Medication tab for Bahmni@next

[abhinab (Abhinab Bharali)]

Greetings,

On 22nd Dec, 2021 we had a discussion on the proposed changes in the UI for the medication tab in Bahmni. We would love to gather more feedback and suggestions on the same. Please find the screenshots and the description of the new medication tab below.

The following describes the user journey under medication for Bahmni@next .

1. Searching for a medicine

Existing system

Located on the left side under “medication” tab

Bahmni@next

In the new UI, we will have a search bar at the top on the page. The functionality will be the same. On entering the second alphabet, a dropdown list of drugs will appear containing the characters typed in

Search-as-you-type

The “add to prescription” button is the replacement of the “accept” button. When the drug is non coded (not appearing in the dropdown list), the add to prescription button will enable the doctor to add the medicine not stored in the system to the prescription , if it is configured to do so. If the configuration is not to allow non coded drugs to be added to a prescription, the doctor will see an error message in this case

2. Adding a drug to prescription

Existing system

No separate prescription box that opens up. The fields are present on the left side on the medication tab

Bamni@next

In the new UI, only on clicking on the drug name or on the click of “add to prescription” button, the prescription box will open up with the fields.

On clicking “done” which is a replacement of the “add” button, the new prescription can be seen in a tabular format.

3. New prescription in Bahmni@next

The new prescription is seen in a tabular format in the new UI. The actions that can be performed are:

1. Edit - Clicking on edit will open the prescription box where the doctor can edit the fields like dose, quantity, route and so on.
2. Favourites- Clicking this button will add the drug as well as the dosage,frequency, duration to the favourites. See more on favourites on point 5
3. Delete- Will remove the drug from the new prescription

New prescription in existing Bahmni

Note - In both the existing and new system, only when the doctor clicks on the “save” button present on the header, the new prescription will be saved. Else, the prescription is discarded.

4. Prescription history

Existing system

Here , the prescription can be seen under the tabs according to the dates as seen below. Also, the active medications, the scheduled medications and completed medications are seen in different colour codes.

	Active
	Scheduled
	Completed

Bahmni@next

Here, there are separate tabs for active prescriptions, scheduled prescriptions and a tab for showing all the prescriptions. The actions remain the same with revise, stop and renew.

5. Favourites

This is a new feature in Bahmni@next. The doctor can have drugs as favourites so that it is easier and convenient for the doctor to prescribe. The functionalities are

1. Adding a drug to favourites.

Once the doctor searches for the drug in the search bar, fills the details in the prescription box and clicks on done, under the action item header in the new prescription, we can see the option to add the drug and the dosage instructions to favourites.

2. Add drug from favourite to prescription and delete drug from favourites

As seen in the screenshot below, when the doctor clicks on the favourites button,we can see the option to add the drug to the prescription or remove it from the favourites list.

3. Having favourites listed on the top of search results.

When the doctor types in the names of the drugs in the search bar, the favourite drugs should be displayed at the top

Some of the suggestions discussed on the call were:

1. The intent of prescribed-as-you-type/speak would just be an additional augment to the experience e.g. “paracetamol 1 tab 4 times daily” would translate into an appropriate prescription.
2. Having a limit on the number of medications that can be saved as favourites.
3. Possibility to search for drugs on the basis of fuzzy logic
4. A tab showing only the completed list of medications which will be separate from “show all”

Kindly use this thread for any suggestions and feedbacks.

@n0man @akhilmalhotra @gsluthra @angshuonline

[gsluthra (Gurpreet Luthra)]

A few more areas for clarification:

1. How does Patient Prescription printout look? If a patient needs to be handed a prescription, so that they know what medicine they need to eat - when and how freq – how will it be done in Bahmni? Is there any change to it with this new implementation?

2. Many times the medicine prescribed by the doctor would be the Generic Salt name, but the medicine given by the pharamacy might be the brand-name. Is there a way to also print the brand-name issued by the pharmacy and track it within Bahmni against the Patient prescription? Does the underlying data model have this ability to track actual medication taken (brand) vs the Generic Salt prescribed?

cc: @abhinab @akhilmalhotra @n0man @angshuonline

[roshanthapa (Roshan Kumar Thapa)]

I try to install on Bhamni 0.92 version but I can’t see change. Can anyone help me.

[abhinab (Abhinab Bharali)]

Hello @roshanthapa . These screens are currently not available in Bahmni. The development is ongoing. Currently you would be able to see the older medication screen.

[roshanthapa (Roshan Kumar Thapa)]

@abhinab Please let me know when completed . Our team so excited on it. Thank you.

[akanter (Andrew Kanter)]

Interesting. I presume the search results are drawn from the drug table rather than the concept table. I always wondered how this was done in LMICs with small formularies. A clinician would typically order a medication based on a dose rather than a strength of pill. For example Amoxacillin 500 mg po TID. The pharmacy might dispense 1 500mg tab TID or 2 250mg tabs TID depending on what was available. I presume that good pharmacy integration would allow the clinician to prescribe exactly what was available (plus it is easier since strength/form is usually included automatically). There are dependencies between forms/route of administration, etc. so ensuring that a prescription is not nonsensical can be a challenge. Does Bahmni start with a core drug table like CIEL uses (WHO EDL)?

[akhilmalhotra]

The search results are indeed drawn from the drug table.

@akanter

There are dependencies between forms/route of administration, etc. so ensuring that a prescription is not nonsensical can be a challenge.

Indeed. Bahmni has the capability to map the drug forms and routes. We will ensure this capability is retained.

@akanter

The pharmacy might dispense 1 500mg tab TID or 2 250mg tabs TID depending on what was available.

Of course, that’s common in LMICs as well. We do not plan to address this problem in phase 1 though. It requires more than the medication screen overhaul and would include upgrades to Odoo (our pharmacy and inventory management system) as well.