Means and method for scheduled WEAN down in implantable infusion therapy system

Abstract

Systems and methods for generating pump instructions are provided. The system may include processors to determine an initial flow rate of a medication, determine a target flow rate of the medication, and generate pump instructions based on the initial flow rate and the target flow rate for a controller to control a pump to administer the medication from the initial flow rate to the target flow rate over time.

Description

MEANS AND METHOD FOR SCHEDULED WEAN DOWN IN IMPLANTABLE INFUSION THERAPY SYSTEMCROSS-REFERENCE TO RELATED APPLICATION(S)

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 565,927, filed March 15, 2024, which is incorporated herein by reference in its entirety.BACKGROUND

[0002] Implantable medical devices, such as an implantable access port or medical pump, are useful in managing delivery and dispensation of prescribed therapeutic agents, nutrients, drugs, medicaments such as antibiotics, blood clotting agents, analgesics, and other fluid and / or fluid like substances (collectively “medications”) to patients. Such implantable devices are particularly useful for treating diseases and disorders that require regular or chronic (i.e., long-term) pharmacological intervention, including but not limited to chronic pain, tremor, spasticity, multiple sclerosis, Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis (ALS), Huntington's disease, cancer, epilepsy, chronic pain, urinary or fecal incontinence, sexual dysfunction, obesity, and gastroparesis. Depending upon their specific designs and intended uses, implantable devices can be adapted to administer medications to specific areas within the central nervous system, including the subarachnoid, epidural, intrathecal, and intracranial spaces.

[0003] Such implantable medical devices may include an external or implantable pump which may be in fluid communication with an implantable access port an implantable catheter. Implantable access ports may be placed cranially or over the ribs and may be connected to a catheter which may be surgically placed in the intraventricular space of the brain or intraspinal area of the spinal cord. When it is desirable to administer a medication, a needle may be inserted through the patient's skin, through a septum of the port, which is in fluid connection with the catheter. The medication may then be injected into the port where it passes through the catheter and into the patient's CSF.

[0004] Implantable pumps may be implanted at a location within the body of a patient (e.g., a subcutaneous region in the lower abdomen) and may be connected to a catheter configured to deliver a medication to a selected delivery site in the patient. Such implantable medical pumps may include an expandable fluid reservoir, which may be accessible for refill through an access port. Medication may flow from the reservoir through the catheter and into the patient's CSF.

[0005] The catheter may be a flexible tube with a lumen running the length of the catheter to a selected delivery site in the body, such as the subarachnoid space. Medication molecules exiting thecatheter lumen may flow into the subarachnoid space and begin mixing with the CSF. The medication may exit the catheter slowly (e.g., at a flow rate of 1 mL per hour or less), where the medication may stagnate in the CSF immediately surrounding the catheter.BRIEF SUMMARY

[0006] Intrathecal medication delivery, a process where drugs are administered directly into the CSF, is often employed in the management of chronic pain, particularly when conventional systemic treatments are either ineffective or produce intolerable side effects. By delivering medication directly to the central nervous system, intrathecal therapy provides a higher concentration of the drug at the target site, allowing for a more potent pain-relieving effect with significantly lower doses compared to oral or systemic administration. The targeted approach provided by intrathecal medication delivery is especially beneficial in managing severe pain conditions and chronic pain syndromes unresponsive to other treatments.

[0007] Dosage modification, including the weaning down or complete cessation of a medication, as well as increases in dosage, is a critical aspect often necessary as a result of a number of clinical factors. For example, drug tolerance, wherein the patient's response to a medication diminishes over time, may necessitate an adjustment in dosage or a transition to alternative therapies to maintain efficacy. Gradual dosage modification is often pivotal for maintaining therapeutic efficacy while minimizing adverse effects. Incremental dosage adjustments may be required in conditions where tolerance to a medication develops, such as with opioids or antihypertensive agents, or in scenarios where the severity of the condition escalates, necessitating a higher dose for effective management.

[0008] The slow and controlled modification of dosages, such as over a week or more, is typically beneficial as it allows for the physiological adaptation of the body to the altered drug levels, thereby reducing the risk of withdrawal symptoms in the case of dose reduction, particularly with medications that have dependency potential. Additionally, gradual dosage adjustments facilitate the monitoring of therapeutic response and the identification of the minimum effective dose. This approach also ensures patient safety. Furthermore, slow dosage modification enhances patient compliance and tolerance to the medication regimen, thereby optimizing therapeutic outcomes.

[0009] Even complex or dose-escalated inherited therapies can be transformed into highly effective, low dose, monotherapy after a taper. However, with conventional implantable infusion systems, executing a wean down or other type of modification to dosage which takes place gradually is challenging and burdensome for clinics and patients. Conventional wean-down involves the patient coming into a clinic weekly to have their rate reduced. Such a conventional approachnegatively impacts the patient and medical resources in a number of ways. For example, a weekly modification of a dosage of a medication may be inadequately long of a duration. A more efficient or healthy modification may require more frequent changes in dosage. The systems and methods described herein enable a dosage of a medication to automatically adjust at any time of day or night. This allows for smaller changes in dosage, providing a smoother transition between dosages. The systems and methods described herein also provide relief to medical resources, enabling providers to spend more time with other patients as fewer appointments may be required to wean a patient off of a medication or to otherwise change a dosage of a medication over time.

[0010] The systems and methods described herein provide a means for configuring, scheduling, and automatically applying a taper of a dose to be executed by a pump. This allows more frequent and gradual dose decreases to be performed without requiring the patient to come back for additional clinician programming. If appropriate, an ongoing therapy rate or pattern can be maintained after the scheduled wean down. In some implementations a workflow user interface may be presented on a clinician programmer device, such as a tablet computer, to enable a clinician to be guided through the process of scheduling and configuring the taper.

[0011] Example aspects of the present disclosure include:

[0012] A system comprising: one or more processors; and one or more processor-readable media storing instructions which, when executed by the one or more processors, cause performance of: determining a first initial flow rate of a first medication; determining a first target flow rate of the first medication; and generating pump instructions based on the first initial flow rate and the first target flow rate, wherein the pump instructions include a series of steps or track an equation, wherein the pump instructions cause a first controller to control a first pump to administer the first medication from the first initial flow rate to the first target flow rate over time.

[0013] Any of the aspects herein, wherein the instructions further cause performance of displaying a user interface, wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

[0014] Any of the aspects herein, wherein the instructions further cause performance of generating a template.

[0015] Any of the aspects herein, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

[0016] Any of the aspects herein, wherein the instructions further cause performance of receiving an edit to one or more steps of the template.

[0017] Any of the aspects herein, wherein the instructions further cause performance of generating an exponential decay equation, wherein the pump instructions control the pump to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

[0018] Any of the aspects herein, wherein the instructions further cause performance of determining a predicted date of refill based on the pump instructions.

[0019] Any of the aspects herein, wherein the instructions further cause performance of prompting a user to schedule an appointment for a refill.

[0020] Any of the aspects herein, wherein the instructions further cause performance of generating a visualization of the pump instructions.

[0021] Any of the aspects herein, wherein the instructions further cause performance of checking the pump instructions for errors.

[0022] Any of the aspects herein, wherein the initial rate is lower than the target rate, and the pump instructions cause the pump to perform an up-titration.

[0023] Any of the aspects herein, wherein the initial rate is higher than the target rate, and the pump instructions cause the pump to wean a patient off the first medication.

[0024] Any of the aspects herein, wherein the pump instructions cause the pump to administer the medication at gradually reducing flow rates.

[0025] Any of the aspects herein, wherein the instructions further cause performance of: determining a second initial flow rate of a second medication; determining a second target flow rate of the second medication; and based on the second initial flow rate and the second target flow rate, generating second pump instructions for a second controller to control a second pump to administer the second medication from the second initial flow rate to the second target flow rate over time in parallel with controlling the first pump to administer the first medication from the first current flow rate to the first target flow rate.

[0026] A method comprising: determining a first initial flow rate of a first medication; determining a first target flow rate of the first medication; and generating pump instructions based on the first initial flow rate and the first target flow rate, wherein the pump instructions include a series of steps or track an equation, wherein the pump instructions cause a first controller to control a first pump to administer the first medication from the first initial flow rate to the first target flow rate over time.

[0027] Any of the aspects herein, further comprising displaying a user interface, wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

[0028] Any of the aspects herein, further comprising generating a template.

[0029] Any of the aspects herein, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

[0030] Any of the aspects herein, further comprising receiving an edit to one or more steps of the template.

[0031] Any of the aspects herein, further comprising generating an exponential decay equation, wherein the pump instructions control the pump to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

[0032] Any of the aspects herein, further comprising determining a predicted date of refill based on the pump instructions.

[0033] Any of the aspects herein, further comprising prompting a user to schedule an appointment for a refill.

[0034] Any of the aspects herein, further comprising generating a visualization of the pump instructions.

[0035] Any of the aspects herein, further comprising checking the pump instructions for errors.

[0036] Any of the aspects herein, wherein the initial rate is lower than the target rate, and the pump instructions cause the pump to perform an up-titration.

[0037] Any of the aspects herein, wherein the initial rate is higher than the target rate, and the pump instructions cause the pump to wean a patient off the first medication.

[0038] Any of the aspects herein, wherein the pump instructions cause the pump to administer the medication at gradually reducing flow rates.

[0039] Any of the aspects herein, further comprising: determining a second initial flow rate of a second medication; determining a second target flow rate of the second medication; and generating second pump instructions based on the second initial flow rate and the second target flow rate for a second controller to control a second pump to administer the second medication from the second initial flow rate to the second target flow rate over time in parallel with controlling the first pump to administer the first medication from the first current flow rate to the first target flow rate.

[0040] A clinician device comprising: one or more processors; and one or more processor- readable media storing instructions which, when executed by the one or more processors, cause performance of: determining a first initial flow rate of a first medication; determining a first targetflow rate of the first medication; and generating pump instructions based on the first initial flow rate and the first target flow rate, wherein the pump instructions include a series of steps or track an equation, wherein the pump instructions cause a first controller to control a first pump to administer the first medication from the first initial flow rate to the first target flow rate over time.

[0041] Any of the aspects herein, wherein the instructions further cause performance of displaying a user interface, wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

[0042] Any of the aspects herein, wherein the instructions further cause performance of generating a template.

[0043] Any of the aspects herein, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

[0044] Any of the aspects herein, wherein the instructions further cause performance of receiving an edit to one or more steps of the template.

[0045] Any of the aspects herein, wherein the instructions further cause performance of generating an exponential decay equation, wherein the pump instructions control the pump to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

[0046] Any of the aspects herein, wherein the instructions further cause performance of determining a predicted date of refill based on the pump instructions.

[0047] Any of the aspects herein, wherein the instructions further cause performance of prompting a user to schedule an appointment for a refill.

[0048] Any of the aspects herein, wherein the instructions further cause performance of generating a visualization of the pump instructions.

[0049] Any of the aspects herein, wherein the instructions further cause performance of checking the pump instructions for errors.

[0050] Any of the aspects herein, wherein the initial rate is lower than the target rate, and the pump instructions cause the pump to perform an up-titration.

[0051] Any of the aspects herein, wherein the initial rate is higher than the target rate, and the pump instructions cause the pump to wean a patient off the first medication.

[0052] Any of the aspects herein, wherein the pump instructions cause the pump to administer the medication at gradually reducing flow rates.

[0053] Any of the aspects herein, wherein the instructions further cause performance of: determining a second initial flow rate of a second medication; determining a second target flow rateof the second medication; and based on the second initial flow rate and the second target flow rate, generating second pump instructions for a second controller to control a second pump to administer the second medication from the second initial flow rate to the second target flow rate over time in parallel with controlling the first pump to administer the first medication from the first current flow rate to the first target flow rate.

[0054] The preceding is a simplified summary of the disclosure to provide an understanding of some aspects of the disclosure. This summary is neither an extensive nor exhaustive overview of the disclosure and its various aspects, embodiments, and configurations. It is intended neither to identify key or critical elements of the disclosure nor to delineate the scope of the disclosure but to present selected concepts of the disclosure in a simplified form as an introduction to the more detailed description presented below. As will be appreciated, other aspects, embodiments, and configurations of the disclosure are possible utilizing, alone or in combination, one or more of the features set forth above or described in detail below.

[0055] Numerous additional features and advantages of the present disclosure will become apparent to those skilled in the art upon consideration of the embodiment descriptions provided herein below.BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

[0056] The accompanying drawings are incorporated into and form a part of the specification to illustrate several examples of the present disclosure. These drawings, together with the description, explain the principles of the disclosure. The drawings simply illustrate preferred and alternative examples of how the disclosure can be made and used and are not to be construed as limiting the disclosure to only the illustrated and described examples. Further features and advantages will become apparent from the following, more detailed, description of the various aspects, embodiments, and configurations of the disclosure, as illustrated by the drawings referenced below.

[0057] Fig. 1 is an illustration of a system implanted in a patient in communication with a computing system in accordance with at least one embodiment of the present disclosure;

[0058] Fig. 2 is a block diagram of a pumping system in communication with a computing system in accordance with at least one embodiment of the present disclosure;

[0059] Figs. 3-7 are illustrations of user interfaces in accordance with at least one embodiment of the present disclosure; and

[0060] Fig. 8 is a flowchart according to at least one embodiment of the present disclosure.DETAILED DESCRIPTION

[0061] It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example or embodiment, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, and / or may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the disclosed techniques according to different embodiments of the present disclosure). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a computing device and / or a medical device.

[0062] Before any embodiments of the disclosure are explained in detail, it is to be understood that the disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Further, the present disclosure may use examples to illustrate one or more aspects thereof. Unless explicitly stated otherwise, the use or listing of one or more examples (which may be denoted by “for example,” “by way of example,” “e.g.,” “such as,” or similar language) is not intended to and does not limit the scope of the present disclosure.

[0063] The terms proximal and distal are used in this disclosure with their conventional medical meanings, proximal being closer to the operator or user of the system, and further from the region of surgical interest in or on the patient, and distal being closer to the region of surgical interest in or on the patient, and further from the operator or user of the system.

[0064] Intrathecal medication delivery, a process where drugs are administered directly into the CSF, is often employed in the management of chronic pain, particularly when conventional systemic treatments are either ineffective or produce intolerable side effects. By delivering medication directly to the central nervous system, intrathecal therapy provides a higher concentration of the drug at the target site, allowing for a more potent pain-relieving effect with significantly lower doses compared to oral or systemic administration. The targeted approach provided by intrathecal medication delivery is especially beneficial in managing severe pain conditions and chronic pain syndromes unresponsive to other treatments.

[0065] Dosage modification, including the weaning down or complete cessation of a medication, as well as increases in dosage, is a critical aspect often necessary as a result of a number of clinical factors. For example, drug tolerance, wherein the patient's response to a medication diminishes over time, may necessitate an adjustment in dosage or a transition to alternative therapies to maintain efficacy. Gradual dosage modification is often pivotal for maintaining therapeutic efficacy while minimizing adverse effects. Incremental dosage adjustments may be required in conditions where tolerance to a medication develops, such as with opioids or antihypertensive agents, or in scenarios where the severity of the condition escalates, necessitating a higher dose for effective management.

[0066] The slow and controlled modification of dosages, such as over a week or more, is typically beneficial as it allows for the physiological adaptation of the body to the altered drug levels, thereby reducing the risk of withdrawal symptoms in the case of dose reduction, particularly with medications that have dependency potential. Additionally, gradual dosage adjustments facilitate the monitoring of therapeutic response and the identification of the minimum effective dose. This approach also ensures patient safety. Furthermore, slow dosage modification enhances patient compliance and tolerance to the medication regimen, thereby optimizing therapeutic outcomes.

[0067] Even complex or dose-escalated inherited therapies can be transformed into highly effective, low dose, monotherapy after a taper. However, with conventional implantable infusion systems, executing a wean down or other type of modification to dosage which takes place gradually is challenging and burdensome for clinics and patients. Conventional wean-down involves the patient coming into a clinic weekly to have their rate reduced. Such a conventional approach negatively impacts the patient and medical resources in a number of ways. For example, a weekly modification of a dosage of a medication may be inadequately long of a duration. A more efficient or healthy modification may require more frequent changes in dosage. The systems and methods described herein enable a dosage of a medication to automatically adjust at any time of day or night. This allows for smaller changes in dosage, providing a smoother transition between dosages. The systems and methods described herein also provide relief to medical resources, enabling providers to spend more time with other patients as fewer appointments may be required to wean a patient off of a medication or to otherwise change a dosage of a medication over time.

[0068] The systems and methods described herein provide a means for configuring, scheduling, and automatically applying a taper of a dose to be executed by a pump. This allows more frequent and gradual dose decreases to be performed without requiring the patient to come back for additional clinician programming. If appropriate, an ongoing therapy rate or pattern can be maintained after the scheduled wean down. In some implementations a workflow user interface may be presented ona clinician programmer device, such as a tablet computer, to enable a clinician to be guided through the process of scheduling and configuring the taper.

[0069] As another example of the benefits provided by the systems and methods described herein, consider a patient with a pump administering an intrathecal medication who complains the medication is not working as well as expected. The provider may be uncertain as to whether the medication is being delivered to the proper point within the patient. Ordinarily, the provider may have the current catheter removed and a new catheter installed in the patient. The provider must next determine the dosage at which to start the patient with the new catheter. If the medication was not being delivered as expected, the risk is high that the provider may over-prescribe the medication at too high of a rate. By using a system or method as described herein, the provider may be enabled to wean down the dosage applied by the current pump at a safe rate before switching the catheter. In this way, the provider can prescribe a safe rate at which the medication should be applied using the new catheter.

[0070] As another example of the benefits provided by the systems and methods described herein, consider a patient needing to switch from one pump to another, such as from an internal pump to an external pump. The systems and methods described herein enable the patient to wean down one pump and increase the other to balance the doses. This process could happen over any range of time, such as over the course of minutes, hours, or days.

[0071] It should be appreciated that in some implementations, systems and methods described herein can be used for automatic, gradual up-titrations of medications, such as for therapy resumption, e.g., in drug-naive patients after catheter revision or other therapy cessation, as well as triggered automatically when a certain time or volume is reached (e.g., to allow for a safer, more gradual wean off in the event that a low reservoir threshold is reached), such as after a continuous or flex therapy. Furthermore, while the systems and methods described herein relate to the use of a pump and an intrathecal medication, it should be appreciated the same or similar systems may be used for other medication technology, such as intravenous (IV) therapy.

[0072] Referring to Fig. 1, a medical device 102 configured to improve disperse a medication to a patient 100 is depicted in accordance with an embodiment of the disclosure. The medical device 102 can include or be connected to an implantable catheter 104, which in some implementations, can be in fluid communication with the medical device 102. The medical device 102, as described in greater detail below, may in some implementations comprise an external or implantable pump. The pump may administer the medication via an implantable port.

[0073] The catheter 104 may be or comprise, for example, the Medtronic Ascenda™ Catheter. In such embodiments, a port may be designed to connect with and be in fluid communication with the catheter 104. In other implementations, the catheter 104 may be any intrathecal catheter 104 that is implantable in a patient 100 and enables medication delivery to a patient 100 or any catheter that enables delivery of therapeutics to a patient 100. The catheter 104 may be implanted anywhere in a patient 100 including, for example, intrathecally in the spinal region or the brain region of the patient 100, etc.

[0074] In some implementations, the medical device 102 may be or comprise a pump 202, such as a Medtronic SynchroMed™ pump or similar pump, or other component capable of delivering medication to the patient 100 via the catheter 104. In other embodiments, the medical device 102 may be or comprise any pump configured to pump medication to the patient 100. The medical device 102 may be implanted in the patient 100 or positioned outside of the patient 100.

[0075] In some implementations, the medical device 102 may also include a port. A port may comprise a housing and a septum disposed in the housing. The septum may be in fluid communication with the catheter. The port implanted subcutaneously under the surface of the patient’s 100 skin. In other implementations, the port may be implanted anywhere on the patient 100 and may be implanted at the surface or above the surface of the patient’s 100 skin. The port may be in fluid communication with the catheter 104 and provide for easy and repeatable access for delivery medication to the patient 100. The port may be in fluid communication with the catheter 104 via one or more connectors. In some embodiments, the port can be coupled to the catheter 104 via the one or more connectors and without sutures.

[0076] In some implementations, the medical device 102 may also include a medication supply 206, referred to herein as a reservoir. The reservoir may comprise an expandable fluid reservoir, which is accessible for refill etc. through an access port. Medication may flow from the reservoir through the catheter 104 and into the patient's 100 CSF according to pump instructions as described herein. One or more sensors of the medical device 102 may be enabled to determine a fill level of the reservoir. For example, a sensor of the medical device 102 may be capable of determining the contents of the reservoir are below a threshold level.

[0077] The medical device 102 may be in communication, such as wireless or wired communication, with a clinical programmer 106. A programmer 106 may comprise a personal computer, smart phone, or tablet device in some implementations. For example, the programmer 106 may communicate over Bluetooth to a telemetry module which may convert data between the programmer 106 and the medical device 102 to provide secure communication.

[0078] As described above, a medical device 102 may include a pump 202 and a medication supply 206. A medical device 102 may also include components such as a controller 200, a power supply 204, memory 208, and a communication interface 210 as illustrated in Fig. 2.

[0079] The controller 200 of the medical device 102 may be carried in housing of the medical device 102 and can be in electrical communication with a power supply 204, the pump 202 and optionally other components of the medical device 102. In one implementation, the controller 200 may comprise a processor. In one implementation, the controller 200 can be an application-specific integrated circuit (ASIC), gate array, or the like. The controller 200 may be configured to control delivery of medication according to pump instructions as described herein.

[0080] The power supply 204 may be a battery, such as a lithium ion battery. The power supply 204 may be carried in housing of the medical device 102 and may be selected to operate the pump 202 and other electronics, including the controller 200 and, for example, a piezoelectric element of the catheter 104.

[0081] The communication interface 210 of the medical device 102 may be configured to receive information from and transmit information to optional external sensors and an external programmer 106 as described herein. The communication interface 210 may be used for receiving data, such as pump instructions, from an external source (such as the programmer 106, database 226, and / or network 228), and / or for transmitting data to an external system or device (e.g., the programmer 106, the database 226, the network 228, and / or any other system or component). The communication interface 210 may comprise one or more wired interfaces (e.g., a USB port, an Ethernet port, a Firewire port) and / or one or more wireless transceivers or interfaces (configured, for example, to transmit and / or receive information via one or more wireless communication protocols such as 802.55a / b / g / n, Bluetooth, NFC, ZigBee, and so forth).

[0082] In some implementations, the medical device 102 can additionally be configured to include or communicate with one or more sensors. Examples of the one or more sensors include a needle detection sensor, a flow detection sensor, a fluid level sensor, or a physiological sensor. The controller 200 may be capable of reading data from sensors and storing the data in the memory 208.

[0083] The sensor(s) may be used to track various parameters of the medical device 102 such as, for example, flow rate of the pump 202, a fluid volume of the medication supply 206, etc. Sensor(s) may comprise a flow rate sensor (e.g., a flow meter), a pinwheel sensor, or any other sensor capable of measuring fluid volume and / or a flow rate. The sensors may include one or more or any combination of components that are electrical, mechanical, electro-mechanical, magnetic,electromagnetic, or the like. In some embodiments, the sensor may output signals (e.g., sensor data) to one or more sources (e.g., the programmer 106).

[0084] The sensors may be positioned adjacent to or integrated with other components of the medical device 102 such as, but not limited to, the pump 202, a port, the catheter 104, and / or the medication supply 206. In some embodiments, sensors may be positioned as standalone components. The sensors may include a plurality of sensors and each sensor may be positioned at the same location or a different location as any other sensor. It will be appreciated that in some embodiments the sensor(s) can be positioned at or on any component of the medical device 102 or environment (e.g., on any portion of the pump 202, the medication supply 206, the catheter 104, and / or any other component of the medical device 102).

[0085] A programmer 106 may comprise a processor 212, a communication interface 214, a user interface 216, and memory 218. Programmers 106, according to other implementations of the present disclosure may comprise more or fewer components than the programmer 106 illustrated in Fig. 2.

[0086] The processor 212 of the programmer 106 may be any processor described herein or any similar processor. The processor 212 may be configured to execute instructions stored in the memory 218, which instructions may cause the processor 212 to carry out one or more computing steps utilizing or based on data received from the medical device 102 via a communication interface 214, a user via a user interface 216, memory 218, a database 226, and / or a network 228.

[0087] Memory 218 of the programmer 106 may include data relating to workflows 220, templates 222, and instructions 224. The memory 218 may be or comprise RAM, DRAM, SDRAM, other solid-state memory, any memory described herein, or any other tangible, non-transitory memory for storing computer-readable data and / or instructions. The memory 218 may store information or data useful for completing, for example, any step of the methods described herein, or of any other methods. The memory 218 may store, for example, pump instructions which may be used by a controller 200 of a medical device 102 to control a pump 202 of the medical device 102 to deliver medication at particular rates. Such pump instructions may, in some implementations, be organized into one or more applications, modules, packages, layers, or engines. Alternatively, or additionally, the memory 218 may store other types of content or data (e.g., machine learning models, artificial neur. networks, deep neural networks, etc.) that can be processed by the processor 212 to carry out the various method and features described herein. Thus, although various contents of memory 218 may be described as instructions, it should be appreciated that functionality described herein can be achieved through use of instructions, algorithms, and / or machine learning models. The data,algorithms, and / or instructions may cause the processor 212 to manipulate data stored in the memory 218 and / or received from or via the medical device 102 via the communication interface 216, a user via the user interface 216, the database 226, and / or the network 228.

[0088] The memory may store data such as workflows 220, templates 222, and instructions 224. Workflows 220 as described herein may be applications or application data which may guide a user, using a series of graphical user interfaces (GUIs) displayed on the user interface 216, through a process of programming a medical device 102 such that the controller 200 of the medical device 102 implements an adjustment over time of a flow rate of the pump 202. Templates 222 as described herein may be pre-programmed pump instructions which may be adjusted automatically based on data such as an initial flow rate, a target flow rate, and a time period, as well as manually through edits made by a user via the user interface 216. Instructions 224 may include instructions for the processor 212 as well as pump instructions for the controller 200 of a medical device 102.

[0089] The communication interface 214 of the programmer 106 may be configured to receive information from and transmit information to a medical device 106, optional external sensors, and / or another programmer 106 as described herein. The communication interface 214 may be used for transmitting data, such as pump instructions, to the medical device 102, a database 226, and / or a network 228. The communication interface 214 may comprise one or more wired interfaces (e.g., a USB port, an Ethernet port, a Firewire port) and / or one or more wireless transceivers or interfaces (configured, for example, to transmit and / or receive information via one or more wireless communication protocols such as 802.55a / b / g / n, Bluetooth, NFC, ZigBee, and so forth).

[0090] The programmer 106 may also comprise one or more user interfaces 216. The user interface 216 may be or comprise a keyboard, mouse, trackball, monitor, television, screen, touchscreen, and / or any other device for receiving information from a user and / or for providing information to a user. The user interface 216 may be used, for example, to receive a user selection or other user input regarding any step of any method described herein. Notwithstanding the foregoing, any required input for any step of any method described herein may be generated automatically by the programmer 106 (e.g., by the processor 212 or another component of the programmer 106) or received by the programmer 106 from a source external to the programmer 106. In some implementations, the user interface 216 may be useful to allow a medical professional or other user to modify pump instructions to be executed by the controller 200 of a medical device 102 according to one or more embodiments of the present disclosure, and / or to modify or adjust a setting of other information displayed on the user interface 216 or corresponding thereto.

[0091] Although the user interface 216 is shown as part of the programmer 106, in some implementations, the programmer 106 may utilize a user interface 216 that is housed separately from one or more remaining components of the programmer 106. In some implementations, the user interface 216 may be located proximate one or more other components of the programmer 106, while in other implementations, the user interface 216 may be located remotely from one or more other components of the programmer 106.

[0092] The database 226 may store information about a patient, pump instructions, and / or information about desired medication dosages. The database 226 may be configured to provide any such information to the programmer 106 or to any other device or external to the programmer 106, whether directly or via the network 228.

[0093] The network 228 may be or represent the Internet or any other wide area network. The programmer 106 may be connected to the network 228 via the communication interface 214, using a wired connection, a wireless connection, or both. In some implementations, the programmer 106 may communicate with the database 226 and / or an external device (e.g., a medical device 102) via the network 228.

[0094] The system illustrated in Fig. 2 or similar systems may be used, for example, to carry out one or more aspects of the methods described herein. The system or similar systems may also be used for other purposes.

[0095] As illustrated in Figs. 3-7, a programmer 106 may display a series of user interfaces guiding a user, such as a clinician or provider, through a process of programming pump instructions to be performed by a medical device 102.

[0096] The process of programming pump instructions to be performed by a medical device 102 may begin with the programmer 106 connecting to the medical device 102. The connection of the programmer 106 to the medical device 102 may occur wirelessly and in some implementations via a secure module to prevent unauthorized programming of the medical device 102. In some implementations, the medical device 102 may be required to be programmed in-person, but it should be appreciated the systems and methods described herein may not require an in-person programming. Also, in some implementations, the medical device 102 may not be required to be present for the programming and may not be required to be in communication with the programmer 106 prior to or during the programming of the pump instructions. For example, pump instructions may be created without involvement of the medical device 102 and may be later sent to the medical device 102.

[0097] Upon connecting to a medical device 102, or upon a user of the programmer 106 initiating the programming process, a software application may begin to be executed by the processor 212 of the programmer 106.

[0098] As illustrated in Fig. 3, a GUI may be displayed on a programmer 106. The GUI may include a number of selectable GUI buttons and may enable a user to select from a variety of options for programming a medical device 102. Such options may include, for example, a wean-down template workflow, an up-titration template workflow, a manual equation workflow, a manual steps workflow, and a multiple pump synchronization workflow.

[0099] Upon selecting a wean-down template workflow, a user may be guided through a process of setting up pump instructions which may be used by a controller 200 of a medical device 102 to control a pump 202 to perform an automatic wean-down. A wean-down as described herein may be a gradual decrease in a flow rate of a medication applied by a pump of a medical device 102. An automatic wean-down template may be loaded or generated by the programmer 106 in response to a selection of a wean-down template workflow. The process of generating a template is described in greater detail below.

[0100] Upon selecting an up-titration template workflow, a user may be guided through a process of setting up pump instructions which may be used by a controller 200 of a medical device 102 to control a pump 202 to perform an automatic up-titration. An up-titration as described herein may be a gradual increase in a flow rate of a medication applied by a pump of a medical device 102. An automatic up-titration template may be loaded or generated by the programmer 106 in response to a selection of an automatic up-titration template workflow. The process of generating a template is described in greater detail below.

[0101] Upon selecting a manual equation workflow, a user may be guided through a process of setting up pump instructions which may be used by a controller 200 of a medical device 102 to control a pump 202 to adjust a flow rate over time based on an equation. The equation may increase and / or decrease the flow rate over time. The user may be enabled to select or input a specific equation to be tracked by the pump 202. In some implementations, as described in greater detail below, the equation may be automatically completed and / or suggested to the user and may be editable by the user.

[0102] Upon selecting a manual steps workflow, a user may be guided through a process of setting up pump instructions which may be used by a controller 200 of a medical device 102 to control a pump 202 to adjust a flow rate over time based on specific steps. The user may be enabled to select a number of steps and, for each step, select a flow rate and a duration. In some implementations, asdescribed in greater detail below, the steps may be automatically completed and may be editable by the user.

[0103] Upon selecting a multiple pump synchronization workflow, a user may be guided through a process of setting up pump instructions for two or more medical devices 102 which may be used by a respective controller 200 of each of the medical devices 102 to control a respective pump 202 to perform an automatic wean-down or up-titration. The multiple pump synchronization workflow is described in greater detail below and may be useful, for example, for scenarios in which a patient is switching from one pump to another.

[0104] After selecting a workflow, the user may select continue and be guided through the remainder of the process of creating pump instructions. Fig. 4 illustrates a GUI which may enable a user to input an initial flow rate, a target flow rate, and a time period for implementing the change. The initial flow rate may be a dosage or rate of flow at which the pump should begin when executing the pump instructions. The initial flow rate may be manually input by the user, may be automatically acquired by the programmer 106, such as by communicating with the medical device 102 to determine a current or recent flow rate, or may be other automatically determined.

[0105] Similarly, the target flow rate may be manually input by the user, may be automatically determined by the programmer 106, such as by determining a minimum required flow rate based on the type of medical device 102, or may be other automatically determined.

[0106] The input time period may be manually input by the user, may be automatically determined by the programmer 106, such as by determining a minimum or suggested amount of time for making the change in flow rates between the input initial flow rate and the input target flow rate, or may be other automatically determined.

[0107] As illustrated in Fig. 5, a GUI may enable a user to input or select from one or more equations. For example, the change from the initial flow rate to the target flow rate may occur based on a formula or equation, such as an exponential decay equation.

[0108] In some implementations, instead of manually entering an entire equation, a user may be enabled to select or input parameters to describe the rate at which the medication application may decay over time. For example, the user may input an initial flow rate, a target flow rate, a daily reduction rate, a number of days the change should take place over, and / or other information. Using an equation may enable a finer level of control, updating every minute for example.

[0109] In some implementations, a tapering formula may be used to methodically adjust the medication flow rate up or down over a predetermined time period. As an example, this approach may be encapsulated in an equation such as Fn= Fo * (1 -r)n, where Fnrepresents the flow rate on thenth day, Fo represents the initial flow rate, r is the daily change in rate expressed as a fraction, and n is the number of days into the change process. The rate r may be determined based on clinical factors including the initial flow rate, duration of therapy, patient's physiological response, and potential withdrawal symptoms. An example approach may involve a reduction rate of 10% to 25% per week, allowing for a gradual decrease in medication concentration and mitigating withdrawal effects.

[0110] As illustrated in Fig. 6, a GUI may enable a user to input or select a number of steps. Each step may include a flow rate and a duration. The user may be enabled to edit the step count, by adding or removing steps. In some implementations, the steps may be automatically completed using one or more templates. For example, the programmer 106 may be enabled to make recommendations based on patient history / current drugs, such as by collecting information from the medical device 102 to determine current settings of the medical device 102.

[0111] In some implementations, a baseline assessment may be conducted to determine a current or initial effective dosage. Following this, a first phase may involve a series of steps implementing a reduction (e.g., 10-20% of the initial effective), implemented over a period of one week. Subsequent phases may involve similar incremental steps. Each phase may span, for example, a duration of 7-10 days, and may include any number of steps. A final step may involve a minimal flow rate, e.g., as low as 5-10% of the initial flow rate, administered for a duration until the patient shows no adverse effects or signs of withdrawal. While this description describes a wean-down, it should be appreciated the change may be an up-titration or any other change depending on needs of the patient.

[0112] In some implementations, the steps or equations GUI may begin with a template. The template may be generated by the programmer 106 or may be loaded into memory of the programmer 106 from another source. A template may enable a user to begin programming pump instructions with a pattern which can be edited. The user may be enabled to accept, adjust, or configure the steps or equation of the template. A user may also be enabled to create their own template.

[0113] A template may include a series of pre-programmed steps or a pre-programmed equation. The pre-programmed steps or equation may be based on an initial flow rate, a target flow rate, and / or a time period over which the changes should occur.

[0114] For example, a template may include multiple steps, and each step is associated with a respective flow rate and duration. A template may appear in memory as a table of slots. Each slot may be a step or a group of steps. Each slot or step may run for a period of time and may be repeated. In this way, a pattern of steps may be executed. A template may include, for example,twenty or more steps. The steps of the template may in some implementations approximate a curve desirable for a particular treatment. The changes in flow rates can occur at any time of day or night and at any increment of flow rate, great or small. At the end of the template, a final step may call for a continuous flow rate or a pattern that may run over and over until the patient returns to refill the reservoir or have the medical device 102 removed.

[0115] The template may be displayed to the user, such as a clinician. The user may be enabled to click any step and edit the steps as needed. For example, the programmer 106 may receive an edit to one or more steps of the template from the user and may update the instructions accordingly.

[0116] Once a user has input the instructions for the pump, whether by following a template or manually entering steps or an equation, the programmer 106 may finalize the instructions and display a visualization of the change in flow rate overtime such as in a graph as illustrated in Fig. 7. While a graph is shown in the figure, other implementations may include showing a list of steps, flow rates at various times, and other information such as an expected date for refill.

[0117] The visualization of the pump instructions may include a zoomed out pattern of the tailoring down or other change in flow rates of the medication, whether over days or weeks. In some implementations, the visualization may show a side-by-side screen or overly to show the difference between previous instructions and the pump instructions being created. This enables users, such as physicians, providers, clinicians, and patients alike to see the doses and times of changes. The visualization may be used to provide a summary to the patient and indicate to the patient as to whether can ask for an increase in dosage at various times if necessary. The visualization also enables a user such as a provider to check the created pump instructions for errors, such as too big of a step which may be dangerous and evidence of a mistake, or to flag errors to users.

[0118] As illustrated in Fig. 8, the process of creating pump instructions may be performed by a programmer 106 through a method 800. This method 800 may be performed before or during an appointment with a patient for whom the pump instructions may be used.

[0119] At 804, an initial flow rate of a medication may be determined. The initial flow rate may be determined based on a manual input from a user, may be determined by communicating with a medical device 102 to determine a recent or current flow rate, or may be otherwise determined.

[0120] At 808, a target, or final, flow rate of the medication may be determined. The target flow rate may be determined based on a manual input from a user, may be determined by communicating with a database 226, or may be otherwise determined. In some implementations, the final rate may be a specific rate which is low enough to be non-therapeutic while being high enough to avoid the pump 202 of the medical device 102 stopping or to avoid other issues with the medical device 102.For example, the target flow rate may be medical device 102-specific and may be set based on the type of medical device 102 being used.

[0121] Depending on the settings, the initial rate may be higher than the target rate, and the pump instructions cause the pump to perform a down-titration or a weaning-off of the medication. On the other hand, the initial flow rate may be lower than the target flow rate. In such a scenario, the pump instructions may cause the pump 202 to perform an up-titration.

[0122] While not illustrated in the flowchart of Fig. 8, the method 800 may further involve receiving additional information such as an equation or formula for the change in flow rate to track, a number of days or other time period over which the change should occur, specific steps which should guide the pump instructions, or other information as may be useful in generating the pump instructions.

[0123] At 812, the programmer 106 may generate pump instructions based on the initial flow rate and the target flow rate for a controller to control a pump to administer the medication from the initial flow rate to the target flow rate over time. In some implementations, generating the pump instructions may involve generating an exponential decay equation to guide the pump from the initial flow rate to the target flow rate over a safe amount of time. In some implementations, generating the pump instructions may involve generating a number of steps to reach the target flow rate from the initial flow rate, such as a 5% reduction over 20 steps. Generating the pump instructions may be performed automatically, such as based on the initial flow rate, the target flow rate, and the amount of time over which the change should occur.

[0124] In some implementations, generating the pump instructions may include performing an automatic check of the pump instructions for errors. For example, certain rules or guidelines may regulate a maximum rate of change over a particular amount of time. If the pump instructions violate such rules or guidelines, the programmer 106 may be enabled to automatically alert the user and suggest edits to the instructions to resolve the violations.

[0125] As described above, the programmer 106 may, upon generating pump instructions, generate a visualization describing the pump instructions. In some implementations, the programmer 106 may also generate a report describing the pump instructions and display the report on a graphical user interface.

[0126] Such a report may provide a graphical and / or numerical visualization of the pump instructions. A report may include, for example, a table of any steps or a list of dates, times, and dosages which may help both a clinician as well as a patient understand the changes in dosages over time. The report may show the initial dosage or flow rate, followed by the different flow rates ordosages and the times of each changes, followed by the end or target flow rate. The visualizations and / or reports of the pump instructions may enable a clinician to review the scheduled changes and to provide confirmation to the programmer 106 of the scheduling.

[0127] The programmer 106 may also be enabled to determine a predicted date of refill based on the pump instructions. Determining a predicted date of refill may involve determining a current or maximum volume of a medication supply 206 of the medical device 102 for which the pump instructions will be applied. Determining the predicted date of refill may also involve determining an estimated decrease in the contents of the medication supply 206 during application of the pump instructions. Determining the estimated decrease in the contents of the medication supply 206 during application of the pump instructions may involve calculating an area under the curve for an equation used to create the pump instructions.

[0128] Along with determining the predicted date of refill, the programmer 106 may be configured to prompt a user to schedule an appointment for a refill of the medication supply 206. For example, a GUI menu may display through which a user may be enabled to select a date and time for an appointment for the medication supply 206 to be refilled.

[0129] A medical device 102 may be configured with one or more thresholds for triggering a low reservoir alarm. The medical device 102 may provide notifications to the user of the medical device 102. For example, the medical device 102 may play an alarm when the medication supply 206 reaches a threshold to avoid an under-dose or the medication running out. By determining the predicted date of refill and scheduling an appointment at an adequate time, the user of the medical device 102 can be relieved of the stress and uncertainty of relying on the low reservoir alarm.

[0130] In some implementations, pump instructions may include one or more steps or equations which may be triggered automatically when a certain time or volume is reached. For example, to allow for a safer, more gradual wean off in the event that a low reservoir threshold is reached, the pump instructions may involve determining a low reservoir threshold has been met and switching to a reduced therapy until a refill of the medication supply 206 is performed.

[0131] Once the pump instructions are generated and approved by the user, the pump instructions may be transmitted by the programmer 106 to the medical device 102 at 816. Transmitting the pump instructions to the medical device 102 may involve using the processor 212 to cause instructions 224 stored in memory 218 to transmit from the communication interface 214 of the programmer 106 to a communication interface 210 of the medical device 102. The controller 200 of the medical device 102 may receive and interpret the pump instructions and cause the pump 202 to perform pumping from the medication supply 206 based on the pump instructions.

[0132] The first pump instructions may cause the pump 202 to administer the medication at gradually reducing or increasing flow rates. For example, the pump instructions may cause the pump 202 to administer the medication by following an exponential decay equation from an initial flow rate to a target flow rate at a specific schedule based on the equation.

[0133] The pump may administer the medication to a patient 100 via an implantable catheter 104 into a flow of CSF of the patient 100. The medication may be administered into an implantable port on the patient 100. By administering the medication, the pump 202 may perform intrathecal analgesia in some implementations. Through a method 800 as described herein, the pump instructions may cause the pump 202 to wean a patient 100 off of an opioid or other drug, though it should be appreciated other uses are possible and contemplated.

[0134] As referenced above, the systems and methods described herein may be used to synchronize multiple pumps. For example, the method 800 may be used to generate first pump instructions to reduce a flow rate of a first pump and second pump instructions to increase a flow rate of a second pump. This may be accomplished by determining an initial flow rate for each pump, determining a target flow rate for each pump, and generating separate pump instructions for each pump. For example, based on a first initial flow rate and a first target flow rate, the programmer 106 may generate first pump instructions for a first medical device 106 and based on a second initial flow rate and a second target flow rate, the programmer 106 may generate second pump instructions for a second medical device 106. This may occur simultaneously by guiding the user through the process of creating pump instructions for each medical device 106.

[0135] After the first and second pump instructions are created, the first pump instructions may be transmitted to the first medical device 106 and the second pump instructions may be transmitted to the second medical device 106. A first controller 200 may control a first pump 202 of the first medical device 102 to administer a first medication from the first initial flow rate to the first target flow rate over time in parallel with a second controller 200 controlling a second pump 202 of the second medical device 102 to administer the second medication from the second initial flow rate to the second target flow rate over time.

[0136] The present disclosure encompasses embodiments of the method 800 that comprise more or fewer steps than those described above, and / or one or more steps that are different than the steps described above. For example, the method 800 may not include the step 816. The present disclosure also encompasses embodiments of the method 800 wherein the steps are performed in any order. For example, the step 808 may occur prior to the step 804.

[0137] As noted above, the present disclosure encompasses methods with fewer than all of the steps identified in Fig. 8 (and the corresponding description of the method 800), as well as methods that include additional steps beyond those identified in Fig. 8 (and the corresponding description of the method 800). The present disclosure also encompasses methods that comprise one or more steps from one method described herein, and one or more steps from another method described herein.

[0138] The foregoing is not intended to limit the disclosure to the form or forms disclosed herein. In the foregoing Detailed Description, for example, various features of the disclosure are grouped together in one or more aspects, embodiments, and / or configurations for the purpose of streamlining the disclosure. The features of the aspects, embodiments, and / or configurations of the disclosure may be combined in alternate aspects, embodiments, and / or configurations other than those discussed above. This method of disclosure is not to be interpreted as reflecting an intention that the claims require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive aspects he in less than all features of a single foregoing disclosed aspect, embodiment, and / or configuration. Thus, the following claims are hereby incorporated into this Detailed Description, with each claim standing on its own as a separate preferred embodiment of the disclosure.

[0139] Moreover, though the foregoing has included description of one or more aspects, embodiments, and / or configurations and certain variations and modifications, other variations, combinations, and modifications are within the scope of the disclosure, e.g., as may be within the skill and knowledge of those in the art, after understanding the present disclosure. It is intended to obtain rights which include alternative aspects, embodiments, and / or configurations to the extent permitted, including alternate, interchangeable and / or equivalent structures, functions, ranges or steps to those claimed, whether or not such alternate, interchangeable and / or equivalent structures, functions, ranges or steps are disclosed herein, and without intending to publicly dedicate any patentable subject matter.

[0140] Aspects of this disclosure may be further described by reference to the following examples:

[0141] Example 1. A system comprising: one or more processors; and one or more processor- readable media storing instructions which, when executed by the one or more processors, cause performance of: determining a first initial flow rate of a first medication; determining a first target flow rate of the first medication; and generating pump instructions based on the first initial flow rate and the first target flow rate, wherein the pump instructions include a series of steps or track an equation, wherein the pump instructions cause a first controller to control a first pump to administer the first medication from the first initial flow rate to the first target flow rate over time.

[0142] Example 2. The system of example 1, wherein the instructions further cause performance of displaying a user interface, wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

[0143] Example 3. The system of any one or more of examples 1 and 2, wherein the instructions further cause performance of generating a template.

[0144] Example 4. The system of any one or more of examples 1-3, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

[0145] Example 5. The system of any one or more of examples 1-4, wherein the instructions further cause performance of receiving an edit to one or more steps of the template.

[0146] Example 6. The system of any one or more of examples 1-5, wherein the instructions further cause performance of generating an exponential decay equation, wherein the pump instructions control the pump to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

[0147] Example 7. The system of any one or more of examples 1-6, wherein the instructions further cause performance of determining a predicted date of refill based on the pump instructions.

[0148] Example 8. The system of any one or more of examples 1-7, wherein the instructions further cause performance of prompting a user to schedule an appointment for a refill.

[0149] Example 9. The system of any one or more of examples 1-8, wherein the instructions further cause performance of generating a visualization of the pump instructions.

[0150] Example 10. The system of any one or more of examples 1-9, wherein the instructions further cause performance of checking the pump instructions for errors.

[0151] Example 11. The system of any one or more of examples 1-10, wherein the initial rate is lower than the target rate, and the pump instructions cause the pump to perform an up-titration.

[0152] Example 12. The system of any one or more of examples 1-11, wherein the initial rate is higher than the target rate, and the pump instructions cause the pump to wean a patient off the first medication.

[0153] Example 13. The system of any one or more of examples 1-12, wherein the pump instructions cause the pump to administer the medication at gradually reducing flow rates.

[0154] Example 14. The system of any one or more of examples 1-13, wherein the instructions further cause performance of: determining a second initial flow rate of a second medication; determining a second target flow rate of the second medication; and based on the second initial flow rate and the second target flow rate, generating second pump instructions for a second controller to control a second pump to administer the second medication from the second initial flow rate to thesecond target flow rate over time in parallel with controlling the first pump to administer the first medication from the first current flow rate to the first target flow rate.

[0155] 15. A method comprising: determining a first initial flow rate of a first medication; determining a first target flow rate of the first medication; and generating pump instructions based on the first initial flow rate and the first target flow rate, wherein the pump instructions include a series of steps or track an equation, wherein the pump instructions cause a first controller to control a first pump to administer the first medication from the first initial flow rate to the first target flow rate over time.

[0156] Example 16. The method of example 15, further comprising displaying a user interface, wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

[0157] Example 17. The method of any one or more of examples 15 and 16, further comprising generating a template.

[0158] Example 18. The method of any one or more of examples 15-17, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

[0159] Example 19. The method of any one or more of examples 15-18, further comprising receiving an edit to one or more steps of the template.

[0160] Example 20. The method of any one or more of examples 15-19, further comprising generating an exponential decay equation, wherein the pump instructions control the pump to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

[0161] Example 21. The method of any one or more of examples 15-20, further comprising determining a predicted date of refill based on the pump instructions.

[0162] Example 22. The method of any one or more of examples 15-21, further comprising prompting a user to schedule an appointment for a refill.

[0163] Example 23. The method of any one or more of examples 15-22, further comprising generating a visualization of the pump instructions.

[0164] Example 24. The method of any one or more of examples 15-23, further comprising checking the pump instructions for errors.

[0165] Example 25. The method of any one or more of examples 15-24, wherein the initial rate is lower than the target rate, and the pump instructions cause the pump to perform an up-titration.

[0166] Example 26. The method of any one or more of examples 15-25, wherein the initial rate is higher than the target rate, and the pump instructions cause the pump to wean a patient off the first medication.

[0167] Example 27. The method of any one or more of claims 15-26, wherein the pump instructions cause the pump to administer the medication at gradually reducing flow rates.

[0168] Example 28. The method of any one or more of examples 15-27, further comprising: determining a second initial flow rate of a second medication; determining a second target flow rate of the second medication; and generating second pump instructions based on the second initial flow rate and the second target flow rate for a second controller to control a second pump to administer the second medication from the second initial flow rate to the second target flow rate over time in parallel with controlling the first pump to administer the first medication from the first current flow rate to the first target flow rate.

[0169] Example 29. A clinician device comprising: one or more processors; and one or more processor-readable media storing instructions which, when executed by the one or more processors, cause performance of: determining a first initial flow rate of a first medication; determining a first target flow rate of the first medication; and generating pump instructions based on the first initial flow rate and the first target flow rate, wherein the pump instructions include a series of steps or track an equation, wherein the pump instructions cause a first controller to control a first pump to administer the first medication from the first initial flow rate to the first target flow rate over time.

[0170] Example 30. The clinician device of example 29, wherein the instructions further cause performance of displaying a user interface, wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

[0171] Example 31. The clinician device of any one or more of examples 29 and 30, wherein the instructions further cause performance of generating a template.

[0172] Example 32. The clinician device of any one or more of examples 29-31, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

[0173] Example 33. The clinician device of any one or more of examples 29-32, wherein the instructions further cause performance of receiving an edit to one or more steps of the template.

[0174] Example 34. The clinician device of any one or more of examples 29-33, wherein the instructions further cause performance of generating an exponential decay equation, wherein the pump instructions control the pump to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

[0175] Example 35. The clinician device of any one or more of examples 29-34, wherein the instructions further cause performance of determining a predicted date of refill based on the pump instructions.

[0176] Example 36. The clinician device of any one or more of examples 29-35, wherein the instructions further cause performance of prompting a user to schedule an appointment for a refill.

[0177] Example 37. The clinician device of any one or more of examples 29-36, wherein the instructions further cause performance of generating a visualization of the pump instructions.

[0178] Example 38. The clinician device of any one or more of examples 29-37, wherein the instructions further cause performance of checking the pump instructions for errors.

[0179] Example 39. The clinician device of any one or more of examples 29-38, wherein the initial rate is lower than the target rate, and the pump instructions cause the pump to perform an up- titration.

[0180] Example 40. The clinician device of any one or more of examples 29-39, wherein the initial rate is higher than the target rate, and the pump instructions cause the pump to wean a patient off the first medication.

[0181] Example 41. The clinician device of any one or more of examples 29-40, wherein the pump instructions cause the pump to administer the medication at gradually reducing flow rates.

[0182] Example 42. The clinician device of any one or more of examples 29-41, wherein the instructions further cause performance of: determining a second initial flow rate of a second medication; determining a second target flow rate of the second medication; and based on the second initial flow rate and the second target flow rate, generating second pump instructions for a second controller to control a second pump to administer the second medication from the second initial flow rate to the second target flow rate over time in parallel with controlling the first pump to administer the first medication from the first current flow rate to the first target flow rate.

Claims

CLAIMSWhat is claimed is:

1. A system (106) comprising: one or more processors (212); and one or more processor-readable media (218) storing instructions which, when executed by the one or more processors, cause performance of: determining a first initial flow rate of a first medication (206); determining a first target flow rate of the first medication (206); and generating pump instructions (224) based on the first initial flow rate and the first target flow rate, wherein the pump instructions (224) include a series of steps or track an equation, wherein the pump instructions cause a first controller (200) to control a first pump (202) to administer the first medication (206) from the first initial flow rate to the first target flow rate over time.

2. The system of claim 1, wherein the instructions further cause performance of displaying a user interface (216), wherein determining the first target flow rate of the first medication comprises receiving instructions from a user.

3. The system of any one or more of claims 1 and 2, wherein the instructions further cause performance of generating a template (222).

4. The system of any one or more of claims 1-3, wherein the template includes a plurality of steps, wherein each step is associated with a respective flow rate and duration.

5. The system of any one or more of claims 1-4, wherein the instructions further cause performance of receiving an edit to one or more steps of the template (222).

6. The system of any one or more of claims 1-5, wherein the instructions further cause performance of generating an exponential decay equation, wherein the pump instructions (224) control the pump (202) to administer the medication by following the exponential decay equation from the initial flow rate to the target flow rate.

7. The system of any one or more of claims 1-6, wherein the instructions further cause performance of determining a predicted date of refill based on the pump instructions (224).

8. The system of any one or more of claims 1-7, wherein the instructions further cause performance of prompting a user to schedule an appointment for a refill.

9. The system of any one or more of claims 1-8, wherein the instructions further cause performance of generating a visualization of the pump instructions (224).

10. The system of any one or more of claims 1-9, wherein the instructions further cause performance of checking the pump instructions (224) for errors.

11. The system of any one or more of claims 1-10, wherein the initial rate is lower than the target rate, and the pump instructions (224) cause the pump (202) to perform an up-titration.

12. The system of any one or more of claims 1-11, wherein the initial rate is higher than the target rate, and the pump instructions (224) cause the pump (202) to wean a patient (100) off the first medication (206).

13. The system of any one or more of claims 1-12, wherein the pump instructions (224) cause the pump (202) to administer the medication (206) at gradually reducing flow rates.

14. A method (800) comprising: determining a first initial flow rate of a first medication (206); determining a first target flow rate of the first medication (206); and generating pump instructions (224) based on the first initial flow rate and the first target flow rate, wherein the pump instructions (224) include a series of steps or track an equation, wherein the pump instructions (224) cause a first controller (200) to control a first pump (202) to administer the first medication (206) from the first initial flow rate to the first target flow rate over time.

15. A clinician device (106) comprising: one or more processors (212); and one or more processor-readable media (218) storing instructions which, when executed by the one or more processors, cause performance of: determining a first initial flow rate of a first medication (206); determining a first target flow rate of the first medication (206); andgenerating pump instructions (224) based on the first initial flow rate and the first target flow rate, wherein the pump instructions (224) include a series of steps or track an equation, wherein the pump instructions (224) cause a first controller (200) to control a first pump (202) to administer the first medication (206) from the first initial flow rate to the first target flow rate over time.

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