Abstract:
A method and an automated pharmacy system to alleviate the risk posed by a queue of printed labels for prescription vials that occurs at the printer. The method and system eliminate the need for physically transferring paperwork from one site (the imaging station) to another site (the filling station). Elimination of the physical transferring step smooths the flow of the dispensing operation, and hence, improves the throughput of the automated pharmacy, and further, helps to prevent the association of the wrong paperwork with a given prescription.

Description:
RELATED PATENT APPLICATION 
     1. Field of the Invention 
     The present invention relates to automated pharmacies and, more particularly, to an automated pharmacy that is more accurate and has a prescription filling throughput greater than those of other systems. 
     2. Background of the Invention 
     In a typical prescription filling system illustrated in U.S. Pat. No. 5,597,995, for AUTOMATED MEDICAL PRESCRIPTION FULFILLMENT SYSTEM HAVING WORKSTATIONS FOR IMAGING, FILLING, AND CHECKING THE DISPENSED DRUG PRODUCT, issued to WILLIAMS et al., a written prescription is presented to a pharmacy and read by a pharmacist or clerk. The pharmacist or clerk at the pharmacy also inquires about the malady of the patient directly, and elicits any additional information from him or her. This information, along with the prescription, is then entered into a computer called a “host” computer via a computer keyboard, and is stored in a database. The computer creates a prescription number associated with the entered data and stores it with the data in the database. The host computer then sends this data record to a first computer, also within the imaging station. The first computer then sends all of this information separately to a first printer, which prints a vial label having a barcode, and to a second printer which then prints a label containing a prescription number, which is affixed to the paper prescription received from the patient. Thereafter, the paper prescription is placed in a scanner, producing a computerized image that is stored in a database. The image is associated in the database with the prescription number. Thereafter, the first computer sends the data to a second computer associated with a filling station, where it is placed in that second computer&#39;s database. 
     In practice, the first printer typically also prints what is commonly referred to in the industry as a “prescription label,” often a single sheet of adhesive-backed paper. It typically consists of a prescription vial label, patient “monograph” (explanations and instructions for the patient), a receipt, a duplicate receipt, and various auxiliary labels such as special warnings, bag labels, and the like. The resultant queue of labeled vials with these associated prescription labels causes confusion, lost time, and is a source of errors which may occur during the filling process. 
     The label is affixed to an empty vial at the first printer resulting in a labeled vial. At this time the labeled vial (and, in practice, associated prescription paperwork) are sent to the filling station. At the filling station, the second computer, which has received the prescription data record from the first computer, controls a drug dispenser. A barcode scanner is used to read the barcode on the label of the vial, sending the prescription number encoded thereon to the second computer. The second computer then searches its database for the prescription number read from the barcode on the vial label. When it is found, the second computer uses the data to dispense the correct type and number of tablets from the automated dispensing system or a manual filling process, into the vial. With the WILLIAMS et al. system, the vial label is produced in the printer, which results in a queue of labeled vials and paperwork, along the system path, between the imaging workstation prescription label printer and the prescription filling station where both automated and manual filling can take place. Unfortunately, this creates potential for confusion and error. 
     The present invention, on the other hand, represents a method and a system to alleviate the risk of errors in filling posed by the queue of multiple labeled vials and their associated paperwork that exists at the filling station. The present invention does so by allowing a workflow in which only one unfilled labeled vial and its associated prescription label paperwork exist at the filling station at any one time. In the event that the pharmacy handles very high volume, and more than one filling station is employed, still only one unfilled labeled vial and its associated prescription label paperwork will exist at each separate filling station. 
     Additionally, the present invention eliminates the need to physically transfer the labeled vial and prescription paperwork from one site (the data entry workstation) to another site (the filling station). Elimination of the physical transferring step smooths the flow of the dispensing operation, and hence, improves the automated pharmacy&#39;s throughput. 
     The WILLIAMS et al. system also has an additional problem, when attempting to give high priority (the order in which vials are filled) to a particular prescription at the filling station. Filling prescriptions out of the originally intended order increases the likelihood of providing the wrong paperwork with any particular vial, because it requires the operator to search through the queue of labeled vials and prescription label paperwork. 
     The present invention, by removing the physical transfer of paperwork and the queue of labeled vials and paperwork at the filling station, greatly reduces the probability of mistakes when a particular prescription is taken out of its normal position in the queue. 
     In the present invention, as in the prior art, a prescription number is generated within the computer at the data entry workstation and associated with the entered data record. The image of the paper prescription is scanned in. At this point the various patient information and patient history already in the database can be updated, as can all of the new information about the present prescription associated with it. Then the data and the prescription number are sent to the second computer, located at the filling station, which controls a second printer that prints a label containing the barcode of the prescription number. The label is affixed to a vial, again resulting in a labeled vial. The barcode is read by a scanner connected to the second computer. The second computer or the first computer then searches the database for the prescription number read from the barcode on the vial. When this prescription number is found, the accompanying data block is sent to the second computer, which uses the data to dispense the correct type and number of tablets from the dispenser into the vial. 
     Both the WILLIAMS et al. and the inventive systems include a checking station, having its own computer or terminal, at which a pharmacist checks the filled vial against the data and the image of the prescription displayed on a screen. The tablets in the vial are also compared with a stored picture of the type of tablet which has been dispensed for this prescription. This validates that the correct drug has been dispensed. 
     Using the system of this invention as compared to the WILLIAMS et al. system, however, it is unnecessary to have a potentially confusing queue of labels between the first computer and the filling station. This improves reliability of the operation and substantially reduces errors. In addition, since there is no flow of labels or vials from the data entry workstation (the imaging workstation in the WILLIAMS et al. system) to the filling station which must be manually tracked, the efficiency and throughput of the pharmacy is improved. 
     In the event that a particular prescription requires a fill-next priority, as for example when a patient arrives at the pharmacy and chooses to wait for the medication, the system of this invention makes it easier to accomplish this task without errors, as only the one unfilled labeled vial exists at the filling station (or at any one filling station) at any one time. This results in streamlining the flow of prescription data, so that the data is held in the computers until needed. In other words, the data is not floating about the pharmacy, as is likely in the WILLIAMS et al. system. 
     Furthermore, in the WILLIAMS et al. system, it is possible for the operator to scan the wrong vial label at the filling station, and thus, the wrong data could be associated with the intended prescription, because a number of labels were in existence at the same time. The present invention prevents this, however, by scanning the barcode on the label of the vial into which the medicine is to be dispensed, since it is the only unfilled labeled vial at the filling station. 
     In U.S. Pat. No. 5,713,485, issued to LIFF et al. on Feb. 3, 1998, entitled DRUG DISPENSING SYSTEM, an automated drug dispensing system is shown. The system comprises a plurality of prepackaged pharmaceuticals. The varieties of pharmaceuticals are each associated with a code. A controller receives requests and generates dispensing signals that cause a dispenser to dispense the packaged pharmaceuticals. After dispensing the pharmaceutical, its code is checked against that originally requested. 
     In U.S. Pat. No. 5,700,998, issued to PALTI on Dec. 23, 1997, for DRUG CODING AND DELIVERY SYSTEM, a drug dispensing system having coded tablets or pills is illustrated. The code is placed directly on the tablet and then compared to the code associated with the requested pharmaceutical, which is meant to ensure that only the exactly ordered pharmaceutical is dispensed. 
     In U.S. Pat. No. 5,660,305, issued to LASHER et al. on Aug. 26, 1997, entitled AUTOMATIC PRESCRIPTION DISPENSING SYSTEM, a dispensing system having a multiplicity of pill dispensers is shown. The dispensers are arranged in rows and columns. Empty pill bottles are conveyed past the dispensers. Pills are released into the individual bottles as they pass under the proper dispenser, thus allowing for simultaneous dispensing. The correct number of pills is counted prior to dispensing, wherein the pills are released en masse. 
     In U.S. Pat. No. 5,502,944, issued to KRAFT et al. on Apr. 2, 1996, for MEDICATION DISPENSER SYSTEM, a dispenser is shown that contains a number of containers for holding a select quantity of medications. A packaging apparatus under robotic control dispenses the prescription from the containers to a package, thus preventing cross-contamination. 
     SUMMARY OF THE INVENTION 
     In accordance with the present invention, there is provided a system for operating a pharmacy. The system provides a greater throughput than previous systems by virtue of eliminating a paper trail and a queuing of prescription labels, in which vials and labels are transported in piles. As one of the first steps, a prescription number is assigned to the written or communicated prescription request. This prescription number is then combined with data transmitted from a first location or operating station, usually comprising a computer. The prescription number is associated with the prescription and this data. 
     Then, the data and the prescription number are sent to a second location or operating station, usually comprising a second computer. The second computer controls a second printer that prints a label containing the barcode and the prescription number. The label is affixed to a vial, resulting in a labeled vial. The barcode is read by a scanner connected to the second computer. The second computer or the first computer then searches a database for the prescription number read from the barcode on the vial. When this is found, the accompanying data block is used by the second computer to dispense the correct type and number of tablets from the dispenser into the vial. 
     The system comprises a checking station, having its own (third) computer or terminal, at which a pharmacist checks the filled vial against the data and the image of the prescription displayed on a screen. The tablets in the vial are also compared with a stored picture of the type of tablet which has been dispensed for this prescription. This validates that the correct drug has been dispensed. 
     It is an object of this invention to provide an improved pharmaceutical dispensing system. 
     It is another object of the invention to provide an automated medication dispensing system having improved throughput. 
     It is a further object of this invention to provide a pharmaceutical dispensing system that is not subject to errors in the dispensing of medications. 
     It is still another object of this invention to provide an automated pharmaceutical dispensing system that can be used in pharmacies of any size. 
     It is a further object of this invention to provide a pharmaceutical dispensing system in which the workflow may be configured as needed in any pharmacy. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     A complete understanding of the present invention may be obtained by reference to the accompanying drawings, when considered in conjunction with the subsequent detailed description, in which: 
     FIG. 1 illustrates a schematic view of the medication dispensing system in accordance with the present invention; 
     FIG. 2 depicts a schematic view of the data entry workstation in accordance with the present invention; 
     FIG. 3 shows a schematic view of the filling workstation in accordance with the present invention; 
     FIG. 4 is a schematic view of the checking workstation in accordance with the present invention; 
     FIGS. 5 a - 5   d  illustrate the communication amongst workstations; 
     FIG. 6 is a block diagram depicting the arrangement of the computer network in accordance with the present invention; 
     FIG. 7 represents a patient and pharmacist at a counselling workstation; and 
     FIG. 8 represents a customer and clerk/cashier at a point-of-sale workstation. 
    
    
     For purposes of brevity and clarity, like elements and components in the figures will bear the same designations and numbering throughout. 
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Generally speaking, this invention features a system for improving the workflow of medication dispensing, and for assuring freedom from errors during the filling of prescriptions at an automated pharmacy. The novel system further pertains to a pharmacy computer network that allows an operator at one workstation to access data from any other workstation. A data bus connects a filling workstation with a microprocessor which controls a particular dispenser. This data bus prevents messages moving between the filling workstation and the microprocessors from interfering with information flow among all other workstations. 
     Referring now to FIG. 1, what is shown is a medication dispensing system  1  comprising a data entry workstation  5 , a filling workstation  6 , a checking workstation  25 , a counseling workstation  40  and a point-of-sale (POS) workstation  41 . While it is preferred to include all five above-identified workstations, the medication dispensing system  1  is adapted to have fewer or more workstations. Moreover, the functions of several workstations may be combined. However, data entry, filling and checking are the three basic sub-systems which must be included in any configuration of medication dispensing system  1 . To obtain a better understanding of system  1  as a whole its individual workstations  5 ,  6 ,  25 ,  40  and  41  are explained hereinbelow. 
     The data entry workstation  5  contains data entry software and is typically part of the pharmacy management system software, which most pharmacies use at present. The technique by which the pharmacy management software is made available to the data entry workstation may be through the use of a screen window within which an interface to the pharmacy management software is presented, or alternatively, through the use of an electrical switching device (not shown) that switches the computer display, keyboard and mouse to the pharmacy management system computer to or from the workstation. 
     The filling workstation  6  contains software to control automated dispensers  22  (FIG. 3) and to direct a fill technician  7  in the filling of prescriptions both from the automated dispensers  22  (FIG. 3) and from shelves  17  and  20  (FIG.  3 ). Shelves  20  are specifically used to replenish the dispensers  22 . 
     The checking workstation  25  presents a pharmacist with the prescription data, a scanned image of the paper prescription, if present, and an image of the tablet or capsule to be dispensed. This enables the pharmacist to check and approve the prescription. A pharmacist is able to check the filled prescription for accuracy and verify that the label is also accurate and complete and that the drug utilization review has been completed. 
     The counseling workstation  40  provides the pharmacist with information on the patient  3 , any other medications the patient  3  is currently taking, and information relating to the medication being dispensed. Moreover, the counseling workstation  40  assists the pharmacist in advising the patient  3  on the use of the medication and on other health issues. 
     The point-of-sale (POS) workstation  41 , in most instances merely a cash register, is where a patient&#39;s payment is accepted by a clerk or cashier. Point-of-sale workstation  41  may include a barcode reader  41   a  (FIG. 8) to identify the prescriptions for which payment is being made, and a signature pad  41   b  (FIG. 8) to record an image of the patient&#39;s signature, when required. Point-of-sale workstation  41  may also be used to trace the status and location of a prescription in the workflow through the pharmacy. 
     In the pharmacy, there is a pharmacist  4 , a data entry technician  24 , a fill technician  7 , a cashier/clerk  68  and a replenishment technician  19  (FIG.  3 ). If necessary, pharmacist  4  can assume the duties of any of the others. Fill technician  7 , cashier/clerk  68 , and replenishment technician  19  (FIG. 3) may assume some or all of the responsibilities of each other. It is preferred to have separate individuals for these tasks, but it is also possible that only one individual may perform all tasks. Conversely, if several computers are disposed at one workstation  5 ,  6 ,  25 ,  40  or  41 , more than one individual may perform the same task. In operation, a physician  61  creates a prescription  2  for a patient  3 . Prescription  2  is given to patient  3  for personal delivery to data entry technician  24 . The data entry technician may also be provided with prescription  2  directly by physician  61  or qualified person in the physician&#39;s office staff (not shown) via telephone  18 , fax, or other method. In the case of refills, the patient  3  may simply place an order without appearing in person. 
     Patient  3  presents prescription  2  either within the pharmacy or at a drive-in window  69 . In the case of refills, the patient may communicate with a computer in the pharmacy by telephone, providing the information about the desired refill through the use of the touch-tone keyboard in response to synthesized voice requests by the computer, often called Interactive Voice Response (“IVR”). 
     Referring now to FIG. 2, shown is the data entry workstation  5 . Upon receiving refill information via telephone  18  or physical prescription  2 , data entry technician  24  enters the data into data entry workstation  5 . The information received from prescription  2  and from the patient  3  contains, at a minimum, the patient&#39;s name, the patient&#39;s address, the physician&#39;s name, the type of drug, the dosage size of the drug, the quantity of drug, the date prescribed, physician&#39;s instructions to the patient, the number of refills allowed, and whether the substitution of a generic version of the drug is permitted by the physician. 
     In a typical pharmacy management system  81  (FIG. 6) in accordance with this invention, data entry technician  24  is asked to consult patient  3  to determine method of payment, through a prescription insurance service with patient copayment, for example. Data entry technician  24  then enters this information into data entry workstation  5 . 
     Similarly, adjudication is also handled by the pharmacy management software  81  at this point. Adjudication is determining whether the insurance company or HMO will allow the patient to use this drug or whether another drug must be substituted. Yet another function of the pharmacy management software  81  is drug utilization review. This requires a pharmacist to examine computerized records of the patient&#39;s illnesses and other medications to detect possible incompatibilities. 
     Data entry workstation  5  creates a new data record or consults and updates an existing data record. Data entry workstation  5  transmits all information via a database to filling workstation  6  and checking workstation  25 . The information includes a recognized code indicating the type of drug and the dosage size, the number of tablets to be dispensed, a prescription number assigned by data entry workstation  5 , the patient&#39;s name and address, the physician&#39;s name, physician&#39;s instructions to the patient, date of the prescription, number of refills allowed, whether a generic version of the drug has been used, and possibly other information. 
     Barcode printer  30  at data entry workstation  5  prints a barcode label  26  representing the assigned prescription number for prescription  2 . Barcode label  26  also contains a printed prescription number which is the same one encoded in the barcode itself. Barcode label  26  may optionally contain other information from the prescription data record. Barcode label  26  is then affixed to either the front side or the back side of prescription  2 . It should be understood, however, that a barcode can be printed directly on the prescription  2 . A scanner  27 , which may be located anywhere in the pharmacy, scans prescription  2  and produces a digitized image. Alternatively, instead of scanner  27 , a digital camera (not shown) may be used. In either case, this step may be preceded by a wanding of the barcode affixed to prescription  2 . The image is stored for later use in checking the prescription  2  and as part of the pharmacy archives. At any time, a list of the prescriptions to be filled may be viewed on the screen of the data entry workstation or any of the other workstations; the particular order in which they are to be filled may be noted; and the filling order of any particular prescription may be changed. 
     Referring now to FIG. 3, the workings of the filling workstation  6  are illustrated. The filling process is performed by a fill technician  7 , when possible, or by a pharmacist  4  if necessary. Filling may be performed manually or automatically (i.e., machine-assisted). 
     In manual filling, printer  31  is located at filling workstation  6  and utilizes the transmitted information from data entry workstation  5  to print a label  9 , which is affixed to the empty medication vial  8 , container or package, not shown. This results in a labeled vial  10 . Now, the labeled vial  10  is ready to be filled with the proper medication, not shown. 
     Manual filling includes counting pills, tablets or capsules by hand, retrieval of packages (i.e., units of use or stock-keeping units) from shelves  17  or motorized carousel shelving  71 , the reconstitution  72  of certain medications, and compounding  73 . Reconstitution is adding sterile water to powders, while compounding  73  is mixing medications immediately prior to dispensing to the patient. Solid medication is placed in labeled vial  10 . Other medication (e.g., liquid, gels) may remain in a package to which label  9  is attached. The filled vial  12  or packages (not shown) are then forwarded to the checking workstation  25  (FIG.  4 ), either singly or combined in pans or bins  74 , where several medications are intended for the same order. Color coding of each bin  74  can be used to indicate priority of completion. 
     The various operations performed at the filling workstation  6  are directed by the computer system, which provides information as to where the medication is found on the shelves  17  or  71 . Shelves  17  and  71  can contain or store certain items that cannot be conveniently dispensed automatically (e.g., creams in a tube). One advantage of this information management system is that frequently-requested medications can be placed on the shelves nearest the filling workstation. Thus, the overall time spent in retrieving medications is reduced. 
     Automatic filling utilizes an array  11  of automatic tablet or capsule dispensers  22 . Using transmitted information from data entry workstation  5 , printer  31  prints a vial label  9  to be affixed to empty vial  8 . Included on this label is a barcode representing the assigned prescription number. 
     Based on the information received from the data entry workstation  5 , including the drug type (pills, tablet or capsule), number, and dosage size required by prescription  2 , filling workstation  6  selects a dispenser  22  in automatic dispenser array  11 . A code is sent to dispenser  22  ordering the specific number of tablets required by prescription  2  be counted and held in a buffer compartment. 
     At approximately the same time, the fill technician  7  receives an order on the screen of filling workstation  6  which indicates to technician  7  that this particular prescription  2  will be dispensed by automatic dispenser array  11 . Filling workstation  6  displays instructions to select a certain size vial, which technician  7  uses to select empty vial  8 . Technician  7  affixes label  9  to vial  8 , thereby creating a labeled vial  10 . Printer  31  does not print label  9  until the specified prescription  2 , associated therewith, is displayed on filling workstation  6 . This prevents any possibility of label  9  being incorrectly affixed to the wrong vial  8 . 
     Next, technician  7  uses a wand  21 , connected to filling workstation  6 , to scan the barcode on label  9 . Upon receipt of the barcoded information, which represents the prescription number of prescription  2 , filling workstation  6  then instructs dispenser  22  to display a ready light. Fill technician  7  places vial  10  underneath the buffer compartment of dispenser  22 . When the dispenser  22  detects that vial  10  is in position, it releases the tablets from its buffer compartment into labeled vial  10 , thus producing filled prescription  12 . 
     Again, the filled vials  12  are forwarded to the checking workstation  25 , either singly or combined in pans or bins  74 , which may be barcode identified. Color coding may be applied to the vials to indicate to the pharmacist at the checking station  25  that a particular prescription or set of prescriptions in the bin is to be checked ahead of other prescriptions. Once the pans or bins  74  contain a completed group of prescriptions in one order, they may be stored in a holding area  77  (FIG. 1) prior to being checked and distributed by pharmacist  4 . 
     Referring now to FIG. 4, shown is a checking workstation  25  at which pharmacist  4  checks the filled prescription order. Pharmacist  4  may, at this workstation, view a list of prescriptions in process, and note which prescriptions are ready to be checked. Pharmacist  4  may also note which prescriptions that are ready to be checked should be accompanied by other prescriptions not yet filled (for example, if those prescriptions are for the same patient), and may adjust the filling priority of such prescriptions. Pharmacist  4  then begins the checking process. The pharmacist  4  first scans or wands the barcode associated with a prescription number on the filled vial  12  or package, not shown. In lieu of scanning the barcode, the pharmacist may elect to enter the prescription number manually. The checking workstation  25  uses the prescription number to obtain information from the database. The checking workstation  25  associates the image (not shown) of the drug with the information it receives from the database. This image appears on a computer screen at checking workstation  25 . The pharmacist examines the image and compares it with the tablet or capsule or package, in the case of units of use to assure that the medication is, in fact, correct. Also, the label is inspected, comparing its information to the information provided at the checking workstation  25 . The image of the paper prescription may also be compared at that time. Pharmacist  4  verifies that the drug utilization review has been performed. If all information is correct and the medication is the correct type, strength, and amount, pharmacist  4  approves the prescription. 
     Optionally, at checking workstation  25 , pharmacist  4  can position an uncapped, filled prescription  12  under a digital camera  13 . The label  9  faces a pair of mirrors (i.e., curved mirror  23  and plane mirror  21 ). Digital camera  13  takes a picture of the capsules inside filled prescription  12  and, on the same image, an image of label  9  transmitted by mirrors  21  and  23 . Mirror  23  is curved so that it reflects a flattened, straight image of the label  9  into mirror  21 . Because the image of label  9  is unavoidably reversed by mirror  23 , mirror  21  is used to reverse the image of label  9  again so that it is readable. Alternatively, this reversal may be accomplished through computer software in the workstation. The combined picture of the tablets within filled prescription  12  and the label  9  is then transmitted to checking workstation  25 , where it is combined with the other information about prescription  2  to form a permanent record thereof. 
     It can thus be seen that the image with the prescription number in the database can be accomplished by two means: 
     a) by scanning the paper prescriptions in a strict sequence so that each one is scanned immediately after the prescription number is assigned, so that, if the sequence is violated, then the wrong paper prescription image will become associated with a given prescription number; and 
     b) by printing out a barcode label and attaching it to the paper prescription, which again must be done in strict sequence. However, then the scanning of the paper prescription can be deferred, and the correct association effected by scanning the barcode pasted to the paper prescription at the time the paper prescription is scanned. 
     Furthermore, pharmacist  4  can provide counseling to patient  3  at checking workstation  25  or at a separate counseling workstation  40 , as shown in FIG.  7 . In either case, a printer  28  or printer  40   c  prints out patient information and/or patient tutorials  29  on the drug of prescription  2 , and various auxiliary labels  29  (some of which may be preprinted) which the pharmacist  4  affixes properly. Alternatively, this information may be been printed out previously at the filling or checking workstation. Printer  28  or printer  40   c  may also print out tutorial material to be given to the patient, the material containing general instructions on self-care of his or her illness. Pharmacist  4  provides the medication, patient instructions, and certain other items (e.g., a bag/receipt label) to the cashier at the point-of-sale workstation  41 . 
     Referring again to FIGS. 1 and 2 and also FIG. 8, if payment instructions  15  and invoice  16  have not already been printed out at another workstation, workstation  41  prints payment instructions  15  and invoice  16  for prescription  2 , which the data entry technician  24  or clerk/cashier  68  may use to accept payment from patient  3 . 
     Referring again to FIG. 3, after a period of time, certain dispensers in dispenser array  11 , say, a dispenser  22 , become empty or too low for filling a prescription. At this point, filling workstation  6  will indicate to an operator that a particular dispenser  22  is empty or low on medication. Filling workstation  6  provides information on its screen to replenishment technician  19  to refill dispenser  22  with a certain type and size of tablet or capsule. Technician  19  selects a supply container  76  for the correct drug and size from stock  20 . On the supply container is a barcode indicating the drug type and size. Technician  19  wands the barcode, which informs filling workstation  6  of the drug type and size. If this is correct, filling workstation  6  then lights a replenish light (not shown) on dispenser  22 . Technician  19  is then told to extend the drawer of dispenser  22  to the replenish position and, after that action is complete, to press a key on the keyboard of filling workstation  6 . Filling workstation  6  sends a message to dispenser  22  to unlock its replenishment door (not shown). Technician  19  can now replenish dispenser  22 . 
     However, filling workstation  6  does not immediately place dispenser  22  back into service. Pharmacist  4  may optionally physically inspect dispenser  22  to ensure that the correct tablets or capsules have been placed therein. Pharmacist  4  must then wand a badge he or she wears, indicating to filling workstation  6  that this is authorized pharmacist  4 . Next, pharmacist  4  scans or wands dispenser  22 , at which time the hopper door of dispenser  22  unlocks and springs open. Pharmacist  4  inspects the contents and closes the door, indicating to filling workstation  6  that he or she has inspected dispenser  22  and approves of the replenishment. Filling workstation  6  then places dispenser  22  back into service. 
     As time passes, certain shelf locations  17  at which medication bottles, or stock-keeping units used by the fill technician  7  when manually filling orders are kept may become depleted. Shelf locations  20  may also become depleted as a result of dispenser replenishment. Technician  19  must restock the shelves  17  and  20 . As cartons  75  of medications come into the store, technician  19  scans or wands the UPC barcode on the arriving stock bottles (not shown). The filling workstation  6  then indicates to technician  19  where to place the bottles. 
     Referring now to FIGS. 5 a,    5   b,    5   c,  and  5   d,  the inter-workstation communication of this invention is disclosed. As mentioned above, any of the workstations may function as any of the others. The screen  48  of each workstation has separate operating system display windows  49  for each of the workstation types. Within each window  49  there can be a hierarchically lower window  49  that groups particular work functions. Normally, each workstation type (e.g., data entry, filling, checking, etc.) uses the window only of its own type. However, a given workstation  5 ,  6 ,  25 ,  40 ,  41  can bring up the window for a different type of workstation for performing the work of the other workstation. For example, an operator at the checking workstation  25  can bring up the window  49  for and perform the work of data entry workstation  5 , provided that all necessary peripherals are available at workstation  25 . 
     Communication between workstations  50  is effected in one of two ways: one is through data entered into or read from the database; a second is by direct message transmission, which is accomplished by sending or receiving a series of individual characters, represented by ASCII character codes. These characters make up a series of commands which convey meaning. The individual character codes  60  are transmitted between workstations using one of several well-known industry-standard character transmission protocols, such as Ethernet. These protocols utilize standard hardware  58  and software  57  which are commercially available. 
     The commands  52  are composed of a command identifier  53  (i.e., a character string identifying a command type) and a group of data fields  54 , each having a meaning which may be unique to the particular command type, each composed of a number of characters which may vary from one field to the next. 
     When a workstation  46  receives a string of characters through the Ethernet line, its Command Interpreting Software  56  first checks the initial characters of the string, thus isolating the character string  53  that identifies the command. The software  56  then determines which subroutine corresponds to this identifier. It branches to that subroutine, which in turn takes actions pertinent to the command. The actions may include, for example: (a) unpacking the data fields  54  in the command using knowledge of the character lengths of each data field, (b) using the data to print a label or send a further command to a drug dispenser, or (c) forming up a return command to the other workstation  47  that holds requested data. 
     Similarly, if a workstation must use a command to send or to request data, it utilizes its Command Forming Software  62 , thereby creating a command  52  by selecting and inserting a command identifier  53 , and by computing or selecting data fields  54  and inserting them into the command  52 . Command  52  is sent, character by character, to the transmission protocol system  51  for the actual transmission. 
     Referring now to FIG. 6, illustrated is the configuration of a pharmacy computer network  80 . In a retail pharmacy, a local area network  84  is provided, which is embodied as an Ethernet or other networking system known in the art. The hierarchical pharmacy computer network  80  consists of a local area network  84  connecting workstations  5 ,  6 ,  25 ,  40 ,  41  and, optionally,  81  and/or a separate database server  85 . There may exist one or more of any workstation so as to allow for multiple operators. 
     The network comprises one or more of any workstation  5 ,  6 ,  25 ,  40 , or  41 . Each workstation may have, but should not be limited to, a personal computer or other device having: one or more microprocessors; a data entry mechanism, such as a computer keyboard, barcode scanner, voice recognition device, or touch screen; and a graphical display, with or without sound. 
     The optional, separate database server  85  may be added to the network, as aforementioned. The database may be contained in this server  85  instead of residing within one of the other workstations. 
     A separate pharmacy management system  81 , which may optionally be connected via a separate long-distance network to a central pharmacy company computer complex, can also be either a part of a separate pharmacy network or be incorporated into the local area network  84 . Alternatively, as mentioned above, the functions of the pharmacy management system can be incorporated into one of the workstations  5 ,  6 ,  25 ,  40 , or  41 . 
     If an operator at counseling workstation  40  needs information about a patient, the operator has access to the database. Similarly, when a patient  3  is retrieving a prescription, the cashier or other qualified operator at a point-of-sale (POS) workstation  41  can check the database to verify that the patient retrieving the prescription  2  is, in fact, receiving the proper prescription. The patient  3  himself or herself can also verify that the prescription has been filled properly either at the counseling workstation  40  or at an optional workstation (not shown) provided for that purpose. 
     An operator at any workstation  5 ,  6 ,  25 ,  40 ,  41  can access the database, barring any security protocols. Security protocols on certain computers prevent a cashier at the point-of-sale (POS) workstation  41  from accessing personal information about a patient. In other words, certain workstations might have access only to selected portions of the database. In this way, the filling workstation can be emulated at other workstations, so that filling can be controlled from, say, the data entry workstation should the pharmacist be alone in the store late at night. In this regard the system can allow optimum staffing of the pharmacy at different times of day. 
     A dedicated data bus  82  is located between filling workstation  6  and a plurality of microprocessors  83  controlling individual dispenser units  22 . The bus  82  may also be an area network (not shown) similar to that of local area network  84 . 
     Alternatively, pharmacy management system  81  may be directly connected to the display, keyboard and mouse of any of the workstations (reference numeral  5 , for example) by providing an electrical switching device  86 . Electrical switching device  86  connects the workstation computer (not shown) or the pharmacy management system computer (not shown) to the workstation display, keyboard and mouse. 
     Also optionally, local area network  84  can have an Internet connection  87  for allowing a pharmacist or patient to access information relating to the drug type/disease status, or patient self-care. The Internet connection can also be used to facilitate videoconferencing among professionals and schools, for example. 
     A blood pressure monitor  88  can also be connected to local area network  84  to permit data representative of a patient&#39;s blood pressure to be stored in the patient information database. 
     As stated above, one microprocessor  83  is provided for every dispenser  22 . Instructions from the filling workstation  6  are passed to the microprocessors  83  via the data bus  82 . Similarly, information can flow from the microprocessors  83  to the filling workstation  6  if, for example, the dispenser  22  malfunctions. 
     One filling workstation  6  can send and receive controlling messages (not shown) to a substantial number of microprocessors  83 . It is preferred to have only one filling workstation  6 ; however, depending upon specific pharmacy requirements, the local area network  84  can include more than one filling workstation  6 . 
     The fact that each dispenser  22  has its own microprocessor  83  enables a dispenser  22  to function with all shapes and sizes of pills, tablets and capsules without the use of different mechanical parts or adjustments. In other words, the microprocessor  83  allows the dispenser  22  to function with variations in medication size and shape. Various components (not shown) within the dispenser  22  are controlled through software programs, such as are disclosed, for example, in U.S. Pat. No. 5,671,262, for METHOD FOR COUNTING AND DISPENSING TABLETS, CAPSULES, AND PILLS, assigned to the common assignee, and hereby incorporated by reference. Internal parts of the dispenser  22  can be moved in any direction necessary to accommodate a pill of a particular size or shape. 
     The inventive configuration further prevents message traffic between filling workstation  6  and microprocessors  83  on the dedicated bus  83  from interfering with the flow of information among the workstations  5 ,  6 ,  25 ,  40 ,  41  and possibly  81  on the local area network  84 . 
     Referring now to FIG. 7, there is shown a more detailed view of the counseling workstation  40 , which comprises barcode reader  40   a,  signature pad  40   b,  and an optional printer  40   c  on which may be printed patient instructions, auxiliary labels and/or patient tutorials. 
     Referring now to FIG. 8, there is shown a more detailed view of the point-of-sale workstation  41 , which comprises barcode reader  41   a,  signature pad  41   b,  and an optional printer  41   c  on which may be printed receipts, patient instructions, auxiliary labels and/or patient tutorials. 
     Since other modifications and changes varied to fit particular operating requirements and environments will be apparent to those skilled in the art, the invention is not considered limited to the example chosen for purposes of disclosure, and covers all changes and modifications which do not constitute departures from the true spirit and scope of this invention. Thus, for example, even when the system is applied in the absence of automated dispensing, it still provides automated control of the entire process. 
     Having thus described the invention, what is desired to be protected by Letters Patent is presented in the subsequently appended claims.