System for monitoring dosage patterns and patient response

Abstract

A method for tracking a dose pattern and patient response can include determining a dose pattern for delivering a medication to a patient based at least on one or more dose events at a pump configured to deliver the medication to the patient. One or more vital signs related to the patient can be received from a patient monitor. A presence of one or more abnormalities can be determined based at least on the dose pattern of the pump and the one or more vital signs of the patient. An electronic alert can be transmitted to a mobile device in response to determining the presence of the one or more abnormalities. Related methods and articles of manufacture, including devices and computer program products, are also disclosed.

Description

[0001] Cross-reference to related applications

[0002] This application claims priority to U.S. Provisional Application No. 62 / 790,876, filed January 10, 2019, entitled “System for Monitoring Dosage Pattern and Patient Responsiveness,” the entire contents of which are incorporated herein by reference. Technical Field

[0003] The topics described in this article generally relate to the distribution of medicines, and more specifically to tracking systems used for drug delivery. Background Technology

[0004] Patient-controlled analgesia (PCA) pumps provide patients with direct control over the delivery of certain medications, including, for example, opioid analgesics, which would otherwise be administered in single doses by a healthcare professional via intramuscular or intravenous injection. A PCA pump is a computerized pump that contains a reservoir for multiple doses of medication and is directly connected to the patient's vein. PCA pumps can be configured to deliver a constant flow of medication to the patient. Alternatively and / or additionally, PCA pumps can allow patients to self-administer individual doses of medication as needed. Summary of the Invention

[0005] Systems, methods, and articles of manufacture are provided for tracking dosing patterns and patient responses of patient-controlled analgesia (PCA) pumps, including computer program products. For example, the PCA pump may be communicatively connected to a tracking engine configured to track the number and / or frequency of attempts to trigger delivery of a dose of medication, delivery of a dose of medication to the patient, and / or refusal to deliver a dose of medication to the patient. The tracking engine may be further configured to track the patient's vital signs, including, for example, respiratory rate, blood oxygen saturation, heart rate, pain level, movement, etc. The tracking engine may determine the correlation between the dosing pattern observed at the PCA pump and the patient's response. Furthermore, the tracking engine may generate an electronic alarm when one or more abnormalities are detected in the dosing pattern and / or patient vital signs observed at the PCA pump.

[0006] According to some aspects, a method may include determining a dosing pattern for delivering a drug to a patient based at least on one or more dosing events at a pump configured to deliver a drug to a patient. The method may also include receiving one or more vital signs associated with the patient from a patient monitor. The method may further include determining the presence of one or more abnormalities based at least on the pump's dosing pattern and the patient's one or more vital signs. The method may also include sending an electronic alarm to a mobile device in response to determining the presence of one or more abnormalities.

[0007] In some aspects, the one or more dosing events may include a patient attempting to trigger the delivery of a dose of the drug, the delivery of a dose of the drug, and / or refusing the delivery of a dose of the drug.

[0008] In some respects, the one or more vital signs include respiratory rate, blood oxygen saturation, heart rate, pain level, and / or movement.

[0009] In some aspects, the method further includes adjusting the pump's dosing mode based at least on the pump's dosing mode and / or one or more vital signs of the patient. In some aspects, the dosing mode is adjusted by at least modifying the quantity and / or frequency of delivering and / or refusing to deliver one or more doses of medication to the patient. In some aspects, the dosing mode is adjusted by at least modifying the duration of the pump's active, inactive, and / or locked-out periods. In some aspects, the dosing mode is adjusted by at least modifying the pump's maintenance dose.

[0010] In some respects, one or more abnormalities include delivering a dose of medication to the patient that is greater than a maximum threshold or less than a minimum threshold. In some respects, one or more abnormalities include one or more of the patient's vital signs that are greater than a maximum threshold or less than a minimum threshold.

[0011] In some aspects, the patient monitor includes one or more sensors configured to measure one or more vital signs of the patient. The one or more sensors may include at least one motion sensor. The presence of one or more abnormalities can be determined based on motion data measured by the at least one motion sensor.

[0012] Implementations of the present subject matter may include methods consistent with the descriptions provided herein, as well as articles of art comprising a machine-readable medium tangibly embodied therein, operable to cause one or more machines (e.g., computers, etc.) to perform operations embodying one or more of the described features. Similarly, computer systems are also described, which may include one or more processors and one or more memories connected to the processors. The memories (which may include non-volatile computer-readable or machine-readable storage media) may include encoding, storing, etc., one or more programs that cause one or more processors to perform one or more of the operations described herein. Computer-implemented methods consistent with one or more embodiments of the present subject matter may be implemented by one or more data processors residing in a single computing system or multiple computing systems. Such multiple computing systems may be connected, exchange data and / or commands or other instructions, etc., via one or more connections (including, for example, connections via networks (e.g., the Internet, wireless wide area networks, local area networks, wide area networks, wired networks, etc.), or via direct connections between one or more computing systems.

[0013] Details of one or more variations of the subject matter described herein are set forth in the accompanying drawings and the description below. Other features and advantages of the subject matter described herein will be apparent from the specification, drawings, and claims. Although certain features of the subject matter disclosed herein relating to dosing patterns and patient response tracking have been described for illustrative purposes, it should be readily understood that such features are not intended to be limiting. The claims following this disclosure are intended to define the scope of the protected subject matter. Attached Figure Description

[0014] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate certain aspects of the subject matter disclosed herein and, together with the specification, help to explain some principles associated with the disclosed embodiments. In the drawings,

[0015] Figure 1 A system diagram illustrating a tracking system according to some example embodiments is depicted;

[0016] Figure 2A A timing diagram illustrating the tracking of drug delivery to a patient and patient response according to some example embodiments is depicted;

[0017] Figure 2B Examples of alarm thresholds associated with a tracking system according to some example embodiments are described;

[0018] Figure 3AA graph depicting the relationship between the frequency of doses administered to a patient and the patient's respiratory rate (BPM) according to some example embodiments is presented;

[0019] Figure 3B A graph depicting the relationship between the frequency of doses administered to a patient and the patient's respiratory rate (BPM) according to some example embodiments is presented;

[0020] Figure 3C A graph illustrating the relationship between the frequency of doses refused to be administered to patients according to some example embodiments and the degree of patient pain is depicted;

[0021] Figure 3D A graph illustrating the relationship between the frequency of doses refused to be administered to patients according to some example embodiments and the degree of patient pain is depicted;

[0022] Figure 3E A graph illustrating an example of a dosage pattern according to some example embodiments is depicted;

[0023] Figure 4 A flowchart illustrating a method for tracking a drug delivered to a patient and the patient's response, according to some example embodiments, is depicted;

[0024] Figure 5 A block diagram illustrating a computing system according to some example embodiments is depicted;

[0025] Figure 6A A front view of a patient care system according to some example embodiments is depicted;

[0026] Figure 6B An enlarged view of a portion of a patient care system according to some example embodiments is depicted; and

[0027] Figure 6C A perspective view of a pump according to some example embodiments is depicted.

[0028] Where feasible, similar reference numerals may indicate similar structures, features, or elements. Detailed Implementation

[0029] Patient-controlled analgesia (PCA) pumps allow patients to directly control the delivery of medications without relying on healthcare professionals to administer opioid analgesics via intramuscular or intravenous injection. For example, in response to a patient pressing a button on a handheld device connected to the PCA pump, the PCA pump can deliver one or more doses of medication. To ensure timely, effective, and safe patient care, medication delivery using a PCA pump may still require frequent supervision by healthcare professionals. This is especially true when the PCA pump is used to deliver controlled substances such as opioid analgesics, which are prone to misuse and transfer and can have adverse effects such as excessive sedation and low respiratory rate, loss of motor function, and / or apnea. Thus, in some example embodiments, a tracking engine can be configured to track the delivery and / or refusal of the dose of medication to / from the patient, as well as the corresponding responses from the patient (e.g., vital signs). For example, the tracking engine can track the number of drug doses that a patient tries, delivers, and / or refuses to deliver, the rate at which a patient tries, delivers, and / or refuses to deliver, and the patient's vital signs, including, for example, respiratory rate, blood oxygen saturation, heart rate, pain level, and movement (e.g., leg movement).

[0030] Figure 1 A system diagram illustrating a tracking system 100 according to some example embodiments is depicted. (Refer to...) Figure 1 The tracking system 100 may include a tracking engine 110, a pump 120, a patient monitor 130, and a client 150. For example... Figure 1 As shown, the tracking engine 110, pump 120, patient monitor 130, and / or client 150 can be communicatively connected via network 160. Client 150 can be a mobile device, such as a smartphone, tablet, wearable device, etc. However, it should be understood that client 150 can be any processor-based device, including, for example, a desktop computer, laptop, workstation, etc. Meanwhile, network 160 can be any wired and / or wireless network, including, for example, a Public Land Mobile Network (PLMN), Local Area Network (LAN), Virtual Local Area Network (VLAN), Wide Area Network (WAN), Internet, etc. Additionally and / or alternatively, in some embodiments, the tracking engine 110 and / or client 150 can be integrated into pump 120.

[0031] Pump 120 may be a patient-controlled analgesia (PCA) pump configured to deliver medication to patient 140. However, it should be understood that pump 120 may be any infusion system configured to deliver substances (e.g., fluids, nutrients, medications, etc.) to a patient's circulatory system or epidural space via, for example, intravenous infusion, subcutaneous infusion, arterial infusion, epidural infusion, etc. Alternatively, the infusion system may be configured to deliver substances (e.g., fluids, nutrients, medications, etc.) to a patient's digestive system via a nasogastric tube (NG), percutaneous endoscopic gastrostomy tube (PEG), nasojejunal tube (NJ), etc. Pump 120 may be configured to receive one or more syringes containing medication, such as opioid analgesics (e.g., morphine, hydromorphone, fentanyl, etc.). Furthermore, pump 120 may deliver one or more doses of medication to patient 140, including, for example, a patient-demanded dose, a clinician's dose, a loading dose, and / or a maintenance dose. For example, patient 140 can trigger the delivery of a patient-required dose by at least pressing a button on a handheld device connected to pump 120. Additionally and / or alternatively, the patient-controlled analgesia pump can deliver one or more doses of medication to the patient at set time intervals. In some embodiments, pump 120 can be used in home settings, clinical settings, rehabilitation settings, etc.

[0032] Pump 120 may include a dose controller 125 configured to detect one or more dose events at pump 120, including, for example, a patient 140 attempting to trigger delivery of a dose of medication, delivery of a dose of medication to patient 140, or rejection of delivery of a dose of medication by patient 140. The dose controller 125 may report one or more dose events detected at pump 120 to tracking engine 110. In some example embodiments, tracking engine 110 may determine a dose pattern of pump 120 based at least on one or more dose events reported by dose controller 125. For example, tracking engine 110 may determine the number and / or frequency of attempts to trigger delivery of a dose of medication, delivery of a dose of medication to patient 140 (e.g., in response to an attempt to trigger delivery of a dose of medication or delivery of a dose of medication at set time intervals), and / or rejection of delivery of a dose of medication to patient 140. As used herein, an attempt to trigger delivery of a dose of medication may refer to patient 140 requesting pump 120 to deliver a dose of medication, for example, by pressing a button on a handheld device connected to pump 120. Simultaneously, refusal to deliver a dose of medication can mean that despite the patient 140's request for delivery of a dose, pump 120 prevents the delivery of a dose of medication to the patient 140. During the lockout period of pump 120, delivery of a dose of medication to the patient 140 may be refused. For example, delivering one or more doses of medication to the patient 140 may trigger a subsequent lockout period of pump 120 to prevent overdose delivery to the patient 140 by the frequency of medication dosage.

[0033] Refer again Figure 1 The patient monitor 130 may include one or more sensors, including, for example, a first sensor 135a, a second sensor 135b, etc. The first sensor 135a and / or the second sensor 135b may be wired and / or wireless sensors configured to measure one or more vital signs associated with the patient 140, including, for example, respiratory rate, blood oxygen saturation, carbon dioxide concentration, heart rate, pain level, motor movement (e.g., leg movement), rate of change of each vital sign, etc. For example, at least one of the first sensor 135a and the second sensor 135b may be a motion sensor configured to detect the presence and / or absence of motor movement (e.g., detecting the presence and / or absence of motor movement in the lower limbs of the patient 140 when medication is administered through the epidural space of the patient 140). Thus, at least one of the first sensor 135a and the second sensor 135b may be located on or near the lower limbs of the patient 140, such as on the leg of the patient 140. Meanwhile, the patient monitor 130 can be configured to report one or more vital signs related to the patient 140 to the tracking engine 110.

[0034] According to some example embodiments, the tracking engine 110 may be configured to track one or more vital signs associated with patient 140 and corresponding dosing patterns observed at pump 120. The tracking engine 110 may associate one or more vital signs associated with patient 140 with dosing patterns observed at pump 120. For example, when patient 140 experiences a certain dosing pattern, the tracking engine 110 may determine the rate of change of patient 140's respiratory rate, blood oxygen saturation, carbon dioxide concentration, heart rate, movement, pain level, and / or vital signs. As described above, the dosing pattern observed at pump 120 may include the number and / or frequency of attempts to trigger delivery of a dose of medication, delivery of a dose of medication to patient 140, and / or rejection of delivery of a dose of medication to patient 140.

[0035] In some example embodiments, the tracking engine 110 may be configured to adjust the dosing pattern of pump 120 based on the dosing pattern observed at pump 120 and / or the vital signs of patient 140 reported by patient monitor 130. The dosing pattern of pump 120 may be adjusted by at least modifying the amount and / or frequency of drug doses delivered to patient 140.

[0036] In some example embodiments, the tracking engine 110 can adjust the dosing pattern of pump 120 by at least changing the duration of active, inactive, and / or locked periods at pump 120. Active periods may occur when medication is delivered to patient 140. Inactive periods may occur when no medication is delivered to patient 140, and when medication delivery to patient 140 is not blocked (e.g., during locked periods). Increasing the duration of active periods and / or decreasing the duration of inactive and / or locked periods of pump 120 may result in an increase in the amount of medication delivered to patient 140. Alternatively and / or additionally, the tracking engine 110 can adjust the dosing pattern of pump 120 by at least modifying the maintenance dose of pump 120. For example, the tracking engine 110 can adjust the dosing pattern of pump 120 by adjusting a maximum dose limit associated with a given time period (e.g., one hour or different time periods) to increase or decrease the amount of medication delivered to the patient during said time period. The tracking engine 110 can also adjust the dosing pattern of pump 120 by interrupting medication delivery to the patient.

[0037] As used herein, maintenance dose may refer to the minimum amount of medication continuously administered to patient 140. Therefore, modifying the maintenance dose of pump 120 may trigger corresponding changes in the number and / or frequency of medication doses delivered to and / or refused to be delivered to patient 140.

[0038] In some example embodiments, the tracking engine 110 may also be configured to generate one or more electronic alerts based on the dosing pattern observed at the pump 120 and / or the vital signs of the patient 140 reported by the patient monitor 130. One or more electronic alerts may include wireless alert messages, such as push notifications, short message service (SMS) messages, etc. Furthermore, one or more electronic alerts may include indications of the type of abnormality appearing in the dosing pattern observed at the pump 120 and / or the vital signs of the patient 140 reported by the patient monitor 130. Abnormalities may include, for example, excessively high end-expiratory CO2 (ETCO2), no breathing, low respiratory rate, exceeding the limit for the number of patient-requested doses, exceeding the limit for the rate of change of vital signs, exceeding the limit for vital sign values, high heart rate, and the number of patient-requested doses that provide no or limited improvement in pain levels, etc. Alternatively and / or additionally, one or more electronic alerts may include a patient identifier, a drug identifier, and / or the amount of medication delivered to the patient. For example, one or more electronic alarms may specify the amount of medication delivered to the patient, the number of doses, the rate of delivery, and / or the type of dose (e.g., patient-required dose, clinician dose, loading dose, maintenance dose, etc.).

[0039] For example, the tracking engine 110 can detect the presence of one or more abnormalities in the dosing pattern observed at pump 120 and / or in the vital signs of patient 140 reported by patient monitor 130. One or more abnormalities may include an amount of medication delivered to patient 140 that is greater than or equal to a maximum threshold and / or less than or equal to a minimum threshold. Alternatively and / or additionally, one or more abnormalities may include one or more vital signs of patient 140 that are greater than or equal to the maximum threshold and / or less than or equal to the minimum threshold. Alternatively and / or additionally, one or more abnormalities may include a rate of change of one or more vital signs of patient 140 that is greater than or equal to the maximum threshold and / or less than or equal to the minimum threshold. Alternatively and / or additionally, one or more abnormalities may include an amount of medication delivered to patient 140 that results in no improvement or limited improvement in pain levels that is greater than or equal to the maximum threshold and / or less than or equal to the minimum threshold. Thresholds can be patient-specific (e.g., predetermined values ​​based on multiple factors such as the patient's medical history, tolerance to certain types of drugs, prior drug exposure, etc.) and / or dynamically calculated based on dosing patterns, patient vital signs, etc. For example, if the patient's medical history includes greater tolerance to certain types of drugs and / or prior drug exposure, the maximum and / or minimum thresholds can be larger.

[0040] To further illustrate, Figure 2A A timing diagram 200 is depicted illustrating the tracking of drug delivery to a patient and patient response according to some example embodiments. (Refer to...) Figure 1 and Figure 2A The tracking engine 110 can determine that the patient 140 experienced adverse symptoms (e.g., pain) at 12:00 PM based at least on the dosing pattern observed at pump 120. Alternatively and / or additionally, the tracking engine 110 can also determine that the patient 140 experienced adverse symptoms (e.g., pain, respiratory depression, apnea, reduced motor movement, etc.) at 12:00 PM based at least on one or more abnormalities in the dosing pattern observed at pump 120 and / or in the patient 140's vital signs. As mentioned above, one or more abnormalities may include the amount of drug delivered to the patient 140 being greater than a maximum threshold and / or less than a minimum threshold. Figure 2A In the example shown, the tracking engine 110 can determine that the patient 140 may be in pain based on the amount of medication administered to the patient by the pump 120. Alternatively and / or additionally, one or more abnormalities may include the patient 140's vital signs being greater than a maximum threshold and / or less than a minimum threshold. Figure 2B Examples of alarm thresholds associated with a tracking system 100 according to some example embodiments are described.

[0041] For example, tracking engine 110 can determine that patient 140 experienced adverse symptoms at 12:00 PM, at least based on patient 140 attempting to trigger the delivery of one or more doses of medication from pump 120. In response to determining that patient 140 experienced adverse symptoms, tracking engine 110 can be configured to adjust the dosing pattern observed at pump 120, for example, by modifying the quantity and / or frequency of medication doses delivered to patient 140. Alternatively and / or additionally, tracking engine 110 can respond to patient 140 experiencing adverse symptoms by at least generating an electronic alert (e.g., push notification, Short Message Service (SMS) message, etc.). The electronic alert can be sent to a client 150 associated with a healthcare professional, allowing the healthcare professional to assess patient 140 and / or, for example, adjust the dosing pattern observed at pump 120 by modifying the quantity and / or frequency of medication doses delivered to patient 140. Electronic alarms can be particularly useful in certain situations, such as when a patient's pain level does not improve or improves only slightly, even after adjusting the dosing pattern and / or when the patient continues to try to trigger the delivery of one or more doses of medication from pump 120.

[0042] In some example embodiments, the tracking engine 110 may be configured to determine the correlation between the dosing pattern observed at pump 120 and the vital signs of patient 140. To further illustrate, Figures 3A-3DA graph illustrating the relationship between dosing patterns and patient response was plotted. For example, Figures 3A-3B The graph shown illustrates the relationship between the frequency of drug administration to patient 140 and patient 140's respiratory rate. The quantity and / or frequency of drug doses delivered to patient 140 may affect patient 140's respiratory rate. For example, Figure 3A The four doses are shown over seven time units. Figure 3A The detected heart rate per minute (BPM) gradually decreases towards the respiratory rate threshold (low RR). Figure 3B In, with Figure 3A Compared to the BPM shown, administering three doses over eleven unit time periods maintained a higher BPM.

[0043] at the same time, Figures 3C-3D The graph shown illustrates the relationship between the frequency of dose refusal for patient 140 and the degree of pain experienced by patient 140. The number and / or frequency of drug doses refused for patient 140 may affect the degree of pain experienced by patient 140 and / or safety (e.g., excessive sedation, low respiratory rate, and / or apnea). For example, as... Figures 3C-3D As shown, when pump 120 refuses to deliver medication to patient 140, patient 140 may experience increased pain levels. In contrast, patient 140 may experience decreased pain levels after pump 120 delivers medication.

[0044] Figures 3C-3D The degree of pain experienced by patient 140 when subjected to different dosage modalities is further illustrated. (See reference...) Figures 3C-3D , and utilization Figure 3D Compared to the dosage pattern shown, using Figure 3C The dosage pattern shown may lead to more frequent medication refusal by patient 140. For example, within the same time period, using... Figure 3D The dosage pattern shown can provide three doses of medication to patient 140, while utilizing... Figure 3C The dosage pattern shown only provides two doses of the drug. Therefore, utilizing... Figure 3C The dosage pattern shown suggests that patient 140 may have been given an insufficient dose of medication because patient 140's pain level spiked to near the level indicating insufficient medication (e.g., 9) (e.g., 8). In contrast, using... Figure 3D With the dosage pattern shown, patient 140's pain level remained relatively low (e.g., between 1 and 3) and did not approach the pain level associated with insufficient medication (e.g., 9).

[0045] As described above, during the lockout period of pump 120, patient 140 may be denied delivery of a certain dose of medication. To prevent overdose of medication (by the frequency of dose delivery) to patient 140, pump 120 may experience a lockout period after delivering one or more doses of medication to patient 140. To further illustrate, Figure 3E A graph illustrating an example of a dosage mode 300 according to some example embodiments is depicted. For example... Figure 3E As shown, pump 120 can be associated with an active state, during which pump 120 responds to at least some attempts from patient 140 to trigger the delivery of a dose of medication by delivering a dose of medication to patient 140. In contrast, when pump 120 is in an inactive state, pump 120 can reject all attempts from patient 140 to trigger the delivery of a dose of medication. Furthermore, Figure 3E The pump 120 is shown to have a lockout period following each successful patient-requested dose. For example, after delivering a dose of medication to patient 140 in response to a request from patient 140, the pump 120 may have a lockout period during which any attempt by patient 140 to trigger delivery of another dose of medication will be rejected.

[0046] Figure 4 A flowchart illustrating a method 400 for tracking dose patterns and patient responses according to some example embodiments is depicted. (See also...) Figure 4 Method 400 can be executed by the tracking system 100.

[0047] At 402, the tracking system 100 may determine the dosing pattern of pump 120 for delivering medication to the patient based at least on one or more dosing events at pump 120. In some example embodiments, the dose controller 125 of pump 120 may detect and report one or more dosing events at pump 120 to the tracking engine 110, including, for example, the patient 140 attempting to trigger the delivery of a dose of medication, delivering a dose of medication to the patient 140, refusing to deliver a dose of medication to the patient 140, etc. The tracking engine 110 may determine the dosing pattern of pump 120 based at least on one or more dosing events at pump 120, which may include, for example, the number and / or frequency of attempting to trigger the delivery of a dose of medication, delivering a dose of medication to the patient 140, and / or refusing to deliver a dose of medication to the patient 140.

[0048] At 404, the tracking system 100 can receive one or more vital signs related to the patient from the patient monitor 130. In some example embodiments, the first sensor 135a and / or the second sensor 135b may be configured to measure and report one or more vital signs related to the patient 140 to the tracking engine 110, including, for example, respiratory rate, blood oxygen saturation, heart rate, pain level, movement, etc.

[0049] At 406, the tracking engine 110 can adjust the dosing pattern of pump 120 based at least on the dosing pattern of pump 120 and one or more vital signs associated with the patient. In some example embodiments, the tracking engine 110 can be configured to adjust the dosing pattern of pump 120 based on the dosing pattern observed at pump 120 and / or the vital signs of patient 140 reported by patient monitor 130. For example, the tracking engine 110 can adjust the dosing pattern of pump 120 by at least modifying the amount and / or frequency of drug doses delivered to patient 140. The amount and / or frequency of drug doses delivered to and / or refused to be delivered to patient 140 can be modified by at least changing the duration of the active period, inactive period, and / or locked period implemented at pump 120.

[0050] At 408, the tracking system 100 may generate an electronic alert and send it to the client 150 in response to detecting an abnormality in the dosing pattern of the pump 120 and / or one or more abnormalities in one or more vital signs associated with the patient. In some example embodiments, the tracking engine 110 may be configured to track one or more vital signs associated with the patient 140 and the corresponding dosing pattern observed at the pump 120. For example, the tracking engine 110 may associate one or more vital signs associated with the patient 140 with the dosing pattern observed at the pump 120. Furthermore, when the tracking engine 110 detects an abnormality in the dosing pattern of the pump 120 and / or one or more abnormalities in one or more vital signs associated with the patient 140, the tracking engine 110 may generate an electronic alert (e.g., push notification, Short Message Service (SMS) message, etc.) and send it to the client 150 associated with a healthcare professional. One or more abnormalities may include the amount of medication delivered to the patient 140 (e.g., medication dosage) being greater than a maximum threshold and / or less than a minimum threshold. Alternatively and / or additionally, one or more abnormalities may include one or more vital signs of patient 140 that are greater than a maximum threshold and / or less than a minimum threshold. An electronic alarm may be sent to client 150, enabling a healthcare professional associated with client 150 to assess patient 140 and / or adjust the dosing pattern observed at pump 120, for example, by modifying the amount and / or frequency of medication doses delivered to patient 140.

[0051] Figure 5 A block diagram illustrating a computing system 500 consistent with an implementation scheme of the present subject is shown. (Refer to...) Figure 1 and Figure 5 The computing system 500 can be used to implement the tracking engine 110 and / or any of its components.

[0052] like Figure 5 As shown, the computing system 500 may include a processor 510, a memory 520, a storage device 530, and an input / output device 540. The processor 510, memory 520, storage device 530, and input / output device 540 are interconnected via a system bus 550. The processor 510 is capable of processing instructions for execution within the computing system 500. Such executed instructions may implement one or more components, such as the tracing engine 110. In some example embodiments, the processor 510 may be a single-threaded processor. Alternatively, the processor 510 may be a multi-threaded processor. The processor 510 is capable of processing instructions stored in the memory 520 and / or the storage device 530 to display graphical information from a user interface provided through the input / output device 540.

[0053] As used herein, a “user interface” (also referred to as an interactive user interface, graphical user interface, or UI) can refer to a web-based interface, including data fields and / or other control elements for receiving input signals or providing electronic information and / or providing information to a user in response to any received input signals. Control elements may include dial pads, buttons, icons, selectable areas, or other perceptible markings presented through the UI, which, when interacted with (e.g., clicked, touched, selected, etc.), initiate data exchange with the device presenting the UI. The UI may be implemented wholly or partially using technologies such as Hypertext Markup Language (HTML), Flash™, Java™, .NET™, web services, or Rich Site Summary (RSS). In some implementations, the UI may be included in a standalone client (e.g., a thick client, a fat client) configured to communicate (e.g., send or receive data) according to one or more of the described aspects. Communication may be to or from a medical device, diagnostic device, monitoring device, or server with which it communicates.

[0054] Memory 520 is a computer-readable medium, such as a volatile or non-volatile computer-readable medium that stores information within computing system 500. For example, memory 520 may store a data structure representing a configuration object database. Storage device 530 provides persistent storage for computing system 500. Storage device 530 may be a floppy disk device, hard disk device, optical disk device, magnetic tape device, or other suitable persistent storage device. Input / output device 540 provides input / output operations for computing system 500. In some example embodiments, input / output device 540 includes a keyboard and / or a pointing device. In various embodiments, input / output device 540 includes a display unit for displaying a graphical user interface.

[0055] According to some example embodiments, input / output device 540 can provide input / output operations for a network device. For example, input / output device 540 may include an Ethernet port or other network port to communicate with one or more wired and / or wireless networks (e.g., local area network (LAN), wide area network (WAN), Internet).

[0056] In some example embodiments, computing system 500 can be used to execute various interactive computer software applications, which can be used to organize, analyze, and / or store data in various formats. Alternatively, computing system 500 can be used to execute any type of software application. These applications can be used to perform various functions, such as planning functions (e.g., generating, managing, and editing spreadsheet documents, word processing documents, and / or any other objects), computing functions, communication functions, etc. Applications may include various additional functions, or may be standalone computing products and / or functions. Once enabled within the application, these functions can be used to generate a user interface provided through input / output device 540. The user interface can be generated and presented to the user by computing system 500 (e.g., on a computer screen monitor, etc.).

[0057] In some example embodiments, pump 120 may be Figure 6A This is part of the patient care system 20 shown. (See reference...) Figure 6A The patient care system 20 may include pump 120 and additional pumps 24, 26, and 28. For example... Figure 6A As shown, each of pumps 120, 24, 26, and 28 can be fluidly connected to upstream fluid lines 30, 32, 34, and 36, respectively. Furthermore, each of the four pumps 120, 24, 26, and 28 can also be fluidly connected to downstream fluid lines 31, 33, 35, and 37, respectively. The fluid lines can be any type of fluid conduit, such as pipes through which fluid can flow. At least a portion of one or more fluid lines can be constructed using a multi-layer configuration as described herein.

[0058] Fluid supply devices 38, 40, 42, and 44 (which may take various forms, but are shown as bottles in this case) are inverted and suspended above the pump. The fluid supply devices may also take the form of bags, syringes, or other types of containers. Both the patient care system 20 and the fluid supply devices 38, 40, 42, and 44 are mounted on a roller support or intravenous (IV) bar 46.

[0059] Individual pumps 120, 24, 26, and 28 can be used to infuse each fluid from the fluid supply device into the patient. Pumps 120, 24, 26, and 28 can be flow control devices that act on the corresponding fluid lines to move fluid from the fluid supply device through the fluid lines to the patient 48. Because individual pumps are used, each pump can be individually set to the pumping or operating parameters required to infuse a specific medical fluid from the corresponding fluid supply device into the patient at a specific rate prescribed by a physician for that fluid. Such medical fluids may include medications, nutrients, or other fluids.

[0060] Typically, medical fluid application devices have more components than Figure 6A The diagram shows many components. Many include check valves, drip chambers, valved ports, connectors, and other devices well known to those skilled in the art. For clarity of illustration, these other devices are not included in the figures. Furthermore, it should be noted that... Figure 6A The illustrations are not scaled proportionally, and the distances have been compressed for clarity. In actual setups, the distances between bottles 38, 40, 42, and 44 and pumps 120, 24, 26, and 28 would likely be much greater.

[0061] Now refer to Figure 6B This image shows an enlarged view of the front of the patient care system 20. The pump 120 may include a front door 50 and a handle 52, which is actuated to lock the door in a closed position for operation and to unlock and open the door to access the internal pumping and sensing mechanism and load the pump's application device. When the door is open, tubing can be connected to the pump, such as... Figure 6C As shown. When the door is closed, the tubing engages operatively with the pumping mechanism, upstream and downstream pressure sensors, and other pump components. In this embodiment, a display 54 (such as an LED display) is located in a plan view of the door and can be used to visually communicate various pump-related information, such as alarm indications (e.g., alarm messages), including electronic alarms as described herein (e.g., upon detection of one or more anomalies). Control keys 56 are present to program and control the operation of the pump as needed. Pump 120 also includes an audio alarm device in the form of a speaker (not shown).

[0062] In the illustrated embodiment, the programming module 60 is attached to the left side of pump 120. Other devices or modules (including another pump) may be attached to the right side of pump 120, such as... Figure 6A As shown. In this system, each attached pump represents a pump channel for the entire patient care system 20. In one embodiment, a programming module is used to provide an interface between the pump 120 and external devices, and to provide most of the operator interface for the pump 120.

[0063] Programming module 60 includes a display 62 for visually conveying various information, such as operating parameters of pump 120, as well as alarm indications and alarm messages. Programming module 60 may also include a speaker to provide audible alarms. In this embodiment, the programming module, or any other module, also has various input devices, including control keys 64 and barcodes or other scanners or readers to scan information from electronic data tags associated with infusion, patient, caregiver, etc. The programming module also has a communication system (not shown) through which it can communicate with external devices (such as a facility server or other computer) and portable processors (such as handheld portable digital assistants (“PDAs”) or laptops) or other information devices (which may be necessary for caregivers to transmit information and download drug catalogs to the programming module or pump). In some embodiments, pump 120 may provide programming module 60 with data such as vital signs, which programming module 60 may then determine dosing patterns, detect one or more abnormalities, and / or send electronic alarms associated with detected abnormalities. In this embodiment, programming module 60 may communicate with tracking engine 110, including or implementing the features of tracking engine 110 as described herein.

[0064] The communication system can take the form of a radio frequency (“RF”) system, an optical system such as infrared, a Bluetooth system, or other wired or wireless systems. The barcode scanner and communication system can alternatively be integrated as a whole, such as without or without a programming module. Furthermore, the information input device does not require hardwired connection to the medical device; information can also be transmitted wirelessly.

[0065] Figure 6B This includes a second pump 26 connected to the programming module 60. For example... Figure 6AAs shown, more pump modules can be connected. Additionally, other types of modules can be connected to the pump modules or programming modules. In this embodiment, the tracking engine 110 can track the number and / or frequency of attempts to trigger delivery of a dose of medication, delivery of a dose of medication to the patient, and / or refusal to deliver a dose of medication to the patient at each pump (e.g., pump 120, pump 26, etc.). Additionally and / or alternatively, the tracking engine 110 can track the patient's vital signs at each pump (e.g., pump 120, pump 26, etc.). Additionally and / or alternatively, the tracking engine 110 can determine the correlation between the dosing pattern observed at the patient-controlled analgesia pump and the patient's response at each pump (e.g., pump 120, pump 26, etc.). In some embodiments, the tracking engine 110 can generate an electronic alarm when one or more abnormalities are detected in the dosing pattern observed at each pump (e.g., pump 120, pump 26, etc.). The tracking engine 110 can provide additional or alternative control messages to adjust the function of one or more components of the pump, at least in part, based on the detected dosing pattern. For example, the tracking engine 110 can disable the dispensing button connected to the patient-controlled analgesia module. As another example, the tracking engine 110 can send control messages to adjust the rate of delivery via the motor pump (e.g., increase the rate, decrease the rate, or stop the pumping). As yet another example, the tracking engine 110 can adjust the pump configuration, such as permitted dosing modes (e.g., PCA lockout duration or frequency).

[0066] Now go to Figure 6C Pump 120 is shown in perspective with front door 50 open, showing upstream fluid line 30 and downstream fluid line 31 effectively engaged with pump 120. Pump 120 acts directly on pipe 66, which connects upstream fluid line 30 to downstream fluid line 31 (also referred to as pump section) to form a flow from the respective fluid supply device 38 ( Figure 6A A continuous fluid conduit extends to the patient 48, and a pump acts on the fluid as it flows through the continuous fluid conduit to move the fluid downstream to the patient. Specifically, a pumping mechanism 70 serves as a flow control device for the pump to allow fluid to pass through the conduit. Upstream and downstream fluid lines and / or tubes 66 may be connected to a pump housing or cylinder configured to connect to the pump 120, as described by reference in co-pending U.S. Patent Application Serial No. 13 / 827,775, which is incorporated herein by reference.

[0067] The type of pumping mechanism can vary and can be, for example, a multi-finger pumping mechanism. For instance, the pumping mechanism can be of the "four-finger" type and include an upstream blocking finger 72, a main pumping finger 74, a downstream blocking finger 76, and an auxiliary pumping finger 78. The "four-finger" pumping mechanism, and other mechanisms used in linear peristaltic pumps, are operated by sequentially pressing sections of the fluid conduit by cams following the pumping fingers and valve fingers 72, 74, 76, and 78. Pressure is applied sequentially to the conduit, starting from the upstream end of the pumping mechanism and working towards the downstream end. At least one finger is always pressed firmly enough to block the conduit. In practice, a finger blocking the conduit does not retract until the next finger has sequentially blocked the conduit; therefore, there is never a direct fluid path from the fluid supply device to the patient. Those skilled in the art are familiar with the operation of peristaltic pumps, including four-finger pumps, and further operational details are not provided herein.

[0068] In this particular embodiment, Figure 6C Further illustrated is a downstream pressure sensor 82 included in pump 120, located downstream of the pumping mechanism. The downstream pressure sensor 82 is mounted to flow control device 70 and is located near and downstream of the flow control device. The downstream pressure sensor is located downstream of the flow control device, i.e., downstream of patient 48. Figure 6A The location between the fluid supply device and the flow control device allows verification of the correct fluid supply device and the correct pump connection before any fluid is pumped to the patient.

[0069] Still refer to Figure 6C The upstream pressure sensor 80 may also be included in the pump 120. The upstream pressure sensor is assigned to the flow control device or pumping mechanism 70, and in this embodiment, is further integrated into the pump 120. The upstream pressure sensor is mounted to the flow control device 70 and is located near and upstream of the flow control device. The upstream pressure sensor is located upstream of the flow control device, i.e., upstream of the fluid supply device 38. Figure 6A The location between the fluid supply device and the flow control device is used to verify the correct fluid supply device and the correct pump connection before any fluid is pumped to the patient. In embodiments where the source is a syringe, the flow control device 70 can be configured to press the plunger of the syringe to provide infusion according to programmed parameters.

[0070] Some of the embodiments shown discuss pump-related features. It should be understood that these features can be implemented, in whole or in part, using other drug dispensing devices, such as automated dispensing devices configured to provide drugs or other substances to users for administration, robot-controlled delivery machines, etc.

[0071] One or more aspects or features of the subject matter described herein can be implemented in digital electronic circuits, integrated circuits, specially designed ASICs, field-programmable gate arrays (FPGAs), computer hardware, firmware, software, and / or combinations thereof. These aspects or features may be implemented in one or more computer programs that are executable and / or interpretable on a programmable system, which includes at least one programmable processor that may be connected for dedicated or general purposes to receive data and instructions from a storage system, at least one input device, and at least one output device, and to send data and instructions to the storage system, at least one input device, and at least one output device. The programmable system or computing system may include clients and servers. Clients and servers are typically geographically separated and typically interact via a communication network. The client-server relationship is established by means of computer programs running on respective computers and having a client-server relationship with each other.

[0072] These computer programs (also referred to as programs, software, software applications, applications, components, or code) include machine instructions for a programmable processor and can be implemented in high-level procedural and / or object-oriented programming languages ​​and / or in assembly / machine language. As used herein, the term "machine-readable medium" means any computer program product, device, and / or apparatus (e.g., disk, optical disk, memory, and programmable logic device (PLD)) that includes a machine-readable medium that receives machine instructions as a machine-readable signal and is used to provide machine instructions and / or data to a programmable processor. The term "machine-readable signal" means any signal used to provide machine instructions and / or data to a programmable processor. Machine-readable media may store such machine instructions non-volatilely, such as non-volatile solid-state memory or magnetic hard disk drives or any equivalent storage medium. Alternatively or additionally, machine-readable media may store such machine instructions temporarily, such as processor caches or other random access memory associated with one or more physical processor cores.

[0073] To provide interaction with the user, one or more aspects or features of the subject matter described herein can be implemented on a computer having a display device (e.g., a cathode ray tube (CRT), liquid crystal display (LCD), or light-emitting diode (LED) monitor for displaying information to the user) and a keyboard and pointing device (e.g., a mouse or trackball), through which the user provides input to the computer. Other types of devices can also be used to provide interaction with the user. For example, feedback provided to the user can be any form of sensory feedback, such as visual, auditory, or tactile feedback; and input from the user can be received in any form, including acoustic, speech, or tactile input. Other possible input devices include touchscreens or other touch-sensitive devices, such as single-point or multi-point resistive or capacitive tracking pads, speech recognition hardware and software, optical scanners, optical pointers, digital image capturing devices, and related interpretation software.

[0074] In the foregoing description and in the claims, phrases such as “at least one” or “one or more” may appear before a list of combinations of elements or features. The term “and / or” may also appear in a list of two or more elements or features. Unless otherwise implied or explicitly contradicted by the context in which it is used, this phrase is intended to refer to any element or feature listed individually, or any recited element or feature in combination with any other recited element or feature. For example, each of the phrases “at least one of A and B,” “one or more of A and B,” and “A and / or B” means “A alone, B alone, or A and B together.” A similar interpretation applies to lists comprising three or more items. For example, each of the phrases “at least one of A, B, and C,” “one or more of A, B, and C,” and “A, B, and / or C” means “A alone, B alone, C alone, A and B together, A and C together, B and C together, or A and B and C together.” The use of the term “based on” in the foregoing and claims is intended to mean “at least partially based on,” thus also allowing for unrecited features or elements.

[0075] As used herein, the term "determine" or "determined" encompasses a wide variety of actions. For example, "determined" can include calculations, operations, processing, deriving, generating, obtaining, searching (e.g., searching in a table, database, or other data structure), and confirmation via hardware components without user intervention. Furthermore, "determined" can include receiving (e.g., receiving information) and accessing (e.g., accessing data in memory) via hardware components without user intervention. "Determined" can also include parsing, selecting, picking, and building via hardware components without user intervention.

[0076] As used herein, the term “provide” or “provide” covers a wide variety of actions. For example, “providing” can include storing a value at a location on a storage device for later retrieval, sending a value directly to a recipient via at least one wired or wireless communication medium, sending or storing a reference to a value, etc. “Providing” can also include encoding, decoding, encrypting, decrypting, verifying, and authenticating via hardware components.

[0077] As used herein, the term "message" encompasses a variety of formats used to transmit (e.g., send or receive) information. A message can include a collection of machine-readable information, such as an XML document, a fixed-field message, a comma-separated message, etc. In some implementations, a message can include one or more signals representing the information being sent. Although stated in the singular, it should be understood that a message can be composed of, sent, stored, received, etc., in multiple parts.

[0078] As used herein, the term "correspondence" or "corresponding to" refers to a structural, functional, quantitative, and / or qualitative correlation or relationship between two or more objects, datasets, information, etc., preferably wherein the correspondence or relationship can be used to translate one or more of the two or more objects, datasets, information, etc., to make them appear identical or equal. Correspondence can be evaluated using one or more of the following: thresholds, value ranges, fuzzy logic, pattern matching, machine learning evaluation models, or combinations thereof.

[0079] In any embodiment, data may be forwarded to a “remote device or location,” where “remote” means a location or device other than the location or device where the program is executed. For example, a remote location could be another location in the same city (e.g., an office, laboratory, etc.), another location in a different city, another location in a different state, another location in a different country, etc. Thus, when indicating that one item is “away” from another item, it means that the two items may be in the same room but separate, or at least in different rooms or different buildings, and may be at least one mile, ten miles, or at least one hundred miles apart. “Transmitting” information means sending data representing this information as an electrical signal through a suitable communication channel (e.g., a private network or a public network). “Forwarding” an item means any means of physically transporting the item or otherwise (where possible) moving the item from one location to another, and at least in the case of data, includes physically transporting the medium carrying the data or transmitting the data. Examples of communication media include radio or infrared transmission channels and network connections to another computer or networked device, as well as the Internet or information including email transmissions and records on websites, etc.

[0080] Depending on the desired configuration, the subject matter described herein can be embodied in systems, devices, methods, and / or articles of art. The embodiments set forth in the foregoing description do not represent all embodiments consistent with the subject matter described herein. Rather, the embodiments are merely examples of aspects consistent with the described subject matter. Although many variations have been described in detail above, other modifications or additions are possible. Specifically, additional features and / or variations may be provided in addition to the features and / or variations set forth herein. For example, the embodiments described above may involve various combinations and sub-combinations of the disclosed features and / or combinations and sub-combinations of several other features disclosed above. Furthermore, the logical flows depicted in the accompanying drawings and / or described herein do not necessarily require the specific order or sequence shown to achieve the desired results. Other embodiments are within the scope of the appended claims.

Claims

1. A system comprising: At least one data processor; as well as At least one memory storing instructions that, when executed by the at least one data processor, produce operations including: The dosing pattern for delivering the drug to the patient is determined based on at least one or more dosing events at the pump configured to deliver the drug to the patient; Receive one or more vital signs related to the patient from the patient monitor; The presence of one or more abnormalities is determined based at least on the pump's dosing pattern and one or more of the patient's vital signs; as well as In response to the detection of one or more anomalies, an electronic alarm is sent to the mobile device; The pump is a patient-controlled analgesia pump, and the drug is an analgesic. The one or more dose events include: a patient attempting to trigger delivery of a dose of medication, delivery of a dose of medication to a patient, and / or refusal to deliver a dose of medication to a patient. A patient attempting to trigger delivery of a dose of medication means that the patient requests the pump to deliver a dose of medication, and refusal to deliver a dose of medication means that the pump prevents the delivery of a dose of medication to the patient despite the patient's request. The pump has an active period, an inactive period, and a locked period; during the active period, the pump delivers a dose of medication to the patient; during the inactive period, the pump does not deliver a dose of medication to the patient, nor does it prevent the patient from attempting to trigger the delivery of a dose of medication; during the locked period, the pump refuses to deliver a dose of medication to the patient. The pump undergoes a locked period after each successful patient attempt to trigger a dose event that delivers a certain dose of the drug.

2. The system according to claim 1, wherein, The one or more vital signs include: respiratory rate, blood oxygen saturation, heart rate, pain level, and / or movement.

3. The system according to any one of claims 1 to 2, further comprising: The pump's dosage mode should be adjusted based at least on the pump's dosage mode and / or one or more of the patient's vital signs.

4. The system according to claim 3, wherein, The dosing pattern is adjusted by modifying at least the number and / or frequency of delivering and / or refusing to deliver one or more doses of the drug to the patient.

5. The system according to claim 3, wherein, Adjust the dosing pattern by modifying at least the duration of the pump's active, inactive, and / or locked periods.

6. The system according to claim 3, wherein, Adjust the dosing pattern by modifying at least the maintenance dose of the pump.

7. The system according to claim 1, wherein, The one or more abnormalities include delivering a drug amount to the patient that is greater than the maximum threshold or less than the minimum threshold.

8. The system according to claim 1, wherein, The one or more abnormalities include one or more vital signs of the patient that are greater than the maximum threshold or less than the minimum threshold.

9. The system according to claim 1, wherein, The patient monitor includes one or more sensors configured to measure one or more vital signs of the patient, wherein the one or more sensors include at least one motion sensor, and wherein the presence of one or more abnormalities is determined based on motion data measured by the at least one motion sensor.

10. A computer-implemented method comprising: The dosing pattern for delivering the drug to the patient is determined based on at least one or more dosing events at the pump configured to deliver the drug to the patient; Receive one or more vital signs related to the patient from the patient monitor; The presence of one or more abnormalities is determined based at least on the pump's dosing pattern and one or more of the patient's vital signs; as well as In response to the detection of one or more anomalies, an electronic alarm is sent to the mobile device; The pump is a patient-controlled analgesia pump, and the drug is an analgesic. The one or more dose events include: a patient attempting to trigger delivery of a dose of medication, delivery of a dose of medication to a patient, and / or refusal to deliver a dose of medication to a patient. A patient attempting to trigger delivery of a dose of medication means that the patient requests the pump to deliver a dose of medication, and refusal to deliver a dose of medication means that the pump prevents the delivery of a dose of medication to the patient despite the patient's request. The pump has an active period, an inactive period, and a locked period; during the active period, the pump delivers a dose of medication to the patient; during the inactive period, the pump does not deliver a dose of medication to the patient, nor does it prevent the patient from attempting to trigger the delivery of a dose of medication; during the locked period, the pump refuses to deliver a dose of medication to the patient. The pump undergoes a locked period after each successful patient attempt to trigger a dose event that delivers a certain dose of the drug.

11. The method according to claim 10, wherein, The one or more vital signs include: respiratory rate, blood oxygen saturation, heart rate, pain level, and / or movement.

12. The method according to any one of claims 10 to 11, further comprising: The pump's dosage mode should be adjusted based at least on the pump's dosage mode and / or one or more of the patient's vital signs.

13. The method according to claim 12, wherein, The dosing pattern is adjusted by modifying at least the number and / or frequency of delivering one or more doses of the drug to the patient.

14. The method according to claim 12, wherein, Adjust the dosing pattern by modifying at least the duration of the pump's active, inactive, and / or locked periods.

15. The method according to claim 12, wherein, Adjust the dosing pattern by modifying at least the maintenance dose of the pump.

16. The method of claim 10, wherein, The one or more abnormalities include delivering a drug amount to the patient that is greater than the maximum threshold or less than the minimum threshold.

17. The method according to claim 10, wherein, The one or more abnormalities include one or more vital signs of the patient that are greater than the maximum threshold or less than the minimum threshold.

18. A non-volatile computer-readable storage medium comprising program code that, when executed by at least one data processor, causes operations including: The dosing pattern for delivering the drug to the patient is determined based on at least one or more dosing events at the pump configured to deliver the drug to the patient; Receive one or more vital signs related to the patient from the patient monitor; The presence of one or more abnormalities is determined based at least on the pump's dosing pattern and one or more of the patient's vital signs; as well as In response to the detection of one or more anomalies, an electronic alarm is sent to the mobile device; The pump is a patient-controlled analgesia pump, and the drug is an analgesic. The one or more dose events include: a patient attempting to trigger delivery of a dose of medication, delivery of a dose of medication to a patient, and / or refusal to deliver a dose of medication to a patient. A patient attempting to trigger delivery of a dose of medication means that the patient requests the pump to deliver a dose of medication, and refusal to deliver a dose of medication means that the pump prevents the delivery of a dose of medication to the patient despite the patient's request. The pump has an active period, an inactive period, and a locked period; during the active period, the pump delivers a dose of medication to the patient; during the inactive period, the pump does not deliver a dose of medication to the patient, nor does it prevent the patient from attempting to trigger the delivery of a dose of medication; during the locked period, the pump refuses to deliver a dose of medication to the patient. The pump undergoes a locked period after each successful patient attempt to trigger a dose event that delivers a certain dose of the drug.

19. An apparatus comprising: A device for determining a dosing pattern for delivering a drug to a patient based on one or more dosing events at a pump configured to deliver a drug to a patient; Device for receiving one or more vital signs related to a patient from a patient monitor; Device for determining the presence of one or more abnormalities based at least on the pump's dosing pattern and one or more of the patient's vital signs; as well as Device for sending an electronic alarm to a mobile device in response to the determination of the presence of one or more anomalies; The pump is a patient-controlled analgesia pump, and the drug is an analgesic. The one or more dose events include: a patient attempting to trigger delivery of a dose of medication, delivery of a dose of medication to a patient, and / or refusal to deliver a dose of medication to a patient. A patient attempting to trigger delivery of a dose of medication means that the patient requests the pump to deliver a dose of medication, and refusal to deliver a dose of medication means that the pump prevents the delivery of a dose of medication to the patient despite the patient's request. The pump has an active period, an inactive period, and a locked period; during the active period, the pump delivers a dose of medication to the patient; during the inactive period, the pump does not deliver a dose of medication to the patient, nor does it prevent the patient from attempting to trigger the delivery of a dose of medication; during the locked period, the pump refuses to deliver a dose of medication to the patient. The pump undergoes a locked period after each successful patient attempt to trigger a dose event that delivers a certain dose of the drug.

20. The apparatus of claim 19, wherein the apparatus is used to perform the method of any one of claims 10 to 17.

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