Drug interval - +PRN

kornyak wrote on Sunday, January 04, 2015:

I am new and maybe missed something. My prescriptions are some interval with or without PRN, like BID or BID PRN. Never PRN by itself. It seems that is not possible to enter this combo. How do I enter an interval AND a PRN? It does not seem a good solution to have to have a duplicate of every interval, one with and one without PRN.

blankev wrote on Sunday, January 04, 2015:

An other option is, to use NOTES in prescription.

  1. “P.R.N.” six characters extra to include by hand in notes.

  2. The other option is to use your solution: Add “B.I.D and P.R.N.” in Administration => List => Drug intervals.

Or use both options: BID and TID for most frequently used prescription intervals and make for those a double entry, for all others use “If needed” or “prn” in NOTES.

kornyak wrote on Monday, January 05, 2015:

Thanks for your reply. Using the notes field would be very confusing because it prints way down under the refill line, and I’m sure would not work especially for e prescribing. This seems to me to be a significant problem, since nearly every interval is sometimes used PRN. Is there any possibility this will get fixed? AND if anyone works on this module, the medication strength should surely be right next to the medication rather than down under the quantity! And, while I am at it, if I were a programmer, I would like to have this module track the dates the prescription is to be used for, based on the previous Rx, to track when the refill is due and whether the patient is over or under using, especially for CII and CIII and CIV. The medication list should also carry over the strength and interval rather than just the name. I surely wish I knew more about programming so I could just do it!

tmccormi wrote on Monday, January 05, 2015:

Would not be hard (or very costly) to hire one of the many developers that
support this project to make those changes …

Tony McCormick, CTO


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kornyak wrote on Monday, January 05, 2015:

Ok, to look into that, who would you suggest? I also would like to add a module to track urine drug screens as I do on a paper flow sheet currently.

visolveemr wrote on Monday, January 05, 2015:

Hello

For Professional OpenEMR developers list you can look into this link OpenEMR Professional Support .

Thanks
OpenEMR Customization/Support Team,
ViSolve Inc
services@visolve.com
Demo’s @ ViSolve Demo Library

bradymiller wrote on Monday, January 05, 2015:

Hi,

This is definitely a place where OpenEMR is falling short. Would be very helpful to integrate Medications and Prescriptions and also provide a place to store whether a medication is scheduled or as needed.

I did (I am a volunteer) begin a project to integrate RxNorm database in addition to integrating Medications with Prescriptions, but quickly ran out of resources(ie. time since the project became to big; http://www.open-emr.org/wiki/index.php/Active_Projects#Medications). Since then Rod(developer from Sunset Systems), did bring in rxnorm coding into the Medications in a much more simpler manner, which was needed for MU2. A developer could extend this to:

  1. Fully integrate prescriptions with medications
  2. Add support for rxnorm(using Rod’s method) in the prescription
  3. Add support for PRN vs ATC medications

-brady
OpenEMR

bradymiller wrote on Monday, January 05, 2015:

Hi,

Also, for the urine tracking, there are always several ways to do this type of thing. Check out the Administration->Forms->Track Anything form for a possible way; there is a video on the Track Anything form here:

-brady
OpenEMR

blankev wrote on Monday, January 05, 2015:

Just some thoughts…

Would it be an option to show the NOTES field just below the DISP# field? If notes field is printed in HTML it seems to be a variable size field. So only the ATC (AROUND THE CLOCK) or PRN (If needed) just below. Where it should be.

What would be another reason to use the Notes field with a long text for prescriptions?

tmccormi wrote on Monday, January 05, 2015:

On Mon, Jan 5, 2015 at 2:41 AM, Brady Miller bradymiller@users.sf.net
wrote:

integrate Medications and Prescriptions

That integration is already done if NewCrop integration is turned on, so it
would not be much to make it the default. Just had to tweak to AMC to
support that, in fact, for CPOE reporting more accurately under certain
circumstances, (Ken will submit that change with MU2)

Tony


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kornyak wrote on Tuesday, January 06, 2015:

Where is the history of previously issued prescriptions? When looking at the list of past encounters, or especially when printing the record for third parties, I see no mention of prescriptions issued on any particular encounter. So far I have been having to duplicate them into the text of my encounter note. I wish it were listed as a separate field to look at or print, along with vitals, encounter, soap, etc

fsgl wrote on Tuesday, January 06, 2015:

Previously prescribed meds are found in the List dialog and in Prescription.

For entry into a form related to an encounter, it must be created.

If the SOAP form is too simplistic, a Layout Based Form with elements like CC, HPI, Meds, PSH, etc. can be created.

The entries in Medications can then be copied & pasted into the Meds section of the LBV form.

kornyak wrote on Wednesday, January 07, 2015:

Thanks for the reply. I see the generic list of previously entered medications, without any actual prescribing history, but I do not find anywhere that I can see an entry recording the actual specific prescriptions that I issued, like on January 1 I Rxd 120, on January 30 another 120 on March 1 another 120, etc. Certainly an absolutely essential part of a medical record is the actual specific history of what prescriptions I have written! So far I can’t find that anywhere. If, in fact, so far OpenEMR does not automatically track it when I issue an Rx, and also associate that with the encounter, I would be interested in how I can support that getting done ASAP, as without it I can not imagine how OpenEMR can be used successfully. It should be a separate item just like VITALS are now. Any third party (especially government) that requests records will need to have this entry included in the daily encounter. If I have to issue the Rx and then separately remember to copy it into the daily note, that is too unreliable and extra overhead, besides which there would be no way to separately print a summary list of prescription history, (and therefore patient usage) over time.

kornyak wrote on Wednesday, January 07, 2015:

When you say “a layout based form can be created” I presume you are talking about someone creating a whole new plugin or some such? Not something a non-programmer can do? Or am I misunderstanding and this is something already available?

visolveemr wrote on Wednesday, January 07, 2015:

Hello

Currently, all the general prescription details are listed under prescription screen. And further, your specific requirement regarding display of prescription history can be done, through customizations.

And the Layout Based Forms(LBF) are used to create our own forms specific to our speciality. The steps, how to create and use those forms can be find in these links Sample LBV Form and LBV Forms.

Thanks
OpenEMR Customization/Support Team,
ViSolve Inc
services@visolve.com
Demo’s @ ViSolve Demo Library

visolveemr wrote on Wednesday, January 07, 2015:

Hello
The prescriptions can also be tracked through “CAMOS” module in OpenEMR. We can provide the prescriptions to the patients through prescriptions category in it. For details regarding CAMOS, you can look into this link CAMOS Module .

If this is used, CAMOS forms will come under patient reports, so that we can able to print the same as other SOAP notes,vitals,etc. are done.

Thanks
OpenEMR Customization/Support Team,
ViSolve Inc
services@visolve.com
Demo’s @ ViSolve Demo Library

fsgl wrote on Wednesday, January 07, 2015:

Tracking/tallying of prescriptions written with linkage to encounters is the essence of the first Core Measure of MU1; otherwise OpenEMR would never have been certified in 2011. The user is unaware of it, because it occurs in the background.

Most of my colleagues, as they go about recording the H & P, usually enter the name of the med, route & frequency in the Present Medications section of the History; rather than a reproduction of the script with Disp & Sig.

It is not necessary to be a programmer to create a Layout Based Visit form, but the user must thoroughly understand the process. There are 3 Wiki articles on the topic.

Rod Roark, the author of the LBV form, has added new features in 4.2.0. The Source attribute, described here may be helpful associating prescriptions & encounters.

Hi,

Please let me know how to use procedure into trackanything.