Issues resulting from unique formularies for each hospital
Hello community.
I am trying to find a solution to an issue that is likely unique to our group. Hopefully someone can offer a bright solution or can help shape the discussion in a manner where a proposed upgrade can help the whole community.
We have multiple locations each of which gets to build their own formulary. Using Rimadyl/carprofen as an example, we have some hospitals that use the brand name and others that use generics, plus you have the different forms (tablet versus chewable) in different locations. As a result, we have over a dozen plus active products that come up when you search for Carprofen but most hospitals will only carry three or maybe six products.
The second way this issue manifests is with the templates. Most of our templates are universal to all hospitals. For our anesthesia template, we have about a dozen injections included but again most hospitals will only stock half those.
The proposal I would pitch is to have a new filter added to the search page to filter by items that appear on that hospital's stocktake list as well as to limit the displayed items on templates in the same manner. Actual quantity on hand would not be relevant as we all know that counts are not always perfect.
Any suggestions on either a workaround or further improving my proposed request?
Thanks, Alan
Re: Issues resulting from unique formularies for each hospital
There would need to be a code change so that if a product doesn't have a stock relationship, it is not available for selection.
The reason for this is that the moment you use a product in an invoice, a stock relationship will be created.
This might need to be a practice level option so that the status quo of listing all products regardless of stock relationships is the default behaviour.
For templates, are you proposing that template expansion only occurs for those products that have a stock relationship? This would work, but if you have 6 possible Carprofen products, and a site has 3 of those, 3 will appear in the expanded template. You would then need to delete any duplicates.
To avoid this, we could introduce template support so that product Equivalents are used if a product is not available at the location. This would only work if the quantities are the same.
Re: Issues resulting from unique formularies for each hospital
I see no issue with filtering Medications by Stock Location relationships. As time said I would make it configurable ...
We really to start making these configurable options almost a seperate workspace in administration. They are expanding almost weekly
Re: Issues resulting from unique formularies for each hospital
Tim, I think we are having the same vision on the templates. I want to be able to load all the medications into the master template that might used for anesthesia but only have a hospital see the ones they stock then they pull it up to use it.
Re: Issues resulting from unique formularies for each hospital
If you list 6 products and:
what happens?
At Site A, you would need to go through and delete the duplicates.
At Site B, the template should fail to expand?
I think from a usability perspective, product equivalents is a nicer approach. E.g.
given a medication Product A, which lists Product B and Product C as equivalents, a template would include Product A. If that is not stocked, the template expansion would use either of Product B or Product C based on availability. If none of the products are available (i.e. not registered as stock for the location), the template fails to expand. If Product A is available, but has no On Hand quantity, then Product B or C could be selected.
Re: Issues resulting from unique formularies for each hospital
Tim:
The example I gave includes substitute items but this will not always be the case. For our anesthesia template we include:
Propofol
Dex
Bup
Telazol
DKT
Ace
Atropine
But
Hydromorphine
Ketamine
Morphine
Most hospitals will carry about 1/2 of these but not because they are equivalents of each other.
On the template, each of these have a 0 min and a 0 max so anything not used drops off the estimate when finalized so there is no disadvantage to listing all of them except that you have to scroll past the 10 you are not using.
Additionally, we would like to see the same filter built for services (which I know would be a larger project since services do not use stock locations). We have specialty hospitals who do not need to see the full list of available service codes and inversely, clinics that will never do some of the advanced items available to the specialists. The same example could be used for large animal vs. companion animal clinics or clinics that do/do not see exotics.
Re: Issues resulting from unique formularies for each hospital
See http://www.openvpms.org/project/product-stock-filter
It caters for medication and merchandise products at present, but could be expanded to include services and templates if they were changed to list the locations they are performed at.