outboard of the second top perforation line  476  such that tearing the bag along the second top perforation line  476  removes the sensitive information and this portion  478  of the bag  402  once removed can be shredded or disposed of according to privacy regulations while the remainder of the bag  402  can be disposed of in a standard waste receptacle thereby minimizing the impact of the demands for compliance with HIPAA regulations and privacy and confidentially safeguards. In one embodiment, multiple med pass bags  402  are heat staked together at a location  480  within the portion  478 . 
     As shown in  FIG. 17 , downstream from the bag formation module  400  is the bag accumulation module  500 . The bag accumulation module  500  includes a base cabinet  506  upon which is supported an accumulation dial  508  for rotation. The accumulation dial  508  includes four stations or hoppers  511 ,  512 ,  513 ,  514  positioned approximately 90° relative to one another. The four stations are identified by the three, six, nine and twelve o&#39;clock positions. As shown in  FIGS. 17-22 , the nine o&#39;clock position includes the picker assembly  502  shown in  FIG. 15C  which retrieves the med pass bag  402  from the bag formation module  400  and transfers it to the bag accumulation module  500 . The picker assembly  502  includes four pneumatically actuated pickers  504  oriented in a cruciform arrangement on two perpendicular mounting arms  516   a ,  516   b . The mounting arms  516   a ,  516  emanate outwardly from a central rotary hub  518  on the picker assembly  502 . The picker assembly hub  518  is coupled to an arm  520  and mounting block  522  which is likewise connected to picker assembly extension bars  524 . The extension bars  524  extend outwardly toward the bag formation module  400  to position the pickers  504  over the med pass bag  402  as shown in  FIG. 15C . A vertical extension post  526  is coupled between the mounting block  522  and the hub  518  to lower the pickers  504  into contact with the med pass bag  402  at which point the pneumatic pickers  504  engage the bag  402  for transfer in the direction of arrow M in  FIG. 15C  when the extension bars  524  are retracted and the elevation post  526  is withdrawn into the orientation shown. 
     As shown sequentially in  FIGS. 18-21 , the picker assembly  502  extends in the direction of arrow N in  FIG. 18  from its home position on the bag accumulation module  500 . Simultaneously, the pickheads  504  are rotated approximately 90° in the direction of arrow P as the extension bars  524  extend as shown by arrows Q in  FIG. 19 . As shown in  FIG. 20 , the reoriented pickheads  504  are lowered so that the pickheads  504  come in contact with the med pass bag  402  and through pneumatic actuation engage the med pass bag  402  and the picker assembly  502  returns to the home position on the bag accumulation module  500  as shown by arrows R in  FIG. 21 . Simultaneously, the picker assembly  502  rotates approximately 90° in the direction of arrow S so as to orient the med pass bag  402  over a collection hopper  511  at the nine o&#39;clock position for repository on the accumulation dial  508 . The med pass bag  402  is deposited into the accumulation hopper  511  with the double-sided tape, top edge and top tear-open perforation lines  472 ,  476  of the med pass bag  402  oriented as shown in  FIG. 21 . If additional med pass bags  402  are included in this particular order for administration time or patient requirements, subsequent bags  402  are likewise retrieved and deposited into the accumulation hopper similar to the sequence as shown in  FIGS. 18 and 20 . After all the med pass bags  402  for a particular order, patient, delivery time or other requirements are accumulated in the hopper  511 , the accumulation dial  508  rotates approximately 90° as shown by arrow T in  FIG. 21 . 
     In cross-sectional view, two med pass bags  402  are deposited into the accumulation hopper  511  in  FIG. 22  according to the process and sequence of events described previously with respect to  FIGS. 18-20 . After all the med pass bags  402  are deposited into the accumulation hopper  511 , the accumulation dial  508  rotates approximately 90° so that the accumulation hopper  511  is positioned over a discharge chute  528  at the six o&#39;clock position. If the med pass bags  402  in the hopper  511  are for a prescription that has been cancelled, the order is no longer required, the unit dose packages  18  are incorrect in the med pass bags  402  or there is any other problem with the order, a plunger  530  extends downwardly into the hopper  511  to push the med pass bags  402  into the chute  528  which discharges the med pass bags  402  from a reject port  532  in the accumulation dial cabinet  506  as shown in  FIG. 17 . The indexing of the accumulation dial  508  from the position shown in  FIG. 21  to the position of  FIG. 24  and the extension of the plunger  530  into the reject chute  528  is shown in  FIG. 25 . 
     If the med pass bags  402  in the accumulation hopper  511  are correct and accurate, the accumulation dial  508  rotates an additional 90° into the three o&#39;clock position shown in  FIG. 26 . As such, the med pass bags  402  are positioned approximately 180° and diametrically opposite on the accumulation dial  508  from their original position in the accumulation hopper  511  as shown in  FIG. 20 . At the position of the med pass bags  402  in the accumulation hopper  511  shown in  FIG. 26 , the module  500  operates to heat stake together the multiple med pass bags  402  in a given order. In this regard, a stabilizing plunger  534  extends upwardly through the open bottom  536  of the accumulation dial  508  at this position into the hopper  511  to engage the lowermost med pass bag  402 . Simultaneously, a heat stake anvil  538  extends downwardly into the hopper  511  to engage the uppermost surface of the top most med pass bag  402  in the hopper  511 . A heat stake iron  540  extends upwardly along with the plunger  534  to heat stake the med pass bags  402  together against the anvil  538  as shown in  FIG. 27 . One advantage of various embodiments of this invention is that the heat stake location is between the first and second top perforated lines  472 ,  476  on the med pass bags  402  coincident with the double-sided tape  418  as shown in  FIG. 16B . After the med pass bags  402  are heat staked together, the anvil  538 , plunger  534  and heat stake iron  540  are retracted and the accumulation dial  508  indexes approximately 90° to rotate the hopper  511  into the twelve o&#39;clock position as shown in  FIG. 28A . 
     The heat staked med pass bags  402  are then in position in the hopper  511  beneath a plunger  542  at the twelve o&#39;clock position shown in  FIG. 28  and above a travel pack shell  602  which has a travel pack  604  fitted over the exterior of the shell  602  as well as the upper open top end  606  of the shell  602 . The plunger  542  then extends downwardly as shown in  FIG. 28B  to force the heat staked med pass bags  402  downwardly through the open bottom of the hopper  511  and onto the travel pack  604  on the shell  602 . Continued movement of the plunger  542  downwardly forces the sealed end  608  of the travel pack  604  and the med pass bags  402  downwardly into the interior of the tubular shell  602  thereby pulling the free edge  610  of the travel pack  604  upwardly along the exterior surface of the shell  602  as shown by comparison of the free edges  610  in  FIGS. 28A and 28B . After the staked med pass bags  402  are deposited into the travel pack  604  and the tubular shell  602 , the plunger  542  retracts upwardly and the accumulation dial  508  rotates 90° to return to the original position shown in  FIG. 20  for the processing and packaging of an additional medpass orders and associated bags  402 . It will be appreciated by one of ordinary skill in the art that the sequential operations shown in  FIGS. 18-28B  are happening simultaneously with other such operations which are 90°, 180° or 270° out of phase with the processing sequence for the hopper  511  shown and described with respect to  FIGS. 18-28B  thereby increasing the efficiency and the decreasing the time required for processing and packaging medpass bag orders according to various embodiments of this invention. 
     The travel pack module  600  is shown in  FIG. 29  and includes a travel pack loader station  612  with a turntable  614  having four tubular shells  602  projecting upwardly and spaced approximately 90° from one another. Each tubular shell  602  has a generally square cross-sectional configuration and may include an oval slot  616  on one or more faces thereof as shown in  FIG. 29 . The travel pack loader station  612  is located adjacent to a travel pack formation station  616  as shown in  FIG. 29 . As shown most clearly in  FIGS. 29-30 , the travel pack formation station  616  includes a spool of travel pack supply material  618  mounted on a bar  620  extending from a back end of the station  616 . The pack supply material  618  is a generally flattened elongated tube of thermoplastic material which is generally translucent or transparent LDPE according to various embodiments of this invention. The supply of pack material  618  extends from a supply spool  622  upwardly around a pair of guide rollers  624 ,  626  mounted atop the station  616 . The bag supply material  618  passes through a seam seal assembly  628  mounted atop the station  616  adjacent the downstream roller  626 . The seam seal assembly  628  includes a weld head  630  which cooperates with a lower anvil  632  on the assembly  628  to thereby seal the two plies of pack material  618  together and form a seam  634 . The weld head and anvil  630 ,  632  reciprocate relative to one another to weld the plies together and form the lateral seam  634  in the pack material  618 . 
     After the pack supply material  618  passes through the seam seal assembly  628  and over the downstream guide roller  626  and around a positioning roller  636 , the pack material  618  is fed into a pack formation assembly  638  on a face of the station  616  adjacent to the turntable  614 . 
     As shown most clearly in  FIGS. 31 and 32 , the leading free end  610  of the supply of pack material  618  exits the positioning roller  636  and enters the space between a pair of clamp mechanisms  640 , each located on a lateral side edge of the pack material  618 . The clamp mechanisms  640  each have a pair of opposing clamp members  642  which selectively grip the lateral edge of the pack material  618  there between. The clamp mechanisms  640  are mounted on the assembly  638  for reciprocal, vertical movement. When the lateral edges of the pack material  618  are clamped between the clamp members and the clamp mechanisms  640  move downwardly, the pack material  618  is advanced or pulled downstream over the roller  636  and off of the supply spool  622  and in a downward direction as shown  FIGS. 37 and 38 . 
     The clamp mechanisms  640  are at the upper end of a carriage assembly  644  which reciprocates vertically to draw the pack material  618  over one of the tubular shells  602  positioned below the carriage assembly  644 . The carriage assembly  644  includes opposed and confronting platens  644 . One of the platens  646  is located immediately below the clamp mechanisms  640  and the opposing platen  648  is in two sections  648   a ,  648   b  and movable toward and away from the first platen  646  on a number of extension rods  650  which extend from a frame  652  of the carriage assembly  644  as shown in  FIG. 32 . When the extension rods  650  move the two section platen  648  toward the opposing platen  646 , it sandwiches there between the pack material  618  in the carriage assembly  644 . Each of the platens  646 ,  648   b  includes a pneumatic suction face. When the pack material  618  is sandwiched between the platens  646 ,  648  it is folded into a two-ply layer arrangement. The lower platen section  648   b  is mounted on a carriage arm  654  extending between the opposing platens  646 ,  648   b  as shown in  FIGS. 31, 32 and 35 . 
     When the pack material  618  is sandwiched between the platens  646 ,  648  as shown in  FIG. 32 , a cutter assembly  656  severs the pack material  618  from the supply of pack material downstream from the clamp mechanisms  640 . The cutter assembly  656  includes a knife  658  which traverses laterally across the pack material  618  to thereby sever the terminal portion of the pack material  618  as shown in  FIG. 35 . The pack material  618  is cut by the knife  658  downstream from the clamp mechanisms  640  and upstream from the seam  634  formed in the pack material  618  by the seam seal assembly  628 . After the knife  658  severs the pack material  618 , the upper platen  648   a  is retracted on the extension rods  650  as shown in  FIG. 35 . Likewise, the pneumatic faces of the lower platen  648   b  and opposing platen  646  are actuated to draw the respective confronting plies of the pack material  618  onto the associated platen  646 ,  648   b  as shown in  FIG. 35 . Once the plies are pneumatically adhered to the respective platens  646 ,  648   b , the lower platen section  648   b  extends along the carriage arm  654  away from the platen  646  thereby expanding the pack material  618 . 
     As shown in  FIGS. 35-36C , as the pack material  618  is expanding between the pneumatic faces of the platens  646 ,  648   b , the lower free edge  610  of the pack material  618  is engaged by two pairs of prongs  660  which extend upwardly. Each pair of prongs  660  is mounted on a mounting bracket  662  which extends generally horizontally and includes an actuation rod  664 . As the two plies of pack material  618  are being drawn apart as shown in  FIG. 35 , the respective prongs  660  are extended toward one another and raised vertically as shown in  FIGS. 36A-36B . The prongs  660  are inserted into the open lower end of the pack material  618  as shown in  FIG. 36B . Once the prongs  660  are inserted into the open lower end of the pack material, they are retracted outwardly as shown in  FIG. 36C  to engage and pull the lower open end of a pack material taut around the four spaced prongs  660 . 
     As shown in  FIG. 37 , the pack material  618  is in an expanded configuration between the opposing platens  646 ,  648   b  with the lower free edge  610  is positioned around the prongs  660 . At this point, the carriage assembly  644  translates downwardly to pull the pack material over the shell  602  positioned on the turntable  614  beneath the carriage assembly  644  as shown in  FIG. 38 . As the carriage assembly  644  translates downwardly, the clamp mechanisms  640  have the free edge  610  of the upstream pack material  618  for a subsequent travel pack secured there between and likewise pull the pack material  618  downwardly across the platen  646  for subsequent travel pack formation. The actuation of the clamp mechanisms  640  relative to the pack material  618  is shown sequentially in  FIGS. 40A and 40B  which are enlarged views of the section  40  shown in  FIG. 38 . 
     Once the pack  604  is pulled downwardly and positioned on the shell  602 , the prongs  660  retract downwardly and outwardly to disengage the lower free edge  610  of the pack  604  and return to their respective home positions as shown in  FIGS. 39A and 39B  which are enlarged views of the portion  39  shown in  FIG. 38 . 
     As shown in  FIG. 41 , after the pack  604  is installed onto the tubular shell  602 , the carriage assembly  644  translates vertically upward with the clamp mechanisms  640  disengaged from the subsequent pack material  618  as shown in  FIG. 42A  which is an enlarged view of the section  42 A shown in  FIG. 41 . Once the carriage assembly  644  and associated clamp mechanisms  640  return to the upper home position as shown in  FIG. 41 , the clamps  642  are actuated to reengage the pack material  618  as shown in  FIG. 42B  and thereby begin the pack formation cycle once again. 
     The cutter assembly  656  operation is shown in  FIGS. 33 and 34  such that when the platens  646 ,  648  are pressed together to sandwich the pack material  618  there between as shown in  FIG. 32 , the cutter assembly  656  translates the knife  658  laterally across the pack material  618  downstream from the clamp mechanisms  640 , but upstream from the seam  634  formed in the pack material  618  as shown in  FIGS. 33 and 34 . 
     A label printing and offload module  700  is located adjacent to the travel pack module boo. As is evident from  FIG. 2A , the dial  508  on the bag accumulation module  500  overlaps the turntable  614  on the travel pack module such that the tubular shell  602  adjacent to the accumulation dial  508  is positioned beneath the hopper  511  on the accumulation dial  508  so that the plunger  542  extends downwardly to initially seat the heat staked medpass bags  402  into the travel pack  604  and the interior of the tubular shell  602  positioned at the six o&#39;clock position as shown in  FIG. 2A . Once the plunger  542  retracts from the shell  602  with the heat staked medpass bags  402  seated in the shell  602 , the turntable  614  on the travel pack module  600  rotates approximately 90° until the shell  602  is in the three o&#39;clock position and positioned beneath an offload plunger  702  on the printing and offload module  700  as shown in  FIG. 43 . 
     A pair of offload conveyors  704 ,  706 , one of which is for processing and offloading travel packs  604  with regularly scheduled medpass bag orders and the other offload conveyor  704  is for processing and offloading stat or special orders of medpass bags  402 . A label printing station  708  is located adjacent to the offload conveyors  704 ,  706  and includes a spool  710  of label material  712  mounted for rotation above a printer  714 . The spool  710  of label material  712  has a supply of labels  716  each of which has an adhesive-coated face  718  initially secured to a substrate  720  of the label material  712  and an opposite front face  722  of the label  716 . 
       FIG. 44  is a top plan view of the label printing and offload module  700  and the adjacent turntable  614  on the travel pack module  600 . The printer  714  prints patient information, medication information, bar codes, QR codes and/or other relevant information on each label  716  for the assigned travel pack  604  containing the appropriate medpass bags  402  and unit dose packages  18 . The label  716  is peeled from the substrate  720  and the substrate  720  is accumulated on a substrate accumulation roller  724  contained within the printer station  708 . The label  716  is deposited onto a pair of flipper arms  726  in an upward orientation with the print face  722  facing upwardly juxtaposed against the flipper arms  726  as shown in  FIG. 45 . Each of the flipper arms  726  includes suction ports  728  which is coupled to a pneumatic assembly such that upon actuation of the assembly, the label  716  is temporarily held by the suction force delivered through the ports  728  against the flipper arms  726  which pivot approximately 180° into a position as shown in  FIG. 46  while still pneumatically securing the label  716  thereto. The front face  722  of the label  716  as shown in  FIG. 46  is facing downwardly with the adhesive surface  718  of the label  716  facing upwardly and which will subsequently be applied to a bottom end of the travel pack  604 . When the flipper arms  726  rotate 180° from the orientation shown in  FIG. 45  to that shown in  FIG. 46 , the flipper arms  726  are seated within a pair of correspondingly sized and shaped notches  730  on a label transfer plate  732 . The label transfer plate  732  likewise has a number of suction ports  734  to pneumatically retain the label  716  onto the label transfer plate  732 . 
     The label transfer plate  732  as shown in  FIG. 44  is mounted atop a shuttle assembly  736  which shuttles the label transfer plate  732  from the position shown in  FIG. 44  in which it is adapted to receive the flipper arms  726  and label  716  from the printing station  708  to a location in which the label transfer plate  732  is positioned beneath the three o&#39;clock position on the travel pack formation turntable  614  as shown in  FIG. 47 . As is seen in  FIG. 48 , the label  716  is transferred to a position beneath the three o&#39;clock position on the travel pack module turntable  614  and above a tubular sleeve  738  beneath the turntable  614 . The tubular sleeve  738  beneath the turntable  614  is vertically aligned with the shell  602  at the three o&#39;clock position on the travel pack formation turntable  614 . The plunger  702  positioned above the shell  602  on the turntable  614  extends downwardly to push the medpass bags  402  and travel pack  604  toward the bottom of the shell  602  and thereby pulling the free edge  610  of the travel pack  604  upwardly, around the upper edge of the shell  602  and then downwardly into the interior of the shell  602  along with the medpass bags  402  as shown in  FIG. 49 . As the plunger  702  pushes the medpass bags  402  and travel pack  604  downwardly through the open bottom of the shell  602  on the turntable  614  and into contact with the label  716  on the label transfer plate  732 , the label  716  is adhered to the travel pack  604  and the suction via the ports  734  and  728  ceases and the transfer plate  732  retracts back toward the printer  714  via the shuttle assembly  736 . Continued downward movement of the plunger  702  seats the medpass bags  402  in the travel pack  604  beneath a pack sealing assembly  740  and within the sleeve  738 . 
     Referring to  FIGS. 51-55 , the downwardly acting plunger  702  extends into the sleeve  738  and seats the travel pack  604  with medpass bags  402  therein on an upwardly acting plunger  742  seated within the lower sleeve  738  as shown in  FIG. 50 . At this point, the downwardly acting plunger  702  retracts upwardly and exits from the sleeve  738 . The pack sealing assembly  736  includes a pair of opposing lugs  744 , each mounted on a mounting bracket  746  on a pair of extension rods  748  as shown in  FIG. 50 . After the downwardly acting plunger  542  retracts, the lugs  744  are extended inwardly and into contact with the pack  604  and above the upper edge of the sleeve  738  as shown in  FIG. 51 . As the lugs  744  advance inwardly toward one another, they gather the travel pack material above the medpass bags  402  together thereby drawing up any slack between the lugs  744  and the medpass bags  402  as shown in  FIG. 52 . As such, the travel pack  604  is uniquely conformed to the volume occupied by and around the medpass bags  402  thereby minimizing any excess pack material  618  around the medpass bags  402 . 
       FIGS. 53-55  show an orthogonal cross-sectional view of the arrangement and sequential pack-sealing operation shown in  FIGS. 50-52 . A pair of oppositely directed pinch rollers  750  extend toward one another thereby pinching the pack material  618  between the rollers  750  and above the lugs  744  after the downwardly acting plunger  702  has retracted. The lugs  744  provide a gusset or fold in each side of the pack material  618  and the folds are completed by the pinch rollers  750  which hold the two plies of the pack material together as shown in  FIG. 53 . Opposing weld members  752  are positioned beneath the pinch rollers  750  and extend toward one another as shown in  FIG. 54  thereby simultaneously forming a seam or weld  754  in the pack  604  and severing excess selvage  756  of the pack material  618  upstream from the weld  754  as shown in  FIG. 55 . After the weld  754  is formed to close the top end of the travel pack  604 , the weld members  752  and lugs  744  retract. After the travel pack  604  is transferred to the offload conveyors  704  or  706 , the selvage material  756  is discharged from between the rollers  750  and collected as scrap. 
     Depending upon whether the travel pack  604  contains standard or stat medpass order medications and supplements, the shuttle assembly  736  aligns the travel pack  604  with the appropriate offload conveyor  704  or  706  as shown in  FIG. 57 . Once positioned relative to the appropriate offload conveyor, the plunger  742  in the lower sleeve  738  extends upwardly thereby pushing the travel pack  604  into one of two U-shaped members  760 ,  762  as shown in  FIG. 58 . The two U-shaped members  760 ,  762  as shown in top plan view of  FIGS. 59 and 60  are joined to the opposite ends of a yoke member  764  which is at the end of a pusher bar  766 . The pusher bar  766  extends thereby advancing the U-shaped members  760 ,  762  toward the offload conveyors  704 ,  706  and likewise the travel pack  604  seated within either of the U-shaped members. Continued extension of the pusher bar  766  into the orientation of  FIG. 60  deposits the travel pack  604  onto the upstream end of the appropriate offload conveyor  704  or  706  which then conveys the travel pack  604  to an offload position and deposits it into an appropriate tote, box or other accumulation receptacle (not shown) at the downstream end of the offload conveyor  704  or  706 . 
     The resulting travel pack  604  and label  716  with the heat staked medpass bags  402  contained therein is shown in  FIG. 61 . After the appropriate travel packs  604  are deposited into the tote or other receptacle, they can then be shipped or otherwise transported to the LTC or other facility for appropriate administration to the prescribed patients. 
     The design of the overall system  12  and its individual components according to this invention allows for physical control of each unit dose package  18  from start to finish without any unit dose package “free fall” in the system. This process is automated via appropriate computer operations and does not rely upon manual sorting or handling. The medpass bags  402  are consolidated into the travel packs  604  and a final shipping tote and do not require manual sorting and packing. The fill event server or control  36  interfaces with the system  12  and provides appropriate packing commands according to the orders. It will be appreciated that although it is preferable to separately retain each of the unit doses within individual packages  18  which are assembled with one another in a given medpass bag  402  such as date sequential for a single patient, medpass or by patient number (for multiple patients within an institutional setting); the medications and supplements may be alternatively packaged in any convenient form which allows a set of medications or supplements which was selected via the order to be taken at a given time or medpass to be easily retrieved for use without departing from the invention. 
     Each individual medpass bag  402  may be configured with an indicia containing information about whom the individualized prescription has been created for, and the time that the dose is to be taken. For example each bag  402  may contain the name of who is to take the order, for example “Jane Doe” and their address, should the packet get misplaced, “1990 Paxit Drive, Columbus, Ohio 43230”. Each medpass bag  402  preferably contains the date and time the dose is to be taken, for example a series may appear as: “8:00 AM on Tuesday, June 1, 2009”, “2:00 PM on Tuesday, June 1, 2009”, “8:00 PM on Tuesday, June 1, 2009”, “8:00 AM on Wednesday, June 2, 2009”, . . . “8:00 PM on Tuesday, June 29, 2009”. The bag  402  may include additional information such as “Take with food” and any other precautions. Inserted instructions or content list may also be included within each bag  402 . In addition, the bag  402  may contain information listing information about the medications or supplements contained therein. The heat staked bags are placed in the travel pack  604  and the tote with any other portions of the order, and shipped to the LTC. 
     Various aspects of this invention include the following which may or may not have been addressed herein above. Each medpass bag  402  may be resident or patient specific. However, the invention offers at least three options of how the medications are included in the medpass bag  402 , including:
         a) All meds for the entire day, such that the medpass bag  402  would be resident and administration day specific only.   b) Meds for a given time grouping. Example: medpass bags  402  would be specific to the resident/admin day/morning, afternoon or evening. All medications to be administered for that time description would be collected for inclusion in the bag  402 .   c) Only medications for one administration time such that the medpass bags  402  are resident/admin day/admin time specific resulting in bags for each resident/admin day/8 AM vs. 9 AM, etc.   d) The above three options are advantageous in that typical dispensing modes use method c). However, the system may be programmed for disaster planning purposes to immediately switch over to Option a). Option b) may be used for more independent living where residents self medicate. As the system may be used for in-home care, if an adult is truly independent, they start them off receiving bags  402  sorted by Option a). As they need more ‘guidance’, they could advance to Option b) and ultimately Option c).       

     Medpass bags  402  are heat staked together at a particular location on the bag  402 . One option is to heat stake the medpass bags  402  in the middle of the bags (right on top of the name and room location) which may make it very hard to see such information. Another option is to move the heat stake location to the corner which may make flipping through the stack of staked medpass bags  402  much easier. 
     Medpass bags  402  may include a message banner. A location is reserved on the medpass bags  402  to communicate to the administration nurses. Typical messages are NEW, STAT, PRN, XD (extra dose), OWE (for a medication that was previously short filled), STAT/NEW, etc. This feature assists the nurses when looking for the medication with that message banner. 
     The variable print (all resident, admin day/time, medications, location, etc.) is accomplished by thermal transfer printing on the medpass bag  402 . This allows one common packaging material to be customized per facility, resident and time, while maintaining the cost leverage of a common packaging material. 
     From the above disclosure of the general principles of this invention and the preceding detailed description of at least one embodiment, those skilled in the art will readily comprehend the various modifications to which this invention is susceptible. Therefore, we desire to be limited only by the scope of the following claims and equivalents thereof.