How to use pharmacy without creating encounter?

Management and Administration
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1

Hi,

We are using open-emr with pharmacy. But sometimes we have to dispense medicines without an encounter.

Can you please suggest if this is possible? I was thinking to create dummy encounter for such dispenses.

Regards,
Numan Ilyas

2

I assume you have the pharmacy enabled and you have medications there
https://www.open-emr.org/wiki/index.php/Pharmacy_Dispensary_Module

Selelct a patient → Edit Prescriptions → Add

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1 Like
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Thank you @moussa for reviewing this post.

We wanted to dispense without creating a patient. Just like a pharmacy would do to a customer. But I guess within open-emr we must have a patient to dispense medication. That’s why I was planning to use a dummy patient profile and wanted to check if there are any other alternatives.

Thanks.

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Hello @numanilyas121

I am no lawyer or pharmacist- my background is in nursing- but my understanding is that the key to the answer to your question is your phrase, ‘just like a pharmacy would do’.

OpenEMR is a medical practice management application, not a pharmacy management application. Different licensing and practice operations are involved in the two environments. The conflict looks like a licensing issue which may be peculiar to the US-- are you practicing here in the States or in another country?

Creating a dummy patient, for example named ‘Retail Patient’, and ordering the med for ‘them’ as you describe, would serve the purpose you describe. But if you are in the US and your practice’s medication activities ever got audited you might get in some serious trouble.

But I’m not a lawyer or pharmacist.
Best- Harley

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Thank you Harley! Your response is spot on.

That’s exactly what I have updated the administration. We are running it for a small hospital in Pakistan. Still early days so exploring various options.

Regards,

6

Hello @numanilyas121
At the risk of telling you what you already know, the OpenEMR wiki has a few more references on the subject than was mentioned by the OP.

This is a bit of an introduction:
https://www.open-emr.org/wiki/index.php/OpenEMR_7_Practice_Settings#Pharmacies

The pharmacy-dispensary module is capable of running an in-house inventory which would do what you want as far as maintaining medication stock and supplies. Activation and configuration details can be found here.
https://www.open-emr.org/wiki/index.php/Pharmacy_Dispensary_Module

Here’s another reference that has some necessary dertails missing from the other config document; especially note the medication templates.
https://www.open-emr.org/wiki/index.php/Using_OpenEMR_Inventory-Dispensary_Module_for_Non-_Pharmaceutical_Products

It’s a fairly complex feature so if you have issues or questions feel free to bring them back to this forum.
Best- Harley

1 Like
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Hi @htuck i kow that Open EMR is a medical practice management application with a pharmacy module to manage the inventory of drugs prescribe by the medical practitioner, . But how about having another facility type as a pharmacy and have its own user as pharmacist with acl/group permission to dispense the prescribe drugs using the in-house drug inventory, in this way Open EMR will have a whole holistic view of a medical practice management. But i am not sure if this is already in-place and i cant just figure it out :-), since i under practice settings there is a option to create a pharmacy.

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The issue as I see it from my incomplete understanding is that OpenEMR is certified as an Electronic Medical Record but it is not certified to conduct pharmacy activities in the approved manner. But if the system is not subject to audit and certification that’s not an issue, is it?

Re: the idea of having a pharmacy facility, I think that would not help because you’d have to have the Providers change their default facility to the pharmacy facility in order to prescribe from that facility… which is extra work for unknown benefit.

Maybe going back to the idea of special- purpose patient records would help.
Even a commercial pharmacy has patient records- they keep track of basic pt information and who prescribed the meds to whom. Over here, only non- prescription/ over the counter meds are simply sold to the general public without tracking pt information. Is that the case in Pakistan or do you not have that chain of accountability for prescription meds also?

It would not take much effort to create a patient record with the minimum required pt data, coming to you for a ‘visit type’ of ‘Pharmacy’, and being prescribed the medication. That would enter enough data to link the transaction to for record keeping purposes and maintaining the pharmacy inventory.

  • HT
9

@numanilyas121 @casper Just re-read my last post to this thread and realized the original question was ‘without creating encounter’.
So I went back to the docs,
https://www.open-emr.org/wiki/index.php/Pharmacy_Dispensary_Module#Add_Prescription_To_Encounter_form

where it says to ‘add a prescription to an encounter’. But the picture has the user clicking a button on the pt’s home page, not on an encounter form. I suddenly realized the document has been incorrect all this time, and as the author of the page I apologize deeply!

It now says,

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So, you do not need an encounter form to dispense prescriptions, but you do need a patient record to contain the medication order. And that record need only have the basic required data (by default, the Names, Sex, DOB unless others have been made required also) so dispensing to a person who is not in the practice would not be too onerous a task. You can simply pull up a patient record, open their prescriptions module and prescribe the med.

HOWEVER- another complication arises, from the fact that this is an in-house pharmacy, not built to be a commercial outpatient pharmacy. The ordering providers that are available in the Prescription module are all in-house users in the OpenEMR. You would not be able to dispense meds from an outside physician unless you gave them an entry in your EMR’s user list.

Or I suppose you could make a user, ‘Outside Provider’ to select as the ordering provider, then note the actual prescriber in the notes section in the prescription? If that’s suitable for your legal auditing requirements.

Hope that helps?

  • HT