[Feature Request] E-Prescription

[pushkarjsh88]

Background:

The healthcare industry has been dealing with minor discrepancies in the patient medication orders prescribed by practitioners. It was primarily due to reliance on handwritten notes on paper. The method of providing handwritten notes to the patients and pharmacies involve a few risk factors such as illegible handwriting of the practitioners, risk of getting the paper damaged, misuse of the prescriptions, improper tracking of prescribed medications etc. 

This pain point has been addressed with the help of digital technologies by making the entire process paperless. This ensures reduction in the medication errors, improved continuity of care and avoidance of any malpractices and accurate track records of prescribed medications.

This is an attempt to provide a way for the Frappe Health users to get benefited from the E-Prescription functionality.

Proposed Flow:

Below is the tentative scope of the feature that satisfied common requirements.

1.Pharmacy Master

• The pharmacy master provides a way for the user to maintain a list of pharmacies attached to the healthcare facility.
• The fields captured in the master can be Pharmacy Name, License Number, Address, Email, Contact Number etc.
• There should be a way for the user to add, edit and delete pharmacy details based on the configured role permissions.

2.Medication Template

• The user should be able to create medication templates for the drugs created in the item master.
• In the medication template, the user should be able to pre-set significant medication details such as Brand Name, Generic Name, Standard Dosage Pattern, Prescription Period, Dosage Form, Minimum Interval Between Dosage etc.   
• The user should be able to pull details from the medication template at the time of creating a patient encounter or e-prescription in the system.

3.E-Prescription From Patient Encounter

• When the practitioner starts recording patient encounters in the system, he/she can pull the medication details from the medication master mentioned above.
• The practitioner should be able to search for a drug in the medication template. Upon selecting the desired drugs, the system should pull and display other relevant details pertaining to the same.
• The system should allow practitioners to make required changes in any of the fields as per the need.
• After submitting the encounter, the system should enable an option of generating an E-Prescription for the prescribed drugs.
• In order to generate an e-prescription from the encounter, the practitioner has to click on the designated button which should open a form asking practitioners to select a pharmacy from the list.
• The e-prescription form should pull all relevant information pertaining to the patient and medication prescribed in the encounter.
• The practitioner should not be able to edit any details at this stage.
• Any modifications should be allowed only before submitting the encounter. Any post submission changes can be made by canceling the encounter and amending it with required changes.
• The practitioner should be able to send the e-prescription to the chosen pharmacy and patient via Email/SMS/WhatsApp.
• The prescriptions sent to the patients or pharmacies should be indicated distinctively.  
• The electronic signature of the practitioner should be included in the e-prescription.
• Once the e-prescription is sent, it should be added to the list of prescriptions for the patient.

4.E-Prescription From Patient

• In certain cases, the practitioners would want to prescribe medications to their patients without getting engaged in any patient appointments or patient encounters.
• In such cases, the practitioner should be able to go to the patient profile in their patient master and initiate a prescription.
• Upon initiating a prescription directly from a patient, the system should ask practitioners to add drugs from the pre-configured list in the medication template master.
• Based on the selection, the drugs should be added in the prescription along with their default details.
• The practitioner should be able to make any changes in the details as per the need.
• The practitioner should be able to send the e-prescription to the chosen pharmacy and patient via SMS/WhatsApp.
• The prescriptions sent to the patients or pharmacies should be indicated distinctively.
• The electronic signature of the practitioner should be included in the e-prescription.
• Once the e-prescription is sent, it should be added to the list of prescriptions for the patient.

5.Prescription List

• Each practitioner should have access to the list of prescriptions generated by him/her for different patients.
• The prescriptions should also be linked with the related patient and patient encounters for quick access.
• The practitioners should be able to search and filter data with the help of different parameters.

[mujeerhashmi]

The Medication Template should also define tax rate, UOM & Conversion (Ex: 1 Strip = 15 Nos, 1Box = 10 Nos of Bottle). This will ease the affairs of pharmacy setup.

[aakvatech]

We have already been using this as part of aakvatech/hms_tz repo.

We have medication doctype replacing the Item doctype in Patient Encounter. We also have Healthcare Service Unit defined with warehouse (Pharmacy) to issue goods from. The Medication doctype is linked with Item doctype (just like Lab, Radiology, etc.)