A medical cabinet

Abstract

The invention relates to controlling patient access to medicines which makes use of a secure medical cabinet comprising a first compartment for securely containing the Patient's Own Drugs (PODs) of the patient and a second compartment for securely containing further medicines. The secure medical cabinet further comprises a computer programmed to provide a reminder to the patient at each reminder time, wherein upon receipt of the reminder, the patient scans a wristband bearing a unique patient code using a code reader. The reading of the unique patient code by the code reader serves to initiate unlocking of the door to the first compartment, but not the second compartment, thereby giving the patient access to a POD. The invention also provides a method of assessing the ability of a patient to comply with a self-administration drug treatment regime by logging the number of times the first locker is unlocked by the scanning of the patient's wristband, and comparing the said number with the number of reminders sent to the patient.

Description

[0001] A MEDICAL CABINET

[0002] This invention relates to a secure medical cabinet, primarily for use in hospitals, where a patient may gain access to a locked compartment containing PODs by use of a wristband bearing a unique patient code in the form of a barcode or like code device.

[0003] Background of the Invention

[0004] Many patients entering hospital will already be taking prescribed medicines on a long-term basis, and it is important that administration of such medicines should continue while the patient is in hospital as well as the administration of any additional medicines that the hospital may deem necessary.

[0005] Self-administration of medicines (known as ‘SAM’) is a support system used on patient wards to help the patient to maintain their independence with their medicine taking and to improve the patient’s knowledge about the medicines they have been prescribed. This may help the patient manage medicines once they get home. If the patient self-administers in hospital, it gives the patient the opportunity to take their own medicines either independently or under supervision. To do this, the nurse and pharmacist will give the patient as much information, help and supervision as required.

[0006] The benefits of self-administration include supporting patients to maintain independence with their medicine-taking, helping the patient understand the purpose of their medicines, helping the patient understand how to take their medicines safely and helping the patient understand more about their condition and general health.

[0007] Prescription medicines that patients are already taking when entering hospital are generally referred to as Patients’ Own Drugs, commonly abbreviated to PODs, and hospitals typically have in place strict procedures for checking PODs when a patient enters hospital. Thus, PODs will be inspected on admission to hospital and any PODs considered unsuitable for use (for example because they have gone past their expiry date or are otherwise considered to be potentially hazardous) will be withheld from the patient and may be destroyed. Where PODs have been checked and approved for use, they may be self-administered by the patient, provided that the patient has been assessed as capable of self-administration, or they may be administered by a medically qualified member of staff. In the UK Nursing and Midwifery Council (2010) Standards for Medicines Management. (http: / / www.nmc-uk.org / Documents / NMC-Publications / NMC-Standards for-medicines- management.pdf) three levels of self-administration of medicines are described:

[0008] Level 1 - A registered nurse is responsible for the safe storage of the medicinal products and the supervision of the administration process ensuring the patient understands the medicinal product being administered.

[0009] Level 2 - A registered nurse is responsible for the safe storage of the medicinal products. At administration time, the patient will ask the registered nurse to open the cabinet or locker. The patient will then self-administer the medication under the supervision of the nurse.

[0010] Level 3 - The patient accepts full responsibility for the storage and administration of the medicinal products. The registered nurse checks the patient’s suitability and compliance verbally. The level of self-administration must be documented in the patient’s notes by the registered practitioner assessing the patient.

[0011] Self-medication is designed for patients who are expecting to be able to take their own medicines with little or no support in the home environment following discharge. Patients are selected from one of the following categories:

[0012] • Patient requests to self-medicate

[0013] • Patient is identified by a registered practitioner as being non-compliant due to, for example, a lack of understanding about their medicines and needs the opportunity to learn in a safe environment.

[0014] Before a patient takes part in a SAM programme, the patient will need to be risk assessed, and the SAM process and benefits discussed with the patient by the nursing and pharmacy support team to explain exactly what self-administration involves and what the possible benefits will be to the patient. If the patient agrees to take part, then, before starting, a nurse or a pharmacist will, where appropriate:

[0015] • Explain self-administration;

[0016] • Explain which medicines have been prescribed and why;

[0017] • Explain the dosage and how to take; and

[0018] • Explain any possible side effects Although patients may have practised self-medication for prolonged periods before entering hospital, the extent to which they have complied with a particular treatment regimen in many cases will not be known to the patient’s medical practitioners, or at best may be uncertain. The National Institute for Health and Clinical Excellence (2009) (National Institute for Health and Clinical Excellence (2009) NICE Clinical Guideline 76: Medicines Adherence. Involving patients in decisions about prescribed medicines and supporting adherence. http: / / www.nice.org.uk / nicemedia / pdf / CG76NICEGuideline.pdf) estimated that between 33% and 50% of medicines prescribed for long-term conditions may not be taken by patients as recommended.

[0019] Therefore, even when a patient entering hospital has been assessed as being capable of self-medication and has been classified as a Level 3 patient, it is by no means guaranteed that the patient will comply with their self-administration treatment regimen while in hospital. This may be a particular problem where the patient’s ability to adhere to a self-administration treatment regimen deteriorates while the patient is in hospital. Whereas it is possible for a member of the medical staff to impose compliance by supervising the self-administration of medicines, this will add considerably to the workload of the medical staff and ultimately will be of little help to the patient who must retake responsibility for self-medication once they are discharged from hospital.

[0020] Thus, a problem facing hospital staff is how to maintain and monitor patient compliance with their POD administration regimes while they are in hospital and to determine whether they are competent to follow a self-administration treatment regimen after they are discharged from hospital.

[0021] The dispensing of medicines in hospitals is frequently carried out from in-room medical cabinets containing drugs for use by the inhabitants of a room, or medical carts loaded up with medicines and wheeled around a hospital or other medical institution by a nurse or other authorised medical staff member. Various computerised systems linked to medical cabinets and medical carts have been proposed in order to improve control over the dispensing of medicines. Examples of such medical cabinets and carts are disclosed in US patent US 10,417,847 (S&S X-Ray Products, Inc.), US patent applications US 2014 / 0172158 (MV Circuit Designs) and US 2003 / 0120384 Haitin et al.), and International patent application WO 2017 / 083863 (Humanscale Corporation). In some cases, patient wristband barcode recognition is used as a means of unlocking a cabinet and ensuring that the correct medicines are administered to a patient. However, none of the above publications address the issue of the self-administration of patients own drugs (PODs), nor the problem of non- compliance associated with self-administration treatment regimens.

[0022] The Invention

[0023] Patients entering hospital, particularly patients entering hospitals as in-patients in UK hospitals, are routinely provided with wristbands carrying their names and optionally other important information. According to the present invention, the patient’s wristband is provided with an electronically readable unique code which can be read by a code reader (e.g. scanner) linked to a computer which is associated with the secure medical cabinet. The computer contains (or is connected to) a database containing details of the patient’s POD and is programmed to send reminders to the patient at defined times to prompt the patient to take one or more PODs. Upon receipt of the reminder, the patient can present the wristband to the scanner, whereupon the scanner reads the code on the wristband and an electronic signal is sent to a lock on a door of a compartment in the secure medical cabinet which contains the patient’s PODs to release the lock allowing the patient access to the PODs. Because the wristband code is unique to the patient, other patients or unauthorised persons cannot access the POD compartment. The reminders, and the patient’s actions (or lack thereof) in response to the reminders, are logged by the computer and provide a record of the patient's compliance with a self-administration treatment regimen while in hospital.

[0024] While in hospital, the patient will typically be provided with additional medicines by the hospital (for example pain medications, blood clot inhibitors, or chemotherapy drugs) and these are stored in a separate secure compartment in the medical cabinet to which the patient does not have access. The separate secure compartment containing hospital medicines is independently lockable and is provided with a lock (e.g. an electronic lock) which can be released by authorised hospital staff but not by the patient.

[0025] Accordingly, in a first aspect (Embodiment 1.1), the invention provides a method of controlling patient access to medicines, which method comprises:

[0026] (a) providing a patient with a wristband bearing a machine-readable unique patient code;

[0027] (b) providing the patient with an apparatus comprising a secure medical cabinet linked to a computer for controlling operation of the secure medical cabinet; wherein the secure medical cabinet comprises:

[0028] (b-i) a first compartment for securely containing the Patient’s Own Drugs (PODs) of the patient; (b-ii) a second compartment for securely containing further medicines; the first and second compartments having doors provided with independently operable locks; the lock of the door of the first compartment being electronically linked to a code reader linked to a computer, the code reader being capable of reading the unique patient code carried by the wristband worn by the patient; and the lock of the door of the second compartment being openable by an authorised person but not by the patient; and

[0029] (c) providing one or more authorised persons with access to the computer, wherein the one or more authorised persons:

[0030] (c-i) register the patient on the computer;

[0031] (c-ii) register one or more Patient’s Own Drugs (POD) of the patient by entering details of each POD into the computer;

[0032] (c-iii) set up one or more reminder times in the computer for administration of at least one POD; and

[0033] (c-iv) place the Patient’s Own Drugs into the first compartment and optionally further medicines into the second compartment; the computer being programmed to provide a reminder to the patient at each reminder time, wherein upon receipt of the reminder the patient scans the wristband bearing the unique patient code using the code reader, the reading of the unique patient code by the code reader serving to initiate unlocking of the door to the first compartment but not the second compartment, thereby giving the patient access to a POD.

[0034] Thus, after receiving a reminder, the patient is able, by presenting the wristband to the code reader, to unlock the first compartment containing the PODs but cannot gain access to the second compartment which contains the hospital medicines. Only authorised persons (e.g. authorised hospital staff) are able to gain access to the second compartment. In this way, a patient can continue to self-administer the PODs without needing the assistance of trained medical staff.

[0035] Step (a) may further comprise assessing the patient’s suitability for self-administration of Patient’s Own Drugs (PODs). In this case, the method comprises providing a patient who has been assessed and adjudged capable of following a self-administration treatment regimen with a wristband bearing a machine-readable unique patient code, as described herein. The locks, which may also be referred to herein as electronic latches, are electronic locks and typically use magnets, solenoids or motors or combinations thereof to move the latching elements of the locks. Such electronic locks are well known and are widely commercially available.

[0036] The unique patient code carried by the patient’s wristband is typically a barcode and may be a 1-dimensional (e.g. linear) barcode or 2-dimensional (2D) barcode, such as a QR code.

[0037] In one embodiment, the unique patient code takes the form of a 1-dimensional linear barcode.

[0038] In another embodiment, the unique patient code takes the form of a 2D barcode.

[0039] As an alternative to a barcode, the unique patient code can take the form of a printed RF-ID tag or a near-field communication (NFC) tag or card.

[0040] In addition to requiring authentication by scanning of the patient’s wristband, one or more additional methods of authentication may be required before the first compartment is unlocked. For example, the patient may be required to input a PIN number or one or more personal details (such as a date or month of birth) before the first compartment will unlock.

[0041] The second compartment has a door which is provided with an independently operable lock which cannot be opened using the unique patient code on the patient’s wristband. The said lock may however be electronically linked to an ID device reader (which can be the same scanner as is used to scan the patient’s wristband, or a separate scanning device linked to the computer) which can read an ID device carried by an authorised person.

[0042] The secure medical cabinet of the invention is linked to a computer to which the code reader capable of reading the unique patient code and optionally any other ID device readers are operably linked.

[0043] The code reader is preferably capable of scanning codes (e.g. barcodes) present on the packaging of the patient’s PODs and thereby extracting information about the PODs which is then stored in the computer.

[0044] The computer is provided with a display screen and a data input mechanism. The display screen may be a touch screen and therefore data input can be by operation of virtual buttons or a virtual keyboard on the touch screen. Alternatively, a separate keyboard can be connected, by cable or wirelessly, to the computer to allow the input of data.

[0045] The computer is programmed to provide timed prompts or reminders to the patient to administer the PODs. The prompts or reminders can be audible, sensory or visual or any combination thereof.

[0046] Alternatively or additionally, the patient may be provided with an alerting device which is connected (typically wirelessly) to the computer and provides the prompts or reminders. The prompts or reminders can be sensory in nature and can take the form of vibrations of the alerting device.

[0047] The prompts or reminders to the patient, which are typically displayed on the computer’s display screen, will alert the patient to the time when the next dose of medicine is due to be taken but will preferably also alert the patient as to the identity of the medicine and the quantity of medicine (e.g. number of unit doses such as tablets or capsules) that need to be taken.

[0048] Optionally, to stop the alert, the patient may be required to scan the appropriate POD packing, so that it can be verified that the POD that the patient is administering corresponds to the one associated with the reminder. This allows the patient to confirm that they are selfadministering the correct POD, if there are multiple PODs contained within the first compartment.

[0049] The computer may be programmed so that the patient is only allowed to use the unique patient code on the wristband to open the first compartment to give access to the PODs at certain times. Alternatively, depending on the circumstances, there may be no such restrictions on the patient’s ability to unlock the first compartment.

[0050] The computer may be a stand-alone computer which is not connected to any other computers and does not form part of a network. More usually, however, the computer will form part of a network with access to a central database. Accordingly, steps (c-i) to (c-iv) above can be carried out by the authorised person interacting directly with the computer (e.g. performing the steps using a data input mechanism forming part of or associated with the secure medical cabinet). However, steps (c-i) to (c-iv) can instead or also be carried out using a computer remote from the secure medical cabinet, but which is in electronic / data communication (e.g. by virtue of the same network) with the computer at the secure medical cabinet. For example, the computer may be in data connection with:

[0051] • An electronic patient record, in order to input into the computer patient information from a scan of the wristband;

[0052] • An e-prescribing module used by the hospital, to input into the computer prescription information (e.g. drug, dose, interval);

[0053] • A drug database, to provide information regarding the PODs; and / or

[0054] • A staff directory (active directory), to provide information regarding the staff who are able to access the first and second compartments when presenting their ID card.

[0055] The computer may also be able to log information regarding the administration of medicines that are not or cannot be stored within the secure medical cabinet (e.g. controlled medicines or those that are required to be kept under refrigerated conditions). This enables a single complete record of the patient’s medications and administrations, even for medicines that are not necessarily stored within the secure medical cabinet.

[0056] In a further embodiment of the invention, the secure medical cabinet may comprise a third lockable compartment for containing personal items of the patient, such as money, jewellery, a mobile phone, computer tablet or books. The third lockable compartment may be provided with a lock which is also operably linked to the code reader for the unique patient code on the patient’s wristband, so that the patient can use the wristband to open the compartment. In this embodiment, the computer may be programmed so that the patient has unlimited access to the third compartment but access to the first compartment containing the PODs at only certain predetermined times. Alternatively, the computer may be programmed so that the patient has unlimited access to both the first and third compartments at all times. Optionally, the third compartment is only openable using the patient’s wristband and not by the ID device of the hospital staff member who is able to access the second and first compartments.

[0057] Thus, in further embodiments (Embodiments 1.2 to 1.10), the invention provides:

[0058] 1.2 A method according to Embodiment 1.1 wherein the patient is registered on the computer by a series of steps including scanning the patient’s wristband using the code reader. 1.3 A method according to Embodiment 1.1 or Embodiment 1.2 wherein step (c-ii), the registration of one or more Patient’s Own Drugs (POD) of the patient, comprises scanning a bar code on packaging containing the POD using a scanner (e.g. the code reader) linked to the computer.

[0059] 1.4 A method according to any one of Embodiments 1.1 to 1.3 wherein, following receipt of the reminder, the patient has a predefined time window in which to scan the wristband bearing the unique patient code using the code reader and unlock the door to the first compartment.

[0060] 1.5 A method according to Embodiment 1.4 wherein the time window is no more than 20 minutes, for example no more than 12 minutes.

[0061] 1.6 A method according to Embodiment 1.4 or Embodiment 1.5 wherein, once the predefined time window has expired, a warning is provided to the patient that the administration of the POD is overdue.

[0062] 1.7 A method according to Embodiment 1.6 wherein, once the time window has expired, the first compartment cannot be unlocked with the wristband without authorization by authorized medical personnel.

[0063] 1.8 A method according to any one of Embodiments 1.1 to1.7 wherein the unique patient code is defined by a barcode or printed RF-ID tag and the code reader is a barcode reader or RF-ID reader as appropriate.

[0064] 1.9 A method according to Embodiment 1.8 wherein the unique patient code is defined by a barcode.

[0065] 1.10 A method according to any one of Embodiments 1.1 to 1.9 wherein the second compartment has a door which is provided with a lock electronically linked to an ID device reader which can read by an ID device carried by an authorised person.

[0066] 1.11 A method according to any one of Embodiments 1.1 to 1.10 wherein the reminder is provided until the POD, for which the patient is being reminded to administer, is scanned by the code reader.

[0067] The apparatus comprising the secure medical cabinet and the computer programmed to perform the method as defined above represent further aspects of the invention. Accordingly, in another aspect (Embodiment 2.1), the invention provides an apparatus comprising a secure medical cabinet linked to a computer for controlling operation of the secure medical cabinet; wherein the secure medical cabinet comprises:

[0068] (b-i) a first compartment for securely containing Patient’s Own Drugs (PODs) of the patient; and

[0069] (b-ii) a second compartment for securely containing further medicines; the first and second compartments having doors provided with independently operable locks; the lock of the door of the first compartment being electronically linked to a code reader linked to the computer, the code reader being capable of reading the unique patient code carried by the wristband worn by the patient; and the lock of the door of the second compartment being openable by an authorised person but not by the patient; wherein the computer contains software enabling the performance of the methods of any one of Embodiments 1 .1 to 1.10.

[0070] In further embodiments (Embodiments 2.2 to 2.5), the invention provides:

[0071] 2.2 An apparatus according to Embodiment 2.1 wherein the reminders provided to the patient are displayed on a display screen of the computer.

[0072] 2.3 An apparatus according to Embodiment 2.1 or Embodiment 2.2 wherein the secure medical cabinet comprises a third lockable compartment for containing personal items of the patient and said third lockable compartment is operably linked to the code reader for the unique patient code on the patient’s wristband, so that the patient can use the wristband to open the compartment.

[0073] 2.4 A combination of a secure medical cabinet as defined in any one of Embodiments 2.1 to 2.3 and a wristband carrying the unique patient code.

[0074] 2.5 A combination according to Embodiment 2.4 wherein the unique patient code is defined by a barcode.

[0075] The methods and apparatus of the invention can be used to assess the suitability of a patient for a self-administration drug regime. Thus, by logging the sending of reminders to the patient and the opening of the first compartment by the patient to retrieve the PODs, the ability of a patient to comply with a self-administered treatment regime can be determined. Accordingly, in a further aspect (Embodiment 3.1), the invention provides a method of assessing the ability of a patient to comply with a self-administration drug treatment regime, which method comprises performing the method of any one of Embodiments 1.1 to 1.10, logging the number of times the first locker is unlocked by the scanning of the patient’s wristband, and comparing the said number with the number of reminders sent to the patient. The number of times the first locker is unlocked and the number of reminders sent to the patient may be measured over the course of a pre-determined period of time, for example, 1 day, 3 days, 7 days or 14 days. When the difference between these two values (over the pre-determined period of time) exceeds a predetermined threshold, it may be concluded that the patient is unable to comply with a self-administration drug treatment regime, whereas when below the threshold, it may be concluded that the patient is able to comply with a selfadministration drug treatment regime.

[0076] Information gathered during the performance of the methods of the invention enables an assessment to be made not only of the suitability of a patient for continued involvement in a self-administration treatment regimen during their stay in hospital but also their suitability for involvement in such a treatment regimen after they are discharged.

[0077] Brief Description of the Drawings

[0078] Figure 1 is an isometric view of a medical cabinet according to one embodiment of the invention.

[0079] Figure 2 is a side view from the left-hand side of the medical cabinet of Figure 1.

[0080] Figure 3 is a side view from the right-hand side of the medical cabinet of Figure 1.

[0081] Figure 4 is a front view of the medical cabinet of Figure 1.

[0082] Figure 5 is a view from above of the medical cabinet of Figure 1.

[0083] Figure 6 is a view from below of the medical cabinet of Figure 1.

[0084] Figure 7 is a larger-scale schematic view of a wristband bearing a bar code for use in conjunction with the medical cabinets of the invention.

[0085] Figures 8A to 8Y show computer screen displays of key steps in the setting up and use of the medical cabinets of the invention. Detailed Description of the Invention

[0086] The invention will now be illustrated, but not limited, by reference to the particular embodiment shown in the accompanying drawings Figures 1 to 8Y.

[0087] The medical cabinet (2) shown in Figures 1 to 6 has a pair of doors (4) and (6) secured by a suitable electronic latch and concealing secure first (right hand) and second (left hand) compartments. The electronic latches may be set up such that, in the event of a power failure, the latches remain in the locked position, thereby preventing the security provided by the cabinet being circumvented merely by turning off the power supply.

[0088] Beneath the doors (4) and (6) are a drawer (8), which may optionally be lockable, and a third lockable door (10) secured by an electronic latch.

[0089] The medical cabinet (2) is mounted on wheels or casters (12) to enable it to be moved around.

[0090] The medical cabinet has a flat worktop (14), at the rear of which is mounted a computer housing (16) containing a computer which has a touch screen (18). Set into the side of the computer housing (16) is a panel (20) containing an on-off switch and optionally various controls and / or ports. Recessed into the underside of the computer housing (16) is a scanner (22) for scanning barcodes and other machine-readable codes. The computer may be a stand-alone computer but more usually is linked to the hospital’s computer network.

[0091] The cabinet (2) is typically located next to a hospital bed and within easy reach of a patient. The computer is provided with a rechargeable battery but a socket for connecting to mains power may also be provided. The electronic locks for the lockable doors will also be provided with power from a battery and optionally also the mains connection.

[0092] Each patient is provided with a wristband (24) which serves as a unique identifier of the patient and carries a bar code (26) unique to the patient. Figure 7 is an enlarged schematic view of the wristband (24) and is of a larger scale than Figures 1 to 6. In addition to the bar code (26), the wristband (24) typically carries other information (not shown) such as the name of the patient.

[0093] The bar code (26) can be read by the bar code scanner (22) in the computer housing (16) and allows the patient, at an allocated time, to open the door (4) to the first compartment but not the door (6) to the other compartment. Only authorised hospital staff members are permitted to open the door (6) to the second compartment and they can do this by means of a separate electronically readable tag or card.

[0094] An on-off power switch (20) is provided on a side wall of the housing (6). The power is provided either by an AC power cable which is linked to a DC power supply unit (e.g. a 12 volt PSU), or by a DC power cable linked to an external power supply unit. The power cables (not shown) can be connected to a socket in the rear of the cabinet or in the panel (20).

[0095] When a patient is admitted on to a hospital ward, if the patient has any Patient Own Drugs (PODs), the bar codes on the packaging for the PODs are scanned and details of the medicines are thereby transferred on to the computer together with any dispensing details such as frequencies of administration and numbers of unit doses to be taken. By means of the information encoded on the bar code, supplemented where necessary by any additional information added manually by hospital staff using the touch screen (18), a timetable for administration of medicines is established within the computer, and a series of alerts is set up to notify the patient when it is necessary to take a medicine. The patient, having received an alert, can then present the wristband bar code (26) to the bar code reader (22) to activate the electronic latch and open the door (4) to the left-hand compartment (8) to give access to the PODs. The patient may also scan a bar code on the POD to stop the alert, thereby confirming that they are administering the medicine that the alert is reminding them to take (e.g. in the case where the patient has multiple PODs that they may be required to take at different times).

[0096] The patient is only allowed to access one of the two upper compartments (in this embodiment the first or right-hand compartment (4)). Authorised medical staff are also allowed to access this compartment. The other compartment (in this embodiment the second or left-hand compartment (10)) is only accessible by authorised medical staff on presentation of a suitable electronic tag to the scanner (22) or other scanning device in the cabinet. Where, as will usually be the case, the patient is being treated by a combination of PODs and hospital medicines, the hospital medicines will be held securely in the second compartment (the left-hand compartment (6)) to which the patient does not have access.

[0097] The manner in which the medical cabinet is set up for a particular patient and used by the patient will now be described with reference to Figures 8A to 8Y.

[0098] In order to set up the medical cabinet for a new patient, the computer is first “woken up” by an authorised user touching the screen and presenting their user ID-card to the scanner (22) to log on to the system. The authorised user is then presented with the screen display shown in Figure 8A. The user taps the user icon (28) and is then presented with the patient access control screen shown in Figure 8B.

[0099] The ‘PATIENT’ tab is then clicked on to enter the patient details and patient access. In this embodiment, there are three options for patient authentication to enable the first compartment to be unlocked, namely:

[0100] (a) Wristband only;

[0101] (b) Wristband + Pin (4 digits).

[0102] (c) Wristband + Pin + Month of Birth.

[0103] If the method of authentication for the patient in question is to be the wristband only, care must be taken to ensure that the ‘PINCODE’ & ‘MONTH OF BIRTH’ tick boxes are not ticked. If this option is selected, the ASSIGN button is clicked and the wristband is scanned in the scanner light (22) under the screen. Once the scan has been completed (Figure 8C), the “SAVE” button is highlighted in green and is clicked to save the scan. The user is then returned to the Patient access control screen where access options (b) or (c) may be selected. Clicking the “Pincode” box and the “Assign” button leads to the appearance of a number pad on the screen (see Figure 8E) by means of which a PIN code is selected, confirmed (by clicking a green “Confirm” button, and saved. The user can then optionally select the Month of Birth as a further authentication option as shown in Figure 8F. Clicking the blue “Assign” button leads to the appearance on the screen of a grid containing the months of the year. The appropriate month for the patient is then selected from the grid and the green “Confirm” button is pressed (Figure 8G).

[0104] Once the patient authentication method has been selected, the user returns to the main menu (e.g. as shown in Figure 8B, 8D or 8F) and clicks on the “Medication” tab. To add a medication, a blue “+” button in the bottom right-hand corner of the screen is clicked (see Figure 8M) and the screen shown in Figure 8H appears. Clicking on the “Name” window brings up the virtual keyboard shown in Figure 8I and allows the medication and size of the dosage unit to be inputted. The user then clicks on the “Set” button next to the barcode window and scans the barcode on the medication packaging using the scanner (22). The number of dosage units of the medication to be administered (two in the embodiment illustrated) is entered and the green highlighted “Save” button is clicked. The medications are placed in the secure first compartment (4). Once a medication has been selected, a reminder for that medication can be entered by clicking on the “Add Time” button (Figure 8J) to bring up the time-setting keypad (Figure 8K), selecting a desired reminder time, and clicking the green “Confirm” button. Further reminder times can be entered by clicking the “Add time” button and going through the time-setting procedure again as many times as desired. Unwanted or incorrect reminder times can be removed by clicking on the “bin” button next to each reminder time (see Figure 8L). Once the list of reminder times is complete and correct, the green “Save” button is clicked and the screen shown in Figure 8M appears. In this embodiment, only three reminder times can be seen at once. Further reminder times can be seen by using the scroller bar to the right of the times.

[0105] A further medication can be selected and entered by clicking on the “+” button in the bottom right-hand corner (see Figure 8M) and then repeating the sequence of steps set out above. Once all medications and reminder times have been entered, the user presses the “Home” button (house icon in the top left-hand corner of the screen) to return to the log-in screen (Figure 8A).

[0106] Hospital medications that are to be administered by medical staff rather than selfadministered by the patient can be stored in the left-hand compartment (second compartment) (6). Details of the medications, doses and administration times can be entered into the computer by clicking on the “Secure storage” button to bring up a blue “+” sign in the bottom right-hand corner (not shown in Figure 8A) and following a series of steps analogous to those described above in relation to the patient’s PODs. The cabinet is then ready for use by the patient.

[0107] In use, reminders are triggered at the preset times and a prominent reminder appears on the computer screen. In this embodiment, the reminder takes the form of a bright green lettered message reading “Medication reminder”. In addition, the “Patient medication” has a similarly prominent bright green colour (see Figure 8N). On seeing the reminder, the patient can click on the green “Patient medication” box, resulting in the appearance on the screen of an instruction to the patient to scan their wristband (see Figure 80). If a 4-digit PIN code and month of birth have also been set as further authentication steps, the patient will be prompted to complete these steps as well. Once the authentication is complete, the door to the first compartment is unlocked. The patient is presented with a screen on the computer (see Figure 8P) listing the medications to be taken and their scheduled times. If the patient clicks on a particular medication, a pop-up screen appears (see Figure 8Q) inviting the patient either to take or to skip the medication. The patient clicks the appropriate button and either takes or skips the medication. If more than one medication is listed, the patient clicks on each in turn and either takes or skips each medication. All of the above actions by the patient are logged and stored on the computer.

[0108] If the patient misses the reminder, the green “Medication reminder” message is replaced by a prominent red “Medication overdue” message and the “Patient medication” box changes colour from green to red (see Figure 8R). If the patient sees the warning, the (now red) “Patient medication” box can still be pressed, bringing up an invitation to scan the wristband (Figure 8S). Once the wristband has been scanned, the message “Awaiting verification” appears on the screen (see Figure 8T. At this point, because the medication is late, the unlocking of the first compartment will require authorisation by a medical staff member (typically by scanning their badge or other machine-readable token). Without this further authentication step, administration of the medication cannot proceed.

[0109] Once the authorised medical staff member has completed the authentication, a screen (see Figure 8U) listing the medications appears and, if the authorised medical staff member clicks on a given medication, the medication pending screen pops up (Figure 8V) inviting the patient to either take or skip the medication. The process is then repeated where necessary for any other medications listed.

[0110] In the event of an unauthorised attempt to access the POD in the first compartment (4), for example where the patient attempts to access the compartment before a reminder has been received, a visual warning appears on the screen in the form of a prominent red border around the start-up screen (see Figure 8W). An authorised user can log on to the computer and can obtain details of the error (Figure 8X). The system can then be reset.

[0111] Each of the actions taking place at the medical cabinet involving the computer are logged (see Figure Y), and thus a record is created of the patient’s compliance (or non-compliance) with the POD treatment regimen. The data gathered in this way can be used to inform a decision whether or not a patient should continue to follow a self-administration treatment regimen. The data also provide hospital staff to provide assistance and training to patients to improve their ability to self-administer medications before they are discharged from the hospital.

[0112] A benefit of the medical cabinet of the invention is that medicines, both the patient’s own drugs (PODs) and the drugs provided by the hospital can be kept securely. Only approved medical staff and the patient are allowed access to the PODs. Because the bar code on the patient’s wristband is unique to the patient, the theft of POD medicines from a patient’s cabinet is prevented. This is in contrast to the situation prevailing in many hospitals where a non-unique entry code number may be assigned to medical cabinets associated with a significant number of hospital beds such that, once the non-unique entry code of one medical cabinet becomes known to or worked out by a non-authorised person, theft of PODs from other medical cabinets having the same non-unique access code can take place with relative ease.

[0113] A further benefit of the medical cabinet of the invention is that, although a patient can continue to self-administer their PODs, the times at which they can access the PODs can be controlled to prevent over-administration.

[0114] The medical cabinet shown in Figures 1 to 6 can also be used to provide secure storage for the patient’s personal effects such as mobile phones, books, wallets etc. Thus, lockable door (10) in the medical cabinet can be used for the patient’s own personal effects. In this arrangement, the patient can use the wristband barcode (24) to access both a compartment containing the PODs and a compartment containing the patient’s personal effects but, whereas access to the personal effects can be unlimited, access to the compartment containing the PODs can be controlled to allow access at specific times or for a limited number of times. Alternatively, the patient may be provided with a key fob for electronically unlocking the door (10).

[0115] It will readily be apparent that numerous modifications and alterations may be made to the specific embodiments of the invention described above without departing from the principles underlying the invention. All such modifications and alterations are intended to be embraced by this application.

Claims

CLAIMS1. A method of controlling patient access to medicines, which method comprises:(a) providing a patient with a wristband bearing a machine-readable unique patient code;(b) providing the patient with an apparatus comprising a secure medical cabinet linked to a computer for controlling operation of the secure medical cabinet; wherein the secure medical cabinet comprises:(b-i) a first compartment for securely containing the Patient’s Own Drugs (PODs) of the patient;(b-ii) a second compartment for securely containing further medicines; the first and second compartments having doors provided with independently operable locks; the lock of the door of the first compartment being electronically linked to a code reader linked to a computer, the code reader being capable of reading the unique patient code carried by the wristband worn by the patient; and the lock of the door of the second compartment being openable by an authorised person but not by the patient; and(c) providing one or more authorised persons with access to the computer, wherein the one or more authorised persons:(c-i) register the patient on the computer;(c-ii) register one or more Patient’s Own Drugs (POD) of the patient by entering details of each POD into the computer;(c-iii) set up one or more reminder times in the computer for administration of at least one POD; and(c-iv) place the Patient’s Own Drugs into the first compartment and optionally further medicines into the second compartment; the computer being programmed to provide a reminder to the patient at each reminder time, wherein upon receipt of the reminder the patient scans the wristband bearing the unique patient code using the code reader, the reading of the unique patient code by the code reader serving to initiate unlocking of the door to the first compartment but not the second compartment, thereby giving the patient access to a POD.

2. A method according to claim 1 wherein the patient is registered on the computer by a series of steps including scanning the patient’s wrist band using the code reader.

3. A method according to claim 1 or claim 2 wherein step (c-ii), the registration of one or more Patient’s Own Drugs (POD) of the patient, comprises scanning a bar code on packaging containing the POD using a scanner (e.g. the code reader) linked to the computer.

4. A method according to any one of claims 1 to 3 wherein, following receipt of the reminder, the patient has a predefined time window in which to scan the wristband bearing the unique patient code using the code reader and unlock the door to the first compartment.

5. A method according to claim 6 wherein the time window is no more than 20 minutes, for example no more than 12 minutes.

6. A method according to claim 4 or claim 5 wherein, once the predefined time window has expired, a warning is provided to the patient that the administration of the POD is overdue.

7. A method according to claim 6 wherein, once the time window has expired, the first compartment cannot be unlocked with the wristband without authorization by authorized medical personnel.

8. A method according to any one of claims 1 to 7 wherein the unique patient code is defined by a barcode or printed RF-ID tag and the code reader is a barcode reader or RF-ID reader as appropriate.

9. A method according to claim 8 wherein the unique patient code is defined by a barcode.

10. A method according to any one of the preceding claims wherein the second compartment has a door which is provided with a lock electronically linked to an ID device reader which can read by an ID device carried by an authorised person.

11. A method according to any one of the preceding claims wherein step a) comprises:(a) assessing a patient’s suitability for self-administration of Patient’s Own Drugs (PODs) and providing a patient who has been assessed and adjudged capable offollowing a self-administration treatment regimen with the wristband bearing a machine-readable unique patient code.

12. An apparatus comprising a secure medical cabinet linked to a computer for controlling operation of the secure medical cabinet; wherein the secure medical cabinet comprises:(b-i) a first compartment for securely containing Patient’s Own Drugs (PODs) of the patient; and(b-ii) a second compartment for securely containing further medicines; the first and second compartments having doors provided with independently operable locks; the lock of the door of the first compartment being electronically linked to a code reader linked to the computer, the code reader being capable of reading the unique patient code carried by the wristband worn by the patient; and the lock of the door of the second compartment being openable by an authorised person but not by the patient; wherein the computer contains software enabling the performance of the methods of any one of claims 1 to 11.

13. An apparatus according to claim 12 wherein the reminders provided to the patient are displayed on a display screen of the computer.

14. An apparatus according to claim 12 or claim 13 wherein the secure medical cabinet comprises a third lockable compartment for containing personal items of the patient and said third lockable compartment is operably linked to the code reader for the unique patient code on the patient’s wristband, so that the patient can use the wristband to open the compartment.

15. A combination of a secure medical cabinet as defined in any one of claims 12 to 14 and a wristband carrying the unique patient code.

16. A combination according to claim 15 wherein the unique patient code is defined by a barcode.

17. A method of assessing the ability of a patient to comply with a self-administration drug treatment regime, which method comprises performing the method of any one of claims 1 to 11, logging the number of times the first locker is unlocked by the21 scanning of the patient’s wristband, and comparing the said number with the number of reminders sent to the patient.

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