Abstract:
A medication dispensing system is described. In some embodiments, the system includes a medication station and a controller responsive to patient admittance status information. The medication station includes at least one securable compartment configured to hold medication. The controller is configured to assign a patient to the at least one securable compartment such that medications for the patient are able to be placed into the at least one securable compartment. The controller is also configured to selectively permit access to the medications for the patient in the at least one securable compartment when the patient admittance status information indicates the patient is currently admitted, and restrict access to retrieval of the medications for the patient in the at least one securable compartment when the patient admittance status information indicates the patient is not currently admitted.

Description:
STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
       [0001]    Not Applicable. 
       FIELD 
       [0002]    The present disclosure generally relates to apparatus and methods for providing health care and, in particular, relates to providing care to a patient through controlled access to medication. 
       BACKGROUND 
       [0003]    It is well known in the medical community, and in particular, in hospitals, to provide centrally located medication and supply dispensing stations, such as wall cabinets, manually secured patient cassette drawers, and automated dispensing machines. Such generally accessible stations serve several functions including the distribution of medicines and supplies to patients. These stations work well for their intended purpose. However, there are disadvantages to such centralized stations. One disadvantage is that after a patient is discharged, the medications are frequently not retrieved from the station, and consequently remain in the station. These easily accessible medications are often either stolen or mixed in the station with medications for other patients. 
       SUMMARY 
       [0004]    Embodiments of the patient-specific medication dispensing and notification system disclosed herein provide patient-specific dispensing of medications with patient-specific notifications to the caretaker responsible for the dispensing of the medications. 
         [0005]    According to one embodiment of the present disclosure, a medication dispensing system comprises a medication station and a controller responsive to patient admittance status information. The medication station comprises at least one securable compartment configured to hold medication. The controller is configured to assign a patient to the securable compartment such that medications for the patient are able to be placed into the securable compartment. The controller is also configured to selectively permit access to the medications for the patient in the securable compartment when the patient admittance status information indicates the patient is currently admitted, and restrict access to retrieval of the medications for the patient in the securable compartment when the patient admittance status information indicates the patient is not currently admitted. 
         [0006]    According to one aspect of the present disclosure, a method, for patient-specific medication dispensing and notification, comprises the following: receiving an admit-discharge-transfer (ADT) alert, evaluating a list of patients whose medications are stored in a medication station to determine if the list includes the patient for whom the ADT alert was received, and transmitting a notification to adjust medications for the patient in response to the ADT alert received for the patient, if the list of patients treated by the medication station includes the patient for whom the ADT alert was received. 
         [0007]    According to another embodiment of the present disclosure, a computer-readable medium having computer-executable instructions for causing a processor to execute instructions to control a medication station by performing steps comprising receiving admittance status information for the patient, and assigning the patient to at least one securable compartment of a medication station, such that at least one medication for the patient is able to be placed into the securable compartment. The computer-readable medium also comprises computer-executable instructions for performing steps comprising selectively permitting access to the medication in the securable compartment when the admittance status information indicates the patient is currently admitted, and restricting access to retrieve the medication in the securable compartment when the admittance status information indicates the patient is not currently admitted. 
         [0008]    Additional features and advantages of the invention will be set forth in the description below, and in part will be apparent from the description, or may be learned by practice of the invention. The objectives and other advantages of the invention will be realized and attained by the structure particularly pointed out in the written description and claims hereof as well as the appended drawings. 
         [0009]    It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are intended to provide further explanation of the discussed embodiments as claimed. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0010]    The accompanying drawings, which are included to provide further understanding and are incorporated in and constitute a part of this specification, illustrate disclosed embodiments and together with the description serve to explain the principles of the disclosed embodiments. In the drawings: 
           [0011]      FIG. 1  illustrates an automated dispensing machine (ADM) for patient-specific medication dispensing and notification according to one embodiment. 
           [0012]      FIG. 2  is a perspective view of the ADM of  FIG. 1  with drawers extended. 
           [0013]      FIG. 3  is a perspective view of the ADM of  FIG. 1  showing the cabinet drawer rail. 
           [0014]      FIG. 4  is a top perspective view of the back of the cabinet of the ADM of  FIG. 1 . 
           [0015]      FIG. 5  is a block diagram of the electronic interface of the ADM of  FIG. 1 . 
           [0016]      FIG. 6  is a block diagram of a network configuration for the ADM of  FIG. 1 . 
           [0017]      FIG. 7  is a flow diagram illustrating a process for treating a patient using the ADM of  FIG. 1 . 
           [0018]      FIG. 8  is a flow diagram illustrating a process for interacting with interactive interface software of the ADM of  FIG. 1 . 
       
    
    
     DETAILED DESCRIPTION 
       [0019]    In the following detailed description, numerous specific details are set forth to provide a full understanding of the present disclosure. It will be obvious, however, to one ordinarily skilled in the art that the embodiments of the present disclosure may be practiced without some of these specific details. In other instances, well-known structures and techniques have not been shown in detail not to obscure the disclosure. 
         [0020]    Referring now to the drawings,  FIG. 1  illustrates an ADM  100  according to certain embodiments. 
         [0021]    The ADM  100  is a patient-specific medication dispensing and notification system configured to provide patient-specific dispensing of medications with patient-specific notifications regarding the medications for the patient. The ADM  100  is a type of medication dispensing system. The ADM  100 , through its electronic interface  110 , allows authorized users, such as caregivers, to access medications securely stored in the station  100 , while restricting access to unauthorized users. Furthermore, when a patient that will be or is assigned to the ADM is admitted to or removed from the facility in which the ADM  100  is used, the ADM  100  transmits an alert to either add or remove medications for the patient. Consequently, the ADM helps prevent the disappearance of medications for patients, such as after they are discharged, or mixing of medications between different current patients. 
         [0022]    The ADM comprises a cabinet  120  and the electronic interface  110 . The cabinet  120  includes a plurality of modular storage compartments, here shown as drawers  122 . The number and type of drawers  122  used can be custom configured within the cabinet  120  to match the medication and supply needs of the facility using the ADM  100 . In the illustrated embodiment, there are two types of drawers  122 : supply drawers  126  for use in holding general supplies and medical drawers  124  for use in holding medical supplies, such as medicine. The medical drawers  124  are securable. In certain embodiments, the supply drawers  126  can also be securable. The secured medical drawers  124  are electronically controlled, while the supply drawers  126  are manually controlled. For example, a person can open and close a manually controlled supply drawer  126  with little or no preliminary requirements such as providing a password or code. Manually controlled drawers can either be accessed (i.e., opened and closed) by hand with no impediments, similar to conventional storage drawers, or alternatively can be made accessible through a first securing arrangement, while electronically controlled drawers are accessible through a second securing arrangement. 
         [0023]      FIGS. 2-3  illustrate a typical configuration of drawers  122  for the ADM  100 . The drawers  122  are matrix drawers, which are drawers divided into equally accessible compartments by adjustable or fixed dividers  132 . The number and type of dividers  132  used can be custom configured within each drawer  122  to match the medication and supply needs of the facility using the station  100 . 
         [0024]    In certain embodiments, the configuration of drawers  122  can be similar to the drawer configuration found in the presently commercially available product known as a MedStation automated medication management system from Cardinal Health, Inc., Dublin, Ohio. A MedStation system can be configured with different kinds of drawers  122  that include drawers with CUBIE receptacles, matrix drawers of different heights, and MiniDrawers™. CUBIE, Matrix and Double Deep Matrix are terms understood by those skilled in the art. CUBIE receptacles, drawers  122 , and related dispensing machines are fully disclosed in U.S. Pat. Nos. 6,116,461 and 6,338,007, which are incorporated herein by reference. There can also be patient-specific CUBIE receptacles that contain multiple medications and supplies for a single patient. 
         [0025]    Supply drawers  126  have handles  128 , whereas medical drawers  124  do not. In certain embodiments, either type of drawer  126  or  128  can have handles  128 . The securable medical drawers  124  automatically open a relatively short distance, e.g., less than two inches, from the cabinet  120  when they are electronically unlocked. This may be accomplished by spring-loaded solenoids. Supply drawers  126  need to be manually opened and do not automatically open when unlocked. In certain embodiments, the supply drawers  126  automatically open as well. The particular drawer  122  design can be any chosen design with sound engineering judgment. In the illustrated embodiment  100 , the drawer design  122  includes rails  134 , as illustrated in  FIG. 3 , that slidably connect the drawers  122  to the cabinet  120  in a well-known manner. Indicators  136  are used in indicating if a drawer  122  is unlocked. In certain embodiments, indicators  136  can be used to indicate if the drawer  122  contains desired supplies. In the illustrated embodiment, the indicators  136  include an indicator light  136  mounted on a front surface of the cabinet  120 , as shown, so that it can be easily observed when a drawer  122  is open. Alternatively, the indicator lights  136  could be on the drawers  122 . The electronic interface  110  could also provide an appropriate indication. 
         [0026]    The ADM  100  is movable in certain embodiments. Returning to  FIG. 1 , the ADM  100  has at least a first ground-engaging wheel  138  (an embodiment with four wheels is shown), and at least a first handle  142  for use in transporting the ADM  100 . In certain embodiments, other means of movement may be used. In certain embodiments, depending on the location and type of electronic interface  110 , the cabinet  120  can also have a top work surface which can vary in size and shape. 
         [0027]    In certain embodiments, the cabinet ADM  100  can include an illumination light inside the handle  142  for illuminating the drawers  122 . In this way, an opened drawer&#39;s  122  contents are illuminated obliquely. This illumination light may be positioned in the cabinet handle  142  or attached to the underside of the handle  142 . The illumination light is turned on when a drawer  122  is opened. The drawers  122  could also incorporate translucent bins and gentle illumination from below to silhouette the drawer  122  contents. 
         [0028]      FIG. 4  is a top perspective view of the back of the cabinet  120  of the ADM of  FIG. 1 . As noted above, secured drawers are electronically controlled. In case there is a loss of power to the ADM  100 , and/or some electrical computer malfunction prevents normal access to the drawers  122 , the cabinet  120  can be equipped with a manual release mechanism for use in unlocking the drawers  122 . An access system  144  is provided so that a manual release mechanism can be accessed. At least one of the cabinet back panels  146  provides the required access system  144 . This gives access to each drawer&#39;s  122  manual release mechanism. 
         [0029]      FIG. 5  is a block diagram of the electronic interface  110  of the ADM  100  of  FIG. 1 . The electronic interface  110  comprises a computing device  116 , display device  112  and an input device  114 . 
         [0030]    The display device  112  is a flat panel display in the exemplary embodiment. In certain other embodiments, the display screen  112  can be a cathode ray tube (CRT) display, vacuum fluorescent display (VFD), light emitting diode (LED) display, plasma display panel (PDP), liquid crystal display (LCD), organic light emitting diode (OLED), or surface-conduction electron-emitter display (SED). The input device  114  is a keyboard. In certain embodiments, the input device  114  can be a keypad integral with the cabinet, touch-screen input, mouse, or a microphone. For example, in embodiments without a physical keyboard, the input device  114  can be a virtual keyboard. The virtual keyboard automatically appears on the display  112  when the system detects a type-in field. The virtual keyboard is a feature that hospital staffs appreciate even more than the physical keyboards because it minimizes the number of objects in the room and also decreases the risk of infection and contamination. 
         [0031]    The computing device  116  comprises a processor  164 , communications module  162 , and memory  150 . The processor  164 , for example, a central processing unit (CPU), drives software stored in the computing device&#39;s memory  150  or elsewhere. 
         [0032]    The communications module  162  provides networking capability in order to connect to a network  510 , which is described in further detail below. Networking capability is achieved via a communication layer that enables data transmissions. Networking can be achieved by the use or the installation of data cables from the ADM  100  to a central network device for the network  510 , such as a router or switch, or by using a wireless connection. An alternate technology would use existing phone cabling of the facility to transport data, thus avoiding the cost and deadlines associated with the installation of new cabling. 
         [0033]    Stored in the memory  150  is software  152  for interfacing with an admit-discharge-transfer (ADT) system, software  154  for interfacing with an electronic medical record (EMR) server, interactive interface software  160 , access information  156 , an access log  156 , and a list of active patients  166 , and a list of discharged (or inactive) patients  168 . The memory  150  can include volatile and/or non-volatile sections. 
         [0034]    The interactive interface software  160  is used in interacting with a user of the ADM  100 , as discussed in further detail below with reference to  FIG. 8 . The interactive interface software  160  maintains at least a list of patients  166  being treated whose items are stored in the corresponding ADM  100  (“active patient list”), and, in certain embodiments, the software can maintain a separate list of patients  168  who were previously being treated and whose items were stored in the ADM  100 , but who are no longer active (“discharged patient list”). Both lists  166  and  168  are stored and maintained in memory  150  by the interactive interface software  160 . The interactive interface software  160  references access information  156  stored in memory  150  when authenticating a caregiver attempting to use the ADM  100  through the interactive interface software  160 . The interactive interface software  160  communicates with and accesses information from the ADT system interface software  152  and the electronic medical record (EMR) interface software  154 , discussed below. In certain embodiments, the interactive interface software  160  is configured to run on any ADM with physical features similar to the features of the ADM(s)  100  discussed herein, in order to provide other ADMs with the interactive software functionality of the ADM(s) discussed herein. For example, the interactive interface software  160  is configured to run on the Medstation discussed above, as well as the ADM disclosed in U.S. patent application Ser. No. 10/810,379, entitled “POINT OF CARE STATION,” filed on Mar. 26, 2004, which is hereby incorporated by reference in its entirety for all purposes. 
         [0035]    The ADT system interface software  152  is configured to receive and interpret alerts received from an ADT system. ADT system alerts, which are patient specific, include admission alerts, discharge alerts, and transfer alerts. In certain embodiments, the ADT system interface software  152  is configured to receive and interpret alerts containing admit, discharge, transfer, or other patient admittance status information from any system. The EMR interface software  154  is configured to access, read, and write information on a device storing EMRs. In certain embodiments, the ADT system interface software  152  and the EMR interface software  154  are standardized using standards available from Health Level Seven, Inc. (HL7), so that the ADM  100  can be used with any facility network. In certain embodiments, the ADM  100  contains software to interface with nearly every major system vendor using proprietary or non-proprietary interfaces. The interactive interface software  160  is configured to broadcast or otherwise transmit admit, discharge, and transfer notifications in response to the ADT alerts interpreted by the ADT system interface software  152 . 
         [0036]    The electronic interface  110  uses the interactive interface software  160  to control access to items stored in the cabinet  120 . In order to access the items, special access must first be granted. Two levels of access to the ADM  100  software systems are supported. Before medication can be dispensed, the caregiver must log in with access information. One method is to have the caregiver enter a username and password, or just a password in order to gain access to the items stored in the drawers  122 . Another method is to have the caregiver use a swipecard authenticated with either password or fingerprint. The ADM  100  can be used with cards with a magnetic strip or chip, proximity cards or chips that the caregiver would carry, and the like. The ADM  100  may also require a password and ID entry in order to gain access to the items stored in the compartments  28 . The interactive interface software  160  can also start a time-out to log off and lock supply drawers  126  in response to closing a drawer  122 . 
         [0037]    In certain embodiments, the electronic interface  110  can be in a remote location with respect to the ADM  100 . Consequently, in certain embodiments, an ADM as disclosed herein does not include an electronic interface. An ADM without an electronic interface, can, for example, include an input for connecting to an electronic interface with similar features to the electronic interface  110  disclosed herein, such as through a physical connection/port, or through a wireless connection. 
         [0038]    The caregiver interacts with the ADM  100  through the electronic interface  110 . If the electronic interface  110  has been idle for a predetermined time, such as three minutes, the system will automatically log off. In certain embodiments, other predetermined amounts of time can be used. To log back on at the same point in the ADM interface software  160 , the access information is re-entered. If the same access information for the same caregiver is entered, the caregiver&#39;s location in the interactive interface software  160  is preserved. If access information for a different caregiver is entered, the initial screen for the interactive interface software  160  will be displayed. In certain embodiments, there is no automatic log off. In certain embodiments, the ADM  100  displays a fast log out button to allow caregivers to interrupt their session and leave the room momentarily, and secures the system. 
         [0039]    To access items within the drawers  122 , while a caregiver is logged on, any one of the authorized drawers  122  can be opened depending on a patient&#39;s admittance status. In another embodiment, while a caregiver is logged on, one or more of authorized supply drawers  126  can be opened. 
         [0040]    In embodiments where tracking of items is included, the needed item can be retrieved and recorded on-screen. This mode of interaction works best for caregivers with a clear mental picture of where items are in the cabinet  120 , or who can quickly recognize an item on sight. This mode also allows items to be accessed and recorded while the interactive interface software  160  is in mid-operation on another task. In another embodiment, the display  112  provides a screen interface for each drawer  122 . This interface may illustrate any and all the items and their locations in drawer  122  sections. This may be shown graphically with pictures or a list of items and their locations. This may help the caregiver to intuitively direct their attention to relevant items. If the caregiver takes nothing from the drawer, the on screen menu for that drawer  122  will persist (even if the drawer  122  has been shut again) until the caregiver presses the “none taken” button or goes to the next screen if another drawer  122  is opened. If the caregiver has taken an item(s) and has recorded what the caregiver has taken on the touch screen, the menu will disappear when the caregiver shuts the drawer  122 . In another embodiment, an “out of stock” button can be provided beside each item button to inform restockers about items that need more urgent attention—for example, a nurse needed a particular item but the item was not there. In yet another embodiment, a “dispatch” button could be provided to prompt a restocker to come to the room immediately with a refill. 
         [0041]    In certain embodiments, the ADM  100  may allow caregivers to inform the system when a particular item has run out and needs to be restocked. At least three alternate policies for use of this interface  160  are possible: (1) a button is pressed any time anybody notices a depleted item; (2) a button is pressed when lack of an item has inconvenienced a caregiver; (3) a button serves as a panic button to request a restocker to immediately bring a set of new stock for that ADM  100 . 
         [0042]    In certain embodiments, the memory  150  further includes a bedside information gateway (BIG). BIG is an application-independent system that allows easy and efficient access to mission-critical applications directly from the ADM  100 . It makes it possible for medical staff to leverage applications throughout the facility regardless of the technology (Web or Windows) used for these applications. BIG makes it possible for physicians and nurses to access quickly and easily a wide variety of medical applications and information, therefore shortening the time it takes the caregiver to make rounds. Whether used to consult a patient file, access laboratory/radiology results or prescriptive applications, the ADM  100  acts as a window on the applications inside the hospital mainframe, such as by using the network  510 . With the BIG technology, only the purchase of verification software is required to implement verification. 
         [0043]    The electronic interface  110  can be located on or in the cabinet  120 . The electronic interface  110  can be removably or permanently attached to the cabinet  120 . In certain embodiments, portions of the electronic interface  110  can be attached to the cabinet  120  via an arm, such as an articulated arm. 
         [0044]      FIG. 6  is a block diagram of a network configuration for the ADM of  FIG. 1 . A plurality of ADMs  100  are connected to a facility network  510  through their respective communication modules  162 . Also connected to the network is a console device  622 , such as a computer. The console device  622  can be located in a pharmacy so it is easily accessible to an individual, such as a pharmacist, responsible for dispensing medications to an ADM  100 . The console device  622  and the ADMs  100  together form the ADM system  620  of the network  510 . The other portion of the network  510  is the facility network  630 , which includes an ADT system  632  and a networked server storing EMRs  634 . Each ADM  100  of the network  510  thus has access to admission/discharge/transfer information for a patient, a patient&#39;s medical record, and possibly any other medical application or information. 
         [0045]    The ADT system  632  broadcasts alerts for a patient, including alerts that a patient has been admitted to, discharged, or transferred from the facility. For example, if a patient John Doe is admitted to a hospital that uses an ADT system  632 , the ADT system  632  would broadcast an alert over the network  510  that patient John Doe has been admitted. The alert would be received by an ADM  100  also connected to the network  510 , as illustrated, which then processes the information that patient John Doe has been admitted to the hospital. The ADM  100  can then transmit a corresponding notification through the network  510  to the console  622 . 
         [0046]    The EMR server  634  stores electronic medical record information, and makes the information available over the network  510  according to appropriate security features and requirements. EMR information can include, for example, notes from patient medical history, family history, complaints, office visits, staff observations, lab tests, X-rays, prescription and drug allergy information, social history, and diagnoses. 
         [0047]      FIG. 7  is a flow diagram illustrating a process  700  for managing medications for a patient using the ADM of  FIG. 1 . The process  700  begins in state  701  when the patient is admitted into the facility. The ADT system  632  issues an admit alert over the network  510  in state  702  that the patient has been admitted. The electronic interface  110  of the ADM  100  receives the admit alert in state  703 , and, in response, determines in state  704  if the patient is already assigned to the ADM  100 . For example, the interactive interface software  160  of the ADM  100  can determine whether the patient is present in the ADM&#39;s list of active patients  166 . If the patient is determined to be already assigned to the ADM  100 , the process  700  is completed. If, however, the patient is determined not to be assigned to the ADM  100 , the process proceeds to state  705 . In certain embodiments, state  704  determines if the patient is assigned to any ADM  100  on the network  510 . 
         [0048]    In state  705 , the ADM  100  sends its own admit notification for the patient. The ADM&#39;s admit notification is broadcast to devices within the ADM system  620  on the network  510 , including the console  622 . The admit notification can be broadcast according to any method known in the art, including, but not limited to, automated telephone call, automated voicemail, Short Message Service (SMS) message, Enhanced Messaging Service (EMS) message, Wireless Application Protocol (WAP) push, instant message, email, RSS feed, screen alert, and page. 
         [0049]    The admit alert received at the console  522  notifies the console&#39;s user, such as a pharmacist, that the patient has been admitted to the hospital. In response, the pharmacist accesses the patient&#39;s medical records from the EMR server  634  on the network  510  in order to obtain the patient&#39;s medical history, which includes the patient&#39;s prescription information. In state  706 , the pharmacist (or other caregiver) assigns to the patient a patient cassette drawer (PCD)  124 , or compartment(s) in the PCD  124 , in the appropriate ADM  100 . The appropriate ADM  100  can be selected based on the patient&#39;s location in the facility, for example. In certain embodiments, a patient can be assigned multiple PCDs  124 . In certain embodiments, a patient can be assigned to a portion of a drawer  124 , such as to a compartment in the drawer  124 . After being assigned the patient in state  706 , the ADM  100  updates its list of active patients  166  in state  707  to include the patient. In certain embodiments, the ADM  100  updates its list of active patients in response to receiving the admit alert from the ADT system  532  in state  703  or after the determination is made in state  704 . An ADM  100  can be selected to house the patient&#39;s medications based on its proximity to the patient or to the relevant nurse station. The PCD assignment is made through the ADM&#39;s interactive interface software  160 , such as by entering access information or entering/selecting the appropriate patient information, and then selecting a PCD  124  to assign to the patient. The pharmacist or other caregiver can then dispense the appropriate medications to the PCD  124  in state  708 , which is discussed in further detail below with reference to  FIG. 8 . 
         [0050]    When the patient is later discharged out of, transferred from, or otherwise leaves the hospital in state  709 , the ADT system  632  issues a discharge (or transfer) alert for the patient in state  710 . The ADM  100  receives the discharge alert in state  711 , and, in response, determines if the patient is assigned to the ADM  100  in state  712 . For example, the interactive interface software  160  of the ADM  100  can determine whether the patient is present in the ADM&#39;s list of active patients  166 . If the patient is determined not to be assigned to the ADM  100 , the process  700  is completed. If, however, the patient is determined to be assigned to the ADM  100 , such as by being listed in the list of active patients  166  for the ADM  100 , the process proceeds to state  713 . In certain embodiments, state  712  determines if the patient is assigned to any ADM  100  on the network  510 . 
         [0051]    If the discharged patient is determined to be an active patient of the ADM in state  712 , then in state  713 , the ADM  100  sends its own discharge notification for the patient. The electronic interface  110  otherwise ignores discharge alerts received for patients not assigned to the ADM  100 . The ADM&#39;s discharge notification is broadcast to devices within the ADM system  620 , including the console  622 . For example, the discharge notification from the ADM  100  is sent to the pharmacist console  622 , and can include information to notify the pharmacist to retrieve medications for the discharged patient from the patient&#39;s assigned PCD. 
         [0052]    Upon receiving the discharge alert at the console  622 , the pharmacist in state  714  removes the patient&#39;s name from the ADM&#39;s active patient list  166 , and, in certain embodiments, adds the patient&#39;s name to the ADM&#39;s inactive patient list  168 . In certain embodiments, this name removal/addition is performed automatically by the ADM  100  in response to receiving the discharge alert from the ADT system  632  in state  711  or after the determination made in state  712 . The addition of the patient&#39;s name to the ADM&#39;s inactive patient list  168  causes the ADM  100  to restrict access to the PCD  124  previously assigned to that patient. The pharmacist or other authorized caregiver can then retrieve the patient&#39;s medications from the appropriate PCD  124  in the ADM  100  in state  715 , such as after being notified by a discharge notification sent by the ADM  100 , as discussed above. Unauthorized users or caregivers will not be able to access the PCD  124  for the discharged patient, even if previously authorized. 
         [0053]      FIG. 8  is a flow diagram illustrating a process  800  for interacting with interface software of the ADM of  FIG. 1 . Although  FIG. 8  illustrates an embodiment where authorized users can have different levels of clearance, in other embodiments, all authorized users can have the same level of clearance. 
         [0054]    The process  800  of interaction begins in state  801  when the caregiver logs into the ADM&#39;s interactive interface software  160 . As discussed above, access to the ADM  100  is granted to the caregiver after the appropriate access information is entered, according to the access information  156  stored in the device&#39;s memory  150 . After the caregiver successfully logs in, the interactive interface software  160  determines the caregiver&#39;s clearance level in state  802  using the stored access information  156 . In the illustrated embodiment, a caregiver can have at least two different clearance levels: a first clearance level which does not have access to empty a discharged patient&#39;s cassette drawer, such as for a nurse, and a second, higher clearance level which does have access to empty a discharged patient&#39;s cassette drawer, such as for a pharmacist. In embodiments where an authorized user can have only one level of clearance, the process would automatically proceed from state  801  to state  807 . 
         [0055]    If in state  802  the caregiver is determined to have the first clearance level, the process moves to state  803 , where a list of active patients  166  is displayed. The caregiver then selects an active patient from the active patient list in state  804 . In certain embodiments, if the patient is assigned to multiple drawers  124 , the interactive interface software  160  can prompt the caregiver to select a drawer  124 . Next, in state  805 , the caregiver is given the option of either refilling the selected patient&#39;s cassette drawer  124 , or dispensing medications from the selected patient&#39;s cassette drawer  124 . The interactive interface software then provides to the caregiver access to the appropriate secured patient cassette drawer  124 , such as by electronically unlocking the drawer, so that the caregiver can complete the task of either refilling or dispensing in state  806 . 
         [0056]    If, however, in state  802  the caregiver is determined to have the second, higher clearance level, the process moves to state  807 , where both a list of active patients  166  and a list of inactive patients  168  is displayed. The caregiver in state  808  can select either an active patient from the active patient list  166 , or an inactive patient from the inactive patient list  168 . In certain embodiments, if the patient is assigned to multiple drawers, the interactive interface software  160  can prompt the caregiver to select a drawer  124 . Next, in state  809  the caregiver is given the option of either refilling or dispensing medications from an active selected patient&#39;s cassette drawer  124 , or emptying medications from an inactive selected patient&#39;s cassette drawer  124 . If the caregiver selects to either refill or dispense medications for an active patient, the process moves to state  806 , as discussed above. If the caregiver selects to empty an inactive patient&#39;s cassette drawer  124 , the interactive interface software  160  provides to the caregiver access to the appropriate secured discharged patient cassette drawer  124 , such as by electronically unlocking the drawer, so that the caregiver can complete the task of emptying in state  810 . Thus, only a caregiver with an appropriate access level has access to medications in a discharged patient&#39;s cassette drawer  124 , while a caregiver without the appropriate access level cannot access the medications in the discharged patient&#39;s cassette drawer  124 . A caregiver may have been notified to log in to the interface software of the ADM to empty an inactive patient&#39;s cassette drawer  124  by receiving a notification at the pharmacist console, as discussed above. 
         [0057]    After the caregiver&#39;s task is completed in either state  806  or  810 , the system records to an access log the caregiver&#39;s identification, the task performed by the caregiver, and the time the caregiver performed the task. In certain embodiments, other information can be logged, such as the dispensing, refilling, or emptying of medications. 
         [0058]    In certain embodiments, the interactive interface software  160  of the ADM  100  is configured to track the movement of medications contained in the cabinet  120 , such as when a medication is loaded and removed, to whom the medication is assigned, and which PCD  124  the medication is assigned to and/or located. These features can be achieved by adding additional tracking functionality to the interactive interface software  160 , such as by expanding states  806  and  810  in the process  800  of  FIG. 8  to include prompting the caregiver for information regarding the medications refilled or dispensed (in state  806 ) or emptied (in state  810 ). 
         [0059]    As illustrated above, the ADM  100  may be integrated into a larger, perhaps care facility(ies) wide, system for controlling supplies and medicines. For one example, the ADM  100  can complement at least two other devices known as the Pyxis MedStation and the Pyxis SupplyStation units. In one recommended use, high use and patient-specific medications are stored in the ADM  100  while the MedStation unit maintains first dose and controlled medications. Slower moving drugs can be placed in the MedStation unit while the fast moving medications can be placed within the cabinet  120  of the ADM  100 . The MedStation and SupplyStation units can be used to manage bulk items while the ADM  100  can manage patient-specific medications and supplies. It should be noted that the interactive interface software  160  of the ADM  100  can be configured to interface with the MedStation units. 
         [0060]    While certain aspects and embodiments of the invention have been described, these have been presented by way of example only, and are not intended to limit the scope of the invention. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms without departing from the spirit thereof. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the invention.