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[0001] The present invention relates generally to healthcare systems and methods and, more particularly, to systems and methods for monitoring healthcare treatment.
[0002] According to the National Medical Expenditure Survey of 1987, 90 million Americans suffer from one or more chronic conditions. Treatment of these chronic conditions represents over 76% of health care expenditures and the total direct costs of treating these chronic conditions is estimated to rise to $798 billion by the year 2030.
[0003] Many patients with chronic conditions are treated at home. Unfortunately, many patients may be unable to reliably manage their treatment, such as medication regimens, at home without the supervision of a healthcare provider. To be effective, medications often must follow various scheduling and dietary guidelines. For example, some medications are to be taken with food, others are not. Some medications are to be taken only once a day, others multiple times per day. Remembering when to take a medication and how much of it can become difficult as the number of concurrent medications increases.
[0004] Various devices for assisting patients in following medication regimens are known. For example, U.S. Pat. No. 4,837,719 to McIntosh describes a medication clock for signaling the times that dosages of a medication should be taken. The McIntosh device also provides a record of when each medicine was taken for comparison with the medication schedule. In addition, the McIntosh device can monitor and record temperature, blood pressure and pulse rate of the user.
[0005] U.S. Pat. No. 5,020,037 to Raven discloses an alarm pill box which cancels the alarm when a compartment lid is opened. A visual display is used to indicate the number of times that the lid has been opened within one day.
[0006] U.S. Pat. No. 4,911,327 to Shepherd et al., describes a dispenser for providing scheduled dosages of pills according to a predetermined medication program. A housing contains a plurality of pill containers from which dosages of pills may be released into a user-accessible pill receiver. The release of pills is controlled such that pills are released at predetermined intervals as dictated by the medication program. On release of a dosage of pills, an alarm is activated to indicate to a user that a dosage is due to be taken, the alarm being deactivated when the user accesses the pill receiver to remove the dosage of pills. If the user does not access the pill receiver within a predetermined time interval from release of the dosage, an optional remote alarm may be activated to alert a supervisor.
[0007] U.S. Pat. No. 4,616,316 to Hanpeter et al. describes a medication compliance monitoring system consisting of a blister pack having an array of plastic blisters defining compartments for medication. The blister pack has a frangible non-conductive backing sheet including conductive traces behind the compartments which are respectively ruptured when the medication doses are removed. An electronic memory circuit detects when individual compartments are ruptured and stores this information.
[0008] U.S. Pat. No. 5,408,443 to Weinberger describes a medication-dispensing system that includes a prescribing data entry station for use by a physician to store prescription information in a portable prescribing module, a dispensing data entry station for use by a pharmacy to store dispensing information in a portable dispensing data storage unit, and a medication dispenser responsive to information stored in the portable prescribing module to describe use of medication in the dispenser in accordance with a regimen prescribed by the physician and to the dispensing data storage unit to control dispensing of the medication. One embodiment has two medication drawers, each having a plurality of compartments with indicating lights selectively indicating the compartment from which medication is to be taken, a screen for displaying instructions regarding loading of the medication compartments and taking of the medication, and a keyboard including a confirming entry key for actuation by the user to confirm compliance with the instructions. Another embodiment has a series of medication-containing compartments, each covered by a separate sliding or folding cover.
[0009] U.S. Pat. No. 5,239,491 to Mucciacciaro describes a holder having a plurality of recesses for holding a plurality of medication containers, each fitting into a unique recess. The geometry of the bottom of each medication container is unique and only matches one recess in the holder. A sensor in each recess signals the presence or absence of the dedicated container to a microprocessor. The microprocessor is programmed with the prescribed dose administration schedule for each of the different medications in the different containers. A real time clock cooperates with the microprocessor and the program to signal audibly and visibly by a light at the appropriate container when a particular pill is to be administered. The signals stop when the appropriate container is removed from its recess. A different, warning sound indicates when the wrong container is lifted.
[0010] E-pill (www.epill.com) offers a pager system that sends reminders to patients to take their medication at specific times of the day. Carebridge (www.carebridge.net) provides an electronic timing device that patients can use to help them to remember to take their medication.
[0011] IBV Technologies (1500 Westlake Avenue North, Seattle, Wash. 98109) provides a medication vial that records the time a patient takes his/her medication when a button is pressed by the patient. When returned to a pharmacy for a refill, the pharmacy can download and review a compliance report from the vial and counsel the patient regarding medication compliance.
[0012] APREX (30112 Eigenbrodt Way, Union City, Calif.) provides a telemedicine service for monitoring medication compliance. Patients take their medication from medication containers outfitted with caps that have a mini-computer therein. When patients remove the cap from a bottle to take a dose of the medication contained therein, the mini-computer records the time and date of the dosing event. At the end of the day, patients place their medication bottles on a specially configured modem that transmits daily dosing information to a selected healthcare provider. If the healthcare provider detects a problem in how or when patients are taking their medication, those patients are called the next day by specially trained healthcare providers.
[0013] The MediMonitor®, available from InforMedix, Inc. (5920 Hubbard Dr., Rockville Md. 20852), is configured to retain a month's supply of up to five medications in individual compartments and alerts patients when and how to take the medications. The MediMonitor® also monitors medication use and health status by providing a date and time-stamped record of a patient's medication-taking behavior, together with patient responses to specific questions. The MediMonitor® can transmit information via an Internet-accessible server and database to clinical drug trial sites, physicians, pharmacies and other healthcare providers. Healthcare providers can communicate information, as well as reminders and specific instructions, directly to patients via the MediMonitor®.
[0014] Szeto et al. describe a holder having receptacles for five standard sized medication containers, a four-line 20-character alphanumeric LCD, and connectors for power supply and data communications. A microswitch embedded in a wall of each receptacle detects whether the receptacle is occupied or empty.
[0015] Unfortunately, existing devices for assisting patients in following medication regimens can be somewhat expensive and complex in design. Furthermore, existing devices for assisting patients in following medication regimens can seem somewhat intrusive to a user.
[0016] The present invention is directed to systems and methods for facilitating effective self-management of medication treatment by patients. A “Smart Tray” is provided that is capable of monitoring and reporting to third parties a patient's compliance with various treatment regimens, including medication regimens. Medication containers are provided with electromagnetic tags or other identifiers that provide various information about one or more medicaments contained within a respective container. A Smart Tray is equipped with a reader that interrogates each respective electromagnetic tag to identify medicament(s) contained within each container. The reader may also retrieve other information as well, such as dosage regimens. Using this retrieved information, a Smart Tray can provide visual and/or audio signals to a patient to remind the patient when and how much of one or more medicaments to take. A Smart Tray also monitors, via a reader, when a medication container is removed and stores this information. This can provide an indication of whether or not medication was taken in accordance with one or more medication regimens.
[0017] A Smart Tray according to the present invention can be configured to communicate with one or more third parties, such as healthcare providers, pharmacies, and other suppliers of healthcare products and services via a computer network such as the internet (or an intranet), a wide area network (WAN), or a local area network (LAN). For example, a Smart Tray, upon sensing that a supply of a particular medicament is low, can place an order for more of the medicament directly with a pharmacy or via a healthcare provider.
[0018] In addition, a Smart Tray can communicate with various appliances and devices including, but not limited to, personal computers, Web TVs, weight scales, refrigerators, exercise devices, and scanners. A Smart Tray can modify medication regimens for particular medicaments in response to data received from various appliances. For example, if a Smart Tray receives data from an exercise device that a patient has increased his/her exercise regimen, a processor within the Smart Tray may adjust one or more of the patient's medication regimens. In addition, data can be retrieved from various health monitoring devices, such as blood pressure monitors and the like. Retrieved data may also be utilized by a Smart Tray to modify various medication regimens.
[0019] According to another embodiment of the present invention, a Smart Tray can be configured to determine whether two or more medicaments are contraindicated. The electromagnetic tags associated with two or more medication containers can be interrogated to identify medicaments contained within the respective containers. The Smart Tray can then determine, based on information retrieved from each respective electromagnetic tag, whether or not medicaments contained within the respective containers are contraindicated. If two or more medicaments are determined to be contraindicated, a patient can be alerted by the Smart Tray. Similarly, a third party healthcare provider may be alerted by the Smart Tray.
[0020] The present invention may facilitate compliance with medication regimens, especially complex regimens involving multiple medications. As such, the present invention may reduce medication errors made by patients, such as taking the wrong drug, taking the wrong dose, taking a dose at the wrong time, or various combinations thereof. Furthermore, the present invention may reduce the need for patients to remember when and how much of a particular medication to take.
[0021] In addition, the present invention may facilitate prescription refills such that a patient receives a new prescription without a lapse in medication occurring.
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[0028] FIGS.
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[0033] The present invention now is described more fully hereinafter with reference to the accompanying drawings, in which preferred embodiments of the invention are shown. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. Like numbers refer to like elements throughout the description of the drawings.
[0034] As will be appreciated by one of skill in the art, the present invention may be embodied as methods and systems. The present invention may take the form of an entirely hardware embodiment, or an embodiment combining software and hardware aspects. Throughout the description of the present invention, the terms medicament, medicine, drug, and medication may be used interchangeably.
[0035] Referring now to
[0036] The Smart Tray
[0037] According to another embodiment of the present invention illustrated in
[0038] Referring now to
[0039] The illustrated Smart Tray
[0040] The illustrated Smart Tray
[0041] As illustrated schematically in
[0042] Preferably, the RF coil array
[0043] The processor
[0044] The modem
[0045] In the embodiment of
[0046] In addition, each RF coil in the array
[0047] RF coils and their use in detecting the proximity of electromagnetic tags and for interrogating electromagnetic tags for information are understood by those of skill in the art and need not be discussed further herein. A particularly preferred Smart Tray having an array of RF coils for detecting the proximity of objects tagged with electromagnetic tags and for interrogating electromagnetic tags for information is disclosed in a co-assigned and co-pending U.S. Provisional Application, entitled Platform for Item Sensing and Identification (Attorney Docket Number 109026-77) which was filed Dec. 29, 1999, and which is incorporated herein by reference, in its entirety.
[0048] RFID tags typically contain circuitry that stores and transmits information about the item attached to the tag in cooperation with a compatible RFID reader/writer. Conventional RFID circuitry does not require a battery or an external energy source. However, a battery may be included. RF energy is typically transmitted by an RF reader specifically adapted to interact with the RF circuitry of an RFID tag. RFID tags are described in U.S. Pat. No. 5,528,222 which is incorporated herein by reference in its entirety.
[0049] Referring now to
[0050] Referring back to
[0051] In addition, the Smart Tray
[0052] The number of flashes and/or audio signals can be used to indicate the number of pills (dosage amount) to be taken. For example, three flashes (or audio signals) can indicate three pills, two flashes (or audio signals) can indicate two pills, and so forth. In addition, voice commands may also be utilized to specify medicament quantity.
[0053] Each time a tagged medication container
[0054] The Smart Tray
[0055] When a medication container
[0056] According to another embodiment of the present invention illustrated in
[0057] Referring back to
[0058] The sensing surface
[0059] A Smart Tray according to the present invention passively and unobtrusively facilitates monitoring patient compliance with medication treatment regimens. For example, the Smart Tray can remind patients which medication to take using visual and/or audio cues. In addition, the Smart Tray can record medication administration as an aid to disease management. Furthermore, the Smart Tray can facilitate disease management by providing education and motivation to patients.
[0060] A Smart Tray according to the present invention also can facilitate control over medicament inventory by automatically placing orders prior to supply depletion. A Smart Tray can be incorporated into a medicine cabinet or shelf, and can be integrated with kitchen shelf for both diet and medication management. A Smart Tray may be utilized with various medicine-dispensing regimens. For example, the Smart Tray can be utilized with dispensers of liquid medicines. A Smart Tray may also be incorporated within a refrigeration device. A portable version of a Smart Tray may be configured for travel.
[0061] According to another embodiment of the present invention, a Smart Tray can be configured to alert patients if one or more medicaments are contraindicated. As is known to those of skill in the art, the term “contraindicated” means that when administered together, two or more medicaments may cause an adverse reaction in a patient or can inhibit the effectiveness of each other. Contraindications may be signaled via a visual indicator or via an audio indicator, or some combination of audio and visual indicators.
[0062] A Smart Tray according to the present invention need not have receptacles for receiving medication containers and other objects. For example, as illustrated in
[0063] Referring now to FIGS.
[0064] The electromagnetic tag is interrogated by a reader, such as an RF coil, to retrieve information, such as an identification of the medicament(s) and/or a dosage regimen(s), from the electromagnetic tag (Block
[0065] A patient may be alerted by the Smart Tray to take a dose of the medicament(s) via visual and/or audio indicators. For example, a light may flash to indicate that a particular medicament is to be taken (and how much is to be taken). Similarly, an audio signal may sound to indicate that a particular medicament is to be taken (and how much is to be taken). Synthesized voice instructions also may be generated. In addition, a patient may be alerted via a display that displays messages.
[0066] Each time a container is returned to a receptacle, an amount of medicament(s) remaining in the container may be determined (Block
[0067] According to another embodiment of the present invention, communications may be established between a Smart Tray and one or more external computing devices via a communications network (Block
[0068] In addition, a patient may establish communications with an external computing device via the Smart Tray, such as a Web site, and retrieve information therefrom (Block
[0069] According to another embodiment of the present invention illustrated in
[0070] A patient may be alerted by the Smart Tray of modified medication regimens (Block
[0071] According to another embodiment of the present invention, a Smart Tray can be configured to modify a dosage regimen based upon data retrieved from a health monitoring device. Referring to
[0072] A health monitoring device is placed within a receptacle (e.g., the sensing surface
[0073] A medication (or other) regimen associated with one or more medicaments can be modified in response to data received from a health monitoring device (Block
[0074] According to another embodiment of the present invention, a Smart Tray can be configured to determine whether two or more medicaments are contraindicated. Referring to
[0075] According to additional embodiments of the present invention, persons and medications can be “tagged.” In the illustrated embodiment of
[0076] As illustrated in
[0077] Referring to
[0078] By tagging individual units of medication, a Smart Tray according to the present invention can accurately track whether a particular dose of a medication has been taken by a patient at a prescribed time. In addition, tagging individual medication units can facilitate control over medication inventories.
[0079] The foregoing is illustrative of the present invention and is not to be construed as limiting thereof. Although a few exemplary embodiments of this invention have been described, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the novel teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the claims. Therefore, it is to be understood that the foregoing is illustrative of the present invention and is not to be construed as limited to the specific embodiments disclosed, and that modifications to the disclosed embodiments, as well as other embodiments, are intended to be included within the scope of the appended claims. The invention is defined by the following claims, with equivalents of the claims to be included therein.