Prescriptions

A Prescription is the prescriber's record of what a patient should receive: the patient, the items, the quantities and the directions. It is written in the clinic, before and separately from dispensing.

Once the prescriber marks a prescription Ready to dispense, Open mSupply creates a dispensing record for the pharmacy. The pharmacy allocates stock and verifies that record in the usual way, and the prescription is automatically marked Dispensed.

Why use Prescriptions?

Prescriptions allow the separation of deciding what a patient should receive and the handling of stock:

• Prescribers (doctors or clinicians) record what should be given to treat the patient
• Dispensers receive a ready-made dispensing record, with the prescribed quantities and directions already filled in, and only need to allocate stock, pick and verify

A prescription never changes stock levels itself. Stock is only affected when the pharmacy processes the dispensing record it generates.

A prescription always belongs to the store it was written in. It is not sent to another store or site.

Permissions

Prescriptions has its own permission, separate from the dispensing permissions:

The permission is granted in mSupply, on the omSupply Permissions tab: View/edit prescriptions. See the Permissions page for the full list of available permissions.

Some things to be aware of:

• Permissions are per store. A user may have Prescriptions access in one store and not another.
• Prescribing and dispensing are separate jobs. A user with only the View/edit prescriptions permission sees the Prescriptions entry and not much else. A user with dispensing permissions but not this one does not see Prescriptions at all.

The store must also be in Dispensary mode (see the virtual stores documentation), as for the rest of the Dispensary section. No store preference or other setting needs to be enabled.

Viewing Prescriptions

Choose Dispensary > Prescriptions in the navigation panel.

You will be presented with a list of prescriptions for your store, newest first.

Prescription List

The list is paged in the same way as other lists in Open mSupply, with the number of rows shown and page controls at the bottom of the screen.

Searching for a prescription

By default you can filter by Patient name and by Prescription date range. Use the filter menu to add filters for:

• Status
• Dispensed date range
• Entered by
• any visible custom field

Exporting Prescriptions

Click the Export button at the top right of the list to download the list as a .csv file, or use the dropdown arrow beside it to download an Excel file instead. The export includes all prescriptions matching the current filters, not just the current page.

Deleting Prescriptions

1. Tick the box at the left of one or more rows in the list.
2. Click Delete in the Actions footer which appears at the bottom of the screen.
3. Confirm.

You can also delete a single New prescription from the Actions section of its side panel.

Creating a Prescription

1. Go to Dispensary > Prescriptions.
2. Click the New prescription button in the top right corner. The same button is available on the home page.
3. Fill in the New prescription window:

4. Click Create.

The new prescription opens with a status of New. The patient's name is shown at the top of the screen.

Header fields

The header of a prescription shows and, while the status is New, lets you edit:

• Patient - change the patient by searching for another one
• Date of birth - read-only, taken from the patient record
• Clinician
• Date - the prescription date
• Diagnosis
• Any custom fields marked as prominent - see Custom fields

Patient details are always read live from the patient record, so a change to the patient's name or date of birth in Patients is reflected here immediately.

Tabs

• Details - the list of prescribed items
• Custom fields - any visible custom fields that have not been promoted to the header
• Log - the activity log for this prescription: Created, Updated (with the fields changed), Sent to dispensary, Dispensed and Deleted

Side panel

Click More in the top right to open the side panel, which contains:

• Additional info - Entered by, Created date and a Comment you can edit while the prescription is New
• Patient details
• Related documents - once the prescription has been marked Ready to dispense, a Dispensation link showing the number of the dispensing record. Click it to open that record in Dispensing
• Actions - Delete, while the prescription is New

Adding items to a Prescription

Items are added from the Details tab while the prescription is New.

1. Click Add item in the top right corner.
2. Search for and select the item. Any item visible in your store can be chosen. The available stock for the item is shown as Available: <quantity> <units> for information only; you can still prescribe an item with no stock.
3. Enter the Quantity. This is always in units (for example tablets), not packs.
4. Enter the directions in one of three ways, as when dispensing:
   • Type an abbreviation in the Abbreviation field and it will be expanded into the Directions field (see the mSupply abbreviations documentation)
   • Select one of the item's default directions from the Item default directions dropdown (see the mSupply item directions documentation). If none are configured for the item the dropdown reads No default directions available
   • Type or edit the text in the Directions field
5. Click Save.

To edit a line, click on it in the list. To delete lines, tick them and click Delete in the Actions footer.

Once the prescription has been marked Ready to dispense, clicking a line opens it read-only.

Prescription Status

The status of a prescription is shown at the bottom left of the screen, in the same way as other records in Open mSupply.

Statuses only move forward. There is no cancellation of a prescription:

• A mistaken New prescription should be deleted.
• A mistake noticed after the prescription is Ready to dispense is handled on the dispensing record, by editing it before it is verified or cancelling it after (see Cancelling a Prescription).

Sending a Prescription to the pharmacy

When all items have been added, click Ready to dispense at the bottom right of the screen. You will be asked to confirm:

This locks the prescription and creates a dispensing record for the pharmacy to fill. Continue?

Click OK to continue. Nothing else needs to be entered.

When you confirm:

• The prescription status changes to Ready to dispense and the record is locked. The log records Sent to dispensary.
• A new dispensing record is created in Dispensary > Dispensing, in the same store, with status New. It carries the patient, clinician, diagnosis and prescription date from the prescription.
• Each prescribed item becomes a line on the dispensing record with the prescribed quantity and directions filled in, but with no stock allocated yet.
• The Related documents section of the side panel shows a link to the new dispensing record.

What the dispenser sees

The dispenser opens the record in Dispensary > Dispensing. It works like any other dispensing record (see Dispensing), with a few differences because it came from a prescription:

• The Patient, Clinician and Diagnosis are read-only. They are the prescriber's entries
• The Prescribed quantity on each line is read-only, and is used as the target when stock is automatically allocated. The dispenser chooses which stock to issue and can adjust the issued quantity as usual.
• The side panel has a Prescription request link back to the source prescription (shown only to users with the Prescription request query permission)
• The record cannot be deleted. If it is not wanted, verify it and then cancel it. Attempting to delete it shows: This dispensing record came from a prescription and cannot be deleted. Cancel it once it has been verified.

When the dispenser confirms the record as Verified, the original prescription is automatically updated to Dispensed, with the Dispensed date set to the time of verification.

Custom fields

Prescriptions support custom fields under their own Prescription requests record type. Unlike other record types, four fields are provided by default on every system with nothing to configure in mSupply:

All four are set to Prominent by default so that they appear together in the header of the prescription. On the Open mSupply central server, Manage > Custom fields > Prescription requests lets you hide any of them or move them to the Custom fields tab. Visible custom fields also appear as columns and filters on the prescriptions list.

Custom field values stay on the prescription. They are not copied to the dispensing record.

Dashboard panel

Users with the Prescription request query permission, in a dispensary store, see a Prescriptions panel on the home page, with a Prescription request section showing:

• Ready to dispense - the number of prescriptions waiting for the pharmacy. Click it to open the list filtered to that status.
• Dispensed this week - the number of prescriptions dispensed since Monday of the current week. Click it to open the list filtered to that dispensed date range.

Clicking the Prescription request heading opens the full list. The New prescription button at the bottom of the panel opens the same New prescription window as the list.

Good to know

• No stock is reserved when a prescription is written or marked Ready to dispense. Stock is only allocated when the pharmacy works on the dispensing record
• Programs are not supported on prescriptions. The generated dispensing record has no program either.
• Prescriptions are not synchronised to mSupply. They stay in the store where they were written. The dispensing records they generate are synchronised in the usual way.