As mentioned in my previous entry (See: Previous Post), here are the details of the Pharmacy Repeat Prescription Management System (PRPMS) that I’ve recently developed, and that is available for any Pharmacy / Chemist store anywhere.
Once the commercials are in place with the end-customer (Pharmacy/Chemist), I will install the system onto their hardware - a hosted version can and will be provided if there is demand for it, but it will be priced accordingly and hosting costs will also have to be taken into consideration. If required, I can get a hosting (dedicated or virtual server depending on requirements) account from my preferred UK-based reputable provider (Fasthosts UK) in the name of the end-customer (Pharmacy/Chemist), configure it accordingly, and provide all the appropriate management and use credentials as part of the package.
Here is a walk through in images of the entire system. If you feel that you need a demo of the system, please let me know and I will arrange for the demo, my contact details are as follows:
Telephone (Landline): +44 203 002 3885
Telephone (Mobile): +44 780 976 9286
Email: shabbir[at]hassanally.net
Scope of Project and Introduction
This system was designed to cope with the issue of repeat prescriptions. These are repeat medication requests that many patients have from their doctors, and which pharmacists have to generally deal with. On a daily basis, a pharmacy may well have to deal with anything from 10 to 1000 repeat prescriptions (possibly more, it’s all dependent on their size), as a result, managing them can become a nightmarish task.
Having spoken to a number of pharmacists, both store owners, as well as locum pharmacists, and this has constantly been an administrative nightmare.
In light of this, I developed a system, which allows the pharmacist (or designated locum and/or other designated staff), to add details of the Patients, Doctors (who issue the prescriptions), actual Prescriptions (scanned images and/or textual representation of the prescription), and the due date. The system - once a prescription is issued, automatically calculates the date that prescription will be due (if for example, a patient is on a 28 day cycle for their prescription, then the pharmacist will be made aware of the next due date, which will allow them to advise their patient, and contact the doctor for the prescription if required).
The system is designed to work with any type of prescription, paper based (which in order to have an electronic copy on the system need to be scanned, and so a scanner will be required, but these are exceptionally cheap now, and even a low-end flat-bed scanner will suffice) or electronic (which are ultimately sent as messages to the dispensing system that pharmacies already have in place (entered into PRPMS as text or an image if one is provided by the dispensing system).
The PRPMS serves as a reminder. It can be configured (through add-on functionality for SMS based alerting, email based alerting and so on, by default it displays a list of pending prescriptions up to those due in the next seven (7) days (as well as any old ones that haven’t been dispensed for whatever reason) on it’s home page as you will see in the system walk through.
The system keeps a log internally of each prescription, and stores who was the dispenser of that prescription, that way it builds up an audit trail of the process, and in the event of any problems with a particular prescription, it can build and present information for accountability, that such and such dispenser dispensed such and such prescription for patient A that was issued by Doctor Y. All of this will become much clearer in the walk through, and in viewing the demo (which is by appointment, if you contact me, I will provide you access to a demo system over the Internet).
Right now, onto the walk through.
Pharmacy Repeat Prescription Management System Walk Through
1/ Login
The first thing you have to do, is put the URL of your particular installation of the PRPMS into your web-browser. The system has been designed to work in all major browsers, ranging from Microsoft Internet Explorer, Mozilla Firefox, Opera and Apple’s Safari.
On going to the designated URL the user is presented with the following login screen (you can click on the image to get a full sized one):
2/ Default Home Page View
Over here the user logs into the system by entering their login credentials, and clicking the Login button. This will validate their account, and present them with the default home page:
The default home page has two main sections, the options at the top and the pending prescription view at the bottom. There are nine (9) options on the menu, all of which we will go through one at a time, as well as a number of other options which are specific to the view that you have - such as Dispense, Edit, Delete and such.
Notice also, that the system shows the name and username in parenthesis of the currently logged in user, the case of our example System Administrator (admin). Next to that, there is a Logout button, which if pressed, will return the user to the login page, from where they will have to log in and authenticate again.
If at anytime, and from any page, the user wishes to return to the default view of prescriptions due in the next seven (7) days, they can click the button with the text Show Prescriptions Due In The Next Seven (7) Days, which is to the right of the page.
The user has the ability to click the name of the patient and doctor, and to view details of the prescriptions and most importantly, when the prescription is due. If a prescription is overdue, then that particular row will have a light red (or pink) colouring, if the prescription is still not over due but is due anytime from today to the next seven days, then it has a light green background, as will be seen through the course of this walk through when we create a new prescription for our demo purposes.
3/ Option 1: Show Prescriptions Due In The Next Seven (7) Days (Default Option)
If the user selects the Option 1 radio button, and then presses the button to the left which has the text Select A Function And Click Here! on it, the user will be presented with the following page:
This option yields a page that is identical to the default home page in every way, except that instead of the gold bar at the top which tells you which page you’re own, it is coloured green, indicating that you have arrived at this page by selecting an option, as opposed to clicking the Show Prescriptions Due In The Next Seven (7) Days button.
The colour scheme for the display of pending and due prescriptions is exactly as described above for the default home page view.
For the purposes of this walk through we will now move onto Option 2 and so on, and then come back to clicking the links available here, in a real world situation, the default home page and this page would probably be the most heavily used pages within the entire system, and their links would be the most clicked.
Moving on then to Option 2.
2/ Option 2: Add New Patient
Selecting the Option 2 radio button and pressing the Select A Function And Click Here! button (to the left of the page as you face it), will allow the user to add information about a new patient. The following form is presented to the user when selecting Option 2:
This page, requires you to add information about the patient, so that a new patient record can be created for that patient. Before you can add a prescription, you must have a record for the patient who has presented the prescription, and you must have a record of the Doctor (see Option 3: Add New Doctor) who has issued the prescription.
It is also important to note, that a patient cannot be removed from the system if they still have pending prescriptions, but that will be covered further in this walk through.
The fields that have comments in Red are mandatory and required, the items that have descriptions in gray are optional and nice to have, but not required. So enter your patients details into the appropriate fields, and then click the Add New Patient button. If you want to add a number of patients together (say when the system is first installed and you want to do initial data population for example), you can select the checkbox, that says:
Please tick the checkbox if you want to add more patients immediately after adding this one, otherwise leave it unchecked to goto the patient list after adding this patient.
This will instead of taking you to the patient list, return you to the Add New Patient page, and will allow you to add a new patient again and again. By default, this option is left unchecked, as for every day use it is unlikely that numerous patients would be added in bulk.
Once you have added a new patient you will be taken to the page shown in Option 6: Show Patients and you will the list of patients in front of you. If you want you can skip ahead to Option 6: Show Patients and see what that looks like, for this walk through we’ll be moving onto the third Option.
For the purposes of this demonstration and walk through we have just entered a Patient with the name and address as follows (we will need this later when we come to adding prescriptions, so for the purposes of demonstration):
Mr Test User
1 The Test Road
Leicester
Leicestershire
LE1 1TS
(The name and address are both fictional and made up for the purposes of demonstration. If you are Mr Test User and live at 1 The Test Road, Leicester, LE1 1TS, then please let me know and once I’ve regained consciousness - I’ll pass out again!!)
3/ Option 3: Add New Doctor
Selecting the Option 3 radio button and pressing the Select A Function And Click Here! button (to the left of the page as you face it), will allow the user to add information about a new doctor. The following form is presented to the user when selecting Option 3:
Again, like in Option 2: Add New Patient this option presents the user with a form, where they can put in details about the doctors that have or will be issuing prescriptions that will be processed by the Chemist / Pharmacist.
This also serves as a contact list of useful phone numbers for the doctor, with things like emergency number and out of hours contact details. It also has a field for the doctors website and off course the email address.
Like with Option 2: Add New Patient the fields that have red descriptions to the right of them are required, and those with gray are optional but nice to have. Also you have the same functionality with the checkbox for bulk adding doctors to the system - such as during initial data population. Without checking the checkbox, once you have added the details for the doctor, the system will return you to the doctor’s list (which is covered in Option 7: Show Doctors). For the purposes of this demonstration, we’ll now move onto the fourth option.
Again, for the purpose of this demonstration, I have added a doctor with the following details:
Dr Medical Person
1 Medical Test Place
Leicester
Leicestershire
LE1 1MP
(Again, the name and address are both fictional, as far as I know, but if that is you, let me know, and like before, once I have regained my composure, I’ll pass out again, and obviously change the details!!)
4/ Option 4: Add New Dispenser (System User)
This option allows you to add a new dispenser. Every dispenser has access to the system, and is classed as a system user. As a result, they have to have a username and password allocated to them when they are created first as we will see.
On selecting the fourth radio button, for Option 4: Add New Dispenser (System User), and depressing the button labeled Select A Function And Click Here! the user is presented with the following screen:
In much the same manner as the previous two options, the dispensers details need to be filled in here, with particular reference to the fields commented in Red as being mandatory.
For the dispenser, since they will also be a user on the system, it is important that a sensible username and password combination are selected - the dispenser will themselves have the ability to change their password once they have logged in and this will be covered later.
The two drop downs, require a little explanation. The first one is Dispenser Type. This is primarily for reference purposes. There are four default dispenser types in the system, being:
- Administrator
- Dispensing Pharmacist
- Pharmacist
- Locum Pharmacist
Other types can be added to the system, but that is something that would have to come through myself, as there is no web form that allows new types to be added (it’s slated as a feature in Version 2.0 of the PRPMS). The default in the case of Dispenser Type is Dispensing Pharmacist, as this seems to be the most sensible default.
The second drop down is the System Role. This drop down provides two options:
- Administrator
- User
This feature is for future use, and currently both the administrator and the user have the same functionality. However, to ensure that your system is ready for future upgrades, it is recommended that no users be created as Administrators - there is always a single Administrator user in the system and that user cannot be deleted. All admin functions should be performed using that user.
For day-to-day use, please be sure to select the User option - this is default so you can leave things as default for that drop down.
Also you have the same functionality with the checkbox for bulk adding dispensers (system users) to the system - such as during initial data population. However, in the case of dispensers, I think that is unlikely to be required, it has been implemented never-the-less for the sake of completeness.
For the purposes of this demonstration, I’ve just created a Dispenser (System User) with the following details:
Mr Average Dispenser
123 Dispensing Lane
Leicester
Leicestershire
LE1 1DP
The username and password for this user have been set up as follows:
Username: adisp
Password: adisppassword
The system will check if the username is unique, and it will also check if the two password fields match. If they do not, you will be presented with an error page where you can remedy your mistake:
On this screen you will be able to fix the password, and not lose the data you’d typed in for that dispenser.
Once you’ve entered the password in correctly you will be taken to the Option 8: Show Dispensers page. If you want you can skip ahead and read about Option 8: Show Dispensers, but for this demonstration, we’ll move sequentially onto the next option which is fifth option.
5/ Option 5: Add New Prescription
This is probably going to be one of the most important data entry pages of the entire system. This page allows you to enter a new prescription into the system.
You arrive at this page, by selecting the fifth radio button and pressing the button labeled Select A Function And Click Here! Once you have done that you will be presented with the following screen, which we will describe in detail:
In order to add a prescription to the system, there are two important pre-requisites.
- The Patient must exist
- The Doctor issuing the Prescription must exist
- You must have the contents of the prescription, either as text or as an image available.
These three pre-requisites are critical, and without them a prescription cannot be entered into the system. It is for this reason, that we initially added the Patient, then the Doctor and now we go onto the Prescription.
On the prescription entry page you will see two drop downs, the first being for the Patient, and the second for the Issuing Doctor. These have to be selected from existing patients and doctors within the system, so if you have a new patient or a prescription from a new doctor, then these must be added prior to adding the prescription.
So you select the patient and doctor from the drop down lists, and then you come to issue date. This is the date on the prescription. For when it was issued by the doctor. For example; a prescription might have been issued on Friday the 9th of November 2007, but not been taken to the pharmacist until Monday the 12th of November 2007. Therefore, you must make sure that the date here is the date the prescription was issued.
Selecting a date is very straightforward, simply click the little icon next to the text box, and in the popup that appears (much like the one in the image to the left), simply choose the date. Once you click your chosen date, the Issue Date field will be populated with the date in the correct format.
The next field is to determine whether this is a repeat prescription or not. The system can also cope with delayed prescriptions. For example, someone might need a series of two (2) injections for example, for a particular purpose. They would be given their first injection at their doctor’s surgery and told to goto a medical clinic for the second, they would also be given a prescription so that they can procure the medication that they need to be injected with at a local pharmacy - your pharmacy. The patient can bring that prescription in with an issue date that is in the future, and then have that ready to collect when it is due. Such a prescription would NOT be a repeat prescription (so you would select No in the drop down for Repeat Prescription but, would still appear on the system when it’s due date approached.
There are other applications for when a prescription is NOT a repeat prescription, and I’m sure that pharmacists will better be able to consider them. I’m not a pharmacist, just a lowly software developer. 
If a prescription is a repeat prescription, then it’s repeat cycle is important. By default this has been set to twenty-eight (28) days, however this can be modified by who ever is entering that prescription in according to specific needs. Generally from what I know, however, twenty-eight (28) days is pretty standard in terms of when repeat prescriptions are issued by doctors.
It is however important, that should the number in the Repeat Cycle text box be changed, that it is changed to a number that is in days - not months, not weeks, not years, but days. So an annual prescription - for example for the influenza virus vaccination - would have a repeat cycle of three hundred and sixty five (365) days - NOT 1 year.
The next element that needs to be filled in is the Prescription Text field. This is a list of the items on the prescription, listed in order in plain text. The text box allows you to make the text bold or italics, and to have numbered lists or bullet points. If the prescription came through via email from the Doctor - or using the NHS’s Electronic Prescription Service, this will generally mean that the prescription is available only as text, so that text can be put here.
Finally, if (and this is highly recommended, especially if dealing with paper based prescriptions) a scanned image of the prescription can be uploaded to the database in JPG format.
Once you have completed the form, press the Add New Prescription button. As with the other functions explained thus far, you have the option of using the checkbox to allow yourself to add a number of prescriptions in succession. This is useful for bulk additions, or for initial data population.
For this demonstration, I have created a new prescription issued by Dr Medical Person for Patient Mr Test User, issued on November 16, 2007, which is a repeating prescription, with a repeat cycle of 28 days. I have then entered "1. Some medicine" as the Prescription Text, and uploaded an image of a prescription as the Prescription Scan.
On pressing the Add New Prescription button, you will be presented with the screen explained in Option 1: Show Prescriptions Due In The Next Seven (7) Days (Default Option) page. - and you can see the new prescription is coloured in light green, because it is not yet over-due:
That’s all there is to it - as long as the patient and doctor exist in the system, entering a new repeat (or one time) prescription is as easy as that!
Let us now move onto the sixth option - that of showing a list of all the patients in the system.
6/ Option 6: Show Patients
This option allows you to view, edit or delete the patients on your system. The functionality is very straightforward. When you select Option 6: Show Patients and click the Select A Function And Click Here! button, you will be presented with a page as shown in the image below:
This page, gives you a list of all the patients in your system, and gives you the ability to view their information - by clicking their name, editing their information (for example if someone’s address changes, or phone number changes, or even name changes, etc), and finally it allows you to delete their record.
When you click on the patients name, a popup window appears with the patients information in it as shown in the image below:
The popup page, has all the functions that are related to the patients record. You can choose to simply view the information - for example - if you need to contact a patient about their prescription, it is very easy to get their phone numbers from this page (if you use Internet Telephony, the phone numbers can be converted to a SIP URI from where you can make the call directly, but that’s another add-on - there will be another post outlining the available add-ons to the PRPMS, and for the developers out there, I’ll be building and exposing an API model, so that everyone can build add-ons for this system as they need).
From this page, you can also edit the patients information, and the page you’d see if you clicked the Edit on the Patient List page is identical to the one you’d see if you click the Edit Patient button on the popup page.
When you click the Edit Patient button, you are presented with the following page:
On this page, you can edit and modify the patient’s information (you cannot, however, change the unique identifier Patient ID that is generated by the system automatically and uniquely identifies the patient internally).
You can change, the name, address, phone numbers, email address of the patient, and then click the Edit Patient button, and the changes will be committed to the system. If you change your mind, and don’t want to edit the patient, you can press the Cancel Edit button and you will be returned to the page where you were viewing the patients details.
Should you choose to update the patient details, the system will advise you with an alert box of the fact that the patient’s record has been updated, as shown in the image below:
To close that page and return to the view of the patient’s (now updated record), simply click the OK button.
This page, also allows you to delete the patient - in the same manner as the main Show Patients Page lets you click the Delete button to delete a patient, this one also allows you to do the same, you simply click the Delete Patient button, and it will perform some checks and advise you accordingly.
It should be noted that if a patient has a prescription in the system, you will not be permitted to delete that patient, since doing so would leave that prescription orphaned and without a patient. So just as with adding a new prescription, a patient is required, deleting a patient, requires that no prescriptions are assigned to that patient.
If you attempt to delete a patient, you will be presented with the following alert box, which requires you to confirm your action, or cancel it:
This prevents accidents from happening. If you confirm this action - by clicking the OK button - then the system will perform a series of checks against that patients data. If the patient has an active prescription against their name, it will refuse to delete them, and will present you with the following alert box:
If however, the patient doesn’t have any prescriptions, it will advise you that the patient has been deleted as shown below:
In the example above, I created a dummy patient "Mr A Test123", and then deleted that patient to show how the process works.
Another function from View Patient page is the ability to see all the patient’s prescriptions. If you click the button that reads Patient’s Prescriptions you will be presented with a page like that shown below:
This page shows you all of the Prescriptions, and their Issuing Doctor, the date they were first issued, and when they are next due for that particular patient. The details for the prescription and doctor will come in sections further down, so for now, we’ll move onto Option 7: Show Doctors.
7/ Option 7: Show Doctors
The next option is Option 7: Show Doctors. This option shows you a list of the doctors on your system, and has the same functionality as the Show Patients section. Again, you are able to edit the doctors information, delete the doctor from the system (if there are no active prescriptions from that doctor, only then can you delete the doctor, see the explanation given in the previous section for details, the same rule as is for patients applies for doctors within this system).
The next option is the eighth option, Show Dispensers.
8/ Option 8: Show Dispensers
This option allows you to see all the dispensers within the system, and modify their information. However, there are certain rules that this system enforced:
- A dispenser may NOT modify the password of any other dispenser except themselves.
- The System Administrator user, with the username of admin cannot be deleted from the system. This is to prevent the system being locked out at any given time, the password for this user can be changed (by logging in as the System administrator and then changing the password, as enforced by the previous rule, outlined above).
For example, if I am logged in as the System Administrator, when I click on Edit button for my user (from within the List of Dispensers), I can change the password for myself, as show below:
However, if I attempt to change the password for Mr Average Dispenser, I cannot do so. I can however, edit the user information for that user, and update their email address, telephone numbers and address, as shown below:
Again, the editing functionality is the same as for the Patient and Doctor, and so won’t be repeated here.
Before we explain in detail how a prescription looks on this system, or how the dispensing process would work, we’ll quickly mention the ninth option.
9/ Option 9: Show Prescriptions From <Enter Start Date> To <Enter End Date>
This options gives a list exactly like the one in Option 1: Show Prescriptions Due In The Next Seven (7) Days with the difference that it displays prescriptions from your chosen start date to your chosen end date. Both dates must be provided, and entered correctly. Using the popup date selection window is the most appropriate way to do this:
10/ Viewing A Prescription
The single most important function within this system, is that of dispensing a prescription, this is a simple two step function, that can be done alongside any other pharmacy dispensing software. The PRPMS does not print labels for medications, this must be done from your own system (or by hand if that is what you do).
The process for dispensing a prescription can be initiated from any of the prescription list views. Our example will use the prescription view from the default home page:
As can be seen there is a very over due prescription, issued by Dr D O Good for patient Master Peter Patient, which was due on the 2nd of April 2005. We will dispense this prescription as a test.
The first step is to click the Dispense button.
Once you click the Dispense you will be presented with a popup window showing the contents and details of that prescription, as show in the image below:
This gives a complete representation of the prescription - including (if available and uploaded at the time of prescription creation) a scanned image of the prescription. It gives the patients details (Name and Address), as well as the Doctor’s Address. It also shows who the dispenser is - in cases where the system is used by multiple dispensers, this can be used to ensure that the correct person is dispensing the correct prescriptions.
At this stage, you have two options:
- Confirm and Dispense
- Cancel, Do NOT Dispense
If you select the second option, the window will simply close and you can choose another prescription. That prescription will remain pending. If however, you have chosen to dispense this prescription, and everything is in order. You can click the Confirm and Dispense button, which will give you an alert box showing the date when this prescription will become due again as show below:
The date when the prescription will become due again, is calculated as the length of the Repeat Cycle from the date the prescription was dispensed. Naturally the repeat cycle calculation is only made if the prescription is flagged (during it’s creation) as a repeat prescription. It should be noted that prescriptions cannot be edited. They can be deleted, though they remain accessible through administration tools (which will be again provided as add-ons to the system for auditing and accountability purposes.
Once you click the OK button on the alert box, the prescriptions due page is automatically refreshed, and the list is updated - in our case, we can see that the prescription for Master Peter Patient due on the 2nd of April 2005, no longer appears on our list of pending prescriptions:
When that prescription becomes due again - in the case of our example 14th December 2007 (as shown in the alert box as explained above), it will again find it’s way onto the pending prescriptions list.
That pretty much sums it up for the dispensing process.
With that, we can conclude this rather lengthy walk through of the Pharmacy Repeat Prescription Management System (PRPMS) Version 1.0. I hope that you have found it useful, and if you know any pharmacy (or possibly yourself?) that would benefit from this application, be sure to them know (there might even be something in it for you - if a sale completes because of a lead you’ve brought in!).
My contact details are provided above. You can arrange a demonstration or just talk about the system by contacting me. I am prepared to make minor customizations (such as branding, and minor functional changes - to be decided on discussion), should there be interest, but naturally such changes would impact the final price for the application.
So what’s the price I hear you ask, well the only way to find that out, would be to talk to me, but I promise you it’s not an unreasonable price.
I look forward to hearing your thoughts on this application, and if you are from another industry, and feel that you have an idea for some software, get in touch, if you can convince me of the sales potential for what you’re suggesting, I am prepared to design and develop any application for any industry.
Warm Regards,
Shabbir
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