1.7 Alpha - Perscription problems

Problems with the new perscription feature:

1) when you dispense it, it's not getting the label text from the perscription record - its coming from the label text for the product

2) no document template so you can't print the perscription

3) I managed to crash it. Patient Bree - created the perscription, dispensed once - OK, dispensed again - this time qty 22 - as expect got an error message, dispensed again with default qty 1 and got the crash below.  I think that the problem is associated with the system 'forgetting' the product - if after the 'dispensed too many' error, I re-select the perscription line, then no crash

4) I am not convinced that 'Times Dispensed' is the best metric - this leads to complication - see http://www.openvpms.org/documentation/csh/1.7/patient/prescription/edit and Bree's 200mg Dimmitrol where I have dispensed it 7 times, the 'Times Dispensed' shows 6. see also bottom screen shot below.

Recommendation - change 'Times Dispensed' to 'Qty Dispensed' - ie count the total number dispensed rather than something that can be confused with the number of dispense operations.

 

Regards, Tim G

PS I have only done the perscription/edit CSH page, I will hold off on the others in case 4 above results in changes.

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Re: 1.7 Alpha - Prescription problems

Thanks Tim. The prescription support isn't quite finished yet. I've deployed early to correct some of the other bugs.

I agree with your point that Times Dispensed is problematic. I'll get some comments from the project sponsor.

I'll do the report template; I'm just waiting on feed back for what it should look like.

Regards,

-Tim A

Re: 1.7 Alpha - Perscription problems

Hi Guys , I must admit I havent deployed 1. on my DEV machine, with some downtime I might do that

I read this though and wanted to make a point

The standard in qld and I think Australia wide, is that a repeat is a dispensing AFTER the first dispensing

therefore

1 REPEAT means it can be dispensed twice, the first time , when the script is written and a 2nd time , hence its repeated once.

This means when you enter 5 repeats you actually mean it can be sold 6 times.

 

This is the pharmaceutical standard I think in Australia, please keep in mind certain states have legislated requirements regarding writing scripts, in particular how many can be issued at once.

 

Looks good

Ben

Re: 1.7 Alpha - Perscription problems

Thanks Ben. Prescription dispensing has max repeats = repeats + 1.

The issue is how (or if) it should report Times Dispensed, if a quantity is dispensed that differs from that on the prescription.

At the moment, Times Dispensed is based on the total quantity dispensed, rather than the no. of physical times dispensed.

If you dispense the correct quantity each time, the Times Dispensed and the no. of Dispensing entries will be the same.  If not, then they may differ. In this case:

  • Times Dispensed will concur with Repeats
  • the no. of Dispensing entries will differ from Repeats (e.g could have more Dispensing entries than the total no. of Repeats)

You can't dispense more than Quantity * (Repeats  + 1), so the question is whether or not Times Dispensed is useful to display, or if it should indicate the total quantity dispensed.

-Tim

Re: 1.7 Alpha - Perscription problems

Strictly speaking it isnt a script at all if people are varying the Qty dispensed.  The vet writing the Script should be considering the time frames that that level of medication would last for. EG He writes the script with enough medication to last for 3mths.   If a different qty was dispensed for example it isnt really a Prescription at all, I would argue that if a employee was using a prescription to generate a dispensing, they should NOT be allowed to vary the qty at all, if they discuss that with the vet and prescribing quidelines ie dose rate changes a new prescription should be generated and the old one marked as expired.

If a client wants MORE of a drug at one dispensing then the employee could effect 2 dispensings at once. IE fill the script twice.  

I would lock the qty and labelling for medication acts generated from prescriptions.  I would have serious concerns if medication dispensed under a script I wrote could be varied on a each dispensing and my name automatically applied to that label.  

Under pharmaceutical guidelines the most a pharmacist can vary is the brand of a drug, not the dose rate or the period and he can confer with the prescriber if he feels the combination of drugs prescribed will cause issues for the patient as well.  But it is up to the prescriber to vary in that case.

I understand the need to maintain flexibility and ensure this project meets the needs of the sponsor, but the provision for dispensing drugs on a long term basis with no input from a veterinarian needs to be carefully managed IMO.

Ben

Re: 1.7 Alpha - Perscription problems

This has now been changed so that when dispensing from a prescription, the quantity and label come from the prescription, and are read-only.

You can try it out at http://demo.openvpms.org/alpha/login

  • user: guest
  • password: User1234

There is also a prescription template, which is loosely based on the AVA template in Appendix 12 of http://www.ava.com.au/sites/default/files/documents/Other/Guidelines_for_prescribing_authorising_and_dispensing_veterinary_medicines.pdf

-Tim

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